Normal Range

Dose/ Route

Use

Side Effects/ Contraindications

Observations/Nursing Considerations

PO: 15 - 45 mg qd

45 mg PO qd

improves insulin resistanceby hepatic glucose metabolism, insulin receptor kinase activity, insulin receptor phosphorylation / stable adult-onset Type II Diabetes Mellitus

C: Hypersensitivity to thiazolidinedione, lactation, children, diabetic ketoacidosis

PO: 30-60 mg qd usually, do not exceed 120mg qd

30 mg po qAM

Inhibits calcium ion influx across cell membrane during cardiac depolarization; relaxes coronary vascular smooth muscle; dialates coronary and peripheral arteries, incr myocardial oxygen delivery in pts w/ vasospastic angina / chronic stable angina pectoris, vasospastic angina, HTN

C: Hypersensitivity

notify doctor if dyspnea, peripheral edema, N/V, severe ataxia, and/or severe rash occur

(* fluticasone/ salmetrol)

Inhalor - 2 puffs BID

prevention of asthmatic symptoms

C: severe cardiac disease, tachydysrhythmias, Hypersensitivity to symypathomimetics;

Assess respiratory function: vital capacity, forced expiration capacity, ABG's, lung sounds, Heart rate and rhythm

(* ibuprofen suspension)

600 mg via G-Tube q4h prn (admin after meals/snacks)

Inhibits prostaglandin synthesis by decreasing enzyme needed for biosynthesis; analgesic, antiinflammatory, antipyretic / Rheumatoid Arthritis, Osteoarthritis, primary dysmenorrhea, gout, dental pain, musculoskeletal disorders, fever

C: Hypersensitivity, asthma, severe renal disease, severe hepatic disease, avoid in 2nd & 3rd trimesters of pregnancy

Albuterol Nebulizer

QID prn

prevention of asthmatic symptoms

C: severe cardiac disease, tachydysrhythmias, Hypersensitivity to symypathomimetics, heart block

Assess respiratory function: vital capacity, forced expiration capacity, ABG's, lung sounds, Heart rate and rhythm

(* spironolactone)

25mg po bid

Competes with aldosterone at receptor sites in distal tubule, resulting in excretion of sodium chloride and water, and the retention of potassium and phosphate / Edema, HTN, diuretic-induced hypokalemia

C: Hypersensitivity, anuria, severe renal disease, hyperkalemia, pregnancy (D)

Administer in morning to minimize sleep disturbance

250 mg-1g q8h

x 48 h

inhibits cell wall synthesis / prevention of infection (S. aureus)

C

assess sensitivity to penicillin & cephalosporins, nephrotoxicity, I/O daily, CBC w/ diff, Hgb/Hct, Electrolytes, Bowel patterns, anaphalaxis, overgrowth of infection.

(* darbapoetin alfa)

100 mcg sq q Tuesday AM

stimulates erythropoetsis by the same mechanism as endogenous erythropoetin / Anemia associated with CKF, for pts on and not on dialysis; Anemia in nonmyeloid malignancies receiving coadministered chemo

C: Hypersensitivity to mammallian cell-derived products or human albumin; uncontrolled HTN

Serious SE: rash, uticaria: stop drug if anaphalaxis occurs

5mg qd hs, inc to 10 mg after 4-6 wks

10 mg via G-Tube qhs

elevates ACh concentrations in cerebral cortex by slowing degredation of ACh released in cholinergic neurons; does not alter underlying dementia / Treatment of mild to moderate dementia in Alzheimer's Disease

C: Hypersensitivity to this drug or piperidine derivatives;

Twichting, N/V, sweating may indicate OD

(* atenelol)

25 mg po qd

blocks stimulation of Beta-adrenergic receptor within vascular smooth muscle, decr oxygen consumption of myocardium, decr HR / mild to moderate HTN; prophylaxis of angina pectoris; suspected or known MI (IV use)

C: Hypersensitivity to Beta blockers; cardiogenic shock, sinus bradycardia, 2nd or 3rd degree heart block, cardiac failure, pregnancy

(* lorazepam)

0.5 mg IVP qhs

potentiates the actions of GABA / anxiety, irritability in psychiatric or organic disorders, insomnia, adjunct to endoscopic procedures, preoperatively

C: narrow-angle glaucoma, children <12 yr., Hypersensitivity to benzodiazepines, hx of drug abuse, COPD, pregnancy

treat OD with lavage, flumazenil

SOL: 500 mcg, 3-4x/day

Inhibits interaction of ACh at receptor sites on the bronchial smooth muscle, resulting in reduced cGMP and bronchodialation / Bronchodialation during bronchospasm in those with COPD

C: Hypersensitivity to Atrovent, atropine, or soya lecithin

Assess for palpitations: if serious, may need to change meds; can build tolerance, may need to increase dose for long-term treatment; use hard condy, frequent drinks, gum to relieve dry mouth.

(* aspirin)

80 mg via G-Tube qAM

Blocks pain impulses in CNS; inhibition of prostaglandin synthesis, antipyretic effect by vasodialationof peripheral BV's, decreases platelet aggregation / mild to moderate pain, fever, arthritis, prophylaxis of MI, angina, ischemic stroke, TIAs,

C: hypersensitivity to salicylates & tartrazine, GI bleeding, bleeding disorders, children <12yo w/ flulike symptoms, pregnancy 3rd trimester, vit K def., PUD

Assess for Hepatoxicity and Ototoxicity

PO 25-50 mg qhs

25 mg PO qHS prn sleep

Allergy symptoms

C:hypersensitivity to H-1 receptor site antagonists, acute asthma attack, lower repiratory tract disease

Assess for urinary retention, ferquency, or dysuria. Assess CBC during long-term therapy. Assess respiratory status.

PO: 20-40mgqd

20 mg po qd

Blocks vasoconstriction & aldosterone-secreting effects of angiotensin II; selectively blocks binging of angiotensin II to receptor sites on tissues / HTN

C: Hypersensitivity, pregnancy in 2nd & 3rd trimesters

Assess hydration status

PO: 80-320 mg qd

40 mg PO q12h

blockade of beta 1 and 2 receptors leads to antidysrhythmic effect; prolongs action potential in myocardial fibers w/o affecting conduction; prolongs QR interval; no effect on QRS interval / Life-threatening ventricular dysrhythmias

C: Hypersensitivity to Beta blockers, cardiogenic shock, 2nd/3rd degree heart block, sinus bradycardia, CHF, bronchial asthma, congenital of aquired long QT syndrome

Assess skin turgor, mucous membranes for hydration status

(* valdecoxib)

10 mg BID

C: Hypersensitivity to NSAIDs, ASA, & iodides; asthma

Take w/ 8oz H2O for incr absorption

Max: 0.5 mcg/day

0.25mcg po qd

Increases intestinal absorption of calcium; provides calcium for bones; increases renal tubular resorption of phosphate / Hypocalcemia in chronic renal disease, hypoparathyroidism, pseudohypoparathyroidism

C: Hypersensitivity, hypercalcemia, vitamin D toxicity, hyperphosphatemia

monitor weight weekly

(* diltiazem)

300 mg po qd

inhibits calcium ion influx across cell membrane during cardiac depolarization, causes relaxation of coronary vascular smooth muscle, decreases SA/AV Node conduction, dialates peripheral arteries / Angina. HTN, Supraventricular tachycardia, atrial flutter

C: Sick-sinus Syndrome, 2nd or 3rd degree heart block, hypotension <90 mmHg systolic, cardiogenic shock, severe CHF

administer PO before meals and/or @hs

Chloraseptic Spray

Bedside PRN

50-300 mg qd prn

100 mg PO BID

Increases water and fat penetration in SI, allows for easier passage of stool / Stool softener; constipation

C: Hypersensitivity, obstruction, fedal impaction, nausea/vomiting

assess cause of constipation, identify whether fluids, bulk, or exercise are missing from diet; If cramping, rectal bleeding, nausea, vomiting occur, discontinue use. Toxic Interaction w/ Mineral Oil.

200mg po qd

/ Ventricular arrhythmias, advanced cardiac life support (ACLS), supraventricular arrhythmias

PO: 3.125 mg - 25mg qd

3.125 mg PO qd

a mixture of nonselective alpha and beta adrenergic blocking activities; decr CO, exercise-induced tachycardia, reflex orthostatic tachycardia; causes vasodialation & reduction in PVR / HTN, CHF

C: Hypersensitivity, bronchial asthma, class IV decompressed CF, 2nd/3rd degree heart block, cardiogenic shock, sever bradycardia, pulmonary edema

Assess qd for edema & fluid overload

PO/IV 2.5-10 mg qd x3, then titrate to INR qd

1 mg po today then d/c

Interferes with blood clotting by indirect means; depresses hepatic synthesis of Vitamin K-dependent coagulation factors (II, VII, IX,X) / PE, DVT, MI, atrial dysrhythmias, postcardiac valve replacement

C: Hypersensitivity, hemophilia, leukemia w/ bleeding, PUD, thrombocytopenic purpura, severe hepatic disease, severe HTN, sub-acute bacterial endocarditis, acute nephritis, pregnancy, eclampsia, preeclampsia, lactation

Assess PT/INR qd

(* losartan)

25 mg via g-tube BID

4mg IV Push q8h

Decreases inflammation by suppression of polymorphonulear leukocytes & fibroblasts, reversal of increased capillary permeability, and lysosomal stabilization / inflammation, allergies, neoplasms, cerebral edema, septic shock, collagen disorders

C: Hypersensitivity, psychosis, ITP, acute glomerulonephritis, fungal infections, non- asthmatic bronchial disease, AIDS, TB, child < 2yo

(* demeclocycline)

(4A-10A-4P-10P)

inhibits bacterial protein synthesis and cell growth; bacteriostatic / uncommon Gram+ or gram- bacterial and protozoal infections

C: Hypersensitivity to tetracyclines, children <8 yrs old, pregnancy (D)

warned of the risk of photosensitivity & avoid direct sunlight

HTN: 5-10 mg/day PO

10 mg PO Qam

HTN and edema

C: Hypersensitivity (sulfonomides), anuria, h

Assess hearing w/ high doses, daily weight, I/O, resp rate, ortho BP, electrolytes, glucose in urine, S/S of hypokalemia & metabolic alkalosis

(* tolterodine)

2mg PO qd

Relaxes smooth muscles in urinary tract by inhibiting acetylcholine (ACh) at postganglionic sites / Overactive Bladder

C: Hypersensitivity, uncontrolled narrow-angle glaucoma, urinary retention, gastric retention

If rash occurs, discontinue use

(* acetazolamide)

250 mg via g-tube qd (3PM)

(* digoxin)

for mgmt. of HF, A-fib, and Atrial flutter

C: Hypersensitivity to digitalis, V-fib, V-tach, carotid sinus syndrome, 2nd or 3rd degree heart block

Antidote is Digoxin Immune Fab (Digibind)

(* phenytoin)

300mg PO qhs

Inhibits spread of seizure activity in motor cortex by altering ion transport; incr AV conduction / Generalized tonic-clonic seizures; status epilepticus; non-epileptic seizures r/t Reye's syndrome or after head trauma; migraines; trigeminal neuropathy; Bell's Palsy, ventricle dysrhythmias not controlled by antidysrhythmics

C: Hypersensitivity, psychiatric condition, bradycardia, SA & AV block, Stokes-Adams Syndrome, hepatic failure

Assess for toxic levels (30-50 mcg/ml) 1 wk after start (therapeudic: 7.5-20 mcg/ml)

1-2mg IVP q4-6h PRN pain

1mg IVP q6h prn pain

alters psychological response to pain as well as perception (partially at a spinal level) and suppresses anxiety and apprehension. Analgesia is produced secondary to action on higher centers of the CNS without loss of consciousness / pain, severe cough

Addiction concern

(* valsartan)

80 mg po qd

Blocks vasoconstriction & aldosterone-secreting effects of angiotensin II; selectively blocks binging of angiotensin II to receptor sites on tissues / HTN

C: Hypersensitivity, pregnancy, severe hepatic disease, bilateral renal artery stenosis

Assess hydration status

Dobutrex

rate 2mcg/KG/min

Dopamine

rate 2mcg/KG/min

10 mg PR single dose

1 PR qd PRN

acts directly on intestine by increasing motor activity; thought to irritate colonic intramural plexus / Short-term treatment of constipation

C: appendicitis, ulcerated hemorrhoids, rectal fissures, hypersensitivity, abdominal pain

D/C drug if cramping rectal bleeding, nausea, or vomiting occur

(*venlafaxine)

150mg po qd

Potent inhibitor of neuronal serotonin and norepinephrine uptake. Weak inhibitor of dopamine. / Depression, General Anxiety Disorder

C: Hypersensitivity

PO: 10-50 mg qhs

10 mg qhs

inhibits reuptake of norepinephrine and serotonin into nerve endings, increasing action of norepinephrine and serotonin in nerve cells / Major depression. Investigational for chronic pain, prevention of migraine headaches, fibromyalgia

C: Hypersensitivity to tricyclics, recovery phase of MI, narrow-angle glaucoma

SC 25 mg 2x/wk.

Binds tumor necrosis factor (TNF), which is involved in immune and inflammatory reactions / Acute, chronic rheumatoid arthritis that has not responded to other disease-modifying agents, polyarticular course juvenile rheumatoid arthritis. Investigational for CHF, psoriasis/psoriac arthritis

C: Hypersensitivity, sepsis

Assess pain, stiffness, ROM, swelling of joints during treatment. Assess for injection site pain, swelling, usually after 2 injections (4-5 days). Do not use if solution is cloudy or discolored. Rotate injection sites. Do not admix with other solutions / meds

erythropoetin is a factor in production of RBC's, drug developed by recombinant DNA technology / Anemia caused by dcreased erythropoetin production in the body, primarily R/T ESRD

C: Hypersensitivity to mammallian cell-derived products or human albumin; uncontrolled HTN

Monitor dialysis pts or circulation impairments through thrill, bruit of shunts

50 mcg IVP q15min PRN (2 doses)

Inhibits ascending pain pathways in CNS, increases pain threshold, alters pain perception by binding to opioid receptors / pre- and post-operative pain; adjunct to general or regional anesthesia

C: Hypersensitivity to opioids, myasthenia gravis

Assess for Resp dysfunction; notify MD for resp rate <10

0.75-1.5 g qd divided into doses tid

325mg PO TID

Iron deficient anemia

C: Hypersensitivity, ulcerative colitis/regional enteritis, hemosiderosis/hemochromatosis, PUD, hemolytic anemia, cirrhosis

assess Hgb/Hct, billirubin,reticulocytes, prior to treatment and monthly during. Asess for toxicity, elimination, Nutrition (amt of iron in diet) cause of iron loss

PR 1 enema (118 ml)

1 PR POD#4 if no BM

increases water absorption in small intestine by osmotic action; laxitive effect occurs by increased peristalsis and water retention / constipation

C: appendicitis, ulcerated hemorrhoids, rectal fissures, hypersensitivity, abdominal pain, sodium restricted diets

D/C drug if cramping rectal bleeding, nausea, or vomiting occur

10 mg TID x 1 wk; not to exceed 60 mg/day x 3 wk

10 mg PO q6h prn spasm

Unknown action; may be related to antidepressant effects / Adjunct for relief of muscle spasm and pain in musculoskeletal conditions.

C: Acute rcovery phase of MI, dysrhythmias, heart block, CHF, hyprsensitivity, childre under 12, thyroid disease

Do not take w/ ETOH or CNS depressants.

PO 0.4mg- 0.8 mg qd

Binds peripherally to alpha-1a receptor subtype located mainly in the prostate / Treat symptoms of BPH

C: Hypersensitivity

Assess change in urinary patterns, CBC w/ diff and LFT's, BP, & HR. Monitor I/O ratios and watch for edema. Weight qd.

Maintenance: 0.4 mg qd

Needed for erythropoeisis; increases RBC, WBC, platelet formation in megaloblastic anemia / Megaloblastic or Macrocytic anemia caused by folic acid deficiency; liver disease, alcoholism, hemolysis, intestinal obstructions, pregnancy

C: Hypersensitivity, anemias other than megaloblastic/macrocytic anemia, vitamin B12 deficiency anemia, uncorrected pernicious anemia

Store in light-resistant container

PO: 500 mg bid initially, then increase to desired response. Max: 2500 mg/day

500 mg PO TID

inhibits hepatic glucose production and increases sensitivity of tissue to insulin / hyperglycemia; Diabetes Mellitus

C: Hypersensitivity; creatinine > or + 1.4 in women; CHF, alcoholism, cardiopulmonary disease, Hx of lactic acidosis

Assess for S/S of lactic Acidosis (malaise, myalgia, abdominal distress). Risk increases w age and/or poor renal function. Monitor electrolytes, pH, lac

(*glyburide / metformin)

5mg/500mg po q12h

gly: stimulates production of insulin by beta cell in pancreas. met: inhibits hepatic glucose production and increases sensitivity of tissue to insulin / hyperglycemia; Diabetes Mellitus

C: Hypersensitivity; creatinine > or + 1.4 in women; CHF, alcoholism, cardiopulmonary disease, Hx of lactic acidosis

Assess for S/S of lactic Acidosis (malaise, myalgia, abdominal distress). Risk increases w age and/or poor renal function. Monitor electrolytes, pH, lac

PO:

0.25 mg po qhs PRN

produces CNS depression at limbic, thalamic, hypothalamic levels of CNS; may be mediated by neurotransmitter (GABA); results in sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, anxiolytic action / Insomnia, sedative, hypnotic

C: Hypersensitivity to benzodiaepines, pregnancy, lactation, intermittent porphyria

Incr action with ETOH

IV Flush: 5000-7000 units/day IV BOL: 5000-7500 units, then IV INF: 1000 units/hr. then titrated to PTT

Interferes with blood clotting

5000 Units q8-12h

5000 Units SQ q12h

Prevents conversion of fibrinogen to fibrin & prothrombin to thrombin by enhancing the inhibitory effects of antithrombin III, therefore interfering with blood clotting. / Prevention of Deep Vein Thrombosis and Pulmonary Emboli

C: Hypersensitivity, hemophilia, Leukemia w/ bleeding, PUD, thrombocytopenia purpura, sever hepatic or renal disease, severe HTN, acute nephritis, subacute bacterial endocarditis

Check platelet couunt q2-3 days, thrombo-cytopenia can occur after 4 days

Humalog R

>400 - 12 units & call MD

lowers blood glucose levels / hyperglycemia; Diabetes Mellitus

C: Hypersensitivity to protamine

Assess for hypoglycemic reactions to treatment

Humalog R

>400 - 20 units & call MD

lowers blood glucose levels / hyperglycemia; Diabetes Mellitus

C: Hypersensitivity to protamine

Assess for hypoglycemic reactions to treatment

Humalog R

>400 - 28 units & call MD

lowers blood glucose levels / hyperglycemia; Diabetes Mellitus

C: Hypersensitivity to protamine

Assess for hypoglycemic reactions to treatment

Humalog NPH

lowers blood glucose levels / hyperglycemia; Diabetes Mellitus

C: Hypersensitivity to protamine

Assess for hypoglycemic reactions to treatment

(* hydrochlorothiazide)

50 mg via g-tube qAM

reduce reabsorption of electrolytes from the renal tubules, thereby increasing the excretion of sodium and chloride ions / edema R/T heart failure, HTN

40-100 mEqin divided doses tid-qid

10 mEq PO QD

needed for adequate function of nerve impulses, cardiac contraction, & kidneys; ion balance / Prevention of hypokalemia

C: Severe renal disease, severe hemolytic disease, Addison's disease, hyperkalemia, acute dehydra

Assess EKG for above variations, K+ levels during treatment, I/O (watch for decreased output), cardiac status; give PO w/ meal

PO 250-1000mg q6h

inhibits bacterial wall synthesis, rendering wall osmotically unstable, leading to cell death by binding to cell wall membrane / Specific Gram negative and Gram positive organisms

C

assess sensitivity to penicillin & cephalosporins, nephrotoxicity, I/O daily, CBC w/ diff, Hgb/Hct, Electrolytes, Bowel patterns, anaphalaxis, overgrowth of infection.

40-100 mEqin divided doses tid-qid

20 mEq po QD

needed for adequate function of nerve impulses, cardiac contraction, & kidneys; ion balance / Prevention of hypokalemia

C: Severe renal disease, severe hemolytic disease, Addison's disease, hyperkalemia, acute dehydra

Assess EKG for above variations, K+ levels during treatment, I/O (watch for decreased output), cardiac status; give PO w/ meal

(* lamotrigine)

100 mg po qd

Unknown, may inhibit voltage-sensative sodium channels / adjunct in treatment of partial seizures; children w/ Lennox-Gastaut syndrome; Investigational for generalized tonic-clonic, absence, atypical absence, myoclonic seizures; investigational for refractory bipolar disorder

C: Hypersensitivity

Do not discontinue abruptly

(* insulin glargine)

50 units SQ

lowers blood glucose levels / hyperglycemia; Diabetes Mellitus

C: Hypersensitivity to protamine

Assess for hypoglycemic reactions to treatment

IV/IM: 20-40 mg increased by 20 mg q2h until desired response

Inhibits reabsorption of sodium and chloride at proximal and distal tubule and in the loop of Henle / Pulmonary edema, edema in CHF, liver disease, nephrotic syndrome, ascites, HTN

C: Hypersensitivity to sulfonomides, anuria, hypovolemia, electrolyte depletion, infants, lactation

Precaution with Diabetes Mellitus, dehydration, renal disease, ascites, cirrhosis

(* levoflaxacin)

500 Mg/D5W 100 Ml IVPB qAM (infuse over 1 hour @ 100ml/hr)

Interferes with conversion of intermediate DNA fragments into high-molecular-weight DNA in bacteria; DNA gyrase inhibitor / Community - aquired pneumonia

C: Hypersensitivity to quinolones, photosensitivity

Teach pt to notify MD of diarrhea w/ blood or pus

(* escitalopram)

20 mg via G-Tube qAM

Inhibits CNS neuron uptake of serotonin but not of norepinephrine or dopamine / Major depreesive disorders

C: hypersensitivity

Assess BP, pulse q4h

(* atorvastatin)

40 mg via G-tube qAM

Inhibit HMG-CoA reductase enzyme, which reduces cholesterol synthesis / used as an adjunct in primary hypercholesterolemia (types Ia, Ib),dysbetalipoproteinemia, elevated triglycerides

IV BOL: 5mg q 2 min x3 then 50 mg

lowers B/P by Beta blocking effects; reduces elevated renin plasma levels; blocks B-2 adrenergic receptors in bronchial & vascular smooth muscle @ high doses / mild to mod. HTN, acute MI to reduce mortality, angina pectoris, NYHA Class II & III heart failure

C: Hypersensitivity to Beta blockers; cardiogenic shock, sinus bradycardia, 2nd or 3rd degree heart block, cardiac failure, Bronchial asthma, MAOI use

Monitor I&O, weight qd

(* betamethasone & clotrimazole)

Apply locally to R side and R groin BID

treatment of tinea pedis, tinea cruris, and tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Microsporum canis

Pregnancy Class

24 hours

90 mg SQ qd @ 11PM

Prevents conversion of fibrinogen to fibrin & prothrombin to thrombin by enhancing the inhibitory effects of antithrombin III, produces higher ratio of anti-factor Xa to IIa / prevention of DVT, pulmonary emboli

C: Active major bleeding; Hypersensitivity to heparin or pork products; Thrombocytopenia

Drug IS NOT interchangable w/ heparin

1 gtt in affected eye qPM

(pt has drops)

mimics the intraocular pressure lowering activity of prostamides via the prostamide pathway; lowers intraocular pressure by enhancing aqueous humor outflow / ocular hypertension, open-angle glaucoma

C: Hypersensitivity

Pt should schedule periodic opthamologist appts

1-2g q12h x 10 days

1G/D5W 50 Ml IVPB q12h (12 AM/12 PM; infuse over 30 min. @ 100ml/hr)

inhibits cell wall synthesis, making cell osmotically unstable / prevention of infection by Gram negative bacilli (E. coli); pneumonia

C: Hypersensitivity to cephalosporins, infants <1 mo old

Teach pt to c+R[12]Check CBS if diabetic, report persistant diarrhea.

Anorexia (AIDS): 800mg qd Oral suspension

800mg PO qd

Affects endometrium by antiluteinizing effect; this is thought to bring about cell death / Breast, endometrial cancer, renal cell cancer, cachexia anorexia in AIDS

C: Hypersensitivity, Pregnancy

Shake oral suspension well

7.5 mg/wk, max 20 mg/wk

Inhibits an enzyme that reduces folic acid; immunisuppressive / Acute lymphocytic leukemia, lymphosarcoma, gestational choricarcinoma, hyadatiform mole, psoriasis, rheumatoid arthritis, mycosis fungoides

SE / C: see page 649 in Mosby's 2004 Drug guide

see page 650 in Mosby's 2004 Drug guide

PO 20-80 mg/day

80mg po qd

Blocks the vasoconstrictor and alderosterone-secreting effects of angiotensin II; selectively blocks the binding of angiotensin II to the AT-1 receptor tissue found in tissue / HTN, investigational for HF

C: Hypersensitiviy; pregnancy in 2nd & 3rd trimester

Monitor and assess for LE edema

40-100 mEq in divided doses tid-qid

needed for adequate function of nerve impulses, cardiac contraction, & kidneys; ion balance / Prevention of hypokalemia

C: Severe renal disease, severe hemolytic disease, Addison's disease, hyperkalemia, acute dehydra

Assess EKG for above variations, K+ levels during treatment, I/O (watch for decreased output), cardiac status; give PO w/ meal

30-60 ml q hs

30 mL PO prn constipation

Increases osmotic pressure, draws fluid into colon, neutralizes HCl / Constipation

C: Hypersensitivity, obstruction, abdominal pain, renal disease, nausea/vomiting

I & O ratio to assess decrease in urinary output; Identify reason for constipation; D/C drug if cramping rectal bleeding, nausea, or vomiting occur; administer w/ 8 oz. Water

4-10 ml diluted in 4-5 ml water for injection, over 5 min

max 30 mg/4hr

depresses pain impulses at spinal cord by blocking opioid receptors

C: Hypersensitivity, addiction (opioid), hemmorrhage, bronchial asthma, increased intracranial press

Assess Pain, Bowel status, I/O ratio (decreased output may indicate urinary retention), B/P, pulse, respirations, CNS changes (dizziness, drowsiness hallucinations), allergic reaction,

4-10 ml diluted in 4-5 ml water for injection, over 5 min

2mg IV q1h (after D/C of PCA)

depresses pain impulses at spinal cord by blocking opioid receptors

C: Hypersensitivity, addiction (opioid), hemmorrhage, bronchial asthma, increased intracranial press

Assess Pain, Bowel status, I/O ratio (decreased output may indicate urinary retention), B/P, pulse, respirations, CNS changes (dizziness, drowsiness hallucinations), allergic reaction,

multivitamin

1 tab via g-tube q AM

needed for adequate metabolism / prevention and treatment of vitamin deficiencies

SUSP:30 mL po q4-6h

30 mg po q6h prn nausea / dyspepsia

neutralizes gastric acidity, binds phosphates in GI tract and excretes them; Increases osmotic pressure, draws fluid into colon, neutralizes HCl ; prevents gas pockets in GI system / Antacid, flatulence, constipation

C: Hypersensitivity to this drug or aluminum products, obstruction, abdominal pain, renal disease, nausea/vomiting

Watch for Mg toxicity

SUSP:30 mL po q4-6h

30 mg po q2h prn

neutralizes gastric acidity, binds phosphates in GI tract and excretes them; Increases osmotic pressure, draws fluid into colon, neutralizes HCl ; prevents gas pockets in GI system / Antacid, flatulence, constipation

C: Hypersensitivity to this drug or aluminum products, obstruction, abdominal pain, renal disease, nausea/vomiting

Watch for Mg toxicity

IV/SC/IM:0.4-2 mg, repeat q 2-3 min if needed

0.04 mg IV PUSH q1min until change in alertness observed

competes with opioids at opioid receptor sites / resp depression induced by opioids, pentazocine, or propoxyphene; refactory circulatory shock; asphyxia neonatorum

C: Hypersensitivity, respiratory depression

Monitor for respiratoy and cardiac effects

(* ropivacaine)

0.2% nerve block infusion continuous via catheter 1 at 10mL qhr

Competes w/ Ca++ for sites in nerve membrane that control Na+ transport across cell membrane; decr rise of depolarization phase of action potential / Peripheral nerve block, caudal anesthesia, central neural block, vaginal, epidural, spinal block

C: Hypersensitivity, children <12yo, ederly, severe liver disease

Assess VS for resp & cardiac distress

1 tab qd

1 tab qd

provides supplemental vit C, folate, niacin, thiamine, riboflavin, vit B-6, vit B-12, pantothenic acid and biotin / wasting syndrome in chronic renal failure; uremia; impaired metabolic fx of kidney; poor dietary intake or exessive excretion of vitamins; stress vitamin

C: No significant contraindications

Take AFTER dialysis treatment (PDR)

PO 900-1800 mg qd divided into 3 doses

600 mg PO TID

structurally similar to GABA; Mechanism of action unknown; may increase seizure threshold / seizures, neuropathic pain (inv.)

C: hypersensitivity to this drug

DO NOT chew or crush caps

(* nitroglycerine)

1 inch q6h

Decr. preload, afterload (decreasing left ventricle end-diastolic pressure, SVR; dialates coronary arteries, improves blood flow through coronary vasculature / Chronic stable angina, prophylaxis of anina pain, CHF associated w/ acute MI

C: Hypersensitivity to nitrates, severe anemia, incr. Intracranial pressure, cerebral hemorrhage

Wear gloves when placing patch, avoid touching w/ hands

(* amlodipine)

5 mg po qd

inhibits calcium ion influx across cell membrane during cardiac depolarization, causes relaxation of coronary and peripheral vascular smooth muscle, dialates coronary vascular arteries, incr myocardial O2 delivery in pts w/ vasospastic angina / chronic stable angina, HTN, vasospastic angina

C: sick sinus syndrome, 2nd or 3rd degree heart block, hypotension < 90 mmHg, hypersensitivity

Contact physician if pulse <50 bpm

(* quinidine sulfate)

prolongs duration of action potential and effective refactory period, thus decreasing myocardial excitability; anticholergenic properties / PVC's, A-Fib, PAT, V-Tach, atrial flutter

C:Hypersensitivity, blood dyscrasias, severe heart block, myasthenia gravis

Assess for cinchonism. Admin AV node blocker before starting to avoid increased ventricular rate

PO: 1-2g qd

1 po tid

neutralizes gastric acidity / Antacid, calcium supplement, not suitable for chronic therapy

C: Hypersensitivity, hypercalcemia, hyperparathyroidism, bone tumors

Asess Ca levels during treatment, cardiac status, EKG for decreased QT and T-wave inversion. Admin PO w/ or following meals to enhance absorption.

PO: 1-2g qd

1250 mg (1 tab) po q12h

neutralizes gastric acidity / Antacid, calcium supplement, not suitable for chronic therapy

C: Hypersensitivity, hypercalcemia, hyperparathyroidism, bone tumors

Asess Ca levels during treatment, cardiac status, EKG for decreased QT and T-wave inversion. Admin PO w/ or following meals to enhance absorption.

10-30 mg q4h

Inhibits ascending pain pathways in CNS, increases pain threshold, alters pain perception / Moderate to severe pain

C: Hypersensitivity to opioids, addiction

Physical dependency may result from prolonged use

200mg po qd

prolongs duration of action potential and effective refractory period, noncompetative alpha- and beta-adrenergic inhibition; increases PR and QT intervals, decreases sinus rate and peripheral vascular resistance / a-fib, severe v-tach, v-fib not controlled by 1st-line agents, cardiac arrest

C: Pregnancy (class D), 2nd and/or 3rd degree heart block, bradycardia,neonates, infants, severe sinus node dysfunction

Assessm for rebound HTN after 1-2 hrs

20mg PO qAM, inc dose in 10mg increments q wk if not therapudic (max:60mg)

Inhibits CNS neuron uptake of serotonin but not of norepinephrine or dopamine / Major depreesive disorders, panic disorders, obsessive-compulsive disorder, ganeralized anxiety disorder. Investigational for Diabetic Neuropathy, headaches, fibromyalgia. bi-polar.

C: hypersensitivity, people taking MAIO's

Increased bleeding w/ Coumadin; DO NOT use w/ MAIOS - can be fatal; Assess mental status, Orthostatic BP; administer with food or milk for decreased GI SE; Increase fluid intake & bulk in diet for constipation and urinary retention

20 mg q12h IV

20 mg IV q24h (until tol PO)

decreses gastric secretions while pepsin remains at a stable level. Inhibits histamine at H2 receptor site / GERD

C: Hypersensitivity

Pregnancy Class B; precaution w/ children <12. Assess for epigastric pain, occult blood in stools and/or emesis, decreasing platelets, hematuria, hematuresis, thrombocytopenia

20 mg q6h PO; may give 160 mg q6h if needed

20 Mg PO BID

decreses gastric secretions while pepsin remains at a stable level. Inhibits histamine at H2 receptor site / GERD

C: Hypersensitivity

Pregnancy Class B; precaution w/ children <12. Assess for epigastric pain, occult blood in stools and/or emesis, decreasing platelets, hematuria, hematuresis, thrombocytopenia

10-30 mg PO q4h

Inhibits ascending pain pathways in CNS, increases pain threshold, alters pain perception / moderate pain

C: Hypersensitivity, opiate addiction

Assess I/O (watch for decreased output), CNS depression, allergic reaction, physical dependence.

PO: 75-150 mg qd

75 mg po qd

Inhibits 1st and 2nd phases of ADP-induced effects in platelet aggregation / reduce risk of stroke, MI, & PAD in high risk pts, Acute coronary syndrome

C: Hypersensitivity, active bleeding

Assess Liver Fx tests and CBCs

40-100 mEqin divided doses tid-qid

30 mEq via g-tube QD

needed for adequate function of nerve impulses, cardiac contraction, & kidneys; ion balance / Prevention of hypokalemia

C: Severe renal disease, severe hemolytic disease, Addison's disease, hyperkalemia, acute dehydra

Assess EKG for above variations, K+ levels during treatment, I/O (watch for decreased output), cardiac status; give PO w/ meal

(* pravastatin)

20mg po qd

inhibits HMG-CoA reductase enzyme, reducing cholesterol synthesis / as an adjunct in primary hyperlipidemia

C: Hypersensitivity, pregnancy, lactation, active liver disease

Assess pt for muscle tenderness

1.5-2.5mg qid-bid then qd or qod, maintainance up to 250 mg/day

5 mg PO q AM

severe inflammation, immunosuppression

C: Psychosis, hypersensitivity, ITP, acute glumerulonephritis, amebiases, AIDS, TB, fungal infections, non-asthmatic bronchial disease

Assess adrenal insufficiency, K, CBS, Urine glucose, daily weight ; I/O ratio, mental status

For Erosive Esophagus: 30mg qd before eating for up to 8 wks

30 mg po qAM

Supresses gstric secretion by inhibiting hydrogen/potassium ATPase enzyme system in gastric parietal cells, blocks final step of acid production / GERD, erosive esophagus, gastric ulcers, maintenance of healed duodenal ulcers

C: Hypersensitivity,

Administer before eating. Swallo whole. Assess bowel sound q 8 hr., assess liver function tests (AST, ALT, alka phosphatase) during treatment.

10-40 mg qd, may inc. to 80 mg if necessary

20 Mg PO qAM

inhibits ACE, preventing conversion of Angiotensin I - Angiotensin II / mild to moderate HTN

C: Pregnancy Class D (2nd/3rd trimester); Hypersensitivity,

Monitor B/P, pulse q4h. Monitor K, Na, & Cl levels. Establish liver and renal functions prior to trearment nd monitor for changes peiodically

40 mg qd x 8 wks, may repeat course

40 mg PO qAM

supresses gastric secretions by inhibiting ATPase / mild pain

SE: dizziness, drowsiness, seizures, thrombocytopenia, agrunulocytosis, hemolytic anemia, urinary retention, Anaphylaxis

Assess for urinary retention, ferquency, or dysuria. Assess CBC during long-term therapy. Assess respiratory status.

PO: 20-80 mg / day

Investigational for Alcoholism, anorexia nervosa, ADHD, bipolar II affective disorder, et al

C: Hypersensitivity, MAIO's

Assess BP, if BP drops 20 mmHg, notify MD & hold drug. Admin at night if over-sedation occurs. Therapudic effect may take 1-4 wks. VS q4h for pt w/ Cardiac disease. Apetite may decrease with drug. Increases CBS levels

(* temazepan)

7.5mg po qhs

produces CNS depression at limbic, thalamic, & hypothalamic levels of CNS; may be mediated by GABA,; results are sedation, hypnosis, skeletal muscle relaxation, anticonvlsant activity, anxiolytic action / Insomnia

C: hypersensitivity to benzodiazepines, pregnancy (class X), lactation, intermittent porphyria

(* docusate 50mg / senna concentrate 187 mg)

Increases water and fat penetration in SI, allows for easier passage of stool; Stimulates peristalsisby action on Auerbach's plexus, softens feces by increasing water and electrolytes in the large intestine / Stool softener; constipation, bowel prep

C: Hypersensitivity, obstruction, fecal impaction, nausea/vomiting, GI bleeding, CHF, lactation, nausea/vomiting, appendicitis, abdominal pain, acute surgical abdomen

DO NOT USE with disulfarim (Antabuse

(* senna, sennosides)

8.6mg PO qhs

Stimulates peristalsis by action on Auerbach's plexus, softens feces by increasing water and electrolytes in the large intestine / Acute constipation, bowel prep

C: Hypersensitivity, obstruction, GI bleeding, CHF, lactation, nausea/vomiting, appendicitis, abdominal pain, acute surgical abdomen

DO NOT USE with disulfarim (Antabuse

(* silver sulfadiazine)

Apply to RT qAM

Interferes with bacterial protein synthesis / Skin infections, minor burns, wounds, skin grafts, primary pyodermas, otitis externa

C: Hypersensitivity, burns, ulcerations, impaired renal function,

Pregnancy Class C

25/100 tid-qid, may increase qd to desired response

decarboxxylation of levodopa to periphery is inhibited by carbidopa; more levodopa is made available for transport to the brain and conversion to dopamine in the brain / Parkinson's disease and Parkinsonism

C: hypersensitivity, narrow-angle glaucoma, malignant melanoma, Hx of maleanoma

Assess for parkinsonian symproms: pill rolling, tremors, drooling, rigidity. Hypertensive Crisis w/ MAIO's. Decreased effect w/ benzodiazapines, hydantions, anticholinergics, pyridoxine, & papaverine. Assess mental status, ortho BP. Give w/ meals if GI SE.

25/250 tid-qid, may increase qd to desired response

decarboxxylation of levodopa to periphery is inhibited by carbidopa; more levodopa is made available for transport to the brain and conversion to dopamine in the brain / Parkinson's disease and Parkinsonism

C: hypersensitivity, narrow-angle glaucoma, malignant melanoma, Hx of maleanoma

Assess for parkinsonian symproms: pill rolling, tremors, drooling, rigidity. Hypertensive Crisis w/ MAIO's. Decreased effect w/ benzodiazapines, hydantions, anticholinergics, pyridoxine, & papaverine. Assess mental status, ortho BP. Give w/ meals if GI SE.

50/200 bid

decarboxxylation of levodopa to periphery is inhibited by carbidopa; more levodopa is made available for transport to the brain and conversion to dopamine in the brain / Parkinson's disease and Parkinsonism

C: hypersensitivity, narrow-angle glaucoma, malignant melanoma, Hx of maleanoma

Assess for parkinsonian symproms: pill rolling, tremors, drooling, rigidity. Hypertensive Crisis w/ MAIO's. Decreased effect w/ benzodiazapines, hydantions, anticholinergics, pyridoxine, & papaverine. Assess mental status, ortho BP. Give w/ meals if GI SE.

PO 10 mg qd pm

10 mg via G-Tube qhs

Inhibits leukotriene formation / Chronic Asthma in adults and children

C: Hypersensitivity

Assess for S/S of Churg-Strauss syndrome (rare), incl neuropathy, eosinophilia, vasculitic rash, worsening pulmonary symptoms, and/or cardiac complications

( *zaleplon)

10 mg po daily PRN

binds selectively to omega-1 receptors of GABA-A receptor complex / insomnia

C: Hypersensitivity

(* levothyroxine (T-4))

0.05 mg (50 mcg) via G-Tube qAM

Incr. Metabolism rate; controls protein synthesis; incr. CO, renal blood flow, O2 consumption, body temp, blood volume, growth, development at cellular level; exact mechanism unknown / Hypothyroidism, some types of thyroid cancer, thyroid hormone replacement

C: Adrenal insufficiency, recent MI, thyrotoxicosis, hypersensitivity to beef, ETOH intolerance (injection only)

use for hormone imbalances only

(trandolapril/verapamil)

240 mg qd

inhibits calcium ion influx across cell membrane during cardiac depolarization, causes relaxation of coronary vascular smooth muscle, decreases SA/AV Node conduction, dialates peripheral arteries / Angina. HTN, Supraventricular tachycardia, atrial flutter

C: Sick-sinus Syndrome, 2nd or 3rd degree heart block, hypotension <90 mmHg systolic, cardiogenic shock, severe CHF

administer PO before meals and/or @hs

(* chlorpromazine)

25 mg po qd

Depresses cerebral cortex, hypothalamus, limbic system, which control activity aggression; blocks neurotransmission produced by dopamine / Psychotic disorders, Nausea & Vomiting, intractible hiccups, Tourette's syndrome

C: Hypersensitivity to phenothiazine drugs, coma, extensive use of CNS depressants, Bone marrow depression, pts < 6 mo old

May cause urine to turn pink or red

PO (Ext. Rel): 50-100mg qd

50mg po qd

lowers B/P by Beta blocking effects; reduces elevated renin plasma levels; blocks B-2 adrenergic receptors in bronchial & vascular smooth muscle @ high doses / mild to mod. HTN, acute MI to reduce mortality, angina pectoris, NYHA Class II & III heart failure

C: Hypersensitivity to Beta blockers; cardiogenic shock, sinus bradycardia, 2nd or 3rd degree heart block, cardiac failure, Bronchial asthma, MAOI use

Monitor I&O, weight qd

150 mg/day in divided doses, may increase in 50 mg ingriments to max 600mg/day

25 mg PO qHS prn sleep

selectively inhibits seritonin, norepinephrine uptake by brain, potentiates behavior changes / Depression, investigational for pain

C: hypersensitivity to tricyclics, recovery phase of MI, convulsive disorders, prostatic hypertrophy

Therapudic effects take 2-3 wks.

max 4g qd

> 38.5 & call HO

May block pain impulses peripherally that occur in response to inhibition of prostaglandin synthesis; antipyretic effect from inhibition of prstaglandins in CNS / mild pain, fever

C: hypersensitivity, intolerance to tartrazine (yellow dye #5), ETOH

Assess for toxicity S/S: Cyanosis, Anemia, Neutopenia, Jaundice, pancytopenia, CNS stimulation, delerium followed by vascular collapse, convulsions, coma, death

1 300mg/30mg tab

1 po q4-6h prn pain

C: Hypersensitivity to opiates, respiratory depression, increased ICP, severe respiratory disorders, ETOH, seizure disorders

Assess for acetaminophen toxicity: cyanosis, anemia, neutopenia, jaundice, pancytopenia, CNS stimulation, delerium followed by vascular collapse, convulsions, coma, death. Assess I/O. assess for CNS depression, productive cough.

not to exceed 400 mg/day

100 mg po q6h

action not completely understood, binds to opiod receptors, inhibits reuptake of norepinepherine and serotonin / Moderate to severe pain

C: Hypersensitivity, acute intoxication with any CNS depressant

(* ampicillin & sulbactam)

(8A-4P-12A)

interrupts bacterial cell wall synthesis and inhibits prduction of beta-lactamase / used for a variety of bacterial infections

C: Hypersensitivity to penicillins

IV: 500mg q6h or 1g q12h

1 g IV q12h

inhibits bacterial cell wall synthesis / resistant staph infections

C: Hypersensitivity, previous hearing loss

Assess for infection S/S, I/O ratio; For Patients with Renal problems, watch for toxicity as drug is excreted slowly through kidneys. Complete C&S prior to admin. Assess respiratory system. Assess for any hearing loss, tinnitus.

PO 10-40 mg qd, initial dose 5mg qd

10 mg PO qd

inhibits ACE, preventing conversion of Angiotensin I - Angiotensin II / HTN, CHF, left ventricle dysfunction

C: Pregnancy Class D (2nd/3rd trimester); Hypersensitivity,

Monitor B/P, pulse q4h. Monitor K, Na, & Cl levels. Establish liver and renal functions prior to trearment nd monitor for changes peiodically

IV BOL: 5-10 mg over 10 min

inhibits calcium ion influx across cell membrane during cardiac depolarization, causes relaxation of coronary vascular smooth muscle, decreases SA/AV Node conduction, dialates peripheral arteries / Angina. HTN, Supraventricular tachycardia, atrial flutter

C: Sick-sinus Syndrome, 2nd or 3rd degree heart block, hypotension <90 mmHg systolic, cardiogenic shock, severe CHF

administer PO before meals and/or @hs

5-10 mg PO q4h

5 mg / 500 mg PO q4h prn pain

binds to opioid receptorsin CNS to reduce pain / moderate pain

C: Hypersensitivity, opiate addiction

Assess for CNS change, allergic reactions, cough and respiratory dysfunction; Watch for signs of physical dependence

****NO LONGER ON MARKET***

25mg po qd

C: Hypersensitivity to NSAIDs, ASA, & iodides; asthma

Take w/ 8oz H2O for incr absorption

SC/IM/IV/PO 200-500mg qd

500 mg via G-tube qAM

Needed for wound healing, collagen synthesis, antioxidant, carbohydrate metabolism / Vitamin C deficiency, scurvy, delayed wound and bone healing (Decubitis Ulcers), chronic disease, urine acidification, before gastrectomy

C: No significant contraindications

Encourage foods high in Vit C (Citrus fruits, vegetables)

PO: 150mg qd, incr to 300mg if initially tolerated

150 mg PO q12h

Inhibits reuptake of dopamine, norepinephrine, and serotonin / Depression

C: Hypersensitivity, eating / seizure disorders

DO NOT crush or chew

1 gtt qd in affected eye(s) in the evening

1 gtt OU qhs

reduces production of aqueous humor / primary open-angle glaucoma

C:Hypersensitivity to latanoprost or benzalkonium chloride

drug may cause burning, itching, blurring, dryness in eyes.

max 10mg/day

depresses subcortical levels of CND, including limbic system, reticular formation. / anxiety, panic disorders. Investigational for depression, social phobias, premenstrual dysphoric disorders.

C: Hypersensitivity to benzodiazepines, narrow-angle glaucoma, psychosis, pregnancy, lactation, addiction.

May cause decreased Hct, Neutropenia. Assess for physical dependancym (Schedule IV Controlled susbstance)

10-40 mg qd, may inc. to 80 mg if necessary

20 Mg PO qAM

inhibits ACE, preventing conversion of Angiotensin I - Angiotensin II / mild to moderate HTN

C: Pregnancy Class D (2nd/3rd trimester); Hypersensitivity,

Monitor B/P, pulse q4h. Monitor K, Na, & Cl levels. Establish liver and renal functions prior to trearment nd monitor for changes peiodically

PO 25-50 mg/day as supplement

220 mg via G-tube qAM

Needed for adequate healing, bone and joint development / prevention of zinc deficiency, adjunct to vitamin A therapy, investigational for wound healing

C: No significant contraindications

Avoid dairy products

no more than 80mg qd

20 mg PO qhs

Inhibits HMG-CoA reductase enzyme, which controls cholesterol synthesis; as an adjunct in primary hypercholesterolemia (types IIa & Iib), isolated hypertriglyceridemia (Frederickson type IV) and type III hyperlipoproteinemia; CAD

C: Hypersensitivity, pregnancy, lactation, active liver disease

*assess for rhabdomyolysis (muscle tenderness, incr CPK indicate need to D/C)

>30 sec.prior to induction of anesthesia

4 mg IV q6h prn nausea

blocks serotonin peripherally, centrally, and in the small intestine

C: Hypersensitivity

assess for hypersensitivity reaction, absence of nausea, dilute single dose 50 mL NS or D5W 0.45% NaCl or NS

Geriatric: 25mg qd

25 mg po qd

Inhibits reuptake of serotonin in CNS;incr. Action of serotonin; does not affect norepinephrine or dopamine / Major depression, OCD, PTSD, panic disorder

SE: Insomnia, agitation, somnolence, dixxiness, tremor, headache, fatigue, male sexual dysfunction, N/V/D, constipation, dry mouth, flatulence, SIADH (ederly pts)

Apetite may decrease w/ drug

IM/IV 2-4g q 4-6 hr

4.5 gm IV q8h

interferes with cell wall replication in certain organisms by causing osmotic instability, cell wall swells & bursts / fight bacterial infections

C: Hypersensitivity to penicillins

Assess for infection S/S, I/O ratio; For Patients with Renal problems, watch for toxicity as drug is excreted slowly through kidneys. Complete C&S prior to admin. Assess respiratory system.

PO: 5-10 mg qd

10 mg po qd

Acts on BV, GI, and resp system by competing w/ histamine for h1-receptor site; decr allergic response by blocking pharmocologic effects of histamine / Rhinitis, allergic symptoms

C: Hypersensitivity to this or hydroxyzine; newborn and premature infants, lactation, severe hepatic disease

Give hard candy, gum, or frequent rinses for dry mouth