DRUG CLASSIFICATION ACTION INDICATION CONTRAINDICATION NURSING RESPOSIBILITIES

BRAND NAME : Classification: Binds to opiate -Severe pain (the 20 Respiratory  Advise patient that
Morphine sulfate Opioid agonist receptors in the CNS. mg/mL oral solution depression, acute or morphine is a drug with
analgesic Alters the perception concentration should severe asthma; known abuse potential.
GENERIC NAME : of and response to only be used in opioid- paralytic ileus; Protect it from theft, and
Timed-release: Pregnancy painful stimuli while tolerant patients). obstructive airway never give to anyone other
Avinza, Kadian, M- Category C producing disease; acute liver than the individual for whom
Eslon (CAN), MS generalized CNS -Pain severe enough disease; comatose it was prescribed. Store out
Contin, Oramorph Controlled depression. to require daily, patients; increased of sight and reach of
SR Substance C-II around-the-clock long- intracranial children, and in a location
Oral solution: term opioid treatment pressure; acute not accessible by others.
Roxanol, Roxanol T and for which alcoholism.  Advise patient to change
Rectal Therapeutic Effect(s): alternative treatment Pulmonary oedema positions slowly to minimize
suppositories: RMS options are inadequate resulting from a orthostatic hypotension.
Decrease in severity (extended-release).
Injection: of pain. Addition of chemical respiratory  Caution patient to avoid
Astramorph PF, naltrexone in irritant. concurrent use of alcohol or
Duramorph -Pulmonary edema. other CNS depressants with
Embeda product is
Preservative- designed to prevent -Pain associated with this medication.
freeconcentrate for abuse or misuse by MI.  Encourage patients who are
microinfusion altering the immobilized or on
devices for formulation. prolonged bedrest to turn,
Intraspinal use: Naltrexone has no cough, and breathe deeply
Infumorph effect unless the every 2 hr to prevent
Liposome capsule is crushed or atelectasil
injection: DepoDur chewed.
 DRUG CLASSIFICATION ACTION INDICATION CONTRAINDICATION NURSING
RESPOSIBILITIES
BRAND NAME : Therapeutic:ant Competitively Reversal of CNS Contraindicated in: -Monitor respiratory
NARCAN / EVZIO idotes (for blocks the effects depression and Hypersensitivity. rate, rhythm, and depth;
GENERIC NAME : opioids) of opioids, respiratory pulse, ECG, BP; and
NALOXONE including CNS and depression because Use Cautiously in: level of consciousness
Pharmacologic: respiratory of suspected opioid Cardiovascular frequently for 3– 4 hr
IV (Adults): 0.02–
opioid depression,without disease; Patients after the expected peak
0.2 mg q 2– 3 min
until response
antagonists producing any overdose. physically dependent of blood concentrations.
obtained; repeat q agonist (opioid-like) Unlabeled Use: on opioids (may
Pregnancy Opioid-induced precipitate severe -Patients who have
1– 2 hr if effects.
Category B pruritus (low dose IV withdrawal); been receiving opioids
needed. Therapeutic infusion). for 1 wk are extremely
Effects: Reversal of Management of OB: May cause acute sensitive to the effects
IV (Children): 0.01 withdrawal syndrome
signs of opioid refractory circulatory of naloxone. Dilute and
mg/kg; may repeat in mother and fetus if
q 2– 3 min until excess shock. administer carefully.
mother is opioid
response obtained.
dependent; -Assess patient for level
Additional doses
may be given q 1–
Lactation:Safety not of pain after
2 hr if needed. established; Pedi:May administration when
cause acute used to treat
IM, IV, Subcut withdrawal syndrome postoperative
(Neonates): 0.01 in neonates of opioid- respiratory depression.
mg/kg; may repeat dependent mothers. Naloxone decreases
q 2– 3 min until respiratory depression
response obtained. but also reverses
Additional doses
analgesia.
may be given q 1–
2 hr if needed.
-Assess patient for
signs and symptoms of
opioid withdrawal
(vomiting, restlessness,
abdominal cramps,
increased BP, and
temperature).
Symptoms may occur
within a few minutes to
2 hr. Severity depends
on dose of naloxone,
the opioid involved, and
degree of physical
dependence.
 DRUG CLASSIFICATION ACTION INDICATION CONTRAINDICATION NURSING
RESPOSIBILITIES
BRAND NAME: Therapeutic:anesth IV, IM: Suppresses IV: Ventricular Contraindicated in: May cause drowsiness
etics (topical/local), automaticity and arrhythmias. IM: Hypersensitivity; and dizziness. Advise
Anestacon, antiarrhythmics spontaneous Self-injected or cross-sensitivity patient to call for
Xylocaine (class IB) depolarization of the when IV unavailable may occur; Third- assistance during
Viscous, Pregnancy ventriclesduring (during transport to degree heart block. ambulation and
LidoPen, & Category B diastole by altering hospital facilities). transfer.
Xylocard the flux of sodium Local: Use Cautiously in:
ions across cell Infiltration/mucosal/t Liver disease, HF, IM: Available in
GENERIC NAME: patients weighing LidoPen Auto-Injector
membranes with opical anesthetic.
littleor no effect on Patch: 50 kg, and geriatric for use outside the
LIDOCAINE
heart rate. patiUTE & DOSAGE hospital setting. Advise
ROUTE AND Pain due to post- :ents (pbolus and/or patient to telephone
DOSAGE : Local: Produces herpetic neuralgia maintenance dose); health care
local anesthesia by Respiratory professional
Brachial: 15-20 inhibiting transport Contraindicated in: depression; Shock; immediately if
mL of 1.5% of ions across Hypersensitivity; Heartblock; symptoms of a heart
solution (225-300 neuronal cross-sensitivity may attack occur. Do not
mg total dose) membranes, thereby occur; Third-degree OB, administer unless
preventing initiation heart block. Lactation:Safety not instructed by health
Dental: 1-5 mL of and conduction of established; care professional.
2% solution (20- Use Cautiously in: Pedi:Safety not
normal nerve
100 mg total Liver disease, HF, established for
impulses.
dose) patients weighing 50 transdermal patch.
Therapeutic Effects: kg, and geriatric
Intercostal: 3 mL Control of ventricular patients (pbolus
of 1% solution (30 arrhythmias.Local and/or maintenance
mg total dose) anesthesia. dose); Respiratory
depression; Shock;
Heart
 block; OB,
Lactation:Safety not
Paravertebral: 3-5 established;
mL of 1% solution Pedi:Safety not
(30-50 mg total established for
dose) transdermal patch.
Pudendeal (each
side): 10 mL of
1% solution (100
mg total dose)
Paracervical
obstetrical
analgesia (each
side): 10 mL of
1% solution (100
mg total dose)
 DRUG CLASSIFICATION ACTION INDICATION CONTRAINDICATION NURSING
RESPOSIBILITIES
BRAND NAME : CENTRAL Anthranilic acid For relief of mild to Hypersensitivity to -Discontinue drug
NERVOUS derivative. Like moderate pain in drug;GI promptly if diarrhea,
PONSTAN/PONSTE SYSTEM AGENT; ibuprofen inhibits patients ≥ 14 years inflammation,or dark stools,
L ANALGESIC; prostaglandin of age, when ulceration.Safety in hematemesis,
NSAID; synthesis and therapy will not children <14 y, ecchymoses,
ANTIPYRETIC affects platelet exceed one week (7 during pregnancy epistaxis, or rash
GENERIC NAME: function. No days). (category C), or occur and do not
Pregnancy evidence that it is lactation is not use again. Contact
MEFENAMIC ACID
Category: C superior to aspirin. For treatment of established. physician.
Adult: primary
dysmenorrhea. -Notify physician if
PO Loading Dose persistent GI
500 mg PO discomfort, sore
Maintenance Dose throat, fever, or
250 mg q6h prn 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.
 DRUG CLASSIFICATION ACTION INDICATION CONTRAINDICATION NURSING RESPOSIBILITIES
BRAND Therapeutic: Binds to opiate Moderate to severe -Significant respiratory -Instruct patient on how
NAME : opioid receptors in the pain. Also provides: depression and when to ask for pain
NUBAIN analgesics CNS. Alters the Analgesia during medication.
perception of and labor, Sedation before -Acute or severe
GENERIC Pharmacologic: response to painful surgery, Supplement bronchial asthma in an -May cause drowsiness or
NAME : opioid stimuli while to balanced unmonitored setting or dizziness. Advise patient
agonists/analges producing anesthesia. in the absence of to call for assistance when
Nalbuhine ics resuscitative ambulating and to avoid
generalized CNS Prevention or
Hydrochloride equipment driving or other activities
depression. In treatment of opioid-
Pregnancy requiring alertness until
ROUTE & addition, has inducedpruritus
Category C -Known or suspected response to the
DOSAGE partial antagonist
gastrointestinal medication is known.
properties, which
obstruction, including
IM, Subcut, IV may result in opioid
paralytic ileus Caution patient to change
(Adults): Usual withdrawal in
positions slowly to
dose is 10 mg q physically -Hypersensitivity to minimize orthostatic
3– 6 hr dependent nalbuphine to any of hypotension.
(maximum: 20 patients. the other ingredients in
mg/dose or 160 Therapeutic NUBAIN. -Advise patient that
mg/day). Effects: Decreased frequent mouth rinses,
pain good oral hygiene, and
IM, Subcut, IV
sugarless gum or candy
(Children): 0.1–
may decrease dry mouth.
0.15 mg/kg q 3–
6 hr (maximum:
20 mg/dose or
160 mg/day).
Supplement to - Encourage patient to
Balanced turn, cough, and breathe
Anesthesia deeply every 2 hr to
prevent atelectasis.
IV (Adults):
Initial—0.3– 3 -Advise patient to avoid
mg/kg over 10– concurrent use of alcohol
15 min. or other CNS depressants
Maintenance— with this medication.
0.25– 0.5mg/kg
as needed.
Opioid-induced
pruritus
IV (Adults): 2.5–
5 mg; may
https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/51518/all/morphine
https://davisplus.fadavis.com/3976/meddeck/pdf/naloxone.pdf
https://davisplus.fadavis.com/3976/meddeck/pdf/lidocaine.pdf
https://rnspeak.com/mefenamic-acid-ponstan-drug-study/
https://rnspeak.com/mefenamic-acid-ponstan-drug-study/
https://davisplus.fadavis.com/3976/meddeck/pdf/nalbuphine.pdf