Name Kaycelyn A.

Jimenez Date March 3, 2021

Group BSN 3B-2A Name of CI Christian Ian Gaerlan

INDICATION /
DRUG NAME MECHANISM OF ACTION ADVERSE EFFECT NURSING RESPONSIBILITIES
CONTRAINDICATION
GENERIC: INDICATIONs: CNS: dizziness, headache, BEFORE:
METRONIDAZOLE Metronidazole diffuses into the  Anaerobic infections ataxia, vertigo, Dx:
organism, inhibits protein  Trichomoniasis incoordination, insomnia, a. Monitor I.V. site.
BRAND: synthesis by interacting with  Amebia fatigue b. Avoid prolonged use of indwelling catheter.
Flagyl, Flagyl ER, DNA and causing a loss of helical  Colorectal surgery EENT: rhinitis, sinusitis, c. Assess pt. Infection
Flagyl IV RTU DNA structure and strand prophylaxis pharyngitis d. Assess skin for severity areas of local adverse
breakage. Therefore, it causes cell  Acne rosacea GI: nausea, vomiting, reactions
CLASS: death in susceptible organisms.  Bacterial vaginosis diarrhea, abdominal e. Check for allergies.
pain, furry tongue, glossitis, f. Assess baseline mental status
THERAPEUTIC SOURCE: Lippincott, W. (2020) dry mouth, anorexia Tx:
ANTIBIOTIC Nursing 2020 DRUG CONTRAINDICATION: GU: dysuria, dark urine, a. Watch carefully for edema because it may
HANDBOOK (2 Vol.-set). Contraindicated with incontinence cause sodium retention
PHARMACOLOGIC: Philadelphia PA ,19103: Two hypersensitivity to metronidazole; Hematologic: leukopenia b. Record number and character of stools
NITROIMIDAZOLE commerce Square, Wolter Kluwer pregnancy (do not use for Skin: rash, urticaria, burning, c. Give drug with meals to minimize GI distress
DERIVATIVE Health, Inc. trichomoniasis in first mild d. Perform a thorough physical assessment to
trimester).Use cautiously with CNS skin dryness, skin irritation, establish baseline data before drug therapy
DOSAGE: Weir, C., & Le, J. (2020). diseases, hepatic disease, transient begins, to determine the effectiveness of
500mg. Metronidazole. Statpearls candidiasis (moniliasis), blood redness (with topical forms) therapy, and to evaluate for the occurrence of
Publishing. Retrieved from dyscrasias, lactation. Other: unpleasant or metallic any adverse effects associated with drug
ROUTE: https://www.ncbi.nlm.nih.gov/boo taste, superinfection, therapy.
IV ks/NBK539728/#:~:text=Go phlebitis at I.V. site e. Periodically assess dose.
%20to%3A-,Mechanism%20of DRUG TO DRUG EDx:
FREQUENCY: %20Action,cell%20death%20in INTERACTION: a. Assess pt.’s and family’s knowledge of drug
q 6o %20susceptible%20organisms. Azathioprine, fluorouracil: therapy
increased risk of leukopenia b. Tell pt. that metallic taste and dark or red
Cimetidine: decreased brown urine may occur
metronidazole c. Instruct to complete full course of therapy
metabolism, increased risk of d. Caution pt. that drowsiness or dizziness may
toxicity occur.
e. Educate client on drug therapy to promote
Disulfiram: acute psychosis and compliance.
confusion f. Insure the patient takes the medication as
Lithium: increased lithium blood prescribed.
level
Phenobarbital: increased DURING:
metronidazole Dx:
metabolism, decreased efficacy a. Monitor for adverse effects (e.g. sedation,
Warfarin: increased warfarin dizziness, respiratory dysfunctions, GU
effects problems, etc).
b. Check for drug or herbal interactions
DRUG TO BEHAVIOR c. Assess for history of seizure disorders.
INTERACTION:
Alcohol use: disulfiram- Tx:
like reaction a. To treat trichomoniasis, give drug for 7 days
instead of 2-g single dose
b. Do not use aluminium needles or hubs, color
will turn orange/rust
c. Limit drug access if patient is suicidal to
decrease the risk of overdose to cause harm.
d. Administer the drug on time

EDx:
a. Inform that the medication may cause
dizziness/ light headedness
b. Instruct pt. SO to report diarrhea, nausea,
dyspepsia, insomnia, drowsiness, dizziness, or
persistent headache to physician.
c. Report diarrhea, nausea, dyspepsia, insomnia,
drowsiness, dizziness, or persistent headache to
physician.
d. Inform of drugs and herbs that can interact
e. Instruct patient to verbalize feelings and
concerns.
AFTER:
Dx:
 a. Assess knowledge/teach patient appropriate
use ,interventions to reduce side effects, and
adverse symptoms to report
b. Monitor for effectiveness as exhibited by a
decrease in symptoms
c. Monitor for side effects.

Tx:
a.
Remember that a lot of these drugs can cause
dizziness in the first few weeks of taking so
take safety precautions.
b. Provide safety measures (e.g. adequate
lighting, raised side rails, etc.) to prevent
injuries.
c. Provide comfort measures (e.g. voiding before
dosing, taking food with drug, etc.) to help
patient tolerate drug effects.
d. Administer drug once a day in the evening to
achieve optimal therapeutic effects.
EDx:
a. Tell pt. not to use alcohol or drugs that contain
alcohol.
b. Monitor patient for 2-4 weeks to ascertain
onset of full therapeutic effect.
c. Advise pt. to avoid alcohol intake.
d. Instruct patient to verbalize feelings and
concerns.

INDICATION /
DRUG NAME MECHANISM OF ACTION ADVERSE EFFECT NURSING RESPONSIBILITIES
CONTRAINDICATION
GENERIC: INDICATIONs: CNS: headache, confusion, BEFORE:
CEFTRIAXONE Interferes with bacterial cell-wall  Infections of respiratory hemiparesis, Dx:
synthesis and division by binding system, bones, joints, and lethargy, paresthesia, syncope, a) Monitor for extreme confusion, tonic-clonic
BRAND: to cell wall, causing cell to die. skin; septicemia seizures seizures, and mild hemiparesis when giving
 Rocephin Active against gram-negative and  Uncomplicated gonorrhea CV: hypotension, palpitations, high doses.
gram-positive bacteria, with  Surgical prophylaxis chest b) Monitor coagulation studies.
CLASS: expanded activity against gram-  Meningitis pain, vasodilation c) Be aware that cross-sensitivity to penicillins
negative bacteria.  Otitis media EENT: hearing loss and cephalosporins may occur.
THERAPEUTIC Exhibits minimal  Skin and skin-structure GI: nausea, vomiting, d) Assess skin for severity areas of local adverse
ANTI-INFECTIVE immunosuppressant activity. infections diarrhea, abdominal reactions
 Other serious infections cramps, oral candidiasis, e) Check for allergies.
PHARMACOLOGIC: SOURCE: Lippincott, W. (2020) pseudomembranous colitis, f) Assess baseline mental status
THIRD- Nursing 2020 DRUG CONTRAINDICATION: pancreatitis, Tx:
GENERATION HANDBOOK (2 Vol.-set). Contraindicated to neonates (28 Clostridium difficile– a) Watch carefully for edema because it may
CEPHALOSPORIN Philadelphia PA ,19103: Two days or younger). Use cautiously associated cause sodium retention
commerce Square, Wolter Kluwer in: diarrhea b) Record number and character of stools
DOSAGE: Health, Inc. GU: vaginal candidiasis c) Give drug with meals to minimize GI distress
 Hypersensitivity to
2 g. Hematologic: lymphocytosis, d) Perform a thorough physical assessment to
cephalosporins or
eosinophilia, bleeding establish baseline data before drug therapy
penicillins, allergies.
ROUTE: tendency, haemolytic anemia, begins, to determine the effectiveness of
 Renal impairment, hepatic
IV hypoprothrombinemia, therapy, and to evaluate for the occurrence of
disease, gallbladder
neutropenia, any adverse effects associated with drug
disease, phenylketonuria
FREQUENCY: thrombocytopenia, therapy.
 History of GI disease,
OD agranulocytosis, e) Periodically assess dose.
diarrhea following
bone marrow depression EDx:
antibiotic therapy
Hepatic: jaundice, a. Instruct patient to report persistent diarrhea,
 Pregnant or breastfeeding hepatomegaly bruising, or bleeding.
patients Musculoskeletal: arthralgia b. Caution patient not to use herbs unless
Respiratory: dyspnea prescriber approves.
Skin: urticaria, maculopapular c. Caution pt. that drowsiness or dizziness may
DRUG TO DRUG or erythematous occur.
INTERACTION: rash d. Educate client on drug therapy to promote
Aminoglycosides, loop Other: chills, fever, compliance.
diuretics: increased risk of superinfection, e. Insure the patient takes the medication as
nephrotoxicity pain at I.M. injection site, prescribed.
anaphylaxis,
Calcium-containing solutions: serum sickness DURING:
possibly fatal reactions caused by Dx:
ceftriaxone calcium precipitates a. Assess CBC and kidney and liver function test
Probenecid: decreased excretion
and increased blood level of
ceftriaxone
DRUG TO HERB
INTERACTION:
Angelica, anise, arnica, asafetida,
bogbean, boldo, celery, chamomile,
clove, danshen, fenugreek,
feverfew, garlic, ginger, ginkgo,
ginseng, horse chestnut,
horseradish, licorice,
meadowsweet, onion, papain,
passionflower, poplar, prickly ash,
quassia, red clover, turmeric, wild
carrot, wild lettuce, willow:
increased risk of bleeding.
results.
b. Monitor for signs and symptoms of
superinfection and other serious adverse
reactions.
c. Monitor for adverse effects (e.g. sedation,
dizziness, respiratory dysfunctions, GU
problems, etc).
d. Check for drug or herbal interactions
Tx:
a. Do not use aluminium needles or hubs, color
will turn orange/rust
b. Limit drug access if patient is suicidal to
decrease the risk of overdose to cause harm.
c. Administer the drug on time
EDx:
a. Inform that the medication may cause
dizziness/ light headedness
b. Instruct pt. SO to report diarrhea, nausea,
dyspepsia, insomnia, drowsiness, dizziness, or
persistent headache to physician.
c. Inform of drugs and herbs that can interact
d. Instruct patient to verbalize feelings and
concerns.
AFTER:
Dx:
a. Assess knowledge/teach patient appropriate
use ,interventions to reduce side effects, and
adverse symptoms to report
b. Monitor for effectiveness as exhibited by a
decrease in symptoms
c. Monitor for side effects.
Tx:
 a.Remember that a lot of these drugs can cause
dizziness in the first few weeks of taking so
take safety precautions.
b. Provide safety measures (e.g. adequate
lighting, raised side rails, etc.) to prevent
injuries.
c. Provide comfort measures (e.g. voiding before
dosing, taking food with drug, etc.) to help
patient tolerate drug effects.
d. Administer drug once a day in the evening to
achieve optimal therapeutic effects.
EDx:
a. Tell pt. not to use alcohol or drugs that contain
alcohol.
b. Monitor patient for 2-4 weeks to ascertain
onset of full therapeutic effect.
c. Advise pt. to avoid alcohol intake.
d. As appropriate, review all other significant and
life-threatening adverse reactions and
interactions, especially those related to the
drugs, tests, and herbs mentioned above.

INDICATION /
DRUG NAME MECHANISM OF ACTION ADVERSE EFFECT NURSING RESPONSIBILITIES
CONTRAINDICATION
GENERIC: INDICATIONs: CNS: drowsiness, headache, BEFORE:
KETOROLAC Interferes with prostaglandin  Moderately severe acute dizziness Dx:
TROMETHAMINE biosynthesis by inhibiting pain CV: hypertension a. Monitor Vital Signs.
 cyclooxygenase pathway of  Ocular itching caused by EENT: tinnitus b. Assess pt. Infection
BRAND: arachidonic acid metabolism; also seasonal allergic GI: nausea, vomiting, c. Assess skin for severity areas of local adverse
Acular, Acular LS, acts as potent inhibitor of platelet conjunctivitis diarrhea, constipation, reactions
Apo-Ketorolac aggregation.  Postoperative ocular flatulence, dyspepsia, d. Check for allergies.
inflammation related to epigastric
CLASS: SOURCE: Lippincott, W. (2020) cataract extraction pain, stomatitis Tx:
Nursing 2020 DRUG  To reduce ocular pain, Hematologic: a.
Be aware that oral therapy is indicated only as
THERAPEUTIC HANDBOOK (2 Vol.-set). burning, or stinging after thrombocytopenia continuation of parenteral therapy.
ANALGESIC, Philadelphia PA ,19103: Two corneal refractive surgery Skin: rash, pruritus, b. Know that parenteral therapy shouldn’t exceed
ANTIPYRETIC, ANTI- commerce Square, Wolter Kluwer diaphoresis 20 doses in 5 days.
INFLAMMATORY Health, Inc. CONTRAINDICATION: Other: excessive thirst, c. For I.V. use, dilute with normal saline solution,
Hypersensitivity to drug, its edema, injection dextrose 5% in water, dextrose 5% and normal
PHARMACOLOGIC: components, aspirin, or other site pain saline solution, Ringer’s solution, or lactated
Nonsteroidal anti- NSAIDs, Concurrent use of aspirin, Ringer’s solution.
inflammatory drug other NSAIDs, or probenecid, d. Administer single I.V. bolus over 1 to 2
(NSAID) Peptic ulcer disease, GI bleeding or minutes.
DOSAGE: perforation, Advanced renal EDx:
30 mg. impairment, risk of renal failure, a. Assess pt.’s and family’s knowledge of drug
Increased risk of bleeding, therapy
ROUTE: suspected or confirmed b. Tell pt. that metallic taste and dark or red
IV cerebrovascular bleeding, brown urine may occur
hemorrhagic diathesis, incomplete c. Instruct to complete full course of therapy
FREQUENCY: hemostasis, Prophylactic use before d. Caution pt. that drowsiness or dizziness may
q 6o RTC major surgery, intraoperative use occur.
when hemostasis is critical, Labor e. Educate client on drug therapy to promote
and delivery, and Breastfeeding. compliance.
f. Insure the patient takes the medication as
DRUG TO DRUG prescribed.
INTERACTION:
Angiotensin-converting DURING:
enzyme inhibitors, beta-adrenergic Dx:
blockers: decreased a. Monitor for adverse effects (e.g. sedation,
antihypertensive dizziness, respiratory dysfunctions, GU
effect problems, etc).
b. Check for drug or herbal interactions
Anticoagulants: prolonged
prothrombin Time
Aspirin: altered ketorolac
distribution, metabolism, and
excretion; increased risk of serious
adverse reactions
Cholestyramine: decreased
ketorolac absorption
Corticosteroids, other NSAIDs:
additive adverse GI effects
Diuretics: decreased diuretic effect
Hydantoins, lithium: increased
blood levels and greater risk of
toxicity of these drugs
Methotrexate: increased risk of
methotrexate toxicity
Probenecid: increased risk of
ketorolac toxicity
DRUG TO HERB
INTERACTION:
Anise, arnica, chamomile,
clove, dong quai, feverfew, garlic,
ginger, ginkgo, ginseng: increased
risk of bleeding
DRUG-DIAGNOSTIC TESTS.
Bleeding time: prolonged for 24 to
c. Assess for history of seizure disorders.
Tx:
a. Inject I.M. dose slowly and deeply.
b. Don’t give by epidural or intrathecal injection.
c. Limit drug access if patient is suicidal to
decrease the risk of overdose to cause harm.
d. Administer the drug on time
EDx:
a. Inform that the medication may cause
dizziness/ light headedness
b. Instruct pt. SO to report diarrhea, nausea,
dyspepsia, insomnia, drowsiness, dizziness, or
persistent headache to physician.
c. Report diarrhea, nausea, insomnia, drowsiness,
dizziness, or persistent headache to physician.
d. Inform of drugs and herbs that can interact
e. Instruct patient to verbalize feelings and
concerns.
AFTER:
Dx:
a. Assess knowledge/teach patient appropriate
use ,interventions to reduce side effects, and
adverse symptoms to report
b. Monitor for effectiveness as exhibited by a
decrease in symptoms
c. Monitor for side effects.
Tx:
a. Remember that a lot of these drugs can cause
dizziness in the first few weeks of taking so
take safety precautions.
b. Provide safety measures (e.g. adequate
lighting, raised side rails, etc.) to prevent

DRUG NAME MECHANISM OF ACTION
GENERIC:
TRAMADOL Inhibits reuptake of serotonin and
HYDROCHLORIDE norepinephrine in CNS. Tramadol
is a centrally acting synthetic
BRAND: opioid analgesic and SNRI
Dromadol SR , (serotonin/norepinephrine
Dromadol XL , Larapam reuptake-inhibitor) that is
SR , Mabron , Nobligan structurally related to codeine and
Retard , Ralivia, morphine. tramadol is generally
Tradorec XL , Tramake , considered a lower-risk opioid
Tridural, Ultram, Ultram option for the treatment of
ER, Zamadol , Zydol , moderate to severe pain
Zytram XL
SOURCE: Lippincott, W. (2020)
CLASS: Nursing 2020 DRUG
HANDBOOK (2 Vol.-set).
THERAPEUTIC Philadelphia PA ,19103: Two
ANALGESIC commerce Square, Wolter Kluwer
Health, Inc.
48 hours after therapy ends injuries.
c. Provide comfort measures (e.g. voiding before
dosing, taking food with drug, etc.) to help
patient tolerate drug effects.
EDx:
a. Inform patient that drug is meant only for
short-term pain management.
b. Monitor patient for 2-4 weeks to ascertain
onset of full therapeutic effect.
c. Instruct patient to verbalize feelings and
concerns.
INDICATION /
ADVERSE EFFECT NURSING RESPONSIBILITIES
CONTRAINDICATION
INDICATIONs: CNS: dizziness, vertigo, BEFORE:
 Moderate to moderately headache, Dx:
severe pain. drowsiness, anxiety, a. Assess patient’s response to drug 30 minutes
stimulation, confusion, after administration.
CONTRAINDICATION: incoordination, euphoria, b. Monitor respiratory status.
Hypersensitivity to drug, its nervousness, c. Withhold drug and contact prescriber if
components, or opioids. Acute sleep disorder, asthenia, respirations become shallow or slower than 12
intoxication with alcohol, sedative- hypertonia, breaths/ minute.
hypnotics, centrally acting seizures d. Monitor for physical and psychological drug
analgesics, opioid analgesics, or CV: vasodilation dependence. Report signs to prescriber.
psychotropic agents. Physical EENT: visual disturbances e. Check for allergies.
opioid dependence. GI: nausea, vomiting,
diarrhea, constipation, Tx:
DRUG TO DRUG abdominal pain, dyspepsia, a. Be aware that oral therapy is indicated only as
INTERACTION: flatulence, dry mouth, continuation of parenteral therapy.
Anesthetics, antihistamines, anorexia b. Know that parenteral therapy shouldn’t exceed
CNS depressants, other opioids, GU: urinary retention and 20 doses in 5 days.
psychotropic agents, sedative- frequency, c. For I.V. use, dilute with normal saline
hypnotics: increased risk of CNS proteinuria, menopausal solution, dextrose 5% in water, dextrose 5%
PHARMACOLOGIC: depression symptoms and normal saline solution, Ringer’s solution,
OPIOID AGONIST Respiratory: respiratory or lactated Ringer’s solution.
Carbamazepine: increased depression d. Administer single I.V. bolus over 1 to 2
DOSAGE: tramadol metabolism and decreased (with large doses, concomitant minutes.
50 mg. efficacy anesthetic EDx:
use, or alcohol ingestion) a. Tell patient drug works best when taken before
ROUTE: MAO inhibitors: increased risk of Skin: pruritus, sweating pain becomes severe.
IV serotonin syndrome and seizures Other: physical or b. Inform patient (and significant other as
psychological drug appropriate) that drug may cause respiratory
FREQUENCY: DRUG TO HERB dependence, drug tolerance depression if used with alcohol. Recommend
q 8o RTC INTERACTION: abstinence.
Chamomile, hops, kava, c. Educate client on drug therapy to promote
skullcap, valerian: increased CNS compliance.
depression d. Insure the patient takes the medication as
prescribed.
DRUG-DIAGNOSTIC TESTS
INTERACTION DURING:
Creatinine, hepatic Dx:
enzymes: increased levels a. Monitor for adverse effects (e.g. sedation,
Hemoglobin: decreased level dizziness, respiratory dysfunctions, GU
problems, etc).
DRUG-BEHAVIORS b. Check for drug or herbal interactions
INTERACTION. c. Assess for history of seizure disorders.
Alcohol use: increased
CNS depression Tx:
a. Encourage client cooperation
b. Limit drug access if patient is suicidal to
decrease the risk of overdose to cause harm.
c. Administer the drug on time

EDx:
a. Instruct patient to immediately report seizure.
b. Instruct pt. SO to report diarrhea, nausea,
dyspepsia, insomnia, drowsiness, dizziness, or
persistent headache to physician.
 c.
Report diarrhea, nausea, insomnia, drowsiness,
dizziness, or persistent headache to physician.
d. Inform of drugs and herbs that can interact
e. Instruct patient to verbalize feelings and
concerns.
AFTER:
Dx:
a. Assess knowledge/teach patient appropriate
use ,interventions to reduce side effects, and
adverse symptoms to report
b. Monitor for effectiveness as exhibited by a
decrease in symptoms
c. Monitor for side effects.

Tx:
a. Remember that a lot of these drugs can cause
dizziness in the first few weeks of taking so
take safety precautions.
b. Provide safety measures (e.g. adequate
lighting, raised side rails, etc.) to prevent
injuries.
c. Provide comfort measures (e.g. voiding before
dosing, taking food with drug, etc.) to help
patient tolerate drug effects.

EDx:
a. Inform patient that drug is meant only for
short-term pain management.
b. Monitor patient for 2-4 weeks to ascertain
onset of full therapeutic effect.
c. Instruct patient to verbalize feelings and
concerns.