MARCOS, Arian May S.
BSN 2F - Group A
Drug Name
Generic Name:
Mefenamic Acid
Brand Name:
Apo-Mefenamic (CAN),
Ponstel
Pregnancy Category: C
Classification
Therapeutic:
Analgesic, nsaid;
antipyretic
Pharmacologic:
Analgesic, Nonsteroidal
Anti-Inflammatory Drug
(Nsaid)
Route/Dosage:
Acute pain: Initially, 500
mg PO followed
by 250 mg every 6 hr as
needed. Do not exceed 1
wk of therapy.
Primary dysmenorrhea:
Initially, 500 mg
PO then 250 mg every 6
hr starting with the onset
of bleeding. Can be
initiated at start of menses
and should not be
necessary for longer than
Action
NSAID that inhibits
COX-1 and COX-2
enzymes necessary for
prostaglandin synthesis. It
affects platelet function.
Source:
Karch, A. M. (2013).
2014 Lippincott’s Nursing
Drug Guide (1st ed.).
Lippincott Williams &
Wilkins.
Wilson, B. A., Shannon,
M., & Shields, K. (2014).
Pearson Nurse’s Drug
Guide 2015 (1st ed.).
Pearson.
February 17, 2021
Side Effects and Adverse
Indication/Contraindication Nursing Assessments
Effects
CNS: Headache, Indications: Assessment:
dizziness, somnolence, Short-term relief of mild to  Monitor for and report
insomnia, fatigue, moderate pain including primary promptly S&S of GI
tiredness, dizziness, dysmenorrhea. ulceration or bleeding.
tinnitus, ophthalmic Significant GI
effects Contraindication: bleeding may occur
Hyper- sensitivity to mefenamic; without prior warning.
CV: hypertension, GI inflam- mation, or ulceration.
tachycardia  Assess patients who
Drug-Drug Interactions: develop severe
Dermatologic: Rash, Mefenamic acid may prolong diarrhea and vomiting
pruritus, sweating, bleeding time with ORAL for dehydration and
dry mucous membranes, ANTICOAGULANTS, heparin; electrolyte imbalance.
stomatitis may ↑ lithium toxicity; ↑
pharmacologic and toxic ac-  Monitor lab tests:
GI: Nausea, dyspepsia, GI tivity of phenytoin, Periodic complete
pain, diarrhea, vomiting, SULFONYLUREAS, blood counts, Hct and
constipation, flatulence, SULFONAMIDES, warfarin Hgb, and kidney
ulcers, GI bleed because of protein binding function tests.
displacement.
GU: Dysuria, renal Implementation:
impairment  Do not use for the
treatment of
Hematologic: Bleeding, Drug-Food Interaction: perioperative pain in
platelet inhibition with Feverfew, garlic, ginger, ginkgo the setting of coronary
higher doses, neutropenia, increase bleeding potential. artery bypass graft
eosinophilia, leukopenia, surgery.
aplastic anemia, decreased
Hgb or Hct, bone  Give with milk or food
marrow depression, to decrease GI up- set.
menorrhagia
 Arrange for periodic
2–3 days. Respiratory: Dyspnea, ophthalmologic
hemoptysis, pharyngitis, examinations during
bronchospasm, rhinitis long-term therapy.

Other: Peripheral edema, Patient/Family Teaching

anaphylactoid reactions to  Take drug with food;
anaphylactic shock take only the
prescribed dosage; do
not take the drug
longer than 1 week.

 Discontinue drug and

consult your health
care provider if rash,
diarrhea, or digestive
problems occur.

 Dizziness or
drowsiness can occur
(avoid driving and
using dangerous
machinery).

GENERIC NAME MECHANISM OF INDICATION/ SIDE EFFECTS AND NURSING RESPONSIBILITY

ACTION CONTRAINDICATI ADVERSE
ON REACTION
Sodium Chloride CHEMICAL EFFECT: INDICATION: CV: Aggravation of  Obtain history of patient’s
Replaces and maintain Fluid and electrolyte heart failure, edema if sodium and chloride levels
BRAND NAME sodium and chloride replacement in hypo- given too rapidly or in before starting therapy, and
Normal Saline levels. natremia caused by excess, reassess regularly thereafter to
severe electrolyte loss, thrombophlebitis. monitor the drug’s
DRUG THERAPEUTIC severe salt depletion. effectiveness.
CLASSIFICATIO EFFECT: Restores Metabolic:  Monitor other electrolyte
N normal sodium and CONTRAINIDCATI Hypernatremia, levels.
THERAPEUTIC: chloride levels. ON: aggravation of existing  Assess patient’s fluid status.
Sodium and chloride Contraindicated in metabolic acidosis with  Be alert for adverse reactions.
replacement patient with excessive infusion,  Assess patients and family
PHARMACOLOGIC: conditions in which electrolyte disturbance, knowledge of drug therapy.
Electrolyte giving sodium and hypokalemia.  Give tablet with a glass of
PEGNANCY RISK chloride is water.
CATEGORY: C detrimental. The 3% Respiratory:  Tell patient to report adverse
and 5% saline solution Pulmonary edema if reactions promptly.
DOSAGE AND is contraindicated in given too rapidly or in
ROUTE patients with excess.
Adults: 3% and 5% increased, normal, or
solutions are used only slightly Skin:
only with frequent decreased electrolyte Local tenderness,
electrolyte levels. abscess, tissue necrosis
determination and at injection site.
given only by slow
IV with half normal
saline solution: 3%
to 8% of body
weight
, according to
deficiencies, over 18
to 24 hour. With
normal saline
solution: 2% to 6%
of body weight,
according to
deficiencies, over 18
to 24 hours.

Indication/
Contraindication
Indications:
Treatment of: Skin and skin
structure infections, Otitis
media, Sinusitis,
Respiratory infections,
Genitourinary infections.
Endocarditis prophylaxis.
Mode of Action Side Effects and Adverse Effects Nursing Assessments
Binds to bacterial cell wall, CNS: Assessment:
causing cell death. Seizures (high doses).  Obtain a history before initiating
therapy to determine previous use of
GI: and reactions to penicillins or
Source: Clostridium Difficile-Associated cephalosporins. Persons with a negative
Vallerand, April hazard, and Diarrhea (Cdad), diarrhea, nausea, history of penicillin sensitivity may still
Cynthia A. Sanoski. DAVIS'S vomiting, ↑ liver enzymes. have an allergic response.
Postexposure inhalational
anthrax prophylaxis.
Management of ulcer
disease due to Helicobacter
pylori.
Contraindication:
Hypersensitivity to
penicillins (cross-sensitivity
exists to cephalosporins and
other betalactams).
Drug-Drug Interactions:
Probenecid ↓renal
excretion and ↑ blood levels
of amoxicillin — therapy
may be combined for this
purpose. May ↑ effect of
warfarin.
May ↓effectiveness of oral
contraceptives.
Allopurinol may ↑ milk, fruit juice, water, or ginger ale.
frequency of rash.
DRUG GUIDE FOR NURSES.
6th ed., F.A. DAVIS Company, Derm:
2019. Rash, urticaria.
Hematologic:
Blood dyscrasias.
Misc:
Allergic reactions including
Anaphylaxis, Serum Sickness,
superinfection.
 Observe for signs and symptoms of
anaphylaxis (rash, pruritus, laryngeal
edema, wheezing). Notify health care
professional immediately if these occur.
 Monitor bowel function. Diarrhea,
abdominal cramping, fever, and bloody
stools should be re- ported to health
care professional promptly as a sign of
Clostridium difficile-associated
diarrhea (CDAD).
Implementation:
 PO: Administer around the clock. May
be given without regard to meals or
with meals to decrease GI side effects.
Capsule contents may be emptied and
swallowed with liquids. Extended-
release tablets should be swallowed
whole; do not crush, break, or chew.
Chewable tablets should be crushed or
chewed before swallowing with liquids.
 Shake oral suspension before
administering. Suspension may be
given straight or mixed in formula,
Administer immediately after mixing.
Discard refrigerated reconstituted
suspension after 10 days.
Patient/Family Teaching
 Instruct patients to take medication
around the clock and to finish the drug
completely as directed, even if feeling
better. Advise patients that sharing of
this medication may be dangerous.
 Advise patient to report the signs of
superinfection (furry overgrowth on the
 tongue, vaginal itching or discharge,
loose or foul-smelling stools) and
allergy.
 Instruct patient to notify health care
professional immediately if diarrhea,
abdominal cramping, fever, or bloody
stools occur and not to treat with
antidiarrheals without consulting health
care professional.
 Instruct female patients taking oral
contraceptives to use an alternate or
additional nonhormonal method of
contraception during therapy with
amoxicillin and until next menstrual
period.

SIDE
GENERIC BRAND INDICATION/CONTRAINDICAT MECHANISM OF NURSING
EFFECTS/ADVE
NAME: NAME: ION/ INTERACTION: ACTION: RESPONSIBILITY:
RSE EFFECTS:
FeSO4- Ferrous Femiron Elevates the serum CNS: Seizures, Before:
Sulfate Hemocyte Indication: Iron concentration, dizziness, • Monitor blood
Ircon To correct simple iron deficiency and and is then headaches, studies of the patient.
Pharmacologic: to treat iron deficiency (microcytic, converted to Hgb or syncope, CNS • Observe the proper
Iron preparation. Dosage: hypochromic) anemias. Also may be trapped in the toxicity, dosage of
• Adults: used prophylactically during periods reticuloendothelial acidosis, coma, medication.
Therapeutic: 100 to of increased iron needs, as in infancy, cells for storage and and death with • Note other drugs the
Hematinic 200 mg childhood, and pregnancy. eventual conversion overdose. patient is taking to
elemental to a usable form of avoid possible
Pregnancy iron P.O. Contraindications: iron. GI: GI upset, interactions.
Category Risk: A t.i.d. For Peptic ulcer, regional enteritis, anorexia,
extended- ulcerative colitis; hemolytic anemias Onset: 4 days nausea, During:
release (in absence of iron deficiency), vomiting, • Give on an empty
capsules, hemochromatosis, hemosiderosis, Peak: 7-10 days constipation, stomach if possible
150 to patients receiving repeated diarrhea, and because oral iron
250 mg transfusions, pyridoxine-responsive Duration: 2-4 dark stools. preparations are best
P.O. once anemia; cirrhosis of liver. Months absorbed then (i.e.,
or twice CV: between meals).
daily. For Interactions: Metabolism: Hypotension, Minimize gastric
 extended- Drug-drug: Antacids, aluminum- Mostly recycled, hypertension, distress if needed by
release containing phosphate binders, small daily losses. and giving with or
tablets, cholestyramine, cimetidine, vitamin tachycardia. immediately after
160 to E: Decreases ferrous fumarate Distribution: meals with adequate
525 mg absorption. Separate doses by 1- to 2- Crosses the Dermatologic: liquid.
once or hour intervals. placenta, enters Flushing and • Take with a full
twice Chloramphenicol: Increases breast milk. urticaria. glass of water or
daily. response to iron therapy. Monitor juice to mask the
• Children patient carefully. Excretion: Sweat, Respiratory: taste and prevent
ages 2 to Doxycycline: May interfere with urine, and bile. Cough and staining of teeth, or
12: 3 ferrous fumarate absorption even dyspnea. have the patient
mg/kg when doses are separated. Avoid use drink solution with a
P.O. daily together. MS: Arthralgia straw.
in three or L-thyroxine: May decrease L- and myalgia. • Do not crush/chew
four thyroxine absorption. Separate doses enteric-coated
divided by at least 2 hours. Monitor thyroid Local: Pain at • tablets and do not
doses. function. IM site. open capsules.
• Children Levodopa, methyldopa: May
ages 6 decrease absorption of these drugs. Others: Staining After:
months Monitor patient carefully. of teeth, • Inform the patient
to 2 Penicillamine: Decreases anaphylaxis, about what possible
years: Up penicillamine absorption. Separate and sweating. adverse effects that
to 6 doses by at least 2 hours. may occur.
mg/kg Quinolones: May decrease quinolone • Inform the patient
P.O. daily absorption. Monitor patient closely. about dark, green, or
in three or Tetracycline: Inhibits absorption of black stools to avoid
four both drugs. Give tetracycline 3 hours panic.
divided after or 2 hours before iron • Encourage the
doses. supplement. patient to avoid
• Infants: Vitamin C: Increases iron absorption. using antacids,
10 to 25 May be used as a beneficial drug coffee, tea, dairy
mg/day interaction. products within 1
P.O. in Drug-herb: Black cohosh, hour after. It may
three or chamomile, feverfew, gossypol, inhibit absorption.
four hawthorn, nettle, plantain, St. John’s • Assess bowel
divided wort: Decreases iron absorption. function for
doses. Discourage use together. constipation/diarrhea
• Elderly Drug-food: Cereals, cheese, coffee, .
patients: eggs, milk, tea, whole-grain breads, • Arrange for periodic
 May need yogurt: May impair oral iron monitoring of Hct
higher absorption. Discourage use together. and Hgb levels.
doses • Monitor for adverse
because effects and
reduced immediately report if
gastric it occurs.
secretions • Document and
and record.
achlorhyd
ria may
lower
capacity
for iron
absorptio
n.

DRUG NAME MECHANISM OF ACTION INDICATION/CONTRAINDICATION ADVERSE EFFECT/SIDE NURSING

EFFECTS RESPONSIBILITIES:
GENERIC: Methyldopa may lower blood INDICATION: Body as a Whole: Dx:
METHYLDOPA pressure by stimulating central Treatment of sustained moderate to severe Hypersensitivity (Fever, skin • Patients with impaired renal
BRAND: Aldomet inhibitory alpha-adrenergic hypertension, particularly in patients with eruptions, ulcerations of soles function may require smaller
CLASS: receptors, false kidney dysfunction. Also used in selected of fe et, flu-like symptoms, maintenance dosage.
CARDIOVASCULAR neurotransmission, and/or patients with carcinoid disease. lymphadenopathy, • Multiple dosing may decrease
AGENT; CENTRAL- reduction of plasma renin CONTRAINDICATION: eosinophilia). patient compliance, but twice-
ACTING, activity or by relaxing blood Special Senses: Nasal daily dosing may provide
ANTIHYPERTENSIV vessels so blood can flow ALDOMET (methyldopa) is stuffiness. adequate control with decreased
E; AUTONOMIC more easily. contraindicated in patients: Endocrine: Gynecomastia, cost.
NERVOUS SYSTEM — with active hepatic disease, such as lactation, decreased libido, • Drug fever usually occurs within
AGENT; ALPHA- acute hepatitis and active cirrhosis impotence, hypothermia (large the first 3 months on therapy and
ADRENERGIC — with liver disorders previously doses), positive tests for lupus may be accompanied by
AGONIST associated with methyldopa therapy (see and rheumatoid factors. Skin: eosinophilia or hepatic function
(SYMPATHOMIMETI WARNINGS) † with hypersensitivity to Granulomatous skin lesions. test changes.
C) any component of these products. • Methyldopate hydrochloride is
THERAPEUTIC: CNS: sedation, headache, administered I.V. Administration
Lowers standing and — on therapy with monoamine oxidase weakness, dizziness, decreased by I.M. or S.C. route isn’t
supine BP, and unlike (MAO) inhibitors. mental acuity, paresthesia, recommended because of
adrenergic blockers, is DRUG TO DRUG INTERACTION: parkinsonism, involuntary unpredictable absorption.
not so prone to produce Anesthetics: Increases effects. Patient choreoathetoid movements, • Patients receiving methyldopa
orthostatic hypotension, undergoing surgery may require reduced psychic disturbances, may become hypertensive after
diurnal BP variations, dosage of anesthetic. depression, nightmares. dialysis because drug is
or exercise Antihypertensives: Potentiates CV: bradycardia, orthostatic dialyzable.
hypertension. Reduces antihypertensive effects. Use together hypotension, aggravated • Methyldopa may cause falsely
renal vascular cautiously. angina, myocarditis, edema. high levels of urine
resistance; maintains Drug-herb. Capsicum: May reduce EENT: nasal congestion. catecholamines, interfering with
cardiac output without antihypertensive effects. Discourage use GI: nausea, vomiting, the diagnosis of
acceleration, but may together. diarrhea, pancreatitis, dry pheochromocytoma. A positive
slow heart rate; tends to Lithium: May increase risk of lithium mouth, constipation. direct antiglobulin (Coombs’) test
support sodium and toxicity. Monitor lithium levels. GU: amenorrhea, impotence. may also occur.
water retention. MAO inhibitors: May cause severe Hematologic: hemolytic Tx:
DOSAGE: hypertension. Avoid use together. anemia, thrombocytopenia, • For I.V. use, add required dose
Adult: leukopenia, bone marrow of drug to 100 ml of 5% dextrose
PO 250 mg b.i.d. or depression. injection. Or, a concentration of
t.i.d., may be increased Hepatic: hepatic necrosis, 100 mg/ml may be used. ADD-
up to 3 g/d in divided hepatitis. Vantage vials contain 50 mg/ml
doses Musculoskeletal: arthralgia. and should be reconstituted per
IV 250–500 mg q6h, Skin: rash. manufacturer direction.
may be increased up to Other: gynecomastia, Administer I.V. infusion over 30
1 g q6h galactorrhea, drug-induced to 60 minutes.
Geriatric: fever, decreased libido. • Take blood pressure in supine,
PO 125 mg b.i.d. or sitting, and standing positions
t.i.d., may increase during dosage adjustment; take
gradually (max: 3 g/d) blood pressure at least every 30
Child: PO 10–65 minutes during I.V. infusion until
mg/kg/d in 2–4 divided patient is stable.
doses (max: 3 g/d) IV • Monitor intake, output, and daily
20–65 mg/kg/d in 4 weights to detect sodium and
divided doses water retention; voided urine
ROUTE: Oral, IV exposed to air may darken
because of the breakdown of
methyldopa or its metabolites.
• Monitor patient for signs and
symptoms of drug-induced
depression.

Edx:
• Teach patient signs and
symptoms of adverse effects, such
as jerky movements, and about
the need to report them; he should
also report excessive weight gain
(5 lb weekly), signs of infection,
or fever.
• Teach patient to minimize
adverse effects by taking drug at
bedtime until tolerance develops
to sedation, drowsiness, and other
 CNS effects; by avoiding sudden
position changes to minimize
orthostatic hypotension; and by
using ice chips or sugarless hard
candy or gum to relieve dry
mouth.
• Warn patient to avoid hazardous
activities that require mental
alertness until sedative effects
subside.
• Instruct patient to call for
instructions before taking OTC
cold preparations.

Side Effects and Adverse

Drug Name Action Indication/Contraindication Nursing Assessments
Effects
GENERIC NAME: Moringa MECHANISM OF ACTION: ADVERSE REACTIONS: INDICATION: Natural health NURSING
Oleifera Malunggay Leaf Enhances milk letdown and  Low Blood Pressure supplement for nursing mothers CONSIDERATIONS:
increases volume of milk (BP) especially those with inadequate  Provide nutrition
BRAND NAME: Natalac production. It is an effective  Interference with lactation. screening and
galactagogue (lactation Fertility appropriate nutrition
enhancer). The active  Cell Mutations CONTRAINDICATION: advice.
CLASSIFICATION: component, malunggay  Lower Blood Sugar Hypersensitivity  Ensure patients are
Supplements, adjuvant (Moringa oleifera), has Levels well supported and
therapy gained acceptance as a health  Uterine Contraction their nutritional
food supplement to help intake is well
DOSE: 250 mg stimulate the secretion and monitored and
flow of milk. documented.
FREQUENCY: 1-2 caps daily  Make sure not to
for 2-4 weeks prior to giving give to patients with
birth and thereafter all known
throughout the lactation hypersensitivity or
period. allergy to any of its
components.
  Monitor patient
response to therapy.
 Monitor patient on
the possible adverse
reactions.
 Advise patient to
take after food is
ingested.
 Advise patient if
experience any side
effects, seek medical
attention
immediately.
 Advise patient to
only take as per
recommended.
ROUTE: Oral (PO)
 Educate client on
drug therapy to
promote
understanding and
compliance.
 Evaluate patient
understanding on
drug therapy by
asking patient to
name the drug, its
indication, and
adverse effects to
watch for.
 Monitor patient
compliance to drug
therapy.