Opioid (narcotics)-Morphine

• Most important patient educations: for long-term use-physical dependency will develop.  This is not the same as addiction and not as appropriate reason to withhold the drug.
  

• Patient safety alert:  check dose and patient status carefully; adverse effects and medication errors are common with this drug.  Monitor patient closely, because fall risk is increased.

Salicylates-Aspirin

Life Span alert:

aspirin should not be given to children with varicella-or flu-like illness; it should not be given during pregnancy, especially during the third trimester; monitor patients older than 60 years carefully.  Low-dose aspirin therapy is routinely given to health adults older than 40 years old to prevent MI and stroke.

Nonsteroidal anti-inflammatory medications-Ibuprofen

Life Span alert:

ibuprofen is in pregnancy category D in the third trimester: monitor patients over the age of 60 years carefully.

Acetaminophen

Life Span alert: acetaminophen is the drug of choice for infants and children with flu or flu-like symptoms; analgesic of choice during pregnancy or lactation

Beta Blockers-“olol” medications-atenolol

Most important patient educations: self-monitoring techniques for adverse effect including how to take a pulse and to detect irregular rhythms or bradycardias

ACE Inhibitors-“pril” medications

• Life span alert;  Captopril can cause injury and death to a developing fetus during the second and third trimesters.

Cardiac Glycosides (Digoxin)

• Most important patient educations: teach how to take pulse and to avoid taking the dose if pulse is below 60, keep out of the reach of children.

Nitrates

Most important patient educations:

If one or two (some books say three) sublingual tablets do not alleviate pain, seek immediate emergency medical treatment. Key:  seek help if medication not relieving chest pain.

Use prophylactic doses before activities that may precipitate angina.

Remove patches or ointment for 10 to 12 hours out of every 24 hours to prevent tolerance.

Heparin

Safety alert:  check concentration of heparin carefully.  Use of the wrong concentration for the route of administration is a common medication error with serious/potentially life-threatening ramifications

Most important patient educations: instruct patients to report any blood in urine or stools or bleeding from gums, nose, vagina, or wounds.

Most important patient educations: teach patients to monitor for bleeding, to modify behavior to avoid injuries, and to keep consistent vitamin K intake.

Lipid-lowering meds

Statin Drugs

Most important patient educations: teach patients to continue on a low-fat diet and to report any unexplained muscle pain, tenderness, or weakness at once.

Bronchodilators -

Albuterol

MOST important patient education:  this rescue drug should be used first for all acute symptoms of shortness of breath or wheezing.

MOST important patient education: 

not to be used as a “rescue drug”

Hydrochlorothiazide HTCZ-

Thiazide Diuretics

Most important patient education: explain the importance of periodic blood work to monitor electrolytes.

Safety alert:  life-threatening hyperkalemia may result when combined with potassium supplements or drugs that increase potassium levels indirectly

Most important patient education: tell the patient to avoid easting potassium-rich food, taking potassium supplements, or using a salt substitute containing potassium chloride.

Peptic Ulcer medications-Proton Pump Inhibitors

Most important patient educations:

take omeprazole before meals, do not crush or chew drug

Most important education:

Treatment is LIFELONG

Safety Alert: Sound-alike names for various types of insulin and the high potency of insulins are both common sources of medication errors.

Most important pt. education:     thorough teaching regarding dosage, administration techniques for subcutaneous injection, delivery devices, diet and exercise, and capillary blood glucose testing; wear medical alert tag identifying diabetic condition treated with insulin alert emergency medical personnel.

Oral hypoglycemic-sulfonylureas-Glyburide

Benzodiazepines

Life Span alert: contraindicated in children under 6 months; pregnancy category D; older adults more likely to develop ataxia and confusion-so give smaller doses.

Most important patient educations: avoid talking alcohol and other CNS depressants while on a benzodiazepine.

Most important patient education: take the medication exactly as prescribed until the entire prescription is completed, despite the absence of symptoms.  Monitor for signs and symptoms of allergic response and stop the medication if any occur. 

Patient safety:  PCN G: Can be given IM (painful), IV (only PCN form given IV), CANNOT PO (unstable in stomach acid), PCN V or VK:  Can be given PO, NOT IM or IV

  Most important patient education:  take the medication exactly as prescribed until the entire prescription is completed, despite the absence of symptoms.  Monitor for signs and symptoms of allergic response and stop the medication if any occur.

Patient safety:  The generic names of the cephalosporins are very similar.  Triple-check the order before administering the medication.

Most important patient education: need for period CBC when taking for prolonged period or high doses.  Need to advise the health care team for changes in hearing.

Most important patient education: teach the patient to complete the entire course of medication, despite feeling better.  Teach the patient to keep medication out of the reach of children.