Drug Card 1

Andy Samelson's Drug Cards CLASS: Anti arrhythmic

Andy Samelson's Drug Cards Digoxin

Generic: digoxinTrade: Digitek, Lanoxin

Action: CHF – increases contractility Arrhythmias – Slows AV node impulse

Uses: Congestive heart failure, decreases arrhythmias and tachycardia.

Dosage Range: Oral- 0.125 mg – 0.5 mg I.V. or I.M.- 0.1 mg – 0.4 mg

Route: Capsule, I.V. or I.M.

Pharmacodynamics: Onset- (PO.) 1-2 hr (I.M.) 5-30 min Peak- (PO) 2-8 hr. (I.V) 1-4 hr

Common Side Effects: Dizziness, orthostatic hypotension, blurred or yellow vision, headache, fatigue, N.V.D.

Nursing Implications: Check apical pulse before administration, monitor B/P, instruct patients to notify physician if experiencing side effects.

Drug Interactions: Benzos, Quinidine, various antibiotics can increase level of digoxin. Loop diuretics can cause dig toxicity.

Andy Samelson's Drug Cards CLASS: Loop Diuretic

Andy Samelson's Drug Cards Lasix

Generic: furosemideTrade: Lasix

Action: Inhibits reabsorption of sodium and chloride in ascending loop of Henle, increasing excretion of water, sodium, magnesium, and calcium.

Uses: Edema r/t CHF or renal disease, management of HTN.

Dosage Range: Oral- 20-80mg/day – increase slowly to desired range. 2X daily for edema. Route: Tablet, PO solution , I.V. or I.M.

Pharmacodynamics: Duration- 12-24 hr.

Common Side Effects: N.V.D., orthostatic hypotension, dizziness, fatigue, electrolyte imbalance.

Nursing Implications: Monitor B/P, orthostasis, electrolyte levels, and monitor for hearing problems (I.V. and parenteral).

Drug Interactions: Can cause hypokalemic digoxin toxicity, hypotension with antihypertensives, salicylates (high dose) toxicity.

Andy Samelson's Drug Cards CLASS: diuretic

Andy Samelson's Drug Cards hydrochlorothiazide (HCTZ)

Generic: hydrochlorothiazide (HCTZ)Trade: Aquazide H, Hydrocot, Oretic, Microzide

Action: Inhibits sodium reabsorption, increasing excretion of sodium, water, and potassium.

Uses: mild HTN, edema in renal failure and CHF.

Dosage Range: Oral- 25-100mg/day max:200mg/day

Route: Capsule, tablet

Pharmacodynamics: Onset- (PO.) 2 hr. Peak- (PO) 4 hr.

Common Side Effects: N.V.D., orthostatic hypotension, dizziness, fatigue, electrolyte imbalance.

Nursing Implications: Monitor B/P, orthostasis, electrolyte levels, interactions with digoxin..

Drug Interactions: Can cause hypokalemic digoxin toxicity, hypotension with antihypertensives, NSAIDs can reduce efficacy.

Andy Samelson's Drug Cards CLASS: Thyroid agent

Andy Samelson's Drug Cards levothyroxine

Generic: levothyroxineTrade: Synthroid, Levoxyl, Levothroid, Unithroid

Action: Elevates metabolic activity by acting as a replacement thyroid hormone.

Uses: Hypothyroidism, pituitary TSH suppression.

Dosage Range: Oral- 1.7 mcg/kg/day I.V./I.M. 50% of oral dose

Route: injection, powder for re-constitution, tablet.

Pharmacodynamics: Onset- (PO.) 3-5 days (I.V./I.M.) 6-8 hr. Peak- 4-6 weeks to see effective action for each dose.

Common Side Effects: elevated B/P, tachycardia, arrhythmia, anxiety, insomnia, increased appetite, decreased bone density, diaphoresis, heat intolerance.

Nursing Implications: I.V. Form must be prepared immediately before administration. Monitor TSH levels, B/P, heart rate, and other side effects.

Drug Interactions: Iron decreases absorption, may have interactions with antidiabetic agents, Ketamine may cause marked HTN, tricyclics change therapeutic index for both drugs.

Andy Samelson's Drug Cards CLASS: ACE inhibitor

Andy Samelson's Drug Cards Vasotec

Generic: enalaprilTrade: Vasotec

Action: Prevents angiotensin 1 conversion to angiotensin 2, reduces aldosterone secretion, ultimately lowering blood pressure.

Uses: Mild to severe HTN, diabetic nephropathy, CHF..

Dosage Range: Oral- 2.5 mg - 5 mg/day then increase as required. I.V.- 1.25 mg/q6hr. Route: injection, tablet

Pharmacodynamics: Onset- (PO.) 1 hr. Peak- (PO) 4-8 hr. Duration-(PO) 12-24 hr.

Common Side Effects: orthostatic hypotension, headache, dizziness, fatigue, N.V.D. Anorexia.

Nursing Implications: Monitor B/P, orthostasis, possible depression, angioedema, instruct patients not to stop abruptly..

Drug Interactions: insulin causes possible hypoglycemia, aspirin dulls effects, lithium toxicity increases, increased risk of hyperkalemia with potassium-sparing diuretics.

Andy Samelson's Drug Cards CLASS: antibiotic

Andy Samelson's Drug Cards sulfamethoxazole and trimethoprim

Generic: sulfamethoxazole and trimethoprimTrade: Bactrim, Septra

Action: Inhibits bacterial synthesis and growth (bacteriostatic).

Uses: oral treatment of UTIs, acute exacerbations of chronic bronchitis, enteritis from Shigella. I.V. treatment of typhoid, PCP (yeast-like fungus that causes pneumonia.) in immuno-compromised patients.

Dosage Range: Oral- one 800/600mg tab qd x12d I.V.- 8-10mg/kg/day x 12 days

Route: injection, oral suspension, tablet & double strength tablet.Pharmacodynamics: N/A

Common Side Effects: N.V. Anorexia, urticaria.

Nursing Implications: Not for I.M. Injection, must dilute well, take with water on empty stomach, maintain adequate fluid intake to ease strain on kidneys.

Drug Interactions: may increase hyperkalemia with ACE inhibitors and potassium-sparing diuretics, may potentiate Warfarin, increase toxicity of methotrexate.

Andy Samelson's Drug Cards CLASS: antibiotic, PCN

Andy Samelson's Drug Cards amoxicillin

Generic: amoxicillinTrade: Trimox

Action: Inhibits bacterial cell-wall synthesis, and eventually lyses them. (Bacteriocidal)

Uses: treatment of ear, sinus, skin, urinary, and respiratory infections, prophylaxis for surgery, part of multi-drug regimen for H. pylori.

Dosage Range: Oral- (typical) 500mg q12hr

Route: capsule, oral suspension, tablet, chewable

Pharmacodynamics: N/A

Common Side Effects: N.V.D. Dermatitis, possible Stevens-Johnson syndrome, possible behavioral changes.

Nursing Implications: Assess for infection during regimen, monitor for anyphylaxis, C&S before first dose, administer round the clock, instead of just daylight hours, S&S of infection should disappear within 1-2 days.

Drug Interactions: may decrease efficacy of oral contraceptives, may increase effects of warfarin.


Andy Samelson's Drug Cards vancomycin

Generic: vancomycinTrade: Vancocin

Action: Inhibits cell wall synthesis of bacteria.

Uses: MRSA, meningitis, C. difficile

Dosage Range: Oral- 125mg qid x 10d I.V.- 10-15mg/kg or 1G q12hr

Route: injection, capsule, infusion


Common Side Effects: N.V. Stomatitis, chills, hypotension, rash.

Nursing Implications: P&T drawn, slow infusion rate if rash appears, dosage modification for renal impairment, do no give I.M., do not administer anti-diarrheal products for patients on oral vancomycin.

Drug Interactions: increased toxicity in: anesthetic agents and/or other ototoxic or nephrotoxic agents.

Andy Samelson's Drug Cards CLASS: antipsychotic

Andy Samelson's Drug Cards Zyprexa

Generic: olanzapineTrade: Zyprexa, Zydis

Action: antagonism of dopamine and serotonin receptor sites.

Uses: schizophrenia, acute manic episodes of bi-polar disorder, maintenance of bi-polar disorder.

Dosage Range: 5-10 mg qd, titrate to max 20mg

Route: injection, tablet


Potential Side Effects: hypotension, anticholinergic effects, arrhythmia, pseudoparkinsonism, dystonia, hyperglycemia, sedation, weight gain

Nursing Implications: P&T drawn, slow infusion rate if rash appears, dosage modification for renal impairment, do no give I.M., do not administer anti-diarrheal products for patients on oral vancomycin.

Drug Interactions: increased toxicity in: anesthetic agents and/or other ototoxic or nephrotoxic agents.

Andy Samelson's Drug Cards CLASS: anticoagulant

Andy Samelson's Drug Cards warfarin

Generic: warfarinTrade: Coumadin

Action: interferes with hepatic synthesis of Vit K dependent coagulation factors.

Uses: prophylaxis and treatment of venous thrombosis, pulmonary embolism, after M.I.

Dosage Range: 2-5 mg qd


Pharmacodynamics: Onset: 36-72 hr. Peak: 5-7 days

Common Side Effects: Prolonged bleeding, headache, hematuria, N.V.D., hemoptysis

Nursing Implications: Avoid all I.M. Injections, monitor for S&S of bleeding.

Drug Interactions: Numerous – primarily decreased or increased efficacy of warfarin.


Andy Samelson's Drug Cards heparin

Generic: heparinTrade: Hep-lock

Action: prevents conversion of fibrinogen to fibrin (prevents clots).

Uses: prophylaxis and treatment of thromboembolic disorders.

Dosage Range: line patency: 100 units DVT prophylaxis: 5000 u SQ q8-12hr M.I.: rates vary with scenario

Route: infusion, injection.

Pharmacodynamics: Onset: subQ- 20-30 min I.V. - immediate Duration: dose-dependant

Common Side Effects: bruising, prolonged bleeding, rebound hyperlipidemia on D/C, osteoporosis, persistent erection.

Nursing Implications: Do not administer I.M. - watch for S&S of bleeding.

Drug Interactions: NSAIDs, aspirin, may potentiate. Nitroglycerin may decrease efficacy, nicotine, digoxin, and antihistamines all may potentiate.

Andy Samelson's Drug Cards CLASS: insulin

Andy Samelson's Drug Cards regular insulin

Generic: insulin regularTrade: Humulin R, U-500, Novolin R.

Action: Breaks down blood sugar and stimulates creation of glycogen.

Uses: Diabetes type 1

Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses.

Route: injection, I.V.

Pharmacodynamics: Onset: 0.5 hr Duration: 6-8 hr

Common Side Effects: hypoglycemia, other assorted adverse effects rarely associated (frequency undetermined.)

Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Draw regular insulin first when mixing preparations. Roll vial to resuspend. Administer 15 min prior to meal.

Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Alcohol, anabolic steroids, MAOI's, salicylates all INCREASE effect.


Andy Samelson's Drug Cards Humalog

Generic: insulin lisproTrade: Humalog.



Dosage Range: SubQ: 0.5-1.2 units/kg/day in divided doses. (equipotent to regular insulin)

Route: injection

Pharmacodynamics: Onset: 0.2 – 0.5 hr Duration: 3-4 hr


Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Draw fast-acting insulins first in mixed doses. Administer 15 min prior to or after meal.



Andy Samelson's Drug Cards Ultra-Lente

Generic: insulin NPHTrade: Humulin N, Novolin N




Route: injection

Pharmacodynamics: Onset: 1-2 hr Duration: 18-24 hr


Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Draw shorter acting insulins first in mixed doses. Roll vial to resuspend.



Andy Samelson's Drug Cards insulin 70/30 (NPH and Regular)

Generic: insulin 70/30Trade: Humulin 70/30, Novolin 70/30.




Route: injection (SubQ only)



Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Roll vial to resuspend. Administer prior to breakfast and supper.


Andy Samelson's Drug Cards CLASS: antibiotic, PCN

Andy Samelson's Drug Cards penicillin

Generic: penicillinTrade: Pfizerpen, Veetids

Action: interferes with cell-wall synthesis and causes death. (Bactericidal)

Uses: Most gram + organisms, except Staph A.

Dosage Range: Varies by disease organism

Route: Infusion, injection, or tablet (Pen V)


Common Side Effects: Anyphylaxis, hypersensitivity, rash.

Nursing Implications: Administer round the clock, instead of daylight hours. Empty stomach is best.

Drug Interactions: decreases efficacy of oral contraceptives, may potentiate warfarin, tetracyclines decrease effectiveness.

Andy Samelson's Drug Cards CLASS: analgesis, narcotic

Andy Samelson's Drug Cards Percocet

Generic: Oxycodone and AcetaminophenTrade: Endocet, Percocet, Roxicet

Action: Oxycodone binds with opiate receptors, and acetaminophen inhibits production of prostaglandins while lowering fever by acting on temp control center.

Uses: moderate to severe pain.

Dosage Range: Oral- 2.5 – 5 mg q6hr Max: 4 G qd acetaminophen-based

Route: Capsule, tablet, solution


Common Side Effects: constipation, over-sedation, dysphoria, euphoria, nausea, respiratory depression, skin rash.

Nursing Implications: Monitor for pain relief, over-sedation, confusion, and constipation.

Drug Interactions: anesthetics can lead to additive CNS depression, anticholinergics can lead to paralytic ileus.

Andy Samelson's Drug Cards CLASS: gastrointestinal agent

Andy Samelson's Drug Cards Prilosec OTC

Generic: omeprazoleTrade: Prilosec OTC

Action: inhibits parietal stomach cells from producing acid.

Uses: erosive esophagitis, gastroesophageal reflux disease, ulcers.

Dosage Range: Oral- 20-40 mg/day

Route: Capsule, tablet (both delayed-release).

Pharmacodynamics: Onset:1 hr, Peak: 2hr Duration: 72 hr.

Common Side Effects: N.V.D., flatulence, headache, dizziness, taste perversion.

Nursing Implications: Maintain integrity of capsule during administration, take before eating.

Drug Interactions: May decrease excretion of methotrexate, may prolong elimination of warfarin

Andy Samelson's Drug Cards Andy Samelson's Drug Cards

CLASS: vasodilator, anti-anginal nitroglycerin

Generic: nitroglycerinTrade: Nitrek, Nitrostat, Nitro-bid

Action: Relaxes smooth muscle, dilating vessels – improves flow to ischemic regeions.

Uses: Treatment of angina pectoris, M.I., acute HTN.

Dosage Range: Oral- 2.5 - 9 mg max: 26mg qd I.V.- 5 mcg/min titrate to max 200mcg/min Ointment: 0.5 - 2” every 6 hr, + 12 hr break Patch: 0.2 – 0.4mg/hr + 12 hr break. Sublingual: 0.2 – 0.6 mg q 5 min max: 3 doses

Route: Capsule, infusion, injection, ointment, solution, tablet, trans-dermal patch.

Pharmacodynamics: Onset- (PO.) 1-3 min (Patch) 40-60 min Peak- (PO) 4-10 min.. (Patch) 1-3 hr Duration- (PO) 30-60 min (Patch) 18-24 hr

Common Side Effects: headache, hypotension, syncope (fainting from loss of O2 to brain), lightheadedness.

Nursing Implications: Do not chew or swallow sublingual form, alternate patch sites, keep patches on 12 on/12 off schedule. Call 911 if no relief after 3 sublingual doses. Must be stored in glass bottles.

Drug Interactions: alcohol can aggravate hypotension, sildenafil, tadafil, and vardenafil are strongly contraindicated for concurrent use with nitrates, as they cause severe hypotension. 24 hour period between nitrates and these drugs is recommended.

Andy Samelson's Drug Cards CLASS: antiarrhythmic agent/anticonvulsant

Andy Samelson's Drug Cards Dilantin

Generic: phenytoinTrade: Dilantin

Action: Prolongs refractory period, and decreases seizure activity.

Uses: management of grand mal seizures, prevention thereof, arrhythmias r/t dig toxicity, and trigeminal neuralgia.

Dosage Range: Oral/I.V. 100mg tid

Route: Capsule, injection, oral suspension, chewable tablet.


Common Side Effects: Hypotension, gingival hypertrophy, bradycardia, headache, insomina, blurred vission, N.V.D., folic acid depletion.

Nursing Implications: Stop enteral feedings 2 hr prior to giving. I.V. Injections should be followed with flush to avoid irritation of vein, must me diluted to <6mg/mL in saline for infusion.

Drug Interactions: Numerous, primarily involving faster metabolism of other drugs, decreasing their efficacy.


CLASS: beta blocker metoprolol

Generic: metoprololTrade: Lopressor, Toprol-XL

Action: inhibits beta1 andrenergic receptors, slowing heart-rate, and lowering blood pressure.

Uses:HTN, angina, prevention of M.I. Atrial fibrillation, CHF, or used in concurrently with ACE inhibitors and/or digoxin.

Dosage Range: Oral- 25 – 300mg/day (typical)

Route: injection, E.R. tablet.

Pharmacodynamics: Onset: 1.5 - 4 hr Duration: 10 - 20 hr

Common Side Effects: drowsiness, insomnia, decreased sexual ability, bradycardia, edema, reduced peripheral circulation, NVD, bronchospasms

Nursing Implications: Monitor for orthostatic hypotension, mental status changes, and apical and peripheral pulses.

Drug Interactions: may decrease metabolism of antipsychotic agents, NSAIDs may decrease efficacy of drug.


Andy Samelson's Drug Cards Lovenox

Generic: enoxaparinTrade: Lovenox

Action: prevents conversion of fibrinogen to fibrin (prevents clots).

Uses: prophylaxis and treatment of thromboembolic disorders, DVTs, unstable angina, and M.I.

Dosage Range: DVT prophylaxis:30-40mg bid M.I.: 1mg/kg SubQ bid with aspirin

Route: injection

Pharmacodynamics: Peak: 3 hr Duration: 275 min.

Common Side Effects: bruising, prolonged bleeding, N.V.D. injection-site hematoma.

Nursing Implications: Do not administer I.M. - watch for S&S of bleeding. SubQ only.

Drug Interactions: NSAIDs, aspirin, may potentiate. Nitroglycerin may decrease efficacy, nicotine, digoxin, and antihistamines all may potentiate.

Andy Samelson's Drug Cards CLASS: ACE Inhibitor

Andy Samelson's Drug Cards Lisinopril

Generic: lisinoprilTrade: Prinvil, Zestril

Action: Reduces blood pressure by inhibiting the renin/angiotensin chain @ angiotensin 1.

Uses: HTN, systolic CHF


Route: PO

Pharmacodynamics: Onset: 1 hr Peak: 6 hr Duration: 24 min.

Common Side Effects: hypotension, dizziness, fatigue, headache, hyperkalemia, NVD, dry cough

Nursing Implications: Watch for hypotensive effect within 1-3 hours of change/increase in dose.

Drug Interactions: Antacids (decrease concentration of ACEI), lithium – may increase blood levels because of salt retention, NSAIDs and salicylates may add to strain on kidneys.


Andy Samelson's Drug Cards morphine sulphate

Generic: morphine sulphateTrade: Roxanol, MS Contin, MSIR, Avinza, Oramorph SR

Action: Binds to opiate receptors in CNS, increasing pain threshold, altering perception of pain, and depressing CNS.

Uses: severe acute and chronic pain, pre-anesthetic, dyspnea of acute L ventricular failure and pulmonary edema.

Dosage Range: Oral- 10-30 mg Q3-4 hr PRN I.V./I.M.- 2.5 – 10 mg Q 3hr PRN

Route: Cap, tab, injection, infusion, suppository

Pharmacodynamics: Onset: 20 min - 1 hr Duration: Epidural – 48 hr. ER tabs – 8-12hr Other- 4-5 hr

Common Side Effects: diaphoresis, constipation, CNS depression, hypotension, drowsiness, dizziness, nausea, xerostomia, NVD, numerous GI problems.

Nursing Implications: Observe patient for signs of tolerance, and/or over sedation and CNS depression.

Drug Interactions: CNS depressants, alcohol, MAOIs, all can potentiate and/or increase toxicity of morphine.

Andy Samelson's Drug Cards CLASS: vasodilator, anti-anginal

Andy Samelson's Drug Cards isosorbidide dinitrate

Generic: isosorbidide dinitrateTrade: Isordil

Action: Relaxes smooth muscle, dilating vessels – improves flow to ischemic regions.

Uses: Treatment of angina pectoris, M.I., acute HTN, dysphagia.

Dosage Range: Oral- 5 - 40 mg QID Sublingual: 2.5 - 5 mg q 5 min max: 3 doses

Route: Capsule, tablet (ER and SL)

Pharmacodynamics: Onset- (PO.) 1-3 min (SL) 2 - 10 min Duration- (PO) 4-6 hr (SL) 1 - 2 hr

Common Side Effects: headache, hypotension, syncope (fainting from loss of O2 to brain), lightheadedness.

Nursing Implications: Do not chew or swallow sublingual form, Call 911 if no relief after 3 sublingual doses.

Drug Interactions: alcohol can aggravate hypotension, sildenafil, tadafil, and vardenafil are strongly contraindicated for concurrent use with nitrates, as they cause severe hypotension. 24 hour period between nitrates and these drugs is recommended.

Andy Samelson's Drug Cards CLASS: corticosteroid

Andy Samelson's Drug Cards prednisone

Generic: prednisoneTrade: Deltasone, Prednisone Intensol, Sterapred

Action: Decreases inflammation, suppresses immune system, anti-emetic effects by inhibition of emetic center prostaglandin synthesis.

Uses: hypercalcemia, rheumatic disorters, respiratory problems, organ transplant, inflammation.

Dosage Range: Oral- 1 - 10 mg QD

Route: solution, tablet

Pharmacodynamics: Loading dose first

Common Side Effects: Insomnia, nervousness, increased appetite, dizziness, hirsutism, diaphoresis.

Nursing Implications: Administer w/ meals, do not D/C abruptly

Drug Interactions: barbituates, phenytoin decrease effect. NSAIDs increase risk of ulceration in GI tract. Decreases vaccine effectiveness.

Andy Samelson's Drug Cards CLASS: oral electrolyte supplement

Andy Samelson's Drug Cards potassium chloride

Generic: potassium chlorideTrade: K-DUR, Klor-Con, Micro-K

Action: Maintains nerve impulses in heart/brain/ muscle, responsible for muscle contraction, acid-base balance, and carbohydrate metabolism.

Uses: treatment of hypokalemia

Dosage Range: Oral- 40 - 80 meq QD Route: Capsule, tablet, injection, infusion, solution


Common Side Effects: NVD, flatulence, bradycardia, kyperkalemia, pain at site of injection, dyspnea

Nursing Implications: Dilute oral preps 2-6 parts dilutant, with water or fruit juice. Wax matrix tabs must be swallowed – not dissolved in mouth, may not be given IV push.

Drug Interactions: Increased effect with potassium-sparing diuretics, ACE inhibitors.

Andy Samelson's Drug Cards CLASS: antidiabetic agent

Andy Samelson's Drug Cards metformin

Generic: metforminTrade: Glucophage

Action: Improves insulin sensitivity, and decreases hepatic synthesis of glucose.

Uses: Diabetes type 2 (non-insulin dependant)

Dosage Range: Oral- 500 mg bid – 850 mg qd

Route: oral


Common Side Effects: NVD (very common), headache, hypoglycemia, indigestion, heart palpitations.

Nursing Implications: Do not crush, break, or chew ER form. NPO patients may need it to be held to prevent hypoglycemia.

Drug Interactions: oral contraceptives, nicotine, thiazide diuretics, thyroid hormone, corticosteroids all DECREASE effect. Cimetidine increases (60%) concentration in blood.

Andy Samelson's Drug Cards CLASS: antidiabetic agent

Andy Samelson's Drug Cards glipizide

Generic: glipizideTrade: Glucotrol

Action: Improves insulin sensitivity, and decreases hepatic synthesis of glucose. Also stimulates insulin release from pancreatic beta cells.

Uses: Diabetes type 2 (non-insulin dependant)

Dosage Range: Oral- 5 mg qd

Route: oral

Pharmacodynamics: Onset- 1.5 – 2 hr Duration- 12 – 24 hr.

Common Side Effects: NVD (very common), headache, hypoglycemia, indigestion, heart palpitations, blurred vision, edema, syncope, urticaria, hepatic jaundice.

Nursing Implications: Monitor for S&S of hypoglycemia, administer 30 min prior to meals.

Drug Interactions: steroids, ACE inhibitors, beta blockers, ethanol all effect blood sugar levels.


Andy Samelson's Drug Cards ciprofloxacin

Generic: ciprofloxacinTrade: Cipro, Ciloxan

Action: Interferes with DNA synthesis in various microbial organisms

Uses: UTI, gonorrhea, opthalmic infections, sinusitis, assorted skin infections, anthrax.

Dosage Range: Oral- 400 – 600 mg bid (typical)

Route: oral, injection, IV infusion, opthalmic ointment


Common Side Effects: dizziness, headache, NVD, nervousness, insomnia, risk for super-infection.

Nursing Implications: Hold antacids 3-4 hour prior to giving, administer round the clock, encourage foods, instruct on use of opthalmic product, preferably administer on empty stomach.

Drug Interactions: low risk of increase of effects/concentrations of many other drugs.

Andy Samelson's Drug Cards CLASS: anti-convulsant

Andy Samelson's Drug Cards valproic acid

Generic: valproic acidTrade: Depakote ER

Action: Increased availability and/or mimicry of GABA. (An inhibitory neurotransmitter)

Uses: absence seizures, migraine prophylaxis, partial seizures, bi-polar disorder.

Dosage Range: Oral- 10-15mg/kg/day in 3 doses

Route: capsule, injection, tablet


Common Side Effects: children < 2yr extreme risk of hepatic failure, teratogenic effects on pregnancy, headache, somnolence, dizziness, insomnia, alopecia, NVD, weakness, tremors, arrhythmia, postural hypotension, edema, tachycardia, incontinence, constipation, weight gain, oral problems.

Nursing Implications: Monitor PT/PTT, liver enzymes, do not administer with carbonated drinks, take with food or milk, do not chew or crush.

Drug Interactions: salicylates increase toxicity, trycyclics are increased in concentration,

Andy Samelson's Drug Cards CLASS: antidepressant

Andy Samelson's Drug Cards sertraline

Generic: sertralineTrade: Zoloft

Action: SSRI

Uses: depression, OCD, PTSD, SAD

Dosage Range: Oral- 25 – 50 mg/day

Route: oral


Common Side Effects: insomnia, dizziness, fatigue, headache, xerostomia, diarrhea, ejaculatory disturbances, nervousness, decreased libido, constipation, anorexia, tremors

Nursing Implications: May increase risk of suicidal thoughts, monitor nutritional intake and weight, if somnolent – administer at bedtime.

Drug Interactions: increased risk of serotonin syndrome with serotonin agonists, alters metabolism of many other drugs.


Andy Samelson's Drug Cards venlafaxine

Generic: venlafaxineTrade: Effexor

Action: Inhibits serotonin and norephinephrine re-uptake


Dosage Range: Oral- 37.5 – 75 mg/day

Route: capsule, tablet





Andy Samelson's Drug Cards CLASS: antispasmodic agent

Andy Samelson's Drug Cards oxybutynin

Generic: oxybutyninTrade: Ditropan, Oxytrol

Action: inhibits action of acetylcholine on smooth muscle, increases bladder capacity, decreases urgency and frequency of voiding.

Uses: urinary incontinence/frequency

Dosage Range: Oral- 5 mg TID Patch- 3.9mg/day 2x weekly Route: tablet, transdermal patch

Pharmacodynamics: Onset- 30-60min Peak- 3-6hr Duration- 6-10 hr

Common Side Effects: dizziness, somnolence, xerostomia (very common), constipation, impaired urination.

Nursing Implications: Caution with geriatric patients because of anti-cholinergic activity.

Drug Interactions: anti-cholinergic and anti-histamine drugs potentiate effects. Additional sedation with alcohol and CNS depressants.

Andy Samelson's Drug Cards CLASS: vitamin

Andy Samelson's Drug Cards Vit B-12

Generic: Vit B-12Trade: Crystamine, Crysti 1000, Cyanoject, Ener-B, Nascobal

Action: coenzyme for many metabolic processes including fat and carb metabolism, protein synthesis, and hematopoesis.

Uses: pernicious anemia, b-12 deficiency, inadequate secretion of intrinsic factor.

Dosage Range: Oral- 250 mcg/day I.M./SubQ- 100-200 mcg/month

Route: oral, injection


Common Side Effects: peripheral vascular disease, anxiety, restlessness, itching, pain, NVD

Nursing Implications: IM or deep SubQ are vastly superior methods of introduction to oral. Monitor potassium concentrations in early therapy.

Drug Interactions: anticonvulsants, and metformin may decrease oral absorption.

Andy Samelson's Drug Cards CLASS: calcium channel blocker

Andy Samelson's Drug Cards diltiazem

Generic: diltiazemTrade: Cardizem, Dilacor, Tiazac

Action: relaxes coronary smooth muscle, increases myocardial O2 delivery

Uses: Oral: HTN, chronic angina Injection: atrial fibrillation


Route: oral, injection (IV)

Pharmacodynamics: Onset: 30-60 min Peak: 2-3 hr

Common Side Effects: edema, headahce, hypotension, NVD, gout, constipation, weakness, dyspnea

Nursing Implications: Do not use with beta-blockers, do not crush/chew XR tabs.

Drug Interactions: May increase concentration/potentiate many other drugs.

Andy Samelson's Drug Cards CLASS: adrenergic agonist

Andy Samelson's Drug Cards clonidine

Generic: clonidineTrade: Catapres

Action: decrease in peripheral resistance, lowering B/P and HR

Uses: moderate HTN, not recommended as first line antihypertensive

Dosage Range:Oral- 0.1 mg BID max: 2.4mg/day Patch- 0.1-0.3mg/day

Route: oral, transdermal patch, injection

Pharmacodynamics: Onset- 0.5 – 1 hr Peak- 2-4 hr Duration- 6-10 hr

Common Side Effects: drowsiness, dizziness, pruritus, dry mouth, orthostatic hypotension, headache, fatigue, skin rash at patch site.

Nursing Implications: rotate patches weekly to hairless portion of upper outer arm or chest. D/C gradually.

Drug Interactions: other CNS depressants, beta blockers, antipsychotics, and narcotics may potentiate hypotensive effects.


Andy Samelson's Drug Cards citalopram

Generic: citalopramTrade: Celexa

Action: SSRI



Route: oral solution, tablet





Andy Samelson's Drug Cards CLASS: cortiosteroid inhalant

Andy Samelson's Drug Cards fluticasone and salmeterol

Generic: fluticasone and salmeterolTrade: Advair Diskus

Action: anti-inflammatory, relaxes bronchial smooth muscle

Uses: maintenance of asthma (not acute bronchospasms), COPD

Dosage Range: one inhalation 12 hours apart.

Route: inhaled


Common Side Effects: URTI, pharyngitis, headache, NVD, sinusitis,

Nursing Implications: Do not use for acute relief of asthma attacks, wash mouth out after use to decrease infections, do not use with spacer device.

Drug Interactions: sympathomimetics may enhance toxic/adverse effects.

Andy Samelson's Drug Cards CLASS: corticosteroid

Andy Samelson's Drug Cards triamcinolone

Generic: triamcinoloneTrade: Azmacort

Action: decreases inflammation and depresses immune response.

Uses: control of asthma, management of seasonal allergies (rhinitis).

Dosage Range: 200mcg QID max: 1600mcg/day

Route: inhaled, cream, injection, oral, ointment


Common Side Effects: angioedema, CHF, HTN, vasculitis, convulsions, mood swings, cushingoid state, diabetes mellitus manifestation, hypokalemix alkalosis, abdominal distension, intraocular pressure

Nursing Implications: Evaluate mental status, inject IM in large muscle (avoid deltoid), avoid SubQ, apply topicals sparingly, dose in morning.

Drug Interactions: barbituates, phenytoin, decrease effect. Salmeterol increases effect. Salicylates increase risk of GI ulcers.

Andy Samelson's Drug Cards CLASS: beta blocker

Andy Samelson's Drug Cards atenolol

Generic: atenololTrade: Tenormin

Action: inhibits beta1 andrenergic receptors, slowing heart-rate, and lowering blood pressure.

Uses:HTN, angina, prevention of M.I. Atrial fibrillation, CHF, or used in concurrently with ACE inhibitors and/or digoxin.


Route: injection, E.R. tablet.


Common Side Effects: drowsiness, insomnia, decreased sexual ability, bradycardia, edema, reduced peripheral circulation, NVD, bronchospasms

Nursing Implications: Monitor for orthostatic hypotension, mental status changes, and apical and peripheral pulses.

Drug Interactions: may decrease metabolism of antipsychotic agents, NSAIDs may decrease efficacy of drug.

Andy Samelson's Drug Cards CLASS: antiemetic

Andy Samelson's Drug Cards ondansetron

Generic: ondansetronTrade: Zofran

Action: blocks serotonin selectively on vagal nerve terminals.

Uses: prevention of nausea associated with chemo, radiation, post-op NV

Dosage Range: Varies with treatment

Route: IM, IV, oral


Common Side Effects: fatigue, headache, drowsiness, anxiety, diarrhea, constipation, urinary retention, hypoxia.

Nursing Implications: Oral dosage should be given 30 min prior to therapy. The IV version has also been used successfully orally.

Drug Interactions: Apomorphine promotes profound hypotension concurrently.


Andy Samelson's Drug Cards fentanyl

Generic: fentanylTrade: Duragesic

Action: increases pain threshold, inhibits ascending pain pathways, alters perception of pain.

Uses: moderate to severe pain, pre-op anesthetic, chronic pain, cancer pain

Dosage Range: IM/slow IV 25-100 mcg 60 min prior to surgery.

Route: injection, IV, patch

Pharmacodynamics: Onset: IV-immediate Duration: 30-60 min


Nursing Implications: Monitor for pain relief, over-sedation, confusion, and constipation. May cause rebound respiratory depression, monitor for 12 hours after removal of patch.

Drug Interactions: anesthetics can lead to additive CNS depression, anticholinergics can lead to paralytic ileus. SSRIs may cause serotonin syndrome. MAOIs are contraindicated.

Andy Samelson's Drug Cards CLASS: antibiotic, 1st gen cephalosporin

Andy Samelson's Drug Cards cephalexin

Generic: cephalexinTrade: Keflex, Keftab, Biocef

Action: Inhibits bacterial cell wall synthesis and causes them to lyse.

Uses: RTI, skin infections, bone infections, UTI, acute bacterial endocarditis prophylaxis.

Dosage Range: Oral- 250 - 1000 mg qd Max: 4 G/day

Route: Capsule, tablet, suspension

Common Side Effects: hallucinations, NVD, agitation, angioedema, vaginitis, super infection risk.

Nursing Implications: administer on empty stomach, to increase absorption. Administer round the clock to increase P&T effectiveness.



Andy Samelson's Drug Cards CLASS: antibiotics

Andy Samelson's Drug Cards Gentamicin

Generic: gentamicinTrade: Garamycin

Action: Interferes with cell membrane on cells

Uses: Treats gram negative organisms like pseudomonas, serratia, bone infections, and septicemia.

Dosage Range: Oral- 1-2.5 mg/kg Q12

Route: ointment, injection


Common Side Effects: neurotoxicity, vertigo, ataxia, ototoxicity, nephrotoxicity

Nursing Implications: Therapeutic vs. nephrotoxic levels vary greatly, so renal tests are required to determine acceptable levels.

Drug Interactions: penicillins, cephalosporins, loop diuretics can potentiate and increase kidney difficulties.

Andy Samelson's Drug Cards CLASS: Parkinson’s agent

Andy Samelson's Drug Cards amantadine

Generic: amantadineTrade: Symmetrel

Action: antiviral for influenza, promotes dopamine increase in brain for anti-Parkinsonian effect.

Uses: treatment of drug-induced extrapyramidal symptoms, influenza A, and Parkinsons.

Dosage Range: Oral- 100-200 mg qd

Route: Capsule, tablet, syrup


Common Side Effects: Orthostatic hypotension, edema, CNS effects, nausea, xerostomia

Nursing Implications: Due not stop abruptly. If insomnia occurs, take early in the afternoon.

Drug Interactions: anti-cholinergics may potentiate, thiazide diuretics may increase toxicity.

Andy Samelson's Drug Cards CLASS: Sedative/Hypnotic

Andy Samelson's Drug Cards Zolpidem

Generic: ZolpidemTrade: Ambien

Action: Dissimilar to benzos, selective GABA agonist.

Uses: Short term insomnia

Dosage Range: Oral- 5-10 mg max @ HS

Route: Capsule, tablet

Pharmacodynamics: Onset- (PO.) 30 min. Duration: 6-8 hr.

Common Side Effects: Dizziness, headache, somnolence, increased B/P, palpitations, numerous CNS effects.

Nursing Implications: Administer on empty stomach. Assist older adults with ambulation.

Drug Interactions: Any CNS depressant can potentiate the effects of this drug.

Andy Samelson's Drug Cards CLASS: Stool Softener

Andy Samelson's Drug Cards docusate

Generic: docusateTrade: Colace

Action: Reduces fecal surface tension, allowing for greater incorporation of water and lipids in stool.

Uses: Stool softener

Dosage Range: 50-500 mg/day in 4 divided doses

Route: Capsule, tablet, enema, suppository, gel cap, syrup.

Pharmacodynamics: Onset- 12-72 hours.

Common Side Effects: diarrhea, cramps, throat irritation.

Nursing Implications: Use for short period of time, assess for dependence as well as electrolyte and fluid loss. Notify doc if bleeding occurs or constipation isn’t relieved.

Drug Interactions: None listed

Andy Samelson's Drug Cards CLASS: CNS Stimulant

Andy Samelson's Drug Cards modafinil

Generic: modafinilTrade: Provigil

Action: Unknown – possibly inhibits GABA transmission.

Uses: treatment of excessive daytime sleepiness, adjunctive therapy for OSA.


Route: tablet


Common Side Effects: headache, nausea, HTN, palpitations, tachycardia, nervousness, insomnia, xerostomia, diarrhea

Nursing Implications: Diabetics should monitor BS levels closely. Avoid ETOH, report chest pain/palpitations, respiratory difficulties.

Drug Interactions: increases metabolic clearance of many drugs, perhaps prematurely – leading to a therapeutic concentration of those drugs in the blood.


Andy Samelson's Drug Cards insulin 70/30










Andy Samelson's Drug Cards CLASS: Vitamin

Andy Samelson's Drug Cards Thiamine

Generic: thiamineTrade: Vitamin B1

Action: Essential in carb metabolism

Uses: Treatment of prophylaxis of various brain disorders, alcoholics, impaired GI absorption.

Dosage Range: 100mg QD



Common Side Effects: None

Nursing Implications: IM injections may cause pain at injection site.

Drug Interactions: None.


Andy Samelson's Drug Cards folic acid

Generic: folic acidTrade: Folvite

Action: Prevents anemia, necessary for metabolism.

Uses: Treatment of anemias...

Dosage Range: 0.4 mg QD

Route: injection, tablet, capsule


Common Side Effects: Bronchospasm (uncommon)

Nursing Implications: Dilute for injectins...

Drug Interactions: May diminish effective concentration of Phenytoin.

Andy Samelson's Drug Cards CLASS: Proton pump inhibitor

Andy Samelson's Drug Cards pantoprazole

Generic: panoprazoleTrade: Protronix

Action: Supresses gastric secretions

Uses: Treatment of GERD

Dosage Range: 40mg QD

Route: injection, tablet, liquid


Common Side Effects: No overly common SE, other than headaches and diarrhea.

Nursing Implications: Do not administer via NGT. Do not crush tablets.

Drug Interactions: Increased anticoagulant effects have been reported with Coumadin and Warfarin.

Andy Samelson's Drug Cards CLASS: Anticonvulsant

Andy Samelson's Drug Cards gabapentin

Generic: gabapentinTrade: Neurontin

Action: Behaves similarly to GABA

Uses: seizures

Dosage Range: 300-1800 mg QD

Route: capsule, solution, tablet


Common Side Effects: Somnolence, fatigue, dizziness, ataxia, edema, confusion, NVD

Nursing Implications: Dosage must be adjusted in renal patients...

Drug Interactions: May increase effect of any CNS depressant.


Andy Samelson's Drug Cards insulin 70/30 (NPH and Regular)










Andy Samelson's Drug Cards CLASS: Antibiotic/Oral Rinse

Andy Samelson's Drug Cards Chlorhexidine Gluconate

Generic: Chlorhexidine GluconateTrade: BactoShield, Avagard, Peridex

Action: Bacteriostatic in small doses – bacteriocidal in large.

Uses: Dental rinse

Dosage Range: 15 ML for 30 sec.

Route: oral


Common Side Effects: Taste changes, teeth staining, tongue irritation.

Nursing Implications: Reduced taste sensation

Drug Interactions: none

Andy Samelson's Drug Cards CLASS: GI Agent/ Histamine2 blocker

Andy Samelson's Drug Cards Famotidine

Generic: FamotidineTrade: Pepcid

Action: Inhibits gastric secretion

Uses: Duodenal ulcers, gastric ulcers, GERD

Dosage Range: 20-40 mg every day.

Route: oral


Common Side Effects: headache, constipation.

Nursing Implications: Take with meals, do not take more than 14 days without consulting physician.

Drug Interactions: May decrease cyclosporin absorption

Andy Samelson's Drug Cards CLASS: Antipsychotic

Andy Samelson's Drug Cards Quetiapine

Generic: QuetiapineTrade: Seroquel

Action: Dopamine and serotonin antagonismUses: Schizophrenia, acute manic episodes of BPD.

Dosage Range: 50-200 mg per day.

Route: oral tablet


Common Side Effects: Somnolence, agitations, dizziness, headache, weight gain, xerostomia, postural hypotension, cholesterol and triglycerides increased, fever, pain, abdominal pain, flu-like symptoms.

Nursing Implications: Vital signs, lipid profile, monitor for cataracts.

Drug Interactions: lorazepam – clearance reduced 20%. Other CNS depressants oversedate.


Andy Samelson's Drug Cards Novolog

Generic: insulin aspart protamineTrade: Novolog Mix 70/30


Uses: Diabetes type 1 + 2


Route: injection



Nursing Implications: SubQ injection in thigh, buttocks, arm, or abdomen – rotate sites. Glucometer measurement important. Draw fast-acting insulins first in mixed doses. Administer 15 min prior to or after meal.


Andy Samelson's Drug Cards CLASS: Thyroid agent

Andy Samelson's Drug Cards levothyroxine

Generic: levothyroxineTrade: Synthroid, Levoxyl, Levothroid, Unithroid

Action: Elevates metabolic activity by acting as a replacement thyroid hormone.

Uses: Hypothyroidism, pituitary TSH suppression.

Dosage Range: Oral- 1.7 mcg/kg/day I.V./I.M. 50% of oral dose

Route: injection, powder for re-constitution, tablet.

Pharmacodynamics: Onset- (PO.) 3-5 days (I.V./I.M.) 6-8 hr. Peak- 4-6 weeks to see effective action for each dose.

Common Side Effects: elevated B/P, tachycardia, arrhythmia, anxiety, insomnia, increased appetite, decreased bone density, diaphoresis, heat intolerance.

Nursing Implications: I.V. Form must be prepared immediately before administration. Monitor TSH levels, B/P, heart rate, and other side effects.

Drug Interactions: Iron decreases absorption, may have interactions with antidiabetic agents, Ketamine may cause marked HTN, tricyclics change therapeutic index for both drugs.


CLASS: Laxative Senna

Generic: SennaTrade: Evacugen, exlax, senokot, x-prep

Action: Laxative

Uses: Constipation

Dosage Range: OTC packaging...

Route: Oral

Pharmacodynamics: Onset- (PO.) 6-10 hrs

Common Side Effects: NVD, cramps

Nursing Implications: Monitor for electrolyte imbalances, administer with water to decrease irritation.

Drug Interactions: N/A

Andy Samelson's Drug Cards CLASS: Lithium

Andy Samelson's Drug Cards Lithium

Generic: LithiumTrade: Lithobid, Eskalith

Action: Influences reuptake of serotonin

Uses: BPD treatment

Dosage Range: 900-2400mg/day in 3-4 divided doses. 50-75% of normal dose in renal impairment

Route: Capsule, tablet, syrup


Common Side Effects: hypotension, edema, syncope, sedation, confusion, stupor, coma, hypothyroidism, ataxia, coldness of fingers or toes.

Nursing Implications: administer with meals to decrease GI upset, encourage fluids, monitor for signs of toxicity.

Drug Interactions: Numerous – most act on decreasing or increasing serum concentrations of lithium... monitor closely.

Andy Samelson's Drug Cards CLASS: Electrolyte Replacement

Andy Samelson's Drug Cards Calcium Acetate

Generic: Calcium AcetateTrade: PhosLo

Action: Binds with phosphate and causes excretion in feces

Uses: Control of hyperphosphatemia in renal failure.

Dosage Range: Oral- 1000mg every day Route: Oral


Common Side Effects: Mild hypercalcemia, NV, constipation.

Nursing Implications: Monitor for hypercalcemia (unlikely)

Drug Interactions: Digitalis may become toxic, tetracycline, ABX, and beta-blockers are significantly reduced in ability to absorb.

Andy Samelson's Drug Cards CLASS: Laxative

Andy Samelson's Drug Cards Metamucil

Generic: PsylliumTrade: Metamucil

Action: Adsorbs water in intestines to form a viscous liquid which promotes peristalsis and decreases transit time.

Uses: constipation

Dosage Range: Varied gram strengths

Route: oral


Common Side Effects: esophageal or bowel obstruction, diarrhea, cramps.

Nursing Implications: monitor for impaction


Andy Samelson's Drug Cards CLASS: SSRI inhibitor

Andy Samelson's Drug Cards sertraline HCL

Generic: sertraline HCLTrade: Zoloft

Action: SSRI inhibitor

Uses: depression, PTSD, OCD

Dosage Range: 25-200 mg every day

Route: oral

Pharmacodynamics: maximum effects usually seen after 4 weeks

Common Side Effects: insomnia, fatigue, dizziness, h/a, nausea, xerostomia, heart palpitations, parasthesia, micturition disorders.

Nursing Implications: monitor nutrition, i/o, if somnolent, offer at bedtime.

Drug Interactions: benzos, amphetamines, carbamazepine, dextromethorphan, erythromycin, meperidine, all may carry risk of serotonin syndrome with this drug.

Andy Samelson's Drug Cards CLASS: gastric or duodenal ulcer treatment

Andy Samelson's Drug Cards sucralfate

Generic: sucralfateTrade: Carafate

Action: forms a viscous, adhesive substance protecting lining from peptic acid, pepsin, and bile salts

Uses: gastric or duodenal ulcers

Dosage Range: 1Gm every 4 hours

Route: oral

Pharmacodynamics: onset: 1-2 hours duration: 6 hours

Common Side Effects: constipation

Nursing Implications: monitor for constipation, administer 2 hr before or after other oral drugs. Tabs may be disintegrated in water first.

Drug Interactions: digoxin, warfarin, ciprofoxacin all may be decreased in effectiveness unless taken separately by 2 hours.

Andy Samelson's Drug Cards CLASS: electrolyte supplement

Andy Samelson's Drug Cards potassium chloride

Generic: potassium chlorideTrade: Kdur, Klor-con

Action: Major intracellular ion – essential for nerve impulses of heart, brain, and skeletal muscle.

Uses: hypokalemia

Dosage Range: 20-40 meq every day

Route: oral


Common Side Effects: NVD, bradykardia, hyperkalemia

Nursing Implications: liquid form should be diluted 2-6 times with water or juice.

Drug Interactions: increased effectiveness of ace inhibitors. Overdose may decrease effectiveness of digoxin therapy.

Andy Samelson's Drug Cards CLASS: Antacid

Andy Samelson's Drug Cards Mylanta

Generic: aluminum hydroxide and magnesium hydroxideTrade: Maalox, Mylanta

Action: antacid

Uses: acute treatment of symptoms of GERD, hyperacidity, prevention of stress ulcers.

Dosage Range: 30 ml PRN typical

Route: oral suspension


Common Side Effects: cramps, constipation, decreased GI motility, fecal impaction.

Nursing Implications: monitor BM's

Drug Interactions: decreased effect of dig, tetracyclines, benzos, and iron salts.

Andy Samelson's Drug Cards CLASS: antiemetic, antipsychotic agent

Andy Samelson's Drug Cards promethazine

Generic: promethazineTrade: phenergan

Action: competes with histamine, and depresses stimuli to brainstem

Uses: motion sickness, sedation

Dosage Range: 25 mg at HS, or 12.5 mg before meals.

Route: supp, tab, syrup

Pharmacodynamics: onset: 20 min duration: 4-6 hours

Common Side Effects: bradycardia, HTN, dizziness, drowsiness, NVD, xerostomia

Nursing Implications: rapid IV push may result in drop in B/P, do not exceed 25mg/min. Monitor mental status, and avoid extravasation.

Drug Interactions: miconazole and sertraline may increase effects.

Andy Samelson's Drug Cards CLASS: antiemetic, antipsychotic agent

Andy Samelson's Drug Cards promethazine

Generic: promethazineTrade: phenergan

Action: competes with histamine, and depresses stimuli to brainstem

Uses: motion sickness, sedation

Dosage Range: 25 mg at HS, or 12.5 mg before meals.

Route: supp, tab, syrup

Pharmacodynamics: onset: 20 min duration: 4-6 hours

Common Side Effects: bradycardia, HTN, dizziness, drowsiness, NVD, xerostomia

Nursing Implications: rapid IV push may result in drop in B/P, do not exceed 25mg/min. Monitor mental status, and avoid extravasation.

Drug Interactions: miconazole (nitrate) and sertraline may increase effects.

Andy Samelson's Drug Cards CLASS: Proton pump inhibitor

Andy Samelson's Drug Cards Nexium

Generic: esomeprazoleTrade: Nexium

Action: Suppresses gastric acid secretions

Uses: Short term treatment of GERD, or erosive esophagus trouble.

Dosage Range: Oral- 20 40 mg Route: Capsule, delayed release


Common Side Effects: H/A, NVD, flatulence, abdominal pain.

Nursing Implications: Do not break or crush capsules...

Drug Interactions: Benzos can be potentiated by excess oxidation. May decrease absorption of iron salts. May increase levels of sertraline.


Andy Samelson's Drug Cards bisacodyl

Generic: bisacodylTrade: Dulcolax

Action: Stimulates bowel muscles to enable bowel movement..

Uses: treatment of constipation


Route: tablet, syrup


Common Side Effects: NVD, diarrhea, H/A, dehydration

Nursing Implications: Monitor for rectal bleeding, use with caution in the elderly. Do not take with antacids or milk.

Drug Interactions: May decrease effective levels of many drugs.

Andy Samelson's Drug Cards CLASS: Sedative/hypnotic

Andy Samelson's Drug Cards chloral hydrate

Generic: chloral hydrateTrade: Aquachloral

Action: depresses central nervous system producing drowsiness and sedation.

Uses: short term treatment of insomnia.

Dosage Range: Oral- 300-500 mg QD (typical)

Route: tablet, syrup, suppository


Common Side Effects: drowsiness, over sedation, hypotension, xerostomia

Nursing Implications: Monitor for orthostatic hypotension, mental status changes, and over sedation. Do not stop taking suddenly – may be habit forming. Do not combine with other CNS depressants.

Drug Interactions: Other CNS depressants can potentiate. Other increases/decreases in effectiveness.

Andy Samelson's Drug Cards CLASS: Amino acid

Andy Samelson's Drug Cards Glutamine

Generic: glutamineTrade: numerous

Action: an essential amino acid used in immune system and brain function. Also inhibits muscle wasting in cancer patients.

Uses: wound healing, brain injuries, HIV

Dosage Range: Oral – 500 – 15,000 mg

Route: tablet, syrup, powder


Common Side Effects: Unknown.

Nursing Implications: Do not add to hot water – heat destroys it. Observe carefully with patients with renal or hepatic disease.

Drug Interactions: May decrease effectiveness of cancer drugs.


Andy Samelson's Drug Cards cholecalciferol

Generic: cholecalciferol Trade: Vitamin D

Action: A fat soluble vitamin used for absorption of calcium.

Uses: Vit D deficiency.

Dosage Range: Oral – 1000 – 3000 IU per day.

Route: tablet, syrup, powder, injection.


Common Side Effects: N/V/D, headache, kidney stones, hypercalcemia

Nursing Implications: Monitor electrolyte levels carefully – use cautiously with renal patients.

Drug Interactions: May potentiate gabapentin, heparin, and phenobarbital.

Andy Samelson's Drug Cards CLASS: Muscle Relaxant

Andy Samelson's Drug Cards baclofen

Generic: baclofenTrade: Lioresal

Action: Prevents muscle spasms at the spinal cord level

Uses: Treatment of spasticity associated with MS or spinal cord lesions

Dosage Range: Oral – 15 mg Qd

Route: injection, solution, tablet

Pharmacodynamics: onset: 3-4 days

Common Side Effects: drowsiness, dizziness, vertigo, hypotension, weakness, rash, confusion, HA, ataxia

Nursing Implications: Avoid abrupt withdrawal, monitor epileptic patients carefully.

Drug Interactions: Increases effects of opiates, benzos, and HTN agents.

Andy Samelson's Drug Cards CLASS: Anti-depressant

Andy Samelson's Drug Cards paroxetine

Generic: paroxetineTrade: Paxil

Action: SSRI

Uses: Treatment of PTSD, GAD, OCD, and depression

Dosage Range: Oral – 20-50 mg QD

Route: Suspension, tablet

Pharmacodynamics: Maximum effect seen after 4 weeks.

Common Side Effects: Somnolence, insomnia, H/A, dizziness, decreased libido, nausea, xerostomia, constipation, weakness, diaphoresis.

Nursing Implications: Do no discontinue abruptly, monitor mood swings. Monitor for constipation.

Drug Interactions: Extensive.

Andy Samelson's Drug Cards CLASS: Narcotic

Andy Samelson's Drug Cards methadone

Generic: methadoneTrade: Dolophine

Action: Binds to opiate receptors in CNS, inhibiting response and perception of pain.

Uses: Management of severe pain, treatment in narcotic withdrawal programs.

Dosage Range: Oral – 2.5 – 10 mg Q 4hr PRN

Route: injection solution, tablet

Pharmacodynamics: oral: 30-60 min parenteral: 10-20 min

Common Side Effects: N/V/D, headache, kidney stones, hypercalcemia

Nursing Implications: Observe for excessive sedation, assist with ambulation.

Drug Interactions: Potentiates other CNS depressants.

Andy Samelson's Drug Cards CLASS: GI agent, prokinetic

Andy Samelson's Drug Cards metoclopramide

Generic: metoclopramideTrade: Reglan

Action: Blocks dopamine and serotonin receptors in high doses, enhances response to acetylcholine in upper GI tract, and increases motility.

Uses: treatment of GERD, gastric stasis, stimulates gastric empyting.

Dosage Range: 10-30 mg Q6HR

Route: injection, syrup, tablet

Pharmacodynamics: oral: 30-60min, IV – 1-3 min.

Common Side Effects: brady/tachycardia, drowsiness, dystonia, confusion, headache, depression, urticara

Nursing Implications: Slow IVP for patient's comfort – rapid push is associated with anxiety.

Drug Interactions: anticholinergic agents may antagonize effectiveness. CNS depressants may potentiate sedation.

Andy Samelson's Drug Cards CLASS: Anti-psychotic

Andy Samelson's Drug Cards risperidone

Generic: risperidoneTrade: Rispedal

Action: dopamine/serotonin antagonist.

Uses: treatment of bi-polar disorder or schizophrenia.


Route: tablet, solution, injection


Common Side Effects: dizziness, sedation, headache, nausea, xerostomia, HTN, hypotension, weight loss/gain, extrapyramidal symptoms

Nursing Implications: Monitor for extrapyramidal effects.

Drug Interactions: Avoid use with MAOI's, CNS depressants, carbamazepine.

Andy Samelson's Drug Cards CLASS: Antineoplastic agent, appetite stimulant

Andy Samelson's Drug Cards megestrol

Generic: megestrolTrade: Megace

Action: synthetic progestin

Uses: treatment of anorexia, carcinoma, and breast cancer.


Route: suspension, tablet


Common Side Effects: headache, HTN, rash, insomnia

Nursing Implications: Monitor for thromboembolism.

Drug Interactions: None reported.


Andy Samelson's Drug Cards oxycodone

Generic: OxycodoneTrade: Oxycontin

Action: Oxycodone binds with opiate receptors


Dosage Range: Oral- 2.5 – 5 mg q6hr Route: Capsule, tablet, patch

Pharmacodynamics: onset – 30-60 min





Andy Samelson's Drug Cards hydromorphone

Generic: hydromorphoneTrade: Dilaudid

Action: Oxycodone binds with opiate receptors,


Dosage Range: 2-8 mg

Route: capsule, suppository, injection, liquid

Pharmacodynamics: onset 15-30 minutes



Drug Interactions: anesthetics can lead to additive CNS depression, SSRI's may be additive, leading to serotonin syndrome.


Andy Samelson's Drug Cards sertraline

Generic: sertralineTrade: Zoloft

Action: SSRI



Route: oral





Andy Samelson's Drug Cards CLASS: Antipsychotic

Andy Samelson's Drug Cards Quetiapine

Generic: QuetiapineTrade: Seroquel

Action: Dopamine and serotonin antagonismUses: Schizophrenia, acute manic episodes of BPD.

Dosage Range: 50-200 mg per day.

Route: oral tablet


Common Side Effects: Somnolence, agitations, dizziness, headache, weight gain, xerostomia, postural hypotension, cholesterol and triglycerides increased, fever, pain, abdominal pain, flu-like symptoms.

Nursing Implications: Vital signs, lipid profile, monitor for cataracts.

Drug Interactions: lorazepam – clearance reduced 20%. Other CNS depressants oversedate.


Andy Samelson's Drug Cards bisacodyl

Generic: bisacodylTrade: Dulcolax

Action: Stimulates bowel muscles to enable bowel movement..

Uses: treatment of constipation




Common Side Effects: NVD, diarrhea, H/A, dehydration

Nursing Implications: Monitor for rectal bleeding, use with caution in the elderly. Do not take with antacids or milk.

Drug Interactions: May decrease effective levels of many drugs.


Andy Samelson's Drug Cards warfarin

Generic: warfarinTrade: Coumadin

Action: interferes with hepatic synthesis of Vit K dependent coagulation factors.

Uses: prophylaxis and treatment of venous thrombosis, pulmonary embolism, after M.I.



Pharmacodynamics: Onset: 36-72 hr. Peak: 5-7 days

Common Side Effects: Prolonged bleeding, headache, hematuria, N.V.D., hemoptysis

Nursing Implications: Avoid all I.M. Injections, monitor for S&S of bleeding.

Drug Interactions: Numerous – primarily decreased or increased efficacy of warfarin.

Andy Samelson's Drug Cards CLASS: AntiParkinson's/Anti-cholinergic

Andy Samelson's Drug Cards benztropine

Generic: benztropineTrade: Cogentin

Action: Anticholinergic, antihistamine, may inhibit reuptake of dopamine.

Uses: Parkinsonian symptoms, tardive dyskinesia

Dosage Range: 0.5 – 4 mg QD


Pharmacodynamics: Onset: 15-60 min. Action: 6- 48 hr

Common Side Effects: tachycardia, CNS disturbances, urinary retention, blurred vision

Nursing Implications: Do not discontinue abruptly. IV and IM methods = same onset time.

Drug Interactions: cumulative effect with anticholinergics, may increase digoxin levels..

Andy Samelson's Drug Cards CLASS: sedative, hypnotic

Andy Samelson's Drug Cards clonazepam

Generic: clonazepamTrade: Klonopin

Action: Unknown, believed to enhance GABA pathways.

Uses: anti-seizure prophylaxis

Dosage Range: 1.5 – 20mg QD

Route: tablet

Pharmacodynamics: Onset: 20-60 min Duration : 12 hr.

Common Side Effects: edema, ataxia, CNS depression, hallucinations, libido disturbances, constipation, blood dyscrasias, respiratory congestion

Nursing Implications: observe for excess sedation, resp depression, and orthostasis.

Drug Interactions: Valproic acid can cause absence seizures when used concurrently. CNS depressants may potentiate.

Andy Samelson's Drug Cards CLASS: Antihyperlipidemic agent

Andy Samelson's Drug Cards rosuvastatin

Generic: rosuvastatinTrade: Crestor

Action: stimulates LDL catabolism

Uses: management of cholesterol


Route: tablet

Pharmacodynamics: Onset: 1 week hr. Peak: 4 weeks

Common Side Effects: edema, HTN, pharyngitis, NVD, GI disturbances, anemia

Nursing Implications: Monitor serum cholesterol levels.

Drug Interactions: Cyclosporines may increase serum levels of drug – limit intake to 5 mg QD when taken concurrently.

Andy Samelson's Drug Cards CLASS: alpha adrenergic blocking agent

Andy Samelson's Drug Cards tamsulosin

Generic: tamsulosinTrade: Flomax

Action: smooth muscle relaxant

Uses: treatment of BPH

Dosage Range: 0.4mg – 0.8mg QD

Route: capsule


Common Side Effects: Orthostatic hypotension, h/a, dizziness, abnormal ejaculation, libido decrease, somnolence.

Nursing Implications: Monitor for orthostasis, do not crush capsule.

Drug Interactions: other cardiac meds (beta blockers, calcium channel blockers) may increase risk of orthostasis.

Andy Samelson's Drug Cards CLASS: traditional anti-psychotic

Andy Samelson's Drug Cards perphenazine

Generic: perphenazineTrade: Trilafon

Action: inhibits post-synaptic dopaminergic receptors in limbic system.

Uses: schizophrenia, nausea


Route: tablet


Common Side Effects: OH, blood sugar disturbances, photosensitivity, urinary disturbances, tardive dyskinesias, restlessness, ataxia, dizziness

Nursing Implications: monitor for OH, dilute concentrated forms with at least 2 oz of juice.

Drug Interactions: may inhibit anticholinergics, increased risk of Parkinsonian symptoms with Reglan, may cause OH in combination.

Andy Samelson's Drug Cards CLASS: vitamin

Andy Samelson's Drug Cards vitamin E

Generic: vitamin ETrade: Aquagem, Aquasol, E-Gems

Action: prevents breakdown of vit A+C, protects from effects of free radicals and hemolysis of RBCs.

Uses: dietary supplement, prevention of hemolytic anemia


Route: capsule, cream, powder, suppository


Common Side Effects: blurred vision (uncommon)

Nursing Implications: toxicity appears as flu-like symptoms.

Drug Interactions: may interfere with warfarin

Andy Samelson's Drug Cards CLASS: expectorant

Andy Samelson's Drug Cards guaifenesin

Generic: guaifenesinTrade: Mucinex, Humibid

Action: stimulates resp secretions and decreases mucous viscosity

Uses: presence of mucous in resp tract, relief of dry cough.


Route: syrup, liquid, tablet


Common Side Effects: dizziness, h/a, stomach pain, NVD, kidney stone formation (with large quantities)

Nursing Implications: Push fluids to ensure therapeutic action


Andy Samelson's Drug Cards CLASS: anti-diarrheal

Andy Samelson's Drug Cards bismuth subsalicylate

Generic: bismuth subsalicylateTrade: Kaopectate

Action: soothes gastric motility

Uses: diarrhea


Route: syrup, tablet


Common Side Effects: constipation, h/a

Nursing Implications: monitor for constipation, push fluids


Andy Samelson's Drug Cards CLASS: anti-diarrheal

Andy Samelson's Drug Cards bismuth subsalicylate

Generic: bismuth subsalicylateTrade: Kaopectate

Action: soothes gastric motility

Uses: diarrhea


Route: syrup, tablet


Common Side Effects: constipation, h/a



Andy Samelson's Drug Cards CLASS: sympathomimetic vasoconstrictor

Andy Samelson's Drug Cards pseudoephedrine

Generic: pseudoephedrineTrade: Sudafed

Action: mimics sympathetic nervous system stimulation, vasoconstricts, dries secretions

Uses: excess mucous production, cold relief (decongestant)




Common Side Effects: CNS stimulation, dry mouth, HTN, h/a, NVD


Drug Interactions: beta-blockers, HTN agents, anti-depressants can interefere.

Andy Samelson's Drug Cards CLASS: antiemetic

Andy Samelson's Drug Cards ondansetron

Generic: ondansetronTrade: Zofran

Action: blocks serotonin selectively on vagal nerve terminals.

Uses: prevention of nausea associated with chemo, radiation, post-op NV

Dosage Range: Varies with treatment

Route: IM, IV, oral


Common Side Effects: fatigue, headache, drowsiness, anxiety, diarrhea, constipation, urinary retention, hypoxia.

Nursing Implications: Oral dosage should be given 30 min prior to therapy. The IV version has also been used successfully orally.

Drug Interactions: Apomorphine promotes profound hypotension concurrently.


Andy Samelson's Drug Cards fentanyl

Generic: fentanylTrade: Duragesic

Action: increases pain threshold, inhibits ascending pain pathways, alters perception of pain.

Uses: moderate to severe pain, pre-op anesthetic, chronic pain, cancer pain

Dosage Range: IM/slow IV 25-100 mcg 60 min prior to surgery.

Route: injection, IV, patch

Pharmacodynamics: Onset: IV-immediate Duration: 30-60 min


Nursing Implications: Monitor for pain relief, over-sedation, confusion, and constipation. May cause rebound respiratory depression, monitor for 12 hours after removal of patch.

Drug Interactions: anesthetics can lead to additive CNS depression, anticholinergics can lead to paralytic ileus. SSRIs may cause serotonin syndrome. MAOIs are contraindicated.

Andy Samelson's Drug Cards CLASS: Adrenal Corticosteroid

Andy Samelson's Drug Cards betamethasone

Generic: betamethasoneTrade: Diprosone

Action: prevents/controls inflammation, stimulates lung/surfactant development in fetus.

Uses: pre-term birth lung development, inflammation treatment.

Dosage Range: 0.6 – 7.2mg QD

Route: IM, oral, topical


Common Side Effects: flushing, sweating, irritability, HTN, fungal infections, acne, bruising, increased appetite.

Nursing Implications: Assess for infection, daily weights, b/p

Drug Interactions: hypokalemia with diuretics, decreases effects of insulin/blood thinners. NSAIDS concurrently risk of GI bleeds.

Andy Samelson's Drug Cards CLASS: hormone

Andy Samelson's Drug Cards oxytocin

Generic: oxytocinTrade: Pitocin

Action: produces uterine contraction, anti-diuretic effect, stimulates breast milk production.

Uses: induction of labor, post-postpartum bleeding.

Dosage Range: 1-2 mU/min (induction) 10-40 U in1000 mL diluted (hemorrhage) Route: IM, IV

Pharmacodynamics: Onset: 1-7 min Duration: 1hr.

Common Side Effects: seizures, tetanic contractions, HTN/OH, cardiac arrhythmias, abruptio placentae.

Nursing Implications: B/P, hemorrhage monitoring. Length, intensity, duration of contractions, FHT monitoring.

Drug Interactions: Concurrent use of vasopressors = HTN.

Andy Samelson's Drug Cards CLASS: HTN agent, tocolytic

Andy Samelson's Drug Cards magnesium sulfate

Generic: magnesium sulfateTrade: N/A

Action: draws fluid into colon, depresses CNS, relaxes smooth muscle

Uses: HTN treatment, dig toxicity, premature labor, seizure prophylaxis.

Dosage Range: 4 – 40 GM QD

Route: IM, oral, IV.

Pharmacodynamics: Duration IV: 30 min.

Common Side Effects: Sedation, depressed deep tendon reflexes, confusion, hypotension, resp depression.

Nursing Implications: Monitor reflexes, level of conciousness, constipation.

Drug Interactions: decreased effect of digoxin, increases effects of neuromuscular blockers, increases effects of anti-hypertensives.

Andy Samelson's Drug Cards CLASS: bronchodilator, tocolytic

Andy Samelson's Drug Cards terbutaline

Generic: terbutalineTrade: Brethine

Action: relaxes smooth muscle, CNS, diureses.

Uses: bronchospasms, hyperkalemia, premature labor.

Dosage Range: 2.5 mg Q 4-6 hr

Route: PO, SubQ

Pharmacodynamics: PO onset: 30 min peak: 1-2 hr duration: 4-8 hr

Common Side Effects: insomnia, anxiety, stimulation, dizziness, tachycardia, NVD.

Nursing Implications: monitor for tolerance, FHT, b/p, contractions.

Drug Interactions: MAOI's may cause hypertensive crisis.

Andy Samelson's Drug Cards CLASS: immune globulin

Andy Samelson's Drug Cards rhogam

Generic: rhogamTrade: RhoGam, BayRho

Action: suppresses immune response of rh negative mother.

Uses: prevention of immune-mediated abortion/sensitization in RH negative women.

Dosage Range: 120-300 mcg 2x in 72 hr.

Route: IM, IV.

Pharmacodynamics: n/a

Common Side Effects: lethargy, injection site pain.

Nursing Implications: assess allergies, confirm blood product accuracy, inject into deltoid – not gluteus.

Drug Interactions: decreased antibody response to live vaccines.

Andy Samelson's Drug Cards CLASS: opioid antagonist

Andy Samelson's Drug Cards naloxone

Generic: naloxoneTrade: Narcan

Action: competes with opioids at receptor sites

Uses: opiate overdose

Dosage Range: 0.4-2mg Q 3 min, max 10mg

Route: IM, IV, SubQ

Pharmacodynamics: IV onset: 1 min. IM/SQ onset: 2-5 min.

Common Side Effects: drowsiness, irritability, rapid pulse, NV, hepatoxicity, pulmonary edema.

Nursing Implications: assess for withdrawal symptoms, cardiac status, resp status, for pain.

Drug Interactions: decreases/eliminates effects of opiates.

Andy Samelson's Drug Cards CLASS: Prostaglandin

Andy Samelson's Drug Cards dinoprostone

Generic: dinoprostoneTrade: Cervidil

Action: stimulates uterine contractions, aborts during 2nd trimester, effaces and dilates cervix at term.

Uses: abortion, cervical dilation, induction.

Dosage Range: 10-20 mg max 240mg

Route: gel, suppository.

Pharmacodynamics: onset: 10min.

Common Side Effects: h/a, dizziness, decelerations, vaginal pain, nvd, leg cramps, rash.

Nursing Implications: check for contractions, monitor FHT, b/p, check for vaginal discharge.

Drug Interactions: increases effects of other oxytocics.

Andy Samelson's Drug Cards CLASS: Prostaglandin

Andy Samelson's Drug Cards misoprostol

Generic: misoprostolTrade: Cytotec

Action: cervical ripening, inhibits gastric secretions, protects gastric mucosa

Uses: abortion, cervical dilation, gastric ulcers, kidney transplant rejection prophylaxis.

Dosage Range: 25 mcg Q 3-6 hr intravaginally for cervical ripening.

Route: PO, gel

Pharmacodynamics: onset: 12 min.

Common Side Effects: nvd, hypermenorrhea.

Nursing Implications: check for contractions, monitor FHT, b/p, check for vaginal discharge.

Drug Interactions: take with food for maximum concentration in ulcer therapy.

Drug Card 1

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