HOLY NAME UNIVERSITY

COLLEGE OF HEALTH SCIENCES

NURSING DEPARTMENT
City of Tagbilaran

DRUG STUDY

Name of Patient: Jolgee G. Address: Dampas District Tagbilaran City Impression: Anemia Date of Visit / Admission: August 16, 2020

Ward: Room: Not stated Status: Married Age: 50 years old Sex: Female

Date Generic Route & CLASSIFICATION: CONTRA NURSING

Brand Name DOSAGE INDICATIONS EVALUATION
Ordered Name Frequency MECHANISM OF ACTION INDICATIONS RESPONSIBILITIES
August 16, Biogesic Paracetamol 500 Orally, Every MECHANISM OF ACTION: Paracetamol Contraindications: The patient
2020 mg/tab 4hrs PRN Decreases fever by a (acetaminophen) is Renal insufficiency, ✓ Do not exceed responded to the
hypothalamic effect a pain reliever and a anemia 4gm/24hr. in adults medication as
leading to sweating and fever reducer. The and 75mg/kg/day in evidenced by
vasodilation. Inhibits exact mechanism of children. fever subsided
pyrogen effect on the action of is not ✓ Do not take for from 38C to 37C
hypothalamic-heat- known. Paracetamol >5days for pain in after 4hrs
regulating centers. is used to treat children, 10 days for administration.
Inhibits CNS prostaglandin many conditions pain in adults, or
synthesis with minimal such as headache, more than 3 days for
effects on peripheral muscle aches, fever in adults.
prostaglandin synthesis. arthritis, backache, ✓ Extended-Release
Does not cause ulceration toothaches, colds, tablets are not to be
of the GI tract and causes and fevers. It chewed.
no anticoagulant action. relieves pain in mild ✓ Monitor CBC, liver
arthritis but has no and renal functions.
Prepared by: dcasquejo@hnu.edu.ph
effect on the ✓ Assess for fecal
underlying occult blood and
inflammation and nephritis.
swelling of the joint. ✓ Avoid using OTC
drugs with
Acetaminophen.
✓ Take with food or
milk to minimize GI
upset.
✓ Report N&V.
cyanosis, shortness
of breath and
abdominal pain as
these are signs of
toxicity.
✓ Report paleness,
weakness, and
heartbeat skips.
✓ Report abdominal
pain, jaundice, dark
urine, itchiness or
clay-colored stools.
✓ Phenmacetin may
cause urine to
become dark brown
or wine-colored.
✓ Report pain that
persists for more
than 3-5 days
✓ Avoid alcohol.
✓ This drug is not for
regular use with any
form of liver disease.
August 16, Feosol Ferrous 1 cap Once a day Acts to normalize RBC ➤ To prevent iron Contraindication: ✓ Give iron tablets and The patient
2020 Sulfate - Iron production by binding deficiency based on capsules with a full responded to the
Supplement with hemoglobin or by U.S. Hemochromatosis, glass of juice or medication as
being and Canadian hemolytic anemias, water. evidenced by
oxidized and stored as recommended daily hemosiderosis, ✓ Don’t crush enteric- patient having
hemosiderin or allowances hypersensitivity to coated tablets or more energy,
aggregated ferritin in iron open capsules. and increase of
reticuloendothelial salts or their ✓ Dilute and administer RBC on the test
cells of the bone marrow, components, other with a straw or place results.
liver, and spleen. Iron is anemic conditions drops in back of
an essential component of unless patient’s throat,
hemoglobin, myoglobin, accompanied by because iron
and several enzymes, iron solutions may stain
including catalase, deficiency teeth.
cytochromes, ✓ Mix the elixir form in
and peroxidase. Iron is water. Fer-In-Sol
needed for catecholamine Drops or Syrup may
metabolism and normal be mixed with juice
neutrophil function. or water.
✓ Know that to
maximize absorption,
iron salts should be
given 1 hour before
or 2 hours after
meals.
✓ If GI irritation occurs,
give with or just after
meals.
✓ Protect liquid form
from freezing.
✓ Don’t give antacids,
coffee, dairy
products, eggs, tea,
or whole-grain
 breads or cereals
within 1 hour before
or 2 hours after iron.
✓ Remember that
unabsorbed iron
turns stool black or
green and can mask
blood in stool. Check
stool for occult
blood, as ordered.

August 16, Nexium Esomeprazol 40mg/ta Once a day Pharmacologic class: To treat Contraindication: ✓ Give oral The patient
2020 e b for 9 days Proton pump inhibitor symptomatic esomeprazole at responded to the
Magnesium more Therapeutic class: gastroesophageal Concurrent least 1 hour before medication as
Antiulcerative reflux disease therapy with meals because food evidenced by
(GERD) rilpivirine decreases reduced gastric
Mechanism of Action: containing bioavailability. acid on the
Interferes with gastric products, ✓ Use delayed-release patient.
acid secretion by hypersensitivity to capsules or oral
inhibiting the hydrogen– esomeprazole, suspension specific Esomeprazole
potassium–adenosine substituted for nasogastric tube may reduce the
triphosphatase (H+–K+– benzimidazoles, or administration and absorption of
ATPase) enzyme system, their components delayed-release oral iron and make
or proton pump, in gastric suspension specific ferrous sulfate
parietal cells. Normally, for nasogastric or less effective in
the proton pump uses gastric tube treating anemia.
energy from hydrolysis of administration
ATPase to drive H+ and whenadministering
chloride (Cl−) out of esomeprazole to a
parietal cells and into the patient with a
stomach lumen in
 exchange for potassium nasogastric or gastric
(K+), which leaves the tube.
stomach lumen and
enters parietal cells. After
this exchange, H+ and Cl
− combine in the stomach
to form hydrochloric acid
(HCl). Esomeprazole
irreversibly inhibits the
final step in gastric acid
production by blocking
exchange of intracellular
H+ and extracellular K+
, thus preventing H+ from
entering the stomach and
additional HCl from
forming.

August 16, Amoxil Amoxicillin 500mg/c 2x/day for 2 Chemical class: ➤ To treat ear, Contraindication: ✓ Patients with The patient
2020 ap days more Aminopenicillin nose, throat, GU mononucleosis responded to the
Therapeutic class: tract, skin, History of severe shouldn’t receive medication by
Antibiotic and soft-tissue hypersensitivity amoxicillin because having
Pregnancy category: B infections caused by reactions this class of drugs underlying cause
susceptible gram- (anaphylaxis or may cause an of infection
Mechanism of Action: positive and gram Stevens-Johnson erythematous rash. treated as
negative organisms syndrome) to other ✓ Use drug cautiously evidenced by
Kills bacteria by binding to beta-lactam in patients with increased red
and inactivating antibiotics, hepatic impairment. blood cells.
penicillin-binding proteins hypersensitivity to Monitor hepatic and
on the inner amoxicillin or its renal function and
components. CBC, as ordered, in
bacterial cell wall, patients on
weakening the bacterial prolonged therapy.
cell wall and causing lysis. Also use cautiously in
breastfeeding and
elderly patients.
✓ Expect to start
therapy before
culture and
sensitivity test results
are known.
✓ Be aware that
chewable tablets and
tablets for oral
suspension contain
phenylalanine.
✓ Don’t confuse
amoxicillin tablets
with amoxicillin
tablets for oral
suspension
(DisperMox). They’re
not interchangeable.
✓ WARNING; If allergic
reaction occurs, stop
amoxicillin
immediately and
provide emergency
care as indicated and
ordered.
✓ Monitor patient
closely for diarrhea,
which may indicate
pseudomembranous
colitis caused by
 Clostridium difficile.
If diarrhea occurs,
notify prescriber,
expect to withhold
amoxicillin, and treat
with
fluids,electrolytes,
protein, and an
antibiotic effective
against C. difficile.
✓ Expect treatment
that lasts at least 10
days for hemolytic
streptococci
infections.
✓ Monitor patient for
superinfection. If it
occurs, expect to
discontinue drug and
provide treatment as
ordered.

August 16, Biaxin Clarithromyci 500 2x/day for 2 Chemical class: Macrolide To treat pharyngitis Concurrent ✓ Expect to obtain a The patient
2020 n mg/tab days more derivative and tonsillitis therapy with specimen for culture responded to the
Therapeutic class: caused by astemizole, and sensitivity tests medication as
Antibiotic Streptococcus cisapride, before giving first evidence by no
Pregnancy category: C pyogenes colchicine (in dose. stomach ulcer
patients with renal ✓ Know that felt, and patient
Mechanism of Action; or hepatic clarithromycin regain its
Inhibits RNA-dependent impairment), therapy should be appetite.
protein synthesis dihydroergotamine avoided in patients at
in many types of aerobic, , ergotamine, risk for QT
anaerobic, gram positive, lovastatin, prolongation such as
and gram-negative pimozide, uncorrected
bacteria. By simvastatin, or hypokalemia or
binding with the 50S terfenadine; hypomagnesemia or
ribosomal subunit of history of significant
the bacterial 70S cholestatic bradycardia, and in
ribosome, clarithromycin jaundice, hepatic patients receiving
causes bacterial cells to dysfunction, Class IA or Class III
dies. QT prolongation or antiarrhythmias.
ventricular cardiac Elderly patients are
arrhythmias, more susceptible to
including torsades clarithromycin’s
de pointes; effect on the QT
hypersensitivity to interval, as well.
clarithromycin, ✓ Use clarithromycin
erythromycin, or cautiously in patients
any macrolide with renal
antibiotic impairment. Be
aware that patients
with severe renal
impairment may
need decreased
dosage or prolonged
dosage interval and
that clarithromycin is
not recommended in
combination with
ranitidine bismuth
citrate therapy if
patient has a
creatinine clearance
less than 2.5
ml/min/1.73 m2 or a
 history of acute
porphyria.
✓ Monitor patient
closely for acute
hypersensitivity
reactions such as
anaphylaxis and
serious skin
disorders. If present,
expect clarithromycin
therapy to be
discontinued
immediately and
appropriate
emergency
treatment initiated.
✓ Monitor patient for
signs and symptoms
of liver dysfunction,
especially hepatitis
(anorexia, dark urine,
jaundice, pruritus, or
tender abdomen).
Notify prescriber
immediately if
present, and expect
clarithromycin to be
discontinued.
✓ Monitor patients
with diabetes who
are also receiving
oral hypoglycemics or
insulin closely for
 hypoglycemia, which
could be severe.
✓ Be watchful for an
elevated INR and
prothrombin time in
patients who are also
taking warfarin, as
serious bleeding may
occur.
✓ Assess patient’s
bowel pattern daily;
severe diarrhea may
indicate
pseudomembranous
colitis caused by
Clostridium difficile.
If diarrhea occurs,
notify prescriber and
expect to withhold
clarithromycin and
treat with fluids,
electrolytes, protein,
and an antibiotic
effective against C.
difficile.
✓ /
✓ /
August 16, Avapro Irbesartan 300 mg Once/day for Chemical class: To manage Contraindication: ✓ If patient has known
2020 maintenance Nonpeptide angiotensin II hypertension, alone Concurrent or suspected
antagonist or with aliskiren use in hypovolemia, provide
Therapeutic class: other patients with treatment, such as
Antihypertensive antihypertensives diabetes or I.V. normal saline
Pregnancy category: D patients with renal solution, as
impairment prescribed, to correct
Selectively blocks binding (GFR less than 60 this condition before
of the potent ml/min), beginning irbesartan
vasoconstrictor hypersensitivity therapy. Or expect to
angiotensin (AT) II to to irbesartan or its begin therapy with a
AT1 receptor sites in components lower dosage.
many tissues, ✓ Check blood pressure
including vascular often to evaluate
smooth-muscle and drug’s effectiveness.
adrenal glands. This ✓ If blood pressure isn’t
inhibits the vaso controlled with
constrictive and irbesartan alone,
aldosterone-secreting expect to also give a
effects of AT II, which diuretic, such as
reduces blood hydrochlorothiazide,
pressure. as prescribed.
✓ WARNING: If patient
receives a diuretic or
another
antihypertensive
during irbesartan
therapy, frequently
monitor blood
pressure because
he’s at risk for
hypotension.
✓ If patient experiences
symptomatic
hypotension, expect
to stop drug
temporarily.
Immediately place
him in supine
position and prepare
to give I.V. normal
 saline solution, as
prescribed. Expect to
resume drug therapy
after blood pressure
stabilizes.
✓ If patient receives a
diuretic, provide
adequate hydration,
as appropriate, to
help prevent
hypovolemia. Also
monitor patient for
signs and symptoms
of hypovolemia, such
as hypotension,
dizziness, and
fainting.
✓ WARNING: Monitor
patient for increased
BUN and serum
creatinine levels if he
has heart failure or
impaired renal
function because
drug may cause acute
renal failure. If
increases are
significant or
persistent, notify
prescriber
immediately