ANGELES UNIVERSITY FOUNDATION

Angeles City
College of Nursing
RELATED LEARNING EXPERIENCE (RLE) 0109
CARE OF MOTHER AND CHILD AT RISK OR WITH PROBLEM
(ACUTE AND CHRONIC)
Second Semester, Academic Year 2020 – 2021

MODULE 7:
DRUG STUDY

Submitted by:
JINGCO, Jashtine E.

BSN II – D

Submitted to:
Karen Cyril Cayanan, RN, LPT, MN

March 18, 2021

DRUG # 1

GENERIC NAME: Paracetamol

BRAND NAME: Biogesic

DRUG CLASSIFICATION: Non-narcotic analgesic, antipyretic

MECHANISM OF ACTION: May block pain impulses peripherally that occur in

response to inhibition of prostaglandin synthesis; does not possess antiinflammatory
properties; antipyretic action results 80 from inhibition of prostaglandins in the CNS
(hypothalamic heat-regulating center)

STOCK DOSAGE: 500 mg tablet

INDICATION: Treatment of mild to moderate pain or fever

CONTRAINDICATIONS: Hypersensitivity to this product or phenacetin

SIDE EFFECTS/ADVERSE REACTIONS:

 GI: Nausea, vomiting, abdominal pain; hepatotoxicity, hepatic seizure

(overdose), GI bleeding
 GU: Renal failure (high, prolonged doses)
 HEMA: Leukopenia, neutropenia, hemolytic anemia (long-term use),
thrombocytopenia, pancytopenia
 INTEG: Rash, urticaria, inj site pain
 SYST: Stevens-Johnson syndrome, toxic epidermal necrolysis
 TOXICITY: Cyanosis, anemia, neutropenia, jaundice, pancytopenia, CNS
stimulation, delirium followed by vascular collapse, seizures, coma, death

NURSING INTERVENTIONS:

 Assess type of pain, location, intensity and duration.

 Monitor temperature frequently.
 Evaluate absence of pain using pain scoring; absence of fever.
DRUG # 2

GENERIC NAME: Clindamycin

BRAND NAME: Cleocin

DRUG CLASSIFICATION: Lincosamides, antibiotic

MECHANISM OF ACTION: Inhibits protein synthesis of bacterial cell wall by binding to

bacterial ribosomal receptor sites. It has a bacteriostatic or bactericidal effect.

STOCK DOSAGE: 150 mg/mL injection

INDICATION: Gynecologic infection (Endometritis)

CONTRAINDICATIONS: Hypersensitivity to nitrites or nitrates; cerebral hemorrhage,

head trauma; hypotension; glaucoma; severe anemia; hyperthyroidism; recent MI; acute
alcoholism.

SIDE EFFECTS/ADVERSE REACTIONS:

CNS: Dizziness, headache, vertigo. 

CV: Arrhythmias, hypotension. 

GI: Pseudomembranous colitis, diarrhea, bitter or metallic taste, nausea, vomiting. 

Derm: Rashes. 

Local: Phlebitis at IV site.

NURSING INTERVENTIONS:

 Culture and susceptibility testing should be performed initially and periodically

during therapy. Periodic CBC with differential and platelet count.
 Assess blood pressure periodically, and compare to normal values. Report low
blood pressure (hypotension), especially if patient experiences dizziness, fatigue,
or other symptoms.
 Monitor injection site for pain, swelling, and irritation. Report prolonged or
excessive injection site reactions to the physician.
  Always wash hands thoroughly and use disinfect equipment (whirlpools,
electrotherapeutic devices, treatment tables, and so forth) to help prevent the
spread of infection. Employ universal precautions or isolation procedures as
indicated for specific patients.
 Take drug for full course of therapy as prescribed.
 Be alert for signs of superinfection.

DRUG # 3

GENERIC NAME: Gentamycin

BRAND NAME: Garamycin, Cidomycin

DRUG CLASSIFICATION: Aminoglycoside antibiotic

MECHANISM OF ACTION: Interferes with protein synthesis in bacterial cell by

binding to 30S ribosomal subunit, thus causing misreading of genetic code;
inaccurate peptide sequence forms in protein chain, thereby causing bacterial
death.

STOCK DOSAGE: 60 mg/50 mL, 80 mg/50 mL, 80 mg/100 mL, 100 mg/50 mL, 100
mg/100 mL, 120 mg/100 mL injection infusion

INDICATION: Used to treat serious bacterial infections by killing bacteria and

preventing their growth. Additionally, it is used with clindamycin for treatment of
endometritis.

CONTRAINDICATIONS: History of hypersensitivity to or toxic reaction with any

aminoglycoside antibiotic.

SIDE EFFECTS/ADVERSE REACTIONS:

 CNS: Confusion, depression, numbness, tremors, seizures, muscle twitching,

neurotoxicity, dizziness, vertigo, encephalopathy, fever, headache, lethargy
 CV: Hypo/hypertension, palpitations, edema
  EENT: Ototoxicity, deafness, visual disturbances, tinnitus
 GI: Nausea, vomiting, anorexia; increased ALT, AST, bilirubin; hepatomegaly,
hepatic necrosis, splenomegaly
 GU: Oliguria, hematuria, renal damage, azotemia, renal failure, nephrotoxicity,
proteinuria
 HEMA: Agranulocytosis, thrombocytopenia, leukopenia, eosinophilia, anemia
 INTEG: Rash, burning, urticaria, dermatitis, alopecia, photosensitivity,
anaphylaxis
 MS: Twitching, myasthenia gravis–like symptoms
 RESP: Apnea

NURSING INTERVENTIONS:

 Perform C&S and renal function prior to first dose and periodically during
therapy.

 Check baseline weight and vital signs; determine vestibular and auditory function
before therapy and at regular intervals.

 Monitor I&O. Keep patient well hydrated to prevent chemical irritation of renal
tubules. Report oliguria, unusual appearance of urine, change in I&O ratio or
pattern, and presence of edema

 Evaluate IV site for phlebitis (heat, pain, red streaking over vein).

 Watch for S&S of bacterial overgrowth (opportunistic infections) with resistant or

non-susceptible organisms (diarrhea, anogenital itching, vaginal discharge,
stomatitis, glossitis).
 Always wash hands thoroughly and disinfect equipment (whirlpools,
electrotherapeutic devices, treatment tables, and so forth) to help prevent the
spread of infection. Employ universal precautions or isolation procedures as
indicated for specific patients.
DRUG # 4

GENERIC NAME: Enoxaparin

BRAND NAME: Lovenox

DRUG CLASSIFICATION: Low molecular weight heparin, anticoagulant

MECHANISM OF ACTION: Acts by enhancing the inhibition rate of activated

clotting factors including thrombin and factor Xa through its action on antithrombin
III. It prevents thrombus formation.

STOCK DOSAGE: 30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, 100
mg/1 mL injection

INDICATION: Treatment for deep vein thrombosis

CONTRAINDICATIONS: Hypersensitivity to enoxaparin. Active major bleeding,

concurrent heparin therapy, hypersensitivity to heparin, pork products,
thrombocytopenia associated with positive in vitro test for antiplatelet antibodies. Not for
IM use.

SIDE EFFECTS/ADVERSE REACTIONS:

 Body as a Whole: Allergic reactions (rash, urticaria),

fever, angioedema arthralgia, pain and inflammation at injection site, peripheral
edema, arthralgia, fever. 
 Digestive: Abnormal liver function tests. 
 Hematologic: Hemorrhage, thrombocytopenia, ecchymoses, anemia. 
 Respiratory: Dyspnea. 
 Skin: Rash, pruritus.

NURSING INTERVENTIONS:

 Monitor platelet count closely. Withhold drug and notify physician if platelet count
less than 100,000/mm3.
  Assess for signs of bleeding and hemorrhage, including bleeding gums,
nosebleeds, unusual bruising, black/tarry stools, hematuria, and a fall in
hematocrit or blood pressure. Notify physician or nursing staff immediately if
enoxaparin causes excessive anticoagulation.
 Watch for signs of pulmonary embolism such as shortness of breath, chest pain,
cough, or bloody sputum. Notify physician or nursing staff immediately if these
signs occur.

 Instruct patient to avoid OTC products containing aspirin, NSAIDs, and not
start any supplements, herbal products, and prescription drugs along with
taking Enoxaparin unless approved by physician.

 Instruct patient to use soft-bristle toothbrush to avoid bleeding gums

 Instruct patient not to breastfeed while taking this drug without consulting
the physician.

DRUG # 5

GENERIC NAME: Warfarin

BRAND NAME: Coumadin

DRUG CLASSIFICATION: Vitamin K antagonist, anticoagulant

MECHANISM OF ACTION: Prevents thrombosis by decreasing clotting ability while

avoiding risk of spontaneous bleeding. It Interferes with blood clotting by indirect
means, depresses hepatic synthesis of vitamin K dependent coagulation factors (II,
VII, IX, X)

STOCK DOSAGE: 1 mg, 2 mg, 2.5 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7.5 mg, 10 mg tablets

INDICATION: Prophylaxis and treatment of deep vein thrombosis and its extension

CONTRAINDICATIONS: Hypersensitivity to warfarin. Hemorrhagic tendencies (e.g.,

cerebral aneurysms, bleeding from GI tract), recent or potential surgery of eye or CNS,
neurosurgical procedures, open wounds, severe uncontrolled or malignant
hypertension, spinal puncture procedures, uncontrolled bleeding, ulcers, unreliable or
noncompliant pts, unsupervised pts, blood dyscrasias, pericarditis or pericardial
effusion, pregnancy (except in women with mechanical heart valves at high risk for
thromboembolism), bacterial endocarditis, threatened abortion. Major regional lumbar
block anesthesia or traumatic surgery, eclampsia/preeclampsia.

SIDE EFFECTS/ADVERSE REACTIONS:

 CNS: Fever, dizziness, fatigue, headache, lethargy

 CV: Angina, chest pain, edema, hypotension, syncope
 GI: Diarrhea, nausea, vomiting, anorexia, stomatitis, cramps, hepatitis,
cholestatic jaundice
 GU: Hematuria
 HEMA: Hemorrhage, agranulocytosis, leukopenia, eosinophilia, anemia,
ecchymosis, petechiae
 INTEG: Rash, dermatitis, urticaria, alopecia, pruritus
 MISC: Epistaxis, hemoptysis, mouth ulcers, taste disturbances, priapism,
dyspnea
 MS: Bone fractures
 SYST: Anaphylaxis, coma, cholesterol, microembolism, exfoliative dermatitis,
purple toe syndrome

NURSING INTERVENTIONS:

 Watch for signs of bleeding and hemorrhage, including bleeding gums,

nosebleeds, unusual bruising, coughing up blood, black/tarry stools, hematuria,
or a fall in hematocrit or blood pressure. Notify physician or nursing staff
immediately if warfarin causes excessive anticoagulation.
 Advise patient to take the medication exactly as prescribe and that dosage
changes made by the physician are common to achieve desired effect
 Encourage patient to avoid vitamin K rich foods, enteral feedings, and certain
multivitamins since this could decrease the effect of warfarin.
  Do not take any other prescription or OTC drug unless specifically approved by
physician
 Instruct patient to take the medication at same time each day.
 Inform the client that urine may become red-orange.

DRUG # 6

GENERIC NAME: Streptokinase

BRAND NAME: Kabikinase, Streptase

DRUG CLASSIFICATION: Thrombolytic, anticoagulants

MECHANISM OF ACTION: Promotes thrombolysis by activating the conversion of

plasminogen to plasmin, the enzyme that degrades fibrin, fibrinogen, and other
procoagulant proteins into soluble fragments. Decreases blood and plasma viscosity
and erythrocyte aggregation tendency, thus increasing perfusion of collateral blood
vessels.

STOCK DOSAGE: 250,000 IU, 750,000 IU, 1,500,000 IU vials

INDICATION: Deep vein thrombosis

CONTRAINDICATIONS: Hypersensitivity to streptokinase or its components, Active

internal bleeding, Aneurysm, Bleeding diathesis, Severe uncontrolled hypertension,
History of stroke or intracranial or intraspinal surgery within the previous 2 months

SIDE EFFECTS/ADVERSE REACTIONS:

 CNS: Intracranial hemorrhage. 
 EENT: Epistaxis, gingival bleeding. 
 Resp: Bronchospasm, hemoptysis. 
 CV: Reperfusion arrhythmias, hypotension, recurrent ischemia or
thromboembolism. 
 GI: GI bleeding, hepatotoxicity, nausea, retroperitoneal bleeding, vomiting. 
  GU: GU tract bleeding. 
 Derm: Ecchymoses, flushing, urticaria. 
 Hemat: Bleeding. 
 Local: Hemorrhage at injection site, phlebitis at injection site. 
 MS: Musculoskeletal pain. 
 Misc: Allergic reactions, including anaphylaxis, fever.

NURSING INTERVENTIONS:

 Obtain hematocrit and platelet count as ordered before giving streptokinase.

 Do not shake the drug during reconstitution to prevent foaming.
 Check frequently for bleeding at IV site and for blood in urine in stool.
Perform neurologic assessment to detect intracranial bleeding.
 If serious spontaneous bleeding that is not controlled by local pressure
occurs, immediately stop infusion of streptokinase and notify the
prescriber.
 In case of fever, treat with acetaminophen instead of aspirin to reduce
risk of bleeding.

DRUG # 7

GENERIC NAME: Naproxen Sodium

BRAND NAME: Aleve

DRUG CLASSIFICATION: Analgesic, Anti-inflammatory, Antipyretic, Propionic acid

derivative

MECHANISM OF ACTION: Inhibits COX-1 and COX-2 enzymes, resulting in decreased

formation of prostaglandin precursors. This reduces inflammatory response and
intensity of pain.

STOCK DOSAGE: 200 mg, 250 mg, 375 mg, 500 mg tablets

INDICATION: Treatment of mild to moderate pain and fever

CONTRAINDICATIONS: History of asthma, urticaria; hypersensitivity to naproxen,
other NSAIDs. Perioperative pain in setting of CABG surgery.

SIDE EFFECTS/ADVERSE REACTIONS:

 CNS: Dizziness, drowsiness, fatigue, tremors, confusion, insomnia, anxiety,

depression
 CV: Tachycardia, peripheral edema, palpitations, dysrhythmias, MI, stroke
 EENT: Tinnitus, hearing loss, blurred vision
 GI: Nausea, anorexia, vomiting, diarrhea, jaundice, hepatitis, constipation,
flatulence, cramps, peptic ulcer, GI ulceration, bleeding, perforation
 GU: Nephrotoxicity: dysuria, hematuria, oliguria, azotemia
 HEMA: Blood dyscrasias
 INTEG: Purpura, rash, pruritus, sweating
 SYST: Anaphylaxis, Stevens-Johnson syndrome

NURSING INTERVENTIONS:

 Assess onset, type, location, duration of pain/inflammation.

 Inform patient not to drive or engage in potentially hazardous activities until
response to drug is known.
 Advise patient to take the medication with food.

 Instruct patient to take drug with a full glass of water and to remain upright
for 15 to 30 minutes after taking it to prevent drug from lodging in
esophagus and causing irritation.
 Educate patient to avoid aspirin and alcohol during therapy since it may
increase risk of GI bleeding.
 Instruct patient to report headache, rash, visual disturbances, weight gain, black
or tarry stools, bleeding, persistent headache.

DRUG # 8
GENERIC NAME: Ceftriaxone

BRAND NAME: Rocephin

DRUG CLASSIFICATION: Third-generation cephalosporin, antibiotic

MECHANISM OF ACTION: Interferes with bacterial cell wall synthesis by inhibiting

cross-linking or peptidoglycan strands which makes the cell membrane rigid and
protective. Without peptidoglycan bacterial cells rupture and die.

STOCK DOSAGE: 250 mg, 500 mg, 1 g, 2 g injection

INDICATION: Treatment to susceptible infections due to gram-negative aerobic

organisms, some gram-positive organisms including those causing endometritis

CONTRAINDICATIONS: Hypersensitivity to cephalosporins and related antibiotics

SIDE EFFECTS/ADVERSE REACTIONS:

 Body as a Whole: Pruritus, fever, chills, pain, phlebitis. 

 GI: Diarrhea, abdominal cramps, pseudomembranous colitis, biliary sludge. 
 Urogenital: Genital pruritus; moniliasis.

NURSING INTERVENTIONS:

 Perform culture and sensitivity tests before initiation of therapy and periodically
during therapy.
 Educate the client to complete full course of treatment, to take missed dose as
soon as remembered unless close to next dose, do not double dose.
 Instruct patient to report loose stools or diarrhea promptly.
 Instruct the patient to report signs of unexplained bleeding.

DRUG # 9

GENERIC NAME: Ampicillin, Sulbactam

BRAND NAME: Unasyn

DRUG CLASSIFICATION: Penicillin, antibiotic

MECHANISM OF ACTION: Ampicillin inhibits bacterial cell wall synthesis. Sulbactam

inhibits bacterial beta-lactamase. Therapeutic Effect: Ampicillin is bactericidal in
susceptible microorganisms. Sulbactam protects ampicillin from enzymatic degradation.

STOCK DOSAGE: 1.5 g (ampicillin 1 g/sulbactam 0.5 g), 3 g (ampicillin 2 g/sulbactam

1g)

INDICATION: Treatment of gynecologic infection (Endometritis)

CONTRAINDICATIONS: Hypersensitivity to ampicillin, any penicillin, or sulbactam. Hx

of cholestatic jaundice, hepatic impairment associated with ampicillin/sulbactam.

SIDE EFFECTS/ADVERSE REACTIONS:

 Body as a Whole: Hypersensitivity (rash, itching, anaphylactoid reaction),

fatigue, malaise, headache, chills, edema. 
 GI: Diarrhea, nausea, vomiting, abdominal distention, candidiasis. 
 Hematologic: Neutropenia, thrombocytopenia. 
 Urogenital: Dysuria. 
 CNS: Seizures. 
 Other: Local pain at injection site; thrombophlebitis.

NURSING INTERVENTIONS:

 Assess baseline C&S tests prior to initiation of therapy.

 Monitor patient carefully during the first 30 min after initiation of IV therapy for
signs of hypersensitivity and anaphylactoid reaction 
 Monitor I&O ratio and pattern. Report dysuria, urine retention, and hematuria.
 Evaluate IV site for phlebitis.
 Inform the client to take antibiotic for full length of treatment.
 Instruct the client to space doses evenly.
 Inform client to report rash, diarrhea, or other new symptoms.
DRUG # 10

GENERIC NAME: Ferrous Sulfate

BRAND NAME: Fer-In-Sol, Feosol, Feratab, Ferospace, Fero-Gradumet, Slow-Fe

DRUG CLASSIFICATION: Iron preparation, nutritional supplement

MECHANISM OF ACTION: Inhibits uterine contractions. Relieves bronchospasm,

reduces airway resistance.

STOCK DOSAGE: 45 mg elemental Fe, 200 mg (65 mg Fe), 300 mg (60 mg Fe), 325
mg (65 mg Fe) tablets

INDICATION: To treat iron deficiency anemia

CONTRAINDICATIONS: Peptic ulcer, regional enteritis, ulcerative colitis; hemolytic

anemias (in absence of iron deficiency), hemochromatosis, hemosiderosis, patients
receiving repeated transfusions, pyridoxine-responsive anemia; cirrhosis of liver.

SIDE EFFECTS/ADVERSE REACTIONS:

 GI: Nausea, constipation, epigastric pain, black and red tarry stools, vomiting,
diarrhea
 INTEG: Temporarily discolored tooth enamel and eyes

NURSING INTERVENTIONS:

 Inform the client that stool color may darken.

 Educate the client to consume citrus fruit or tomato juice with iron preparation
since it may increase absorption.
 If GI discomfort occurs, instruct client to take medicine after meals or with
food.
 Instruct client not to take within 2 hours of other medication or eggs,
milk, tea, coffee, cereal.
 Instruct client not to take antacids or OTC calcium supplements.
REFERENCES:

Ciccone, C. D. (2013). Davis’s Drug Guide for Rehabilitation Professionals. Retrieved

March 03, 2021 from https://fadavispt.mhmedical.com/book.aspx?bookid=1873

Comerford, K. C. (2017). Nursing 2017 drug handbook. Philadelphia, Pa: Wolters

Kluwer Health/Lippincott Williams & Wilkins

Kizior, R.J., & Hodgson, K.J. (2019). Saunders nursing drug handbook. 3251 Riverport
Lane, St. Louis, Missouri 63043. Elsevier

Prentice Hall Nurse's Drug Guide. Retrieved March 18, 2021 from
http://www.robholland.com/Nursing/Drug_Guide/

RNspeak. (2018). Ceftriaxone drug study. Retrieved March 18, 2021 from
https://rnspeak.com/ceftriaxone-drug-study/
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