Medicotion worksheet lo//2011

Gener|c Name]8rand Name

sy|||um (s||||yum)]Metamuc||

Gener|c Name]8rand Name
Sennos|des (senohs|des)]Senokot
Dose] koute] Irequency Crdered
1 packet]Cra|]8ID
8eg|n when to|erat|ng c|ear ||qu|ds
Is th|s route appropr|ate for pat|ent? ?es /no
Dose] koute] Irequency Crdered
14 tab|ets]Cra|]8ID
8eg|n when to|erat|ng c|ear ||qu|ds In|t|a| dose 2 tab|ets or 2 doses If
not resu|ts |ncrease to 3 tabs for 2 doses If no resu|ts |ncrease to 4
tabs If greater than 2 bowe| movements |n 24 hours at any po|nt
reduce to 1 tab|et
Is th|s route appropr|ate for pat|ent? es ]No
n|gh A|ert? es ]No Why? n|gh A|ert? es ]No Why?
C|ass|f|cat|on (1herapeut|c]harmaco|og|c)
Laxat|ves]8u|kform|ng agents
C|ass|f|cat|on (1herapeut|c]harmaco|og|c)
Laxat|ves]St|mu|ant |axat|ves
Act|on (therapeut|c effect)
ke||ef and prevent|on of const|pat|on
Act|on (therapeut|c effect)
Laxat|ve act|on
Why |s th|s person gett|ng th|s med|cat|on (lndlcaLlon)
Management of s|mp|e or chron|c const|pat|on part|cu|ar|y |f
assoc|ated w|th a |owf|ber d|et Usefu| |n s|tuat|ons |n wh|ch stra|n|ng
shou|d be avo|ded (after MI recta| surgery and pro|onged bed rest)
Used |n management of chron|c watery d|arrhea
Why |s th|s person gett|ng th|s med|cat|on (Ind|cat|on)
1reatment of const|pat|on part|cu|ar|y when assoc|ated w|th s|ow
trans|t t|me const|pat|on drugs Irr|tab|e or spast|c bowe| syndrome
neuro|og|c const|pat|on
nome Med|cat|on es ]No If yes dose change? (rev|ous dose
t|me)

nome Med|cat|on es ]No If yes dose change? (rev|ous dose
t|me)

harmacok|net|cs (onset peak durat|on metabo||sm)
1224 hr 23 days Unknown Lxcreted |n feces
harmacok|net|cs (onset peak durat|on metabo||sm)
612 hr unknown 34 days Unknown
1extbook Dose kange (for ordered route and |nd|cat|on)
12 tsp]packet]wafer (36 g psy|||um) |n or w|th a fu|| g|ass of ||qu|d 23
t|mes da||y Up to 30 g da||y |n d|v|ded doses
1extbook Dose kange (for ordered route and |nd|cat|on)
12S0 mg 12 t|mes da||y
Contra|nd|cat|ons]Caut|ous use
nypersens|t|v|ty Abdom|na| pa|n nausea or vom|t|ng (espec|a||y
when assoc|ated w|th fever) Ser|ous adhes|ons Dysphag|a]Some
dosage forms conta|n sugar aspartame or excess|ve sod|um and
shou|d be avo|ded |n pt on restr|cted d|ets
Contra|nd|cat|ons]Caut|ous use
nypersens|t|v|ty Abdom|na| pa|n of unknown cause espec|a||y |f
assoc|ated w|th fever kecta| f|ssures U|cerated hemorrho|ds known
a|coho| |nto|erance (some ||qued products)]Chron|c use may |ead to
|axat|ve dependence oss|b|e |ntest|na| obstruct|on
Adverse keact|on
Common kash (d|scont|nue drug at f|rst s|gn of rash)


Severe


1ox|c|ty s|gns]Cverdose Ant|dote?

Adverse keact|on
Common Cramp|ng and D|arrhea

Severe

1ox|c|ty s|gns]Cverdose Ant|dote?
Adm|n|strat|on arameters ora|]entera| (empty stomach w|th food)
arentera| (compat|b|||ty d||ut|on requ|red and rate)
ackets are not standard|zed for vo|ume but each conta|ns 33S g of
psy|||um C Adm|n|ster w|th a fu|| g|ass of water or [u|ce fo||owed by
an add|t|ona| g|ass of ||qu|d So|ut|on shou|d be taken |mmed|ate|y
after m|x|ng |t w||| congea| Do not adm|n|ster w|thout suff|c|ent f|u|d
and do not chew granu|es
Adm|n|strat|on arameters ora|]entera| (empty stomach w|th food)
arentera| (compat|b|||ty d||ut|on requ|red and rate)
C 1ake w|th a fu|| g|ass of water Adm|n|ster at bedt|me for
evacuat|on 612 hr |ater Adm|n|ster on an empty stomach for more
rap|d resu|ts Shake ora| so|ut|on we|| before adm|n|ster|ng Granu|es
shou|d be d|sso|ved or m|xed |n water or other ||qu|d before
adm|n|strat|on
Assessment needed (pre dur|ng and post)
Assess pt for abdom|na| d|stent|on presence of bowe| sounds and
usua| pattern of bowe| funct|on Assess co|or cons|stency and amount
of stoo| produced May cause e|evated b|ood g|ucose |eve|s w|th
pro|onged use of preparat|ons conta|n|ng sugar
Assessment needed (pre dur|ng and post)
Assess pt for abdom|na| d|stent|on presence of bowe| sounds and
usua| pattern of bowe| funct|on Assess co|or cons|stency and amount
of stoo| produced
keference(s)
Dav|s Drug Gu|de 1079
keference(s)
Dav|s Drug Gu|de 114S


Medicotion worksheet lo//2011
Gener|c Name]8rand Name
1ramado| (tramado|)]U|tram
Gener|c Name]8rand Name
S|mvastat|n (s|mvastat|n)]2ocor
Dose] koute] Irequency Crdered
S0100 mg]Cra|]1ID kN
Is th|s route appropr|ate for pat|ent? ?es /no
Dose] koute] Irequency Crdered
10 mg]Cra|]8edt|me
Is th|s route appropr|ate for pat|ent? ?es /no
n|gh A|ert? es ]No Why? n|gh A|ert? es ]No Why?
C|ass|f|cat|on (1herapeut|c]harmaco|og|c)
Ana|ges|cs (centra||y act|ng)
C|ass|f|cat|on (1herapeut|c]harmaco|og|c)
L|p|d|ower|ng agents]nMGCoA reductase |nh|b|tors
Act|on (therapeut|c effect)
Decrease pa|n
Act|on (therapeut|c effect)
Lowers tota| and LDL cho|estero| and tr|g|ycer|des S||ght|y |ncrease
nDL S|ows of the progress|on of coronary atherosc|eros|s w|th
resu|tant decrease |n CnDre|ated events (a|| agents except
rosuvastat|n have |nd|cat|on for decrease events)
Why |s th|s person gett|ng th|s med|cat|on (lndlcaLlon)
Moderate to moderate|y severe pa|n (extendedre|ease formu|at|ons
|nd|cated for pt who requ|re aroundthec|ock pa|n management)
Why |s th|s person gett|ng th|s med|cat|on (lndlcaLlon)
Secondary prevent|on of card|ovascu|ar events (decreases r|sk of MI
coronary revascu|ar|zat|on stroke and card|ovascu|ar morta||ty) |n pt
w|th c||n|ca||y ev|dent CnD or those at h|ghr|sk for CnD (h|story of
d|abetes per|phera| arter|a| d|sease or stroke)
nome Med|cat|on es ]No If yes dose change? (rev|ous dose
t|me)

nome Med|cat|on es ]No If yes dose change? (rev|ous dose
t|me)

harmacok|net|cs (onset peak durat|on metabo||sm)
1 hr 23 hr 46 hr Most|y by the ||ver 30 unchanged by ur|ne
harmacok|net|cs (onset peak durat|on metabo||sm)
Severa| days 24 wk Unknown Lxtens|ve|y by the ||ver 13
unchanged by ur|ne
1extbook Dose kange (for ordered route and |nd|cat|on)
kap|d t|trat|on S0100 mg q 46 hr (not to exceed 400 mg]day or 300
mg |n pt 7Syr) Gradua| t|trat|on 2S mg]day |n|t|a||y |ncrease by 2S
mg]day q 3 days to reach dose of 2S mg 4 t|mes da||y then |ncrease by
S0 mg]day q 3 days to reach dose of S0 mg 4 t|mes da||y may then use
S0100 mg q 46 hr (max dose 400 mg]day)
1extbook Dose kange (for ordered route and |nd|cat|on)
S80 mg once da||y |n the even|ng
Contra|nd|cat|ons]Caut|ous use
nypersens|t|v|ty Crosssens|t|v|ty w|th op|o|ds may occur pt who are
acute|y |ntox|cated w|th a|coho| sedat|ves]hypnot|cs centra||y act|ng
ana|ges|cs op|o|d ana|ges|cs or psychotrop|c agents t who are
phys|ca||y dependent on op|o|d ana|ges|cs]Use w|th extremes caut|on
|n pt 7S yr not to exceed 300 mg]day t w|th a h|story of se|zures
kena| |mpa|rment nepat|c |mpa|rment t rece|v|ng MAC |nh|b|tors
or CNS depressants t who are su|c|da| Increase |ntracran|a| pressure
or head trauma t w|th a h|story of op|o|d dependence or who have
recent|y rece|ved |arge doses of op|o|ds
Contra|nd|cat|ons]Caut|ous use
nypersens|t|v|ty Act|ve ||ver d|sease or unexp|a|ned pers|stent
|ncrease |n AS1 or AL1 Concurrent use of gemf|broz|| or azo|e
ant|funga|s macro||des protease |nh|b|tors n|ac|n cyc|ospor|ne
am|odarone or verapam|| (|ncreased r|sk of
myopathy]rhabdomyo|ys|s) Concurrent use of ne|f|nav|r or
r|tonav|r]n|story of ||ver d|sease A|coho||sm
Adverse keact|on
Common D|zz|ness n]A Somno|ence Const|pat|on and Nausea


Severe Se|zures


1ox|c|ty s|gns]Cverdose Ant|dote? Cverdose may cause resp|ratory
depress|on and se|zures Na|oxone (Narcan) may reverse some but not
a|| of the symptoms of overdose 1x shou|d be symptomat|c and
support|ve Ma|nta|n adequate resp|ratory exchange nemod|a|ys|s |s
Adverse keact|on
Common Abdom|na| Cramps Const|pat|on D|arrhea I|atus
neartburn and kashes

Severe khabdomyo|ys|s


1ox|c|ty s|gns]Cverdose Ant|dote?

not he|pfu| because |t removes on|y a sma|| port|on of adm|n|stered
dose Se|zures may be managed w|th barb|turates or benzod|azep|nes
na|oxone |ncreases r|sk of se|zures

Adm|n|strat|on arameters ora|]entera| (empty stomach w|th food)
arentera| (compat|b|||ty d||ut|on requ|red and rate)
Do not confuse tramado| w|th torado| (ketoro|ac) 1ramado| |s
cons|dered to prov|de more ana|ges|a than code|ne 60 mg but |ess
than comb|ned asp|r|n 6S0 mg]code|ne 60 mg for acute postoperat|ve
pa|n Ior chron|c pa|n da||y doses of 2S0 mg of tramado| prov|de pa|n
re||ef s|m||ar to that of S doses]day of acetam|nophen 300 mg]code|ne
30 mg S doses]day of asp|r|n 32S mg]code|ne 30 mg or 23 doses]day
of acetam|nophen S00 mg]oxycodone S mg 1ramado| shou|d be
d|scont|nued gradua||y after |ongterm use to prevent w|thdrawa|
symptoms 1ramado| may be adm|n|stered w|thout regard to mea|s
Lxtendedre|ease tabs shou|d be swa||owed who|e do not crush
break or chew
Adm|n|strat|on arameters ora|]entera| (empty stomach w|th food)
arentera| (compat|b|||ty d||ut|on requ|red and rate)
Do not confuse ravacho| (pravastat|n) w|th revac|d (|ansoprazo|e)
C Adm|n|ster extended re|ease tab|ets at bedt|me Lxtended re|ease
tab|ets shou|d be swa||owed who|e do not break crush or chew
Adm|n|ster once da||y |n the even|ng Avo|d |arge amounts of
grapefru|t [u|ce dur|ng therapy may |ncrease r|sk of tox|c|ty
Assessment needed (pre dur|ng and post)
Assess type |ocat|on and |ntens|ty of pa|n before and 23 hr (peak)
after adm|n|strat|on Assess 8 and kesp|ratory rate before and
per|od|ca||y dur|ng adm|n|strat|on kesp|ratory depress|on has not
occurred w|th recommended doses Assess bowe| funct|on rout|ne|y
Const|pat|on shou|d be |nst|tuted w|th |ncrease |ntake of f|u|ds and
bu|k and w|th |axat|ves to m|n const|pat|ng effects Assess prev|ous
ana|ges|c h|story ro|onged use may |ead to phys|ca| or psycho|og|ca|
dependence and to|erance Mon|tor pt for se|zures A|so mon|tor
menta| status changes autonom|c |nstab|||ty neuromuscu|ar
aberrat|ons and]or gastro|ntest|na| symptoms May cause |ncrease
serum creat|n|ne e|evated ||ver enzymes decreased hemog|ob|n and
prote|nur|a
Assessment needed (pre dur|ng and post)
Cbta|n a d|etary h|story espec|a||y w|th regard to fat consumpt|on
Lva|uate serum cho|estero| and tr|g|ycer|de |eve|s before |n|t|at|ng
after 46 weeks of therapy and per|od|ca||y thereafter Mon|tor ||ver
funct|on tests |nc|ud|ng AS1 before at 12 wk after |n|t|at|on of
therapy or after dose eve|vat|on and then q 6 mo If AS1 |eve|s
|ncrease to 3 t|me norma| nMGCoA reducatase |nh|b|tor therapy
shou|d be reduced or d|scont|nued May a|so cause |ncrease a|ka||ne
phosphatase and b|||rub|n |eve|s If pt deve|ops musc|e tenderness
dur|ng therapy mon|tor Ck |eve|s If Ck |eve|s are 10 t|mes the upper
||m|t of norma| or myopathy occurs therapy shou|d be d|scont|nued
keference(s)
Dav|s Drug Gu|de 1246
keference(s)
Dav|s Drug Gu|de 669