CONTRAINDIC

DRUG MECHANISM INDICATION ATION ADVERS NURSING RESPONSIBILITIES

NAME OF ACTION EFFECTS
Relief of Acute intermittent Assessment
Carisoprodol blocks discomfort porphyria,
-Dizziness,  History: Allergic or idiosyncratic reactions to
Generic hypersensitivity.
interneuronal associated with drowsiness, nausea, carisoprodol, meprobamate; acute intermittent
Name: acute, painful
Lactation. porphyria, suspected porphyria; lactation
synaptic activity in epigastric distress,
 Physical: T; skin color, lesions; orientation, affect;
carisoprodol the descending musculoskeletal tachycardia,
P, BP, orthostatic BP; bowel sounds, liver
conditions as an orthostatic
(isomeproba reticular formation evaluation; LFTs, renal function tests, CBC
adjunct to rest, hypotension,
mate) and spinal cord Interventions
Hypersensitivity.  WARNING: Monitor patient for potentially serious
resulting in skeletal physical therapy, -reactions, rash.
and other idiosyncratic reactions—most likely with first few
muscle relaxation. Potentially Fatal: doses.
Brand Duration: 4-6 hrs. measures Idiosyncratic reaction  Reduce dose with hepatic impairment.
Name: Absorption: Absorbed (rare).  Provide safety measures if CNS effects occur.
from the GIT (oral);  Drug may be habit forming. Monitor patient.
Soma peak plasma Teaching points
 Take this drug exactly as prescribed; do not take a
Classificatio concentrations after higher dosage; take with food if GI upset occurs.
n: 30 min.  Avoid alcohol, sleep-inducing, or over-the-counter
Distribution: Enters drugs; these could cause dangerous effects; if you
Centrally breast milk feel you need one of these preparations, consult your
health care provider.
acting (significant  You may experience these side effects: Drowsiness,
skeletal amounts). dizziness, vertigo (avoid driving or activities that
muscle Metabolism: require alertness); dizziness when you get up or
relaxant Hepatic; yields climb stairs (avoid sudden changes in position, use
caution climbing stairs); nausea (take drug with
meprobamate. food; eat frequent small meals); insomnia, headache,
Excretion: Via urine depression (transient effects).
Dosage:
(as metabolites  Report rash, severe nausea, dizziness, insomnia,
350 mg fever, difficulty breathing.

Route:
Oral
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERS EFFECTS NURSING RESPONSIBILITIES
ACTION
 Precise  Relief of discomfort  Contraindicated  Antimuscarinic effects, Assessment
mechanism associated with with neurological adverse  History: Hypersensitivity to cyclobenzaprine,
Generic Name: not known; acute, painful hypersensitivity to effects, GI disorders, acute recovery phase of MI, arrhythmias, CHF,
cyclobenzaprine does not musculoskeletal cyclobenzaprine, orthostatic hyperthyroidism, urinary retention, angle-
directly relax conditions, as acute recovery hypotension, closure glaucoma, increased IOP, lactation
hydrochloride tense skeletal adjunct to rest, phase of MI, tachycardia,  Physical: Orientation, affect, ophthalmic
muscles but physical therapy arrhythmias, heart hypersensitivity examination (tonometry); bowel sounds, normal
appears to act  Unlabeled block or conduction reactions. Rarely, GI output; prostate palpation, normal voiding
Brand Name: mainly at use: Adjunct in the disturbances, CHF, cholestatic jaundice pattern; thyroid function tests
brain stem management of hyperthyroidism. and blood disorders. Interventions
Apo-Cyclobenzaprine levels or in fibrositis syndrome Endocrine effects,  Arrange for analgesics if headache occurs.
(CAN), Flexeril, Novo- the spinal . sexual dysfunction, Teaching points
Cycloprine (CAN) cord. changes in blood sugar.  Take this drug exactly as prescribed. Do not
Increased appetite with take a higher dosage.
wt gain, sweating.  Avoid alcohol, sleep-inducing, or over-the-
Classification: - counter drugs; these may cause dangerous
effects.
Skeletal muscle  You may experience these side effects:
relaxant (centrally Drowsiness, dizziness, blurred vision (avoid
acting) driving or engaging in activities that require
alertness); dyspepsia (take drug with food; eat
frequent small meals); dry mouth (suck
sugarless lozenges or ice chips).
Dosage:
 Report urinary retention or difficulty voiding,
5 mg pale stools, yellow skin or eyes

Route:
po
 CONTRAINDI
DRUG NAME MECHANISM INDICATION CATION ADVERS EFFECTS NURSING RESPONSIBILITIES
OF ACTION
Esophageal ulceration, nausea, Assessment
Tetracycline exhibits Systemic administration Hypersensitivity; vomiting, oral candidiasis, History: Systemic administration and dermatologic solutions:
Generic Name: its bacteriostatic Infections caused by rickettsiae; pregnancy, diarrhea, epigastric burning, Allergy to any of the tetracyclines; hepatic or renal impairment,
tetracycline action by reversible Mycoplasma pneumoniae; agents lactation, children; sore throat, black hairy tongue, pregnancy, lactation.
binding to the 30s of psittacosis, ornithosis, renal impairment. pancreatitis, oncholysis, Physical: Systemic administration, topical dermatologic solutions:
hydrochloride
subunits of the lymphogranuloma venereum and discoloration of tooth (children Site of infection, skin color, lesions; R, adventitious sounds; bowel
ribosome thus with developing teeth) and sounds, output, liver evaluation; urinalysis, BUN, LFTs, renal
granuloma inguinale; Borrelia
preventing protein nails, tinnitus, visual function tests. Dermatologic ointment: Site of infection.
Brand Name: synthesis and
recurrentis, Haemophilus ducreyi, disturbances, superinfections, Interventions
arresting cell Yersinia pestis, Yersinia tularensis, photosensitivity, Administer oral medication on an empty stomach, 1 hr before or
: Apo-Tetra Bartonella bacilliformis,
growth. It has a hypersensitivity, 2–3 hr after meals. Do not give with antacids. If antacids must be
(CAN), Nu-Tetra
broad spectrum of Bacteroides, Vibrio cholerae, Potentially Fatal: Anaphylaxis, used, give them 3 hr after the dose of tetracycline.
(CAN), Sumycin antimicrobial activity Campylobacter fetus, Brucella, hepatotoxicity, nephrotoxicity, Culture infection before beginning drug therapy; many resistant
Classification: including Escherichia coli, Enterobacter blood dyscrasias. strains have been identified.
Chlamydiaceae, aerogenes, Shigella, Acinetobacter Do not administer during pregnancy; drug is toxic to the fetus.
Antibiotic, Tetracy Mycoplasma spp., WARNING: Do not use outdated drugs; degraded drug is highly
calcoaceticus, Haemophilus
cline Rickettsia spp., nephrotoxic and should not be used.
spirochetes, many
influenzae, Klebsiella, trachoma Arrange for regular renal function tests with long-term therapy.
aerobic and When penicillin is contraindicated, Teaching points
Dosage: anaerobic Gram- infections caused by Neisseria Take the drug throughout the day for best results. The drug should
positive and Gram- gonorrhoeae, Treponema be taken on an empty stomach, 1 hour before or 2–3 hours after
Available forms :
Capsules—250,
negative pathogenic pallidum, Treponema pertenue, meals, with a full glass of water. Do not take the drug with food,
bacteria, and some Listeria monocytogenes, dairy products, iron preparations, or antacids.
500 mg;
protozoa. Clostridium, Bacillus anthracis, Finish your complete prescription; if any is left, discard it
suspension—125
immediately. Never take an outdated tetracycline product.
mg/5 mL Fusobacterium fusiforme,
There have been reports of pregnancy occurring when taking
Actinomyces tetracycline with hormonal contraceptives. To be certain of
Adjunct to amebicides in acute avoiding pregnancy, use an additional type of contraceptive.
Route:
intestinal amebiasis This drug should not be used during pregnancy; using barrier
Oral Uncomplicated urethral, contraceptives is advised.
endocervical or rectal infections in You may experience these side effects: Stomach upset, nausea
adults caused by Chlamydia (reversible); superinfections in the mouth, vagina (frequent
trachomatis washing may help this problem; if severe, request medication);
sensitivity of the skin to sunlight (use protective clothing and a
Adjunctive therapy for severe acne
sunscreen).
Report severe cramps, watery diarrhea, rash or itching, difficulty
breathing, dark urine or light-colored stools, yellowing of the skin
or eyes.
 DRUG NAME MECHANISM OF ACTION INDICATION CONTRAINDICATION ADVERS NURSING RESPONSIBILITIES
EFFECTS

Generic Name: Tramadol acts as a μ-opioid -Relief of - Hypersensitivity to Skin: 1) Determine patient’s past or present history of
Tramadol receptor agonist, serotonin moderate to the drug Sweating addiction to or dependence on opoids.
releasing moderately -Dry mouth
agent, norepinephrine severe pain. -Raised intracranial 2) Instruct patient to increase fluid intake to prevent dry
Brand Name: reuptake inhibitor, NMDA pressure CNS: mouth and constipation.
Ultram receptor antagonist 5-HT2C Dizziness
receptor - -Severe renal Fatigue 3) For better analgesic effect, give drugs before onset of
Classification: antagonist, impairment GI: intense pain.
- Opioid analgesic (α7)5 nicotinic acetylcholine -Constipation
receptor antagonist 4) Reassess level of pain at least 30 minutes after
Dosage: TRPV1 receptor agonist, administration.
50 mg and M1 and M3 muscarinic
acetylcholine receptor 5) Monitor CV and respiratory status. Withhold dose and
Route: antagonist. notify prescriber if respirations decrease or rate is below
Intravenous 12 breaths/minute.
 DRUG NAME MECHANISM OF INDICATION CONTRAINDIC ADVERS EFFECTS NURSING RESPONSIBILITIES
ACTION ATION

Generic Name: Metronidazole is Acute infection with History of GI disturbances e.g. Assessment
converted to reduction susceptible anaerobic hypersensitivit nausea, unpleasant History: CNS or hepatic disease; candidiasis
metronidazole
products that interact bacteria y to metallic taste, vomiting, (moniliasis); blood dyscrasias; pregnancy; lactation
with DNA to cause Acute intestinal metronidazole diarrhoea or Physical: Reflexes, affect; skin lesions, color (with
Brand Name:: destruction of helical amebiasis or other constipation. Furred topical application); abdominal examination, liver
Apo- DNA structure and Amebic liver abscess nitroimidazole tongue, glossitis, and palpation; urinalysis, CBC, LFTs
Metronidazole strand leading to a Trichomoniasis (acute derivatives. stomatitis due to Interventions
(CAN), Flagyl, protein synthesis and partners of patients Pregnancy (1st overgrowth of Candida. BLACK BOX WARNING: Avoid use unless necessary.
Flagyl 375, Flagyl inhibition and cell death with acute infection) trimester) and Rarely, antibiotic- Metronidazole may be carcinogenic.
in susceptible Preoperative, lactation. associated colitis. Administer oral doses with food.
ER, Flagyl IV,
organisms. It is effective intraoperative, Weakness, dizziness, Apply topically (MetroGel) after cleansing the area.
MetroGel, against a wide range of postoperative ataxia, headache, Advise patient that cosmetics may be used over the
MetroGel- organisms including E. prophylaxis for patients drowsiness, insomnia, area after application.
Vaginal, NidaGel histolytica, T. vaginalis, undergoing colorectal changes in mood or Reduce dosage in hepatic disease.
(CAN), Noritate, Giardia, anaerobes e.g. surgery mental state. Teaching points
Protostat Bacterioides sp, Topical application: Numbness or tingling in Take full course of drug therapy; take the drug with
Fusobacterium sp, Treatment of the extremities, food if GI upset occurs.
Clostridium sp, inflammatory papules, epileptiform seizures Do not drink alcohol (beverages or preparations
Classification:
Peptococcus sp and pustules, and erythema (high doses or containing alcohol, cough syrups); severe reactions
Classification: Peptostreptococcus sp, of rosacea prolonged treatment). may occur.
Antibiotic, and moderately active Unlabeled uses: Transient leucopenia Your urine may be a darker color than usual; this is
Antibacterial, against Gardnerella sp Prophylaxis for patients and thrombocytopenia. expected.
Amebicide, and Campylobacter sp. undergoing gynecologic, Hypersensitivity Refrain from sexual intercourse during treatment for
Antiprotozoal abdominal surgery; reactions. Urethral trichomoniasis, unless partner wears a condom.
hepatic encephalopathy; discomfort and Apply the topical preparation by cleansing the area
Dosage: Crohn’s disease; darkening of urine. and then rubbing a thin film into the affected area.
antibiotic-associated Raised liver enzyme Avoid contact with the eyes. Cosmetics may be
mg pseudomembranous values, cholestatic applied to the area after application.
colitis; treatment of hepatitis, jaundice. You may experience these side effects: Dry mouth
Route: Gardnerella vaginalis, Thrombophlebitis (IV). with strange metallic taste (frequent mouth care,
giardiasis (use Potentially Fatal: sucking sugarless candies may help); nausea,
recommended by the Anaphylaxis. vomiting, diarrhea (eat frequent small meals).
CDC) Report severe GI upset, dizziness, unusual fatigue or
weakness, fever, chills.