-Dyspepsia, epigastric, distress,

nausea, GI bleeding, tinnitus

ASPIRIN Antipyretics, non-
opioid analgesics, salicylates
INDICATION:
-Osteoarthritis, rheumatoid
arthritis, pain, fever
NURSING CONSIDERATIONS:
-Administer after meals or an
antacid
-Instruct to remain in upright
position for 15-30 minutes
-Ask to report if there are any
signs of bleeding

CONTRAINDICATION:
-Bleeding disorders

MECHANISM OF ACTION:
-Produce analgesia and reduce
inflammation and fever by
inhibiting the production of
prostaglandins

SIDE EFFECTS:
 -Dizziness, hypotension, fatigue,
chest pain, edema, tachycardia,
diarrhea

LOSARTAN Antihypertensive; NURSING CONSIDERATIONS:

Angiotensin II receptor antagonist -Monitor blood pressure and pulse
pressure during therapy
INDICATION: -Instruct to avoid salt substitutes
-Hypertension, diabetic containing potassium
nephropathy, stroke risk, heart -Caution patient to avoid sudden
failure changes in position
-Instruct to avoid driving or other
CONTRAINDICATION: activities requiring alertness
-Hypotension

MECHANISM OF ACTION:
-Blocks vasoconstrictor and
aldosterone-producing effects of
angiotensin II at receptor sites,
including vascular smooth muscle
and the adrenal glands
SIDE EFFECTS:

NICARDIPINE, AMLODIPINE
Antianginals, antihypertensive;
calcium channel blockers
INDICATION:
-Hypertension, angina pectoris,
systolic BP < 90 mmHg
CONTRAINDICATION:
-Sick sinus syndrome, AV block,
and hypotension
MECHANISM OF ACTION:
-Inhibits the transport of calcium
into myocardial and vascular
smooth muscle cells, resulting in
inhibition of excitation-contraction
coupling and subsequent
contraction
SIDE EFFECTS:
-Peripheral edema, headache,
dizziness, tinnitus, palpitations,
constipation, tachycardia,
diarrhea
NURSING CONSIDERATIONS:
-Monitor BP and pulse prior to,
during, and after therapy
-Monitor intake and output ratios
and daily weight and assess for
signs of heart failure
-Instruct to change positions
slowly
-Advise to avoid activities that
require alertness

DEXAMETHASONE
Antiasthmatics; Long-acting
corticosteroids (systemic)
INDICATION:
-Inflammatory, allergic,
hematologic, neoplastic,
autoimmune disorders; Pain
CONTRAINDICATION:
-Infection, immunosuppressed,
administration of live vaccines
MECHANISM OF ACTION:
-Suppress inflammation and the
normal immune response; have
negligible mineralocorticoid
activity
SIDE EFFECTS:
-depression, euphoria,
hypertension, anorexia, nausea
and vomiting, delayed wound
healing
NURSING CONSIDERATIONS:
-Monitor intake and output ratios
and daily weights
-Assess for any signs of infection
-Administer in the morning to
coincide with normal secretion of
cortisol

AMOXICILLIN / CLAVULANATE
Anti infectives; Aminopenicillins /
beta lactamase inhibitors
INDICATION:
Skin infections, otitis media,
sinusitis, respiratory tract
infections, and genitourinary
infections
CONTRAINDICATION:
-Hypersensitivity
MECHANISM OF ACTION:
-Binds to bacterial cell wall,
causing cell death; spectrum of
amoxicillin is broader than
penicillin. Clavulanate resists
action of beta-lactamase an
enzyme produced by bacteria that
is capable of inactivating some
penicillins
SIDE EFFECTS:
-diarrhea, nausea and vomiting,
rash, hepatic dysfunction
NURSING CONSIDERATIONS:
-Instruct to take in with meals
-Advice to report signs of
superinfection and allergy
-Instruct to notify health team if
diarrhea, abdominal cramps, fever
or bloody stools occur.

FUROSEMIDE - Diuretics; Loop
diuretics
INDCATION:
-Edema due to heart failure,
hepatic impairment or renal
disease; Hypertension
CONTRAINDICATION:
-Hypersensitivity, electrolyte
imbalance, hypovolemia
MECHANISM OF ACTION:
-Inhibits the reabsorption of
sodium and chloride from the loop
of Henle and distal renal tubule.
Increases renal excretion of water,
sodium, chloride, magnesium,
potassium, and calcium.
SIDE EFFECTS:
-hypovolemia, metabolic alkalosis,
hypotension, tinnitus, nausea and
vomiting
NURSING CONSIDERATIONS:
-Assess fluid status, monitor
intake and output
-Observe for signs of dehydration
-Monitor BP and pulse before,
during and after therapy
-Assess the electrolyte status and
symptoms of electrolyte
imbalance

DIGOXIN Antiarrythmics,
inotropics; digitalis glycosides
INDICATION:
-Heart failure; Atrial fibrillation
and atrial flutter; Paroxysmal
atrial tachycardia
CONTRAINDICATION:
-Uncontrolled ventricular
arrythmia, AV block, idiopathic
subaortic stenosis, constrictive
pericarditis
MECHANISM OF ACTION:
-Increases the force of myocardial
contraction. Prolongs refractory
period of the AV node. Decreases
deduction through the SA and AV
nodes.
SIDE EFFECTS:
-Nausea and vomiting, anorexia,
diarrhea, bradycardia, fatigue,
weakness, blurred and discolored
vision
NURSING CONSIDERATION:
-Monitor apical pulse for 1 full
minute before administering. If <
60 bpm, withhold drug
-Monitor intake and output ratios
and daily weights. Assess for
peripheral edema
-Assess the ECG status for
changes

CLOPIDOGREL Antiplatelet;
Platelet aggregation inhibitors
INDICATION:
-Reduction of atherosclerotic
events (MI, stroke, vascular death)
who are at risk for MI, acute
coronary syndrome, stroke or
peripheral vascular disease
SIDE EFFECTS:
-Decreased wound healing,
epistaxis, dizziness, fatigue,
abdominal pain, neutropenia
NURSING CONSIDERATIONS:
-Monitor CBC with differential and
platelet count periodically during
therapy
-Observe for any signs of bleeding
-Monitor vital signs accordingly

CONTRAINDICATION:
-Pathologic bleeding

MECHANISM OF ACTION:
-Inhibits platelet aggregation by
irreversibly inhibiting the binding
of ATP to platelet receptors
 -Nausea and vomiting,
drowsiness, cough, fever,
tachycardia, bronchospasm

N-ACETYLCYSTEINE Mucolytic NURSING CONSIDERATIONS:

-Prepare suction apparatus for
INDICATION: possible suctioning
-With abnormal, viscid or -Observe for signs of difficulty in
inspissated mucous secretions clearing the airway
-Monitor pulmonary function and
CONTRAINDICATION oxygen saturation
-Hypersensitivity

MECHANISM OF ACTION:
-Splitting disulfide linkages
between mucoprotein molecular
complexes thereby reducing
viscosity of pulmonary secretions

SIDE EFFECTS:

ATORVASTATIN - Lipid-lowering;
HMG-CoA reductase inhibitors
INDICATION:
-Primary hypercholesterolemia
and mixed dyslipidemia
CONTRAINDICATION:
-Active liver disease
MECHANISM OF ACTION:
-Inhibit an enzyme, 3-hydroxy-3-
methylglutaryl-coenzyme A (HMG-
CoA) reductase which is
responsible for catalyzing an early
step in the synthesis of
cholesterol
SIDE EFFECTS:
-Nausea, abdominal cramps,
diarrhea, constipation, flatus,
blurred vision, elevated liver
enzymes
NURSING CONSIDERATIONS:
-Monitor liver function tests
-Inform that this drug should be
used in conjunction with diet
restriction
-Instruct to report if signs of liver
injury or unexplained muscle pain,
tenderness or weakness occurs
 -Nausea and vomiting, headache,
edema

NURSING CONSIDERATIONS:
TRIMETAZIDINE Antianginal -Monitor blood pressure and pulse
rate before and after drug therapy
INDICATION: -Note prescribing signs of heart
-Angina pectoris failure

CONTRAINDICATION:
-Lactation

MECHANISM OF ACTION:
-Selective inhibition of an enzyme
of fatty acid -oxidation: the long
chain 3-ketoacyl CoA thiolase (3-
KAT) resulting in reduced fatty
acid oxidation and stimulation of
glucose oxidation

SIDE EFFECTS:

PREGABALIN Analgesic,
anticonvulsant; Gamma
aminobutyric acid analogues,
nonopioid analgesic
INDICATION:
-Neuropathic pain associated with
diabetic peripheral neuropathy or
spinal cord injury
CONTRAINDICATION:
-Myopathy, lactation
MECHANISM OF ACTION:
-Binds to calcium channels in CNS
tissues which regulate
neurotransmitter release
SIDE EFFECTS:
-Abdominal pain, dizziness,
drowsiness, increased appetite,
edema, dry mouth, depression,
weight gain
NURSING CONSIDERATIONS:
-Monitor closely for notable
changes in behavior
-Caution patient to avoid driving
or activities requiring alertness
until response to medication is
known
-Instruct to promptly report
unexplained muscle pain,
tenderness, or weakness
especially if accompanied by
malaise or fever

CITICOLINE CNS stimulant,
peripheral vasodilator, cerebral
activator; Nootropic
INDICATION:
-Cerebrovascular disease
CONTRAINDICATION:
-Hypertonia of the
parasympathetic nervous system
MECHANISM OF ACTION:
-Activates the biosynthesis of
structural phospholipids in the
neuronal membrane; Increases
cerebral metabolism and
increases the level of various
neurotransmitters including
acetylcholine and dopamine
SIDE EFFECTS:
-Hypotension, itching, edema,
chest tightness, tingling in mouth
or throat
NURSING CONSIDERATIONS:
-Monitor neurologic status
-Assess vital signs and closely
monitoring blood pressure and
pulse rate
 NURSING CONSIDERATIONS:
-Monitor closely for notable
changes in behavior
-Caution to avoid activities
LAMOTRIGINE Anticonvulsant
requiring alertness
INDICATION:
-Partial seizures, tonic-clonic
seizures

CONTRAINDICATION:
-Hypersensitivity

MECHANISM OF ACTION:
-Stabilizes neuronal membranes
by inhibiting sodium transport

SIDE EFFECTS:
-Nausea and vomiting,
drowsiness, dizziness, headache,
photosensitivity, ataxia,
depression

ATENOLOL Antianginal,
antihypertensive; Beta blocker
INDICATION:
-Hypertension, angina pectoris,
prevention of MI
CONTRAINDICATION:
-Pulmonary edema,
uncompensated heart failure,
cardiogenic shock, bradycardia
MECHANISM OF ACTION:
-Blocks stimulation of
beta1(myocardial)-adrenergic
receptors, does not usually affect
beta2(pulmonary, vascular,
uterine)-receptor sites
SIDE EFFECTS:
-Fatigue, weakness, dizziness,
drowsiness, mental status
changes, erectile dysfunction
NURSING CONSIDERATIONS:
-Monitor blood pressure and pulse
rate throughout therapy
-Monitor intake and output and
daily weights
-Assess routinely for HF (dyspnea,
rales/crackles, weight gain,
peripheral edema, jugular vein
distention)
 selectively blocks the HCN
channel, inhibits the If current,
and lowers heart rate.

IVABRADINE Antianginal; SIDE EFFECTS:

Cardiotonic agent -Nausea and vomiting, headache,
dizziness, difficulty in breathing,
INDICATION: bradycardia, hypotension
-Angina pectoris
NURSING CONSIDERATIONS:
CONTRAINDICATION: -Monitor vital signs before, during
-Severe heart disease, Calcium and after administration of the
channel blocker user drug
-Monitor for signs of respiratory
MECHANISM OF ACTION: distress
- Mixed sodium and potassium -
channel that carries the If current.
Inward flow of positively charged
ions that initiates the
spontaneous diastolic
depolarization phase, modulating
heart rate. Within the SA node,
NORGESIC
INDICATION:
CONTRAINDICATION:
MECHANISM OF ACTION:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

ISOSORBIDE MONONITRATE
(ISMN) Antianginal; Nitrate
INDICATION:
-Acute treatment of anginal
attacks
CONTRAINDICATION:
-Hypersensitivity
MECHANISM OF ACTION:
- Produce vasodilation (venous
greater than arterial). Decrease
left ventricular end-diastolic
pressure and left ventricular end-
diastolic volume (preload). Net
effect is reduced myocardial
oxygen consumption. Increase
coronary blood flow by dilating
coronary arteries and improving
collateral flow to ischemic regions.
SIDE EFFECTS:
- Nausea and vomiting, dizziness,
headache, hypotension,
tachycardia, paradoxic
bradycardia, syncope
NURSING CONSIDERATIONS:
-Monitor blood pressure and pulse
routinely during drug adjustment
-Instruct to change positions
slowly
-Avoid activities that may require
alertness such as driving
 SIDE EFFECTS:
-Nausea and vomiting, diarrhea,
rashes

AMPICILLIN / SULBACTAM NURSING CONSIDERATIONS:

Anti-infective; Aminopenicillins /
beta lactamase inhibitors
INDICATION:
-Treatment for infection
-Administer drug after meals to
minimize side effects
-Monitor for a decrease in the
signs of infection

CONTRAINDICATION:
-Hypersensitivity

MECHANISM OF ACTION:
- Binds to bacterial cell wall,
resulting in cell death; spectrum is
broader than that of penicillin.
Addition of sulbactam increases
resistance to beta-lactamases,
enzymes produced by bacteria
that may inactivate ampicillin.

SALBUTAMOL Bronchodilator;
Adrenergic
INDICATION:
-Used as a bronchodilator to
control and prevent reversible
airway obstruction caused by
asthma or COPD
CONTRAINDICATION:
-Hypersensitivity
MECHANISM OF ACTION:
- Binds to beta 2-adrenergic
receptors in airway smooth
muscle, leading to activation of
adenyl cyclase and increased
levels of cyclic-3, 5-adenosine
monophosphate (cAMP). Increases
in cAMP activate kinases, which
inhibit the phosphorylation of
myosin and decrease intracellular
calcium. Decreased intracellular
calcium relaxes smooth muscle
airways. Relaxation of airway
smooth muscle with subsequent
bronchodilation
SIDE EFFECTS:
-Nausea and vomiting, headache,
dry mouth, nervousness,
restlessness, tremor, chest pain,
palpitations
NURSING CONSIDERATIONS:
-Assess for lung sounds, pulse,
and BP before administration
-Inform that the drug may cause
an unusual or bad taste
-Advise to rinse mouth with water
after each inhalation to minimize
dry mouth
ITOPRIDE
INDICATION:
CONTRAINDICATION:
MECHANISM OF ACTION:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
LOMOTIL
INDICATION:
CONTRAINDICATION:
MECHANISM OF ACTION:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

SEVELAMER Electrolyte
modifier; Phosphate binders
INDICATION:
-Reduction of serum phosphate
levels in patients with
hyperphosphatemia associated
with end-stage renal disease.
CONTRAINDICATION:
-Hypersensitivity;
Hypophosphatemia; Bowel
obstruction
MECHANISM OF ACTION:
-A polymer that binds phosphate
in the GI tract, preventing its
absorption.
SIDE EFFECTS:
-Diarrhea, dyspepsia, nausea and
vomiting, constipation, flatulence,
bowel obstruction/perforation,
esophageal obstruction
NURSING CONSIDERATIONS:
-Instruct patient to take
sevelamer with meals as directed
and to adhere to prescribed diet
-Advise patient to notify health
care professional if GI effects are
severe or prolonged
LACIDIPINE
INDICATION:
CONTRAINDICATION:
MECHANISM OF ACTION:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

CLONIDINE Antihypertensive;
Adrenergic (centrally acting)
INDICATION:
-Mild to moderate hypertension
CONTRAINDICATION:
-Hypersensitivity, anticoagulant
therapy, bleeding problems
MECHANISM OF ACTION:
-Stimulates alpha-adrenergic
receptors in the CNS, which
results in decreased sympathetic
outflow inhibiting
cardioacceleration and
vasoconstriction centers. Prevents
pain signal transmission to the
CNS by stimulating alpha-
adrenergic receptors in the spinal
cord.
SIDE EFFECTS:
-Nausea and vomiting,
drowsiness, dry mouth,
constipation, hypotension,
bradycardia
NURSING CONSIDERATIONS:
-Monitor blood pressure and pulse
prior to administration
-Monitor intake and output ratios
and weigh daily
-Assess for edema especially at
beginning of therapy
-Advise to avoid activities that
require alertness
CARVEDILOL
INDICATION:
CONTRAINDICATION:
MECHANISM OF ACTION:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

FLUCONAZOLE Antifungal
INDICATION:
-Fungal infections caused by
susceptible organisms
-Ensure specimen for culture is
taken before instituting therapy
-Assess infected area and monitor
CSF cultures before and
periodically during therapy
-Monitor liver function tests
periodically during therapy

CONTRAINDICATION:
-Hypersensitivity

MECHANISM OF ACTION:
-Inhibits synthesis of fungal
sterols, a necessary component of
the cell membrane

SIDE EFFECTS:
-Nausea and vomiting, headache,
dizziness, diarrhea, hypokalemia
NURSING CONSIDERATIONS:
 SIDE EFFECTS:
-Dizziness, hypotension, fatigue,
chest pain, edema, tachycardia,
CANDESARTAN diarrhea
Antihypertensive; Angiotensin II
receptor antagonist NURSING CONSIDERATIONS:
-Monitor blood pressure and pulse
INDICATION: pressure during therapy
-Hypertension, diabetic -Instruct to avoid salt substitutes
nephropathy, stroke risk, heart containing potassium
failure -Caution patient to avoid sudden
changes in position
CONTRAINDICATION: -Instruct to avoid driving or other
-Hypotension activities requiring alertness

MECHANISM OF ACTION:
-Blocks vasoconstrictor and
aldosterone-producing effects of
angiotensin II at receptor sites,
including vascular smooth muscle
and the adrenal glands

NEBIVOLOL Antihypertensive;
Beta blocker (selective)
INDICATION:
-Hypertension
CONTRAINDICATION:
-Hypersensitivity, severe
bradycardia, heart block greater
than first degree cardiogenic
shock, decompensated heart
failure, hepatic impairment,
bronchospastic disease
MECHANISM OF ACTION:
-Blocks stimulation of beta
adrenergic receptor sites;
selective for beta1 (myocardial)
receptors in most patients
SIDE EFFECTS:
-Dizziness, fatigue, headache,
hypotension, bradycardia
NURSING CONSIDERATIONS:
-Monitor blood pressure, pulse,
and ECG prior to and periodically
during therapy
-Monitor intake and output ratios
and daily weights. Assess
routinely for signs and symptoms
of HF (dyspnea, rales/crackles,
weight gain, peripheral edema,
jugular venous distention)
ERDOSTEINE
INDICATION:
CONTRAINDICATION:
MECHANISM OF ACTION:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

OXYCODONE Opioid analgesic;
Opioid agonist, nonopioid
analgesic combination
INDICATION:
-Moderate to severe pain
CONTRAINDICATION:
-Hypersensitivity, respiratory
depression, paralytic ileus, acute
or severe bronchial asthma
MECHANISM OF ACTION:
-Binds to opiate receptors in the
CNS. Alters the perception of and
response to painful stimuli, while
producing generalized CNS
depression.
SIDE EFFECTS:
-Nausea and vomiting,
constipation, dry mouth,
confusion, sedation, blurred vision
NURSING CONSIDERATIONS:
-Assess type, location, and
intensity of pain prior to and 1
hour (peak) after administration
-Monitor for signs of respiratory
depression
-Assess for signs of dehydration
and bowel function routinely
-Instruct to increase fluid intake

VANCOMYCIN Anti-infective
INDICATION:
-Treatment of potentially life-
threatening infections when less
toxic anti-infectives are
contraindicated;
Particularly useful in
staphylococcal infections
CONTRAINDICATION:
Renal impairment, hearing
impairment, intestinal obstruction
or inflammation
MECHANISM OF ACTION:
-Binds to bacterial cell wall,
resulting in cell death
SIDE EFFECTS:
-Nausea and vomiting,
nephrotoxicity, ototoxicity,
hypotension
NURSING CONSIDERATIONS:
-Monitor IV site closely because it
is irritating to tissues and may
cause necrosis and severe pain
with extravasation
-Rotate infusion site of suspected
to have irritation on previous site
-Assess for any hearing damage
which is a sign of ototoxicity
-Monitor intake and output ratios
and daily weight. Cloudy or pink
urine may be a sign of
nephrotoxicity
PIGLITAZONE
INDICATION:
CONTRAINDICATION:
MECHANISM OF ACTION:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

PREDNISONE Antiasthmatic;
Intermediate-acting corticosteroid
INDICATION:
-Inflammatory diseases,
prevention of organ rejection in
transplant surgery
CONTRAINDICATION:
-Acute untreated infections
MECHANISM OF ACTION:
-Suppress inflammation and the
normal immune response; have
negligible mineralocorticoid
activity
SIDE EFFECTS:
-Nausea and vomiting,
hypertension, delayed wound
healing, depression
NURSING CONSIDERATIONS:
-Monitor intake and output ratios
and daily weights
-Observe for peripheral edema,
steady weight gain, rales/crackles,
or dyspnea
-Administer in the morning to
coincide with body's normal
secretion of cortisol

METHYLPREDNISOLONE
Antiasthmatic; Intermediate-
acting corticosteroid (systemic)
INDICATION:
-Inflammatory, allergic,
hematologic, neoplastic and
autoimmune disorders
CONTRAINDICATION:
-Active untreated infection
MECHANISM OF ACTION:
-Suppresses inflammation and the
normal immune response
SIDE EFFECTS:
- Nausea and vomiting,
hypertension, delayed wound
healing, depression
NURSING CONSIDERATIONS:
-Monitor intake and output ratios
and daily weights
-Observe for peripheral edema,
steady weight gain, rales/crackles,
or dyspnea
-Administer in the morning to
coincide with body's normal
secretion of cortisol
 separated out and becomes part
of iron stores.

SIDE EFFECTS:
FERROUS SULFATE Anti- -Nausea and vomiting,
anemic; Iron supplement constipation, dark stools,
diarrhea, epigastric pain,
INDICATION: hypotension, staining of skin and
-Prevention or treatment of teeth
anemia
NURSING CONSIDERATIONS:
CONTRAINDICATION: -Increase fluid intake
-Hemochromatosis, hemosiderosis -Increase intake of foods high in
fiber in the diet
MECHANISM OF ACTION:
-An essential mineral found in
hemoglobin, myoglobin, and
many enzymes. Enters the
bloodstream and is transported to
the organs of the
reticuloendothelial system (liver,
spleen, bone marrow), where it is

LISINOPRIL Antihypertensive;
ACE inhibitor
INDICATION:
-Alone or with other agents in the
management of hypertension
CONTRAINDICATION:
-Hypotension
MECHANISM OF ACTION:
-ACE inhibitors block the
conversion of angiotensin I to the
vasoconstrictor angiotensin II.
ACE inhibitors also prevent the
degradation of bradykinin and
other vasodilatory prostaglandins.
ACE inhibitors also plasma renin
levels and aldosterone levels.
Net result is systemic
vasodilation.
SIDE EFFECTS:
-Nausea and vomiting, dizziness,
drowsiness, taste disturbances,
hypotension, nephrotoxic
NURSING CONSIDERATIONS:
-Monitor blood pressure and pulse
before and after administration of
the medication
-Caution patient to change
positions slowly to minimize
hypotension
-Advise to avoid driving or other
activities requiring alertness