VELEZ COLLEGE

COLLEGE OF NURSING
F. Ramos St. Cebu City

NURSING CARE MANAGEMENT 107:

CARE OF MOTHER, CHILD AND ADOLESCENT (WELL CLIENTS)
Drug Study
Generic and Classificatio Nursing
Action Indications Contraindications Adverse Effects
Brand Name n Considerations
1. Methergine Ergot alkaloid -Used to decrease  Active  Severe or  Nausea and  Monitor and
Generic name: uterine bleeding by management of uncontrolled HTN vomiting record blood
Methylergometri causing contraction 3rd stage of  Shock  Abdominal pressure,
ne of the uterine labor  Severe or pain pulse rate,
Maleate/ muscle after  Prevention or persistent sepsis  Diarrhea and uterine
Methylergonovin delivery of the
treatment of  Peripheral  Headache response,
e Maleate placenta.
postpartum or vascular disease  Dizziness sudden
- Acts directly on  Tinnitus change in
Brand name: postabortal  Ischemic heart
the smooth  Chest pain vital signs,
Methergine hemorrhage disease
muscle of the  Palpitations frequent
uterus and caused by  Temporal arthritis periods of
 Bradycardia
increases the uterine atony  Hyperthyroidism uterine
and other
tone, rate, and  Hepatic or renal relaxation,
cardiac
amplitude of impairment and
rhythmic arrythmias
 Basilar or  Coronary character
contractions.
hemiplegic artery and amount
Thus, it induces a
migraine vasospasm of vaginal
rapid and
sustained tetanic  Induction of labor  MI bleeding.
uterotonic effect  Dyspnea and  Monitor
or during 1st stage
which shortens the pulmonary contractions
of labor
third stage of labor edema , which may
 Pregnancy
and reduces blood  Hypotension begin
loss. The onset of immediately
action after I.V.  Hypersensitiv .
ity reactions Contractions
including may
shock continue for
up to 45
minutes
after I.V. use
or for 3
hours or
more after
P.O. or I.M.
use.
 Look alike-
sound alike:
Don’t
confuse
Methergine
with
Terbutaline.
 Explain use
of drug to
patient and
family.
 Instruct
patient to
report
adverse
reactions
promptly.
Oxytocic By direct action on  To induce or  Hypersensitive to Frequency Not Alert: All patients
myofibrils – stimulate labor drug when vaginal Defined receiving oxytocin I.V
produces phasic  To accelerate delivery is advised  Sinus must be under
contraction normal  Cephalopelvic bradycardia, continuous
characteristic of parturition disproportion is observation
tachycardia,
normal delivery.  To reduce present  Drug is induced
premature
postpartum  Unfavorable fetal ventricular or reinforce
Promotes milk
bleeding after positions or complexes & labor when
injection (letdown)
expulsion of presentations, other vaginal delivery
reflex in nursing
mother, thereby placenta e.g., transverse arrhythmias is indicated,
increasing flow  Postpartum lies, which are  Permanent CNS when fetal
(not volume) of evacuation of undeliverable or brain damage, maturity is
milk. It also uterine debris without and death assured, and
facilitates flow of  Incomplete or conversion prior secondary to when fetal
milk during period inevitable to delivery asphyxia position is
of breast abortion  Fetal distress  Neonatal seizure favorable
engorgement.  Postoperative where delivery is  Neonatal  Use drug only in
contraction of not imminent jaundice hospital where
Uterine sensitivity  critical care
the uterus Contraindicated  Fetal death
to oxytocin facilities and
following vaginal delivery,  Uteroplacental
increases during Cesarean e.g., invasive prescriber are
gestation period hypoperfusion &
section and cervical variable immediately
and peaks sharply available
control of carcinoma, active deceleration of
before parturition.
uterine herpes genitals, fetal heart rate  Monitor fluid
Not used for hemorrhage total placenta  Fetal hypoxia intake and
elective induction previa, vasa  Perinatal hepatic output
of labor. previa, & cord necrosis  Monitor and
presentation or  Fetal hypercapnia record uterine
prolapse of cord  CV: Severe contractions,
decreases in heart rate, blood
maternal systolic pressure,
& diastolic blood intrauterine
pressure, pressure. Fetal
hypertension, heart rate, and
increases in heart character of
rate, systemic blood every 15
venous return & minutes
 Have 20%
 cardiac output, & magnesium
arrhythmia sulfate solution
 GI: nausea and  If contraction
vomiting occur less than 2
 RESPIRATORY: minutes apart,
anoxia, asphyxia exceed 50 mm,
 Others: Low or 90 seconds or
APGAR score at 5 longer, stop
mins infusion, turn
patient on her
side, and notify
prescriber
 Don’t confuse
Pitocin with
Pitressin
 Explain to
patient that the
drug doesn’t
cause fetal
abnormalities
3. Carboprost Therapeutic Produces strong,  To terminate  Contraindicated in CNS: fever, headache,  Unlike other
Generic name: class: prompt pregnancy patients anxiety, paresthesia, prostaglandi
Carboprost Oxytocic contractions of between weeks hypersensitive to syncope, weakness. n
tromethamine uterine smooth 13 and 20 of drug and in those abortifacient
Brand name: Pharmacologi muscle, possibly gestation with acute pelvic CV: arrythmias, chest s, drug is
Hemabate c class: mediated by  Is used when inflammatory pain, flushing. given by I.M.
Prostaglandin calcium and cAMP. another disease or active injection.
method of cardiac, EENT: blurred vision, Injectable
abortion has pulmonary, renal, eye pain. form avoids
not completely or hepatic disease. risk
emptied the  Use cautiously in GI: vomiting, expelling
uterus, or when patients with diarrhea, nausea. vaginal
a complication history of asthma, suppositorie
of pregnancy hypotension, GU: uterine rupture, s if patient
would cause the hypertension, endometritis, uterine has profuse
baby to be born anemia, jaundice, or vaginal pain. vaginal
too early to or diabetes; and bleeding.
survive. those with seizure Musculoskeletal:  Pretreating
  Postpartum disorders, backache, leg cramps. and giving
hemorrhage previous uterine with
from uterine surgery, or CV, Respiratory: antiemetics
atony not adrenal, renal, or coughing, wheezing. and
managed by hepatic disease. antidiarrheal
conventional Skin: rash, s decreases
methods diaphoresis. the risk of
 common GI
Other: breast effects.
tenderness, chills, hot  the patient
flashes. to limit or
stop caffein
intake, only
consume at
least 200 g
per day
 (for
arrythmias)
palpate
pules, note
its rate,
regularity
and
amplitude,
and
symmetry
 Determine
the
extent/sever
ity and
location of
discomfort.

4. Hemostan Haemostatics  It is an anti-  for short term  Hypersensitivity  Hypersensitivity · Note any
Generic Name: - fibrinolytic that use for to the active reactions including unusual
Tranexamic acid Antifibrinolyti competitively hemorrhage substance anaphylaxis change in
Brand Name: cs inhibits the  risk of  Active  Convulsions, bleeding
particularly in case
Hemostan activation of hemorrhage in thromboembolic of misuse pattern and
plasminogen to those with disease.  Colour vision it should be
plasmin increased  History of disturbances, reported
(fibrinolysin), an fibrinolysis or venous or retinal vein/artery immediately
enzyme that fibrinogenolysis arterial occlusion to the
degrades fibrin  Prophylaxis of thrombosis.  Thromboembolic physician.
clots, fibrinogen hereditary  Fibrinolytic events · Instruct
and other angioedema conditions  Arterial or venous client that
plasma  Prostatectomy following thrombosis this
proteins, and bladder consumption  Malaise with medication
including the surgery coagulopathy. hypotension, with should only
or without loss of
procoagulant  Menorrhagia  Severe renal be taken
consciousness
factors V and  Epistaxis impairment during
 Digestive effects
VIII.  Conisation of because of risk menstrual
such as nausea,
 It also directly the cervix of accumulation. period for
vomiting and
inhibits plasmin  Traumatic  History of diarrhoea
women
activity but hyphaema convulsions. taking
  Allergic skin
higher doses  Management of reactions
Tranexamic
are required dental acid to
than are extraction in control
needed to haemophiliacs. heavy
reduce the bleeding.
plasmin · Inform client
formation that this
medication
can be taken
with or
without
meals.
· Instruct
client to
swallow
Tranexamic
Acid whole
with plenty
of liquids.
Do not
break, crush,
 or chew
before
swallowing.
· Inform client
that
whenever
they miss a
dose of
Tranexamic
acid, take a
dose of it
whenever
they
remember,
then take
the next
dose at least
6 hours
later.
· Inform the
client that
he/she
should
inform the
physician
immediately
if the
following
severe side
effects
occur:
Ø Severe
allergic
reactions
such as rash,
hives,
itching,
dyspnea,
 tightness in
the chest,
swelling of
the mouth,
face, lips or
tongue
Ø Calf pain,
swelling or
tenderness
Ø Chest pain
Ø Confusion
Ø Coughing up
blood
Ø Decreased
urination
Ø Severe or
persistent
headache
Ø Severe or
persistent
body
malaise
Ø Shortness of
breath
Ø Slurred
speech
Ø Vision
changes

5. Demerol Therapeutic  Binds with  Moderate  Contraindicat CNS: agitation, Regularly monitor
class: opioids to severe ed in patients incoordination, patients for
Generic name: Opioid receptors pain that hypersensitiv clouded sensorium, development of
Meperidine analgesics in the CNS, requires an e to drug and dizziness, euphoria, opioid addiction,
altering opioid in those with light headedness, abuse and misuse.
Pharmacologi perception analgesic significant sedation,
c class: of and and for respiratory somnolence, Monitor patients
Opioids emotional which depression, seizures, closely especially
response alternative acute or hallucinations, within first 24 to 72
to pain. treatments severe headache, hours of starting
are bronchial paradoxical anxiety, drug and after a
inadequate asthma in an physical dependence, dosage increase.
unmonitored syncope, tremor and
setting or in confusion Carefully monitor
the absence vital signs, pain level,
of CV: bradycardia, respiratory status
resuscitative cardiac arrest, shock, and sedation level in
equipment, hypotension, all patients receiving
and with tachycardia, opioids, especially
known or palpitations, flushing those receiving IV
suspected GI drugs.
obstruction, GI: biliary tract
including spasms, constipation, Monitor patients for
paralytic dry mouth, ileus, signs and symptoms
ileus. nausea, vomiting of adrenal
 In patients insufficiency and
who have GU: urine retention decreased sex
received hormone levels
MAO MUSCULOSKELETAL: especially when
inhibitors muscle twitching starting treatment or
within past increasing dosage.
14 days. RESPIRATORY:
 Opioids Respiratory arrest, When giving drug
should only respiratory parentally, make
be prescribed depression sure patient is lying
with down.
benzodiazepi SKIN: diaphoresis,
nes or other pruritus, urticaria Drug may be used in
CNS some patients who
depressants Others: induration, are allergic to
to patients local tissue irritation, morphine.
for whom pain at injection site,
alternative phlebitis after IV Reassess patient’s
treatment delivery level of pain at least
options are 15 and 30 mins after
inadequate. administration.
 In neonates exposed
to drug during labor,
monitor respirations.
Have resuscitation
equipment and
naloxone available.

If postoperative
patients, monitor
bladder function.

Warn patient to
keep drug out of
reach of children as
accidental ingestion
of even one dose can
be fatal.
6. Promethazine Therapeutic  Promethazi  To prevent or  Hypersensitivity to CNS: drowsiness, Alert: Perivascular
Class: ne is a an treat motion drug sedation, confusion, extravasation,
Generic Name: antagonist sickness  Previous sleepiness, dizziness, unintentional intra-
Gastrointestin of  To treat vertigo idiosyncratic disorientation, arterial injection, or
Promethazine al Agent histamine  To prevent or reaction to extrapyramidal intraneuronal or
H1, post- treat nausea phenothiazines symptoms. perineuronal
Brand Name/s: Pharmacologi synaptic and vomiting in  Coma CV: hypotension, infiltration of the
c Class: mesolimbic certain types of  Intra-arterial and hypertension. drug may result in
Phenergan, and Antihistamine dopamine, anesthesia and subcutaneous EENT: dry mouth, irritation and tissue
Phenadoz. alpha surgery injection blurred vision. damage, including
adrenergic,  To treat signs  Children younger GI: nausea, vomiting gangrene.
muscarinic, and symptoms than age 2 GU: urine retention.  Monitor patient
and NMDA of allergic Hematologic: for neuroleptic
receptors. response leukopenia, malignant
 The  To provide agranulocytosis, syndrome
antihistami nighttime, thrombocytopenia. altered mental
ne action is preoperative, or Metabolic: status,
used to postoperative hyperglycemia autonomic
treat sedation Respiratory: instability,
allergic  To relieve respiratory muscle rigidity,
reactions. apprehension depression, apnea and
 and promote Skin: photosensitivity hyperpyrexia.
 Antagonis sleep the night and rash  Stop drug 4 days
m of before surgery before diagnostic
muscarinic  To provide skin testing
and NMDA obstetric because
receptors sedation antihistamines
contribute can prevent,
to its use reduce, or mask
as a sleep positive skin test
aid, as well response.
as for  Drug is used as
anxiety and an adjunct to
tension. analgesics,
usually to
 Antagonis increase
m of sedation; it has
histamine no analgesic
H1, activity.
muscarinic,  Drug may be
and mixed with
dopamine meperidine in
receptors same syringe.
in the  In patients
medullary scheduled for a
vomiting myelogram, stop
center drug 48 hours
make before
promethazi procedure. Don’t
ne useful in resume drug
the until 24 hours
treatment after procedure
of nausea because of the
and risk of seizures.
vomiting.

7. Evening Oenothera This oil can help  Soften and  Contraindicat CNS: headache, Record observations
Primrose biennis with the thinning efface the ed to patients seizure on the partograph
 and dilation of the cervix to who have a
Scientific name: cervix due to its induce bleeding GI: upset stomach, Ensure privacy for
Oenothera linolenic acid which labor disorder or diarrhea, nausea, the patient by closing
biennis can trigger a  for bleeding vomiting, loose stool, doors, closing the
prostaglandin preventing problems abdominal pain, curtain, asking other
response in the high blood (postpartum bleeding guests to step out of
Brand name:
body pressure bleeding the room, and proper
Effamol problems or Skin: bleeding into draping of the client
(pre-
Eprim newborn the skin or bruising,
eclampsia)
Rosem-1000
 premenstru bleeding rashes or skin lesions Observe aseptic
Evelife al problems) (if allergic) technique
syndrome  Epilepsy or
(PMS) Schizophrenia Rare Side Effects: A Clean the
 breast pain  Other seizure Decrease in Platelet surrounding perineal
disorder Clotting area first to ensure
 endometrio
sis  Within 2 no bacteria gets into
weeks of Others: Taste the genital
 To
going for a Impairment, Weight
decrease
general gain When cleaning the
bone loss
and anesthetic perineal area, always
increase  Allergy or clean from front to
bone sensitivity back
density reactions to
 Nerve pain Evening Make sure to
primrose thoroughly dry the
area especially in the
folds of the skin to
minimize the growth
of microorganisms

8. Buscopan Antispasmodi BUSCOPAN BUSCOPAN • BUSCOPAN (hyoscine Solution  Drug

c (hyoscine (hyoscine butylbromide) tablets Cardiac disorders: compatibility
butylbromide) is an butylbromide) are contraindicated in Tachycardia should be
Generic name: antispasmodic tablets are indicated patients with Eye disorders: Visual monitored
Hyoscine Butyl- agent which relaxes for: myasthenia gravis, accommodation closely in
N-Bromide the smooth muscle - The relief of megacolon, glaucoma disorders, mydriasis, patients
of the smooth muscle or obstructive increased intraocular requiring
gastrointestinal, spasm/cramping of prostatic hypertrophy. pressure. adjunctive
biliary and urinary the gastrointestinal Gastrointestinal therapy
(parenteral system and its • Parenteral disorders: Xerostomia  Avoid driving &
formulation) tracts. associated pain and administration is (dry mouth) Immune operating
It is believed to act discomfort. contraindicated in system disorders machinery after
predominantly at patients with There have been very parenteral
the BUSCOPAN solution myasthenia gravis, rare reports of administration.
parasympathetic is indicated for: untreated narrow anaphylactic reactions  Avoid strict heat
ganglia in the walls - The relief of acute angle glaucoma, and anaphylactic  Raise side rails as
of the viscera of genitourinary or prostatic hypertrophy shock including fatal a precaution
these organs. gastrointestinal with urinary retention, outcome. because some
Structurally, spasm (e.g., renal or stenotic lesions or Skin reactions: patients become
BUSCOPAN exists as biliary colic), or to mechanical stenosis of (e.g. urticaria, rash, temporarily
a quaternary produce smooth the gastrointestinal erythema, pruritus), excited or
ammonium muscle relaxation tract, tachycardia, and other disoriented and
compound and as a prior to radiological angina, cardiac failure, hypersensitivity, some develop
single positively procedures such as paralytic or obstructive angioedema and fixed amnesia or
charged cation pyelography or ileus, and megacolon. drug eruptions have become drowsy.
throughout the other diagnostic been reported rarely.  Reorient patient,
entire pH range. procedures where • BUSCOPAN solution Dyspnea as needed,
spasm may be a should not be given by Renal and urinary Tolerance may
problem (e.g., intramuscular injection disorders: develop when
gastroduodenal to patients being Urinary retention therapy is
endoscopy) treated with Skin and prolonged
anticoagulant drugs subcutaneous tissue  Atropine-like
since intramuscular disorders: toxicity may
hematoma may occur. Hypohidrosis, heat cause dose
In these patients, the sensation/transpiratio related adverse
subcutaneous or n reactions.
intravenous routes Vascular disorders: Individual
may be used. There have been rare tolerance varies
reports of dizziness, greatly
blood pressure  Overdose may
decreased and cause curare-like
flushing. effects, such as
 respiratory
Tablets paralysis. Keep
Cardiac disorders: emergency
Tachycardia equipment
Gastrointestinal available.
disorders:
Xerostomia (dry
mouth), diarrhea,
nausea.
Immune system
disorders:
There have been very
rare reports of
anaphylactic reactions
and anaphylactic
shock. Skin reactions
(e.g. urticaria, rash,
erythema, pruritus),
and other
hypersensitivity,
angioedema and fixed
drug eruptions have
been reported rarely.
Dyspnea
Renal and urinary
disorders:
Urinary retention Skin
and subcutaneous
tissue disorders:
Hypohidrosis, heat
sensation/transpiratio
n Vascular disorders
Adverse events
reported during
therapy with
BUSCOPAN include
increased pulse rate.