Drug Card Template

Drug Card Template Trade & Generic name Drug class Purpose of the drug Dosage Promethazine (Phenergan) Antiemetics antihistamines For the treatment of various allergic conditions and motion sickness. Preoperative sedation. Treatment and prevention of nausea and vomiting. Adjunct to anesthesia and analgesia. By mouth; Adults: 6.25–12.5 mg 3 times/day and 25 mg at bedtime. Children ≥2 yr: 0.1 mg/kg/dose (not to exceed 12.5 mg) q 6 hr during the day and 0.5 mg/kg/dose (not to exceed 25 mg) at bedtime. IM/ IV Rect: Adults- 25 mg; may repeat in 2 hr. Children ≥2 yr- 0.125 mg/kg q 4–6 hr or 0.5 mg/kg at bedtime. Interactions CNS depression with other CNS depressants, including alcohol, other antihistamines, opioid analgesics, and other sedative/hypnotics. Neuroleptic malignant syndrome can occur when used concurrently with antipsychotics. Additive anticholinergic effects with other drugs possessing anticholinergic properties, including other antihistamines, antidepressants, atropine, haloperidol, other phenothiazines, quinidine, and disopyramide. May precipitate seizures when used with drugs that lower seizure threshold. Concurrent use with MAO inhibitors may result in increased sedation and anticholinergic side effects. Common Side Effects Adverse Effects Unique information (antidotes, nursing considerations/teaching points, criteria that must be met to give or hold the medication, and contraindications) blurred vision, diplopia, tinnitus, bradycardia, hypertension, hypotension, tachycardia, constipation, drug-induced hepatitis, dry mouth, photosensitivity. Neuroleptic malignant syndrome May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known. Caution patient to avoid concurrent use of alcohol and other CNS depressants with this medication. Advise patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may decrease dry mouth. Trade & Generic name Pantoprazole (Protonix) Drug class Purpose of the drug Antiulcer To treat erosive esophagitis associated with GERD. Maintenance of healing of erosive esophagitis Pathologic gastric hypersecretory conditions. By mouth; Adults: Short-term treatment of erosive esophagitis associated with GERD– 40 mg once daily for up to 8 wk; Maintenance of healing of erosive esophagitis– 40 mg once daily. Children ≥5 yr: 15–39 kg– 20 mg once daily for up to 8 wk; ≥40 kg– 40 mg once daily for up to 8 wk. May decrease levels of atazanavir and nelfinavir; avoid concurrent use with either of these antiretrovirals. May decrease absorption of drugs requiring acid pH, including ketoconazole, itraconazole, ampicillin esters, iron salts, erlotinib, and mycophenolate mofetil; concomitant use w/ atazanavir not recommended. May increase risk of bleeding with warfarin. Hypomagnesemia increase risk of toxicity. May increase methotrexate levels Dosage Interactions Common Side Effects Adverse Effects Unique information (antidotes, nursing considerations/teaching points, criteria that must be met to give or hold the medication, and contraindications): Trade & Generic name Drug class Purpose of the drug Dosage Headache, cutaneous lupus erythematosus, hyperglycemia, hypomagnesemia, b12 deficiency, risk of bone fractures, lupus. Clostridioides difficile associated diarrhea Contraindicated in: Hypersensitivity to rabeprazole or related drugs (benzimidazoles). Do not confuse Protonix (pantoprazole) with Lotronex (alosetron) or protamine. Can be given with or without food. Instruct patient to take medication as directed for the full course of therapy, even if feeling better. Tell patient to read Medication Guide before starting therapy and with each Rx refill in case of changes. Advise patient to avoid alcohol, products containing aspirin or NSAIDs, and foods that may cause an increase in GI irritation. Asprin (Acuprin, aspir-low, easprin, Ecotrin, healthprin, vazalore) antipyretics nonopioid analgesics Inflammatory disorders for example, Rheumatoid arthritis and Osteoarthritis. Mild to moderate pain, Fever, Prophylaxis of transient ischemic attacks and MI. Pain/Fever; PO Adults- 325–1000 mg every 4–6 hr (not to exceed 4 g/day). ER tablets– 650 mg every 8 hr or 800 mg every 12 hr. Common Side Effects PO Children 2–11 yr: 10–15 mg/kg/dose every 4–6 hr; maximum dose: 4 g/day. Inflammation PO Adults: 2.4 g/day initially; increase to maintenance dose of 3.6– 5.4 g/day in divided doses PO Children: 60–100 mg/kg/day in divided doses (up to 130 mg/kg/day for acute rheumatic fever). Prevention of Transient Ischemic Attacks PO Adults- 50–325 mg once daily. Prevention of MI/Antiplatelet Effects PO Adults- 80–325 mg once daily. Suspected acute MI– 160 mg as soon as MI is suspected. PO Children- 3–10 mg/kg/day given once daily (round dose to a convenient amount). Can increase risk of bleeding with warfarin, heparin, heparin like agents, thrombolytic agents, dipyridamole, clopidogrel, tirofiban, or eptifibatide, although these agents are frequently used safely in combination and in sequence. Taking with natural drug products can cause; anticoagulant effect and bleeding risk with arnica, chamomile, clove, garlic, ginger, ginkgo, Panax ginseng, etc. rash, urticaria, tinnitus, Adverse Effects Hypersensitivity reactions such as anaphylaxis and laryngeal edema. Unique information (antidotes, nursing considerations/teaching points, criteria that must be met to give or hold the medication, and contraindications): Caution patient to avoid concurrent use of alcohol with this medication to minimize possible gastric irritation; 3 or more glasses of alcohol per day may increase risk of GI bleeding. Caution patient to avoid taking concurrently with acetaminophen or NSAIDs for more than a couple days. Trade & Generic name hydrocodone (Vicodin) (Norco) [hydrocodone + acetaminophen] Drug class Purpose of the drug opioid analgesics For management of moderate to severe pain Dosage By mouth; Adults- 2.5–10 mg every 3–6 hr as needed, if using combination products, acetaminophen dosage should not exceed 4 g/day and should not exceed 5 tablets/day of ibuprofen containing products. Use with extreme caution in patients receiving MAO inhibitors may Interactions Interactions Common Side Effects produce severe, unpredictable reactions–do not use within 14 days of each other. Use with benzodiazepines or other CNS depressants including other opioids, non-benzodiazepine sedative/hypnotics, anxiolytics, general anesthetics, muscle relaxants, antipsychotics, and alcohol may cause profound sedation, respiratory depression, coma, and death; reserve concurrent use for when alternative treatment options are inadequate. Administration of partial antagonist opioids (buprenorphine, butorphanol, or nalbuphine) may decrease analgesia or precipitate opioid withdrawal in physically dependent patients. confusion, dizziness, sedation, euphoria, hallucinations, headache, unusual dreams, blurred vision, diplopia, miosis, constipation, dyspepsia, nausea, choking, dysphagia, esophageal obstruction, vomiting, urinary retention and physical dependance. Adverse Effects Respiratory depression Unique information (antidotes, nursing considerations/teaching points, criteria that must be met to give or hold the medication, and contraindications): Tell patient to take medication as directed and not to take more than the recommended amount. Severe and permanent liver damage may result from prolonged use or high doses of acetaminophen. Renal damage may occur with prolonged use of acetaminophen. May caused drowsiness/dizziness, avoid use of alcohol or other CNS depressants while taking this medication. Do not confuse hydrocodone and oxycodone with each other. Trade & Generic name Oxycodone (Percocet) (oxycodone + acetaminophen) Drug class Purpose of the drug Opioid analgesics To treat moderate to severe pain. Dosage PO Adults ≥50 kg Opioid-naive patients– 5–10 mg every 3–4 hr initially, as needed. Once optimal analgesia is obtained, patients with chronic pain may be converted to an equivalent 24-hr dose given in 2 divided doses as extended-release tablets every 12 hr. PO Adults <50 kg Opioid-naive patients– 0.2 mg/kg every 3–4 hr initially, as needed. Once optimal analgesia is obtained, patients with chronic pain may be converted to an equivalent 24-hr dose given in 2 divided doses as extended-release tablets every 12 hr. PO Children ≥11 yr 0.05–0.15 mg/kg every 4–6 hr as needed, as immediate-release product. Once optimal analgesia is obtained, Interactions Common Side Effects Adverse Effects patients with chronic pain may be converted to an equivalent 24-hr dose given in 2 divided doses as extended-release tablets every 12 hr. Use with caution in patients receiving MAO inhibitors (may result in unpredictable reactions decrease initial dose of oxycodone to 25% of usual dose). Additive CNS depression with alcohol, antihistamines, & sedative/hypnotics. Administration of partial-antagonist opioid analgesics may precipitate withdrawal in physically dependent patients. Nalbuphine/ buprenorphine may decrease analgesia. Concurrent use of CYP3A4 inhibitors including ritonavir, ketoconazole, itraconazole, fluconazole, clarithromycin, erythromycin, nefazodone, diltiazem, verapamil, nelfinavir, & fosamprenavir can increase levels & risk of opioid toxicity; careful monitoring during initiation, dose changes, or discontinuation of the inhibitor is recommended. When taking alongside benzodiazepines or other CNS depressants including other opioids, non-benzodiazepine sedative/hypnotics, anxiolytics, general anesthetics, muscle relaxants, antipsychotics, & alcohol may cause profound sedation, respiratory depression, coma, and death; reserve concurrent use for when alternative treatment options are inadequate. confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams, orthostatic hypotension, sweating, blurred vision, dry mouth, constipation, nausea. Respiratory depression Unique information (antidotes, nursing considerations/teaching points, criteria that must be met to give or hold the medication, and contraindications): Discuss how to properly take medication and if stopped suddenly the chances of having withdrawal symptoms, assess abuse potential, protect it from theft, never share medication, tell patient to avoid alcohol and other CNS depressants. Trade & Generic name Digoxin (Lanoxin) Drug class Purpose of the drug Antiarrhythmics To treat heart failure, atrial fibrillation/ flutter, paroxysmal atrial tachycardia. Dosage IV/ IM -Adults Digitalizing dose– 0.5–1 mg given as 50% of the Interactions dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. IV/ IM-Children >10 yr Digitalizing dose– 8–12 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. IV /IM -Children 5–10 yr Digitalizing dose– 15–30 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. PO Adults Digitalizing dose– 0.75–1.5 mg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 0.125–0.5 mg/day depending on patient's lean body weight, renal function, and serum level. PO Geriatric Patients-Initial daily dose should not exceed 0.125 mg. PO Children >10 yr Digitalizing dose: 10–15 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 2.5–5 mcg/kg given daily as a single dose. PO Infants (full term) Digitalizing dose: 25–35 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 6–10 mcg/kg given daily in 2 divided doses Thiazide and loop diuretics, piperacillin/tazobactam, amphotericin B, corticosteroids, and excessive use of laxatives may cause hypokalemia which may increase risk of toxicity. Quinidine and ritonavir may increase levels and lead to toxicity; decrease digoxin dose by 30–50%. Amiodarone may increase levels and lead to toxicity; decrease digoxin dose by 50%. Cyclosporine, itraconazole, mirabegron, propafenone, quinine, spironolactone, and verapamil may increase levels and lead to toxicity; serum level monitoring/dose decrease may be required. Levels may be decrease by some antineoplastics (bleomycin, carmustine, cyclophosphamide, cytarabine, doxorubicin, methotrexate, procarbazine, vincristine), activated charcoal, cholestyramine, colestipol, metoclopramide, penicillamine, rifampin, or sulfasalazine. In a small percentage (10%) of patients gut bacteria metabolize digoxin to inactive compounds macrolide anti-infectives (erythromycin, azithromycin, clarithromycin ) and tetracyclines , by killing these bacteria, will cause increase levels and toxicity; dose may need to be ↓ for up to 9 wk. Additive bradycardia may occur with beta blockers, diltiazem, verapamil, clonidine, ivabradine, and other antiarrhythmics (quinidine, disopyramide). Concurrent use of sympathomimetics may increase risk of Common Side Effects Adverse Effects Unique information (antidotes, nursing considerations/teaching points, criteria that must be met to give or hold the medication, and contraindications): arrhythmias. Thyroid hormones may decrease therapeutic effects. fatigue, headache, weakness, blurred vision, yellow or green vision, anorexia, nausea, vomiting, diarrhea. Heart arrhythmias Advise patient to take meds as directed and the same time daily. Teach how to measure medication for infants/children. Any missed doses should be taken within 12hrs or just omitted. Instruct patient to take pulse before taking medication and contact doctor if less than 60 or over 100 beats per min. Go over signs of digitalis toxicity w/ patient and family. Notify doctor before starting any new medications or herbal products and all that you are currently taking. Females should let doctor know if becoming pregnant or trying to get pregnant.