Drug Cards Set 3

Front 1

Regular Insulin/Short Acting Insulin

Humulin R or Novolin R

Back 1

Insulin - Regular/Short Acting Insulins
Trade names:Humulin R, Novolin R, Humilin U-500
Pharm. Class: pancreatics
Ther. Class: antidiabetic hormones
Uses: Control of hyperglycemia in patients with diabetes mellitus
Unlabelled Use(s): Treatment of hyperkalemia
Forms: Insulin injection (regular insulin): 100 units/mL OTC; Regular (concentrated) insulin injection: 500 units/mL; In combination with: NPH insulins (Humulin 70/30, Novolin 70/30)
Action: Lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production; Other actions of insulin: inhibition of lipolysis and proteolysis; enhanced protein synthesis
Therapeutic Effect(s): Control of hyperglycemia in diabetic patients
Route/Dosage: SC: 0.5–1 unit/kg/day in divided doses; Dose depends on blood glucose, response, and many other factors
Side Effects: HYPOGLYCEMIA, lipodystrophy, pruritus, erythema, swelling, ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS .
Patient/Family Education: Instruct patient on proper technique for administration. Include type of insulin, equipment (syringe, cartridge pens, alcohol swabs), storage, and place to discard syringes. Discuss the importance of not changing brands of insulin or syringes, selection and rotation of injection sites, and compliance with therapeutic regimen. Opened, unused insulin vials should be discarded 1 month after opening; Demonstrate technique for mixing insulins by drawing up regular insulin first and rolling intermediate-acting insulin vial between palms to mix, rather than shaking (may cause inaccurate dose); Explain to patient that this medication controls hyperglycemia but does not cure diabetes. Therapy is long term; Instruct patient in proper testing of serum glucose and ketones. These tests should be closely monitored during periods of stress or illness and health care professional notified of significant changes; Emphasize the importance of compliance with nutritional guidelines and regular exercise as directed by health care professional; Advise patient to consult health care professional prior to using alcohol or other Rx, OTC, or herbal products concurrently with insulin; Advise patient to notify health care professional of medication regimen prior to treatment or surgery; Advise patient to notify health care professional if nausea, vomiting, or fever develops, if unable to eat regular diet, or if blood glucose levels are not controlled; Instruct patient on signs and symptoms of hypoglycemia and hyperglycemia and what to do if they occur; Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding or planning to breastfeed; Patients with diabetes mellitus should carry a source of sugar (candy, glucose gel) and identification describing their disease and treatment regimen at all times; Emphasize the importance of regular follow-up, especially during first few weeks of therapy

Front 2

GLIPIZIDE

Trade names: Glucotrol, Glucotrol XL

Back 2

GLIPIZIDE
Trade names: Glucotrol, Glucotrol XL
Pharm. Class: sulfonylureas
Ther. Class: antidiabetics
Uses: Controls of blood sugar in type 2 diabetes mellitus when diet therapy fails. Requires some pancreatic function
Forms: Tablets: 5 mg, 10 mg; Extended-release tablets: 2.5 mg, 5 mg, 10 mg; In combination with: metformin (MetaGlip)
Action: Lowers blood sugar by stimulating the release of insulin from the pancreas and increasing the sensitivity to insulin at receptor sites; May also decrease hepatic glucose production
Therapeutic Effect(s): Lowering of blood sugar in diabetic patients
Route/Dosage: PO (Adults): 5 mg/day initially, ↑ as needed (range 2.5–40 mg/day); XL dose form is given once daily. Doses >15 mg/day may be given as 2 divided doses of regular-release product (not XL).
Side Effects: dizziness, drowsiness, headache, weakness, constipation, cramps , diarrhea, drug-induced hepatitis, dyspepsia, ↑ appetite, nausea, vomiting, photosensitivity, rashes, hypoglycemia, hyponatremia, APLASTIC ANEMIA, agranulocytosis, hemolytic anemia, leukopenia, pancytopenia, thrombocytopenia.
Patient/Family Education: Instruct patient to take medication at same time each day. Take missed doses as soon as remembered unless almost time for next dose. Do not take if unable to eat; Explain to patient that this medication controls hyperglycemia but does not cure diabetes. Therapy is long term; Review signs of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise patient to drink a glass of orange juice or ingest 2–3 tsp of sugar, honey, or corn syrup dissolved in water or an appropriate number of glucose tablets and notify health care professional; Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent hypoglycemic or hyperglycemic episodes; Concurrent use of alcohol may cause a disulfiram-like reaction (abdominal cramps, nausea, flushing, headaches, and hypoglycemia); Instruct patient in proper testing of serum glucose and ketones. These tests should be closely monitored during periods of stress or illness and health care professional notified if significant changes occur; May occasionally cause dizziness or drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known; Caution patient to avoid other medications, especially aspirin and alcohol, while on this therapy without consulting health care professional; Insulin is the recommended method of controlling blood sugar during pregnancy. Counsel female patients to use a form of contraception other than oral contraceptives and to notify health care professional promptly if pregnancy is planned or suspected; Caution patient to use sunscreen and protective clothing to prevent photosensitivity reactions; Advise patient to inform health care professional of medication regimen prior to treatment or surgery; Advise patient to carry a form of sugar (sugar packets, candy) and identification describing disease process and medication regimen at all times; Advise patient to notify health care professional promptly if unusual weight gain, swelling of ankles, drowsiness, shortness of breath, muscle cramps, weakness, sore throat, rash, or unusual bleeding or bruising occurs; Emphasize the importance of routine follow-up exams

Front 3

PROPRANOLOL

Trade names: Inderal, Inderal LA, InnoPran XL

Back 3

PROPRANOLOL
Trade names: Inderal, Inderal LA, InnoPran XL
Pharm. Class: beta blockers
Ther. Class:antianginals, antiarrhythmics (Class II), antihypertensives, vascular headache suppressants
Uses: Management of hypertension, angina, arrhythmias, hypertrophic cardiomyopathy, thyrotoxicosis, essential tremors, pheochromocytoma; Also used in the prevention and management of MI, and the prevention of vascular headaches
Unlabelled Use(s): Also used to manage alcohol withdrawal, aggressive behavior, antipsychotic-associated akathisia, situational anxiety, and esophageal varices; Post-traumatic stress disorder (PTSD)
Forms: Oral solution: 4 mg/mL, 8 mg/mL; Tablets: 10 mg, 20 mg, 40 mg, 60 mg, 80 mg; Sustained-release capsules (Inderal LA): 60 mg, 80 mg, 120 mg, 160 mg; Extended-release capsules: 60 mg, 80 mg, 120 mg, 160 mg; Injection: 1 mg/mL; In combination with: hydrochlorothiazide (Inderide).
Action: Blocks stimulation of beta1(myocardial) and beta2 (pulmonary, vascular, and uterine)-adrenergic receptor sites
Therapeutic Effect(s):Decreased heart rate and blood pressure; Suppression of arrhythmias; Prevention of MI
Route/Dosage: PO, IV (see book)
Side Effects: fatigue, weakness, anxiety, dizziness, drowsiness, insomnia, memory loss, mental depression, mental status changes, nervousness, nightmares, blurred vision, dry eyes, nasal stuffiness, bronchospasm, wheezing, ARRHYTHMIAS, BRADYCARDIA, CHF, PULMONARY EDEMA, orthostatic hypotension, peripheral vasoconstriction, constipation, diarrhea, nausea, erectile dysfunction, ↓ libido, itching, rashes, hyperglycemia, hypoglycemia (↑ in children), arthralgia, back pain, muscle cramps, paresthesia, drug-induced lupus syndrome.
Patient/Family Education: Advise patient to notify health care professional if slow pulse, difficulty breathing, wheezing, cold hands and feet, dizziness, light-headedness, confusion, depression, rash, fever, sore throat, unusual bleeding, or bruising occurs; HIGH ALERT MEDICATION (SEE BOOK)

Front 4

AMANTADINE

Trade names: Symmetrel

Back 4

AMANTADINE
Trade names: Symmetrel
Pharm. Class:
Ther. Class:antiparkinson agents, antivirals
Uses: Symptomatic initial and adjunct treatment of Parkinson's disease; Prophylaxis and treatment of influenza A viral infections
Forms: Liquid-filled capsules: 100 mg; Tablets: 100 mg; Syrup (raspberry flavor): 50 mg/5 mL
Action: Potentiates the action of dopamine in the CNS; Prevents penetration of influenza A virus into host cell
Therapeutic Effect(s):Relief of Parkinson's symptoms; Prevention and decreased symptoms of influenza A viral infection
Route/Dosage: Parkinson's Disease; PO (Adults): 100 mg 1–2 times daily (up to 400 mg/day).
Influenza A Viral Infection; PO (Adults and Children >12 yr): Treatment—200 mg/day as a single dose or 100 mg bid (not >100 mg/day in geriatric patients); Prophylaxis—100 mg/day in 1–2 divided doses.
Side Effects: ataxia, dizziness, insomnia, anxiety, confusion, depression, drowsiness, psychosis, seizures, urges (gambling, sexual), nausea, vomiting, anorexia, constipation, blurred vision, dry mouth, dyspnea, hypotension, CHF, edema, urinary retention, mottling, livedo reticularis, melanoma, rashes, leukopenia, neutropenia.
Patient/Family Education: Advise patient to take medication around the clock as directed and not to skip doses or double up on missed doses. If a dose is missed, do not take within 4 hr of the next dose; May cause dizziness or blurred vision. Advise patient to avoid driving or other activities that require alertness until response to the drug is known; Advise patient to make position changes slowly to minimize orthostatic hypotension; Inform patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may decrease dry mouth. Consult health care professional if dry mouth persists for >2 wk; Advise patient to confer with health care professional before taking OTC medications, especially cold remedies, or drinking alcoholic beverages; Instruct patient to notify health care professional if confusion, mood changes, difficulty with urination, edema and shortness of breath, new or increased gambling, sexual, or other intense urges, or worsening of Parkinson's disease symptoms occurs

Front 5

IBUPROFEN
Advil, Advil Migraine Liqui-Gels, Children's Advil, Children's Motrin, Excedrin IB, Genpril, Haltran, Junior Strength Advil, Menadol, Medipren, Midol Maximum Strength Cramp Formula, Motrin, Motrin Drops, Motrin IB, Motrin Junior Strength, Motrin Migraine Pain, Nu-Ibuprofen, Nuprin, PediaCare Children's Fever, Caldolor (injection)

Back 5

IBUPROFEN
Trade names: Advil, Advil Migraine Liqui-Gels, Children's Advil, Children's Motrin, Excedrin IB, Genpril, Haltran, Junior Strength Advil, Menadol, Medipren, Midol Maximum Strength Cramp Formula, Motrin, Motrin Drops, Motrin IB, Motrin Junior Strength, Motrin Migraine Pain, Nu-Ibuprofen, Nuprin, PediaCare Children's Fever, Caldolor (injection)
Pharm. Class: nonopioid analgesics
Ther. Class: antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti inflammatory agents
Uses: PO, IV: Treatment of Mild to moderate pain, Fever; PO: Treatment of Inflammatory disorders including rheumatoid arthritis (including juvenile) and osteoarthritis; Dysmenorrhea; IV: Moderate to severe pain with opioid analgesics
Forms: Tablets: 100 mgOTC, 200 mgOTC, 300 mg, 400 mg, 600 mg , 800 mg; Capsules (liqui-gels): 200 mgOTC; Chewable tablets (fruit, grape, orange, and citrus flavor ): 50 mgOTC, 100 mgOTC; Liquid (berry flavor): 100 mg/5 mLOTC; Oral suspension (fruit, berry, grape flavor): 100 mg/5 mLOTC, 100 mg/2.5 mLOTC; Pediatric drops (berry flavor): 50 mg/1.25 mLOTC; Solution for injection: 100 mg/mL In combination with: decongestants, OTC, hydrocodone (Vicoprofen), oxycodone (Combunox). See combination drugs
Action: Inhibits prostaglandin synthesis
Therapeutic Effect(s): Decreased pain and inflammation; Reduction of fever
Route/Dosage: PO (Adults): Anti-inflammatory—400–800 mg 3–4 times daily (not to exceed 3200 mg/day). Analgesic/antidysmenorrheal/antipyretic—200–400 mg q 4–6 hr (not to exceed 1200 mg/day).
Side Effects: headache, dizziness, drowsiness, psychic disturbances; amblyopia, blurred vision, tinnitus; arrhythmias, edema, hypertension; GI BLEEDING, HEPATITIS, constipation, dyspepsia, nausea, vomiting, abdominal discomfort; cystitis, hematuria, renal failure; EXFOLIATIVE DERMATITIS, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, rashes; anemia, blood dyscrasias, prolonged bleeding time; ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS .
Patient/Family Education: Caution patient that use of ibuprofen with 3 or more glasses of alcohol per day may increase the risk of GI bleeding

Front 6

TRAMADOL

Trade names: Ryzolt, Ultram, Ultram ER

Back 6

TRAMADOL
Trade names: Ryzolt, Ultram, Ultram ER
Pharm. Class:
Ther. Class: analgesics
(centrally acting)
Uses: analgesics
(centrally acting)
Forms: Tablets: 50 mg; Extended-release tablets: 100 mg, 200 mg, 300 mg; In combination with: acetaminophen (Ultracet).
Action: Binds to mu-opioid receptors; Inhibits reuptake of serotonin and norepinephrine in the CNS
Therapeutic Effect(s): Decreased Pain
Route/Dosage: PO (Adults B18 yr): Rapid titration—50–100 mg q 4–6 hr (not to exceed 400 mg/day or 300 mg in patients >75 yr). Gradual titration—25 mg/day initially, ↑ by 25 mg/day q 3 days to reach dose of 25 mg 4 times daily, then ↑ by 50 mg/day q 3 days to reach dose of 50 mg 4 times daily; may then use 50–100 mg q 4–6 hr (maximum dose = 400 mg/day).
Side Effects: SEIZURES, dizziness, headache, somnolence, anxiety, CNS stimulation, confusion, coordination disturbance, euphoria, malaise, nervousness, sleep disorder, weakness; visual disturbances; vasodilation; constipation, nausea, abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, flatulence, vomiting; menopausal symptoms, urinary retention/frequency; pruritus, sweating; hypertonia; physical dependence, psychological dependence, tolerance.
Patient/Family Education: instruct patient on how and when to ask for pain medication; May cause dizziness and drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known; Advise patient to change positions slowly to minimize orthostatic hypotension; Caution patient to avoid concurrent use of alcohol or other CNS depressants with this medication. Advise patient to notify health care professional before taking other RX, OTC, or herbal products concurrently; Advise female patients to notify health care professional if pregnancy is planned or suspected, or if breastfeeding; Advise patient to notify health care professional if seizures or if symptoms of serotonin syndrome occur; Encourage patient to turn, cough, and breathe deeply every 2 hr to prevent atelectasis

Front 7

GLUCAGON

Trade names: GlucaGen

Back 7

GLUCAGON
Trade names: GlucaGen
Pharm. Class: pancreatics
Ther. Class: hormones
Uses: Acute management of severe hypoglycemia when administration of glucose is not feasible; Facilitation of radiographic examination of the GI tract
Unlabelled Use(s):
Antidote to Beta blockers; Calcium channel blockers
Forms: Powder for injection: 1-mg (equivalent to 1 unit) vials as an emergency kit for low blood glucose and a diagnostic kit
Action: Stimulates hepatic production of glucose from glycogen stores (glycogenolysis); Relaxes the musculature of the GI tract (stomach, duodenum, small bowel, and colon), temporarily inhibiting movement; Has positive inotropic and chronotropic effects
Therapeutic Effect(s): Increase in blood glucose; Relaxation of GI musculature, facilitating radiographic examination
Route/Dosage: Hypoglycemia; IV, IM, SC (Adults and Children B20 kg): 1 mg; may be repeated in 15 min if necessary; IV, IM, SC (Children <20 kg ): 0.5 mg or 0.02–0.03 mg/kg; may be repeated in 15 min if necessary.
Side Effects: hypotension; nausea, vomiting; HYPERSENSITIVITY REACTIONS INCLUDING ANAPHYLAXIS.
Patient/Family Education: Teach patient and family signs and symptoms of hypoglycemia. Instruct patient to take oral glucose as soon as symptoms of hypoglycemia occur—glucagon is reserved for episodes when patient is unable to swallow because of decreased level of consciousness; Home Care Issues: Instruct family on correct technique to prepare, draw up, and administer injection. Health care professional must be contacted immediately after each dose for orders regarding further therapy or adjustment of insulin dose or diet; Advise family that patient should receive oral glucose when alertness returns; Instruct family to position patient on side until fully alert. Explain that glucagon may cause nausea and vomiting. Aspiration may occur if patient vomits while lying on back; Instruct patient to check expiration date monthly and to replace outdated medication immediately; Review hypoglycemic medication regimen, diet, and exercise programs; Patients with diabetes mellitus should carry a source of sugar (such as a packet of sugar or candy) and identification describing disease process and treatment regimen at all times

Front 8

FERROUS SULFATE

ED-IN-SOL, Fe50, Feosol, Feratab, Fer-gen-sol, Fer-In-Sol, Fer-Iron, Slow FE

Back 8

FERROUS SULFATE
Trade names: ED-IN-SOL, Fe50, Feosol, Feratab, Fer-gen-sol, Fer-In-Sol, Fer-Iron, Slow FE
Pharm. Class: iron supplements
Ther. Class: antianemics
Uses: PO: Treatment & prevention iron deficiency anemia
Forms: Tablets: 195 mgOTC, 300 mgOTC, 325 mgOTC; Capsules: 150 mgOTC, 250 mgOTC; Timed-release tablets: 525 mgOTC; Syrup: 90 mg/5 mLOTC; Elixir: 220 mg/5 mLOTC; Drops: 75 mg/0.6 mLOTC, 125 mg/1 mLOTC
Action: An essential mineral found in hemoglobin, myoglobin, and many enzymes; Enters the bloodstream and is transported to the organs of the reticuloendothelial system (liver, spleen, bone marrow) where it becomes part of iron stores
Therapeutic Effect(s): Resolution or prevention of iron deficiency anemia
Route/Dosage: PO (Adults): Deficiency–2–3 mg/kg/day in 2–4 divided doses or 60–100 mg elemental iron twice daily. Prophylaxis-60–100 mg elemental iron daily.
Side Effects: dizziness, headache, syncope, nausea, constipation, dark stools, epigastric pain, GI bleeding, vomiting, temporary staining of teeth (liquid preparations).
Patient/Family Education: Explain purpose of iron therapy to patient; Encourage patient to comply with medication regimen. Take missed doses as soon as remembered within 12 hr; otherwise, return to regular dosing schedule. Do not double doses; Advise patient that stools may become dark green or black; Instruct patient to follow a diet high in iron (see Food Sources for Specific Nutrients), Discuss with parents the risk of a child overdosing on iron. Medication should be stored in the original childproof container and kept out of reach of children. Do not refer to vitamins as candy. In the event of a suspected overdose, parents should contact poison control center (1–800–222–1222) or emergency medical services (911) immediately