West Visayas State University

COLLEGE OF NURSING
La Paz, Iloilo City

DRUG STUDY
Name of Patient:_________________
Age:____________

Generic:

Dosage, Route,
Frequency and
Timing
Dosage:

Paracetamol

40 mg

Name of Drug

Route:
Brand:

IV

Biogesic drops

Frequency:
Q4H for
Temp >37.8

Timing:

Mechanism of
Action
Inhibits the enzyme
cyclooxygenase,
blocking
prostaglandin
production and
interfering with pain
impulse generation
in the peripheral
nervous
system.Acetaminoph
en also acts directly
on temperatureregulating center in
the hypothalamus by
inhibiting synthesis
of prostaglandin E2.

Ward/Bed Number:________________
Indication
Temporary relief of pain and
discomfort from headache,
fever, cold, flu.

Adverse Reactions
Hematologic:
Hemolytic anemia,
leukopenia, neutropenia,
pancytopenia,
thrombocytopenia
Hepatic: liver damage,
jaundice
Metabolic: hypoglycemia

Attending Physician:________________
Impression/ Diagnosis:______________
Special
Precautions

Nursing Responsibilities

Use cautiously in
patients with long term
alcohol use because
therapeuticdoses cause
hepatotoxicity in these
patients

Independent
Monitor vital signs and assess
pain scale
Use liquid form for children and
patients who have difficulty
swallowing.
In children, dont exceed five doses
in 24 hours.
Advise patient that drug is only for
short term use and to consult the
physician if giving to children for
longer than 5 days or adults for
longer than 10 days.
Advise patient or caregiver that
many over the counter products
contain acetaminophen; be aware of
this when calculating total daily
dose.
Warn patient that high doses or
unsupervised long term use can
cause liver damage.
Teach patient to recognize signs of
hepatotoxicity,such as
bleeding,easy bruising, and
malaise, which commonly occurs
with chronic overdose.
Dependent
Administer medication as
prescribed by the physician

Collaborative
Monitor liver function test
results,including AST,ALT, bilirubin,
and creatinine levels, as ordered.
Monitor renal function in patient on
long term therapy. Keep in mind that
blood or albumin in urine may
indicate nephritis; decreased urine
output may indicate renal failure;
and dark brown urine may indicate
presence of the metabolite
phenacetin.

Classification
Functional:
Antipyretic,
nonopioid
analgesic

Contraindications
Contraindicated to patients
hypersensitivity to the drug.

Side Effects
GI: Abdominal pain,
hepatotoxicity, nausea,
vomiting
SKIN:Jaundice, rash,
urticaria Other:
Angioedema,
hypoglycemic coma

Chemical:
Nonsalicylate,
paraaminophenol
derivative

West Visayas State University

COLLEGE OF NURSING
La Paz, Iloilo City

DRUG STUDY
Name of Patient:_________________

Attending Physician:________________

Age:____________
Name of Drug
Generic:
Furosemide

Dosage, Route,
Frequency and
Timing
Dosage:
4 mg/ pr tab, 1 pr
tab

Route: PO
Brand:
Lasix

Frequency:
OD

Timing:

Ward/Bed Number:________________
Mechanism of
Action
Inhibits sodium and
water reabsorption in
the loop of Henle
and increases urine
formation.As the
bodys plasma
volume decreases,
aldosterone
production
increases, which
promotes sodium
reabsorption and the
loss of potassium
and hydrogen ions.
Furosemide also
increases the
excretion of calcium,
magnesium,
bicarbonate,
ammonium, and
phosphate. By
reducing intracellular
and extracellular
fluid volume, the
drug reduces blood
pressure and
decreases cardiac
output. Over time,
cardiac output
returns to normal.

Indication
To treat breathing
problems caused by
excess fluids in the
lungs due to heart
problems

Adverse Reactions
CNS: Fever, headache,
paresthesia, restlessness,
vertigo, weakness
CV: Orthostatic ,shock,
thromboembolism,
thrombophlebitis
EENT:Blurred vision,oral
irritation,ototoxicity,
stomatitis, tinnitus,
transient hearing loss
(rapid I.V. injection), yellow
vision
ENDO: Hyperglycemia GI:
Abdominal cramps,
anorexia, constipation,
diarrhea, gastric irritation,
hepatocellular
insufficiency, indigestion,
jaundice, pancreatitis,
GU:Bladder spasms,
glycosuria
HEME:Agranulocytosis
(rare),anemia, aplastic
anemia
(rare),azotemia,hemolytic
anemia, leukopenia,
thrombocytopenia MS:
Muscle spasms
SKIN:Bullous pemphigoid,
erythema multiforme,
exfoliative dermatitis,
photosensitivity, pruritus,
purpura, rash, urticaria
Other:Allergic reaction
(interstitial nephritis,
necrotizing vasculitis,
systemic vasculitis),
dehydration,
hyperuricemia,
hypochloremia,
hypokalemia,
hyponatremia,
hypovolemia

Impression/ Diagnosis:______________
Special
Precautions

Nursing Responsibilities

Use cautiously in
patients anuria,
hypokalemia or
hyponatremia.

Independent

Use furosemide
cautiously in patients
with advanced hepatic
cirrhosis, especially
those who also have a
history of electrolyte
imbalance or hepatic
encephalopathy; drug
may lead to lethal
hepatic coma.

Obtain patients weight before and

periodically during furosemide
therapy to monitor fluid loss.

May increase risk of

cardiac arrythmias if
mixed with cardiac
glycosides

Monitor vital signs especially blood

pressure

For once-a-day dosing, give drug in

the morning so patients sleep wont
be interrupted by increased need to
urinate.
Notify prescriber if patient
experiences hearing loss, vertigo, or
ringing, buzzing, or sense of fullness
in her ears. Drug may need to be
discontinued.

Has decreased GI
absorption effects with
charcoal

Advise patient to change position

slowly to minimize effects of
orthostatic hypotension and to take
furosemide with food or milk to
reduce GI distress.

Profound diuresis with

water and electrolyte
depletion can occur;
medical supervision is
required.

Emphasize the importance of

weight and diet control, especially
limiting sodium intake.

Be aware that
furosemide may worsen
left ventricular
hypertrophy and
adversely affect glucose
tolerance and lipid
metabolism.
Caution patient about
drinking alcoholic
beverages, standing for

Instruct patient to keep follow-up

appointments with prescriber to
monitor progress. Urge her to notify
prescriber about persistent, severe
nausea, vomiting, and diarrhea
because they may cause
dehydration.
Dependent
If patient is at high risk for
hypokalemia, give potassium
supplements along with furosemide,

prolonged periods, and

exercising in hot
weather because these
actions increase the
hypotensive effect of
furosemide.

as prescribed.
Discontinue furosemide at
maximum dosage if oliguria persists
for more than 24 hours.
Administer medications as
prescribed by the physician
Collaborative
Monitor blood pressure and hepatic
and renal function as well as
BUN,blood glucose, and serum
creatinine, electrolyte, and uric acid
levels, as appropriate.
Unless contraindicated,urge patient
to eat more high-potassium foods
and to take a potassium supplement,
if prescribed, to prevent
hypokalemia.

Classification
Functional:
Diuretics,
Antihypertensive

Chemical:
Sulfonamide

Contraindications
Anuria unresponsive to
furosemide;
Hypersensitivity to
furosemide, sulfonamides,
or their components

Side Effects
Nausea, rash, diarrhea,
abdominal pain,
hypotension, dizziness.

West Visayas State University

COLLEGE OF NURSING
La Paz, Iloilo City

DRUG STUDY
Name of Patient:_________________
Age:____________
Name of Drug
Generic:

Dosage, Route,
Frequency and
Timing
Dosage: 50
mcg/ml 0.4 ml

digoxin
Brand:

Route: PO

Lanoxin
Frequency: BID

Timing: 8 6

Mechanism of
Action
Increases the influx of
calcium ions, from
extracellular to
intracellular cytoplasm
by inhibition of sodium
and potassium ion
movement across the
myocardial
membranes; this
increase in calcium
ions results in a
potentiation of the
activity of the
contractile heart
muscle fibers and an
increase in the force of
myocardial contraction
(positive inotropic
effect); inhibits
adenosine
triphosphatase
(ATPase); decreases
conduction through the
S-A and A-V nodes

Ward/Bed Number:________________
Indication
To increase myocardial
contractility in pediatrics
with cardiac disease
specifically CHF

Adverse Reactions
CV: Accelerated junctional
rhythm, asystole, atrial or
nodal ectopic beats, atrial
tachycardia with or without AV block, A-V block, AV
dissociation, bigeminy, facial
edema, PR prolongation, S-A
block, sinus bradycardia, ST
segment depression,
trigeminy, ventricular
arrhythmias, ventricular
tachycardia or ventricular
fibrillation; first-, second(Wenckebach), or thirddegree heart block
CNS: Anxiety, apathy,
confusion, delirium,
depression, disorientation,
dizziness (6%), drowsiness,
fatigue, fever, hallucinations,
headache (4%), lethargy,
mental disturbances (5%),
vertigo
Dermatologic: Angioneurotic
edema, pruritus, rash
[erythematous,
maculopapular (most
common), papular,
scarlatiniform, vesicular, or

Attending Physician:________________
Impression/ Diagnosis:______________
Special
Precautions

Nursing Responsibilities

Use with caution and

reduce dosage in
patients with renal
impairment.

Independent

Use with caution in

patients with sinus nodal
disease (may worsen
condition).

Auscultate heart sounds to note

the presence of abnormal sounds

Withdrawal of digoxin in
patients with heart failure
may lead to recurrence of
heart failure symptoms
(monitor carefully).
Atrial arrhythmias
associated with
hypermetabolic states
are difficult to treat (use
with caution).
Use with extreme caution
in patients with hypoxia,
hypothyroidism, acute
myocarditis, electrolyte
disorders, acute MI.
Correct electrolyte
disturbances, especially
hypokalemia or
hypomagnesemia, prior
to use and throughout
therapy. Hypercalcemia
may increase the risk of

Monitor vital signs especially

pulse rate

Before giving each dose, take

patients apical pulse and notify
prescriber if its below 60
beats/minute (or other specified
level).
Monitor patient closely for signs
of digitalis toxicity, such as altered
mental status, arrhythmias,heart
block,nausea,vision disturbances,
and vomiting.
Stress importance of taking
digoxin exactly as prescribed.
Warn about possible toxicity from
taking too much and decreased
effectiveness from taking too little.
Instruct patient to take digoxin at
same time each day to help
increase compliance.
Emphasize need to use special
dropper supplied with elixir to
ensure accurate dose
measurement.

bullous], urticaria
Endocrine & metabolic:
Hyperkalemia with acute
toxicity
Neuromuscular & skeletal:
Neuralgia, weakness
GI: anorexia
Ocular: Blurred vision,
diplopia, flashing lights, halos,
photophobia, yellow or green
vision
Respiratory: Laryngeal
edema

digoxin toxicity; maintain

normocalcemia. Monitor
for proarrhythmic effects
(especially with toxicity);
monitor and adjust dose
to prevent
QTc prolongation.

Urge patient to notify prescriber if

she experiences adverse
reactions, such as GI distress or
pulse changes.
Advise patient to consult
prescriber before using other
drugs,including OTC products.
Avoid giving it with meals
Monitor I&O ratio,including
urinary and bowel elimination
Dependent
Administer drug as prescribed by
the physician
Frequently obtain ECG tracings
as ordered
Collaborative
Monitor patients serum
potassium level regularly because
hypokalemia predisposes to
digitalis toxicity and serious
arrhythmias.
Monitor ECG tracing
continuously.

Classification
Functional:
Antiarrhythmic,
cardiotonic
Chemical:
Cardiac
Glycoside

Contraindications
Hypersensitive carotid
sinus syndrome
Hypersensitivity to
digoxin, presence or
history of digitalis toxicity
or idiosyncratic reaction
to digoxin, ventricular
fibrillation, ventricular
tachycardia unless heart
failure occurs unrelated
to digoxin therapy

Side Effects
CNS: Confusion, depression,
drowsiness,headache,syncope
GI: Abdominal discomfort or
pain, diarrhea, nausea, vomiting
Other:Electrolyte imbalances

West Visayas State University

COLLEGE OF NURSING
La Paz, Iloilo City

DRUG STUDY
Name of Patient:_________________
Age:____________
Name of Drug
Generic:

Dosage, Route,
Frequency and
Timing
Dosage:
400 mg

piperacillin
tazobactam
Route: IV
Brand:
Zosyn

Frequency: Q8H

Timing:

Mechanism of
Action
Antibacterial
combination product
consisting of the
semisynthetic
piperacillin and the
beta-lactamase
inhibitor tazobactam.
Binds to specific
penicillin-binding
proteins and inhibits
the third and final
stage of bacterial cell
wall synthesis by
interfering with an
autolysin inhibitor.
Uninhibited autolytic
enzymes destroy the
cell wall and result in
cell lysis.

Ward/Bed Number:________________

Attending Physician:________________
Impression/ Diagnosis:______________

Indication

Adverse
Reactions

Special Precautions

To treat moderate to severe

nosocomial or communityacquired pneumonia
caused by piperacillinresistant

CNS: Dizziness,
hallucinations, lethargy,
seizures, stroke
CV: Cardiac arrest,
hypotension,
palpitations,
tachycardia,
vasodilation, vasovagal
reactions
EENT: Oral
candidiasis, pharyngitis
GI: Diarrhea, epigastric
distress, intestinal
necrosis,
pseudomembranous
colitis,
GU: Hematuria,
impotence, nephritis,
neurogenic bladder,
priapism, proteinuria,
renal failure, vaginal
candidiasis
HEME:
Agranulocytosis,
eosinophilia, hemolytic
anemia, leukopenia,
neutropenia,
pancytopenia,
prolonged bleeding
time, thrombocytopenia
MS: Arthralgia
RESP: Dyspnea,

Piperacillin and tazobactam

combination may cause
diarrhea, and in some
cases it can be severe. It
may occur 2 months or
more after you stop
receiving this medicine.
Serious skin reactions can
occur with this medicine.
Check with your doctor right
away if your child have
blistering, peeling, or
loosening of the skin, red
skin lesions, severe acne or
skin rash, sores or ulcers
on the skin, or fever or chills
while you are receiving this
medicine.
Safety and efficacy in
children <12 y are not
established.
Use cautiously to patients
with renal impairment.

Nursing Responsibilities
Independent
Monitor vital signs because of
cardiac arrhythmias,
hypertension
and fever as adversere actions.
Monitor patient carefully during
the first 30 min after initiation of
the infusion for signs of
hypersensitivity.
Obtain history of
hypersensitivity to penicillins,
cephalosphorins, or other
drugs prior to administration
Check for diarrhea during and
after therapy because it may
indicate pseudomembranous
colitis caused by Clostridium
difficile.
Monitor for hemorrhagic
manifestations because
high dose may induce
coagulation abnormalities.
Advise patients folks to consult
prescriber before using OTC
drugs during piperacillin therapy
because of the risk of
interactions.

pulmonary embolism,
pulmonary
hypertension
SKIN: Exfoliative
dermatitis, mottling,
rash, toxic epidermal
necrolysis, urticaria
Other:
Anaphylaxis;facial
edema;hypokalemia;
hyponatremia; injection
site pain, phlebitis, and
skin ulcer;
superinfection

Inform patient that increased

bruising may occur if she takes
anti-inflammatory drugs during
piperacillin therapy.
Advise patient to notify
prescriber about signs
ofsuperinfection,such as white
patches on tongue or in mouth.
Instruct patient to complete full
course of therapy, even if
symptoms subside.
Dependent
Administer drugs as prescribed
by the physician
Collaborative
Monitor serum potassium level
to detect hypokalemia from
urinary potassium loss.
Monitor CBC regularly, as
ordered, to detect hematologic
abnormalities, such as
leukopenia and neutropenia.

Classification
Functional:
Antiinfective;
beta-lactam
antibiotic

Chemical:
Extendedspectrum
penicillin, beta
lactamase inhibitor

Contraindications
Hypersensitivity to
piperacillin, tazobactam,
penicillins, cephalosporins,
or beta-lactamase inhibitors
such as clavulanic acid and
sulbactam.

Side Effects
CNS:Headache,
insomnia, fever.
GI:Diarrhea,
constipation, nausea,
vomiting, dyspepsia.

West Visayas State University

COLLEGE OF NURSING
La Paz, Iloilo City

DRUG STUDY
Name of Patient:_________________
Age:____________
Name of Drug
Generic:
amikacin
sulfate

Dosage, Route,
Frequency and
Timing
Dosage:
60 mg
Route: IV

Brand:
Cinmik

Frequency:
Q24H

Timing: 8

Mechanism of
Action
Binds to negatively
charged sites on
bacterias outer cell
membrane,disrupting
cell integrity.Also binds
to bacterial ribosomal
subunits and inhibits
protein synthesis. Both
actions lead to cell
death

Ward/Bed Number:________________

Attending Physician:________________
Impression/ Diagnosis:______________

Indication

Adverse
Reactions

Special Precautions

To treat serious gram-negative

bacterial infections caused by
Acinetobacter, Enterobacter,
Escherichia coli, Klebsiella,
Proteus,Providencia,Pseudom
onas, and Serratia; and
staphylococcal infec
tions when penicillin is
contraindicated.

CNS:Drowsiness, loss
of balance,
neuromuscular
blockade,tremor,vertigo
EENT:Hearing loss,
ototoxicity, tinnitus
GU: Azotemia, dysuria,
nephrotoxicity, oliguria
or polyuria, proteinuria
MS:Acute muscle
paralysis; arthralgia;
muscle fatigue,
spasms, and weakness
RESP:Apnea
Other:Hyperkalemia

This medicine may cause

nerve problems. Check
right away if your child have
numbness, skin tingling,
muscle twitching, or
seizures.
Patients treated with
parenteral aminoglycosides
should be under close
clinical observation
because of the potential
ototoxicity and
nephrotoxicity associated
with their use.

Nursing Responsibilities
Independent
Monitor vital signs to obtain
baseline data
Expect to obtain results of
culture and sensitivity testing
before therapy begins.
Watch for signs of ototoxicity,
such as tinnitus and vertigo,
especially during highdosage or
prolonged amikacin therapy.
Tell patient that daily laboratory
tests are necessary during
treatment.
Instruct patient to report ringing
in ears, hearing changes,
headache, nausea, vomiting,
and changes in urination.
Weight patient and review renal
function before therapy begins
Evaluate patients hearing
before and during therapy if he
will be receiving drug for longer
than 2 weeks.
Watch for signs
and symptoms of super infection
(especially URT),such as

continued fever, chills,

andincreased pulse rate.
Dependent
Administer drugs as prescribed
by the physician
Correct dehydration before
therapy because of increase risk
of toxicity.
Collaborative
Monitor serum creatinine or
creatinine clearance (generally
preferred) more often, in the
presence of impaired renal
function, in neonates
Monitor peak and trough
amikacin blood levels

Classification
Functional:
Antibiotic

Contraindications
Hypersensitivity to
aminoglycoside
antibiotics, pregnancy
and breast-feeding.

Side Effects
Skin rash,drug fever,
headache,paresthesia,
tremor, nausea
and vomiting, anemia,
and hypotension

Chemical:
Aminoglycoside

West Visayas State University

COLLEGE OF NURSING
La Paz, Iloilo City

DRUG STUDY
Name of Patient:_________________
Age:____________
Name of Drug
Generic:

Dosage, Route,
Frequency and
Timing
Dosage: 1
nebule

albuterol
(salbutamol)
Brand:

Route:
Pulmonary
Inhalation

Ventolin
Frequency:
Q6H

Timing: 8 2 8

Mechanism of
Action
Albuterol attaches to
beta 2 receptors on
bronchial cell
membranes, which
stimulates the
intracellular enzyme
adenylate cyclase to
convert adenosine
triphosphate (ATP) to
cyclic adenosine
monophosphate
(cAMP). This reaction
decreases intracellular
calcium levels. It also
increases intracellular
levels of cAMP, as
shown. Together, these
effects relax bronchial
smooth-muscle cells
and inhibit histamine
release.

Ward/Bed Number:________________
Indication

Adverse
Reactions

Used as a bronchodilator to
control and prevent
reversible airway
obstruction caused by
Pneumonia

CNS: Anxiety,
dizziness, drowsiness,
headache,
hyperkinesia, insomnia,
irritability, vertigo,
weakness CV: Angina;
arrhythmias, including
atrial fibrillation,
extrasystoles,
supraventricular
tachycardia,and
tachycardia;chest pain;
hypertension;
hypotension;
palpitations EENT:
Altered taste,dry mouth
and throat, ear pain,
glossitis, hoarseness,
oropharyngeal edema,
pharyngitis, rhinitis,
taste perversion
ENDO:Hyperglycemia
GI:Anorexia, diarrhea,
dysphagia, heartburn,
nausea, vomiting
GU:UTI MS: Muscle
cramps RESP:
Bronchospasm, cough,
dyspnea, paradoxical
bronchospasm,pulmon
ary edema SKIN:
Diaphoresis, flushing,
pallor, pruritus, rash,
urticaria Other:
Angioedema,
hypokalemia, infection,
metabolic acidosis

Attending Physician:________________
Impression/ Diagnosis:______________
Special Precautions

Nursing Responsibilities
Independent

Use cautiously in patients

with cardiac disorders,
diabetes mellitus, digitalis
intoxication, hypertension,
hyperthyroidism, or history
of seizures.Albuterol can
worsen these conditions.

Thyrotoxicosis. Inhaled
salbutamol prep are not
appropriatefor managing
premature labour.

Children less than 2 years

of age because safety of
its use has not been
established
Excess inhaler use which
may lead to tolerance
and paradoxical
bronchospasm

Assess lung sounds, pulse and

blood pressure before
administration and during peak
of medication.
Observe for paradoxical
bronchospasm (wheezing). If
condition occurs, with hold
medication and notify physician.
Instruct mother to take missed
dose as soon as
remembered, spacing remaining
doses at regular intervals.
Inform the mother not to smoke
near the child & to avoid
respiratory irritants
Advise the mother to rinse the
childs mouth w/ water after
each inhalation dose to
minimize dry mouth
Advise patient to wait at least 1
minute between inhalations.
Instruct patient to wash
mouthpiece with water once a
week and let it air-dry.
Be aware that drug tolerance
can develop with prolonged use.
Dependent

Administer drug as prescribed

by the physician
Collaborative
Monitor serum potassium level
because albuterol may cause
transient hypokalemia
Monitor pulmonary function tests
before initiating therapy
&periodically throughout course
to determine effectiveness
of medication

Classification

Contraindications

Functional:
Bronchodilator

Contraindicated with
hypersensitivity to albuterol;
tachyarrhythmias,tachycardia
cause by digitalis intoxication.

Nervousness

Restlessness

Chemical:
Selective beta2adrenergic
agonist,
sympathomimeti
c

Side Effects

Hypersensitivity to adrenergic
amines

Hypersensitivity to
fluorocarbons

Tremor

Chest pain

Palpitations