XIII.

DRUG STUDY
Generic Name Actual Dose, Classification Indication Mechanism of action Adverse Effects Nursing consideration
(Brand Name) Route,
Frequency,
Timing

 Monitor degree of
Fluticason Therapeutic:  Seasonal or  CNS: nasal stuffiness
Potent, locally acting
(Avamys) 2 sprays per Anti- perennial allergic Headache ,amount and color
anti-inflammatory and
nostril, OD , 8am inflammatory rhinitis.  EENT: of nasal discharge,
immune modifier.
(steroidal) epistaxis, nasal and frequency of
Date ordered: Therapeutic effects: burning, nasal sneezing.
02 / 16 / 18 Pharmacologic: decrease in symptoms irritation,  Patients on long-
corticosteroids of allergic and nasopharynge term therapy

nonallergic rhinitis al fungal should have

infection, periodic
pharyngitis. otolaryngologic
 Gi: Nausea, examinations to
vomiting monitor nasal
 Endo: Adrenal mucosa and
suppression passages for
 Derm: Rash, infection or

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 uticaria ulceration.
 Resp: Cough  Monitor growth rate
 Misc: in children
Anaphylaxis, receiving chronic
Angioedema therapy; use lowest
possible dose.
 Monitor for signs
and symptoms of
hypersensitivity
reactions (rash,
pruritis, swelling of
face and neck,
dyspnea)
periodically during
therapy.

 Assess patient
for symptoms of
 CNS: depression,
 Reduction of Inhibits platelet stroke ,peripheral
dizziness, fatigue, vascular disease,

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Clopidogrel 75 mg tab,OD Therapeutic: atherosclerotic aggregation by headache. or MIperiodi-
cally during
(Plavix) PO, 1pm Antiplatelet events (MI, stroke, irreversibly inhibiting  EENT: epistaxis.
therapy.
agents vascular death) in the binding of ATP to  Resp: cough,  Monitor patient
for signs of
patients at risk for platelet receptors. dyspnea,
thrombotic
Date ordered: Pharmacologic: such events Therapeutic Effects: eosinophilic thrombocytic
purpura (throm-
02 / 16 / 18 Platelet including recent MI Decreased pneumo- nia.
bocytopenia,
aggregation occurrence of  CV: chest pain, microangiopathic
hemolytic
inhibitors atherosclerotic events edema,
anemia,
in patients at risk. hypertension. neurologic
findings, renal
 GI: GI bleeding,
dysfunction,
abdominal pain, fever). May rarely
occur, even after
diar- rhea,
short exposure
dyspepsia, (􏰁2 wk).
Requires prompt
gastritis.
treatment.
 Derm: Drug rash  Lab Test
with eosinophilia Considerations:
Monitor bleeding
and systemic time during
symptoms, therapy. Pro-
longed bleeding
pruritus, purpura, time, which is
rash. time- and dose-
dependent, is
 Hemat: Bleeding, expected.
neutropenia,  Monitor CBC with
differential and

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 thromboctic platelet count
periodically
thrombocytopenic
during therapy.
purpura Neutropenia and
thrombocytopeni
 Metab:
a may rarely
hypercholesterole occur.
 May cause
mia.
serum bilirubin,
 MS: arthralgia, hepatic enzymes,
total cholesterol,
back pain.
nonprotein ni-
 Misc: fever, trogen (NPN),
and uric acid
hypersensitivity
concentrations.
reactions.

Therapeutic:  Perioperative  Assess for infection

The bactericidal  CNS: Seizures
Ceftriaxone 2gm IVTT, OD, Antibiotic Prophylaxis (vital signs;
activity of ceftriaxone (high doses).
(Rocephin) 6am Anti-Infectives appearance of
results from inhibition  GI:
wound ,sputum
of bacterial cell wall Pseudomembran
Pharmacologic: ,urine ,and stool;
synthesis. ous Colitis,
Date ordered: Cephalosporin WBC) at beginning
Ceftriaxone exerts in- diarrhea,
02 / 16 / 18 of and throughout
vitro activity against a cholelithia- sis,
therapy.

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wide range of gram- gallbladder  Before initiating
negative and gram- sludging. therapy, obtain a
positive  Derm: rashes, history to determine
microorganisms. urticaria. previous use of and
Ceftriaxone is highly  Hemat: bleeding, reactions to
stable to most ß- eosinophilia, penicillins or
lactamases, both hemolytic cephalosporins.
penicillinases and anemia, Persons with a
cephalosporinases, of leukopenia, negative history of
gram-positive and thrombocytosis. penicillin sensitivity
gram-negative  Local: pain at IM may still have an
bacteria. site, phlebitis at allergic response.
IV site.  Obtain specimens
 Misc: allergic for culture and
reactions sensitivity before
including initiating therapy.
Anaphylaxis, First dose may be
superinfection given before
receiving results.
 Observe patient for
signs and symptoms
of anaphylaxis (rash,

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 pruritus, laryngeal
edema, wheezing).
Discontinue the drug
and notify health
care professional
immediately if these
symptoms occur.
Keep epinephrine,
an antihistamine,
and resuscitation
equipment close by
in the event of an
anaphylactic
reaction.
 Monitor bowel
function. Diarrhea,
abdominal cramping,
fever, and bloody
stools should be
reported to health
care professional
promptly as a sign of

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pseudomembranous
colitis. May begin up
to several weeks
following cessation
of therapy.

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  Treatment of  Bronchospasm  Assess cough of
Exerts mucolytic action
Acetylcysteine 200 mg sachet Therapeutic: respiratory  Angioedema, patient
through its free
(Fluimucil) + ½ grams Mucolytic affections  Rashes
sulfhydryl group which
water, PO, TID characterized by  Nausea and  Assess
opens up the disulfide
thick and vomiting characteristics, rate,
bonds in the
Date ordered: viscous  Fever rhythm of
mucoproteins thus
01/ 09 /17 hypersecretions.  Syncope respirations
lowering mucous
 Sweating
viscosity. The exact
 Arthralgia
mechanism of action in  Provide adequate
 Blurred vision
acetaminophen toxicity hydration
 Disturbances of
is unknown. It is
liver function
thought to act by
providing substrate for
conjugation with the
toxic metabolites

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 Salbutamol  Bronchodilator  Dizziness  Monitor the patient’s
The ipratropium
Salbutamol + 1 neb q8hrs Therapeutic: for maintenance  Blurred vision vital signs, noting
ingredient is an
Ipatropium Bronchodilator therapy of  Nausea hypotension and an
anticholinergic drug
(Combivent) bronchospasm  Dry mouth irregular or
which relaxes smooth
Pharmacologic:  Dyspnea abnormal pulse.
muscle in the lung.
Date ordered: Adrenergics  Bronchospasm  Maintain a quiet,
01 / 10 / 17 The salbutamol  Hoarseness comfortable
Ipatropium ingredient is a beta-2  Palpitations environment to
Therapeutic: agonist which  Chest pain minimize anxiety
cold and cough stimulates beta-2 sites and perhaps
remedies, in the lungs to relax the decrease
bronchodilators bronchi. palpitations.
 Observe for
Pharmacologic: paradoxical
Anticholinergics bronchospasm
(wheezing)

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 Midazolam 20 mg, IVTT, Therapeutic:  Provides  Agitation  Assess level of
Acts at many
(Versed) q6hrs Antianxiety sedation/anxiolytics/amnesi  Drowsiness consciousness
levels of the
agents, sedative a during therapeutic,  Excess sedation throughout and for
CNS to produce
/ hypnotics diagnostic, or radiographic  Laryngospasm 2-6 hours following
generalized CNS
Date ordered: procedures (conscious  Respiratory administration
depression.
01 / 05 / 17 Pharmacologic: sedation). depression  Monitor blood
Effects may be
Benzodiazepines  Bronchospasm pressure, pulse and
mediated by
 As a continuous infusion,  Coughing respiratory during IV
GABA, an
provide sedation of  Cardiac arrest administration.
inhibitory
mechanically ventilated  Arrhythmias Oxygen and
neurotransmitter.
patients during anesthesia resuscitative
or in critical care setting. equipment should
be immediately
 For status epilepticus available.

Therapeutic:  Treatment for  Seizures  Assess for infection

Inhibit bacterial DNA
Levofloxacin 500 mg, IVTT, Anti-infective respiratory tract  Dizziness by monitoring vital
synthesis by inhibiting
(Levaquin) every other day infections  Headache signs and cloudy or
DNA gyrase
Pharmacologic: including  Agitation foul-smelling urine
Fluoroquinolones pneumonia  Drowsiness prior to and during

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Date ordered:  Arrhythmias therapy.
01 / 10 / 17  Diarrhea  Observe for signs
 Nausea and symptoms of
 Rash anaphylaxis.
 Hyperglycemia  Report if diarrhea
 Abdominal develops, especially
pain if stool contains
blood, pus or mucus

 Treatment of  Hypotension  Assess patient for

Binds to bacterial cell
Vancomycin 1 gram, IV, Therapeutic: potentially life-  Nausea infection by
wall, resulting in cell
(Vancocin) q6hours Anti-infective threatening  Vomiting monitoring vital sign
death.
infections when  Rashes and WBC at the
less toxic anti-  Phlebitis beginning of any
Date ordered: infective are  Anaphylaxis throughout the
01 / 08 / 17 contraindicated.  Fever therapy.
Particularly useful  Chills  Monitor blood
in staphylococcal  superinfection pressure throughout
infections such as IV infusion
pneumonia.  Monitor intake and
output ratios and

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 daily weight. Cloudy
or pink urine may be
a sign of
nephrotoxicity.

Therapeutic:  Treatment /  Restlessness  Assess for signs and

Maintain acid-base
Potassium Chloride 1 tab, PO, TID Mineral and prevention of  Weakness symptoms of
balance, isotonicity and
(KCL) electrolyte potassium  Arrhythmias hypokalemia (fatigue,
electrophysiologic balance
replacements / depletion.  Abdominal weakness,
of the cell. Activator in
supplements pain arrhythmias, polyuria,
many enzymatic reactions;
Date ordered:  Diarrhea and polydipsia) and
essential to transmission
01 / 10 / 17  Flatulence hyperkalemia.
of nerve impulses;
 Nausea  Monitor intake and
contraction of cardiac,
 Vomiting ouput.
skeletal, and smooth
 Paresthesia  Monitor pulse and
muscle; gastric secretion;
 paralysis blood pressure.
renal function; tissue
 Administer with or
synthesis; and
after meals to
carbohydrate metabolism.
decrease GI irritation.

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 Therapeutic:  Partial seizure  Dizziness  Assess location,
Appears to inhibit burst
Levetiracetam 500 mg tab, PO, Anticonvulsants adjunt (adjunct)  Fatigue duration and
firing without affecting
(Keppra) BID  Myoclonic  Somnolence characteristics of
normal neuronal
Pharmacologic: seizures in adults  Weakness seizure activity.
excitability and may
Pyrrolidines with myoclonic  Behavioral  Assess for CNS
selectively prevent
Date ordered: epilepsy (adjunct) abnormalities adverse effects
hypersynchronization of
01 / 09 / 17  Coordination throughout therapy.
epileptiform burst firing
difficulties  May be administered
and propagation of
without regard to
seizure activity.
meals.
 Seizure precaution

Therapeutic:  Treatment for  Ataxia  Monitor intake and

Inhibits protein
Amikacin 500 mg, IVTT, Anti-infectives serious gram-  Ototoxicity output and daily
synthesis in bacteria at
(amikin) q8hours negative bacillary  Nephrotoxicity weight to assess
level of 30S ribosome.
Pharmacologic: infections and  Hypo- hydration status and
Aminoglycosides infections caused magnesemia renal function.
Date ordered: by staphylococci  Muscle  Assess for infection
01 / 05 / 17 when penicillins paralysis at beginning of and
or other less toxic  Apnea throughout therapy.

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 drugs are  Assess for signs of
contraindicated. superinfections
(fever, upper
respiratory infection,
increasing malaise)

 Arrhythmias  Monitor blood

Essential for nervous,
Calcium Carbonate 1 tab, PO, TID Therapeutic:  Treatment and  Constipation pressure, and pulse.
muscular, and skeletal
(Tums) Mineral and prevention of  Calculi May cause
systems. Maintain cell
electrolyte hypocalcemia  Hypercalciuria vasodilation with
membrane and capillary
replacements /  May be used as  phlebitis resulting hypotension,
permeability. Act as an
Date ordered: supplements an antacid. bradycardia, and
activator in the
01 / 10 / 17 arrhythmias.
transmission of nerve
 Observe for
impulses and contraction
symptoms for
of cardiac, skeletal, and
hypocalcemia
smooth muscle. Essential
 Inspect abdomen and
for bone formation and
auscultate bowel
blood coagulation.
sounds

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 Therapeutic:  Prevention and  Seizures  Most effectively
As an essential mineral
Multivitamins + 1 tab, PO, OD Vitamins and treatment of iron-  Hypotension absorbed if
found in hemoglobin,
FeSO4 (Ferrous minerals, vitamin and  Tachycardia administered 1 or 2
myoglobin, and many
Sulfate) antianemics dietary deficiency  Dark stools hours before meal
enzymes. Enters the
(Mulvitron) anemias  Diarrhea  Observe proper
bloodstream and is
Pharmacologic:  Flushing dosage
transported to the
Water-soluble  Arthralgia  Assess bowel
organs of the
Date ordered: vitamins, iron  Myalgia function for
reticuloendothelial
01 / 09 / 17 supplements  Sweating constipation /
system (liver, spleen
diarrhea
bone marrow); where it
is separated out and
becomes part of iron
stores.

Therapeutic:  Management of  Edema  Assess for epigastric

Act as an alkalinizing
Sodium 1 tab, PO, TID Antiulcer agent metabolic  Metabolic or abdominal pain
agent by releasing
Bicarbonate acidosis alkalosis and frank or occult
bicarbonate ions.
Pharmacologic:  Antacid  Hypernatremia blood in the stool,
Following oral
Alkalinizing  Flatulence emesis, or gastric
administration, releases

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Date ordered: agents bicarbonate, which is  Hypocalcemia aspirate.
01 / 09 / 17 capable of neutralizing  Sodium and  Monitor intake and
gastric acid. water retention output, daily weight,
 Tetany edema and lung
sounds throughout
therapy.

Therapeutic:  Treatment for  Seizures  Obtain a history

Piperacilllin binds to
Piperacillin – 2.25 gram, IV, Anti-infectives community-  Confusion before initiating
bacterial cells wall
Tazobactam q6hours acquired and  Lethargy therapy to determine
membrane, causing cell
( Zosyn ) Pharmacologic: nosocomial  Diarrhea previous use of and
death. Spectrum is
Extended pneumonia  Drug- induced reactions to
extended compared
spectrum caused by hepatitis penicillins or
with other penicillins.
Date ordered: penicillins piperacillin-  Interstitial cephalosporins.
Tazobactam inhibits
01 / 10 / 17 resistant, beta- nephritis  Assess patient for
beta-lactamase, an
lactamase –  Urticarial infection by
enzyme that can
producing bleeding pain monitoring vital signs
destroy penicillins.
bacteria.  Phlebitis at Iv and WBC at
site beginning of and
during therapy.

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