Drug Card Update

8/8/2019 Drug Card Update

1/13

Name OTC/

Prescription

Dosage Classification &

Mechanism of Action of

Drug

Nursing Consideration

Acetaminophen Dosage forms: 325,500,650; 120,160/5 mL;

500/15 mL; 325,650 supp

pain, mild

[325-1000 mg PO/PR q4-6h]

Max: 1 g/dose, 4 g/24h

fever

[325-1000 mg PO/PR q4-6h]

Max: 1 g/dose, 4 g/24h

renal dosing

[adjust dose frequency]CrCl 10-50: give q6h; CrCl 1wk; retain x15-20min

renal dosing

[not defined]

hepatic dosing

[not defined]

Gastrointestinal

Mechanism of Action

increases peristalsis

hypersens. to

drug/class/compon.

acute abdomen

abdominal pain,

undiagnosed

nausea/vomiting,

undiagnosed

GI obstruction or ileu

GI perforation

toxic megacolon

gastroenteritis

rectal bleeding

appendicitis

caution if inflammato

bowel dz


2/13


3/13

Name OTC/

Prescription



Drug


Glipizide Dosage forms: 5,10; 2.5,5,10 ER

diabetes mellitus, type 2

[2.5-20 mg PO qd-bid]

Start: 5 mg PO qd or 2.5 mg PO qd in

elderly pts; Max: 40 mg/day or 20 mg/day

ER; Alt: 5-10 mg ER PO qd; Info: fornon-ER form, div doses >15 mg/day and

give 30min before meals; do notcut/crush/chew ER form

renal dosing

[adjust dose amount]

CrCl


4/13

Alt: 20 mg IV q12h; Info: if unable to

take PO may use IV short term only

Zollinger-Ellison syndrome

[20-60 mg PO q6h]

Max: 160 mg PO q6h; Alt: 20 mg IVq12h

intractable ulcers

[20 mg IV q12h]

renal dosing

[adjust dose amount, frequency]

CrCl


5/13

renal dosing

[see below]

renal impairment: caution advised; renal

failure: IV use contraindicated

hepatic dosing

[not defined]

caution if dehydratio

caution if extensive t

breakdown (burns,

chemo)

caution in elderly pts

Name OTC/

Prescription



Drug


Aspirin Dosage forms: 81,165,325,500,650; 81 CH;

120,200,300,600 PR

pain/fever

[325-650 mg PO q4h prn]

Alt: 300-600 mg PR q4-6h prn; Max: 4

g/day PO

acute coronary syndrome

[162-325 mg PO x1]

Info: chew tab

MI prevention

[81-325 mg PO qd]

TIA/thrombotic stroke prevention

[75-325 mg PO qd]

*arthritis

[2.6-5.4 g PO qd div q4-6h]

*rheumatic fever

[5-8 g PO qd div q4-6h x1-2wk]

Info: taper dose over next 2-8wk

renal dosing

[see below]

CrCl


6/13

hepatic dosing

[not defined]

impairment

caution if sodium

restriction (buffered A

forms)


7/13

Name OTC/

Prescription



Drug


Simvastatin Dosage forms: 5,10,20,40,80

hypercholesterolemia

[5-80 mg PO qpm]

Start: 20 mg PO qpm; 40 mg qpm for

LDL reduction goal >45%; Max: 80

mg/day; Info: see Drug Interactions fordose adjustments based on concurrent tx

hypertriglyceridemia

[5-80 mg PO qpm]

Start: 20 mg PO qpm; Max: 80 mg/day;

Info: see Drug Interactions for dose

adjustments based on concurrent tx

dysbetalipoproteinemia

[5-80 mg PO qpm]




familial hypercholesterol., homozygous

[40 mg PO qpm]

Max: 80 mg/day; Alt: 80 mg/day dividedtid into 20, 20, and 40 mg doses; Info: see

Drug Interactions for dose adjustments

based on concurrent tx

cardiovascular event risk reduction

[5-80 mg PO qpm]




renal dosing


severe impairment: start 5 mg qpm;

HD/PD: not defined

hepatic dosing

[see below]

Cardiovascular

Mechanism of Action

inhibits 3-hydroxy-3-

methylglutaryl-coenzyme A

(HMG-CoA) reductase

hypersens. todrug/class/compon.

hepatic dz, active

elevated LFTs,

unexplained

pregnancy

breastfeeding

myopathy

markedly elevated C

hypotension

sepsis/acute infection

endocrine dz, severe

metabolic dz, severe

electrolyte imbalance

severe

dehydration

seizure disorder,

uncontrolled

surgery, major

trauma

caution if hepatic dz

caution if renal

impairment

caution if alcohol abu


8/13

active hepatic dz/unexplained elev. LFTs:

contraindicated

Name OTC/

Prescription



Drug


Senna S(Sennosides/Docu

sate Sodium)

Dosage forms: 50/8.6

constipation

[1-2 tab PO qd-bid]

Info: onset 6-12h

renal dosing

[not defined]

hepatic dosing

[not defined]

GastrointestinalMechanism of Action

combination: see individual

drugs


intestinal obstruction

fecal impaction

abdominal pain,undiagnosed

mineral oil use

caution if nausea/vom

caution if sodium

restriction

caution if CHF

caution if renalimpairment, severe

caution if HTN

Name OTC/

Prescription



Drug


Metoclopramide Dosage forms: 5,10; 5/5 mL; IM; IV

GERD

[chronic sx]

Dose: 10-15 mg PO/IM/IV qac and qhs;

Max: x12wk; Info: decr. dose 50% in

elderly pts; give 30min before meals[intermittent sx]

Dose: up to 20 mg PO/IM/IV x1 before sx

diabetic gastroparesis

[10 mg PO/IM/IV qac and qhs]Max: x12wk; Info: decr. dose 50% in

elderly pts; give 30min before meals

nausea/vomiting prevention, chemo-related

[1-2 mg/kg IV q2-3h]

Info: give 30min prior to chemo, then

repeat q2h x2 doses, then repeat q3h x3

GastrointestinalMechanism of Action

exact mechanism of action

unknown; sensitizes tissues

to acetylcholine, stimulating

upper GI tract motility;

antagonizes central and

peripheral dopaminereceptors, producing

antiemetic effects


pheochromocytoma

seizure disorder

GI bleed or perforati

GI obstruction

avoid use >12wk

caution if depression

caution if Parkinson'

caution if NADH

methemoglobin redu

deficiency

caution if HTN

caution if CHF

caution if cirrhosis


9/13

doses; pretreat w/ diphenhydramine to

decr. EPS; not 1st-line agent

nausea/vomiting prevention, postop

[10 mg IM/IV x1]

Alt: 20 mg IM/IV x1; Info: give dose nearend of procedure; may repeat q6-8h prn;

not 1st-line agent

small bowel intubation

[10 mg IV x1 dose]

radiologic exam

[10 mg IV x1 dose]

renal dosing


CrCl 10-40: decr. dose 50%; CrCl


10/13

renal dosing


CrCl 10-30: start 5 mg qd; CrCl


11/13

Alt: 850-1000 mg PO bid; Info: may incr.

dose if inadequate response; give w/

meals; hold for iodinated contrast study[extended-release form]

Dose: 1500-2000 mg ER PO qpm; Info:

give w/ meals; hold for iodinated contrast

study; do not cut/crush/chew ER form

renal dosing

[see below]

renal impairment: contraindicated

hepatic dosing

[see below]

hepatic impairment: avoid use

caution if alcohol abu

caution if hypoglycem

risk

caution: may induce

ovulation

Lactic Acidosis can o

due to melformin

accumulation

Name OTC/

Prescription


Mechanism of Action ofDrug


Zoloft Dosage forms: 25,50,100; 20 mg/mL

major depressive disorder

[50-200 mg PO qd]

Start: 50 mg PO qd; Info: taper dosegradually to D/C

obsessive-compulsive disorder

[50-200 mg PO qd]Start: 50 mg PO qd; Info: taper dose

gradually to D/C

panic disorder

[50-200 mg PO qd]

Start: 25 mg PO qd; Info: taper dose

gradually to D/C

post-traumatic stress disorder

[50-200 mg PO qd]

Start: 25 mg PO qd x7 days, may incr. 25-

50 mg/day qwk; Max: 200 mg/day; Info:

taper dose gradually to D/C

premenstrual dysphoric disorder

[daily dosing]

Dose: 50 mg PO qd; may incr. 50 mg/day

Psychiatric

Mechanism of Action

selectively inhibits

serotonin reuptake

hypersens. to

drug/class/compon.

see Drug Interactions

MAO inhibitor use w

14 days

disulfiram use (oral s

caution in pts


12/13

each cycle; Max: 150 mg/day; Info: taper

dose gradually to D/C[luteal phase dosing]

Dose: 50 mg PO qd on cycle days 15-28;

Max: 100 mg/day; Info: begin each cycle

w/ 50 mg/day x3 days

social anxiety disorder

[50-200 mg PO qd]

Start: 25 mg PO qd x7 days; Info: taper

dose gradually to D/C

renal dosing

[no adjustment]

HD/PD: not defined

hepatic dosing

[adjust dose amount, frequency]

hepatic impairment: decr. dose or

frequency, amount not defined


13/13

Name OTC/

Prescription



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Name OTC/Prescription Dosage Classification &Mechanism of Action of

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