Clinical Drug Assignment

CLASSIFICATION: Inotropic Dysrhythmic, cardiac glycoside

• USES: Rapid digitalization in acute and chronic CHF, atrial fibrillation, atrial flutter, atrial tachycardia; cardiogenic
• shock, paroxysmal atrial tachycardia

• CONTRAINDICATIONS: Hypersensitivity to digoxin, ventricular fibrillation, ventricular tachycardia, carotid sinus syndrome, 2nd-or
• 3rd degree heart block

ADVERSE REACTIONS: Headache, drowsiness, apathy, confusion, dysrhythmias, AV block, blurred vision, nausea, vomiting

• PATIENT TEACHING: Avoid OTC meds; Notify prescriber of any loss of appetite, lower stomach pain, diarrhea, weakness, drowsiness, headache,
• blurred or yellow-green vision, rash, depression: teach toxic symptoms and when to call MD; NA+ restricted diet as ordered, K supplements to avoid toxicity

LAB VALUES TO WATCH: Electrolytes (K, NA+, CL, MG, CA+), Renal function studies: BUN, Creatinine; other blood studies: ALT, AST, bilirubin, H&H

NAME: PANTOPRAZOLE (PROTONIX)

CLASSIFICATION: Proton Pump Inhibitor

USES: Gastroesophageal reflux disease (GERD), severe erosive esophagitis, maintenance, long-term pathological hypersecretory conditions including Zollinger-Ellison syndrome

CONTRAINDICATIONS: Hypersensitivity

ADVERSE REACTIONS: Headache, insomnia, diarrhea, abdominal pain, flatulence, rash, hyperglycemia

PATIENT TEACHING: Report severe diarrhea; product may have to be discontinued. Advise diabetic pt that hyperglycemia may occur. Advise pt to avoid hazardous activities,dizziness may occur. Advise pt to avoid alcohol, salicylates, ibuprofen; may cause GI upset.

LAB VALUES TO WATCH: Hepatic enzymes: AST, ALT, alkaline phosphatase

NAME: DOCUSATE CALCIUM (COLACE)

CLASSIFICATION: Laxative, emollient

USES: To soften stools, prevent constipation, soften fecal impaction (rectal route)

CONTRAINDICATIONS: Hypersensitivity, obstruction, fecal impaction, nausea/vomiting

ADVERSE REACTIONS: Bitter taste, throat irritation, nausea, anorexia, cramps, diarrhea, rash

• PATIENT TEACHING: Discuss with pt that adequate fluid consumption is as necessary as bulk, exercise for adequate bowel
• function. Teach pt that normal bowel movements do not always occur daily. Advise pt not to use in presence of abd pain, nausea, vomiting. Advise pt that product may take up to 3 daysto soften stools.

LAB VALUES TO WATCH: None

NAME: FUROSEMIDE (LASIX)

CLASSIFICATION: Loop Diuretic

USES: Edema in CHF, nephritic syndrome, ascites, caused by hepatic disease, hepatic cirrhosis

• CONTRAINDICATIONS: Hypersensitivity to sulfonamides; anuria, hypovolemia, breastfeeding, infants, electrolyte
• depletion

• ADVERSE REACTIONS: circulatory collapse, loss of hearing, Hypokalemia, Hypochloremic alkalosis, hypo
• magnesemia, hyperuricemia, hypocalcemia, hyponatremia, metabolic acidosis, hyperglycemia, nausea, Polyuria, Glycosuria, pruritis, renal failure,
• thrombocytopenia

• PATIENT TEACHING: Take early in day to prevent nocturia. Maintain record of
• weight weekly and notify md if loss >5lb. Add potassium rich foods to diet, caution for orthostatic hypotension

LAB VALUES TO WATCH: Electrolytes (K, NA+, CA+, MG), BUN, Blood pH, ABGs, Uric Acid, CBC, blood glucose

NAME: HEPARIN

CLASSIFICATION: Anticoagulant, antithrombotic

USES: Prevention of DVT and PE, MI, open heart surgery, disseminated intravascular clotting syndrome, atrial fibrillation with embolization, as an anticoagulant in transfusion and dialysis procedures, to maintain patency of indwelling venipuncture devices, diagnosis, treatment of disseminated intravascular coagulation (DIC)

• CONTRAINDICATIONS: Hypersensitivity, hemophilia, leukemia with bleeding, peptic ulcer disease, severe
• thrombocytopenic purpura, renal/hepatic disease (severe), blood dyscrasias, severe hypertension, subacute bacterial endocarditits, acute nephritis

ADVERSE REACTIONS: Fever, hematuria, hemorrhage, thrombocytopenia, anemia, rash, anaphylaxis

• PATIENT TEACHING: Avoid OTC preparations unless directed by prescriber. Tell pt that product may be held during active bleeding
• (menstruation), depending on condition. Use soft-bristle toothbrush to avoid bleeding gums; avoid contact sports, use electric razor, avoid IM injections. Advise pt to report any signs of bleeding even after discontinuing product.

LAB VALUES TO WATCH: Hct, blood in stools q3 mos. PTT, platelet count

NAME: WARFARIN (COUMADIN)

CLASSIFICATION: Anticoagulant

USES: DVT, prevention or treatment of venous thrombosis, pulmonary embolism, thromboembolic complications associated with atrial fibrillation or cardiac valve replacement, after MI to reduce risk of death

• CONTRAINDICATIONS: Pregnancy X, breastfeeding, hypersensitivity, hemophilia, leukemia with bleeding, peptic ulcer disease, thrombocytopenic
• purpura, hepatic disease (severe), malignant hypertension, subacute bacterial endocarditis, acute nephritis, blood dyscrasias, preeclampsia, eclampsia,
• hemorrhagic tendencies

• ADVERSE REACTIONS: Fever, diarrhea, hepatitis, hematuria, hemorrhage, agranulocytosis, leukopenia, eosinphilia,
• rash, anaphylaxis, exfoliative dermatitis, purple toe syndrome

• PATIENT TEACHING: Avoid OTC preparations unless directed by prescriber. Tell pt that product may be held during active bleeding
• (menstruation), depending on condition. Use soft-bristle toothbrush to avoid bleeding gums; avoid contact sports, use electric razor, avoid IM injections. Advise pt to report any signs of bleeding even after discontinuing product. LIMITED INTAKE OF VIT K

LAB VALUES TO WATCH: Hct, PTT, INR, B/P

NAME: HYDROCODONE/ACETAMINOPHEN (VICODIN)

CLASSIFICATION: Antitussive opioid analgesic/ nonopioid analgesic

USES: Hyperactive and nonproductive cough, mild to moderate pain

CONTRAINDICATIONS: Hypersensitivity, addiction (opioid)

ADVERSE REACTIONS: Drowsiness, seizures, circulatory depression, nausea, vomiting, anorexia, constipation, respiratory depression

PATIENT TEACHING: Instruct pt to report any symptoms of CNS changes, allergic reactions; to avoid CNS depressants: alcohol, sedative/hypnotics for at least 24 hr after taking this product. Teach pt that dizziness, drowsiness, and confusion are common and to avoid getting up without assistance, driving, or other hazardous activities

LAB VALUES TO WATCH: VS, respirations – notify prescriber if <10/min

NAME: BABY ASPIRIN (81 MG)

CLASSIFICATION: Nonopioid analgesic

USES: Mild to moderate pain or fever including rheumatoid arthritis, osteoarthritis, thromboembolic disorders, transient ischemic attacks in men, rheumatic fever, post-MI, prophylaxis of MI, ischemic stroke, angina

CONTRAINDICATIONS: Pregnancy D (3rd trimester), breastfeeding, children <12yr, children with flulike symptoms, hypersensitivity to salicylates, tartrazine (FDC yellow dye #5), GI bleeding, bleeding disorders, vit K deficiency, peptic ulcer

• ADVERSE REACTIONS: Tinnitus, hypoclycemia, hyponatremia, Hypokalemia, nausea, vomiting, GI bleeding,
• Reye’s Syndrome (children), anaphylaxis, laryngeal edema

• PATIENT TEACHING: Teach pt to report any symptoms of renal/hepatic toxicity, visual changes, ototoxicity, allergic
• reactions, bleeding (long term therapy) Take with 8oz water, do not exceed recommended dosage, advise pt to
• read label on other OTC products; many contain aspirin. Avoid alcohol

LAB VALUES TO WATCH: Liver function studies: AST, ALT, bilirubin, Creatinine if pt is on long-term therapy

NAME: REGULAR INSULIN

CLASSIFICATION: Antidiabetic, pancreatic hormone

USES: Type 1 DM, Type 2 DM, gestational diabetes

CONTRAINDICATIONS: Hypersensitivity to protamine, creosol (aspart)

ADVERSE REACTIONS: Hypoglycemia, rebound hyperglycemia, anaphylaxis, lipodystrophy, flushing, rash, Urticaria, warmth, lipohypertrophy, swelling, blurred vision, dry mouth

• PATIENT TEACHING: Advise pt that blurred vision occurs; not to change corrective lens until vision is stabilized 1-2 mos. Advise pt to keep
• insulin, equipment available at all times; carry a glucagons kit, candy, or lump sugar to treat hypoglycemia.
• Instruct pt to recognize hypoglycemia reaction: headache, tremors, fatigue, weakness. Instruct pt to
• recognize hyperglycemia reaction: frequent urination, thirst, fatigue, hunger.

LAB VALUES TO WATCH: Fasting blood glucose, self monitoring glucose check, A1c

NAME: LANTUS

CLASSIFICATION: Antidiabetic, pancreatic hormone

USES: Type 1 DM, Type 2 DM, gestational diabetes

CONTRAINDICATIONS: Hypersensitivity to protamine, creosol (aspart)

ADVERSE REACTIONS: Hypoglycemia, rebound hyperglycemia, anaphylaxis, lipodystrophy, flushing, rash, Urticaria, warmth, lipohypertrophy, swelling, blurred vision, dry mouth

PATIENT TEACHING: Advise pt that blurred vision occurs; not to change corrective lens until vision is stabilized 1-2 mos. Advise pt to keep insulin, equipment available at all times; carry a glucagons kit, candy, or lump sugar to treat hypoglycemia. Instruct pt to recognize hypoglycemia reaction: headache, tremors, fatigue, weakness. Instruct pt to recognize hyperglycemia reaction: frequent urination, thirst, fatigue, hunger.

LAB VALUES TO WATCH: Fasting blood glucose, self monitoring glucose check, A1c

NAME: NPH

CLASSIFICATION: Antidiabetic, pancreatic hormone

USES: Type 1 DM, Type 2 DM, gestational diabetes

CONTRAINDICATIONS: Hypersensitivity to protamine, creosol (aspart)

ADVERSE REACTIONS: Hypoglycemia, rebound hyperglycemia, anaphylaxis, lipodystrophy, flushing, rash, Urticaria, warmth, lipohypertrophy, swelling, blurred vision, dry mouth

• PATIENT TEACHING: Advise pt that blurred vision occurs; not to change corrective lens until vision is stabilized 1-2 mos. Advise pt to keep
• insulin, equipment available at all times; carry a glucagons kit, candy, or lump sugar to treat hypoglycemia. Instruct pt to recognize hypoglycemia reaction: headache, tremors, fatigue, weakness. Instruct pt to recognize hyperglycemia reaction: frequent urination, thirst, fatigue, hunger.

LAB VALUES TO WATCH: Fasting blood glucose, self monitoring glucose check, A1c

NAME: LENTE

CLASSIFICATION: Antidiabetic, pancreatic hormone

USES: Type 1 DM, Type 2 DM, gestational diabetes

CONTRAINDICATIONS: Hypersensitivity to protamine, creosol (aspart)

ADVERSE REACTIONS: Hypoglycemia, rebound hyperglycemia, anaphylaxis, lipodystrophy, flushing, rash, Urticaria, warmth, lipohypertrophy, swelling, blurred vision, dry mouth

PATIENT TEACHING: Advise pt that blurred vision occurs; not to change corrective lens until vision is stabilized 1-2 mos. Advise pt to keep insulin, equipment available at all times; carry a glucagons kit, candy, or lump sugar to treat hypoglycemia. Instruct pt to recognize hypoglycemia reaction: headache, tremors, fatigue, weakness. Instruct pt to recognize hyperglycemia reaction: frequent urination, thirst, fatigue, hunger.

LAB VALUES TO WATCH: Fasting blood glucose, self monitoring glucose check, A1c

NAME: 70/30 NPH/Reg

CLASSIFICATION: Antidiabetic, pancreatic hormone

USES: Type 1 DM, Type 2 DM, gestational diabetes

CONTRAINDICATIONS: Hypersensitivity to protamine, creosol (aspart)

ADVERSE REACTIONS: Hypoglycemia, rebound hyperglycemia, anaphylaxis, lipodystrophy, flushing, rash, Urticaria, warmth, lipohypertrophy, swelling, blurred vision, dry mouth

PATIENT TEACHING: Advise pt that blurred vision occurs; not to change corrective lens until vision is stabilized 1-2 mos. Advise pt to keep insulin, equipment available at all times; carry a glucagons kit, candy, or lump sugar to treat hypoglycemia. Instruct pt to recognize hypoglycemia reaction: headache, tremors, fatigue, weakness. Instruct pt to recognize hyperglycemia reaction: frequent urination, thirst, fatigue, hunger.

LAB VALUES TO WATCH: Fasting blood glucose, self monitoring glucose check, A1c