This document lists several medications a patient is currently taking including dosages, classifications, mechanisms of action, potential side effects, contraindications, and relevant nursing implications. The medications include the anticoagulant enoxaparin, the antifungal fluconazole, the bronchodilator ipratropium/albuterol, the anticonvulsant levetiracetam, the corticosteroid methylprednisolone, the proton pump inhibitor pantoprazole, and others. Nurses should monitor for side effects and interactions for each medication according to the implications provided.

1. Current Medications
Name Classification Dosage Action Side Effects and Nursing Implications
(generic & Contraindications
brand name)
Enoxaparin Anticoagulant, 40 mg Prevents the formation ofSide effects: Monitor Hct, CBC, coagulation
(Lovenox) antithrombotic blood clots by inhibitingFever, confusion, studies, occult blood (Swearingen,
the conversion of hemorrhage, hypochronic 2008, p. 353)
fibrinogen to fibrin, as anemia, Assess for bleeding of gums,
well as inhibiting thrombocytopenia, petechiae, ecchymosis, black tarry
prothrombin to thrombin ecchymosis, edema stools, hematuria, epistaxis,
(Swearingen, 2008, p. (Swearingen, 2008, p. decreased B/P, hemorrhage
352). 353). (Swearingen, 2008, p. 353).
Contraindications:
Hypersensitivity, benzyl
alcohol, heparin, pork,
hemophelia, leukemia
with bleeding, peptic ulcer
disease, thrombocytopenic
purpura, heparin-induced
(Swearingen, 2008, p.
353).
Fluconzaole Antifungal 200 mg Damages the cell wall of Side effects: Headache, Assess for signs of infection
(Diflucan) fungi and is used for nausea, vomiting, (Swearingen, 2008, p. 411).
organisms such as diarrhea, cramping, flatus, Monitor for hepatotoxicity
Candida, Crytpococcus, hepatotoxicity, Stevens- (increased AST, ALT, alkaline
neoformans (Swearingen, Johnson Syndrome phosphatase, bilirubin)
2008, p. 411). (Swearingen, 2008, p. (Swearingen, 2008, p. 411).
411).
Contraindications:
Hypersensitivity to this

2. medication or aazoles
(Swearingen, 2008, p.
411).
Ipratroprium/ Bronchodilaor 0.5- Ipratroprium: Creates Side effects: Anxiety, Monitor vital capacity, FEV, ABG
Albuterol 2.5mg/3 bronchodilation by dizziness, headache, values, lung sounds, HR,
(Duoneb) mL inhibiting the interaction nausea, vomiting, cough, respirations (baseline rhythm and
(3mL) of acetylcholine with worsening of symptoms during treatment) (Swearingen,
receptor sites of smooth (Ipratroprium) 2008, p. 515)
muscle (Swearingen, (Swearingen, 2008, p. Monitor for signs and symptoms of
2008, p. 514). 515). an allergic reactions, paradoxic
Albuterol: Causes Tremors, anxiety, bronchospasm (Swearingen, 2008,
bronchodilation on B2 palpitations, tachycardia, p. 515).
receptors by increasing hypertension, heartburn, Find out if patient has been on a
cyclic adenosine nausea, vomiting, theophylline therapy to prevent an
monophosphate levels bronchospasm (Albuterol) increased effect (Swearingen, 2008,
(Swearingen, 2008, p. 51 (Swearingen, 2008, p. 51 p. 52).
). ).
Contraindications:
Hypersensitivity, atropine,
soya lecithin (Ipratrprium)
(Swearingen, 2008, p. 515
).
Hypersensitivity to
sympathomimetics,
tachydysrhythmias,
cardiac disease (severe)
(Albuterol) heart block
(Swearingen, 2008, p. 51).

3. Levetiracetam Anticonvulsant 500 mg Exact action is unknown, Side effects: Dizziness, Monitor urine (BUN, urine
(Keppra) possibly helps prevent somnolence, suicidal protein) (Swearingen, 2008, p.
seizures by limiting the ideation, asthenia, 550).
amount of sodium inos psychosis (Swearingen, Assess seizures (type, location,
across the cell membrane 2008, p. 550). duration and character), seizure
(Swearingen, 2008, p. Contraindications: precautions (Swearingen, 2008, p.
550). Hypersensitivity 550).
Methylprednis Corticosteroid 40 mg Decreases inflammation Side effects: Depression, Monitor potassium, blood and urine
onolone by decreasing the flushing, hypertension, glucose, if on long term therapy
(Solu-Medrol) movement of circulatory collapse, (Swearingen, 2008, p. 619).
polymorphonuclear thrombophlebitis, Weigh patient daily, notify PCP is
leukocytes and embolism, tachycardia more than 5 lbs in one week
fibroblasts, reverses (Swearingen, 2008, p. (Swearingen, 2008, p. 619).
increased capillary 618) Monitor VS every 4 hrs, be alert for
permiability Contraindications: an chest pain (Swearingen, 2008, p.
(Swearingen, 2008, p. Corticosteroids 619).
618). hypersensitivity, fungal Monitor I&O, check signs of fluid
infections, psychosis, retention (Swearingen, 2008, p.
idiopathic 619).
thrombocytopenia, acute Monitor plasma cortisol: 138-635
glomerulonephritis, mmol.L when drawn in the
amebiasis, AIDS, TB morning) (Swearingen, 2008, p.
(Swearingen, 2008, p. 619).
618). Monitor adrenal function, signs of
infection, mental status, and
(Swearingen, 2008, p. 619).
Pantoprazole Proton pump 40 mg Inhibits Side effects: Headache, Assess: bowel sounds every 8
(Protonix IV) inhibitor hydrogen/potassium diarrhea, abdominal pain, hours, abdominal pain, swelling,
ATPase enzyme system rash (Swearingen, 2008, p. lack and anorexia (Swearingen,
in gastric parietal cells 733). 2008, p. 733).

4. therefore decreasing Contraindications: Monitor liver enzymes: AST, ALT,
gastric secretions Hypersensitivity alkaline phosphatase (Swearingen,
(Swearingen, 2008, p. (Swearingen, 2008, p. 2008, p. 733).
732). 733).
Piperacillin/T Broad spectrum 3.375 g Piperacillin interferes Side effects: Nausea, Assess allergies (penicillins,
azobactam aniinfective with cell wall replication vomiting, diarrhea, cephalosporins), signs and
(Zosyn) of bacterial organisms vaginitis, moniliasism, symptoms for infection
and tazobactam prevents pseudomembranous (Swearingen, 2008, p. 771).
the breakdown of colitis, oliguria, Monitor C&S values to determine
pipericillin (Swearingen, proteinuris, hematuria, the effectiveness of treatment
2008, p. 770). glomerulonephritis, bone (Swearingen, 2008, p. 771).
marrow depression, Monitor I&O, AST, ALT, CBC
agranulocytosis Hct, bilirubin, LDH, alakaline
(Swearingen, 2008, p. phosphatase (Swearingen, 2008, p.
770). 771).
Contraindications: Assess bowel movement, and
Hypersnsitivity to monitor for signs of bleeding
penicillin, carbapenem (Swearingen, 2008, p. 771).
allergy (Swearingen,
2008, p. 770).
Vancomycin Antiinfective 1g Prevents bacterial cell Side effects: Ototoxicity, Assess signs and symptoms for
wall synthesis permanent deafness, infections, monitor I&O,
(Swearingen, 2008, p. nausea, nephrotoxicity, compromised renal system
989). leucopenia, eosinophilia, (Swearingen, 2008, p. 990).
chills, wheezing, dysnpea, Monitor blood tests: WBC, serum
anaphalaxis (Swearingen, levels, peak and trough levels
2008, p. 989). (Swearingen, 2008, p. 990).
Contraindications: Monitor C&S before and during
Hypersensitivity, previous treatment to determine its

5. hearing loss (Swearingen, effectiveness (Swearingen, 2008, p.
2008, p. 989). 990).
Assess for otoxicity, B/P and
allergies (Swearingen, 2008, p.
990).