http://www.nationalpainfoundation.

org/articles/162/pain-in-older-adults

Lovenox
anticoagulant

prevent
thrombus
formation

VTE
prophylaxis
following
abdominal
surgery--40
mg once daily
starting 2 hr
before
surgery and
then
continued for
7-12 days or
until
ambulatory
(up to 14
days);

BLEEDING, anemia, bruising

Instruct patient
not to take
aspirin or
NSAIDs
without
consulting
health care
professional
while on
therapy

Assess for signs of

bleeding and
hemorrhage
(bleeding gums;
nosebleed;
unusual bruising;
black, tarry stools;
hematuria; fall in
hematocrit or blood
pressure; guaiacpositive stools);
bleeding from
surgical site. Notify
physician or other
health care
professional if
these occur.

Invanz
anti-infective

bactericidal
against
susceptible
bacteria

1 g once daily
for up to 14
days (IV

SEIZURES
PSEUDOMEMBRANOUS
COLITIS

Fluoxetine
(Prozac)
antidepressant

Selectively
inhibits the
reuptake of
serotonin in the
CNS.

Doses greater
than 20
mg/day
should be
given in 2
divided
doses, in the
morning and
at noon (not
to exceed 80
mg/day).

anxiety, drowsiness, headache,

insomnia, nervousness,
diarrhea sexual dysfunction,
excessive sweating, pruritus,
tremor

report the
signs of
superinfection
(black, furry
overgrowth on
the tongue;
vaginal itching
or dischar
loose or foulsmelling
stools).
Caution
patient to notify
hcp if fever
and diarrhea
occur,
especially if
stool contains
blood, pus, or
mucus.
Encourage
patient
participation in
psychotherapy
to improve
coping skills
discontinuation
may cause
anxiety,
insomnia,
nervousness

Obtain a history
before initiating
therapy to
determine previous
use of and
reactions to
penicillins,
cephalosporins or
carbapenems.
Persons with a
negative history of
penicillin sensitivity
may still have an
allergic response.

May be
administered with
food to minimize GI
irritation

Simvastatin
lipid-lowering agents
HMG-CoA reductase
inhibitors

Levothyroxine
hormone
replacement
therapy

Lowers total
and LDL
cholesterol and
triglycerides.
Slightly
increase HDL.
Slows of the
progression of
coronary
atherosclerosis
with resultant
decrease in
CHD-related
events

up to 80
mg/day

abdominal cramps,
constipation, diarrhea, flatus,
heartburn, altered taste, rashes

Instruct patient
to notify health
care
professional if
unexplained
muscle pain,
tenderness, or
weakness
occurs,
especially if
accompanied
by fever or
malaise.

Principal effect
is increasing
metabolic rate
of body tissues:
Promote
gluconeogenesi
s, Increase
utilization and
mobilization of
glycogen
stores,
Stimulate
protein
synthesis,
Promote cell
growth and
differentiation,
Aid in the
development of
the brain and

usual
maintenance
dose is 75125 mcg/day
(1.5
mcg/kg/day).

nervousness

Instruct patient
to take
medication as
directed at the
same time
each day. Take
missed doses
as soon as
remembered
unless almost
time for next
dose

headache, nervousness,
diarrhea, excessive sweating,
heat intolerance, chest pain,
increased pulse rate,
palpitations, weight loss >2
lb/wk

Monitor liver
function tests,
including AST,
before, at 12 wk
after initiation of
therapy or after
dose elevation,
and then q 6 mo. If
AST levels to 3
times normal,
HMG-CoA
reductase inhibitor
therapy should be
reduced or
discontinued.
Assess apical
pulse and blood
pressure prior to
and periodically
during therapy.
Assess for
tachyarrhythmias
and chest pain.
monitor tsh lvls

Lisinopril
aceinhibitor/antihypert
ensive

CNS.
ACE inhibitors
block the
conversion of
angiotensin I to
the
vasoconstrictor
angiotensin II.
ACE inhibitors
also increase
plasma renin
levels and
reduce
aldosterone
levels. Net
result is
systemic
vasodilation

maintenance
dose of 20-40
mg/day in 1-2
divided doses

cough, hypotension,
taste disturbances

Monitor blood
pressure and pulse
frequently during
initial dose
adjustment and
periodically during
therapy. Notify
health care
professional of
significant
changes.

Metronidazole
anti-infective

bactericidal,
trichomonac
idal (bv),
amebicidal
(giardia)
action

not to exceed
4 g/day

abdominal pain, anorexia,

nausea, dizziness, headache,
dry mouth

may cause
urine to turn
dark.

Assess patient for

infection

Mirtazapine
antidepressant

Potentiates the
effects of
norepinephrine
and serotonin.

up to 45
mg/day

constipation, dry mouth,

increased appetite,
drowsiness, weight gain,
hypotension, vasodilation

Emphasize the
importance of
follow-up exam
to monitor
effectiveness
and side
effects

Assess mental
status (orientation,
mood, behavior)
frequently. Assess
4 suicidal
tendencies,
especially during
early therapy.
monitor BP

Protonix
antiulcer (proton
pump inhibitor)

Vesicare
urinary tract
antispasmodics

Diminished
accumulation of
acid in the
gastric lumen,
with lessened
acid reflux.
Healing of
duodenal ulcers
and
esophagitis.
Decreased acid
secretion in
hypersecretory
conditions
Decreased
symptoms of
overactive
bladder

40 mg once
daily
(up tp 120mg)

headache.
GI: abdominal pain, diarrhea,
eructation, flatulence.
Endo: hyperglycemia.

up to 10 mg
once daily

blurred vision.
GI: constipation, dry mouth,
dyspepsia, nausea.

do not take 2
doses in same
day if dose is
missed

Monitor voiding
pattern and assess
symptoms of
overactive bladder
(urinary urgency,
urinary
incontinence,
urinary frequency)
to and periodically
during therapy.

Acetaminophen
antipyretics,

Inhibits the
synthesis of
prostaglandins

nonopioid analgesics

Darvocet n 100
opioid analgesics

Alters the
perception of
and response to
painful stimuli,
while producing
generalized
CNS
depression.

not to exceed
4 g or 2.5
g/24 hr in
patients with
hepatic/renal
impairment

HEPATIC FAILURE,
HEPATOTOXICITY(OVERDOS
E).

600 mg/day

dizziness, weakness,
dysphoria, euphoria,
headache, insomnia,
paradoxical excitement,
sedation.

GU: renal failure (high

doses/chronic use).

EENT: blurred vision.

CV: hypotension.
GI: nausea, abdominal pain,
constipation, vomiting.
Derm: rashes.
Misc: physical dependence,
psychological dependence,
tolerance.

Caution patient
to check labels
on all OTC
products.
Advise patients
to avoid taking
more than one
product
containing
acetaminophe
n at a time to
prevent
toxicity.
Severe and
permanent
liver damage
may result
from prolonged
use or high
doses of
acetaminophe
n. Renal
damage may
occur with
prolonged use
of
acetaminophe
n or aspirin

Assess blood
pressure, pulse,
and respirations
before and
periodically during
administration. If
respiratory rate is
<10/min, assess
level of sedation.
Physical
stimulation may be
sufficient to
prevent significant
hypoventilation.
Dose may need to
be decreased by
25-50%. Initial
drowsiness will
diminish with
continued use.

Maalox
anti-ulcer, antacid

Ondansetron
anti-emetic

Neutralization
of gastric acid
with healing of
ulcers and
decrease in
associated
pain.

5-10 ml (5401080 mg)

between
meals and at
bedtime.

aluminum salts: constipation

magnesium salts: diarrhea.

Decreased
incidence and
severity of
nausea and
vomiting
following
chemotherapy
or surgery.

4 mg

headache, constipation,
diarrhea
extrapyramidal reactions

magnesium salts:
hypermagnesemia aluminum
salts: hypophosphatemia.

Caution patient
to consult
health care
professional
before taking
antacids for
more than 2
wk if problem
is recurring, if
relief is not
obtained, or if
symptoms of
gastric
bleeding
(black, tarry
stools; coffeeground
emesis) occur.

For an antacid
effect, administer
1-3 hr after meals
and at bedtime. .

notify health
care
professional
immediately if
involuntary
movement of
eyes, face, or
limbs occurs.

assess

Promethazine
antiemetics,
antihistamines,
sedative/hypnotics

Relief of
symptoms of
histamine
excess usually
seen in allergic
conditions.
Diminished
nausea or
vomiting.
Sedation.
(depress CNS)

12.5-25 mg q
4 hr as
needed

confusion, disorientation,
sedation

Advise patient
to change
positions
slowly to
minimize
orthostatic
hypotension

Monitor patient for

onset of
extrapyramidal
side effects
(akathisia-restlessness;
dystonia--muscle
spasms and
twisting motions;
pseudoparkinsonis
m--mask-like face,
rigidity, tremors,
drooling, shuffling
gait, dysphagia).
Notify physician or
other health care
professional if
these symptoms
occur.