DRUG STUDY

Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities

Precautions Adverse Effects
Generic Name: Inhibits the Hypertension Hypersensitive to drug. Side Effects  Drug can cause fluid retention. Monitor
Methyldopa central patient with hypertension, edema or heart
vasomotor  CNS: failure.
Therapeutic centers, headache, dizziness,  Assess patient for cardiovascular risk
Classification: decreasing weakness factors before therapy.
Antihypertensive sympathetic  CV:
outflow to the  Drug may be hepatotoxic; watch for signs
orthostatic
Pharmacologic heart, kidneys and symptoms of liver toxicity.
hypotension
Classification: and peripheral  GI:  Before starting drug therapy, rehydrate
Centrally acting vasculature, nausea, vomiting, dehydrated patient.
adrenergic diarrhea, constipation,  Monitor patient’s renal function; renal
diarrhea insufficiency is possible in patients with
Date, Time and  Metabolic: pre-existing renal disease. Long term
Dosage/Order: Dark urine administration may cause renal papillary
January 20-  Musculoskeletal: necrosis and other renal injury.
9:30am 250 mg 2  arthralgia
tabs now then  Skin: Rash
TID
Adverse Effects

 CV:
bradycardia, heart
failure, myocarditis
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Replaces Seizures in Pre-  Myocardial damage, Side Effects:  Keep I.V. calcium available to
Magnesium Sulfate magnesium eclampsia or heart block or coma. reverse magnesium intoxication.
and maintains Eclampsia  Use cautiously in  CNS:  Test knee- jerk and patellar reflexes
Therapeutic magnesium patients with toxicity, weak or before each additional dose. If
Classification: level; as an absent tendon
impaired renal absent notify the prescriber and
Electrolyte anticonvulsant, reflexes
function give no more magnesium until
replacement reduces muscle  CV:
contractions by reflexes return.
weak pulse,
Pharmacologic interfering with hypotension  Check magnesium level after
Classification: release of  GI: diarrhea repeated doses. Monitor levels
Minerals acetylcholine at  Metabolic: hourly in patients with severe
myoneural Hypocalcemia hypomagnesemia.
Date, Time and junction.  Skin: diaphoresis  Monitor input and output.
Dosage/Order:  Monitor renal function.
January 20- 9:30am Adverse Effects:
4g slow IV then 5g IM
in each buttock  CV:
arrhythmias,
circulatory collapse
 Respiratory:
respiratory paralysis
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Prevents Accelerates Side Effects  Monitor patient’s weight, blood pressure
Dexamethasone alveolar maturation of  CNS: and electrolyte levels.
collapse and  Hypersensitive to
fetal lungs headache, paresthesia  Monitor patients for cushingoid effects
Therapeutic transudation of drug.  CV: edema including moon face, buffalo hump,
Classification: fluid at low lung
Caution:  GI: central obesity and increased
Corticosteroids volume by GI irritation, peptic susceptibility to infection.
diminishing the  Recent MI ulceration, nausea,
Pharmacologic surface tension  For better results and less toxicity, give
 GI ulcer, Renal vomiting
once daily dose every morning
Classification: at alveolar air- Disease and HPN  Metabolic:
Glucocorticoids liquid hyperglycemia  Always adjust to lowest effective dose.
interfaces.  Musculoskeletal:  Gradually reduce dosage after long term
Date, Time and Muscle weakness therapy.
Dosage/Order:
January 20- Adverse Effects
9:30 am 12mg  CNS: seizures
IM every 12  CV:
hours x 2 doses heart failure,
arrhythmias
 GI: pancreatitis
 Metabolic:
hypocalcemia,
hypokalemia
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Inhibits cell wall Perioperative  Hypersensitive to Side Effects:  Monitor patient for signs and symptoms of
Cefuroxime synthesis, prophylaxis drug or other superinfection and diarrhea.
Sodium promoting cephalosporin.  CV:  Tell patient to take drugs as prescribed,
osmotic phlebitis, even after getting better.
Therapeutic instability, Caution: thrombophlebitis  Instruct patient to notify prescriber about
Classification: usually  GI:
Antibiotics bactericidal.  Hypersensitive to rash, loose stools, diarrhea, or evidence of
diarrhea, nausea,
penicillin because of superinfection.
anorexia, vomiting
Pharmacologic possibility of cross-  Hematologic:  Advise patient receiving drug I.V to report
Classification: sensitivity with other hemolytic anemia, discomfort at I.V insertion site.
Second- beta- lactam antibiotics. eosinophilia
generation  History of colitis or  Skin:
cephalosporin renal insufficiency. maculopapular and
erythematous
Date, Time and rashes, pain
Dosage/Order:
January 21- Adverse Effects:
8:00am 1.5g IV
before OR ANST  Hematologic:
January 21- thrombocytopenia,
11:00am 1.5g IV transient neutropenia
every 8 hours  Other:
anaphylaxis
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Causes potent To reduce  Contraindicated in Side Effects:  Monitor fluid I and O. Antidiuretic effect mat
Oxytocin and selective postpartum patients hypersensitive  CV: lead to fluid overload, seizures and coma
stimulation of bleeding to drug. hypertension from water intoxication.
Therapeutic uterine and  GI:  Monitor and record uterine contractions,
Classification: mammary nausea, vomiting, heart rate, BP, intrauterine pressure, and
Oxytocic gland smooth  GU: character of blood loss.
muscle impaired uterine
Pharmacologic  Instruct patient to promptly report adverse
blood flow, increased
Classification: reactions.
uterine motility
Exogenous  Hematologic:
Hormones hypersensitivity
reactions
Date, Time and
Dosage/Order: Adverse Effects:
January 21-
11:00am IVF  CNS:
D5LRS 1L + 20u seizures, coma
oxytocinx8hours  CV: arrhythmias
TF: D5LRS 1L +
10u oxytocinx 8
hours
D5LRS 1L x
8hours
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Thought to bind Moderate to  Hypersensitive to drug Side Effects:  Reassess patient’s level of pain at least 30
Tramadol to opioid severe pain or opioids, in patients minutes after administration.
Hydrochloride receptors and with severe renal  CNS:  Monitor CV and respiratory status.
inhibit reuptake impairment and in dizziness, headache, Withhold dose and notify prescriber if
Therapeutic of those with acute somnolence respirations are shallow or rate is below 12
Classification: norepinephrine
alcohol intoxication.  CV: vasodilation breaths per minute.
Analgesics and serotonin.
  GI:
Significant respiratory  Monitor bladder and bowel function.
nausea, vomiting,
Pharmacologic depression or acute or Anticipate need for stimulant laxative.
anorexia, diarrhea,
Classification: severe bronchial dry mouth  Tell patient to take drugs as prescribed and
Synthetic asthma.  GU: not to increase dose or dosage interval
centrally acting urinary frequency, unless ordered by prescriber.
analgesics urinary retention  Caution ambulatory patient to be careful
 Skin: when rising and walking.
Date, Time and diaphoresis, pruritus,
Dosage/Order: rash
January 21-
11:00am 50mg IV Adverse Effects:
every 8 hours x 3  CNS: seizures
doses  Respiratory:
respiratory
depression
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Increases Dietary  Use of sodium Side Effects  Assess patient’s condition
Ascorbic Acid protection supplement ascorbate in patients  CNS:  Inform patient about possible effects of
mechanism of on sodium restriction headache, dizziness drug
Therapeutic the immune  Use of calcium  GI:  Instruct patient to be cautious of the
Classification: system nausea, vomiting,
ascorbate on patients contraindications of drug
Vitamins heartburn, diarrhea
receiving digitalis
 Urogenital:
Pharmacologic urethritis, dysuria,
Classification: crystaliuria
Vitamins

Date, Time and

Dosage/Order:
January 22-24 –
8:00am 80mg 1
tab OD
Take home
medication- 80mg
1 tab OD
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Thought to To relieve pain  Contraindicated in Side Effects:  Watch for signs and symptoms of overt
Celecoxib inhibit patients hypersensitive  CNS: and occult bleeding.
prostaglandin to drug, headache, dizziness,  Drug can cause fluid retention. Monitor
Therapeutic synthesis, sulphonamides, aspirin insomnia patient with hypertension, edema or
Classification: impending or other NSAIDs.  CV: heart failure.
NSAID’s cyclooxygenas hypertension,
 Contraindicated in  Assess patient for cardiovascular risk
e-2, to produce peripheral edema
patients who factors before therapy.
Pharmacologic anti-  EENT:
Classification: inflammatory, experienced asthma,
pharyngitis, rhinitis,  Drug may be hepatotoxic; watch for
Cyclooxygenase- analgesic and urticarial, or allergic- sinusitis signs and symptoms of liver toxicity.
2 Inhibitors anti- pyretic type reaction after  GI:  Before starting drug therapy, rehydrate
effects. taking aspirin or other abdominal pain, dehydrated patient.
Date, Time and NSAIDs and in those diarrhea, dyspepsia,  Monitor patient’s renal function; renal
Dosage/Order: who have flatulence, GI reflux, insufficiency is possible in patients with
January 20- 9:30 demonstrated allergic- nausea pre-existing renal disease. Long term
am 200mg 1 tab type reaction to  Metabolic: administration may cause renal papillary
BID sulphonamides. hypochloremia necrosis and other renal injury.
January 22- 200  Musculoskeletal:
 Use cautiously in
mg 1 tab BID back pain
patients with history of
ulcers or GI bleeding,  Respiratory:
advanced renal dyspnea, upper
disease, dehydration, respiratory tract
infection
anemia, symptomatic
 Skin: rash
liver disease,
Adverse Effects
hypertension, edema,
 Skin:
heart failure or asthma.
erythema multiform,
exfoliative dermatitis,
Toxic epidermal
necrolysis
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Forms a Anti-  Not advisable to use Side Effects:  Monitor patient’s vital signs.
Tranexamic Acid reversible hemorrhagic prolonged periods in  CNS:  Dosage modification required in patients
complex that patients predisposed to headache may with renal impairment.
Therapeutic displaces thrombosis. appear  Watch out for any signs of bleeding.
Classification: plasminogen  CV:
Anti-fibrinolytics from fibrin hypotension may
resulting in occur when IV
Pharmacologic inhibition of injection too rapid
Classification: fibrinolysis, it  GI:
Anti-hemophilic also inhibits nausea, vomiting
agents proteolytic
activity of
Date, Time and plasmin
Dosage/Order:
January 21-
11:00am 2g IV
every 8 hours x 3
doses
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Replaces iron Treatment for  Hemolytic Anemias Side Effects  Monitor Hgb values during therapy.
Ferrous Sulfate stores found in Iron Deficiency/  Iron metabolism  GI:  Monitor for bowel movements.
hemoglobin in Supplement disorders stomach pain,  Give on an empty stomach if possible
Therapeutic red blood cells constipation, change because iron preparations are best
Classification: in the body. of stool color,
absorbed.
Iron supplement Additionally, it stomach cramps
allows the  Consuming citrus fruits can increase
Pharmacologic transportation absorption.
Classification: of oxygen via  Be aware that it may cause black stools.
Iron supplement hemoglobin.

Date, Time and

Dosage/Order:
January 22-24 –
8:00am 325mg 1
tab OD
Take home
medication- 1 tab
OD
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Co-amoxiclav Infection  Contraindicated to Side Effects  Assess bowel pattern before and during
Co-Amoxiclav is an prophylaxis patients hypersensitive  GI: treatment.
antibacterial to drug and its diarrhea, nausea and  Observe for anaphylaxis.
Therapeutic combination components. vomiting  Report hematuria or oliguria as high doses
Classification: consisting of  Hematology: can be nephrotoxic.
Antibiotics amoxicillin and anemia, neutropenia
 Ensure that the patient has adequate fluid
beta lactamase  Skin:
Pharmacologic inhibitor, intake during any diarrhea attack.
itching, rashes
Classification: clavulanic acid.  Respiratory:  Dose with caution and monitor hepatic
H2- receptor Amoxicillin wheezing function at regular intervals.
antagonist hinders the cell  Hepatic: jaundice
wall synthesis
during bacterial
Date, Time and multiplication.
Dosage/Order:
January 22-
8:00am 625mg 1
tab BID x 7 days
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Competitively To prevent ulcer  Contraindicated to Side Effects:  Assess patient for abdominal pain. Note
Ranitidine inhibits action development patients hypersensitive  CNS: headache, presence of blood in the stool, emesis or
hydrochloride of histamine at to drug. malaise gastric aspirate.
H2- receptor  Use cautiously in  Hepatic: Jaundice  Urge patient to avoid cigarette smoking
Therapeutic sites of parietal
patients with hepatic  Other: anaphylaxis because this may increase gastric acid
Classification: cells, decrease
dysfunction. Adjust secretion and worsen the disease.
Antiulcer gastric acid
secretion. dosage in patients with
Pharmacologic impaired renal function.
Classification:
H2- receptor
antagonist

Date, Time and

Dosage/Order:
January 21-
11:00am 50mg IV
every 8 hours x
while on NPO
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Inhibits calcium Hypertension  Contraindicated in Side Effects:  Monitor BP frequently during initiation of
Amlodipine ion influx across patients therapy. Because drug- induced
Besylate cardiac and hypersensitive to  CNS: vasodilation has a gradual onset, acute
smooth- muscle drug. Headache, somnolence, hypotension is rare.
Therapeutic cells, dilates fatigue, dizziness
 Use cautiously in  Notify prescriber if signs of heart failure
Classification: coronary arteries
patients receiving  CV: occur, such as swelling of hands and
Anti- and arterioles, Edema, flushing,
hypertensives and decreases other peripheral feet or shortness of breath.
palpitations
vasodilators.
BP and  GI:
Pharmacologic myocardial  Use cautiously in Nausea, Abdominal pain
Classification: oxygen demand. patient with
Calcium Channel severe hepatic
Blockers disease.

Date, Time and

Dosage/Order:
January 20-
8:00am 10 mg 1
tab OD
Take home
medication
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: May inhibit Pain  Contraindicated in Side Effects:  Teach patient signs and symptoms of GI
Diclofenac prostaglandin patients bleeding including blood in vomit, urine or
Sodium synthesis, to hypersensitive to  CNS: stool. Tell him or her to notify prescriber
produce anti- drug. headache, dizziness, immediately if this occurs.
Therapeutic inflammatory drowsiness
 Use cautiously in  Monitor patient closely because drug impairs
Classification: analgesic and
patients with  CV: the synthesis of renal prostaglandins which
NSAIDs antipyretic edema, fluid retention
history of peptic can decrease renal blood flow and lead to
effects.  GI:
Pharmacologic ulcer disease, reversible renal impairment.
constipation diarrhea
Classification: hepatic
 Hepatic: jaundice  LFT values may increase during therapy.
NSAIDs dysfunction and Monitor transaminase especially ALT levels
 Skin:
impaired renal allergic purpura periodically in patients undergoing long term
function. therapy.
Date, Time and Adverse Effects
Dosage/Order:  GI: bleeding
January 21-  CV: heart failure
11:00am 75mg IV
 Other: anaphylaxis
every 6 hours x 3
doses ANST
 Drug Action Indication Contraindication/ Side Effects/Adverse Nursing Responsibilities
Precautions Effects
Generic Name: May potentiate Preoperative  Contraindicated in Side Effects:  Monitor patient’s BP, pulse rate, heart
Midozalam the effects of sedation to patients hypersensitive  CNS: rhythm, respirations, airway integrity and
Hydrochloride GABA, depress induce to drug and in those headache, drowsiness, pulse oximetry during procedure.
the CNS and sleepiness or with patients with amnesia, over sedation,  Warn patient to avoid hazardous activities
Therapeutic suppress the drowsiness and shock, coma or acute involuntary movements that require alertness or good coordination
Classification: spread of relieve alcohol intoxication.  CV: until effects of drug are known.
Anxiolytics seizure activity. variations in BP and
apprehension  Use cautiously in
heart rate
patients with
Pharmacologic  GI:
Classification: uncompensated acute nausea, vomiting,
Benzodiazepines illness and in elderly or  GU: hematuria
controlled debilitated patients.  Respiratory:
substance decreased respiratory
schedule: IV rate, oxygen
desaturation
Date, Time and
Dosage/Order: Adverse Effects:
January 21, 2019 Respiratory: Apnea
10:15am
2.5mg IV
Given slowly
 Drug Action Indication Contraindication/ Side Effects/Adverse Nursing Responsibilities
Precautions Effects
Generic Name: Binds with  Adjunct to  Contraindicated in Side Effects:  Monitor patient’s sodium level because
Nalbuphine opioid balance patients hypersensitive  CNS: each gram of drug contains 2.9 meq of
Hydrochloride receptors in the anesthesia to drug. headache, dizziness, sodium.
CNS, altering  Moderate to  Use cautiously in sedation  Monitor WBC counts twice weekly in
Therapeutic perception of
severe pain patients with history of  GI: patents receiving drug for longer than 2
Classification: and emotional nausea, vomiting,
drug abuse and in weeks. Neutropenia commonly occurs in
Opioid analgesics response to
those with emotional  GU: hematuria the third week.
pain.
Pharmacologic instability, impaired  Monitor for signs and symptoms of
Adverse Effects:
ventilation, hepatic or interstitial nephritis.0
Classification:  CV: bradycardia
Opioid agonist- renal insufficiency.
 Respiratory:
antagonist- opioid  Drug may cause mood respiratory
partial agonists disorder and depression
osteoporosis.
Date, Time and
Dosage/Order:
January 21- 20mg
IV
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Causes Mild to  Contraindicated in Adverse Effects :  Assess patient’s fever or pain, type of pain,
Paracetamol analgesia by moderate Pain patients location, intensity, duration, temperature
inhibiting CNS hypersensitivity to  Hematologic: and diaphoresis.
Therapeutic prostaglandin acetaminophen or leukopenia,  Assess allergic reactions, if these occur,
Classification: synthesis. The phenacetin. neutropenia drug may have to be continued.
Analgesic mechanism of  Hepatic: jaundice
 Teach patient to recognize signs of chronic
morphine  Skin: rash, urticaria
Pharmacologic believed to overdose, bleeding, bruising, malaise,
Classification: involve fever, sore throat.
Analgesic decreased  Tell patient to notify prescriber to pain/
permeability of fever lasting for more or three days.
Date, Time and the cell
Dosage/Order: membrane to
January 20- sodium, which
500mg every 6 results in
hours RTC diminished
transmission of
pain impulses.
 Drug Action Indication Contraindication/ Side Effects/ Nursing Responsibilities
Precautions Adverse Effects
Generic Name: Local anesthetic Local anesthetic  Hypersensitivity; Side Effects:  Patient should be informed in advance that
Bupivacaine inhibit initiation for surgical cross sensitivity  Decrease blood they may experience temporary loss of
hydrochloride and conduction obstetric or with other amide pressure, sensation and motor activity, usually in the
of sensory nerve diagnostic local anesthetics bradycardia, lower half of the body.
Therapeutic impulses by dizziness, anxiety,
procedure may occur.  Monitor vital signs and cardiovascular
Classification: altering the influx restlessness
Bupivacaine status.
Anesthetic of sodium and Adverse Effects :
contains bisulfites  Assess for systemic toxicity.
efflux of  Seizure,
Pharmacologic potassium in and should be
cardiovascular
Classification: neurons, slowing avoided in collapse, respiratory
Epidural local or stopping patients with arrest
anesthetics transmission. known allergy.
Epidural
Date, Time and administration
Dosage/Order: allows action to
January 21- 50mg take place at the
(as 0.25% level of the
solution) spinal nerve
roots
immediately
adjacent to the
site of
administration.