Gero-Rehab Course



Medication Information

|Drug Name |Drug Action/ |Normal Dose |Major side |Nursing Considerations |

|(generic/trade name) |Purpose |Range |Effects | |

|omeprazole |Omeprazole interferes with gastric |* To treat GERD with erosive |CNS: |* Give omeprazole before meals, |

| |acid secretion by inhibiting the |esophagitis |Agitation, asthenia, dizziness, |preferably in the morning for |

|Losec (CAN), Prilosec, Zegerid |hydrogen-potassium-adenosine | |drowsiness, fatigue, headache, psychic|once-daily dosing. If neces-sary, also|

| |triphosphatase (H+K+-ATPase) enzyme |Delayed-release capsules, |disturbances, somnolence |give an antacid, as prescribed. |

| |system, or proton pump, in gastric |delayed-release tablets, oral |CV: |* If needed, open capsule and sprinkle|

| |parietal cells. Normally, the proton |suspension |Chest pain, hypertension, peripheral |enteric-coated granules on applesauce |

| |pump uses energy from the hydrolysis |Adults. |ed-dema |or yogurt or mix with water or acidic |

| |of adenosine triphos-phate to drive |20 mg daily for 4 to 8 wk. |EENT: |fruit juice, such as apple or |

| |hydrogen (H+) and chloride (Cl-) out | |Anterior ischemic optic neuropathy, |cranberry juice. Give immediately. |

| |of parietal cells and into the stomach| |optic atrophy or neuritis, stomatitis |* To give drug via NG tube, mix |

| |lumen in exchange for potassium (K+), | |ENDO: |granules in acidic juice because |

| |which leaves the stomach lumen and | |Hypoglycemia |enteric coating dissolves in alkaline |

| |enters the parietal cells. After this | |GI: |pH. |

| |exchange, H+ and Cl-combine in the | |Abdominal pain, constipation, |* Because drug can interfere with |

| |stomach to form hydrochloric acid | |diarrhea, dyspepsia, elevated liver |absorption of vitamin B12, monitor for|

| |(HCl), as shown below left. Omeprazole| |function test results, flatulence, |macrocytic anemia. |

| |irreversibly blocks the exchange of | |hepatic dysfunction or failure, |* Be aware that long-term use of |

| |intracellu-lar H+ and extracellular | |indigestion, nausea, pancreatitis, |omeprazole may increase the risk of |

| |K+, as shown below right. By | |vomiting |gastric carcinoma. |

| |preventing H+ from entering the | |GU: | |

| |stomach lumen, omeprazole prevents | |Interstitial nephritis | |

| |additional HCl from forming. | |HEME: | |

| | | |Agranulocytosis, anemia, hemolytic | |

| | | |anemia, leukopenia, leukocytosis, | |

| | | |neutrope-nia, pancytopenia, | |

| | | |thrombocytopenia | |

| | | |MS: | |

| | | |Back pain | |

| | | |RESP: | |

| | | |Cough | |

| | | |SKIN: | |

| | | |Erythema multiforme, photosensitivity,| |

| | | |pruritus, rash, Stevens-Johnson | |

| | | |syndrome, toxic epidermal necrolysis, | |

| | | |urticaria | |

| | | |Other: | |

| | | |Anaphylaxis, angioedema, hypona-tremia| |

|prednisone |Binds to intracellular glucocorticoid |* To treat adrenal insufficiency and |CNS: |* Administer once-daily doses of |

| |receptors and suppresses inflammatory |acute and chronic inflammatory and |Euphoria, headache, insomnia, |prednisone in the morning to match the|

|Apo-Prednisone (CAN), Deltasone Liquid|and immune responses by: |immunosuppressive disorders |nervousness, psychosis, restlessness, |body’s normal cortisol secretion |

|Pred, Meticorten, Orasone 1, Orasone |inhibiting neutrophil and monocyte | |seizures, vertigo |schedule. |

|5, Orasone 10, Prednicen-M, Prednicot,|accumulation at inflammation site and |Oral solution, syrup,tablets |CV: |* Because prednisone can produce many |

|Prednisone Intensol, Sterapred, |suppressing their phagocytic and |Adults and adolescents. |Edema, heart failure, hypertension |adverse reactions, assess regularly |

|Sterapred DS, Winpred (CAN) |bactericidal activitystabilizing |5 to 60 mg daily as a single dose or |EENT: |for signs and symptoms of such |

| |lysosomal membranessuppressing antigen|in divided doses. |Cataracts, exophthalmos, glaucoma, |reactions as heart failure and |

| |response of macrophages and helper T | |increased ocular pressure |hypertension. Also monitor fluid |

| |cellsinhibiting synthesis of | |ENDO: |intake and output and daily weight. |

| |inflammatory response mediators, such | |Adrenal insufficiency, Cushing’s |* Monitor growth pattern in children |

| |as cytokines, interleukins, and | |syndrome, growth suppression in |because prednisone may retard bone |

| |prostaglandins. | |children, hyperglycemia |growth. |

| | | |GI: |* Be aware that prolonged use of |

| | | |Anorexia, GI bleeding and ulceration, |prednisone may cause |

| | | |increased appetite, indigestion, |hypothalamic-pituitary-adrenal |

| | | |intestinal perforation, nausea, |suppression. |

| | | |pancreatitis, vomiting |* WARNING Withdraw prednisone |

| | | |GU: |gradually, as ordered, if therapy |

| | | |Menstrual irregularities |lasts longer than 2 weeks. Abrupt |

| | | |MS: |discontinuation may cause acute |

| | | |Avascular necrosis of joints, bone |adrenal insufficiency and, possibly, |

| | | |fractures, muscle atrophy or weakness,|death. |

| | | |myalgia, osteoporosis | |

| | | |SKIN: | |

| | | |Acne; diaphoresis; ecchymosis; | |

| | | |flushing; petechiae; striae; thin, | |

| | | |fragile skin | |

| | | |Other: | |

| | | |Delayed wound healing, hypernatremia, | |

| | | |hypokalemia, negative nitrogen balance| |

|acetaminophen |Inhibits the enzyme cyclooxygenase, |* To relieve mild to moderate pain |GI: |* Before and during long-term therapy,|

| |blocking prostaglandin production and |associated with headache, muscle ache,|Abdominal pain, hepatotoxicity, |monitor liver function test results, |

|Abenol (CAN), Acephen, Aceta Elixir, |interfering with pain impulse |backache, minor arthritis, common |nausea, vomiting |including AST, ALT, bilirubin, and |

|Aceta-minophen Uniserts, Aceta |generation in the peripheral nervous |cold, toothache, and menstrual cramps;|HEME: |creatinine levels, as ordered. |

|Tablets, Apacet Capsules, Apacet |system. Acetamin-ophen also acts |to reduce fever |Hemolytic anemia (with long-term use),|* Monitor renal function in patient on|

|Elixir, Apacet Extra Strength Tablets,|directly on temperature-regulating | |leukopenia, neutropenia, pancytopenia,|long-term therapy. Keep in mind that |

|Apacet Regular Strength Tablets, |center in the hypothalamus by |Caplets, capsules, chewable tablets, |thrombocytopenia |blood or albumin in urine may indicate|

|Aspirin Free Pain Relief, Exdol (CAN),|inhibiting synthesis of prostaglandin |elixir, e.r. caplets, gelcaps, liquid,|SKIN: |nephritis; decreased urine output, |

|Feverall, Feverall Sprinkle Caps, |E2. |solution, sprinkles, suspension, |Jaundice, rash, urticaria |renal failure; and dark brown urine, |

|Genapap Infants’ Drops, Genebs Extra | |tablets |Other: |presence of the metabolite phenacetin.|

|Strength, Halenol Children's Junior | |Adults. |Angioedema, hypoglycemic coma |* Expect to reduce dosage for patients|

|Strength, Liquiprin Elixir, Liquiprin | |325 to 650 mg every 4 to 6 hr, or | |with renal dysfunction. |

|Infants’ Drops, Meda Cap, Neopap, | |1,000 mg t.i.d. or q.i.d., or 2 E.R. | |* Store suppositories under 80° F |

|Oraphen-PD, Panadol, Panadol Infants’ | |caplets every 8 hr. Maximum: 4,000 mg | |(26.6° C). |

|Drops, Pediaphen, Redutemp, Robigesic | |daily. | |* WARNING Be aware that Pediaphen is a|

|(CAN), St. Joseph Aspirin-Free Infant | | | |concentrated form of acetaminophen |

|Drops, Tapanol Extra Strength, Tempra,| | | |containing 80 mg/0.8 ml (standard |

|Tempra Drops, Tylenol, Tylenol | | | |liquid forms contain 32 mg/ml). Make |

|Caplets, Tylenol Children's Chewable | | | |sure to use correct concentration and |

|Tablets, Tylenol Extra Strength, | | | |correct dosage of liquid acetaminophen|

|Tylenol Gel-caps, Tylenol Infants’ | | | |because serious adverse reactions can |

|Drops | | | |result from confusing concentrated |

| | | | |form with regular liquid form. |

|Levsin |Competitively inhibits acetylcholine |* To treat peptic ulcers and GI tract |CNS: |* Use hyoscyamine cautiously in |

| |at autonomic postganglionic |disorders caused by spasm |Drowsiness, insomnia |patients who have arrhythmias, |

|hyoscyamine sulfate, Anaspaz, A-Spas |cholinergic receptors. Because the | |EENT: |autonomic neuropathy, coronary artery |

|S/L, Cystospaz, Cystospaz-M, Donnamar,|most sensitive receptors are in the |Elixir, oral solution |Blurred vision; dry mouth, nose, and |disease, heart failure, hiatal hernia |

|ED-SPAZ, Gastrosed, Levbid, Levsin/SL,|salivary, bronchial, and sweat glands,|Adults and adolescents. |throat; photophobia |with reflux esophagitis, hypertension,|

|Levsinex Timecaps, Symax SL, Symax SR |hyoscyamine acts mainly to reduce |0.125 to 0.25 mg every 4 to 6 hr. |ENDO: |hyperthyroidism, renal failure, or |

| |salivary, bronchial, and sweat gland | |Decreased lactation |tachycardia. |

| |secretions. It also causes GI smooth | |GI: |* Give drug 30 to 60 minutes before |

| |muscle to contract and decreases | |Constipation |meals and at bedtime. Give bedtime |

| |gastric secretion and GI motility. In | |GU: |dose at least 2 hours after the day’s |

| |addition, hyoscyamine causes the | |Impotence, urine retention |last meal. |

| |bladder detrusor muscle to contract; | |SKIN: |* Anticipate that tablets may not |

| |reduces nasal and oropharyngeal | |Decreased sweating |disintegrate and may appear in stool. |

| |secretions; and decreases airway | |Other: |* WARNING Anticipate an increased risk|

| |resistance from relaxation of smooth | |Heatstroke, injection site redness and|of drug-induced heatstroke in hot or |

| |muscle in the bronchi and bronchioles.| |urticaria |humid weather because hyoscyamine |

| | | | |decreases sweating. |

| | | | |* WARNING Be aware that lower doses |

| | | | |may paradoxically decrease heart rate.|

| | | | |Higher doses affect nicotinic |

| | | | |receptors in autonomic ganglia, |

| | | | |causing delirium, disorientation, |

| | | | |hallucinations, and restlessness. |

| | | | |* Monitor urine output, and be alert |

| | | | |for urine retention. |

|Maalox |Neutralizes or reduces gastric |To treat hyperacidity associated with |CNS: |* Don't administer aluminum hydroxide |

| |acidity, resulting in increased |gastric hyperacidity, gastritis, |Encephalopathy |within 1 to 2 hours of other oral |

|magnesium hydroxide (milk of |stomach and duodenal alkalinity. |hiatal hernia, peptic esophagitis, and|GI: |drugs. |

|magnesia)/ aluminum hydroxide |Protects stomach and duodenum lining |peptic ulcers; to prevent phosphate |Constipation, intestinal obstruction, |* Be aware that two 0.6-g aluminum |

| |by inhibiting pepsin's prote-olytic |renal calculus formation; to reduce |white-speckled stool |hydroxide tablets can neutralize 16 |

| |activity. Binds with phosphate ions in|hyperphosphatemia in chronic renal |MS: |mEq of acid. |

|(contains 135 mg elemental magnesium |the intestine to form insoluble |failure |Osteomalacia, osteoporosis |* Monitor patient's serum levels of |

|per tablet, 129 to 130 mg elemental |aluminum-phosphate compounds, which | |Other: |sodium, phosphate, and other |

|magnesium per chewable tablet, and 164|lower the blood phosphate level. |Aluminum hydroxide capsules, |Aluminum accumulation in serum, bone, |electrolytes, as appropriate. |

|to 328 mg elemental magnesium per 5 ml| |suspension, or tablets |and CNS; aluminum intoxication; | |

|liquid, liquid concentrate, or oral | |Adults. |electrolyte imbalances | |

|solution) | |500 to 1,500 mg as capsules or tablets| | |

| | |in divided doses 3 to 6 times daily, | | |

|Phillips’ Chewable Tablets, Phillips’ | |taken between meals and at bedtime; 5 | | |

|Magnesia Tablets (CAN), Phillips’ Milk| |to 30 ml as suspension p.r.n., taken | | |

|of Magnesia, Phillips’ Milk of | |between meals and at bedtime. | | |

|Magnesia Concentrate | | | | |

| | | | | |

|AlternaGEL, Alu-Cap, Alugel (CAN), | | | | |

|Alu-Tab, Amphojel, Dialume | | | | |

|Zoloft |Inhibits reuptake of the |* To treat major depression |CNS: |* Monitor liver function test results |

|sertraline hydrochloride |neurotransmitter serotonin by CNS | |Aggressiveness, agitation, anxiety, |and BUN and serum creatinine levels, |

| |neurons, thereby increasing the amount|Oral concentrate,tablets |dizziness, drowsiness, fatigue, fever,|as appropriate, in patients with |

| |of serotonin available in nerve |Adults. |headache, hyperkinesia, insomnia, |hepatic or renal dysfunction. |

| |synapses. An elevated serotonin level |Initial: 50 mg daily, increased after |nervousness, neuroleptic malignant |* WARNING Monitor patient closely for |

| |may result in elevated mood and |several wk in increments of 50 mg |syndrome–like reaction, paresthesia, |evidence of serotonin syndrome, such |

| |reduced depression. This action may |daily every wk, as needed. Maximum: |serotonin syndrome, suicidal ideation,|as agitation, hallucinations, coma, |

| |also relieve symptoms of other |200 mg daily. |tremor, weakness, yawning |tachycardia, labile blood pressure, |

| |psychiatric conditions attributed to | |CV: |hyperthermia, hyperreflexia, |

| |serotonin deficiency. |* To treat obsessive-compulsive |Palpitations |incoordination, nausea, vomiting, and |

| | |disorder |EENT: |diarrhea. Serotonin syndrome in its |

| | | |Dry mouth, epistaxis, sinusitis, |most severe form can resemble |

| | |Oral concentrate,tablets |vision changes |neuroleptic malignant syndrome, which |

| | |Adults and adolescents. |ENDO: |includes hyperthermia, muscle |

| | |Initial: 50 mg daily, increased after |Syndrome of inappropriate ADH |rigidity, autonomic instability, |

| | |several wk in increments of 50 mg |secretion |possibly rapid changes in vital signs,|

| | |daily every wk, as needed. Maximum: |GI: |and mental status changes. Notify |

| | |200 mg daily. |Abdominal cramps, anorexia, |prescriber immediately because |

| | | |constipation, diarrhea, flatulence, |serotonin syndrome reactions that |

| | | |increased appetite, indigestion, |resemble neuroleptic malignant |

| | | |nausea, vomiting |syndrome may be life-threatening. Be |

| | | |GU: |prepared to provide supportive care. |

| | | |Anorgasmia, decreased libido, |* Monitor patient for hypoosmolarity |

| | | |ejaculation disorders, impotence, |of serum and urine and for |

| | | |urinary incontinence |hyponatremia, which may indicate |

| | | |SKIN: |sertraline-induced syndrome of |

| | | |Diaphoresis, flushing, purpura, rash |inappropriate ADH secretion. |

| | | |Other: |* Be aware that effective |

| | | |Weight loss |antidepressant therapy can promote |

| | | | |development of mania in predisposed |

| | | | |people. If mania develops, notify |

| | | | |prescriber immediately and expect to |

| | | | |withhold sertraline. |

| | | | |* Watch closely for suicidal |

| | | | |tendencies, especially when therapy |

| | | | |starts and dosage changes and |

| | | | |especially in children and |

| | | | |adolescents. |

| | | | |* Monitor patient closely for evidence|

| | | | |of GI bleeding, especially if patient |

| | | | |takes a drug known to cause it, such |

| | | | |as aspirin, an NSAID, a serotonin or |

| | | | |norepinephrine reup-take inhibitor, or|

| | | | |warfarin. |

| | | | |* When theray stops, expect to taper |

| | | | |dosage to minimize adverse effects |

| | | | |rather than stopping drug abruptly. |

|Coumadin |Interferes with the liver’s ability to|To prevent or treat pulmonary |CNS: |* Reconstitute parenteral warfarin |

| |synthesize vitamin K–dependent |embolism; recurrent MI; thromboembolic|Coma, intracranial hemorrhage, loss of|just before administration with 2.7 ml|

|warfarin sodium |clotting factors, depleting clotting |complications from atrial |consciousness, syncope, weakness |of sterile water for injection to |

| |factors II (prothrombin), VII, IX, and|fibrillation, heart valve replacement,|CV: |yield 2 mg/ml. Then administer slowly |

| |X. This action, in turn, interferes |or MI; and venous thrombosis (and its |Angina, chest pain, hypotension |over 1 to 2 minutes through peripheral|

| |with the clotting cascade. By |extension) |EENT: |I.V. |

| |depleting vitamin K-dependent clotting|Tablets |Epistaxis, intraocular hemorrhage |* Expect to administer another |

| |factors and interfering with the |Adults. |GI: |parenteral anticoagulant, such as |

| |clotting cascade, warfarin prevents |Initial: 2 to 5 mg daily |Abdominal cramps and pain, diarrhea, |heparin or enoxaparin, with oral |

| |coagulation. | |hepatitis, nausea, vomiting |warfarin for at least 3 days, or until|

| | | |GU: |desired response occurs, before giving|

| | | |Hematuria, vaginal bleeding (abnormal)|warfarin only. |

| | | |HEME: |* Avoid I.M. injections during |

| | | |Anemia, potentially fatal hemorrhage |warfarin therapy, if possible, because|

| | | |(from any tissue or organ) |they can result in bleeding, bruising,|

| | | |SKIN: |and hematoma. |

| | | |Alopecia, ecchymosis, jaundice, |* Monitor INR (daily in acute care |

| | | |petechiae, pruritus, purple-toe |setting) and assess for therapeutic |

| | | |syndrome, tissue necrosis |effects, as prescribed. Therapeutic |

| | | |Other: |INR levels are 2.0 to 3.0 for |

| | | |Anaphylaxis |bioprosthetic heart valve, nonvalvular|

| | | | |atrial fibrillation, and venous |

| | | | |thromboembolism, and 2.5 to 3.5 after |

| | | | |MI and for mechanical heart valve. |

| | | | |* Expect treatment to last up to 12 |

| | | | |weeks for bioprosthetic heart valve, 1|

| | | | |to 3 months for nonvalvular atrial |

| | | | |fibrillation or venous |

| | | | |thromboembolism, and for rest of life |

| | | | |after MI and for mechanical heart |

| | | | |valve replacement. |

| | | | |* WARNING Be aware of the increased |

| | | | |risk for intracranial hemorrhage if |

| | | | |patient has cerebral ischemia (such as|

| | | | |recent transient ischemic attack or |

| | | | |minor ischemic CVA) and INR of 3 to |

| | | | |4.5. As prescribed, withhold next |

| | | | |warfarin dose and give vitamin K if |

| | | | |INR exceeds 4 because of the risk of |

| | | | |bleeding. |

| | | | |* Assess for occult bleeding if |

| | | | |patient receives I.V. lipid emulsion |

| | | | |or other medical product that contains|

| | | | |soybean oil. Such products can |

| | | | |decrease vitamin K absorption and |

| | | | |increase warfarin’s anticoagulant |

| | | | |effect. |

|ibuprofen |Blocks the activity of cyclooxygenase,|* To relieve pain in rheumatoid |CNS: |* Use ibuprofen with extreme caution |

| |the enzyme needed to synthesize |arthritis and osteoarthritis |Aseptic meningitis, dizziness, |in patients with a history of ulcer |

|Actiprofen Caplets (CAN), Advil, |prostaglandins, which mediate the | |headache, nervousness, seizures, |disease or GI bleeding because NSAIDs |

|Apo-Ibuprofen (CAN), Bayer Select |inflammatory response and cause local |Capsules, chewable tablets, oral |stroke |such as ibuprofen increase the risk of|

|Ibuprofen Pain Relief Formula Caplets,|vasodilation, swelling, and pain. By |suspension, tablets |CV: |GI bleeding and ulceration. Expect to |

|Children’s Advil, Children’s Motrin, |inhibiting prostaglandins, this NSAID |Adults. |Fluid retention, heart failure, |use ibuprofen for the shortest time |

|Dolgesic, Excedrin IB, Genpril, |reduces inflammatory symptoms and |300 mg q.i.d., or 400, 600, or 800 mg |hypertension, MI, peripheral edema, |possible in these patients. |

|Hal-tran, Ibifon 600 Caplets, Ibuprin,|relieves pain. Ibuprofen’s antipyretic|t.i.d. or q.i.d. Range: 1.2 to 3.2 g |tachycardia |* Be aware that serious GI tract |

|Ibuprohm Caplets, Ibu-Tab, Medipren, |action probably stems from its effect |daily. |EENT: |ulceration, bleeding, and perforation |

|Midol IB, Motrin, Motrin-IB, |on the hypothalamus, which increases | |Amblyopia, epistaxis, stomatitis, |may occur without warning symptoms. |

|Novo-Profen (CAN), Nu-Ibuprofen (CAN),|peripheral blood flow, causing | |tinnitus |Elderly patients are at greater risk. |

|Nuprin, Pamprin-IB, Q-Profen, Rufen, |vasodilation and encouraging heat | |GI: |To minimize risk, give drug with food.|

|Trendar |dissipation. | |Abdominal cramps, distention, or pain;|If GI distress occurs, withhold drug |

| | | |anorexia; constipation; diarrhea; |and notify prescriber immediately. |

| | | |diverticulitis; dyspepsia; dysphagia; |* Use ibuprofen cautiously in patients|

| | | |elevated liver function test results; |with hypertension, and monitor blood |

| | | |epigastric discomfort; esophagitis; |pressure closely throughout therapy. |

| | | |flatulence; gastritis; |Drug may cause hypertension or worsen |

| | | |gastroenteritis; gastroesophageal |it. |

| | | |reflux disease; GI bleeding, |* WARNING Monitor patient closely for |

| | | |hemorrhage, perforation, or |thrombotic events, including MI and |

| | | |ulceration; heartburn; hemorrhoids; |stroke, because NSAIDs increase the |

| | | |hepatic failure; hepatitis; hiatal |risk. |

| | | |hernia; indigestion; melena; nausea; |* Monitor patient—especially if he’s |

| | | |stomatitis; vomiting |elderly or receiving long-term |

| | | |GU: |ibuprofen therapy—for less common but |

| | | |Cystitis, hematuria, renal failure |serious adverse GI reactions, |

| | | |(acute) |including anorexia, constipation, |

| | | |HEME: |diverticulitis, dysphagia, |

| | | |Agranulocytosis, anemia, aplastic |esophagitis, gastritis, |

| | | |anemia, eosinophilia, hemolytic |gastroenteritis, gastroesophageal |

| | | |anemia, leukopenia, neutropenia, |reflux disease, hemorrhoids, hiatal |

| | | |pancytopenia, prolonged bleeding time,|hernia, melena, stomatitis, and |

| | | |thrombocytopenia |vomiting. |

| | | |RESP: |* Monitor liver function test results |

| | | |Bronchospasm, dyspnea, wheezing |because, in rare cases, elevations may|

| | | |SKIN: |progress to severe hepatic reactions, |

| | | |Blisters, erythema multiforme, |including fatal hepatitis, liver |

| | | |photosensitivity, pruritus, rash, |necrosis, and hepatic failure. |

| | | |Stevens-Johnson syndrome, toxic |* Monitor BUN and serum creatinine |

| | | |epidermal necrolysis, urticaria |levels in elderly patients, patients |

| | | |Other: |taking diuretics or ACE inhibitors, |

| | | |Anaphylaxis, angioedema, flulike |and patients with heart failure, |

| | | |symptoms, weight gain |impaired renal function, or hepatic |

| | | | |dysfunction; drug may cause renal |

| | | | |failure. |

| | | | |* Monitor CBC for decreased hemoglobin|

| | | | |and hematocrit. Drug may worsen |

| | | | |anemia. |

| | | | |* WARNING If patient has bone marrow |

| | | | |suppression or is receiving an |

| | | | |antineoplastic drug, monitor |

| | | | |laboratory results (including WBC |

| | | | |count), and watch for evidence of |

| | | | |infection because antiinflammatory and|

| | | | |antipyretic actions of ibuprofen may |

| | | | |mask signs and symptoms, such as fever|

| | | | |and pain. |

| | | | |* Assess patient’s skin regularly for |

| | | | |signs of rash or other |

| | | | |hypersensitivity reaction because |

| | | | |ibuprofen is an NSAID and may cause |

| | | | |serious skin reactions without |

| | | | |warning, even in patients with no |

| | | | |history of NSAID sensivitity. At first|

| | | | |sign of reaction, stop drug and notify|

| | | | |prescriber. |

| | | | |* Although drug’s analgesic effect |

| | | | |occurs at low doses, expect to give at|

| | | | |least 400 mg four times daily for |

| | | | |antiinflammatory effect. |

| | | | |* Expect higher doses for rheumatoid |

| | | | |arthritis than for osteoarthritis. |

| | | | |* Be aware that ibuprofen oral |

| | | | |suspension may contain sucrose, which |

| | | | |may affect blood glucose level in |

| | | | |patients with diabetes. |

Source: Davis’s Drug Guide for Nurse 2011

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