Medication Memorization

Trade name of Lisinopril

Prinivil, Zestril

Generic name of Prinivil / Zestril

Lisinopril

Drug class of Lisinopril

ACE inhibitor

Typical dose and route for Lisinopril

10–40 mg PO daily

Indications for Lisinopril

Treats hypertension (HTN); Manages heart failure (CHF) – decreases afterload & preload to improve cardiac output; Prevents heart damage after myocardial infarction (MI); Protects kidneys in diabetes (nephroprotection)

Mechanism of action of Lisinopril

Blocks ACE enzyme → prevents conversion of angiotensin I to angiotensin II → vasodilation, decreased aldosterone, decreased sodium/water retention, increased potassium retention → lowers BP and cardiac workload

Therapeutic effects of Lisinopril

Lowers BP and heart workload; Decreases pulmonary congestion and edema in HF; Improves activity tolerance and energy; Prevents HF progression and ventricular remodeling post-MI

Common side effects of Lisinopril

Dry cough (from bradykinin buildup); Dizziness or headache; Fatigue; Hyperkalemia (high potassium)

Adverse reactions to Lisinopril

Angioedema (swelling of lips, face, tongue, throat); Severe hypotension or syncope; Renal impairment; Hyperkalemic arrhythmias

Labs to monitor for Lisinopril

Potassium (↑K⁺); BUN; Creatinine; Sodium (↓Na⁺ occasionally); Monitor BP before administration

Nursing implications for Lisinopril

Hold if systolic BP

If patient develops swelling or facial edema

Hold the medication immediately and notify the provider – possible angioedema

Antidote for Lisinopril overdose

No specific antidote; Treat hypotension with IV fluids; Manage hyperkalemia with insulin + dextrose; Give epinephrine for angioedema

Onset, peak, and duration for Lisinopril (PO)

Onset: 1 hr; Peak: 6 hr; Duration: 24 hr

Patient education for Lisinopril

Take at the same time daily; Avoid foods high in potassium (bananas, oranges, salt substitutes); Report facial/lip/throat swelling, persistent cough, or dizziness; Rise slowly from sitting or lying; Continue medication even if feeling well

Important nursing tip for Lisinopril

Always check potassium level and BP before giving—ACE inhibitors increase potassium

💉 Anticoagulant – Lovenox

Trade name: Lovenox | Generic name: Enoxaparin Sodium | Drug class: Anticoagulant (LMWH)

Indications for Lovenox

Prevent DVT; Prevent PE; Prevent clot formation after surgery; Prevent ischemic complications; Used as bridge therapy until warfarin therapeutic (INR 2–3)

Action of Lovenox

Enhances antithrombin III → inhibits clotting cascade → prevents new clot formation and stops growth of existing clots

Therapeutic effects of Lovenox

Prevents thrombus formation; Reduces risk of stroke, DVT, and PE; Maintains venous and arterial patency

Side effects of Lovenox

Bleeding (most common); Injection-site bruising or hematoma; Anemia; Mild pain, redness, or irritation at site

Adverse reactions of Lovenox

Hemorrhage; Heparin-induced thrombocytopenia (HIT); Allergic reaction (rash, urticaria, anaphylaxis)

Labs for Lovenox

Platelet count (watch for decrease); Hgb/Hct (for occult bleeding); anti-Xa levels (esp. in pediatrics, renal impairment, or obesity)

Toxicity/Overdose for Lovenox

Excessive bleeding, hematuria, melena, hypotension; Antidote: Protamine sulfate (1 mg per 1 mg enoxaparin)

Nursing implications for Lovenox

Check platelet count before giving (hold if

Implementation considerations for Lovenox

Give SubQ only (never IM); Use prefilled syringe; Do not expel air bubble; Rotate sites; Avoid bruised areas; Double-check dose for accuracy

Patient education for Lovenox

Report bleeding, bruising, or pink urine; Avoid NSAIDs/aspirin; Use soft toothbrush/electric razor; Teach injection technique; Keep follow-up lab appointments

💉 Anticoagulant – Heparin

Trade name: Heparin Sodium | Generic name: Heparin | Drug class: Anticoagulant (Unfractionated Heparin)

Indications for Heparin

Prevention and treatment of thromboembolic disorders (DVT, PE, MI)

Action of Heparin

Inactivates thrombin and factor Xa → inhibits fibrin formation → prevents new clots

Side effects of Heparin

Bleeding, bruising, irritation at injection site

Adverse reactions of Heparin

Hemorrhage, Heparin-induced thrombocytopenia (HIT), hypersensitivity reactions

Labs for Heparin

Platelet count, Hgb/Hct, aPTT if IV (therapeutic: 60–80 sec)

Onset/Peak/Duration for Heparin

SubQ: Onset 20–60 min, Peak 2 hr, Duration 8–12 hr | IV: Onset immediate, Peak 5–10 min, Duration 2–6 hr

Implementation considerations for Heparin

Give SubQ or IV bolus/drip; Do not expel air bubble; Rotate injection sites; Use 2-nurse verification

Antidote for Heparin

Protamine sulfate

Patient education for Heparin

Report bleeding, bruising, or black stools; Avoid NSAIDs and aspirin; Use soft toothbrush and electric razor

💉 Insulin – Aspart (NovoLog)

Rapid-acting insulin

Appearance of Aspart

Clear

Onset/Peak/Duration for Aspart

10–20 min / 1–3 hr / 3–5 hr

Timing with meals for Aspart

Give right before meals

Side effects of insulin

Severe hypoglycemia, allergic reaction (rare)

Therapeutic effects of insulin

Lowers blood glucose by promoting cellular uptake of glucose; Inhibits hepatic glucose production

💉 Insulin – Regular (Humulin R / Novolin R)

Short-acting insulin

Appearance of Regular

Clear

Onset/Peak/Duration for Regular

30–60 min / 2–4 hr / 5–8 hr

Timing with meals for Regular

Give 30 min before meals

Route for Regular

SubQ or IV (only insulin that can be given IV)

💉 Insulin – NPH (Humulin N / Novolin N)

Intermediate-acting insulin

Appearance of NPH

Cloudy (roll vial gently)

Onset/Peak/Duration for NPH

1–2 hr / 4–12 hr / 14–24 hr

Timing with meals for NPH

Morning & bedtime

💉 Insulin – Glargine (Lantus / Basaglar / Toujeo)

Long-acting insulin

Appearance of Glargine

Clear

Onset/Peak/Duration for Glargine

1–2 hr / No peak / 24 hr

Timing with meals for Glargine

Same time daily, not meal dependent

💉 Insulin – General Nursing & Education

Check BG before giving; Rotate injection sites; Use insulin syringe only; Educate on hypoglycemia signs (tetany, confusion, sweating); Teach mixing rule: Clear before Cloudy (Regular before NPH); Do NOT mix Glargine with any insulin; Monitor HbA1C for long-term control; Keep unopened insulin refrigerated, opened vial room temp 28 days

❤️ Cardiac Glycoside – Digoxin

Trade name: Lanoxin | Generic name: Digoxin | Drug class: Cardiac Glycoside

Indications for Digoxin

Treats heart failure (↑ contractility and cardiac output); Controls atrial fibrillation/flutter (↓ HR via AV node conduction)

Action of Digoxin

Increases force of myocardial contraction (positive inotrope); Decreases HR (negative chronotrope); Decreases AV node conduction (negative dromotrope)

Therapeutic effects of Digoxin

Improves cardiac output and tissue perfusion; Decreases edema and pulmonary congestion; Regular HR and rhythm

Side effects of Digoxin

Fatigue, headache, dizziness, bradycardia, nausea, vomiting, anorexia, visual disturbances (yellow halos)

Adverse reactions of Digoxin

Digoxin toxicity (>2.0 ng/mL); Severe bradycardia; AV block; Ventricular fibrillation; Confusion

Labs for Digoxin

Digoxin level 0.5–2.0 ng/mL; Potassium 3.5–5.0 mEq/L; BUN/Creatinine; Magnesium and Calcium

Toxicity/Overdose for Digoxin

Early signs: anorexia, nausea, vomiting, bradycardia, vision changes (yellow halos); Late signs: dysrhythmia, confusion, cardiac arrest; Treat underlying cause, correct hypokalemia, hold Digoxin

Nursing implications for Digoxin

Check apical pulse 1 min (hold if HR

Antidote for Digoxin toxicity

Digoxin Immune Fab (DigiFab / Digibind)

Patient education for Digoxin

Take pulse daily before dose; Never double dose; Report signs of toxicity; Maintain normal potassium; Avoid OTC drugs affecting HR; Keep follow-up appointments

💊 Opioid Analgesic – Percocet

Trade name: Percocet | Generic name: Oxycodone + Acetaminophen | Drug class: Opioid Analgesic (Combination)

Indications for Percocet

Management of moderate to severe pain not relieved by non-opioids; Used post-surgery, injury, or chronic pain conditions

Action of Percocet

Oxycodone binds to opioid receptors in CNS → CNS depression; Acetaminophen inhibits prostaglandin synthesis → analgesic & antipyretic

Therapeutic effects of Percocet

Relief of moderate to severe pain; Improved comfort & mobility; Reduced fever (from acetaminophen)

Side effects of Percocet

Drowsiness, dizziness, sedation, nausea, vomiting, constipation, lightheadedness, dry mouth, mild rash, euphoria

Adverse reactions of Percocet

Respiratory depression (↓ RR); Hypotension, bradycardia; Severe constipation; Hepatotoxicity (acetaminophen overdose); CNS depression or seizures (rare)

Labs for Percocet

Liver function (AST, ALT, bilirubin); Renal function (BUN, creatinine); Serum acetaminophen level (>150 mcg/mL after 4 hr = toxic)

Toxicity/Overdose for Percocet

Early: nausea, vomiting, diaphoresis, abdominal pain; Late: liver failure, jaundice, coagulopathy, respiratory depression; Treat supportively (airway, oxygen, cardiac monitor)

Antidote for Percocet overdose

Naloxone (Narcan) for opioid toxicity; Acetylcysteine (Mucomyst) for acetaminophen toxicity

Nursing implications for Percocet

Assess pain & RR before/after admin; Hold if RR

Implementation considerations for Percocet

Administer with food or milk; Avoid crushing or chewing ER forms; Taper gradually to prevent withdrawal; Keep naloxone available; Monitor pain & sedation frequently

Patient education for Percocet

Take exactly as prescribed; Do not exceed daily limit; Avoid alcohol & sedatives; Change position slowly; Increase fluids & fiber; Report trouble breathing, severe drowsiness, or dark urine

💉 Vaccine – Influenza

Trade name: Fluzone, Fluarix, Flulaval, Afluria, Flucelvax | Generic name: Influenza Vaccine | Drug class: Vaccine / Immunizing Agent

Indications for Influenza Vaccine

Prevents seasonal influenza A & B; Given annually; Encouraged for ≥6 months old, immunocompromised, healthcare workers

Action of Influenza Vaccine

Exposes immune system to inactivated/weakened viral proteins → body makes antibodies for future protection

Therapeutic effects of Influenza Vaccine

Produces immunity; Reduces infection risk, severity, and complications (like pneumonia or hospitalization)

Side effects of Influenza Vaccine

Mild soreness/redness; Low-grade fever, headache, fatigue; Muscle aches/malaise (short-term)

Adverse reactions of Influenza Vaccine

Severe allergic reaction (anaphylaxis); Guillain-Barré syndrome (very rare); Peripheral neuropathy (extremely rare)

Contraindications for Influenza Vaccine

Severe allergy to flu shot/components; Active fever or moderate illness (delay vaccination)

Antidote/Emergency treatment for Influenza Vaccine

No antidote; If anaphylaxis → IM epinephrine, airway support, oxygen, antihistamines, steroids

Nursing responsibilities for Influenza Vaccine

Verify consent/allergy history; Check expiration & proper storage (2–8°C fridge); Use correct route/site; Observe for allergic reaction; Educate on mild side effects

Patient education for Influenza Vaccine

Get vaccine yearly; You cannot get flu from inactivated vaccine; Expect soreness or tiredness 1–2 days; Report breathing trouble or hives; Stay hydrated & rest