B.

DRUG STUDY

DRUG CLASSIFI INDICATI CONTRAINDICAT SIDE EFFECT NURSING

NAME CATION ON ION CONSIDERATION
MEFENA CENTRAL Short-term Hypersensitivity to CNS: Drowsiness, insomnia,  Assess patients
MIC ACID NERVOU relief of drug; GI dizziness, nervousness, confusion, who develop
500 mg S mild to inflammation, or headache. GI: Severe severe diarrhea
TAB SYSTEM moderate ulceration. Safety in diarrhea, ulceration, and vomiting for
AGENT; pain children <14 y, and bleeding; nausea, dehydration and
ANALGES including during pregnancy vomiting, abdominal cramps, electrolyte
IC; primary (category C), or flatus, constipation, hepatic imbalance.
NSAID; dysmenorrh lactation is not toxicity. Hematologic: Prolonged  Lab tests: With
ANTIPYR ea. established. prothrombin time, severe long-term therapy
ETIC autoimmune hemolytic anemia (not
(long-term use), leukopenia, recommended)
eosinophilia, agranulocytosis, obtain periodic
thrombocytopenic purpura, complete blood
megaloblastic anemia, counts, Hct and
pancytopenia, bone marrow Hgb, and kidney
hypoplasia. Urogenital: Nephroto function tests.
xicity, dysuria, albuminuria, Discontinue drug
hematuria, elevation of promptly if
BUN. Skin: Urticaria, rash, facial diarrhea, dark
edema. Special Senses: Eye stools,
irritation, loss of color vision hematemesis,
(reversible), blurred vision, ear ecchymoses,
pain. Body as a epistaxis, or rash
Whole: Perspiration. CV: Palpitati occur and do not
on. Respiratory: Dyspnea; acute use again.
exacerbation of asthma; Contact
bronchoconstriction (in patients physician.
sensitive to aspirin).  Notify physician
if persistent GI
discomfort, sore
throat, fever, or
B. DRUG STUDY

malaise occur.
 Do not drive or
engage in
potentially
hazardous
activities until
response to drug
is known. It may
cause dizziness
and drowsiness.
 Monitor blood
glucose for loss
of glycemic
control if
diabetic.
 Do not breast
feed while taking
this drug without
consulting
physician.
B. DRUG STUDY

DRUG CLASSIFICAT INDICATI CONTRAINDIC SIDE EFFECT NURSING CONSIDERATION

NAME ION ON ATION
PHENOBA CENTRAL Long-term Sensitivity to Body as a Whole: Myalgia,  Observe patients receiving
RBITAL 90 NERVOUS manageme barbiturates; neuralgia, CNS depression, large doses closely for at least
mg tab OD SYSTEM nt of tonic- manifest hepatic coma, and 30 min to ensure that sedation
AGENT; clonic or familial death. CNS: Somnolence, ni is not excessive.
ANTICONVUL (grand mal) history of ghtmares, insomnia,  Keep patient under constant
SANT; seizures porphyria; severe "hangover," headache, observation when drug is
SEDATIVE- and partial respiratory or anxiety, thinking administered IV, and record
HYPNOTIC; seizures; kidney disease; abnormalities, dizziness, vital signs at least every hour
BARBITURAT status history of nystagmus, irritability, or more often if indicated.
E epilepticus, previous paradoxic excitement and  Lab tests: Obtain liver function
eclampsia, addiction to exacerbation of hyperkinetic and hematology tests and
febrile sedative behavior (in children); determinations of serum folate
convulsion hypnotics; confusion or depression or and vitamin D levels during
s in young uncontrolled marked excitement (older prolonged therapy.
children. pain; pregnancy adult or debilitated  Monitor serum drug levels.
Also used (particularly patients); Serum concentrations >50
as a early pregnancy) ataxia. CV: Bradycardia, mcg/mL may cause coma.
sedative in (category D), syncope, Therapeutic serum
anxiety or lactation; hypotension. GI: Nausea, concentrations of 15–40
tension sustained release vomiting, constipation, mcg/mL produce
states; in formulation for diarrhea, epigastric pain, anticonvulsant activity in most
pediatrics children <12 y of liver patients. These values are
as age. damage. Hematologic: Meg usually attained after 2 or 3 wk
preoperativ aloblastic of therapy with a dose of 100–
e and anemia, agranulocytosis, 200 mg/d.
postoperati thrombocytopenia. Metabol  Expect barbiturates to produce
ve sedation ic: Hypocalcemia, restlessness when given to
and to treat osteomalacia, patients in pain because these
pylorospas rickets. Musculoskeletal: F drugs do not have analgesic
B. DRUG STUDY
m in olic acid deficiency, vitamin
infants. D 
deficiency. Respiratory: Re
spiratory
depression. Skin: Mild
maculopapular,
morbilliform rash; erythema
multiforme, Stevens-
Johnson syndrome,
exfoliative dermatitis (rare).
Patient & Family Education
action.
Be prepared for paradoxical
responses and report promptly
in older adult or debilitated
patient and children [i.e.,
irritability, marked excitement
(inappropriate tearfulness and
aggression in children),
depression, and confusion].
 Monitor for drug interactions.
Barbiturates increase the
metabolism of many drugs,
leading to decreased
pharmacologic effects of those
drugs. Whenever a barbiturate
is added to an established
regimen of another drug,
observe for changes in
effectiveness of the first drug
at least during early phase of
barbiturate use.
 Monitor for and report chronic
toxicity symptoms (e.g.,
ataxia, slurred speech,
irritability, poor judgment,
slight dysarthria, nystagmus on
vertical gaze, confusion,
insomnia, somatic complaints).
 Be aware that anticonvulsant
therapy may cause drowsiness
B. DRUG STUDY

during first few weeks of

treatment, but this usually
diminishes with continued use.
 Avoid potentially hazardous
activities requiring mental
alertness until response to drug
is known.
 Do not consume alcohol in any
amount when taking a
barbiturate; it may severely
impair judgment and abilities.
 Increase vitamin D-fortified
foods (e.g., milk products)
because drug increases vitamin
D metabolism. A vitamin D
supplement may be prescribed.
 Maintain adequate dietary
folate intake: fresh vegetables
(especially green leafy), fresh
fruits, whole grains, liver.
Long-term therapy may result
in nutritional folate (B9)
deficiency. A supplement of
folic acid may be prescribed.
 Adhere to drug regimen (i.e.,
do not change intervals
between doses or increase or
decrease doses) without
contacting physician.
 Do not stop taking drug
abruptly because of danger of
withdrawal symptoms (8–12 h
B. DRUG STUDY

after last dose), which can be

fatal.
 Report to physician the onset
of fever, sore throat or mouth,
malaise, easy bruising or
bleeding, petechiae, jaundice,
rash when on prolonged
therapy.
 Avoid pregnancy when
receiving barbiturates. Use or
add barrier device to hormonal
contraceptive when taking
prolonged therapy.
 Do not breast feed while
taking this drug.

DRUG CLASSIFI INDICATIO CONTRAINDIC SIDE EFFECT NURSING CONSIDERATION

NAME CATION N ATION
Antipasmo Muscle Lactation Shock, anaphylaxis reactions Weakness, light-headedness,sleepiness or
Eperisone dic, spasms. (e.g. redness, itching, othersymptoms mayoccur. In the eventof
50 mg skeletal urticaria, oedema, dypnoea), such symptoms,the dosage shouldbe
muscle Stevens-Johnson syndrome reduced ortreatmentdiscontinued.
TAB BID
relaxant and toxic epidermal  
necrolysis. Patients should becautioned
Blood and lymphatic system againstengaging inpotentiallyhazardous
disorders: Anaemia. activitiesrequiring alertness,such as
Cardiac disorders: operatingmachinery ordriving a car
Palpitations.
B. DRUG STUDY

Gastrointestinal disorders:
Nausea, vomiting, stomach
discomfort, abdominal pain,
diarrhoea, constipation,
stomatitis, feeling of
enlarged abdomen.
General disorders and admin
site conditions: Weakness,
fatigue, diaphoresis.
Hepatobiliary disorders:
Hiccup.
Investigations: Elevated
BUN.
Metabolism and nutrition
disorders: Anorexia, thirst.
Musculoskeletal and
connective tissue disorders:
Stiffness, muscle hypotonia.
Nervous system disorders:
Headache, numbness of
extremities, tremor, light-
headedness, dizziness.
Psychiatric disorders:
Sleepiness, insomnia.
Renal and urinary disorders:
Proteinuria, urinary
retention, urinary
incontinence.
Skin and subcutaneous tissue
disorders: Rash, pruritus,
erythema exudative
multiforme.
Vascular disorders: Hot
B. DRUG STUDY

flushes.
B. DRUG STUDY

DRUG CLASSIFI INDICATI CONTRAINDICAT SIDE EFFECT NURSING

NAME CATION ON ION CONSIDERATION
CELECOX CENTRAL Relief of Severe hepatic Body as a Whole: Back pain, Assessment & Drug
IB 200mg NERVOU S&S of impairment; peripheral edema. Increased risk of Effects
cap BID for S osteoarthriti hypersensitivity to cardiovascular  Therapeutic
3 days SYSTEM s and celecoxib; asthmatic events. GI: Abdominal pain, effectiveness is
AGENT, rheumatoid patients with aspirin diarrhea, dyspepsia, flatulence, indicated by
ANALGES arthritis. triad; advanced renal nausea. CNS: Dizziness, headache, relief of joint
IC, Treatment disease; concurrent insomnia. Respiratory:Pharyngitis, pain.
NSAID, of acute use of diuretics and rhinitis, sinusitis, URI. Skin: Rash.  Lab tests:
CYCLOO pain and ACE inhibitors; Periodically
XYGENA primary anemia; pregnancy monitor Hct and
SE-2 dysmenorrh (category D) in third Hgb, liver
INHIBITO ea. trimester; lactation. functions, BUN
R, Reduction and creatinine,
ANTIPYR of polyp and serum
ETIC formation in electrolytes.
familial  Monitor closely
adenomatou lithium levels
s polyposis when the two
(FAP), drugs are given
ankylosing concurrently.
spondylitis  Monitor closely
PT/INR when
used concurrently
with warfarin.
 Monitor for fluid
retention and
edema especially
in those with a
history of
hypertension or
CHF.
B. DRUG STUDY

Patient & Family

Education
 Avoid using
celecoxib during
the third trimester
of pregnancy.
 Promptly report
any of the
following:
unexplained
weight gain,
edema, skin rash.
 Stop taking
celecoxib and
promptly report
to physician if
any of the
following occurs:
S&S of liver
dysfunction
including nausea,
fatigue, lethargy,
itching, jaundice,
abdominal pain,
and flulike
symptoms; S&S
of GI ulceration
including black,
tarry stools and
upper GI distress.
 Do not breast
feed while taking
this drug.
B. DRUG STUDY

DRUG CLASSIFI INDICATI CONTRAINDICAT SIDE EFFECT NURSING

NAME CATION ON ION CONSIDERATION
DICHLOR CENTRAL Antiseptic Hypersensitivity. No study reports are published on Overdose:
OBENZYL NERVOU treatment of the adverse effects after the use of  Excessive
ALCOHOL S minor the lozenges containing ingestion of these
1.2mg SYSTEM infections of Dichlorobenzyl Alcohol and lozenges may
AMYLME AGENT, mouth & Amylmetacresol. result in serious
TACRESO ANALGES throat.  problems with
L 600mcg IC, deadening of the
TAB 1 NSAID, mucosa of the
LOZENGE CYCLOO mouth and
Q6 XYGENA larynx. This may
SE-2 lead to serious
INHIBITO impairment of
R, swallowing.
ANTIPYR Overdose can
ETIC also lead to major
systemic
absorption of the
local anaesthetic,
resulting in
cardiac and
central nervous
system
symptoms. These
include severe
hypotension,
asystole,
bradycardia,
apnoea, seizures,
coma, cardiac
arrest, respiratory
arrest and death.
B. DRUG STUDY

Store below 30oC

in a dry place.
Protect from
moisture