Medication Reference Guide

Omeprazole
Classification: Proton Pump Inhibitor (PPI)

Pharmacologic Action: Blocks the H⁺/K⁺ ATPase enzyme in gastric parietal cells, reducing
gastric acid secretion.

Indication(s): GERD, peptic ulcer, Zollinger-Ellison syndrome.

Contraindication(s): Hypersensitivity to omeprazole or other PPIs. May increase risk of

fractures, gastrointestinal infections. Hepatic impairment, pts of Asian descent.

Adverse Effects / Side Effects: Headache, abdominal pain, nausea, diarrhea, risk of C. difficile
infection.

Nursing Responsibilities:
Before: Assess for GI symptoms and concurrent medications.
During: Administer 30-60 minutes before meals.
After: Monitor for symptom relief and potential nutrient deficiencies.

Do not break, crush, dissolve, or divide delayed-release forms. • May open capsule, mix
with applesauce, and give immediately

Furosemide
Classification: Loop Diuretic

Pharmacologic Action: Inhibits sodium and chloride reabsorption in the ascending loop of
Henle, promoting diuresis.

Indication(s): treatment of Edema associated with HF, hypertension, congestive heart

failure. (Produces diuresis, lowers B/P.)

Contraindication(s): Anuria, hypersensitivity, severe electrolyte depletion.

Adverse Effects / Side Effects: Expected: Increased urinary frequency/volume. Frequent:

Nausea, dyspepsia, abdominal cramps, diarrhea or constipation, electrolyte disturbances.
Hypokalemia, hypotension, dehydration, ototoxicity.

Nursing Responsibilities:
Before: Check BP and electrolyte levels.
During: Administer slowly if IV to prevent ototoxicity.
After: Monitor urine output, electrolytes, and signs of dehydration.
Check vital signs, esp. B/P, pulse, for hypotension before administration. Assess baseline
renal function, serum electrolytes, esp. serum sodium, potassium. Assess skin turgor,
mucous membranes for hydration status; observe for edema. Assess muscle strength,
mental status. Note skin temperature, moisture. Obtain baseline weight.

Ondansetron
Classification: Antiemetic, 5-HT3 receptor antagonist

Pharmacologic Action: Blocks serotonin receptors in the chemoreceptor trigger zone and
vagal nerve terminals in the GI tract.

Indication(s): Prevention and treatment of nausea and vomiting due to chemotherapy,

radiation, or surgery.

Contraindication(s): Hypersensitivity to ondansetron or other 5-HT3 antagonists. Use of

apomorphine. Cautions: Mild to moderate hepatic impairment, pts at risk for QT
prolongation or ventricular arrhythmia (congenital long QT prolongation, medications
prolonging QT interval, hypokalemia, hypomagnesemia)

Adverse Effects / Side Effects: drowsiness, urinary retention, fatigue Headache,

constipation, QT prolongation, dizziness.

Nursing Responsibilities:
Before: Assess for nausea, vomiting, and electrolyte imbalance.
During: Administer IV slowly over 2-5 minutes to avoid cardiac effects.
After: Monitor ECG inAssess mental status. Assess bowel sounds for peristalsis. Monitor
daily pattern of bowel activity, stool consistency. high-risk patients, evaluate nausea control.

Clindamycin
Classification: Lincosamide antibiotic

Pharmacologic Action: Inhibits bacterial protein synthesis by binding to the 50S ribosomal
subunit.

Indication(s): Serious infections due to anaerobes or Gram-positive cocci. Treatment of

aerobic grampositive staphylococci and streptococci (not enterococci), for treatment of
respiratory tract infections, skin/soft tissue infections, sepsis, intra-abdominal infections,
infections of female pelvis and genital tract, bacterial endocarditis prophylaxis for dental
and upper respiratory procedures in penicillin-allergic pts, perioperative prophylaxis.

Contraindication(s): History of antibiotic-associated colitis or hypersensitivity.

Adverse Effects / Side Effects: Abdominal pain, vomiting, Diarrhea, C. difficile colitis, rash,
liver enzyme elevation.

Nursing Responsibilities:
Before: Assess for infection and bowel history.
During: Administer with full glass of water orally; infuse IV slowly.
After: Monitor for diarrhea, superinfection, and liver function.

Tranexamic Acid
Classification: Antifibrinolytic

Pharmacologic Action: Inhibits activation of plasminogen to plasmin, preventing fibrin

degradation and stabilizing clots.

Indication(s): Heavy menstrual bleeding, trauma, surgery with high bleeding risk.

Contraindication(s): Active intravascular clotting, history of thromboembolism.

Adverse Effects / Side Effects: Nausea, vomiting, headache, thrombotic events.

Nursing Responsibilities:
Before: Assess bleeding risk and history of clotting disorders.
During: Monitor infusion site and signs of thromboembolism.
After: Watch for visual disturbances or leg swelling.

Vitamin K
Classification: Fat-soluble vitamin, coagulation modifier

Pharmacologic Action: Promotes liver synthesis of clotting factors II, VII, IX, and X, reversing
warfarin effects.

Indication(s): Warfarin overdose, vitamin K deficiency, bleeding disorders.

Contraindication(s): Hypersensitivity, severe liver disease (caution).

Adverse Effects / Side Effects: Flushing, injection site pain, allergic reactions, hemolytic
anemia (in neonates).

Nursing Responsibilities:
Before: Check PT/INR and bleeding status.
During: Give IV slowly to prevent hypersensitivity reactions.
After: Recheck PT/INR, assess bleeding control.
Gentamicin
Classification: Aminoglycoside antibiotic

Pharmacologic Action: Inhibits bacterial protein synthesis by binding to 30S ribosomal

subunit; bactericidal.

Indication(s): Severe Gram-negative infections, sepsis, UTIs.

Contraindication(s): Hypersensitivity, caution in renal impairment. Elderly, neonates due to

renal insufficiency or immaturity, neuromuscular disorders (potential for respiratory
depression), vestibular or cochlear impairment, renal impairment, hypocalcemia,
myasthenia gravis

Adverse Effects / Side Effects: Nephrotoxicity (increased serum BUN, creatinine; decreased
creatinine clearance), ototoxicity (tinnitus, dizziness, diminished hearing) , neuromuscular
blockade.

Nursing Responsibilities:
Before: Check renal function, obtain peak/trough levels.
During: Administer slowly IV, monitor for hearing changes.
After: Monitor renal labs and hearing, assess infection response.

Dexamethasone
Classification: Corticosteroid

Dosage/Route/Frequency: 0.5–10 mg / Oral/IV/IM / Once to multiple times daily

Pharmacologic Action: Suppresses inflammation and immune response by modifying

transcription of inflammatory mediators.

Indication(s): Allergic reactions, cerebral edema, inflammation, adrenal insufficiency.

Contraindication(s): Systemic fungal infections, live vaccines.

Adverse Effects / Side Effects: Hyperglycemia, infection risk, mood changes, GI upset,
adrenal suppression.

Nursing Responsibilities:
Before: Assess for infection, baseline glucose and electrolytes.
During: Monitor glucose, give with food to reduce GI upset.
After: Watch for mood swings, taper dose after long use.

Ciprofloxacin
Classification: Fluoroquinolone antibiotic
Dosage/Route/Frequency: 250–750 mg / Oral/IV / Every 12 hours

Pharmacologic Action: Inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA
replication.

Indication(s): UTIs, respiratory infections, GI infections.

Contraindication(s): Hypersensitivity, concurrent tizanidine use.

Adverse Effects / Side Effects: Tendon rupture, GI upset, QT prolongation, CNS effects.

Nursing Responsibilities:
Before: Assess infection and renal function.
During: Avoid giving with dairy/antacids, monitor ECG in high-risk patients.
After: Watch for tendon pain, superinfections, or CNS changes.

Tramadol
Classification: Opioid analgesic

Dosage/Route/Frequency: 50–100 mg / Oral / Every 4–6 hours as needed

Pharmacologic Action: Binds to opioid receptors and inhibits norepinephrine and serotonin
reuptake, modifying pain transmission.

Indication(s): Moderate to moderately severe pain.

Contraindication(s): Severe respiratory depression, acute intoxication (alcohol, CNS

depressants).

Adverse Effects / Side Effects: Drowsiness, nausea, constipation, respiratory depression,

seizure risk.

Nursing Responsibilities:
Before: Assess pain level, respiratory rate.
During: Monitor sedation and respiratory status.
After: Reassess pain, monitor for dependence or misuse.

HNBB (Hyoscine N-Butylbromide)

Classification: Anticholinergic, antispasmodic

Dosage/Route/Frequency: 10–20 mg / Oral/IV/IM / 3–5 times daily as needed

Pharmacologic Action: Blocks muscarinic receptors in smooth muscle, reducing GI and

urinary tract spasms.

Indication(s): Abdominal cramping, irritable bowel syndrome, renal colic.

Contraindication(s): Myasthenia gravis, glaucoma, prostatic hypertrophy.

Adverse Effects / Side Effects: Dry mouth, blurred vision, tachycardia, urinary retention.

Nursing Responsibilities:
Before: Assess for abdominal pain and urinary output.
During: Monitor for anticholinergic effects like dry mouth or blurred vision.
After: Reassess pain relief and watch for urinary retention.

Ketorolac
Classification: NSAID

Dosage/Route/Frequency: 15–30 mg (IV), 10 mg (oral) / IV/IM/Oral / Every 6 hours (max

5 days)

Pharmacologic Action: Inhibits cyclooxygenase (COX), reducing prostaglandin synthesis and

inflammation.

Indication(s): Moderate to severe acute pain.

Contraindication(s): Active GI bleeding, renal impairment, NSAID allergy.

Adverse Effects / Side Effects: GI bleeding, renal dysfunction, headache, dizziness.

Nursing Responsibilities:
Before: Assess for history of ulcers or bleeding disorders.
During: Monitor renal function and signs of bleeding.
After: Evaluate pain relief and GI tolerance.

Metronidazole
Classification: Antibiotic, antiprotozoal

Dosage/Route/Frequency: 500 mg / Oral/IV / Every 8–12 hours

Pharmacologic Action: Disrupts DNA synthesis in anaerobic bacteria and protozoa, leading
to cell death.

Indication(s): Anaerobic bacterial infections, C. difficile, trichomoniasis.

Contraindication(s): Alcohol use during and 3 days post-treatment, first trimester of

pregnancy.

Adverse Effects / Side Effects: Metallic taste, nausea, peripheral neuropathy, disulfiram-like
reaction.
Nursing Responsibilities:
Before: Confirm no alcohol use; assess for infection.
During: Give with food if GI upset occurs.
After: Warn about metallic taste and dark urine; monitor for neurologic symptoms.

Albumin 25%
Classification: Plasma volume expander

Dosage/Route/Frequency: 25 g/100 mL (typical vial) / IV / As needed based on condition

Pharmacologic Action: Increases plasma oncotic pressure, pulling fluid into circulation from
tissues.

Indication(s): Hypovolemia, hypoalbuminemia, burns, shock.

Contraindication(s): Severe anemia, heart failure, known hypersensitivity.

Adverse Effects / Side Effects: Fluid overload, allergic reactions, fever, chills.

Nursing Responsibilities:
Before: Check serum albumin and fluid status.
During: Infuse slowly; monitor vitals closely.
After: Watch for pulmonary edema, monitor I&O.

15. Piperacillin-Tazobactam (PipTaz)

 Classification: Extended-spectrum penicillin + beta-lactamase inhibitor

 Dosage/Route/Frequency: 3.375–4.5 g IV every 6–8 hours
 Pharmacologic Action: Inhibits bacterial cell wall synthesis and protects against
beta-lactamase.
 Indication: Severe infections (pneumonia, intra-abdominal infections, sepsis).
Contraindication: Penicillin allergy.
 Adverse Effects: Diarrhea, allergic reactions, thrombocytopenia.
 Desired Action: Clear serious bacterial infection.
 Nursing Responsibilities:
o Before: Allergy history (penicillin)
o During: Monitor IV site for phlebitis; assess infection signs
o After: Watch for allergic reactions, superinfection.
16. Cefazolin

 Classification: 1st generation cephalosporin antibiotic

 Dosage/Route/Frequency: 1–2 g IV every 8 hours
 Pharmacologic Action: Inhibits bacterial cell wall synthesis.
 Indication: Surgical prophylaxis, skin infections, bone infections.
Contraindication: Cephalosporin allergy, severe penicillin allergy.
 Adverse Effects: Rash, diarrhea, allergic reaction.
 Desired Action: Prevent or treat bacterial infection.
 Nursing Responsibilities:
o Before: Allergy check
o During: Administer IV slowly
o After: Monitor for allergic reaction, infection control.

17. Ceftriaxone

 Classification: 3rd generation cephalosporin antibiotic

 Dosage/Route/Frequency: 1–2 g IV/IM once daily or divided BID
 Pharmacologic Action: Inhibits bacterial cell wall synthesis.
 Indication: Serious infections (sepsis, meningitis, respiratory infections).
Contraindication: Neonates with calcium-containing IV solutions; cephalosporin
allergy.
 Adverse Effects: Diarrhea, gallbladder sludge, allergic reaction.
 Desired Action: Eradicate infection.
 Nursing Responsibilities:
o Before: Allergy check, assess infection severity
o During: Reconstitute properly; give deep IM if IM route
o After: Monitor for superinfection (candida, C. difficile).

18. Cefuroxime

 Classification: 2nd generation cephalosporin antibiotic

 Dosage/Route/Frequency: 750 mg–1.5 g IV every 8 hours
 Pharmacologic Action: Inhibits bacterial cell wall synthesis.
 Indication: Respiratory infections, skin infections, urinary tract infections.
Contraindication: Cephalosporin allergy.
 Adverse Effects: GI upset, rash, allergic reactions.
 Desired Action: Treat bacterial infection.
 Nursing Responsibilities:
o Before: Allergy check
o During: Administer over recommended time frame
o After: Monitor therapeutic response and possible superinfection.
19. Ceftazidime

 Classification: 3rd generation cephalosporin antibiotic

 Dosage/Route/Frequency: 1–2 g IV every 8–12 hours
 Pharmacologic Action: Inhibits bacterial cell wall synthesis; excellent
pseudomonal coverage.
 Indication: Pseudomonas infections, serious Gram-negative infections.
Contraindication: Allergy to cephalosporins.
 Adverse Effects: Diarrhea, allergic reactions, C. difficile infection risk.
 Desired Action: Control Gram-negative infection.
 Nursing Responsibilities:
o Before: Confirm pathogen if possible
o During: Administer IV slowly
o After: Monitor for hypersensitivity reactions.

20. Hydrocortisone

 Classification: Corticosteroid (glucocorticoid)

 Dosage/Route/Frequency: 100–500 mg IV every 6–8 hours (depends on
indication)
 Pharmacologic Action: Anti-inflammatory and immunosuppressive action.
 Indication: Adrenal insufficiency, allergic reactions, inflammation, septic shock.
Contraindication: Systemic fungal infections, known hypersensitivity.
 Adverse Effects: Hyperglycemia, fluid retention, hypertension, infection risk.
 Desired Action: Suppress inflammation, manage adrenal crisis.
 Nursing Responsibilities:
o Before: Assess for infection, baseline glucose
o During: Monitor blood sugar, electrolytes
o After: Taper dose if long-term therapy to prevent adrenal insufficiency.