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| Beta-Blockers (e.g., Metoprolol, Atenolol, Propranolol) | ACE Inhibitors (e.g., Lisinopril, Enalapril) |
| Angiotensin II Receptor Blockers (ARBs) (e.g., Losartan, Valsartan) | Calcium Channel Blockers (e.g., Amlodipine, Diltiazem, Verapamil) |
| Loop Diuretics (e.g., Furosemide, Bumetanide) | Potassium-Sparing Diuretics (e.g., Spironolactone) |
| Cardiac Glycosides (Digoxin) | Anticoagulant: Warfarin |
| Mechanism: Blocks conversion of Angiotensin I to II, causing vasodilation. Side Effects: Dry cough, hyperkalemia, angioedema (medical emergency), orthostatic hypotension. Nursing Considerations: Monitor potassium levels and renal function. Patient Teaching: Change positions slowly; report swelling of face or tongue immediately. | Mechanism: Blocks beta-1 receptors to decrease heart rate and contractility. Side Effects: Bradycardia, hypotension, bronchospasm (non-selective). Nursing Considerations: Always check pulse and BP before administration; hold if HR <60 bpm or SBP <90-100 mmHg. Patient Teaching: Do not stop abruptly (risk of rebound tachycardia); masks symptoms of hypoglycemia in diabetics. |
| Mechanism: Inhibits calcium influx into myocardial and vascular cells, causing vasodilation and slowed conduction. Side Effects: Peripheral edema, constipation, bradycardia. Nursing Considerations: Monitor for heart failure (edema, weight gain). Patient Teaching: Avoid grapefruit juice (increases drug levels); increase fiber/fluids for constipation. | Mechanism: Blocks Angiotensin II at receptor sites. Side Effects: Hyperkalemia, hypotension, renal impairment. Nursing Considerations: Often used as an alternative for patients who develop a cough on ACE inhibitors. Monitor potassium levels. Patient Teaching: Avoid salt substitutes containing potassium. |
| Mechanism: Antagonizes aldosterone in the distal tubule. Side Effects: Hyperkalemia, gynecomastia. Nursing Considerations: Monitor for cardiac arrhythmias related to high potassium. Patient Teaching: Avoid potassium-rich foods and salt substitutes. | Mechanism: Inhibits sodium and chloride reabsorption in the Loop of Henle. Side Effects: Hypokalemia, hyponatremia, ototoxicity (if given too fast IV), dehydration. Nursing Considerations: Monitor daily weights and potassium. Administer in the morning to prevent nocturia. Patient Teaching: Eat potassium-rich foods (bananas, potatoes). |
| Mechanism: Vitamin K antagonist. Side Effects: Bleeding. Nursing Considerations: Monitor PT/INR (Target INR usually 2-3). Antidote: Vitamin K. Patient Teaching: Consistent intake of leafy greens (Vit K); use electric razors and soft toothbrushes. | Mechanism: Positive inotrope (increased contraction) and negative chronotrope (decreased HR). Side Effects: Bradycardia, Digoxin toxicity. Nursing Considerations: Check apical pulse for 1 full minute (hold if <60). Therapeutic range: 0.5 - 2.0 ng/mL. Monitor potassium (low K+ increases risk for toxicity). Patient Teaching: Report yellow/green halos or blurred vision. |
| Anticoagulant: Heparin (and Enoxaparin) | HMG-CoA Reductase Inhibitors (Statins) (e.g., Atorvastatin, Simvastatin) |
| Benzodiazepines (e.g., Alprazolam, Lorazepam, Diazepam) | Selective Serotonin Reuptake Inhibitors (SSRIs) (e.g., Fluoxetine, Sertraline) |
| Tricyclic Antidepressants (TCAs) (e.g., Amitriptyline) | Monoamine Oxidase Inhibitors (MAOIs) (e.g., Phenelzine) |
| Atypical Antipsychotics (e.g., Risperidone, Quetiapine, Clozapine) | Opioid Analgesics (e.g., Morphine, Hydromorphone, Oxycodone) |
| Mechanism: Inhibits cholesterol synthesis in the liver. Side Effects: Myalgia, rhabdomyolysis, hepatotoxicity. Nursing Considerations: Monitor LFTs (liver enzymes) and CK levels. Patient Teaching: Take in the evening (cholesterol synthesis peaks at night); report unexplained muscle pain immediately. | Mechanism: Potentiates Antithrombin III. Side Effects: Bleeding, Heparin-Induced Thrombocytopenia (HIT). Nursing Considerations: Monitor aPTT (for IV Heparin). Antidote: Protamine Sulfate. Patient Teaching: Report any unusual bruising or dark stools. |
| Mechanism: Inhibits serotonin reuptake. Side Effects: Sexual dysfunction, weight gain, Serotonin Syndrome. Nursing Considerations: Takes 4-6 weeks for full effect. Monitor for increased suicidal ideation in the first few weeks. Patient Teaching: Do not take with St. John's Wort or MAOIs. | Mechanism: Enhances GABA effects in the CNS. Side Effects: Sedation, respiratory depression, physical dependence. Nursing Considerations: Monitor respiratory rate and level of consciousness. Antidote: Flumazenil. Patient Teaching: Avoid alcohol; do not stop abruptly (seizure risk). |
| Mechanism: Inhibits the enzyme that breaks down dopamine, NE, and serotonin. Side Effects: Hypertensive crisis. Nursing Considerations: Monitor BP. Patient Teaching: Strict avoidances of tyramine-rich foods (aged cheese, red wine, cured meats, fermented products) to prevent hypertensive crisis. | Mechanism: Increases levels of norepinephrine and serotonin. Side Effects: Anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation), cardiotoxicity in overdose. Nursing Considerations: Highly lethal in overdose (cardiac dysrhythmias). Patient Teaching: Chew sugarless gum for dry mouth; move slowly to prevent dizziness. |
| Mechanism: Binds to opiate receptors in the CNS. Side Effects: Respiratory depression, constipation, sedation, hypotension. Nursing Considerations: Assess RR (hold if <12). Antidote: Naloxone. Patient Teaching: Increase fluids and fiber; do not operate heavy machinery. | Mechanism: Blocks dopamine and serotonin receptors. Side Effects: Weight gain, diabetes, agranulocytosis (especially Clozapine). Nursing Considerations: For Clozapine, monitor absolute neutrophil count (ANC) weekly. Patient Teaching: Report signs of infection (fever, sore throat) immediately. |
| Aminoglycosides (e.g., Gentamicin, Tobramycin) | Fluoroquinolones (e.g., Ciprofloxacin, Levofloxacin) |
| Rapid-Acting Insulin (e.g., Lispro, Aspart) | Short-Acting Insulin (Regular / Humulin R) |
| Intermediate-Acting Insulin (NPH) | Long-Acting Insulin (e.g., Glargine, Detemir) |
| Biguanides (Metformin) | Thyroid Supplement (Levothyroxine) |
| Mechanism: Inhibits bacterial DNA replication. Side Effects: Achilles tendon rupture, photosensitivity. Nursing Considerations: Monitor for tendon pain. Patient Teaching: Wear sunscreen/protective clothing; avoid taking with antacids, iron, or dairy. | Mechanism: Inhibits bacterial protein synthesis. Side Effects: Nephrotoxicity and Ototoxicity. Nursing Considerations: Monitor BUN/Creatinine and Peak/Trough levels. Trough is drawn 30 mins before the next dose. Patient Teaching: Report ringing in ears (tinnitus) or hearing loss. |
| Onset: 30-60 mins. Peak: 2-4 hours. Duration: 6-10 hours. Nursing Considerations: This is the only insulin type that can be given IV. Monitor for hypoglycemia, especially at the peak. | Onset: 15 mins. Peak: 1-2 hours. Duration: 3-5 hours. Nursing Considerations: Ensure the patient has food tray present before administration. Monitor for hypoglycemia (diaphoretic, shaky, confused). |
| Onset: 1-2 hours. Peak: None (plateau). Duration: 24 hours. Nursing Considerations: Do NOT mix with any other insulin in the same syringe. Usually administered once daily at bedtime. | Onset: 1-2 hours. Peak: 4-12 hours. Duration: 16-24 hours. Nursing Considerations: Cloudy appearance—roll vial gently to mix. Monitor for hypoglycemia in the mid-to-late afternoon. |
| Mechanism: Synthetic form of T4. Side Effects: Hyperthyroidism symptoms (tachycardia, insomnia, tremors). Nursing Considerations: Monitor TSH levels. Patient Teaching: Take on an empty stomach 30-60 mins before breakfast; lifelong therapy is usually required. | Mechanism: Decreases glucose production by the liver and increases insulin sensitivity. Side Effects: GI upset, lactic acidosis (rare but fatal). Nursing Considerations: Hold 48 hours before and after IV contrast to prevent kidney failure. Patient Teaching: Take with food. |
| Glucocorticoids (e.g., Prednisone, Methylprednisolone) | Beta-2 Adrenergic Agonists (e.g., Albuterol) |
| Inhaled Corticosteroids (e.g., Fluticasone, Budesonide) | Proton Pump Inhibitors (PPIs) (e.g., Omeprazole, Pantoprazole) |
| Vancomycin | Nitrates (e.g., Nitroglycerin) |
| Nonsteroidal Anti-inflammatory Drugs (NSAIDs) (e.g., Ibuprofen, Naproxen) | Acetaminophen (Tylenol) |
| Mechanism: Bronchodilation via beta-2 stimulation. (Rescue Inhaler). Side Effects: Tachycardia, tremors, hypokalemia. Nursing Considerations: Always give the bronchodilator BEFORE the steroid inhaler. Patient Teaching: Use during acute asthma attacks. | Mechanism: Suppresses inflammation and immune response. Side Effects: Hyperglycemia, weight gain/buffalo hump, osteoporosis, peptic ulcers, delayed wound healing. Nursing Considerations: Monitor blood sugar and signs of infection. Patient Teaching: Never stop abruptly (risk of Addisonian crisis); taper the dose. |
| Mechanism: Inhibits the H+/K+ ATPase pump to block gastric acid secretion. Side Effects: C-diff risk, bone fractures (long-term). Nursing Considerations: Take 30-60 mins before meals. Patient Teaching: Increase calcium and Vitamin D intake. | Mechanism: Reduces airway inflammation. Side Effects: Oral candidiasis (thrush). Nursing Considerations: Not for acute attacks. Patient Teaching: Rinse mouth and spit after use to prevent fungal infection. |
| Mechanism: Vasodilation of coronary arteries/veins. Side Effects: Headache, hypotension, flushing. Nursing Considerations: Contraindicated with Sildenafil (Viagra). Store in dark, original bottle. Patient Teaching: Take 1 tab every 5 mins up to 3 doses; if no relief after first dose, call 911. | Mechanism: Glycopeptide antibiotic. Side Effects: Red Man Syndrome (infusion reaction), nephrotoxicity. Nursing Considerations: Infuse over at least 60 minutes. Monitor trough levels. Patient Teaching: Report any changes in hearing. |
| Mechanism: Analgesic and antipyretic. Side Effects: Hepatotoxicity. Nursing Considerations: Max daily dose is generally 4,000 mg (3,000 mg in elderly/liver disease). Antidote: Acetylcysteine. Patient Teaching: Be aware of hidden acetaminophen in OTC cold meds. | Mechanism: Inhibits COX-1 and COX-2. Side Effects: GI bleeding, renal impairment. Nursing Considerations: Avoid in patients with peptic ulcers or kidney disease. Patient Teaching: Take with food; report black tarry stools. |
| Phenytoin (Dilantin) | Leukotriene Modifiers (e.g., Montelukast) |
| H2 Receptor Antagonists (e.g., Famotidine, Ranitidine) | Metoclopramide (Reglan) |
| Antifungal (e.g., Amphotericin B) | Antiviral (e.g., Acyclovir) |
| Theophylline | Lithium |
| Mechanism: Blocks leukotrienes to prevent airway edema/inflammation. Side Effects: Mood changes/suicidality. Nursing Considerations: Used for long-term asthma prophylaxis and allergies. Patient Teaching: Take in the evening; report behavioral changes. | Mechanism: Anticonvulsant. Side Effects: Gingival hyperplasia, ataxia, nystagmus. Nursing Considerations: Therapeutic level: 10-20 mcg/mL. Monitor for skin rash (Stevens-Johnson). Patient Teaching: Frequent dental checkups; use soft toothbrush. |
| Mechanism: Dopamine antagonist; promotes gastric emptying (prokinetic). Side Effects: Extrapyramidal symptoms (EPS), Tardive Dyskinesia. Nursing Considerations: Monitor for lip-smacking or involuntary movements. Patient Teaching: Report facial tics immediately. | Mechanism: Blocks H2 receptors in the stomach to decrease acid. Side Effects: Confusion (elderly), headache. Patient Teaching: Avoid smoking and alcohol, which increase acid production. |
| Mechanism: Interferes with viral DNA synthesis. Side Effects: Nephrotoxicity (crystallization in tubules). Nursing Considerations: Administer IV slowly; ensure the patient is well-hydrated to protect kidneys. | Mechanism: Disrupts fungal cell membrane. Side Effects: Severe nephrotoxicity, infusion reactions ('Shake and Bake'). Nursing Considerations: Pre-medicate with Acetaminophen, Diphenhydramine, and Steroids. Monitor BUN/Creatinine and Electrolytes. |
| Mechanism: Mood stabilizer for Bipolar. Side Effects: Polyuria, fine tremors, hypothyroidism. Nursing Considerations: Therapeutic range: 0.6 - 1.2 mEq/L. Toxicity occurs with low sodium. Patient Teaching: Maintain consistent salt and fluid intake. | Mechanism: Methylxanthine bronchodilator. Side Effects: Tachycardia, seizures, arrhythmias. Nursing Considerations: Very narrow therapeutic range (10-20 mcg/mL). Patient Teaching: Avoid caffeine (increases toxicity risk). |
| Laxative: Lactulose | Antiplatelet: Clopidogrel (Plavix) |
| Cephalosporins (e.g., Cephazolin, Ceftriaxone) | Sulfonamides (e.g., Trimethoprim/Sulfamethoxazole) |
| Sodium Nitroprusside | |
| Mechanism: Inhibits platelet aggregation. Side Effects: Bleeding, bruising. Nursing Considerations: Monitor hemoglobin and hematocrit. Patient Teaching: Discontinue 5-7 days before elective surgery. | Mechanism: Osmotic laxative that pulls ammonia into the gut to be excreted. Nursing Considerations: Primarily used in hepatic encephalopathy to lower ammonia levels. Goal: 2-3 soft stools per day. |
| Mechanism: Inhibits folic acid synthesis in bacteria. Side Effects: Crystalluria, photosensitivity, Stevens-Johnson Syndrome. Patient Teaching: Drink 2-3L of water daily; stay out of the sun. | Mechanism: Inhibits bacterial cell wall synthesis. Nursing Considerations: Cross-sensitivity—if a patient is allergic to Penicillin, they may be allergic to Cephalosporins. Patient Teaching: Report any rash. |
| Mechanism: Potent vasodilator used for hypertensive crisis. Side Effects: Cyanide toxicity. Nursing Considerations: Protect the IV bag from light with an opaque cover. Monitor BP continuously. | |