drug study

1. In Partial Fulfillment
Of The Requirements for the Subject
Pharmacology
AY 2020 – 2021
Submitted by:
Vincent M. Material
BSN 2
Submitted to:
Ms. Maria Teresa Ira Bandelaria, MAN, RN, MHoA
NCM 107 Clinical Instructor
January 22, 2021
DRUG STUDY
Lipa City Colleges
College of Nursing

3. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic Name:
oxytocin
Brand Name:
Pitocin
CLASSIFICA-
TION:
Pharmacologic
class: Posterior
pituitary hormone
Therapeutic
class: Uterine-
active agent
Pregnancy risk
category NR
Unknown.
Thought to directly
stimulate
smooth muscle
contractions in
uterus and cervix.
➣To induce or
stimulate labor
➣To control
postpartum
bleeding
➣Incomplete
abortion
● Hypersensitivity to
drug
● Cephalopelvic
disproportion
● Fetal distress when
delivery is not
imminent
● Prolonged use in
uterine inertia or
severe toxemia
● Hypertonic or
hyperactive uterine
pattern
● Unfavorable fetal
position or presentation
that’s undeliverable
without
conversion
● Labor induction or
augmentation
when vaginal delivery is
contraindicated
(as in invasive cervical
cancer,
active genital herpes, or
total placenta
previa)
 CNS: seizures,
coma, neonatal
brain damage,
subarachnoid
hemorrhage
 CV: premature
ventricular
contractions,
arrhythmias,
neonatal
bradycardia
 GI: nausea,
vomiting
 GU: postpartal
hemorrhage;
pelvic
hematoma;
uterine
hypertonicity,
spasm, or tetanic
contraction;
abruptio
placentae;
uterine rupture
(with
excessive doses)
 Hematologic:
afibrinogenemia
 Hepatic: neonatal
Availability
Injection: 10 units/ml
ampule or vial
Dosages
➣To induce or stimulate
labor
Adults: Initially, 1-ml
ampule
(10 units) in compatible
I.V. solution
infused at 1 to 2
milliunits/minute
(0.001 to 0.002
units/minute).
Increase rate in
increments of 1 to
2 milliunits/minute q 15
to 30 minutes
until acceptable
contraction pattern is
established.
➣To control postpartum
bleeding
Adults: 10 to 40 units in
compatible
I.V. solution infused at
rate adequate to
control bleeding; or 10
Patient monitoring
 Continuously monitor
contractions, fetal and maternal
heart rate, and maternal blood
pressure and ECG. Discontinue
infusion if uterine hyperactivity
occurs.
 Monitor patient extremely
closely during first and second
stages of labor because of risk of
cervical laceration, uterine
rupture, and maternal and fetal
death.
● When giving drug to control
postpartal bleeding,monitor and
record vaginal bleeding.
● Assess fluid intake and output.
Watch for signs and symptoms of
water intoxication.
Patient teaching
● Inform patient about risks and
benefits of oxytocin-induced
labor.
 Teach patient to recognize and
immediately report adverse drug
effects.

4. jaundice
 Other:
hypersensitivity
reactions
including
anaphylaxis, low
5-minute
Apgar score
(neonate)
units I.M. after
placenta delivery
➣Incomplete abortion
Adults: 10 units in
compatible I.V.
solution infused at 10 to
20 milliunits/
minute (0.01 to 0.02
units/minute)

5. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic Name:
codeine sulfate
Brand Name:
(only available in
generic form)
CLASSIFICA-
TION:
Pharmacologic
class: Opioid
agonist
Therapeutic
class: Opioid
analgesic,
antitussive
Controlled
substance
schedule II
Pregnancy risk
Binds to opioid
receptors in CNS,
altering perception
of painful stimuli.
Causes
generalized CNS
depression,
decreases cough
reflex, and
reduces GI
motility.
➣Mild to
moderately severe
pain
● Hypersensitivity to
drug, its components,
or other opioids
● Respiratory
depression, severe
bronchial asthma,
hypercarbia
● Paralytic ileus or
suspected paralytic
ileus
 CNS: confusion,
sedation, malaise,
agitation,
euphoria, floating
feeling,
headache,
hallucinations,
unusual dreams,
apathy, mood
changes
 CV: hypotension,
bradycardia,
peripheral
vasodilation,
reduced peripheral
resistance
 EENT:blurred or
double vision,
miosis,
reddened sclera
 GI: nausea,
vomiting,
constipation,
decreased gastric
motility
 GU: urinary
retention, urinary
tract spasms,
urinary urgency
Availability
Tablets: 15 mg, 30 mg,
60 mg
Dosages
➣Mild to moderately
severe pain
Adults: 15 to 60 mg
P.O. q 4 hours as
needed. Doses above
60 mg may fail to
give commensurate pain
relief, and
may be associated with
an increased
incidence of undesirable
adverse effects.
Dosage adjustment
● Renal or hepatic
impairment
● Elderly or debilitated
patients
Patient monitoring
● Monitor vital signs and CNS
status.
● Assess pain level and efficacy
of pain relief.
● Evaluate patient for adverse
reactions.
 Stay alert for overdose signs
and symptoms, such as CNS and
respiratory depression, GI
cramping, and constipation.
● Assess other drugs in patient’s
drug regimen for those that could
cause additive or adverse
interactions.
● Monitor patient for signs and
symptoms of drug dependence
or tolerance.
Patient teaching
● Teach patient to minimize
adverse GI effects by taking
doses with food or milk.
 Tell patient to notify prescriber
promptly if he experiences
shortness of breath or difficulty
breathing or if nausea,
vomiting, or constipation become
pronounced.

6. category C  Respiratory:
suppressed cough
reflex,
respiratory
depression
 Skin: flushing,
sweating
 Other:physical or
psychological drug
dependence, drug
tolerance
● Caution patient to avoid driving
and other hazardous activities
until he knows how drug affects
concentration, alertness, vision,
coordination, and physical
dexterity.
● Instruct patient to move slowly
when sitting up or standing, to
avoid dizziness or light-
headedness from sudden blood
pressure decrease.
● As appropriate, review all other
significant and life-threatening
adverse reactions and
interactions, especially
those related to the drugs, herbs,
and behaviors mentioned above.

7. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic Name:
lidocaine
hydrochloride
Brand Name:
Anesticaine
CLASSIFICA-
TION:
Pharmacologic
class: Amide
Therapeutic
class:
Antiarrhythmic
(class IB), local
anesthetic
Pregnancy risk
category B
Suppresses
automaticity of
ventricular
cells, decreasing
diastolic
depolarization
and increasing
ventricular
fibrillation
threshold.
Produces local
anesthesia by
reducing sodium
permeability of
sensory nerves,
which
blocks impulse
generation and
conduction.
➣Ventricular
arrhythmias
➣Caudal
anesthesia (without
epinephrine)
➣Epidural
anesthesia (without
epinephrine)
➣I.V. regional
infiltration (without
epinephrine)
➣I.V. local
infiltration (without
epinephrine)
➣Spinal anesthesia
(without
epinephrine)
➣Paracervical
anesthesia (without
epinephrine)
➣Peripheral nerve
block
➣Sympathetic
nerve block (without
epinephrine)
➣Dental
anesthesia
➣Topical
● Hypersensitivity to
drug, its components,
or other amide local
anesthetics
● Heart failure,
cardiogenic shock,
second- or third-degree
heart block,
intraventricular block in
absence of a
pacemaker
● Wolff-Parkinson-White
or Adams-
Stokes syndrome
● Severe hemorrhage,
shock, or heart
block (lidocaine with
dextrose)
● Local infection at
puncture site
(lidocaine with dextrose)
● Septicemia (lidocaine
with dextrose)
 CNS: anxiety;
confusion; difficulty
speaking;
dizziness;
hallucinations;
lethargy;
paresthesia; light-
headedness;
fatigue;
drowsiness;
headache;
persistent
sensory, motor, or
autonomic
deficit of lower
spinal segment;
septic
meningitis;
seizures
 CV: bradycardia,
hypotension, new
or worsening
arrhythmias,
cardiac arrest
 EENT:diplopia,
abnormal vision
 GI: nausea,
vomiting, dry
mouth
 GU: urinary
Availability
Injection for I.M. use: 300 mg/3
ml (automatic injection device)
Injection for direct I.V. use: 1%
and 2% in syringes and vials
Injection for I.V. infusion: 2
mg/ml, 4 mg/ml, 8 mg/ml
Injection for I.V injection
admixtures: 40 mg/ml, 100
mg/ml, 200 mg/ml
Patch: 5%
Topical cream: 0.5%, 4%
Topical gel: 0.5%, 2.5%
Topical jelly: 2%
Topical liquid, ointment: 2.5%,5%
Topical solution: 4%
Topical solution (viscous): 2%
Topical spray: 0.5%
Dosages
➣Ventricular arrhythmias
Adults: Initially, 50 to 100 mg I.V.
bolus given at rate of 25 to 50
mg/minute. If desired response
doesn’t occur after 5 minutes,
give repeat dose at 25 to 50
mg/minute; maximum dosage is
300 mg given over 1 hour.
Maintenance dosage is 1 to 4
mg/minute by continuous I.V.
Patient monitoring
 Monitor vital signs
and ECG continuously.
Watch for cardiac
depression.
 Evaluate level of
consciousness closely.
 Watch for adverse
reactions, particularly
anaphylaxis.
 Stay alert for
seizures.
 Monitor neurologic
status for lower spinal
segment deficits.
● Give supportive
oxygen therapy, as
indicated and
prescribed.
● Monitor electrolyte,
blood urea nitrogen,
and creatinine levels.
● Assess topical site for
adverse reactions.
Patient teaching
● Discuss reason for
drug therapy with
patient and family,

8. anesthesia for skin
or
mucous
membranes
➣Prevention or
treatment of pain
during procedures
involving male or
female urethra
➣Oral cavity
disorders;
pharyngeal
disorders
➣Local anesthesia
(oral or nasal
mucosa)
retention
 Metabolic:
methemoglobine
mia
 Respiratory:
suppressed cough
reflex,
respiratory
depression,
respiratory
arrest
 Skin: rash;
urticaria; pruritus;
erythema;
contact dermatitis;
cutaneous
lesions; tissue
irritation,
sloughing, and
necrosis
 Other:fever;
edema; infection,
burning,
stinging,
tenderness, and
swelling
at injection site;
anaphylaxis
infusion for no more than 24
hours.
Children:Initially, 1 mg/kg I.V.
bolus, then repeated based on
patient response; don’t exceed
5 mg/kg. Maintenance dosage is
30 mcg/kg/minute by continuous
I.V. infusion.
➣Caudal anesthesia (without
epinephrine)
Adults: For obstetric analgesia,
200 to 300 mg caudally as 1%
solution. For surgical anesthesia,
225 to 300 mg as 1.5% solution.
For continuous caudal
anesthesia, don’t repeat
maximum dosage at intervals of
less than 90 minutes.
➣Epidural anesthesia (without
epinephrine)
Adults: For lumbar analgesia,
250 to 300 mg epidurally as 1%
solution, 225 to 300 mg as 1.5%
solution, or 200 to 300 mg as 2%
solution. For thoracic anesthesia,
200 to 300 mg as 1% solution.
For continuous epidural
anesthesia, don’t repeat
maximum dosage at intervals of
less than 90 minutes.
➣I.V. regional infiltration (without
epinephrine)
when appropriate.
● Explain that patient
will be monitored
continuously during
therapy.
 Instruct patient to
promptly report
discomfort at I.V. site as
well as adverse effects,
especially
cardiovascular,
respiratory, or
neurologic problems or
allergic reactions.
● As appropriate,
review all other
significant and life-
threatening adverse
reactions and
interactions, especially
those related to the
drugs and tests
mentioned above.

9. Adults: 50 to 300 mg I.V. as
0.5% solution. For I.V. regional
anesthesia, maximum dosage is
4 mg/kg.
➣I.V. local infiltration (without
epinephrine)
Children:Up to 4.5 mg/kg I.V. as
0.25% to 1% solution
➣Spinal anesthesia (without
epinephrine)
Adults: For obstetric low-spinal
or saddle-block anesthesia
(normal vaginal delivery), 50 mg
of 5% Xylocaine-MPF with
glucose 7.5%, or 9 to 15 mg
of 1.5% Xylocaine-MPF with
dextrose 7.5%. For cesarean
section, 75 mg of 5% Xylocaine-
MPF with glucose 7.5%. For
surgical anesthesia, 75 to 100 mg
of 5% Xylocaine-MPF with
glucose 7.5%.
➣Paracervical anesthesia
(without epinephrine)
Adults: For obstetric analgesia,
100 mg paracervically as 1%
solution (each side). For
paracervical block, maximum
dosage is 200 mg over each
90-minute period (half
administered on each side)
.
➣Peripheral nerve block

10. Adults: For brachial nerve block,
225 to 300 mg as 1.5% solution.
For dental nerve block, 20 to 100
mg as 2% solution with
epinephrine 1:100,000 or
1:50,000. For intercostal nerve
block, 30 mg as 1% solution. For
pudendal nerve block, 100 mg as
1% solution. For paravertebral
nerve block, 30 mg to 50 mg as
1% solution.
➣Sympathetic nerve block
(without epinephrine)
Adults: For cervical nerve block,
50 mg as 1% solution. For lumbar
nerve block, 50 to 100 mg as 1%
solution.
➣Dental anesthesia
Adults: 1 to 5 ml of lidocaine 2%
with epinephrine 1:50,000 or
1:100,000. Maximum dosage is
less than 500 mg (7 mg/kg).
Children:20 to 30 mg as 2%
solution with epinephrine
1:100,000
➣Topical anesthesia for skin or
mucous membranes
Adults: Apply thin layer of gel,
jelly, or ointment to skin or
mucous membranes as needed
before procedure; or apply 5%
patch to most painful areas
and intact skin (up to three

11. patches at a time for up to 12
hours within a 24-hour period).
For new denture fittings, use 5-g
ointment (250 mg) per single
dose or 20 g/day. For
oropharyngeal use, apply to
desired area or to instrument
before insertion.
Children:Apply thin layer of
ointment to skin or mucous
membranes p.r.n. before
procedure.Maximum dosage
is 2.5 g ointment per 6 hours or
4.5 mg/kg.
➣Prevention or treatment of pain
during procedures involving male
or female urethra
Adults: For female urethral
examination, apply 3 to 5 ml of
2% jelly topically several minutes
before exam. For male sounding
or cystoscopy, apply 5 to 10 ml of
2% jelly topically before
procedure, or apply 30 ml to fill or
dilate urethra in divided doses
using penile clamp for several
minutes between doses. For male
catheterization, apply 5 to 10 ml
of 2% jelly to anterior urethra
before procedure. Don’t use
more than 600 mg/12 hours.
➣Oral cavity disorders;
pharyngeal disorders
Adults: For oral cavity disorders,

12. 300 mg (15 ml) of viscous oral
topical solution swished and then
expelled, or applied with cotton
swab q 3 hours p.r.n. For
pharyngeal disorders, use
same dosage, but solution may
be swallowed.
Children older than age 3:
Dosage individualized based on
age, weight, and physical
condition.Maximum
dosage is 4.5 mg/kg q 3 hours.
Children up to age 3: 1.25 ml
applied with swab q 3 hours
➣Local anesthesia (oral or nasal
mucosa)
Adults: 0.6 to 3 mg/kg or 40 to
200 mg of 4% topical solution, not
to exceed 4.5 mg/kg or 300 mg
(7.5 ml)
Children:Dosage individualized