Med | 5

Date: [Insert Date] Prepared for: Clinical Reference / Nursing Staff Purpose: Summary of indications, mechanisms, adverse effects, and safety considerations. Med 1: Metformin (Biguanide) | Category | Details | |----------|---------| | Class | Antidiabetic (Biguanide) | | Indication | Type 2 diabetes mellitus | | Mechanism | Decreases hepatic gluconeogenesis, reduces intestinal glucose absorption, improves insulin sensitivity | | Common Side Effects | GI distress (diarrhea, nausea, bloating), metallic taste | | Serious Adverse Effects | Lactic acidosis (rare but fatal – risk if renal impairment/heart failure) | | Nursing Considerations | – Hold before radiology with IV contrast (risk of AKI) – Monitor renal function (eGFR) – Take with meals to reduce GI upset – Avoid excessive alcohol | Med 2: Lisinopril (ACE Inhibitor) | Category | Details | |----------|---------| | Class | Antihypertensive (ACE inhibitor) | | Indication | Hypertension, heart failure, post-MI, diabetic nephropathy | | Mechanism | Inhibits ACE → reduces angiotensin II → vasodilation & decreased aldosterone | | Common Side Effects | Dry cough, dizziness, headache | | Serious Adverse Effects | Angioedema (swelling of tongue/lips), hyperkalemia, acute kidney injury | | Nursing Considerations | – Check BP and potassium before administration – Monitor for persistent cough (switch to ARB if needed) – Educate: report any facial/lip swelling immediately | Med 3: Atorvastatin (Statin) | Category | Details | |----------|---------| | Class | Lipid-lowering agent (HMG-CoA reductase inhibitor) | | Indication | Hyperlipidemia, ASCVD prevention | | Mechanism | Blocks cholesterol synthesis in liver → upregulates LDL receptors | | Common Side Effects | Myalgia, mild GI upset, increased liver enzymes | | Serious Adverse Effects | Rhabdomyolysis (rare), new-onset diabetes, hepatotoxicity | | Nursing Considerations | – Administer once daily (evening preferred due to cholesterol synthesis) – Report unexplained muscle pain/dark urine – Avoid grapefruit juice (increases toxicity) – Monitor LFTs and CK if muscle symptoms | Med 4: Albuterol (Short-Acting Beta-2 Agonist – SABA) | Category | Details | |----------|---------| | Class | Bronchodilator | | Indication | Asthma exacerbation, COPD, exercise-induced bronchospasm | | Mechanism | Stimulates beta-2 receptors in bronchial smooth muscle → bronchodilation | | Common Side Effects | Tachycardia, tremor, nervousness, headache | | Serious Adverse Effects | Hypokalemia (high doses), paradoxical bronchospasm, arrhythmias | | Nursing Considerations | – Count heart rate before use (>120 bpm → caution) – Inhaled: use spacer for better deposition – Monitor for wheezing improvement (peak flow) – Overuse indicates poor asthma control – reassess | Med 5: Ondansetron (5-HT3 Antagonist) | Category | Details | |----------|---------| | Class | Antiemetic | | Indication | Nausea/vomiting (post-op, chemotherapy, radiation) | | Mechanism | Blocks serotonin receptors in chemoreceptor trigger zone (CTZ) and GI tract | | Common Side Effects | Headache, constipation, dizziness | | Serious Adverse Effects | QT prolongation (dose-dependent), serotonin syndrome (with other serotonergics) | | Nursing Considerations | – Obtain baseline ECG if giving high IV doses (>16 mg) – Monitor for arrhythmias in patients on antiarrhythmics or with electrolyte imbalance – Oral dissolving tablet (ODT) available for NPO patients | Summary Table | Med | Class | Main Use | Top Safety Point | |-----|-------|----------|------------------| | Metformin | Biguanide | Type 2 diabetes | Avoid in renal failure (lactic acidosis) | | Lisinopril | ACE inhibitor | Hypertension | Watch for angioedema & dry cough | | Atorvastatin | Statin | High cholesterol | Report muscle pain – avoid grapefruit | | Albuterol | SABA | Asthma/COPD | Monitor heart rate & overuse | | Ondansetron | Antiemetic | Nausea/vomiting | QT prolongation risk | This report is for educational purposes. Always verify against current drug references and individual patient factors (allergies, renal/hepatic function, pregnancy, drug interactions).