Nursing Reference: Frequently Administered Inpatient Medications and Potential Side Effects

Vocabulary practice flashcards covering therapeutic indications and potential adverse effects of common inpatient pain control, GI, GU, antimicrobial, cardiovascular, anticoagulant, and glycemic medications.

Opioid analgesics

A class of pain relievers including Oxycodone, Hydromorphone (Dilaudid), Morphine, Fentanyl, and Tramadol. Potential side effects include itching, drowsiness, confusion, slower breathing, nausea/vomiting, and constipation.

Acetaminophen (Tylenol)

A non-opioid pain reliever and fever reducer. Potential side effects include nausea, rash, and liver damage with doses $>4000\text{ mg/24 hours}$.

Ibuprofen (Motrin/Advil) and Ketorolac

Non-opioid pain relievers and fever reducers. Potential side effects include bleeding, stomach ulcer/bleed, high blood pressure, acute kidney injury, and acute heart failure exacerbation.

Gabapentin and Pregabalin (Lyrica)

Non-opioid medications used for nerve pain relief. Potential side effects include drowsiness, dizziness, coordination issues, and nausea/vomiting.

Methocarbamol (Robaxin)

A non-opioid muscle relaxant. Potential side effects include drowsiness, dizziness, low blood pressure, low heart rate, and nausea/vomiting.

Tizanidine

A non-opioid muscle relaxant. Potential side effects include drowsiness, dizziness, dry mouth, low blood pressure, low heart rate, and weakness.

Lidocaine

A local anesthetic used for pain relief after surgery (less frequent to rare with low-dose analgesic dosing). Potential side effects include drowsiness, dizziness, metallic taste, mouth numbness, muscle tremor, headache, high/low blood pressure, ringing in ears, hallucinations, contact skin rash (topical patches), and rarely seizures and heart arrhythmias.

Ketamine

A medication that blocks pain-signaling in the brain to help with pain relief after surgery. Potential side effects include increased/decreased blood pressure and heart rate, heart rhythm changes, hallucinations, delirium ("Out of body" dreamlike feeling), and rarely slower breathing.

Nerve block (Ropivacaine, Bupivacaine)

Regional anesthetic administered via epidural or regional block that blocks nerves to provide pain relief in certain areas of the body after surgery. Potential side effects include swelling at insertion site, foul/metallic taste in mouth, low blood pressure, heart rhythm changes, headache, itching, dizziness, drowsiness, GI distress (nausea, vomiting, constipation), and urinary retention with epidural placement.

Ondansetron (Zofran)

An antiemetic medication that prevents and treats nausea and vomiting. Potential side effects include headache, constipation, and heart rhythm changes (QTc prolongation).

Prochlorperazine (Compazine)

An antiemetic that prevents and treats nausea and vomiting. Potential side effects include blurry vision, confusion, constipation, dry eyes, urinary retention, dry mouth, heart rhythm changes (prolongs QTc), drowsiness, dizziness, internal/motor restlessness, tremor, and low blood pressure with position changes (orthostatic hypotension).

Metoclopramide (Reglan)

An antiemetic that prevents and treats nausea and vomiting, and helps gut move (such as with gastroparesis). Potential side effects include drowsiness, dizziness, fatigue, confusion, internal/motor restlessness, tremor, and heart rhythm changes (QTc prolongation).

Bowel Regimen (Docusate, Bisacodyl, Senna, Polyethylene Glycol [Miralax])

Medications indicated for constipation prevention and treatment. Potential side effects include diarrhea, abdominal pain, abdominal cramps, nausea, and indigestion.

Alvimopan (Entereg)

An ileus prevention agent used to prevent ileus (slowing of gut) after surgery. Potential side effects include diarrhea, abdominal pain, abdominal cramps, nausea, and indigestion.

Output/Diarrhea Slower (Loperamide [Imodium], Diphenoxylate-atropine [Lomotil])

Agents that slow the gut, thicken stool, and reduce output from an ostomy. Potential side effects include constipation, abdominal cramps, nausea, drowsiness, dizziness, and heart rhythm changes (loperamide can prolong QTc).

Pantoprazole (Protonix)

A proton pump inhibitor that protects the lining of the stomach and small bowel to prevent ulcers from forming (typically given after bariatric surgery) and treats acid reflux. Potential side effects include headache, abdominal pain, GI upset (vomiting, constipation, diarrhea), rare skin rash, Clostridioides difficile (C. diff)-associated diarrhea, and long-term risks: magnesium deficiency, B12 deficiency, and risk of bone fractures.

Tamsulosin (Flomax)

A medication that helps with voiding urine with or without a Foley catheter in place, especially when a patient has an epidural catheter. Potential side effects include low blood pressure with changes in position (orthostatic hypotension), dizziness, headache, and back pain.

Oxybutynin and Tolterodine

Genitourinary-related medications that decrease bladder spasms. Potential side effects include drowsiness, dizziness, blurry vision, confusion, constipation, dry eyes, urinary retention, dry mouth, nausea, and headache.

Beta-Lactams and Cephalosporins (Augmentin, Zosyn, Keflex, Cefazolin, Ceftriaxone, etc.)

Antibiotics used for prevention and treatment of infections caused by bacteria (including Amoxicillin, Amoxicillin-Clavulanate, Piperacillin-Tazobactam, Cephalexin, Cefdinir, Cefazolin, Ceftriaxone, Cefepime, Meropenem). Potential side effects include diarrhea, nausea/vomiting, blood count abnormalities, liver count abnormalities, skin rash, kidney damage, and rarely seizures.

Vancomycin

An anti-infective antibiotic used for prevention and treatment of bacterial infections. Potential side effects include skin rash, flushing, blood count abnormalities, and kidney damage (with high levels and other agents that can hurt the kidney).

Levofloxacin (Levaquin) and Ciprofloxacin (Cipro)

Anti-infective antibiotics used for bacterial infections. Potential side effects include diarrhea, nausea/vomiting, confusion, low blood sugar with diabetes meds, heart arrhythmia (QTc prolongation), and rare risks of tendonitis/tendon rupture and aortic dissection.

Metronidazole (Flagyl)

An anti-infective antibiotic. Potential side effects include headache, nausea/vomiting (avoid alcohol), metallic taste, and peripheral neuropathy.

Sulfamethoxazole/Trimethoprim (Bactrim)

An anti-infective antibiotic. Potential side effects include skin rashes/reactions, high potassium levels, decreased kidney function, and low blood counts.

Nitrofurantoin (Macrobid)

An anti-infective antibiotic. Potential side effects include headache, nausea, tingling/numbness in legs/arms, and rarely liver/lung injury.

Fluconazole (Diflucan)

An antifungal medication for prevention and treatment of infection caused by fungi. Potential side effects include headache, nausea/vomiting, diarrhea, liver count abnormalities, heart arrhythmia (QTc prolongation), and skin rash.

Hydralazine

A vasodilator that widens blood vessels to lower blood pressure. Potential side effects include low blood pressure, dizziness, lightheadedness, flushing, and increased heart rate.

Labetalol and Metoprolol

Beta blocker medications that lower heart rate (metoprolol and labetalol) and blood pressure (labetalol). Potential side effects include low heart rate, low blood pressure, dizziness, lightheadedness, fatigue, and nausea.

Anticoagulants (Heparin, Enoxaparin, Apixaban, Rivaroxaban, Warfarin)

Blood thinners used to prevent or treat blood clots. Potential side effects include bleeding, bruising, low platelets, and low hemoglobin.

Blood Glucose-Lowering Insulins (Lispro, Glargine, Regular)

Medications that prevent and treat high blood sugar. Potential side effects include low blood sugar (sweating, heart racing, nausea, lightheaded, dizziness, fainting), injection site reaction/swelling/itching, low potassium, and weight gain with long-term use.