4.

Drug Study

GENERIC NAME: MECHANISM OF ACTION: SIDE EFFECTS/ADVERSE NURSING

REACTION RESPONSIBILITY
Metoclopramide causes
metaclopramide antiemetic effects by inhibiting
dopamine D2 and serotonin 5-
HT3 receptors in the Extrapyramidal - Assess for
chemoreceptor trigger zone symptoms, restlessness, extrapyramidal
(CTZ) located in the area drowsiness, anxiety, symptoms and
postrema of the brain. diarrhea, hypotension, tardive dyskinesia
Administration of this drug leads (more likely in
hypertension, headache,
to prokinetic effects via inhibitory older patients).
depression, blood - Assess for
actions on presynaptic and disorders (e.g.
postsynaptic D2 receptors, gastrointestinal
aganulocytosis, complaints, such
agonism of serotonin 5-HT4
receptors, and antagonism of
methaemoglobinaemia), as nausea,
muscarinic receptor inhibition. hypersensitivity reactions vomiting and
This action enhances the release (e.g. bronchospasm, constipation.
of acetylcholine, causing rash), galactorrhoea or - In oral
increased lower esophageal related disorders, administration, for
sphincter (LES) and gastric tone, transient increase in better absorption
accelerating gastric emptying and plasma aldosterone allow 30 minutes
transit through the gut. to one hour before
levels
Metoclopramide antagonizes the eating.
dopamine D2 receptors. - Rinse mouth
Potentially Fatal: Neuroleptic frequently to
Dopamine exerts relaxant effect
malignant syndrome; cardiac combat dryness.
on the gastrointestinal tract conduction disorders may
through binding to muscular D2 - Monitor BP
occur with IV dosage form.
receptors. carefully during
IV administration.
BRAND NAME: INDICATION: - Monitor for
extrapyramidal
Metoclopramide is the oral tablet reactions, and
Apo-Metoclop (CAN), Nu- form is used for symptomatic consult physician
Metaclopramide (CAN), Octamide treatment of both acute and if they occur.
recurrent diabetic gastroparesis, - Monitor diabetic
PFS, Reclomide, Reglan
in addition to the treatment of patients, arrange
gastroesophageal reflux disease for alteration in
(GERD) in patients who have insulin dose or
DRUG ILLUSTRATION:
failed to respond to traditional timing if diabetic
therapy. A nasal spray control is
formulation is also indicated to compromised by
treat adults with acute, recurrent alterations in
diabetic gastroparesis. In the timing of food
intravenous injection form, it is absorption.
indicated for the above conditions
as well as for the prevention of
vomiting that may follow
emetogenic chemotherapy or
nausea and vomiting after
surgery. Intravenous
metoclopramide facilitates
intubation of the small bowel and
 stimulates gastric emptying and
barium flow in patients who
require radiological examination
of the stomach or small intestine.
In some cases, the delay of
gastrointestinal emptying
interferes with the radiographic
visualization of the
gastrointestinal tract, and
metoclopramide is used to
facilitate emptying in these cases,
allowing for adequate diagnostic
visualization.

CLASSIFICATION CONTRAINDICATION:

GI hemorrhage, mechanical
GI Stimulant, Antiemetic, obstruction, and perforation;
Dopaminergic blocker phaeochromocytoma; history of
seizures.

DOSAGE/FREQUENCY/ROUTE:

10mg/ every 8 hours/ IV

Reference/s:
https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/metoclopramide/

https://go.drugbank.com/drugs/DB01233
GENERIC NAME: MECHANISM OF ACTION: SIDE EFFECTS/ADVERSE NURSING
REACTION RESPONSIBILITY
Produces analgesia by unknown
acetaminophen mechanism, perhaps by action on
peripheral nervous system. CNS: Headache
Reduces fever by direct action - Do not exceed the
on hypothalamus heat-regulating CV: Chest pain, dyspnea, recommended
center with consequent myocardial damage when doses dosage.
peripheral vasodilation, of 5–8 g/day are ingested daily for - Consult physician
sweating, and dissipation of heat. several weeks or when doses of 4
Unlike aspirin, acetaminophen if needed for
g/day are ingested for 1 yr
has little effect on platelet children < 3 yr; if
aggregation, does not affect GI: Hepatic toxicity and failure, needed for longer
bleeding time, and generally jaundice than 10 days; if
produces no gastric bleeding. continued fever,
GU: Acute kidney failure, renal severe or
BRAND NAME: INDICATION: tubular necrosis recurrent pain
Analgesic-antipyretic in patients occurs (possible
with aspirin allergy, hemostatic Hematologic:
serious illness).
Aceta, Apacet, Atasol, Panadol, Tapanol, disturbances, bleeding diatheses, Methemoglobinemia—cyanosis;
Tempra, Tylenol upper GI disease, gouty arthritis hemolytic anemia—hematuria, - Avoid using
Arthritis and rheumatic disorders anuria; neutropenia, leukopenia, multiple
DRUG ILLUSTRATION: involving musculoskeletal pain pancytopenia, thrombocytopenia, preparations
(but lacks clinically significant hypoglycemia containing
antirheumatic and anti- acetaminophen.
inflammatory effects) Hypersensitivity: Rash, fever Carefully check
Common cold, flu, other viral all OTC products.
and bacterial infections with pain - Give drug with
and fever
food if GI upset
Unlabeled use: Prophylactic for
children receiving DPT occurs.
vaccination to reduce the - Discontinue drug
incidence of fever and pain. if hypersensitivity
reactions occur.
- Treatment of
overdose: Monitor
serum levels
regularly, N-
acetylcysteine
should be
available as a
specific antidote;
basic life support
measures may be
necessary.

CLASSIFICATION CONTRAINDICATION:

Contraindicated with allergy to

Antipyretic, Analgesic acetaminophen.

DOSAGE/FREQUENCY/ROUTE: Use cautiously with impaired

hepatic function, chronic
alcoholism, pregnancy, lactation.
300mg/ when necessaru, if temp is >37.8/

IV
 References:

https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/acetaminophen-n-acetyl-p-aminophenol/

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/A006.html

GENERIC NAME: MECHANISM OF ACTION: SIDE EFFECTS/ADVERSE NURSING

REACTION RESPONSIBILITY
Cefuroxime, like the penicillins,
Cefuroxime, cefuroxime axetil, cefuroxime sodium is a beta-lactam antibiotic. By
binding to specific penicillin-
binding proteins (PBPs) located Large doses can cause - Determine history
inside the bacterial cell wall, it cerebral irritation and of hypersensitivity
inhibits the third and last stage of convulsions; nausea, reactions to
bacterial cell wall synthesis. Cell cephalosporins,
vomiting, diarrhea, GI
lysis is then mediated by penicillins, and
bacterial cell wall autolytic disturbances; erythema history of allergies,
enzymes such as autolysins; it is multiforme, Stevens- particularly to
possible that cefuroxime Johnson syndrome, drugs, before
interferes with an autolysin epidermal necrolysis. therapy is initiated.
inhibitor. Potentially - Lab tests: Perform
Fatal: Anaphylaxis, culture and
BRAND NAME: INDICATION: nephrotoxicity, sensitivity tests
pseudomembranous colitis. before initiation of
therapy and
Ceftin, Zinacef Pharyngitis, tonsillitis caused periodically during
by Streptococcus pyogenes therapy if indicated.
DRUG ILLUSTRATION: Otitis media caused Therapy may be
by Streptococcus instituted pending
test results. Monitor
pneumoniae, S. pyogenes, periodically BUN
Haemophilus influenzae, and creatinine
Moraxella catarrhalis clearance.
Lower respiratory infections - Inspect IM and IV
caused by S. pneumoniae, injection sites
Haemophilus parainfluenzae, frequently for signs
H. influenzae of phlebitis.
UTIs caused by Escherichia - Report onset of
loose stools or
coli, Klebsiella pneumoniae
diarrhea. Although
Uncomplicated gonorrhea pseudomembranous
(urethral and endocervical) colitis (see Signs &
Dermatologic infections, Symptoms,
including impetigo caused Appendix F) rarely
by Streptococcus aureus, S. occurs, this
pyogenes potentially life-
Treatment of early Lyme threatening
disease complication should
 be ruled out as the
cause of diarrhea
during and after
antibiotic therapy.
- Monitor for
manifestations of
hypersensitivity (see
Appendix F).
Discontinue drugs
and report their
appearance
promptly.
- Monitor I&O rates
and pattern:
Especially important
in severely ill
patients receiving
high doses. Report
any significant
changes.

CLASSIFICATION CONTRAINDICATION:

Hypersensitivity to
Antibiotic, Cephalosporin cephalosporins

DOSAGE/FREQUENCY/ROUTE:

750mg/ ANST/ IV

References:

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/C051.html

https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/cefuroxime/

https://go.drugbank.com/drugs/DB01112
GENERIC NAME: MECHANISM OF ACTION: SIDE EFFECTS/ADVERSE NURSING
REACTION RESPONSIBILITY
Metronidazole diffuses into
metronidazole the organism, inhibits protein
synthesis by interacting with
DNA, and causing a loss of Body as a Whole: - Discontinue
helical DNA structure and Hypersensitivity (rash, therapy
strand breakage. Therefore, it urticaria, pruritus, flushing), immediately if
causes cell death in fever, fleeting joint pains, symptoms of CNS
susceptible organisms. overgrowth of Candida.  toxicity (see
Appendix F)
CNS: Vertigo, headache, develop. Monitor
BRAND NAME: INDICATION: ataxia, confusion, irritability, especially for
depression, restlessness, seizures and
Acute infection with susceptible peripheral
weakness, fatigue,
Apo-Metronidazole (CAN), Flagyl, Flagyl 375, anaerobic bacteria neuropathy (e.g.,
Flagyl ER, Flagyl IV, MetroGel, MetroGel- Acute intestinal amebiasis drowsiness, insomnia,
paresthesias, sensory numbness and
Vaginal, NidaGel (CAN), Noritate, Protostat Amebic liver abscess paresthesia of
Trichomoniasis (acute and neuropathy (rare). 
extremities).
DRUG ILLUSTRATION: partners of patients with acute
infection) GI: Nausea, vomiting,
Preoperative, intraoperative, anorexia, epigastric distress, - Lab tests: Obtain
postoperative prophylaxis for abdominal cramps, diarrhea, total and
patients undergoing colorectal constipation, dry mouth, differential WBC
surgery metallic or bitter taste, proctitis. counts before,
Topical application: Treatment Urogenital: Polyuria, dysuria, during, and after
of inflammatory papules, pyuria, incontinence, cystitis, therapy, especially
pustules, and erythema of decreased libido, dyspareunia, if a second course
rosacea dryness of vagina and vulva, is necessary.
Unlabeled uses: Prophylaxis for sense of pelvic pressure.
patients undergoing gynecologic, - Monitor for S&S of
abdominal surgery; hepatic Special Senses: Nasal sodium retention,
encephalopathy; Crohn’s congestion. especially in
disease; antibiotic-associated patients on
pseudomembranous colitis; corticosteroid
CV: ECG changes
treatment of therapy or with a
Gardnerellavaginalis, giardiasis (flattening of T wave). history of CHF.
(use recommended by the CDC)
- Monitor patients
CLASSIFICATION CONTRAINDICATION: on lithium for
elevated lithium
History of hypersensitivity to levels.
Antibiotic, Antibacterial, Amebicide, Antiprotozoal metronidazole or other
nitroimidazole derivatives.
DOSAGE/FREQUENCY/ROUTE: Pregnancy (1st trimester) and - Report
lactation. appearance of
candidiasis or it is
500mn/100ml (5mg/ml) / becoming more
prominent with
therapy to
physician
promptly.
- Repeat feces
examinations,
usually up to 3
mo, to ensure that
amebae have
been eliminated.

References:
 https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/metronidazole/
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/M062.html
GENERIC NAME: MECHANISM OF ACTION:
Oxygen molecules adjust
hypoxic ventilatory drive by
Oxygen acting on chemoreceptors on
carotid bodies that
sequentially relay sensory
information to the higher
processing centers in
brainstem. It also attenuates
hypoxia-induced
mitochondrial depolarization
that generates reactive
oxygen species and/or
apoptosis.
BRAND NAME: INDICATION:
Oxygen therapy in clinical
settings is used across diverse
Alnox, Entonox, Ez-OX, Heliox, Oxygen, specialties, including various
Southern Medical types of anoxia, hypoxia or
dyspnea and any other
disease states and conditions
DRUG ILLUSTRATION: that reduce the efficiency of
gas exchange and oxygen
consumption such as
respiratory illnesses, trauma,
poisonings and drug
overdoses. Oxygen therapy
tries to achieve hyperoxia 6
to reduce the extent of
hypoxia-induced tissue
damage and malfunction.
CLASSIFICATION CONTRAINDICATION:
SIDE EFFECTS/ADVERSE NURSING
REACTION RESPONSIBILITY
Dry of bloody nose Nurses play an
important role in
Tiredness identifying factors that
can compromise oxygen
Headaches
delivery to the lungs and
tissues throughout the
Oxygen Toxicity
body, as well as
Atelectasis ensuring that patients
who may require
Fire hazard supplemental oxygen
therapy are assessed and
Blindness managed safely and
competently.
Ensure that prongs are in
the nares properly.
Apply water-soluble
jelly to nares PRN.
Assess the patency of
the nostrils
Assess the patient for
changes in respiratory
rate and depth
Monitor the patient
closely for risk for
aspiration.
Medical gas
Oxygen therapy increases the
DOSAGE/FREQUENCY/ROUTE: arterial pressure of oxygen
and is effective in improving
gas exchange and oxygen
oxygen inhalation at 2L/min via nasal delivery to tissues, provided
that there are functional
alveolar units. Oxygen plays
cannula
a critical role as an electron
acceptor during oxidative
phosphorylation in the
electron transport chain
through activation of
cytochrome c oxidase
(terminal enzyme of the
electron transport chain).
This process achieves
successful aerobic respiration
in organisms to generate ATP
molecules as an energy
source in many tissues.
Oxygen supplementation acts
to restore normal cellular
activity at the mitochondrial
level and reduce metabolic
acidosis. There is also
evidence that oxygen may
interact with O2-sensitive
voltage-gated potassium
channels in glomus cells and
cause hyperpolarization of
mitochondrial membrane.

References:

https://go.drugbank.com/drugs/DB09140

https://www.physio-pedia.com/Oxygen_Therapy