DRUG STUDY

NAME OF DRUG GENERAL ACTION SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
Acetaminophen Non-steroidal anti- Drug may relieve  Fever  Hypersensitive to the CNS 1. Give without regard for food.
(Paracetamol) inflammatory drug fever through central drug  Agitation (IV) 2. Before and during long-term
300mg IV now then action in the  Severe hepatic  Headache therapy, monitor liver function test
every 4 hours for hypothalamic heat- impairment or severe  Insomnia results, including AST, ALT, bilirubin,
fever >37.8 ̊C; regulating center. active liver disease  Pyrexia and creatinine levels, as ordered.
CV
Acetaminophen  Use cautiously in 3. Monitor renal function in patient
 Hypertension
(Paracetamol) patients with any type on long-term therapy. Keep in mind
 Hypotension
300mg IV every 4 of liver disease, chronic that blood or albumin in urine may
 Peripheral edema
hours PRN for malnutrition, severe indicate nephritis; decreased urine
 Periorbital edema
temp. >38.5 ̊C and hypovolemia  Tachycardia (IV)
output may indicate renal failure;
above; (dehydration or blood GI and dark brown urine may indicate
Acetaminophen loss) or severe renal  Nausea presence of the metabolite
(Paracetamol) impairment  Vomiting phenacetin.
500mg 1 tab for  Use cautiously in  Diarrhea 4. Expect to reduce dosage for
temp. >37.8 ̊C; patients with long-term  Constipation (IV) patients with renal dysfunction.
Acetaminophen alcohol use because GU 5. Tell patient that tablets may be
(Paracetamol) therapeutic doses can  Oliguria (IV) crushed or swallowed whole.
300mg IV for temp. cause hepatotoxicity in  Anemia 6. Instruct patient to read
38 ̊C these patients  Leukopenia manufacturer’s label and follow
 Neutropenia dosage guidelines precisely. Explain
 Pancytopenia that infants’ and children’s
Metabolic acetaminophen liquid aren’t equal in
 Hypervolemia
drug concentration and aren’t
 Hypoalbuminemia (IV)
interchangeable.
 Hypoglycemia
7. Advise him to contact prescriber
 Hypokalemia
 Hypomagnesemia
before taking other prescription or
 Hypophosphatemia (IV) OTC products because they may
Musculoskeletal contain acetaminophen.
 Muscle spasms
 Extremity pain (IV)
Respiratory
 Hypoxia
 Atelectasis
 Pulmonary edema
 Stridor
 Wheezing (IV)
NAME OF DRUG GENERAL SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION
Omeprazole 40mg Antiulcer drugs; Inhibit proton pump  Symptomatic GERD  Hypersensitive to drug CNS 1. Long-term therapy may cause
IV now then OD PPIs activity by binding to without esophageal or its components  Asthenia vitamin B12 absorption problems.
before breakfast hydrogen-potassium lesions  Long-term  Dizziness Assess patient for signs and
adenosine triphosphate,  Erosive esophagitis administration of  Headache symptoms of cyanocobalamin
located at secretory  Pathologic bicarbonate with deficiency (weakness, heart
surface of gastric hypersecretory calcium or milk GI palpitations, dyspnea, paresthesia,
parietal cells, to conditions (such as  Use cautiously in  Abdominal pain pale skin, smooth tongue, CNS
suppress gastric acid Zollinger-Ellison patients with  Constipation changes, and loss of appetite).
secretion. syndrome) hypokalemia and  Diarrhea 2. Dosage adjustments may be
 Duodenal ulcer respiratory alkalosis in  Flatulence necessary in Asians and patients with
 Helicobacter pylori patients on a low-  Nausea hepatic impairment.
infection and sodium diet  Vomiting 3. Periodically assess patient for
duodenal ulcer  Use cautiously in osteoporosis.
disease breastfeeding women Musculoskeletal 4. Gastric level rises in most patients
 Short-term during the first 2 weeks of therapy
 Back pain
treatment of active 5. Caution patient to avoid hazardous
benign gastric ulcer activities if he gets dizzy.
Respiratory
 Frequent heartburn 6. Teach patient to recognize and
 Cough
(2 or more times a report signs and symptoms of low
 Upper respiratory
week) potassium levels.
tract infection
 Stress ulcer
prophylaxis Skin
 Metabolic Acidosis  Rash
 NAME OF DRUG GENERAL SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION
Ampicillin + Antibiotic; Inhibits bacterial cell  To treat GI  Hypersensitivity to any CNS: 1. Avoid giving ampicillin to patients
Sulbactam 1.3gram Semisynthetic wall synthesis. The rigid, infections and penicillin  Chills with mon-nucleosis because of
IVTT every 8 hours aminopenicillin cross-linked cell wall is genitourinary  Infection caused by  Fatigue increased risk of rash.
assembled in several infections penicillinase-producing  Fever 2. Expect to give ampicillin for 48 to
steps. Ampicillin exerts  To treat organism  Headache 72 hours after patient becomes
its effects on susceptible gonorrhea  Malaise asymptomatic. For streptococcal
bacteria in the final  To treat CV: infection, expect to give ampicillin
stage of the cross-linking septicemia  Chest pain for at least 10 days after cultures
process by binding with  To prevent  Edema show streptococcal eradication to
and inactivating bacterial  Thrombophlebitis reduce risk of rheumatic fever or
penicillin-binding endocarditis from EENT: glomerulonephritis.
proteins (enzymes dental, oral, or  Epistaxis 3. To dilute ampicillin for I.M. use,
responsible for linking upper respiratory add (depending on manufacturer)
 Glossitis
the cell wall strands). tract procedures 1.2 ml of sterile water or
 Laryngeal stridor
This action causes  To treat bacterial bacteriostatic water for injection to
 Stomatitis
bacterial cell lysis and meningitis each 125-mg vial, 1 ml of diluent to
 Throat tightness
death.  To treat listeriosis each 250-mg vial, 1.8 ml of diluent
GI:
to each 500-mg vial, 3.5 ml of
 Abdominal distention diluent to each 1-g vial, or 6.8 ml of
 Diarrhea, diluent to each 2-g vial.
 Flatulence 4. To dilute ampicillin for intermittent
 Gastritis infusion, add 5 ml of sterile water
 Nausea or bacteriostatic water for injection
 Pseudomembranous to each 125-, 250-, or 500-mg vial
colitis or 7.4 to 10 ml of diluent to each 1-
 Vomiting or 2-g vial. Infuse in suitable diluent
GU: at less than 30 mg/ml. WARNING
 Dysuria, Infuse I.V. solution for 3 to 5
 Urine retention minutes for each 125 or 500 mg or
 Vaginal candidiasis 10 to 15 minutes for each 1 or 2 g.
Hematologic: More rapid infusion may cause
 Agranulocytosis seizures.
 Anemia 5. Monitor patient closely for
 Eosinophilia anaphylaxis, which may be life-
 Leukopenia threatening. Patients at greatest
risk are those with a history of
 Thrombocytopenia multiple allergies, hypersensitivity
 Thrombocytopenic to cephalosporins, or a history of
purpura asthma, hay fever, or urticaria.
Skin: WARNING In an anaphylactic
 Erythema multiforme reaction, stop drug, notify
exfoliative dermatitis prescriber immediately, and
 Pruritus provide immediate treatment with
 Urticarial epinephrine, airway management,
Other: oxygen, and I.V. corticosteroids, as
 Anaphylaxis needed.
 Facial edema 6. Notify prescriber if patient has
 Injection site pain evidence of superinfection; expect
to stop drug and provide
appropriate treatment.
7. If long-term or high-dose ampicillin
therapy is required, closely monitor
results of renal and liver function
tests and CBCs.
8. Monitor patient closely for
diarrhea, which may be
pseudomembranous colitis caused
by Clostridium difficile. If diarrhea
occurs, notify prescriber and expect
to withhold ampicillin and
administer fluids, electrolytes,
protein, and an antibiotic effective
against C. difficile.
 NAME OF DRUG GENERAL ACTION SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
Regular Insulin 10 Antidiabetics; Lowers blood glucose  As adjunct to diet  Hypersensitivity to drug CV 1. Monitor blood glucose level and
units now; Insulins level by stimulating and exercise to or its components  Peripheral Edema adjust insulin dosage as needed for
Regular Insulin 8 peripheral glucose improve glycemic  During episodes of patient-specific goals.
“U” SQ for CBG uptake by binding to control in patients hypoglycaemia Metabolic 2. Monitor patient carefully when
>180 mg/dL insulin receptors on with type 1 and type  Use cautiously in  Hypoglycemia initiating therapy. Time course of
skeletal muscle and 2 diabetes mellitus patients susceptible to  Hypokalemia insulins varies with each patient.
in fat cells and by hypoglycemia and  Weight gain 3. Assess patient for signs and
inhibiting hepatic hypokalemia symptoms of hypoglycemia
glucose production;  Use cautiously in Skin (sweating, shaking, trembling,
also inhibits lipolysis patients with hepatic or  Injection-site confusion) and hyperglycemia
and proteolysis, and renal impairment reactions (drowsiness, fruity breath odor,
enhances protein  Use cautiously in  Lipodystrophy frequent urination, and thirst). Notify
synthesis. elderly patients, prescriber if any of these signs and
pregnant women and Other symptoms occur.
breastfeeding women.  Allergic reactions 4. Mild episodes of hypoglycemia
 Anaphylaxis may be treated with oral glucose.
 Insulin antibody 5. Periodically measure HbA1c levels.
production 6. Monitor potassium levels in
patients at risk for hypokalemia,
including those taking potassium-
depleting drugs.
7. Increase frequency of glucose
monitoring in patients who are
acutely ill or under emotional stress,
or if changes in diet, exercise, or
medication regimen occur because
these may affect the rate of insulin
absorption. Also monitor patient
closely after changes to insulin
dosage.
8. Monitor patients for generalized
allergic reactions, including
anaphylaxis.
 GENERAL
NAME OF DRUG SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION
Insujet 70/30 100 Antidiabetes Accelerates absorption  Type 1 DM  Hypoglycemia  Hypoglycemia 1. Load the pen by filling the insulin
IU/mL 10 units of rapid-acting insulin  Type 2 DM  Patients in coma due  Headache adapter with insulin. Once the
pre-breakfast, 10 from the  Gestational to hypoglycemia  Nausea device is loaded, set the gauge to
units pre-dinner subcutaneous area diabetes  Palpitation the prescribed insulin dose. Then,
into the systemic  Emergency  Local and general place the device against the skin,
circulation management of hypersensitivity typically in an area with some fatty
diabetic reactions tissue.
ketoacidosis
2. Sterilize the insulin jet injector on
a regular basis.

3. Make sure that all of the pieces

of the insulin jet injector are
connected properly before taking
insulin into the device. Also, be sure
to hold the device correctly when
taking insulin into it.
 NAME OF DRUG GENERAL ACTION SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
Levofloxacin 300mg Antibiotics; Inhibits bacterial DNA  Acute bacterial  Hypersensitivity to drug CNS 1. If patient experiences symptoms of
IVTT OD; Fluoroquinolones gyrase and prevents sinusitis or its components  Encephalopathy excessive CNS stimulation
Levofloxacin 500mg DNA replication,  Mild to moderate  History of myasthenia  Seizures (restlessness, tremor, confusion,
1 tab after lunch x 5 transcription, repair skin and skin- gravis  Dizziness hallucinations), stop drug and notify
days and recombination in structure infections  Use cautiously in  Headache prescriber. Begin seizure precautions.
susceptible bacteria.  Acute bacterial patients with history of  Insomnia 2. Monitor patient for signs and
worsening of chronic seizure disorders or EENT symptoms of peripheral neuropathy
bronchitis other CNS diseases,  Eye pain (pain, burning, tingling, numbness,
 To prevent such as cerebral  Vision loss weakness, or a change in sensation of
inhalation anthrax arteriosclerosis light touch, pain, temperature, or
 Photophobia
after confirmed or  Use cautiously in GI
sense of body position), and report
suspected exposure patients with renal them immediately to health care
 Pseudomembranous provider.
 Chronic bacterial impairment
colitis 3. Warn patient to avoid hazardous
prostatitis
 Abdominal pain tasks until adverse effects of drugs
 Community-
acquired pneumonia  Constipation are known.
 Nosocomial  Diarrhea 4. Advise patient to avoid excessive
pneumonia  Dyspepsia sunlight exposure.
 Complicated UTI  Nausea 5. Instruct patient to notify prescriber
 Mild to moderate  Vomiting of loose stools or diarrhea
uncomplicated UTI GU 6. Instruct patient to stop the drug
and notify prescriber if rash or other
 Prophylaxis or  Vaginitis
signs and symptoms of
treatment of Hematologic
hypersensitivity develop.
pneumonic and  Lymphopenia
septicemic plague  Eosinophilia
 Bacterial  Hemolytic anemia
conjunctivitis Metabolic
 Infection prophylaxis  Hypoglycemia
to neutropenia Musculoskeletal
 Drug-resistant TB  Back pain
 Device-related
 Tendon rupture
osteoarticular
Respiratory
infection (MRSA)
 Allergic pneumonitis
 Surgical prophylaxis
 Dyspnea
 NAME OF DRUG GENERAL ACTION SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
Losartan K 100mg 1 Antihypertensives; Inhibits  Hypertension  Hypersensitive to the CNS 1. Give without regard for food.
tab after breakfast Angiotensin II vasoconstrictive and  Nephropathy in drug  Dizziness 2. Drug can be used alone or with
receptor antagonists aldosterone-secreting patients with type 2  Breastfeeding  Asthenia other hypertensives.
action of angiotensin diabetes  Use cautiously in  Fatigue 3. If antihypertensive effect is
II by blocking  To reduce risk of patients receiving other  Headache inadequate using once-daily doses, a
angiotensin II stroke in patients peripheral vasodilators,  Insomnia twice-daily regimen using the same
receptor on the with hypertension especially those with or increased total daily dose may give
surface of vascular and left ventricular severe aortic stenosis CV a more satisfactory response.
smooth muscle and hypertrophy or hypertrophic  Edema 4. Monitor patient’s BP closely to
other tissue cells. cardiomyopathy with  Chest pain evaluate effectiveness of therapy.
outflow tract When used alone, drug has less of an
obstruction, and in EENT effect on BP in black patients than in
patients with heart  Nasal congestion patient of other races.
failure  Sinusitis 5. Monitor patients who are also
taking diuretics for symptomatic
 Pharyngitis
hypotension.
 Sinus disorder
6. Regularly assess the patient’s renal
function (via creatinine and BUN
GI
levels).
 Nausea
7. Patients with severe heart failure
 Abdominal pain
whose renal function depends on the
 Diarrhea angiotensin-aldosterone system may
 Dyspepsia develop acute renal failure during
therapy. Closely monitor patient’s BP,
Musculoskeletal renal function, and potassium levels,
 Muscle cramps especially during after few weeks of
 Myalgia therapy and after dosage
 Back or leg pain adjustments.
8. Tell patient to avoid salt
Respiratory substitutes; these products may
 Cough contain potassium, which can cause
 Upper respiratory high potassium level in patients
tract infection taking losartan.

Other
 Angioedema
NAME OF DRUG GENERAL ACTION SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
Sitagliptin + Antidiabetes Inhibits the dipeptidyl  To achieve control  Hypersensitivity CNS: 1. Monitor patient for
Metformin peptidase-4 enzyme of glucose level in to sitagliptin or  Headache hypersensitivity reactions that,
2.5mg/500mg 1 tab to slow inactivation type 2 diabetes its components EENT: although uncommon, may be severe.
BID after lunch of incretin hormones. mellitus as  Type 1 diabetes  Nasopharyngitis If present, notify prescriber and
These hormones are monotherapy or GI: expect sitagliptin to be discontinued.
released by the with metformin or  Abdominal pain 2. Monitor patient’s blood glucose
intestine throughout other  Acute pancreatitis level, as ordered, to determine
the day but increase thiazolidinediones  Diarrhea effectiveness of sitagliptin therapy.
in response to a  Elevated hepatic 3. Stress the need to follow an
meal. When blood enzymes exercise program and a diet control
glucose level is  Nausea program during sitagliptin therapy.
normal or increased,  Vomiting 4. Advise patient to notify prescriber
incretin hormones RESP: immediately if she has trouble
increase insulin  Upper respiratory breathing, hives, rash, or swelling.
synthesis and release tract infection 5. Inform patient that periodic blood
from pancreatic beta SKIN: tests will be done to determine
cells. One type of effectiveness of drug and assess
 Cutaneous vasculitis
incretin hormone, kidney function.
 Rash
glucagon-like peptide 6. Teach patient how to monitor
 Stevens Johnson
(GLP-1) also lowers blood glucose level and when to
syndrome
glucagon secretion report changes.
 urticaria
from pancreatic 7. Caution patient that taking other
Other:
alpha cells which drugs in addition to sitagliptin to
reduces hepatic  Anaphylaxis control his diabetes may lead to
glucose production.  angioedema hypoglycemia. Review signs,
These combined symptoms, and appropriate
actions decrease prescribed treatment with him.
blood glucose level in 8. Instruct patient to contact
type 2 diabetes. prescriber if he develops other
illnesses, such as infection, or
experiences trauma or surgery
because his diabetes medication may
need adjustment.
9. Instruct patient to stop taking
sitagliptin and report persistent
severe abdominal pain, possibly
radiating to the back and
accompanied by vomiting.
 GENERAL
NAME OF DRUG SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION
 Hypertensitivity to any  Hypoglycemia
↑ Biphasic Antidiabetes Inhibits hepatic  Type 1 DM 1. Assess patient periodically for
components of this  Nervousness or
Human Insulin 12 glucose production  Type 2 DM symptoms of hypoglycemia
“U” SQ pre-dinner and enhances medication tremor (anxiety; restlessness; tingling of
either alone or
and 15 “U” pre- peripheral glucose  Hypoglycemia  Anxious feeling hands, feet, lips, or tongue; chills;
in combination
breakfast; disposal, thereby with oral anti-  Coma due to  Fatigue cold sweat; confusion; cool, pale
reducing blood- diabetic agents hyperglycemia  Weakness skin; difficulty in concentration;
↑ Insulin pre-
glucose concentration.  Gestational  Confusion drowsiness; excessive hunger;
breakfast 18 “U”
It also inhibits lipolysis, diabetes  Headache headache; irritability; nausea;
SQ and 15 “U” SQ
thereby preventing  Emergency  Nausea nervousness; tachycardia; tremor;
pre-dinner;
the formation of management of  Palpitation weakness; unsteady gait) during
↑ Biphasic ketone bodies. diabetic  Skin rash therapy.
Human Insulin 17 ketoacidosis  Sweating 2. Monitor body weight
“U” SQ pre-dinner  Difficulty in periodically. Changes in weight may
and 20 “U” pre- breathing necessitate changes in insulin dose.
breakfast;
3. Lab test considerations: monitor
blood glucose every 6 hours during
therapy, more frequently in
ketoacidosis and times of stress.
3. Instruct patient on signs and
symptoms of hypoglycemia and
hyperglycemia and what to do
when they occur.
4. Insulin should be stored in a cool
dry place but does not need to be
refrigerated.
NAME OF DRUG GENERAL SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION
 Hypersensitive to
Sultamicillin Antibiotic; Irreversible inhibitor  Upper respiratory  Diarrhea 1. Instruct patient to immediately
the drug and its
750mg 1 tab BID Aminopenicillin of most important tract infections  Nausea report signs and symptoms of
components
for 7 days Beta-Lactamase beta – lactamases that including sinusitis,  Vomiting hypersensitivity reaction, such as
inhibitor occur in penicillin – otitis media, and  Rashes rash, fever, or chills.
resistant organisms; tonsillitis  Pruritis 2. Advise patient to minimize GI
bactericidal  Lower respiratory  Blood dyscrasias upset by eating small, frequent
component of the tract infections  Superinfections servings of food and drinking plenty
combination, as it including bacterial  Dizziness of fluids.
inhibits the pneumonias and  Dyspnea
biosynthesis of cell bronchitis 3. Inform patient that drug lowers
wall mucopeptide of  Urinary tract resistance to certain infections.
many Gram positive, infections Instruct him to report new signs
Gram negative aerobic  Pyelonephritis and symptoms of infections,
and anaerobic  Skin and soft tissue especially in mouth or rectum. Tell
bacteria. infections patient to promptly report unusual
bleeding or bruising.
 Gonococcal
infections 4. Instruct patient to avoid activities
that can cause injury. Advise him to
use soft toothbrush and electric
razor to avoid gum and skin injury.
 GENERAL
NAME OF DRUG SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION
Piperacillin + Antibiotics; Inhibits cell-wall  Moderate to severe  Hypersensitive to drug CNS 1. Monitor patient for diarrhea and
Tazobactam 4.5 Extended- synthesis during infections from or other penicillins  Headache initiate therapeutic measures as
grams IVTT every 8 spectrum bacterial multiplication. piperacillin-  Use cautiously in  Insomnia needed. Drug may need to be
hours penicillins-beta- resistant, patients with bleeding  Fever stopped.
lactamase piperacillin- tendencies, uremia,  Seizures
inhibitors tazobactam- hypokalemia and  Agitation 2. Monitor patient’s sodium intake
susceptible, beta- allergy to other drugs,  Anxiety and electrolyte levels. Drug contains
lactamase-producing especially  Dizziness 2.35 mEq sodium/g of piperacillin.
strains of cephalosporins,  Pain
microorganisms in because of possible CV 3. Monitor hematologic and
appendicitis and cross-sensitivity  Arrhythmia coagulation parameters.
peritonitis  Chest pain
 Skin and skin-  Edema
4. Patients with cystic fibrosis may
structure infections have a higher rate of fever and rash.
 Hypertension
 Moderately severe Monitor these patients closely.
 Tachycardia
community-acquired
GI
pneumonia 5. Tell patient to report adverse
 Constipation
 Appendicitis reactions promptly.
 Diarrhea
 Peritonitis
 Nausea 6. Tell patient to report discomfort at
 Moderate to severe
 Pseudomembranous the IV site.
nosocomial
colitis
pneumonia
 Abdominal pain
 Catheter-related
 Vomiting
bloodstream
GU
infection
 Candidiasis
 Interstitial nephritis
Hematologic
 Leukopenia
 Neutropenia
 Thrombocytopenia
 Anemia
 Eosinophilia
Respiratory
 Dyspnea
 GENERAL
NAME OF DRUG SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION
Amlodipine 5mg 1 Antihypertensive Inhibits calcium ion  Chronic stable  Hypersensitive to the CNS 1. Give without regard for food.
tab OD after ; Calcium influx across cardiac angina drug  Headache 2. Monitor patient carefully. Some
dinner Channel Blocker and smooth muscle  Vasospastic angina  Use cautiously in  Somnolence patients, especially those with
cells, decreasing (Prinzmetal or patients receiving  Fatigue severe obstruction CAD, have
myocardial variant angina) other peripheral  Dizziness developed increased frequency,
contractility and  Hypertension vasodilators, duration, or severity of angina or
oxygen demands especially those with CV acute MI after initiation of calcium
severe aortic stenosis  Edema channel blocker therapy or at time
or hypertrophic  Flushing of dosage increase.
cardiomyopathy with  Palpitations 3. Monitor BP frequently during
outflow tract initiation of therapy. Because
obstruction, and in GI drug-induced vasodilators has a
patients with heart  Nausea gradual onset, acute hypotension
failure  Abdominal pain is rare.
4. Notify prescriber if signs of
heart failure occur, such as
swelling of hands and feet or
shortness of breath.
5. Abrupt withdrawal of drug may
increase frequency and duration
of chest pain. Taper dose
gradually under medical
supervision.
6. Caution patient to continue
taking drug, even when he feels
better.
7. Tell patient S.L nitroglycerin
may be taken as needed when
angina symptoms are acute.
8. Don’t confuse amlodipine with
amiloride.
 NAME OF DRUG GENERAL ACTION SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
Sodium Electrolyte; Antacid, Increases plasma  Hyperacidity  Hypocalcemia CNS: 1. Monitor sodium intake of patient
Bicarbonate 50 electrolyte bicarbonate level,  Provide urinary  Hypochloremic alkalosis  Mental or mood taking sodium bicarbonate because
mEq/vial 1 vial slow replenisher, buffers excess alkalization secondary to vomiting changes effervescent powder contains 700.6
IV push in 10 systemic and urinary hydrogen ions, and  Metabolic acidosis  Diuretics mg of sodium/ 3.9 g; oral powder
minutes; Sodium alkalizer raises blood pH, during cardiac arrest  Nasogastric suction CV: contains 952 mg of sodium/tsp; and
Bicarbonate thereby reversing   Pre-existing metabolic  Irregular heartbeat tablets contain 325 mg/ 3.9-mEq
650mg/tab 1 tab metabolic acidosis. or respiratory alkalosis  Peripheral edema tablet, 520 mg/6.2-mEq tablet, and
TID PO; Sodium Sodium bicarbonate (with large doses) 650 mg/7.7-mEq tablet.
Bicarbonate 650mg also increases the  Weak pulse 2. For I.V. infusion, dilute drug with
1 tab x 1 month excretion of free normal saline solution, D5W, or other
bicarbonate ions in EENT: standard electrolyte solution before
urine, raising urine  Dry mouth administration.
pH; increased 3. Avoid rapid I.V. infusion, which can
alkalinity of urine GI: cause severe alkalosis. Be aware that
may help to dissolve  Abdominal Cramps during cardiac arrest, risk of death
uric acid calculi. In  Thirst from acidosis may outweigh risks of
addition, it relieves rapid infusion.
symptoms of MS: 4. Monitor urine pH, as ordered, to
hyperacidity by  Muscle spasms determine drug’s effectiveness as
neutralizing or  Myalgia urine alkalizer.
buffering existing 5. If patient on long-term sodium
stomach acid, SKIN: bicarbonate therapy is consuming
thereby increasing calcium or milk, watch for milk-alkali
 Extravasation with
the pH of stomach syndrome, characterized by anorexia,
necrosis
contents. confusion, headache, hypercalcemia,
 tissue sloughing
metabolic acidosis, nausea, renal
 ulceration
insufficiency, and vomiting.
6. Be aware that parenteral forms are
hypertonic and that increased
sodium intake can produce edema
and weight gain.
7. Assess I.V. site often for evidence
of extravasation. If it occurs, notify
prescriber at once and remove I.V.
catheter. Elevate the limb, apply
warm compresses, and expect
prescriber to administer a local
injection of hyaluronidase or
lidocaine.
8. Advise patient not to take sodium
bicarbonate with large amounts of
dairy products or for longer than 2
weeks, unless directed by prescriber.
9. Caution patient not to take more
drug than prescribed to avoid
adverse reactions.
10. Direct patient not to take drug
within 2 hours of other oral drugs.
11. Advise patient to avoid taking
other prescribed or OTC drugs
without prescriber’s approval
because many drugs interact with
sodium bicarbonate.
 GENERAL
NAME OF DRUG SPECIFIC ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION
Ketoanalogue Supplements  Prevention and  Hypercalcemia  Hypercalcemia 1. Assess electrolyte levels.
600mg 1 tab TID therapy of damages  Disturbed amino 2. Explain therapeutic value of drug.
due to faulty or acid metabolism 3. Assess allergy to the drug.
deficient protein  Hereditary 4. Caution patient of the different
metabolism in phenylketonuria side effects.
chronic renal 5. Monitor vital signs.
insufficiency in 6. Proper preparation of the drug.
connection with 7. Administer with food to prevent
limited protein food GI upset.
or <40 g/day (for 8. Advise to swallow the tablet
adults) whole.
 Patients having 9. Instruct patient to report
urologic problems immediately if symptoms of
like chronic kidney hypercalcemia occurs like muscle
disease weakness, constipation.
10. Monitor calcium levels.
11. Monitor for signs of
hypercalcemia and electrolyte
levels.