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DRUG MECHANISM OF
ACTION
INDICATION CONTRAINDICATIONS ADVERSE EFFECTS
AND SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic Name
Potassium
Chloride
Brand Name
Kalium Durule
Classification
Electrolyte
Sub
Classification
Dosage
1 tab
Route
oral
Frequency
Every 8 hours
Form
Tablet
Color
White
Principal
intracellular cation
of most body
tissues participates
in a number of
physiologic
processes –
maintaining
intracellular
tonicity;
transmission of
nerve impulses,
contraction of
cardiac, skeletal,
and smooth muscle;
maintenance of
normal renal functi
on; also plays a role
in carbohydrate
metabolism and
various enzymatic
reactions.
 Prevention
and
correction of
potassium
deficiency;
when
associated
with
alkalosis,
use potassium
chloride;
when
associated
acidosis,
use potassium
acetate bicarb
onate, citrate,
or gluconate.
 Contraindicated
with allergy to
tartrazine, aspirin (t
artrazine is found in
some preparations
marketed as Kaon-
Cl, Klor-Con);
therapy with
potassium-sparing
diuretics or
aldosterone-
inhibiting agents;
severerenal impair
ment with oliguria,
anuria, azotemia;
untreated
Addison’s disease;
hyperkalemia;
adynamiaepisodica
hereditaria; acute
dehydration; heat
cramps; GI
disorders that delay
passage in the GI
tract.
 Use cautiously
with cardiac
disorders,
especially if treated
with cardiac
glycosides,
pregnancy and
lactation.
Adverse Effects:
 Dermatologic:
Rash
 GI: Nausea,
vomiting,
diarrhea, abdomina
l discomfort, GI
obstruction, GI
bleeding,
GI ulceration or
perforation.
 Hematologic:
Hyperkalemia-
increased serum
potassium, ECG
changes (peaking
of T waves, loss of
P waves,
depression of ST
segment,
prolongation of
OTC interval).
 Local: Tissue
sloughing, local
necrosis,
local phlebitis, and
venospasm with
injection.
Side Effects:
 Confusion,
anxiety, feeling
like you might
pass out
 Uneven heartbeat
 Extreme thirst,
 Consider the 10
Golden Rights of
administering
medication
 Arrange for serial
serum potassium
levels before and
during therapy
 Administer oral
drugs after meals
or with food and a
full glass of water
to decrease GI
upset.
 Caution patient
not to chew or
crush tablet; have
patient swallow
tablet whole.
 Caution patient
that expanded wax
matrix capsules
will be found in
stool.
 Caution patient
not to use salt
substitutes.
 Ask the patient to
have periodic
blood tests and
medical
evaluation.
 Tell the patient to
report tingling of
hands or feet,
unusual tiredness
or weakness,
feeling of
increased urination
 Leg discomfort
 Muscle weakness
or limp feeling
 Numbness or
tingly feeling in
your hands or feet,
or around your
mouth
 Severe stomach
pain, ongoing
diarrhea or
vomiting
 Black, bloody, or
tarry stools; or
 Coughing up blood
or vomit that looks
like coffee grounds
heaviness in the
legs, severe
nausea, vomiting,
abdominal pain,
black or tarry
stool.
DRUG MECHANISM OF
ACTION
INDICATION CONTRAINDICATIONS ADVERSE
EFFECTS AND SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic
Name
Metronidazole
Brand Name
Flagyl
Classification
Amebicide,
Antibacterial,
Antibiotic,
Antiprotozoal
Sub
Classification
Dosage
500mg/tablet
Route
Oral
Frequency
Thrice a day
(TID)
Form
Tablet
Color
White
 Bactericidal:
inhibits DNA
synthesis in
specific
(obligate)
anaerobes,
causing cell
death;
antiprotozoal-
trichomonacidal
, amebicidal:
Biochemical
mechanism of
action is not
known.
 Acute infection
with susceptible
anaerobic bacteria
 Acute intestinal
amebiasis
 Amebic liver
abscess
 Trichomoniasis
(acute and partners
of patients
undergoing
colorectal surgery
 Unlabeled uses:
Prophylaxis for
patients
undergoing
gynecologic,
abdominal surgery,
hepatic
encephalopathy,
Crohn’s disease;
antibiotic-
associated pseudo
membranous
colitis, treatment
of Gardnerella
vaginalis,
giardiasis (use
recommended by
the CDC); infected
decubitus ulcers;
perioral dermatitis
 Contraindicated
with
hypersensitivity to
metronidazole;
pregnancy ( do not
use for
trichomoniasis in
first trimester)
 Use continuously
with CNS diseases,
hepatic diseases,
candidiasis
(moniliasis), blood
dyscrasias,
lactation.
Adverse Effect:
 CNS:
Headache,
dizziness,
ataxia,
vertigo,
incoordiantio
n, insomnia,
seizures,
peripheral
neurophaty,
fatigue
 GI:
Unpleasant
metallic taste,
anorexia,
nausea,
vomiting,
diarrhea, GI
upset, cramps
 GU: Dysuria,
incontinence,
darkening of
the urine
 Local:
Thrombophle
bitis (IV);
redness,
burning,
dryness, and
skin irritation
(topical)
 Others:
Severe,
disulfiram-
like
interaction
 Consider the
10 Golden
Rights of
administering
medication
 Tell the
patient to
take full
course drug
therapy; take
the drug with
food if GI
upset occur.
 Tell the
patient not to
take alcohol
(beverages or
preparations
containing
alcohol,
cough
syrups) for
24-72 hr of
drug use;
severe
reactions may
occur.
 Caution the
patient that
their urine
may be
darker in
color than
usual; this is
expected
 Tell the
patient that
they may
with alcohol,
candidiasis
(superinfectio
n)
Side Effects:
 Numbness or
tingling in
your hands or
feet;
 White patches
or sores
inside your
mouth or on
your lips;
 Pain or
burning when
you urinate;
 Diarrhea that
is watery or
bloody;
 Vision
problems,
pain behind
your eyes;
 Trouble
concentrating,
slurred
speech, mood
or behavior
changes,
tremors,
muscle
twitching,
seizure
(convulsions);
 Fever, chills,
experience
this side
effects like:
Dry mouth
with strange
metallic taste
(frequent
mouth care,
sucking
sugarless
candies may
help); nausea,
vomiting,
diarrhea (eat
frequent
small meals)
 Tell the
patient to
report severe
GI upset,
dizziness,
unusual
fatigue or
weakness,
fever, chills.
muscle pain,
confusion,
headache,
sore throat,
neck stiffness,
increased
sensitivity to
light,
drowsiness,
nausea and
vomiting; or
 Severe skin
reaction --
fever, sore
throat,
swelling in
your face or
tongue,
burning in
your eyes,
skin pain,
followed by a
red or purple
skin rash that
spreads
(especially in
the face or
upper body)
and causes
blistering and
peeling.
DRUG MECHANISM
OF ACTION
INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND
SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic Name
Metoclopramide
Brand Name
Reglan
Classification
Antiemetic,
Dopaminergic
blocker, GI
stimulant
Sub
Classification
Dosage
1 ampule
Route
Parenteral
Frequency
TID/ q6
Form
Liquid ampule
Color
Clear
 Stimulates
motility of
upper GI
tract without
stimulating
gastric,
biliary, or
pancreatic
secretions,
appears to
sensitize
tissues to
action of
acetylcholin
e, relaxes
pyloric
sphincter
which when
combined
with effects
on motility,
accelerates
gastric
emptying
and
intestinal
transit; little
effect on
gallbladder
or colon
motility;
increases
lower
esophageal
sphincter
pressure;
has sedative
properties,
 Relief
symptoms of
acute and
recurrent
diabetic
gastroparesis.
 Short term
therapy (4-
12weeks) for
adults with
symptomatic
gastro
esophageal
reflux who fail
to respond to
conventional
therapy
 Prophylaxis of
postoperative
nausea and
vomiting when
nasogastric
suction is
undesirable
 Contraindicated
with allergy to
metaclopramide, GI
hemorrhage,
mechanical
obstruction or
perforation;
pheochromocytoma
(may cause
hypertensive
crisis); epilepsy.
 Use continuously
with previously
detected breast
cancer (one third of
such tumors are
prolactin
dependent);
lactation,
pregnancy; fluid
overload; renal
impairment.
Adverse Effects:
 CNS: Restlessness,
drowsiness, fatigue,
lasitudes, insomnia,
extrapyramidalreact
ion, parkinsonism-
like reactions,
akathisia, dystonia,
myoclonus,
dizziness, anxiety
 CV: Transient
hypertension
 GI: Nausea,
diarrhea
Side Effects:
 tremors, or restless
muscle movements
in your eyes,
tongue, jaw, neck,
arms, or legs
 mask-like
appearance of the
face
 very stiff (rigid)
muscles, high
fever, sweating,
confusion, fast or
uneven heartbeats,
tremors, feeling
like you might pass
out
 depressed mood,
thoughts of suicide
or hurting yourself
 hallucinations,
 Consider the 10
Golden Rights of
administering
medication
 Asses if the
patient has
historyof
allergies
tometocloprami
de.
 ·Monitor BP
carefully during
IVadministratio
n.
 Monitor
extrapyramidal
reactions and
consultphysician
if they occur.
 Monitor patients
with diabetes,
arrange for
alteration in
insulin dose or
timing ifdiabetic
control is
comprisedby
alterations in
timing of food
absorption.
 Keep
diphenhydramin
e injection
readily available
in case
extrapyramidal
reaction occur
(50mg IM)
induces
release of
prolactin.
anxiety, agitation,
jittery feeling,
trouble staying still
 swelling, fluid
retention
 jaundice (yellowing
of your skin or
eyes)
 seizure
(convulsions)
Less serious side effects
may include:
 feeling restless,
drowsy, tired, or
dizzy
 headache, sleep
problems
(insomnia)
 nausea, vomiting,
diarrhea
 breast tenderness or
swelling
 changes in your
menstrual periods
 urinating more than
usual
 Have
phentolamine
readily available
in case of
hypertensive
crisis (most
likely to occur
with
undiagnosed
pheochromocyto
ma)
 Do not use
alcohol, sleep
remedies, or
sedatives;
serious sedation
could occur.
 Tell the patient
that they may
experience these
side effects:
drowsiness,
dizziness (do
not drive or
perform other
task that
requires
alertness);
restlessness,
anxiety,
depression,
headache,
insomnia
(reversible);
nausea, diarrhea.
 Tell the patient
to report
involuntary
movement of
the face, eyes, or
limbs, severe
depression, and
severe diarrhea.
DRUG MECHANISM
OF ACTION
INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND
SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic
Name
Furosemide
Brand Name
Lasix
Classification
Loop
Diuretics
Sub
Classification
Dosage
10mg
Route
Parenteral
Frequency
STAT
Form
Liquid ampule
Color
Clear
Inhibits
reabsorption of
sodium chloride
from the
proximal and
distal tubules
and ascending
limb of the loop
of Henle,
leading to a
sodium-rich
diuresis.
 Oral, IV:
Edema
associatedwit
h heart
failure,
cirrhosis,rena
l disease.
 IV: acute
Pulmonary
Edema
 Oral:
hypertension
 Contraindicated
with allergy to
furosemide,
sulfonamides,
allergy to tartrazine
(in oral solution);
anuria, severe renal
failure; hepatic
coma; pregnancy;
lactation.
 Use cautiously with
SLE, gout, diabetes
mellitus.
Adverse Effects:
 CNS: dizziness,
vertigo, paresthesias,
xanthopsia, weakness,
headache, drowsiness,
fatigue, blurred vision,
tinnitus, irreversible
hearing loss
 CV: orthostatic
hypotension, volume
depletion, cardiac
arrhythmias,
thrombophlebitis
 Dermatologic:
photosensitivity, rash,
pruritus, urticaria,
purpura, exfoliative,
dermatitis, erythema
multiforme
 GI: nausea, anorexia,
vomiting, oral and
gastric irritation,
constipation, diarrhea,
acute pacreatitis,
jaundice
 GU: polyuria, nocturia,
glycosuria, urinary
bladder spasm.
 Hematologic:
leukopenia, anemia,
thrombocytopenia, fluid
and electrolytes
imbalance,
hyperglycemia,
hyperuricemia
 Consider the
10 Golden
Rights of
administering
medication
 Profound
dieresis with
water and
electrolyte
depletion can
occur, careful
medical
supervision is
required.
 Administer
with food or
milk to prevent
GI upset.
 Reduce dosage
if given with
other anti
hypertensive;
readjust
dosage
gradually as
BP responds.
 Give early in
the day so that
increase
urination will
not disturb
sleep.
 Do not mix
parenteral
solution with
highly acidic
 Others: Muscle cramps
and muscle spasm
Side Effects:
Common side effects of
furosemide:
 low blood pressure
 dehydration
 electrolyte depletion
(for example, sodium,
potassium)
Less common side effects
include :
 jaundice,
 ringing in the ears
(tinnitus)
 sensitivity to light
(photophobia)
 rash
 pancreatitis
 nausea
 diarrhea
 abdominal pain
 dizziness
 Increased blood sugar
 increase uric acid level
salutions with
pH below 3.5
 Do not expose
to light, which
may discolor
tablets or
solution; do
not use
discolored
drug or
solution.
 Discard
diluted
solutions after
24 hr.
 Measure and
record weight
to monitor
fluid change
 Arrange to
monitor serum
electrolytes,
hydration,
liver and renal
function.
 Arrange with
potassium rich
diet or
supplemental
potassium as
needed.
 Tell the patient
that they may
experience this
side effects:
increased
volume and
frequency of
urination;
dizziness,
feeling faint on
arising,
drowsiness
(avoid rapid
position
changes;
hazardous
activities, like
driving and
consumption
of alcohol);
sensitivity to
sun light( use
sun glasses,
wear
protective
clothing, or
use sunscreen;
increased thirst
(suck on
sugarless
lozenges; use
frequent
mouth care);
loss of body
potassium(a
potassium rich
diet or
potassium
supplement
will be
needed).
 Tell the patient
to report loss
or gain of
more than
1.5kg in 1 day,
swelling in the
ankle or
fingers,
unusual
bleeding or
bruising,
dizziness,
trembling,
numbness,
fatigue, muscle
weakness or
cramps.
DRUG MECHANISM
OF ACTION
INDICATION CONTRAINDICATIONS ADVERSE EFFECTS
AND SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic Name
Omeprazole
Brand Name
Zefxon
Classification:
Antisecretory
drug
Proton pump
inhibitor
Sub
Classification
Dosage
40mg
Route
Parenteral
Frequency
twice a day (BID)
Form
Powder in vial,
diluted with
sterile water
Color
Cloudy
Gastric acid
pump inhibitor
suppresses
gastric acid
secretion by
specific
inhibition of
the hydrogen
potassium
ATPase
enzymes
system at the
secretory
surface of the
gastric parietal
cells; blocks
the finalstep
acid
production.
 Short term
treatment of
active
duodenal ulcer.
 Treatment of
heartburn or
symptoms of
GERD
 Short term
treatment of
active benign
gastric ulcer
 GERD, severe
erosive
esophagitis,
poorly
responsive
symptomatic
GERD
 Long term
therapy:
treatment of
pathologic
hypersecretory
conditions
(Zollinger
Ellison’s
syndrome,
multiple
adenomas,
systemic
mastocytosis)
 Eradication of
H. pylori with
amoxicillin or
metronidazole
 Contraindicated
with
hypersensitivity to
Omeprazole or it’s
components
 Use cautiously with
pregnancy,
lactation
Adverse Effects:
 CNS: headache,
dizziness,
asthenia, vertigo,
insomnia, apathy,
anxiety,
paresthesias,
dream
abnormalities
 Dermatologic:
rash,
inflammation,
urticaria, pruritus,
alopecia, dry skin.
 GI: diarrhea,
abdominal pain,
nausea, vomiting,
constipation, dry
mouth, tongue
atrophy
 Respiratory: URI
symptoms, cough,
epistaxis
 Others: cancer in
preclinical studies,
back pain, fever
Side Effects:
 Dizziness (avoid
driving or
performing
hazardous tasks)
 headache (request
medications)
 Consider the 10
Golden Rights
of administering
medication
 Assess other
medications
patient may be
taking for
effectiveness
and interactions
(especially
those dependent
on cytochrome
P450
metabolism or
those dependent
on acid
environment for
absorption).
 Monitor
therapeutic
effectiveness
and adverse
reactions at
beginning of
therapy and
periodically
throughout
therapy.
 Assess GI
system: bowel
sounds every
8hours,
abdomen for
pain and
swelling,
and
clarithromycin
 nausea
 vomiting
 diarrhea (maintain
proper nutrition)
 symptoms of URI
 cough (do not self-
medicate; consult
with your health
care provider if
uncomfortable).
appetite loss.
 Monitor hepatic
enzymes: AST,
ALT, increased
alkaline
phosphatase
during
treatment.
 Tell the patient
to report if
experiencing
this side effects:
dizziness,
headache,
nausea,
vomiting,
diarrhea.
DRUG MECHANISM
OF ACTION
INDICATION CONTRAINDICATIONS ADVERSE EFFECT
AND SIDE EFFECT
NURSING
RESPONSIBILITIES
Generic Name
Ambroxol HCL
Brand Name
Ambrolex
Classification
Mucolytic
Sub
Classification
Dosage
75mg
Route
Oral
Frequency
Once a day
Form
Capsule
Color
Half white and
half green
It makes phlegm
in the airways
thinner and less
sticky. It does this
by increasing the
body's natural
production of
surfactant. This
contributes to a
secretomotoric
effect: it helps the
cilia - tiny hairs
that line the
respiratory tract -
to transport the
phlegm out of the
lungs.
Adjuvant therapy in
patients with abnormal,
viscid, or in spissated
mucous secretions in
acute and chronic
broncho pulmonary
diseases, and in
pulmonary
complications of cystic
fibrosis and surgery,
tracheostomy, and
atelectasis.
There is no absolute
contraindication but in
patient with gastric
ulceration relative caution
should be observed.
Adverse Effect:
 Occasional
gastrointestinal
side effects may
occur but these
are almost
invariably mild
 Rashes
 Fatigue
 Dry mouth
 Rhinorrhea
 Constipation
 Dysuria
 Contact
dermatitis
 Consider the 10
Golden Rights of
administering
medication
 Monitor S/Sx of
aspiration of
excess secretions
and for
bronchospasm.
 Have suction
apparatus
immediately
available.
 Tell the client to
report difficulty
with clearing the
airway or any
other respiratory
distress.
 Tell the client to
report if
experiencing this
side effects: GI
upset, rashes,
fatigue, dry mout.
DRUG MECHANISM
OF ACTION
INDICATION CONTRAINDICATIO
NS
ADVERSE EFFECT
AND SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic Name
Cefuroxime Sodium
Brand Name
Zinacef
Classification
Antibiotic,
Cephalosporin
Sub Classification
Second generation
Dosage
750mg
Route
Parenteral
Frequency
q8
Form
powder in vial,
diluted with sterile
water
Color
Bactericidal:
inhibits synthesis
of bacterial cell
wall, causing cell
death.
 Lower
respiratory
infections
caused by S.
pneumonia, S.
aureus, E. coli,
Klebsiella
pneumonia, H.
influenza, S.
pyogenes
 Dermatologic
infections
caused by S.
aureus, S.
pyogenes, E.
coli, K.
pneumonia,
Enterobacter
 UTIs caused
by E. coli, K.
pneumonia
 Uncomplicated
and
disseminated
gonorrhea
caused by N.
gonorrhoeae
 Septicimia
caused by S.
 Contraindicate
d with allergy
to
cephalosporins
or penicillins
 Use
continuously
with renal
failure,
lactation,
pregnancy
Side Effects
 Diarrhea, stomach
upset
 Difficulty of
breathing
 Anusual tiredness
or fatigue
 Pain at injection
site
Adverse Effect:
 CNS: headache,
dizziness,
lethargy,
paresthesias
 GI: nausea,
vomiting,
diarrhea,
anorexia,
abdominal pain,
flatulence,
pseudomenbranou
se colitis,
hepatotoxicity
 GU:
Nephrotoxicity
 Hematologic:
 Consider the 10
Golden Rights of
administering
medication
 Determine history
of hypersensitivity
reactions
to cephalosporins,
penicillins, and
history of
allergies,
particularly to
drugs, before
therapy is initiated.
 Lab tests: Perform
culture and
sensitivity tests
before initiation of
therapy and
periodically during
therapy if
indicated. Therapy
may be instituted
pending test
results. Monitor
periodically BUN
and creatinine
clearance.
 Do skin test before
Light yellow pneumonia, S.
aureus, E. coli,
K pneumonia,
H. influenza
 Meningitis
caused by S.
pneumoniae,
H. influenza,
S. aureus, N.
meningitides
 Bone and joint
infections due
to S. aureus
 Perioperative
prophylaxis
 Treatment of
acute bacterial
maxillary
sinusitis in
patients 3-mo
12yr
Bone marrow
depression
 Hypersensitivity:
ranging from rash
to fever to
anaphylaxis;
serum sickness
reaction
 Local: pain,
abcess at injection
site, phlebitis,
inflammation of
IV site
 Others:
superinfection,
disulfram- like
reaction with
alcohol
administering the
drug
 Inspect IV
injection sites
frequently for
signs of phlebitis.
 Monitor for
manifestations of
hypersensitivity.
Discontinue drug
and report their
appearance
promptly.
 Monitor I&O rates
and pattern:
Especially
important in
severely ill
patients receiving
high doses. Report
any significant
changes.
 Tell the client to
report loose stools
or diarrhea
promptly.
 Tell the client to
avoid alcohol
while taking this
drug and for 3days
after because
severe reaction
often occurs.
DRUG MECHANISM OF
ACTION
INDICATION CONTRAINDICATIO
NS
ADVERSE
EFFECTS AND
SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic Name
Paracetamol
Brand Name
Biogesic
Classification
Non- narcotic
analgesic,
Antipyretic
Sub
Classification
Dosage
300mg
Route
P.O
Frequency
PRN
Form
Ttablet
Color
Orange
 Decreases
fever by a
hypothalamic
effect leading
to sweating
and
vasodilation
 Inhibits
pyrogen effect
on the
hypothalamic-
heat-regulating
centers
 Inhibits
CNS prostagla
ndin synthesis
with minimal
effects on
peripheral pros
taglandin synth
esis
 Does not cause
ulceration of
the GI tract
and causes no
anticoagulant
action
 Control of pain
due to headache,
earache,
dysmenorrhea,
arthralgia,
myalgia,
musculoskeletal
pain,
arthritis, immuni
zations, teething,
tonsillectomy
 Reduce fever in
viral
and bacterial infe
ctions
 As a substitute
for aspirin in
upper GI disease,
bleeding
disorders clients
in anticoagulant
therapy and
gouty arthritis
 Anemia, cardiac
& pulmonary
disease. Hepatic
or severe renal
disease.
 Liver toxicity
(hepatocyte
necrosis) may
occur with
doses not far
beyond labeled
dosing.
Side Effects:
 Minimal GI
upset,
methemoglo
binemia,
hemolytic
anemia,
neutropenia,
thrombocyto
penia,
pancytopenia
,
leucopenia,ur
ticaria, CNS
stimulation,
hypoglycemi
c coma,
jaundice,
glissitis,
drowsiness,
liver damage
Adverse Effect
 Allergic skin
reactions &
GI
disturbances.
 Consider the 10
Golden Rights of
administering
medication
 Monitor CBC,
liver and renal
functions.
 Assess for fecal
occult blood and
nephritis.
 Tell the patient to
avoid using OTC
drugs
with Acetaminoph
en
 Tell the patient to
take the drug with
food or milk to
minimize GI upset.
 Tell the client to
report N&V.
cyanosis, shortness
of breath and
abdominal pain as
these are signs of
toxicity.
 Tell the client to
report paleness,
weakness and heart
beat skips
 Tell the client to
report abdominal
pain, jaundice,
dark urine,
itchiness or clay-
colored stools.
 Tell the client that
Phenmacetin may
cause urine to
become dark
brown or wine-
colored.
 Tell the client to
report pain that
persists for more
than 3-5 days
 Tell the client that
this drug is not for
regular use with
any form of liver
disease because it
might cause further
damage.
DRUG MECHANISM
OF ACTION
INDICATION CONTRAINDICATIO
NS
ADVERSE EFFECT
AND SIDE EFFECT
NURSING
RESPONSIBILITIES
Generic Name
Aminoleban
Brand Name
Classification
V06DD - Amino
acids, incl.
combinations with
polypeptides ; Used
as general nutrients.
Sub Classification
Dosage
500mg
Route
Parenteral
Frequency
q8
Form
Liquid
Color
Clear
 Given to
normalize
the amino
acid,
carbohydr
ates, fats,
vitamins
and
minerals
in the
plasma
 Hepatic
encephalopathy
due to acute or
chronic liver
diseases & of -
ve nitrogen
balance when
adequate
nutrition PO or
gastro duodenal
tube is
impossible or
undesirable.
 Patient with
abnormal amino
acid metabolism
(since the infuse
amino acids are
not adequately
metabolized,
the patient
clinical
condition may
be worsened.)
 Severe renal
disorders
Adverse Effect:
 Cardiovascular:
Chest discomfort,
& palpitation.
 Hypersensitivity:
rare skin
eruptions
 Gastrointestinal:
occasional nausea
and vomiting
 Others:
occasional chills,
fever, headache
Side Effects:
 Hypoglycemia
may occur and
 hyperammonemia
has been reported.
 Hypersensitivity
reactions such as
skin rash may
occur rarely.
 Nausea, vomiting,
chest discomfort
and palpitations
may occur
infrequently.
 Large doses and
rapid
 Consider the 10
Golden Rights of
administering
medication
 Asses’ patient’s
condition before
starting the
therapy.
 Be alert to
adverse reaction.
 Monitor patient
temperature.
 If GI reaction
occur monitor
patient
hydration.
 Tell the patient
to report if felt
this side effects:
nausea,
vomiting, chest
discomfort,
palpitation occur.
administration
may lead to
acidosis.
 Chills, fever and
headache may
infrequently
occur.
DRUG MECHANISM OF
ACTION
INDICATION CONTRAINDICATI
ONS
ADVERSE EFFECT
AND SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic Name
Sinutab extra-
strength
Brand Name
Sinutab Forte
Classification
phenylpropanola
mine,
combinations ;
Belongs to the
class of systemic
sympathomimeti
c preparations
used as nasal
decongestant
Sub
Classification
Dosage
1 cap
Route
oral
Frequency
TID
Form
Capsule
Color
Red and yellow
 Sinutab Extra-
Strength is a
fixed-dose
combination
capsule containing
the following 3
active ingredients:
Phenylpropanola
mine HCl (PPA)
or Phenylephrine:
A systemic
decongestant to
relieve clogged
nose and sinuses.
 Chlorphenamine
Maleate or
Phenyltoloxamine
Citrate: An
antihistamine/anti
allergy.
 Paracetamol: A
pain killer, as well
as an antipyretic
(for fever).
 Temporary
relief of sinus
headache;
promote nasal
and sinus
drainage; help
relieve runny
nose, facial
pain, malaise
and fever often
associated with
colds,
influenza,
acute and
chronic
sinusitis,
allergic rhinitis
(hay fever) and
vasomotor
rhinitis.
 Patients who
are
hypersensiti
ve or allergic
to any of the
components
of Sinutab
Extra-
Strength.
Unless
otherwise
advised by a
physician,
during
pregnancy
and
lactation,
patients with
severe
kidney
disease or
who are
taking other
medications
containing
PPA.
Adverse Effect:
 chest pain, rapid
pulse, fast or
uneven heart
rate;
 confusion,
hallucinations,
severe
nervousness;
 tremor, seizure
(convulsions);
 easy bruising or
bleeding,
unusual
weakness;
 little or no
urinating;
 nausea, pain in
your upper
stomach,
itching, loss of
appetite, dark
urine, clay-
colored stools,
jaundice
(yellowing of
your skin or
eyes); or
 Dangerously
high blood
pressure (severe
headache,
blurred vision,
buzzing in your
ears, anxiety,
 Consider the 10
Golden Rights of
administering
medication
 Tell the patient not
take more of this
medication than is
recommended. An
overdose of
acetaminophen can
damage your liver
or cause death.
 Instruct the patient
that this
medication could
not use if she/he
are allergic to
acetaminophen,
chlorpheniramine,
or
pseudoephedrine.
 Inform patient that
she need to avoid
drinking alcohol. It
may increase your
risk of liver
damage while
taking
acetaminophen,
and can increase
certain side effects
of
chlorpheniramine.
 Explain to the
patient that there’s
a side effects that
chest pain,
shortness of
breath, uneven
heartbeats,
seizure).
Side Effect:
 dizziness,
drowsiness;
 mild headache,
blurred vision;
 dry mouth,
nose, or throat;
 constipation;
 feeling nervous;
 sleep problems
(insomnia);
she may
experience upon
taking the
medication such as
blurred vision or
impair your
thinking or
reactions.
 If other unwanted
effects not
previously listed
occur, consult a
physician.
DRUG MECHANISM OF
ACTION
INDICATION CONTRAINDICATION
S
ADVERSE EFFECTS
AND SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic Name
Ketorolac
Tromethamine
Brand Name
Toradol
Classification
nonsteroidal anti-
inflammatory
agents, nonopioid
analgesics
Sub Classification
pyrroziline
carboxylic acid
Dosage
30 mg
Route
Parenteral
Frequency
q8
Form
Liquid ampule
Color
Clear
 Inhibits
prostaglandin
synthesis,
producing
peripherally
mediated
analgesia.
 Also has
antipyretic and
anti-
inflammatory
properties.
Therapeutic
Effects:
Decreased pain.
 Short-term
manageme
nt of pain
(not to
exceed 5
days total
for all
routes
combined).
 Contraindicated
in:
 Hypersensitivity
 Cross-sensitivity
with other
NSAIDs may exist
 Pre- or
perioperative use
 Known alcohol
intolerance
(injection only)
 Perioperative pain
from coronary
artery bypass graft
(CABG) surgery .
 Use Cautiously
in:
 Cardiovascular
disease or risk
factors for
cardiovascular
disease (may ↑ risk
of serious
cardiovascular
thrombotic events,
myocardial
infarction, and
stroke, especially
with prolonged
Adverse Effects:
 CNS:
drowsiness,
abnormal
thinking,
dizziness,
euphoria,
headache.
 Respiratory:
asthma,
dyspnea.
 CV: edema,
pallor,
vasodilation.
 GI: GI
bleeding,
abnormal taste,
diarrhea, dry
mouth,
dyspepsia, GI
pain, nausea.
 GU: oliguria,
renal toxicity,
urinary
frequency.
 Dermatologic:
exfoliative
dermatitis,
Stevens Johnson
Syndrome, toxic
 Consider the 10
Golden Rights of
administering
medication
Assessment
Patients who have
asthma, aspirin-induced
allergy, and nasal polyps
are at increased risk for
developing
hypersensitivity reactions.
Assess for rhinitis,
asthma, and urticaria.
Pain: Assess pain (note
type, location, and
intensity) prior to and 1-2
hr following
administration.
Lab Test
Considerations: Evaluate
liver function tests,
especially AST and ALT,
periodically in patients
receiving prolonged
therapy. May cause ↑
levels.
tell the patient that it
may cause prolonged
bleeding time that may
persist for 24-48 hr
following discontinuation
of therapy.
Inform the patient that
it may cause ↑ BUN,
serum creatinine, or
use)
 History of GI
bleeding
 Renal impairment
(dosage reduction
may be required)
necrolysis
pruritus,
purpura,
sweating,
urticaria.
 Hematology:
prolonged
bleeding time.
 Local: injection
site pain.
 Neurology:
paresthesia.
 Misc: allergic
reactions
including,
anaphylaxis
Side Effects:
 chest pain,
weakness,
shortness of
breath, slurred
speech,
problems with
vision or
balance;
 black, bloody,
or tarry stools;
 coughing up
blood or vomit
that looks like
coffee grounds;
 swelling or
rapid weight
potassium concentrations.
.
Implementation
Do not confuse Toradol
(ketorolac) with Torecan
(thiethylperazine) or
tramadol (Ultram).
Administration in
higher-than-recommended
doses does not provide
increased effectiveness but
may cause increased side
effects. Duration of
ketorolac therapy, by all
routes combined, should
not exceed 5 days Use
lowest effective dose for
shortest period of time.
Coadministration with
opioid analgesics may
have additive analgesic
effects and may permit
lower opioid doses. .
PO: Ketorolac therapy
should always be given
initially by the IM or IV
route. Use oral therapy
only as a continuation of
parenteral therapy.
 injection, 0.9%
NaCl.
Patient/Family
Teaching
Instruct patient
on how and when
to ask for pain
gain;
 urinating less
than usual or
not at all;
 nausea, stomach
pain, low fever,
loss of appetite,
dark urine, clay-
colored stools,
jaundice
(yellowing of
the skin or
eyes);
 fever, sore
throat, and
headache with a
severe
blistering,
peeling, and red
skin rash;
 the first sign of
any mouth sores
or skin rash, no
matter how
mild;
 pale skin, easy
bruising, severe
tingling,
numbness, pain,
muscle
weakness; or
 fever, headache,
neck stiffness,
chills, increased
sensitivity to
light, purple
spots on the
skin, and/or
medication.
Instruct patient
to take medication
exactly as directed.
Take missed doses
as soon as
remembered if not
almost time for
next dose. Do not
double doses. Do
not take more than
prescribed or for
longer than 5 days.
May cause
drowsiness or
dizziness. Advise
patient to avoid
driving or other
activities requiring
alertness until
response to the
medication is
known.
Caution patient
to avoid the
concurrent use of
alcohol, aspirin,
NSAIDs,
acetaminophen, or
other OTC
medications
without consulting
health care
professional.
Advise patient
to inform health
care professional
of medication
regimen prior to
seizure
(convulsions).
Less serious side
effects may include:
 upset stomach,
mild nausea or
vomiting,
diarrhea,
constipation;
 mild heartburn,
stomach pain,
bloating, gas;
 dizziness,
headache,
drowsiness;
 sweating; or
 ringing in your
ears.
treatment or
surgery.
Advise patient
to consult health
care professional if
rash, itching,
visual
disturbances,
tinnitus, weight
gain, edema, black
stools, persistent
headache, or
influenza-like
syndrome (chills,
fever, muscle
aches, pain)
occurs. .
Evaluation/Desire
d Outcomes
Decrease in
severity of pain.
Patients who do
not respond to one
NSAID may
respond to another.
DRUG MECHANISM OF
ACTION
INDICATION CONTRAINDICATIO
NS
ADVERSE EFFECTS
AND SIDE EFFECTS
NURSING
RESPONSIBILITIES
Generic Name
Perindopril
Brand Name
Coversyl plus
Classification
Antihypertensive
Sub
Classification
ACE Inhibitor
Dosage
1 cap
Route
oral
Frequency
BID
Form
Tablet
Color
White
 Antihypertensive
.
Pharmacology:
Perindopril is an
ACE-inhibitor
that works by
widening the
blood vessels,
which makes it
easier for the
heart to pump
blood through
them.
Indapamide is a
diuretic that
causes an
increase in the
amount of urine
produced.
Each of the
active ingredients
of Coversyl Plus
reduces blood
pressure and
work together to
control blood
pressure.
 Treatment
of essential
hypertensio
n
 Allergy to
perindopril or
other ACE-
inhibitors, or to
indapamide or
any other
sulfonamides.
 History or
presence of
wheezing,
swelling of the
face or tongue,
intense itching
or severe skin
rashes with
previous ACE-
inhibitor
treatment, or
other
circumstances
(eg,
angioedema).
Severe liver
diseases or if
suffering from
hepatic
encephalopathy
; severe kidney
disease, or on
dialysis; low or
high blood
potassium;
Adverse Effect:
 CNS: dizziness,
asthenia, sleep
disorder,
paresthesia,
depression,
somnolence,ner
vousness,
headache.
 CV: palpitati
ons, edema,
chest pain, ab
normal ECG.
 EENT:rhinitis,
sinusitis, ear
infection,
pharyngitis,
tinnitus.
 GI: dyspepsia,
diarrhea,
abdominalpain,
nausea, vomi
ting, flatulenc
e.
 GU: proteinur
ia, urinarytrac
t infection, m
alesexual
dysfunction,
menstrual
disorder.
 Consider the 10
Golden Rights of
administering
medication
 Assess patient’s
condition.
 Don’t let the
patient to take this
if she has an
allergy to
penidopril. And if
she has a history of
wheezing, swelling
of the face or
tongue, intense
itching or severe
skin rashes.
 Explain to patient
what was the
medication for,
and what are the
side effects that
she may encounter.
 Instruct the patient
to consult her
doctor if she
experiencing
unwanted effect.
untreated
decompensated
heart failure
(severe water
retention,
difficulty in
breathing);
children.
 Use in
pregnancy &
lactation: Cove
rsyl Plus should
not be used
during the first
3 months of
pregnancy and
must not be
taken from the
4th month of
pregnancy.
When
pregnancy is
planned or
confirmed, the
switch to an
alternative
treatment
should be
initiated as soon
as possible.
Do not take
Coversyl Plus if
breastfeeding.
 Musculoskele
tal: back
pain,
hyperonia,
neck pain,
joint pain,
myalgia,
arthritis, arm or
leg pain
 Respiratory:
cough, upper
respiratory
infection
 Skin: Rash
 Other: viral
infection,
injury, seasonal
allergy
Side Effect:
 Cough, often
described as dry
and irritating,
shortness of
breath,
discomfort on
exertion.
 Headache,
dizziness,
vertigo, pins
and needles.
 Changes in the
rhythm or rate
of the heart
beat, fast or
irregular heart
beat
 Stroke,
myocardial
infarction,
angina pectoris
(a feeling of
tightness,
pressure or
heaviness in the
chest).
 Feeling tired or
lethargic.
 Tinnitus
(persistent noise
in the ears),
vision
disturbances.
 Hypotension,
flushing,
impaired
peripheral
circulation, nose
bleeds.
 Nausea,
vomiting, taste
disturbances,
indigestion,
diarrhoea,
constipation or
stomach pain.
 Muscle cramps.
 Rash, pruritus
(itching).
 Eosinophilic
pneumonia.
 Hepatitis.
 Renal failure.
 Bleeding or
bruising more
easily than
normal caused
by a low blood
platelet count ,
frequent
infections such
as fever, severe
chills, sore
throat or mouth
ulcers caused by
a lack of white
blood cells,
pancytopenia (a
rare type of
anaemia).
 Decreased
blood sugar
levels.
 Fainting.

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241603963 drug-study-final

  • 1. Get Homework/Assignment Done Homeworkping.com Homework Help https://www.homeworkping.com/ Research Paper help https://www.homeworkping.com/ Online Tutoring https://www.homeworkping.com/ click here for freelancing tutoring sites DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES
  • 2. Generic Name Potassium Chloride Brand Name Kalium Durule Classification Electrolyte Sub Classification Dosage 1 tab Route oral Frequency Every 8 hours Form Tablet Color White Principal intracellular cation of most body tissues participates in a number of physiologic processes – maintaining intracellular tonicity; transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscle; maintenance of normal renal functi on; also plays a role in carbohydrate metabolism and various enzymatic reactions.  Prevention and correction of potassium deficiency; when associated with alkalosis, use potassium chloride; when associated acidosis, use potassium acetate bicarb onate, citrate, or gluconate.  Contraindicated with allergy to tartrazine, aspirin (t artrazine is found in some preparations marketed as Kaon- Cl, Klor-Con); therapy with potassium-sparing diuretics or aldosterone- inhibiting agents; severerenal impair ment with oliguria, anuria, azotemia; untreated Addison’s disease; hyperkalemia; adynamiaepisodica hereditaria; acute dehydration; heat cramps; GI disorders that delay passage in the GI tract.  Use cautiously with cardiac disorders, especially if treated with cardiac glycosides, pregnancy and lactation. Adverse Effects:  Dermatologic: Rash  GI: Nausea, vomiting, diarrhea, abdomina l discomfort, GI obstruction, GI bleeding, GI ulceration or perforation.  Hematologic: Hyperkalemia- increased serum potassium, ECG changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of OTC interval).  Local: Tissue sloughing, local necrosis, local phlebitis, and venospasm with injection. Side Effects:  Confusion, anxiety, feeling like you might pass out  Uneven heartbeat  Extreme thirst,  Consider the 10 Golden Rights of administering medication  Arrange for serial serum potassium levels before and during therapy  Administer oral drugs after meals or with food and a full glass of water to decrease GI upset.  Caution patient not to chew or crush tablet; have patient swallow tablet whole.  Caution patient that expanded wax matrix capsules will be found in stool.  Caution patient not to use salt substitutes.  Ask the patient to have periodic blood tests and medical evaluation.  Tell the patient to report tingling of hands or feet, unusual tiredness or weakness, feeling of
  • 3. increased urination  Leg discomfort  Muscle weakness or limp feeling  Numbness or tingly feeling in your hands or feet, or around your mouth  Severe stomach pain, ongoing diarrhea or vomiting  Black, bloody, or tarry stools; or  Coughing up blood or vomit that looks like coffee grounds heaviness in the legs, severe nausea, vomiting, abdominal pain, black or tarry stool. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES
  • 4. Generic Name Metronidazole Brand Name Flagyl Classification Amebicide, Antibacterial, Antibiotic, Antiprotozoal Sub Classification Dosage 500mg/tablet Route Oral Frequency Thrice a day (TID) Form Tablet Color White  Bactericidal: inhibits DNA synthesis in specific (obligate) anaerobes, causing cell death; antiprotozoal- trichomonacidal , amebicidal: Biochemical mechanism of action is not known.  Acute infection with susceptible anaerobic bacteria  Acute intestinal amebiasis  Amebic liver abscess  Trichomoniasis (acute and partners of patients undergoing colorectal surgery  Unlabeled uses: Prophylaxis for patients undergoing gynecologic, abdominal surgery, hepatic encephalopathy, Crohn’s disease; antibiotic- associated pseudo membranous colitis, treatment of Gardnerella vaginalis, giardiasis (use recommended by the CDC); infected decubitus ulcers; perioral dermatitis  Contraindicated with hypersensitivity to metronidazole; pregnancy ( do not use for trichomoniasis in first trimester)  Use continuously with CNS diseases, hepatic diseases, candidiasis (moniliasis), blood dyscrasias, lactation. Adverse Effect:  CNS: Headache, dizziness, ataxia, vertigo, incoordiantio n, insomnia, seizures, peripheral neurophaty, fatigue  GI: Unpleasant metallic taste, anorexia, nausea, vomiting, diarrhea, GI upset, cramps  GU: Dysuria, incontinence, darkening of the urine  Local: Thrombophle bitis (IV); redness, burning, dryness, and skin irritation (topical)  Others: Severe, disulfiram- like interaction  Consider the 10 Golden Rights of administering medication  Tell the patient to take full course drug therapy; take the drug with food if GI upset occur.  Tell the patient not to take alcohol (beverages or preparations containing alcohol, cough syrups) for 24-72 hr of drug use; severe reactions may occur.  Caution the patient that their urine may be darker in color than usual; this is expected  Tell the patient that they may
  • 5. with alcohol, candidiasis (superinfectio n) Side Effects:  Numbness or tingling in your hands or feet;  White patches or sores inside your mouth or on your lips;  Pain or burning when you urinate;  Diarrhea that is watery or bloody;  Vision problems, pain behind your eyes;  Trouble concentrating, slurred speech, mood or behavior changes, tremors, muscle twitching, seizure (convulsions);  Fever, chills, experience this side effects like: Dry mouth with strange metallic taste (frequent mouth care, sucking sugarless candies may help); nausea, vomiting, diarrhea (eat frequent small meals)  Tell the patient to report severe GI upset, dizziness, unusual fatigue or weakness, fever, chills.
  • 6. muscle pain, confusion, headache, sore throat, neck stiffness, increased sensitivity to light, drowsiness, nausea and vomiting; or  Severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES
  • 7. Generic Name Metoclopramide Brand Name Reglan Classification Antiemetic, Dopaminergic blocker, GI stimulant Sub Classification Dosage 1 ampule Route Parenteral Frequency TID/ q6 Form Liquid ampule Color Clear  Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions, appears to sensitize tissues to action of acetylcholin e, relaxes pyloric sphincter which when combined with effects on motility, accelerates gastric emptying and intestinal transit; little effect on gallbladder or colon motility; increases lower esophageal sphincter pressure; has sedative properties,  Relief symptoms of acute and recurrent diabetic gastroparesis.  Short term therapy (4- 12weeks) for adults with symptomatic gastro esophageal reflux who fail to respond to conventional therapy  Prophylaxis of postoperative nausea and vomiting when nasogastric suction is undesirable  Contraindicated with allergy to metaclopramide, GI hemorrhage, mechanical obstruction or perforation; pheochromocytoma (may cause hypertensive crisis); epilepsy.  Use continuously with previously detected breast cancer (one third of such tumors are prolactin dependent); lactation, pregnancy; fluid overload; renal impairment. Adverse Effects:  CNS: Restlessness, drowsiness, fatigue, lasitudes, insomnia, extrapyramidalreact ion, parkinsonism- like reactions, akathisia, dystonia, myoclonus, dizziness, anxiety  CV: Transient hypertension  GI: Nausea, diarrhea Side Effects:  tremors, or restless muscle movements in your eyes, tongue, jaw, neck, arms, or legs  mask-like appearance of the face  very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out  depressed mood, thoughts of suicide or hurting yourself  hallucinations,  Consider the 10 Golden Rights of administering medication  Asses if the patient has historyof allergies tometocloprami de.  ·Monitor BP carefully during IVadministratio n.  Monitor extrapyramidal reactions and consultphysician if they occur.  Monitor patients with diabetes, arrange for alteration in insulin dose or timing ifdiabetic control is comprisedby alterations in timing of food absorption.  Keep diphenhydramin e injection readily available in case extrapyramidal reaction occur (50mg IM)
  • 8. induces release of prolactin. anxiety, agitation, jittery feeling, trouble staying still  swelling, fluid retention  jaundice (yellowing of your skin or eyes)  seizure (convulsions) Less serious side effects may include:  feeling restless, drowsy, tired, or dizzy  headache, sleep problems (insomnia)  nausea, vomiting, diarrhea  breast tenderness or swelling  changes in your menstrual periods  urinating more than usual  Have phentolamine readily available in case of hypertensive crisis (most likely to occur with undiagnosed pheochromocyto ma)  Do not use alcohol, sleep remedies, or sedatives; serious sedation could occur.  Tell the patient that they may experience these side effects: drowsiness, dizziness (do not drive or perform other task that requires alertness); restlessness, anxiety, depression, headache, insomnia (reversible); nausea, diarrhea.  Tell the patient to report involuntary
  • 9. movement of the face, eyes, or limbs, severe depression, and severe diarrhea.
  • 10. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Furosemide Brand Name Lasix Classification Loop Diuretics Sub Classification Dosage 10mg Route Parenteral Frequency STAT Form Liquid ampule Color Clear Inhibits reabsorption of sodium chloride from the proximal and distal tubules and ascending limb of the loop of Henle, leading to a sodium-rich diuresis.  Oral, IV: Edema associatedwit h heart failure, cirrhosis,rena l disease.  IV: acute Pulmonary Edema  Oral: hypertension  Contraindicated with allergy to furosemide, sulfonamides, allergy to tartrazine (in oral solution); anuria, severe renal failure; hepatic coma; pregnancy; lactation.  Use cautiously with SLE, gout, diabetes mellitus. Adverse Effects:  CNS: dizziness, vertigo, paresthesias, xanthopsia, weakness, headache, drowsiness, fatigue, blurred vision, tinnitus, irreversible hearing loss  CV: orthostatic hypotension, volume depletion, cardiac arrhythmias, thrombophlebitis  Dermatologic: photosensitivity, rash, pruritus, urticaria, purpura, exfoliative, dermatitis, erythema multiforme  GI: nausea, anorexia, vomiting, oral and gastric irritation, constipation, diarrhea, acute pacreatitis, jaundice  GU: polyuria, nocturia, glycosuria, urinary bladder spasm.  Hematologic: leukopenia, anemia, thrombocytopenia, fluid and electrolytes imbalance, hyperglycemia, hyperuricemia  Consider the 10 Golden Rights of administering medication  Profound dieresis with water and electrolyte depletion can occur, careful medical supervision is required.  Administer with food or milk to prevent GI upset.  Reduce dosage if given with other anti hypertensive; readjust dosage gradually as BP responds.  Give early in the day so that increase urination will not disturb sleep.  Do not mix parenteral solution with highly acidic
  • 11.  Others: Muscle cramps and muscle spasm Side Effects: Common side effects of furosemide:  low blood pressure  dehydration  electrolyte depletion (for example, sodium, potassium) Less common side effects include :  jaundice,  ringing in the ears (tinnitus)  sensitivity to light (photophobia)  rash  pancreatitis  nausea  diarrhea  abdominal pain  dizziness  Increased blood sugar  increase uric acid level salutions with pH below 3.5  Do not expose to light, which may discolor tablets or solution; do not use discolored drug or solution.  Discard diluted solutions after 24 hr.  Measure and record weight to monitor fluid change  Arrange to monitor serum electrolytes, hydration, liver and renal function.  Arrange with potassium rich diet or supplemental potassium as needed.  Tell the patient that they may experience this side effects: increased volume and frequency of
  • 12. urination; dizziness, feeling faint on arising, drowsiness (avoid rapid position changes; hazardous activities, like driving and consumption of alcohol); sensitivity to sun light( use sun glasses, wear protective clothing, or use sunscreen; increased thirst (suck on sugarless lozenges; use frequent mouth care); loss of body potassium(a potassium rich diet or potassium supplement will be needed).  Tell the patient to report loss or gain of more than
  • 13. 1.5kg in 1 day, swelling in the ankle or fingers, unusual bleeding or bruising, dizziness, trembling, numbness, fatigue, muscle weakness or cramps.
  • 14. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Omeprazole Brand Name Zefxon Classification: Antisecretory drug Proton pump inhibitor Sub Classification Dosage 40mg Route Parenteral Frequency twice a day (BID) Form Powder in vial, diluted with sterile water Color Cloudy Gastric acid pump inhibitor suppresses gastric acid secretion by specific inhibition of the hydrogen potassium ATPase enzymes system at the secretory surface of the gastric parietal cells; blocks the finalstep acid production.  Short term treatment of active duodenal ulcer.  Treatment of heartburn or symptoms of GERD  Short term treatment of active benign gastric ulcer  GERD, severe erosive esophagitis, poorly responsive symptomatic GERD  Long term therapy: treatment of pathologic hypersecretory conditions (Zollinger Ellison’s syndrome, multiple adenomas, systemic mastocytosis)  Eradication of H. pylori with amoxicillin or metronidazole  Contraindicated with hypersensitivity to Omeprazole or it’s components  Use cautiously with pregnancy, lactation Adverse Effects:  CNS: headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities  Dermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skin.  GI: diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy  Respiratory: URI symptoms, cough, epistaxis  Others: cancer in preclinical studies, back pain, fever Side Effects:  Dizziness (avoid driving or performing hazardous tasks)  headache (request medications)  Consider the 10 Golden Rights of administering medication  Assess other medications patient may be taking for effectiveness and interactions (especially those dependent on cytochrome P450 metabolism or those dependent on acid environment for absorption).  Monitor therapeutic effectiveness and adverse reactions at beginning of therapy and periodically throughout therapy.  Assess GI system: bowel sounds every 8hours, abdomen for pain and swelling,
  • 15. and clarithromycin  nausea  vomiting  diarrhea (maintain proper nutrition)  symptoms of URI  cough (do not self- medicate; consult with your health care provider if uncomfortable). appetite loss.  Monitor hepatic enzymes: AST, ALT, increased alkaline phosphatase during treatment.  Tell the patient to report if experiencing this side effects: dizziness, headache, nausea, vomiting, diarrhea.
  • 16. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECT AND SIDE EFFECT NURSING RESPONSIBILITIES Generic Name Ambroxol HCL Brand Name Ambrolex Classification Mucolytic Sub Classification Dosage 75mg Route Oral Frequency Once a day Form Capsule Color Half white and half green It makes phlegm in the airways thinner and less sticky. It does this by increasing the body's natural production of surfactant. This contributes to a secretomotoric effect: it helps the cilia - tiny hairs that line the respiratory tract - to transport the phlegm out of the lungs. Adjuvant therapy in patients with abnormal, viscid, or in spissated mucous secretions in acute and chronic broncho pulmonary diseases, and in pulmonary complications of cystic fibrosis and surgery, tracheostomy, and atelectasis. There is no absolute contraindication but in patient with gastric ulceration relative caution should be observed. Adverse Effect:  Occasional gastrointestinal side effects may occur but these are almost invariably mild  Rashes  Fatigue  Dry mouth  Rhinorrhea  Constipation  Dysuria  Contact dermatitis  Consider the 10 Golden Rights of administering medication  Monitor S/Sx of aspiration of excess secretions and for bronchospasm.  Have suction apparatus immediately available.  Tell the client to report difficulty with clearing the airway or any other respiratory distress.  Tell the client to report if experiencing this side effects: GI upset, rashes, fatigue, dry mout.
  • 17. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIO NS ADVERSE EFFECT AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Cefuroxime Sodium Brand Name Zinacef Classification Antibiotic, Cephalosporin Sub Classification Second generation Dosage 750mg Route Parenteral Frequency q8 Form powder in vial, diluted with sterile water Color Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death.  Lower respiratory infections caused by S. pneumonia, S. aureus, E. coli, Klebsiella pneumonia, H. influenza, S. pyogenes  Dermatologic infections caused by S. aureus, S. pyogenes, E. coli, K. pneumonia, Enterobacter  UTIs caused by E. coli, K. pneumonia  Uncomplicated and disseminated gonorrhea caused by N. gonorrhoeae  Septicimia caused by S.  Contraindicate d with allergy to cephalosporins or penicillins  Use continuously with renal failure, lactation, pregnancy Side Effects  Diarrhea, stomach upset  Difficulty of breathing  Anusual tiredness or fatigue  Pain at injection site Adverse Effect:  CNS: headache, dizziness, lethargy, paresthesias  GI: nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomenbranou se colitis, hepatotoxicity  GU: Nephrotoxicity  Hematologic:  Consider the 10 Golden Rights of administering medication  Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated.  Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results. Monitor periodically BUN and creatinine clearance.  Do skin test before
  • 18. Light yellow pneumonia, S. aureus, E. coli, K pneumonia, H. influenza  Meningitis caused by S. pneumoniae, H. influenza, S. aureus, N. meningitides  Bone and joint infections due to S. aureus  Perioperative prophylaxis  Treatment of acute bacterial maxillary sinusitis in patients 3-mo 12yr Bone marrow depression  Hypersensitivity: ranging from rash to fever to anaphylaxis; serum sickness reaction  Local: pain, abcess at injection site, phlebitis, inflammation of IV site  Others: superinfection, disulfram- like reaction with alcohol administering the drug  Inspect IV injection sites frequently for signs of phlebitis.  Monitor for manifestations of hypersensitivity. Discontinue drug and report their appearance promptly.  Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.  Tell the client to report loose stools or diarrhea promptly.  Tell the client to avoid alcohol while taking this drug and for 3days after because severe reaction often occurs.
  • 19. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIO NS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Paracetamol Brand Name Biogesic Classification Non- narcotic analgesic, Antipyretic Sub Classification Dosage 300mg Route P.O Frequency PRN Form Ttablet Color Orange  Decreases fever by a hypothalamic effect leading to sweating and vasodilation  Inhibits pyrogen effect on the hypothalamic- heat-regulating centers  Inhibits CNS prostagla ndin synthesis with minimal effects on peripheral pros taglandin synth esis  Does not cause ulceration of the GI tract and causes no anticoagulant action  Control of pain due to headache, earache, dysmenorrhea, arthralgia, myalgia, musculoskeletal pain, arthritis, immuni zations, teething, tonsillectomy  Reduce fever in viral and bacterial infe ctions  As a substitute for aspirin in upper GI disease, bleeding disorders clients in anticoagulant therapy and gouty arthritis  Anemia, cardiac & pulmonary disease. Hepatic or severe renal disease.  Liver toxicity (hepatocyte necrosis) may occur with doses not far beyond labeled dosing. Side Effects:  Minimal GI upset, methemoglo binemia, hemolytic anemia, neutropenia, thrombocyto penia, pancytopenia , leucopenia,ur ticaria, CNS stimulation, hypoglycemi c coma, jaundice, glissitis, drowsiness, liver damage Adverse Effect  Allergic skin reactions & GI disturbances.  Consider the 10 Golden Rights of administering medication  Monitor CBC, liver and renal functions.  Assess for fecal occult blood and nephritis.  Tell the patient to avoid using OTC drugs with Acetaminoph en  Tell the patient to take the drug with food or milk to minimize GI upset.  Tell the client to report N&V. cyanosis, shortness of breath and abdominal pain as these are signs of toxicity.  Tell the client to report paleness, weakness and heart beat skips
  • 20.  Tell the client to report abdominal pain, jaundice, dark urine, itchiness or clay- colored stools.  Tell the client that Phenmacetin may cause urine to become dark brown or wine- colored.  Tell the client to report pain that persists for more than 3-5 days  Tell the client that this drug is not for regular use with any form of liver disease because it might cause further damage.
  • 21. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIO NS ADVERSE EFFECT AND SIDE EFFECT NURSING RESPONSIBILITIES Generic Name Aminoleban Brand Name Classification V06DD - Amino acids, incl. combinations with polypeptides ; Used as general nutrients. Sub Classification Dosage 500mg Route Parenteral Frequency q8 Form Liquid Color Clear  Given to normalize the amino acid, carbohydr ates, fats, vitamins and minerals in the plasma  Hepatic encephalopathy due to acute or chronic liver diseases & of - ve nitrogen balance when adequate nutrition PO or gastro duodenal tube is impossible or undesirable.  Patient with abnormal amino acid metabolism (since the infuse amino acids are not adequately metabolized, the patient clinical condition may be worsened.)  Severe renal disorders Adverse Effect:  Cardiovascular: Chest discomfort, & palpitation.  Hypersensitivity: rare skin eruptions  Gastrointestinal: occasional nausea and vomiting  Others: occasional chills, fever, headache Side Effects:  Hypoglycemia may occur and  hyperammonemia has been reported.  Hypersensitivity reactions such as skin rash may occur rarely.  Nausea, vomiting, chest discomfort and palpitations may occur infrequently.  Large doses and rapid  Consider the 10 Golden Rights of administering medication  Asses’ patient’s condition before starting the therapy.  Be alert to adverse reaction.  Monitor patient temperature.  If GI reaction occur monitor patient hydration.  Tell the patient to report if felt this side effects: nausea, vomiting, chest discomfort, palpitation occur.
  • 22. administration may lead to acidosis.  Chills, fever and headache may infrequently occur.
  • 23. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATI ONS ADVERSE EFFECT AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Sinutab extra- strength Brand Name Sinutab Forte Classification phenylpropanola mine, combinations ; Belongs to the class of systemic sympathomimeti c preparations used as nasal decongestant Sub Classification Dosage 1 cap Route oral Frequency TID Form Capsule Color Red and yellow  Sinutab Extra- Strength is a fixed-dose combination capsule containing the following 3 active ingredients: Phenylpropanola mine HCl (PPA) or Phenylephrine: A systemic decongestant to relieve clogged nose and sinuses.  Chlorphenamine Maleate or Phenyltoloxamine Citrate: An antihistamine/anti allergy.  Paracetamol: A pain killer, as well as an antipyretic (for fever).  Temporary relief of sinus headache; promote nasal and sinus drainage; help relieve runny nose, facial pain, malaise and fever often associated with colds, influenza, acute and chronic sinusitis, allergic rhinitis (hay fever) and vasomotor rhinitis.  Patients who are hypersensiti ve or allergic to any of the components of Sinutab Extra- Strength. Unless otherwise advised by a physician, during pregnancy and lactation, patients with severe kidney disease or who are taking other medications containing PPA. Adverse Effect:  chest pain, rapid pulse, fast or uneven heart rate;  confusion, hallucinations, severe nervousness;  tremor, seizure (convulsions);  easy bruising or bleeding, unusual weakness;  little or no urinating;  nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay- colored stools, jaundice (yellowing of your skin or eyes); or  Dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety,  Consider the 10 Golden Rights of administering medication  Tell the patient not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death.  Instruct the patient that this medication could not use if she/he are allergic to acetaminophen, chlorpheniramine, or pseudoephedrine.  Inform patient that she need to avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen, and can increase certain side effects of chlorpheniramine.  Explain to the patient that there’s a side effects that
  • 24. chest pain, shortness of breath, uneven heartbeats, seizure). Side Effect:  dizziness, drowsiness;  mild headache, blurred vision;  dry mouth, nose, or throat;  constipation;  feeling nervous;  sleep problems (insomnia); she may experience upon taking the medication such as blurred vision or impair your thinking or reactions.  If other unwanted effects not previously listed occur, consult a physician.
  • 25. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION S ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Ketorolac Tromethamine Brand Name Toradol Classification nonsteroidal anti- inflammatory agents, nonopioid analgesics Sub Classification pyrroziline carboxylic acid Dosage 30 mg Route Parenteral Frequency q8 Form Liquid ampule Color Clear  Inhibits prostaglandin synthesis, producing peripherally mediated analgesia.  Also has antipyretic and anti- inflammatory properties. Therapeutic Effects: Decreased pain.  Short-term manageme nt of pain (not to exceed 5 days total for all routes combined).  Contraindicated in:  Hypersensitivity  Cross-sensitivity with other NSAIDs may exist  Pre- or perioperative use  Known alcohol intolerance (injection only)  Perioperative pain from coronary artery bypass graft (CABG) surgery .  Use Cautiously in:  Cardiovascular disease or risk factors for cardiovascular disease (may ↑ risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, especially with prolonged Adverse Effects:  CNS: drowsiness, abnormal thinking, dizziness, euphoria, headache.  Respiratory: asthma, dyspnea.  CV: edema, pallor, vasodilation.  GI: GI bleeding, abnormal taste, diarrhea, dry mouth, dyspepsia, GI pain, nausea.  GU: oliguria, renal toxicity, urinary frequency.  Dermatologic: exfoliative dermatitis, Stevens Johnson Syndrome, toxic  Consider the 10 Golden Rights of administering medication Assessment Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria. Pain: Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration. Lab Test Considerations: Evaluate liver function tests, especially AST and ALT, periodically in patients receiving prolonged therapy. May cause ↑ levels. tell the patient that it may cause prolonged bleeding time that may persist for 24-48 hr following discontinuation of therapy. Inform the patient that it may cause ↑ BUN, serum creatinine, or
  • 26. use)  History of GI bleeding  Renal impairment (dosage reduction may be required) necrolysis pruritus, purpura, sweating, urticaria.  Hematology: prolonged bleeding time.  Local: injection site pain.  Neurology: paresthesia.  Misc: allergic reactions including, anaphylaxis Side Effects:  chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;  black, bloody, or tarry stools;  coughing up blood or vomit that looks like coffee grounds;  swelling or rapid weight potassium concentrations. . Implementation Do not confuse Toradol (ketorolac) with Torecan (thiethylperazine) or tramadol (Ultram). Administration in higher-than-recommended doses does not provide increased effectiveness but may cause increased side effects. Duration of ketorolac therapy, by all routes combined, should not exceed 5 days Use lowest effective dose for shortest period of time. Coadministration with opioid analgesics may have additive analgesic effects and may permit lower opioid doses. . PO: Ketorolac therapy should always be given initially by the IM or IV route. Use oral therapy only as a continuation of parenteral therapy.  injection, 0.9% NaCl. Patient/Family Teaching Instruct patient on how and when to ask for pain
  • 27. gain;  urinating less than usual or not at all;  nausea, stomach pain, low fever, loss of appetite, dark urine, clay- colored stools, jaundice (yellowing of the skin or eyes);  fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;  the first sign of any mouth sores or skin rash, no matter how mild;  pale skin, easy bruising, severe tingling, numbness, pain, muscle weakness; or  fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or medication. Instruct patient to take medication exactly as directed. Take missed doses as soon as remembered if not almost time for next dose. Do not double doses. Do not take more than prescribed or for longer than 5 days. May cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known. Caution patient to avoid the concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional. Advise patient to inform health care professional of medication regimen prior to
  • 28. seizure (convulsions). Less serious side effects may include:  upset stomach, mild nausea or vomiting, diarrhea, constipation;  mild heartburn, stomach pain, bloating, gas;  dizziness, headache, drowsiness;  sweating; or  ringing in your ears. treatment or surgery. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain) occurs. . Evaluation/Desire d Outcomes Decrease in severity of pain. Patients who do not respond to one NSAID may respond to another.
  • 29. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIO NS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Perindopril Brand Name Coversyl plus Classification Antihypertensive Sub Classification ACE Inhibitor Dosage 1 cap Route oral Frequency BID Form Tablet Color White  Antihypertensive . Pharmacology: Perindopril is an ACE-inhibitor that works by widening the blood vessels, which makes it easier for the heart to pump blood through them. Indapamide is a diuretic that causes an increase in the amount of urine produced. Each of the active ingredients of Coversyl Plus reduces blood pressure and work together to control blood pressure.  Treatment of essential hypertensio n  Allergy to perindopril or other ACE- inhibitors, or to indapamide or any other sulfonamides.  History or presence of wheezing, swelling of the face or tongue, intense itching or severe skin rashes with previous ACE- inhibitor treatment, or other circumstances (eg, angioedema). Severe liver diseases or if suffering from hepatic encephalopathy ; severe kidney disease, or on dialysis; low or high blood potassium; Adverse Effect:  CNS: dizziness, asthenia, sleep disorder, paresthesia, depression, somnolence,ner vousness, headache.  CV: palpitati ons, edema, chest pain, ab normal ECG.  EENT:rhinitis, sinusitis, ear infection, pharyngitis, tinnitus.  GI: dyspepsia, diarrhea, abdominalpain, nausea, vomi ting, flatulenc e.  GU: proteinur ia, urinarytrac t infection, m alesexual dysfunction, menstrual disorder.  Consider the 10 Golden Rights of administering medication  Assess patient’s condition.  Don’t let the patient to take this if she has an allergy to penidopril. And if she has a history of wheezing, swelling of the face or tongue, intense itching or severe skin rashes.  Explain to patient what was the medication for, and what are the side effects that she may encounter.  Instruct the patient to consult her doctor if she experiencing unwanted effect.
  • 30. untreated decompensated heart failure (severe water retention, difficulty in breathing); children.  Use in pregnancy & lactation: Cove rsyl Plus should not be used during the first 3 months of pregnancy and must not be taken from the 4th month of pregnancy. When pregnancy is planned or confirmed, the switch to an alternative treatment should be initiated as soon as possible. Do not take Coversyl Plus if breastfeeding.  Musculoskele tal: back pain, hyperonia, neck pain, joint pain, myalgia, arthritis, arm or leg pain  Respiratory: cough, upper respiratory infection  Skin: Rash  Other: viral infection, injury, seasonal allergy Side Effect:  Cough, often described as dry and irritating, shortness of breath, discomfort on exertion.  Headache, dizziness, vertigo, pins and needles.  Changes in the rhythm or rate of the heart beat, fast or irregular heart beat
  • 31.  Stroke, myocardial infarction, angina pectoris (a feeling of tightness, pressure or heaviness in the chest).  Feeling tired or lethargic.  Tinnitus (persistent noise in the ears), vision disturbances.  Hypotension, flushing, impaired peripheral circulation, nose bleeds.  Nausea, vomiting, taste disturbances, indigestion, diarrhoea, constipation or stomach pain.  Muscle cramps.  Rash, pruritus (itching).  Eosinophilic pneumonia.  Hepatitis.  Renal failure.  Bleeding or bruising more
  • 32. easily than normal caused by a low blood platelet count , frequent infections such as fever, severe chills, sore throat or mouth ulcers caused by a lack of white blood cells, pancytopenia (a rare type of anaemia).  Decreased blood sugar levels.  Fainting.