University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
Date_________________ Client’s Initials ________
Student ____________________________
Allergies:
Priority Nursing Diagnosis:
Long and Short term goals (must be measurable):
Interventions:
MEDICATION WITH
INDIVIDUAL DESIRED
NURSING IMPLICATIONS/
EVALUATION OF DESIRED
PRESCRIBED DOSEAGE
EFFECT OF DRUG FOR
CONSIDERATIONS FOR
EFFECT FOR THE PATIENT.
CLASSIFICATION OF THE
THIS PATIENT
THIS PATIENT
INCLUDING ASSESSMENT,
DRUG
LAB RESULTS AND
USUAL DOSE/SAFE DOSE
PROCEDURES
AND ADMINISTRATION
Reglan (metoclopramide
Prevents or minimizes nausea
Adverse Effects:
Effects on lab test results:
hydrocholoride)
and vomiting. Also reduces gag CNS: anxiety, dizziness,
*May increase aldosterone and
reflex, improves gastric
drowsiness, dystonic reactions, prolactin levels
Pharmacologic Class: para
emptying, and reduces gastric
extrapyramidal symptoms,
*May decrease neutrophil and
aminobenzoic acid derivative,
reflux
fatigue, fever, headache,
granulocyte counts
dopamine receptor agonist
insomnia, lassitude,
restlessness, sedation, seizures, Considerations:
Therapeutic Class: antiemetic,
suicidal ideation, tardive
*Contraindicated in pts
GI stimulant
dyskinesia
hypersensitive to drug
CV: arrhythmias, AV block,
*Use cautiously in patients
To prevent or reduce
bradycardia, heart failure,
with hx of depression,
postoperative nausea and
hypotension, transient
Parkinson disease, HTN, or
vomiting: 10-20 mg I.M. near
hypertension
renal impairment
end of surgical procedure,
GI: bowel disturbances,
*Safety and effectiveness
repeat q4-6h PRN
diarrhea, nausea
haven’t been established for
Hematologic: agranulocytosis, therapy that lasts longer than 12
Dilute doses larger than 10 mg
leucopenia, neonatal
weeks
in 50 ml of compatible dilutant,
methemoglobinemia,
*In pregnant women use
and infuse over at least 15
neutropenia
cautiously
minutes
Skin: rash
*In breast feeding women use
Other: loss libido, prolactin
cautiously it is unknown if the
Give doses of 10 mg or less by
secretion
drug appears in breast milk
direct injection over 1-2
*Use cautiously in elderly pts
minutes
1/2009
N478 Drug Sheet
University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
Drugs Interactions:
Patient Education:
Drug-Drug: acetaminophen,
*Instruct patient not to drink
aspirin, diazepam, levodopa,
alcohol during therapy
lithium, anticholinergics,
*Advise patient to avoid
opiods, CNS depressants,
activities requiring alertness for
Digoxin, insulin
2 hours after taking each dose
Drug-Lifestyle: alcohol use
1/2009
N478 Drug Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Zantac (rantitidine
hydrochloride)
Antiulcerative, H2 receptor
antagonist
Administration: 150 mg PO bid
or 300 mg hs, or 50 mg IV or
IM q6-8h
To give drug by intermittent IV
infusion dilute 50 mg (2ml) in
100 ml compatible solution and
infuse at a rate of 5-7 ml/min
(premixed solution does not
need to be diluted)
1/2009
N478 Drug Sheet
University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
INDIVIDUAL DESIRED
NURSING IMPLICATIONS/
EVALUATION OF DESIRED
EFFECT OF DRUG FOR
CONSIDERATIONS FOR
EFFECT FOR THE PATIENT.
THIS PATIENT
THIS PATIENT
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Relieves GI discomfort
Adverse Reactions:
CNS: malaise, vertigo
EENT: blurred vision
GI: abdominal discomfort,
constipation, diarrhea, nausea,
vomiting
Hematologic: pancytopenia,
reversible leucopenia,
thrombocytopenia
Hepatic: jaundice
Skin: rash
Other: anaphylaxis,
angioedema, burning and
itching at injection site
Drug Interactions:
Drug-Drug: antacids,
diazepam, glipizide,
procainamide, warfarin
Drug-Lifestyle: smoking
Effects on Lab Test Results:
may increase creatinine and
ALT levels
May decrease RBC, WBC, and
platelet counts
May cause false positive test
for urine protein using multistix
Considerations:
contraindicated in patients
hypersensitive to the drug or
any of its components
Use cautiously in patients with
hepatic dysfunction. Adjust
dosage in patients with
impaired kidney function
In children safety and
effectiveness haven’t been
established for pathological
hypersecretory conditions or
the maintenance of healing
duodenal ulcer.
In neonates younger than one
month, safety and effectiveness
haven’t been established
In elderly patients use
cautiously
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
Page _____ of ______
Patient Teaching: remind
patient taking drug once daily
to take it at bedtime
Instruct patient to take drug
with or without food
Urge patient not to smoke
cigarettes; smoking may
increase gastric acid secretion
and worsen disease
1/2009
N478 Drug Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Ancef (cefazolin sodium)
Antibiotic, first generation
cephalosporin
Administration: 250 mg IV or
IM q8h to 1g q6h…max 12g
daily in life threatening
situations
Give 1g IV or IM 30-60 min
before surgery; then 0.5 to 1g
IV or IM q6-8h for 24 hours
Reconstitute with sterile or
bacteriostatic water as follows:
2ml to 500mg vial to yield 225
mg/ml; or 2.5 ml to 1g vial to
yield 330 mg/ml…shake well
If IV therapy >3d alternate sites
University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
INDIVIDUAL DESIRED
NURSING IMPLICATIONS/
EVALUATION OF DESIRED
EFFECT OF DRUG FOR
CONSIDERATIONS FOR
EFFECT FOR THE PATIENT.
THIS PATIENT
THIS PATIENT
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Hinders or kills susceptible
bacteria
Adverse Effects:
CNS: dizziness, headache,
malaise, paresthesia
GI: abdominal cramps, anal
pruritus, anorexia, diarrhea,
dyspepsia, glossitis, nausea,
oral candidiasis,
pseudomembranous colitis,
vomiting, tenesmus
GU: gential pruritus and
candidiasis, vaginitis
Hematologic: anemia,
eosinophilia, leucopenia,
thrombocytopenia, transient
neutropenia
Respiratory: dyspnea
Skin: injection site reactions,
maculopapular and
erythematous rashes, Stevens
Johsnon syndrome, urticaria
Other: hypersensitivity
reactions
Drug Interaction:
Drug-Drug: probenecid
Effects on lab test results:
*May increase ALT, AST,
alkaline phosphatasae,
bilirubin, GGT, and LDH
levels
*May increase eosinophil
count. May decrease
neutrophil, WBC, and platelet
counts
*May cause false positive urine
glucose determinations with
copper sulfate tests (Clinitest)
Considerations:
*Contraindicated in patients
hypersensitive to other
cephalosporins
*Use cautiously in patients
with a history of sensitivity to
penicillin because of cross
allergic reaction and in patients
with renal impairment
*In pregnant and breast feeding
women use cautiously
Patient Education:
*Tell patient to report adverse
reactions
1/2009
N478 Drug Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Vancocin (vacomycin)
Pharmacologic Class:
glycopeptides
Therapeutic Class: antibiotic
Administration: 500 mg IV
over 1 hour, q6h, or 1 g q12h
Dilute in 200 ml of saline
solution injection or D5W…
check site daily for phlebitis
and irritation
University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
INDIVIDUAL DESIRED
NURSING IMPLICATIONS/
EVALUATION OF DESIRED
EFFECT OF DRUG FOR
CONSIDERATIONS FOR
EFFECT FOR THE PATIENT.
THIS PATIENT
THIS PATIENT
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Kills susceptible bacteria
Adverse Effects:
CNS: fever, pain
CV: hypotension
EENT: ototoxicity, tinnitus
GI: nausea,
pseudomembranous colitis
GU: nephrotoxicity
Hematologic: eosinophilia,
leukopenia
Respiratory: dyspnea,
wheezing
Skin: red man syndrome
Other: anaphylaxis, chills,
superinfection,
thrombophlebitis at injection
site
Drug Interactions:
Drug-Drug: aminoglycosides,
amphotericin B, cisplatin,
pentamidine
Effect on lab test results:
*May increase BUN and
creatinine levels
*May increase eosinophil
count. May decrease neutrophil
and WBC counts
Considerations:
*Contraindicated in patients
hypersensitive to the drug or
any of its components
*Use cautiously in patients
receiving other neurotoxic,
nephrotoxic, or ototoxic drugs;
patients older than age 60; and
those with impaired liver or
kidney function, hearing loss,
or allergies to other antibiotics
*In pregnant women use
cautiously
*In breast feeding women
safety and effectiveness haven’t
been established
Patient Education:
*Tell patient to take entire
amount of drug exactly as
directed even after feeling
better
1/2009
N478 Drug Sheet
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
Page _____ of ______
*Tell patient to stop taking the
drug and immediately report
any adverse reactions
especially ringing in ears or
fullness
1/2009
N478 Drug Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Versed (midazolam)
Pharmacologic Class:
benzodiazepine
Therapeutic Class: sedative
Administration: give 0.07 mg
to 0.08 mg/kg IM about 1 hr
before surgery…for induction
of general anesthesia if the pt
hasn’t received preanesthsia
drug give 0.3 to 0.35mg/kg IV
over 20-30 seconds; if they
have then give 0.15-0.35mg/kg
IV over 20-30 seconds
When mixing infusion use
5mg/ml vial, dilute to 0.5
mg/ml with D5W or NS
Give slowly over at least 2
minutes and wait at least 2
minutes when adjusting dose to
desired effect
1/2009
N478 Drug Sheet
University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
INDIVIDUAL DESIRED
NURSING IMPLICATIONS/
EVALUATION OF DESIRED
EFFECT OF DRUG FOR
CONSIDERATIONS FOR
EFFECT FOR THE PATIENT.
THIS PATIENT
THIS PATIENT
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Promotes calmness and sleep
Adverse Effects:
CNS: amnesia, combativeness,
headache, involuntary
movements, oversedation
CV: cardiac arrest,
hypotension, variations in
blood pressure and pulse rate
GI: hiccups, nausea, vomiting
Respiratory: apnea, decreased
respiratory rate
Other: pain, tenderness at
injection site
Drug Interactions:
Drug-Drug: cimetidine,
verapamil, CNS depressants,
diltiazem, flucoonazole,
ketoconazole, miconazole,
hormonal contraceptives,
opiods, rifamycin
Drug-Food: grapefruit juice
Drug-Lifestyle: alcohol use
Effect on lab test results:
*None reported
Considerations:
*Contraindicated in patients
hypersensitive to drug or any of
its components
*Use cautiously in patients
with uncompensated acute
illness and in debilitated
patients
*In pregnant women drug is
contraindicated
*In breast feeding women use
cautiously its unknown if drug
appears in breast milk
*Use with caution in neonates
and avoid rapid injection
*Use cautiously in elderly
Patient Education:
*Use extra caution when
teaching patient because drug
will diminish predrug memory
*Instruct patient not to use
alcohol during therapy
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Diprivan (propofol)
Sedative/hypnotic
Administration: 40 mg every
10 seconds until induction of
anesthesia (2-2.5 mg/kg)
100-200 mcg/kg/min (6-12
mg/kg/h) for maintenance of
general anesthesia
Most of time it is provided as a
ready to use formulation…but
if dilution is necessary it should
only be diluted with 5%
dextrose injection and should
not be diluted to a
concentration less than 2 mg/ml
1/2009
N478 Drug Sheet
University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
INDIVIDUAL DESIRED
NURSING IMPLICATIONS/
EVALUATION OF DESIRED
EFFECT OF DRUG FOR
CONSIDERATIONS FOR
EFFECT FOR THE PATIENT.
THIS PATIENT
THIS PATIENT
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Initiates and maintains
anesthesia
Teach patient that performance
of activities requiring mental
alertness, such as operating a
motor vehicle, or hazardous
machinery or signing legal
documents may be impaired for
some time after general
anesthesia or sedation
*Patient remains sedated until
drug effectively wears off
*Patient reacts positively to
drug therapy
*Patient and family state
understanding of drug therapy
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Anectine (succinylcholine)
Pharmacologic Class:
depolarizing neuromuscular
blocker
Therapeutic Class: skeletal
muscle relaxant
Administration: Dosage
depends on anesthetic used,
individual needs, and
response…give 0.6mg/kg IV
over 10-30 seconds; then give
2.5 mg/minute prn OR 2.5-4
mg/kg IM u p to max of 150
mg IM in deltoid muscle
1/2009
N478 Drug Sheet
University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
INDIVIDUAL DESIRED
NURSING IMPLICATIONS/
EVALUATION OF DESIRED
EFFECT OF DRUG FOR
CONSIDERATIONS FOR
EFFECT FOR THE PATIENT.
THIS PATIENT
THIS PATIENT
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Relaxes skeletal muscle
For lab results it may increase
myoglobin and potassium
levels
Explain to patient all events
and happenings because he can
still hear, reassure patient that
he is being monitored at all
times, inform patient that
postoperative stiffness is
normal and will soon subside
*Patient responds well to
therapy
*Patient maintains adequate
respiratory patterns with
mechanical assistance
*Patient and family state
understanding of drug therapy
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Mivacron (mivacurium)
Skeletal muscle relaxant
Doses should be individualized
and a peripheral nerve
stimulator should be used to
emasure neuromuscular
function during administration
in order to monitor drug effect
and need for additional doses,
confirm recovery from
neuromuscular block
Usually though doses are 0.15
mg/kg over 5-15 seconds, 0.20
mg/kg over 30 seconds, or 0.25
mg/kg in divided doses (IV)
1/2009
N478 Drug Sheet
Page _____ of ______
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Used as adjunct to general
anesthesia…facilitate tracheal
intubation and to provide
skeletal muscle relaxation
during surgery or mechanical
ventilation
Explain to patient all events
and happenings, reassure
patient that he will be
monitored at all times, teach
about post op stiffness (similar
teaching to Anectine)
*Patient reacts positively to
drug therapy
*Patient does not have an
allergic hypersensitivity to the
drug
*Patient and family understand
need for therapy
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Zemuron (rocuronium)
Skeletal muscle relaxant,
neuromuscular blocking agent
Recommended initial dose is
0.6 mg/kg…enough for
sufficient intubation
Maintenance dose is 0.1 to 0.2
mg/kg
Best to keep dosages
individualized though…the
above are general dosages
1/2009
N478 Drug Sheet
Page _____ of ______
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Used ad adjunct to general
anesthesia to facilitate both
rapid sequence an routine
tracheal intubation, and to
provide skeletal muscle
relaxation during surgery or
mechanical ventilation
Teach patient about possible
side effects such as having an
anaphylactic reaction is
possible and that hypotension is
possible, request previous
anaphylactic reactions to other
neuromuscular blocking agents,
reassure them that they will be
monitored at all times and will
not be left alone, teach patient
that certain medical condition
and medications may influence
how it works
*Patient reacts positively
*Patient does not have an
allergic reaction
*Patient and family understand
need for therapy
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Atropine
Antiarrhythmic, vagolytic,
anticholinergic, belladonna
alkaloid
Administration: 0.4mg IM or
subq 30-60 min before
anesthesia (preop to decrease
secretions), 0.5 to 1 mg IV
push; repeat q3-5m to a max of
2 mg prn (for symptomatic
bradycardia)
Give by direct injection into a
large vein or IV tubing over 1-2
minutes
1/2009
N478 Drug Sheet
Page _____ of ______
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Increases heart rate, decreases
secretions, and slows GI
motility. Antidote for
anticholinesterase insecticide
poisoning
May increase WBC count
*Patient underlying condition
improves
Teach patient about atropine
sulfate theapy, instruct patient
to ask for assistance with
activities if adverse CNS
reactions occur, teach patient
how to handle distressing
anticholinergic effects
*Patient has no injury as a
result of therapy
*Patient and family state
understanding of drug therapy
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Robinul (glycopyrrolate)
Class: anticholinergic
Route: IV or IM
Dosage:
Preanesthetic Medication:
The recommended dose of
Robinul Injection is 0.004
mg/kg by intramuscular
injection, given 30 to 60
minutes prior to the anticipated
time of induction of anesthesia
or at the time the preanesthetic
narcotic and/or sedative are
administered.
Intraoperative Medication:
Administered intravenously as
single doses of 0.1 mg and
repeated, as needed, at intervals
of 2 to 3 minutes.
1/2009
N478 Drug Sheet
Page _____ of ______
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
It is used as a preoperative
antimuscarinic to reduce
salivary, tracheobronchial, and
pharyngeal secretions; to
reduce the volume and free
acidity of gastric secretions;
and to block cardiac vagal
inhibitory reflexes during
induction of anesthesia and
intubation. When indicated,
Robinul Injection may be used
intraoperatively to counteract
surgically or drug- induced or
vagal reflexes associated
arrhythmias.
Adverse Reactions:
Xerostomia (dry mouth),
urinary hesitancy and retention,
blurred vision and photophobia
due to mydriasis (dilation of the
pupil), cycloplegia, increased
ocular tension, tachycardia,
palpitation, decreased sweating,
loss of taste, headache,
nervousness, drowsiness,
weakness, dizziness, insomnia,
nausea, vomiting, impotence,
suppression of lactation,
constipation, bloated feeling,
severe allergic reactions
hypersensitivity urticaria,
pruritus, dry skin, some degree
of mental confusion especially
in elderly persons. Malignant
hyperthermia, cardiac
arrhythmias, cardiac arrest,
hypertension, hypotension,
seizures, and respiratory arrest
Drug Interactions:
anticholinergics and
Effects on lab test results: Has
not shown any effects.
Consideration: Use caution in
the elderly because they may be
more sensitive to the effects of
the drug, especially drowsiness,
confusion, and urinary effects
Patient Education: Caution
not to engage in activities
requiring mental alertness
and/or visual acuity such as
operating a motor vehicle or
other machinery, or performing
hazardous work while taking
this drug. Use caution during
exercise or hot weather since
overheating may result in heat
stroke. Sensitivity of the eyes
to light. Avoid alcohol.
University of Evansville
Page _____ of ______
Department of Nursing and Health Sciences
Drug Dispensing Sheet
medications with
anticholingeric activities may
intensify the antimuscarinic
effects and may result in an
increase in anticholinergic side
effects.
1/2009
N478 Drug Sheet
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Sublimaze (fentanyl)
Class: Opiod
Therapeutic Class: analgesic
and anesthetic
Route and Dosage: Injection 50
mcg/ml, Transdermal patch
12.5, 25, 50, 75, or 100 mcg/hr
can be delivered, Transmucosal
lozenge 200, 400, 600, 800,
1,200, 1,600 mcg,
Transmucosal tablets 100, 200,
400, 600, 800 mcg.
1/2009
N478 Drug Sheet
Page _____ of ______
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Used for postoperative pain, to
manage persistent, moderate to
severe chronic pain in opiodtolerant patients who require
continous, around-the-clock
opiod analgesics for an
extended amount of time,
breakthrough cancer pain in
opiod-tolerant patients
Adverse Reactions: anxiety,
asthenia, clouded sensorium
confusion, depression,
dizziness, euphoria
hallucinations, headache,
nervousness, sedation,
somnolence, arrhythmias,
bradycardia, chest pain
hypertension, hypotension, dry
mouth, abdominal pain,
constipation, nausea, vomiting,
urine retention, apnea, dyspnea,
hypoventilation, respiratory
depression, diaphoresis,
pruritis, physical dependence,
reaction at site.
Drug Interactions: CNS
depressants, general
anesthetics, hypnotics, MAOIs,
opioid analgesics, sedatives,
tricyclic antidepressants,
diazepam, droperiod, CYP3A4
inhibitors, protease inhibitors,
alcohol
Effects on lab results: none
reported.
Consideration: Use cautiously
in patients with renal
impairment. Keep naloxone
and resuscitation equipment
available when giving IV. This
drug is often used IV with
droperidol to produce
neroleptanalgesia. Monitor rate
and depth of respirations along
with oxygen saturation. Also
monitor bladder function. Give
drug before patient has intense
pain. When given postop, have
pt. turn cough and deep breathe
to prevent atelectasis. Don’t use
patch for post op pain.
Immediately report respiratory
rate less than 12/min.
Patient Education: Consume
lozenge in 15 minutes. Lozenge
and tablets may be fatal to a
child. Instruct how to properly
place patch (trim hair, clean
with just water, and dry
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
Page _____ of ______
completely). Tell pt to fold the
patch so adhesive sides adhere
to self, then flush patch to
dispose. Make sure to remove
old patch before putting on a
new one. Inform that heat from
fever or environment can
increase patches medication
delivery and can cause toxicity.
1/2009
N478 Drug Sheet
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Dilaudid (Hydromorphone)
Class: Opiod
Route and Dosage: Injection: 1,
2, 4, 10 mg/ml. Injection
(powder): 250 mg/vial. Liquid:
5mg/5ml. Suppositories: 3 mg.
Tablets: 2, 4, 8 mg.
1/2009
N478 Drug Sheet
Page _____ of ______
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Binds with opiate receptors in
the CNS, altering perception of
and emotional response to pain.
Suppresses cough reflex by
direct action on cough center in
medulla. Relieves pain and
cough.
Adverse Effects: Clouded
sensorium, dizziness, euphoria,
sedation, seizures, somnolence,
bradycardica, hypotension,
blurred vision, diplopia,
nystagmus, constipation,
nausea, vomiting, urine
retention, bronchospasm,
respiratory depression,
induration with subq injections,
and dependence.
Drug Interactions: CNS
depressants, general
anesthetics, hypnotics, MAOIs,
other opiod analgesics,
sedatives, tranquilizers, TCAs,
and alcohol.
Effects on lab results: may
increase amylase and lipase
levels
Consideration: Controlled
Substance II. Use with caution
in COPD pts and other
respiratory problems. Drug
may worse or mask gallbladder
pain. Give drug before pain is
intense. Mix drug in D5W,
D5W NS, D5W ½ NS, ringers
or lactated ringers. Give over 2
minutes. Respiratory
depression and hypotension can
occur. Monitor circulation and
respirations. May increase
adrenal insufficiency. Give one
daily dose in morning. Give
oral dose with food. Give IM
deep into the gluteal muscle.
Avoid subq injections. Don’t
give high doses for more than
48 hours. Give potassium
supplements.
Patient Education: Teach pt
signs of adrenal insufficiency
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
Page _____ of ______
(fatigue, muscle weakness,
joint pain, fever, anorexia,
nausea, dyspnea, dizziness,
fainting). Don’t immediately
stop. Warn about easy bruising.
Tell to report sudden weight
gain and warn of Cushionings.
1/2009
N478 Drug Sheet
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Darvocet (propoxyphene with
acetaminophen)
Class: nonnarcotic analgesic
(NSAID)
Route and Dose: Tablets
A500=500mg acetaminophen
and 100mg propoxyphene
napsylate (1 tab q 4 hrs. max=8
in 24hr)
N50=325 acetaminophen and
50 mg propoxyphene napsylate
(2 tab q 4 hrs. max=12 in 24 hr)
N100=650mg acetaminophen
and 100 mg propoxyphene
napsylate (1 tab q 4 hrs. max=6
in 24 hrs)
1/2009
N478 Drug Sheet
Page _____ of ______
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Pain relief
Adverse Effects: May cause
sleepiness, and poor
breastfeeding in infants. Large
doses cause toxic psychosis.
Excessive does often prove
fatal. Nausea, vomiting,
constipation, lightheadedness,
drowsiness, headache, and
vision changes.
Drug Interactions: blood
thinners, carbamazepine,
MAOIs, other pain
medications, TCAs, antianxiety drugs, antidepressants,
antihistamines, anti-seizure
drugs, medicine for sleep,
muscle relaxants, psychiatric
medicines, tranquilizers
Effects on Lab Results:
Consideration: Don’t
prescribe to patients with
suicidal tendencies, people with
seizures, slow heart beat,
abnormally low blood pressure,
asthma attacks, COPD, and
those already on medications
that cause drowsiness.
Patient Education: Don’t take
more than prescribed. Lay
down for 1-2hrs with minimal
head movement may reduce
upset stomach. Get up slowly
when lying down or seated to
reduce dizziness. May pass into
breast milk.
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Toradol (ketorolac)
Class: NSAID
Therapeutic Class: analgesic
and anti-inflammatory
Route and Dose: Injection: 15
and 30 mg/ml
Ophthalmic solution: 0.4% and
0.5%
Tablets: 10 mg
1/2009
N478 Drug Sheet
Page _____ of ______
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Relieves pain and
inflammation. Short term
management of pain, ocular
itching caused by seasonal
allergic rhinitis, post op
inflammation following
cataract surgery, pain and
burning or stinging following
corneal refractive surgery.
Adverse Effects: Dizziness,
drowsiness, headache,
insomnia, syncope, edema,
hypertension, palpitations,
corneal edema, keratitis, ocular
irritation, transient stinging and
burning, diarrhea, dyspepsia,
GI pain, nausea, hematuria,
polyuria, renal failure, anemia,
eosinophila, purpura, sweating,
pain at injection site
Drug Interactions:
antihypertensives, diuretics,
cyclosporine, lithium, blood
thinners, methotrexate, Dong
quai, feverfew, garlie, ginger,
horse chestnut, red clover, st.
johns wort.
Effects on lab Results: May
increase BUN and creatinine
levels. May decrease
hemoglobin and hematocrit.
May increase eosinophil count
and liver function test values.
Consideration: May cause
peptic ulcers, GI bleeding,
perforation of the stomach or
intestines. Increases risk of
serious CV thrombotic events,
MI, and stroke. Don’t exceed
120mg on day of transition
when switching from IM to PO.
IM use may cause pain at site.
Apply pressure for 15-30 secs
to minimize local effects.
Duration of therapy shouldn’t
exceed 5 days.
Patient Education: Teach to
recognize and report signs of
GI bleeding. Don’t use drops
while wearing contact lenses.
Tell that it is short term use.
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Loratab (hydrocodone with
acetaminophen)
Class: non-salicylate analgesic
and antipyretic
Dose and Route:
Lortab 2.5/500=500mg
acetaminophen and 2.5 mg
hydrocodone (1-2 q4-6hr.
max=8 in 24hrs)
7.5/500=500mg acetaminophen
and 7.5mg hydrocodone (1 q46hr. max=8 in 24hrs)
10/500=500mg acetaminophen
and 10mg hydrocodone (1 q46hr. max=6 in 24hrs)
Elixir=167mg acetaminophen
2.5mg/5ml hydrocodone (15ml
q4-6hr. max=90ml/day
1/2009
N478 Drug Sheet
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
Page _____ of ______
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
Relieve moderate to moderately Adverse Effects: lightsevere pain.
headedness, dizziness, sedation,
nausea and vomiting,
drowsiness, mental clouding,
lethargy, impairment of mental
and physical performance,
anxiety, fear, dysphoria,
psychic dependence, mood
changes, constipation, Ureteral
spasm, spasm of vesical
sphincters and urinary
retention, respiratory
depression,hearing impairment
or permanent loss, skin rash,
and pruritus, allergic reactions,
rash, thrombocytopenia,
agranulocytosis
Drug Interactions: narcotics,
antihistamines, antipsychotics,
antianxiety agents, or other
CNS depressants (including
alcohol), MAOIs or TCAs
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Effects on lab results: may
produce false-positive test results
for urinary 5-hydroxyindoleacetic
acid.
Consideration: Respiratory
depression, increased
intracranial pressure. Narcan
can reverse an overdose. 10g is
considered toxic for adults.
Patient Education: Don’t take
with alcohol. Lay down for 1-2
hrs with minimal head
movement to decrease nausea.
Taking with food may decrease
effectiveness. Don’t suddenly
stop if you have taken for an
extended amount of time. Use
caution engaging in activities
requiring alertness such as
driving or using machinery. To
minimize dizziness and
lightheadedness, get up slowly
when rising from a seated or
lying position.
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Percocet (oxycodone with
acetaminophen)
Class: non-opiate, nonsalicylate analgesic and
antipyretic
Route and dose:
Percocet 2.5 mg/325 mg
The usual adult dosage is one
or 2 tablets every 6 hours. The
total daily dose of
acetaminophen should not
exceed 4 grams.
Percocet 5 mg/325 mg;
Percocet 7.5 mg/500 mg;
Percocet 10 mg/650 mg
The usual adult dosage is one
tablet every 6 hours as needed
for pain. The total daily dose of
acetaminophen should not
exceed 4 grams.
Percocet 7.5 mg/325 mg;
Percocet 10 mg/325 mg
The usual adult dosage is one
tablet every 6 hours as needed
1/2009
N478 Drug Sheet
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
Page _____ of ______
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
Relieve moderate to moderately Adverse Effects: Nausea,
severe pain.
vomiting, constipation,
lightheadedness, dizziness,
drowsiness, flushing, vision
changes, or mental/mood
changes
Drug Interactions: opioid
analgesics, general anesthetics,
phenothiazines, other
tranquilizers, centrally-acting
anti-emetics, sedativehypnotics or other CNS
depressants (including alcohol),
and Agonist/antagonist
analgesics
Drug/Drug Interactions with
Acetaminophen: Alcohol,
ethyl, Anticholinergics,
Contraceptives, Charcoal, Beta
Blockers, Loop diuretics,
Lamotrigine, Probenecid,
Zidovudine
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Effects on lab results: may
cross-react with assays used in
the preliminary detection of
cocaine or marijuana in human
urine. may interfere with home
blood glucose measurement
systems; decreases of > 20% in
mean glucose values may be
noted
Consideration: Risk for abuse.
Respiratory depression (may
need narcan). Use with caution
in pts with respiratory
problems. May produce
orthostatic hypotension.
Increases intracranial pressure.
Patient Education: Keep in a
secure place out of the reach of
children. In the case of
accidental ingestions,
emergency medical care should
be sought immediately. Unused
tablets should be destroyed by
flushing down the toilet. May
impair mental and/or physical
ability required for the
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
for pain. The total daily dose of
acetaminophen should not
exceed 4 grams.
1/2009
N478 Drug Sheet
Page _____ of ______
performance of potentially
hazardous tasks (e.g., driving,
operating heavy machinery).
Don’t take with alcohol. May
be passed in breast milk. Don’t
abruptly stop medication after
using for a few weeks.
Potential drug of abuse.
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Demerol (meperidine)
Pharmacologic class: opioid
Therapeutic class: analgesic,
adjunct to anesthesia
For moderate to severe pain:
adults receive 50-150 mg PO,
IM, or SubQ every 3-4 hours,
prn Or 15-35 mg/hour by
continuous IV infusion;
children receive 1.1-1.75 mg/kg
PO, IM, or SubQ, up to the
adult dose, every 3-4 hours, prn
1/2009
N478 Drug Sheet
Page _____ of ______
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
EVALUATION OF DESIRED
EFFECT FOR THE PATIENT.
INCLUDING ASSESSMENT,
LAB RESULTS AND
PROCEDURES
Relief of pain
Assess patient’s pain before
therapy and regularly thereafter
to monitor drug effectiveness;
Monitor patient for increased
toxic effect, especially in a
patient with renal impairment;
May be used in patients with
pain who are allergic to
morphine; If respiratory rate is
less than 12 breaths/minute, if
respiratory depth decreases, or
if pupil size decreases, don’t
give drug; Oral dose is less than
half as effective as parenteral
dose; give IM if possible; when
changing from parenteral to
oral rout, increase dose; Syrup
has local anesthetic effect; give
with full glass of water;
Subcutaneous injection is
painful; avoid if possible
Effects on lab values:
May increase amylase and
lipase levels
Outcome:
Patient is free from pain
Patient doesn’t experience
injury
Patient and family state
understanding of drug therapy
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
Page _____ of ______
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
Phenergan (promethazine)
Prevents motion sickness and
relieves nausea, nasal
congestion, and allergy
symptoms. Also promotes
calmness
Assess patient’s condition
before starting therapy and
regularly thereafter to monitor
drug’s effectiveness
Pronounced sedative effect
limits use in many ambulatory
patients
Give drug with food or milk to
reduce GI distress;Check
patient for sulfite allergy
before giving Phenergan IM;
Inject IM deep into large
muscle mass, rotate injection
sites; Do not give Sub Q; Drug
may be safely mixed with
Demerol in the same syringe;
In children it is especially
important to monitor
respiratory depressant effects
and avoiding combining the
drug with other drugs known
to have respiratory depressive
effects; Warn patient about
photosensitivity and
precautions to avoid it
Pharmacologic class:
phenothiazine derivative
Therapeutic class: antiemetic,
antihistamine, sedative
For nausea and vomiting:
adults receive 12.5 to 25 mg
PO, IM, or PR every 4 hours,
prn; Children older than age 2
receive 0.5 mg/kg
1/2009
N478 Drug Sheet
EVALUATION OF
DESIRED EFFECT FOR
THE PATIENT.
INCLUDING
ASSESSMENT, LAB
RESULTS AND
PROCEDURES
Effects on lab values:
May increase glucose and
hemoglobin levels and
hematocrit
May decrease WBC, platelet,
and granulocyte counts
May have false-positive or
false-negative results with
urine pregnancy tests
May interfere with blood
typing of ABO group
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
MEDICATION WITH
PRESCRIBED DOSEAGE
CLASSIFICATION OF THE
DRUG
USUAL DOSE/SAFE DOSE
AND ADMINISTRATION
Morphine sulfate
Pharmacologic class: opioid
agonist
Therapeutic class: analgesic
For severe pain: adults receive
5 to 20 mg/70kg SubQ or IM
every 4 hours, prn Or 10 to 30
mg PO every 4 hours prn Or 10
to 20 mg PR every 4 hours prn
Or 15 to 30 mg of controlledrelease tablets PO every 8 to 12
hours Or 5 mg of epidural
injection by epidural catheter
(maximum total epidural dose
is 10 mg). If adequate pain
relief is not obtained within 1
hour, give additional doses of
1-2 mg at intervals sufficient to
assess effectiveness. Children
receive 0.1 to 0.2 mg/kg IM or
SubQ every 4 hours, prn.
Maximum single dose is 15
mg. Or, 0.05 to 0.1 mg/kg by
slow IV injection
1/2009
N478 Drug Sheet
Page _____ of ______
INDIVIDUAL DESIRED
EFFECT OF DRUG FOR
THIS PATIENT
NURSING IMPLICATIONS/
CONSIDERATIONS FOR
THIS PATIENT
Relieves pain
Assess patient’s pain before
therapy and regularly
thereafter to monitor drug
effectiveness; Drug may
worsen or mask gallbladder
pain; Monitor patient for
respiratory depression after
administration; Assess patient
for constipation often; adjust
GI drugs as needed when
increasing morphine dose;
Keep opioid antagonist and
resuscitation equipment
available; If respiratory rate is
below 12 breaths/minute
except in terminal conditions,
don’t give the dose. Notify
prescriber; Because
constipation is often severe
with maintenance dosage, give
stool softener or other laxative
Warn patient about getting out
of bed or walking without
assistance.
EVALUATION OF
DESIRED EFFECT FOR
THE PATIENT.INCLUDING
ASSESSMENT, LAB
RESULTS AND
PROCEDURES
Effects on lab values:
May increase amylase level
May decrease platelet count
Outcomes:
Patient states that pain is
relieved
Patient maintains adequate
breathing patterns throughout
therapy
University of Evansville
Department of Nursing and Health Sciences
Drug Dispensing Sheet
1/2009
N478 Drug Sheet
Page _____ of ______