Mindanao State University – Iligan Institute of Technology Student: Salimbagat, Christine P.

Block: CCC
COLLEGE OF NURSING Group: K

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: _______________________________ Generic Name: Morhpine Sulfate Pharmacologic Classification: Central Nervous System Agent; Analgesic; Narcotic Agonist

Dosage, Route & Frequency Drug-Drug & Drug- Side Effects Adverse Reactions
Drug Action Indications Contraindications
Recommended Prescribed Food Interactions (By System) (By System)
For Pain Relief Natural opium Drug Used to relieve Hypersensitivity to Body as a Whole Body as a Whole
Not Indicated alkaloid that binds MAO, dyspnea of acute opiates Urticaria Hypersensitivity
Adult to endogenous Inhibitors Cautiously; left ventricular Increased edema hemorrhagic
PO 10–30 mg opioid peptide may precipitate failure and intracranial sweating urticaria
q4h prn or 15–30 receptors and has Hypertensive Crisis pulmonary edema pressure, cold, clammy skin anaphylactoid
mg sustained agonist action. Phenothiazines may and pain of MI. Convulsive hypothermia reaction
release q8–12h; Narcotic agonist antagonize analgesia disorders, Acute CNS skeletal muscle
effects are identified CNS, Depressants, Symptomatic alcoholism, Acute Euphoria flaccidity
IM/SC 5–20 mg with 3 types of Sedatives, relief of severe bronchial asthma, insomnia CNS
q4h PR 10–20 mg receptors: Analgesia Barbiturates acute and chronic Chronic pulmonary disorientation Paradoxic CNS
q4h prn at supraspinal level, Benzodiazepines pain after diseases, Severe visual disturbances stimulation
euphoria, Tricyclic nonnarcotic respiratory dysphoria decreased cough
respiratory Antidepressants Pote analgesics have depression, drowsiness reflex
depression and ntiate failed and as Chemical-irritant dizziness coma
physical Herbal preanesthetic induced pulmonary deep sleep continuous
dependence; Kava-Kava, Valerian medication edema, Prostatic CV intrathecal infusion
analgesia at spinal St. John's Wort may hypertrophy, Bradycardia may cause
level, sedation and increase sedation Diarrhea caused by Palpitations granulomas leading
miosis; and Food poisoning until the Syncope to paralysis
dysphoric, Use toxic material has flushing of face, Special Senses
hallucinogenic and with alcohol may been eliminated, neck, and upper Miosis
cardiac stimulant lead to potentially Undiagnosed acute thorax CV
effects. fatal overdoses. abdominal GI orthostatic
 conditions Constipation hypotension
Following biliary Anorexia cardiac arrest
tract surgery and dry mouth GI
surgical nausea biliary colic
anastomosis vomiting elevated
Pancreatitis Urogenital transaminase levels
Acute ulcerative Urinary retention Urogenital
colitis Dysuria reduced libido or
Severe liver or renal oliguria potency
insufficiency Hematologic
Addison's disease Precipitation of
Hypothyroidism porphyria
Respiratory
Severe respiratory
depression or arrest
pulmonary edema
Responsibilities in the Nursing Process

- Assess type, location and intensity of pain prior to and 1 hour after PO, IM, IV, SQ
administration of the drug.
- Obtain patient history for any allergies in opiates.
- Obtain patient medical past and present illness history and check for
contraindications.
- When titrating opioid doses, increases of 25-50% should be administered until
there is a reduction of 50% in the pain scale of the patient.
- When titrating doses of short0acting morphine sulfate, a repeat dose can be
administered at time of peak if previous dose was ineffective.
- Patients on a continuous infusion should have additional bolus doses provided
every 15-30 minutes, as needed, for breakthrough pain.
- Do not confuse drug with oxycontin.
- Do not confuse non-concentrated oral liquid morphine sulfate with concentrated
oral liquid morphine sulfate.
- Do not confuse morphine sulfate with hydromorphone.
- Use only preservative-free formulations for neonates and for epidural and
intrathecal routes in all patients.
- Instruct and teach the patient and significant others to watch for signs of
hypersensitivity or anaphylactoid shock and immediately report to the nurse
and doctor.
- Prepare the drug naloxone for any emergency that may arise. It would serve as
the antidote to the drug morphine sulfate.
 Mindanao State University – Iligan Institute of Technology Student: Salimbagat, Christine P. Block: CCC
COLLEGE OF NURSING Group: K

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: ___________________________ Generic Name: Propofol Pharmacologic Classification: Central Nervous System Agent, General Anesthesia; Sedative-Hypnotic

Dosage, Route & Frequency Drug-Drug & Drug- Side Effects Adverse Reactions
Drug Action Indications Contraindications
Recommended Prescribed Food Interactions (By System) (By System)
Induction of Not Indicated Sedative-hypnotic Drug Conscious Hypersensitivity to CNS CNS
Anesthesia used in the Concurrent sedation in propofol or propofol Headache Twitching
Adult:  induction and continuous infusions mechanically emulsion, which Dizziness Bucking
Special Senses Jerking
IV 2–2.5 mg/kg maintenance of of propofol ventilated patients. contain soybean oil
Decreased Thrashing
q10sec until anesthesia or and alfentanil produc and egg phosphatide intraocular pressure clonic/myoclonic
induction onset sedation. e higher plasma Induction or Obstetrical CV movements
Maintenance of levels maintenance of procedures Hypotension CV
Anesthesia of alfentanil than anesthesia as part Patients with GI ventricular asystole
Adult: expected of a balanced increased Vomiting
IV 100–200 CNS depressants anesthesia intracranial pressure abdominal
cramping
mcg/kg/min cause additive CNS technique or impaired cerebral
Respiratory
Geriatric:  depression circulation Cough
IV 50–100 Hiccups
mcg/kg/min Apnea
Other
Conscious Sedation Pain at injection site
Adult: 
IV 5 mcg/kg/min
for at least 5 min,
may increase by
5–10 mcg/kg/min
q5–10 min until
desired level of
sedation is
achieved (may
need maintenance
rate of 5–50
mcg/kg/min)
Responsibilities in the Nursing Process (ADPIE)
- Obtain culture and sensitivity specimen before initiating drug administration. - When using the drug for ICU sedation, wake up and assessment of CNS
- Obtain patient history for any allergies in propofol and its components. function should be done daily during maintenance to determine minimum dose
of drug required for sedation.
- Assess the patient’s IV site for phlebitis, burning sensation and stinging.
- Shake the container well before using.
- Assess the patient’s respiratory dysfunction and note for any respiratory
depression, character, rate, and rhythm. Notify the physician if respiratory rate is - Administer the drug promptly after opening. 1 vial per patient.
more than 30 cpm. - Use a drop counter, syringe pump or volumetric pump to safely control the
- Assess the patient’s level of sedation and level of consciousness throughout and infusion rate of the drug if in IV route.
following administration of the drug. - Monitor patient for propofol infusion syndrome.
- Monitor hemodynamic status and assess for dose-related hypotension.
- Make sure to remember that dosage must be tapered before stopping the drug
therapy.