Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

morphine Astramorph Opioid analgesic
Peak Onset Duration
20 min rapid 4-5 hrs
Why is your patient getting this medication
Pain
Mechanism of action and indications
(Why med ordered)
Binds to opiate receptors in the CNS. Alters the perception of
and response to painful stimuli while producing generalized
CNS depression
Interactions with other patient drugs, OTC or herbal
medicines (ask patient specifically)
Detrol: Coadministration of narcotic analgesics with
anticholinergic agents may have additive central nervous
system (CNS) and gastrointestinal (GI) system effects, and
increase the risk of severe constipation or paralytic ileus and
CNS depression.
Baclofen: Central nervous system- and/or respiratory-
depressant effects may be additively or synergistically
increased in patients taking multiple drugs that cause these
effects, especially in elderly or debilitated patients.
Norvasc: The concomitant administration of agents with
hypotensive effects and psychotherapeutic agents (e.g.,
anxiolytics, sedatives, hypnotics, antidepressants,
antipsychotics), narcotic analgesics, alcohol, or muscle
relaxants may additively increase hypotensive and/or central
nervous system depressant effects.
Nursing Process- Assessment Assessment
(Pre-administration assessment) Why would you hold or not give this med?
Assess type, location, and intensity of pain prior to If respiratory rate is <10/min, assess level of
and 20 min (peak) following IV administration. sedation. Toxicity (administer Narcan)
Assess level of consciousness, blood pressure,
pulse, and respirations before and periodically
during administration. Assess bowel function
routinely.
2mg-4mg IV Q 3 hrs
Normal dosage range
Usual starting dose for moderate to severe pain in opioid-naive
patients--4-10 mg q 3-4 hr.
Rate: Administer 2.5-15 mg over 4-5 min. Rapid administration may
lead to increased respiratory depression, hypotension, and circulatory
collapse
For IV meds, compatibility with IV drips and/or solutions
Solution is colorless; do not administer discolored solution. Dilute
with at least 5 ml of sterile water or 0.9% NaCl for injection to a
concentration of 0.5-5 mg/ml
Y-Site Incompatibility: amphotericin B cholesteryl sulfate,
azithromycin, cefepime, doxorubicin liposome, minocycline,
phenytoin, sargramostim
Nursing Implications (what to focus on)
Contraindications/warnings/interactions
Hypersensitivity, Some products contain tartrazine, bisulfites, or
alcohol and should be avoided in patients with known hypersensitivity
Common side effects
confusion, sedation, RESPIRATORY DEPRESSION, hypotension,
constipation
Lab value alterations caused by medicine
May ↑ plasma amylase and lipase levels
Be sure to teach the patient the following about this medication
Instruct patient how and when to ask for pain medication. May cause
drowsiness or dizziness. Caution patient to call for assistance when
ambulating or smoking and to avoid driving or other activities
requiring alertness until response to medication is known. Advise
patient to change positions slowly to minimize orthostatic hypotension.
Caution patient to avoid concurrent use of alcohol or other CNS
depressants with this medication. Encourage patients who are
immobilized or on prolonged bedrest to turn, cough, and breathe
deeply every 2 hr to prevent atelectasis.
Evaluation
Check after giving
Decrease in severity of pain
without a significant alteration in
level of consciousness or
respiratory status