Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

Tamag, Vigan City
2700 Ilocos Sur
DRUG STUDY
NICOLAS, KRIZHA ANGELA S. ISPH -GS -ER/ICU
BSN-4E 01/04/2022

NAME & DOSAGE,

CLASSIFICATION FREQUENCY, MECHANISM ADVERSE EFFECT NURSING
OF DRUG DURATION OF OF ACTION INDICATION CONTRAINDICATION RESPONSIBILITY
ACTION,
ROUTE
MIDAZOLAM Dosage: 1mg/mL May potentiate -Preoperative -Contraindicated in CNS: Over sedation,  A qualified
Route: IV the effects of sedation (to patients hypersensitive to drowsiness, amnesia, individual, other
GABA, depress induce drug or its components headache, seizure, than the
Generic Name: the CNS, and sleepiness or and in those with acute involuntary movements, practitioner
Midazolam suppress the drowsiness and angle-closure glaucoma, hiccups, paradoxical performing the
spread of relieve shock, coma, or acute behavior or excitement procedure, should
Brand Name: seizure activity apprehension alcohol intoxication. CV: variations in BP monitor patient
Versed -Moderate -Intrathecal or epidural and pulse rate throughout
sedation before injection of parenteral EENT: nystagmus procedure.
Therapeutic Class: short diagnostic forms containing benzyl GI: nausea, vomiting  Have oxygen and
Anxiolytics or endoscopic alcohol is contraindicated Respiratory: apnea, resuscitation
-To induce decreased respiratory equipment
Pharmacologic general rate, oxygen available in case of
Class: anesthesia desaturation, coughing severe respiratory
Benzodiazepines -As continuous Other: pain at injection depression.
infusion to site, redness excessive amounts
sedate and rapid infusion
intubated in have been linked
critical care to respiratory
unit arrest.
 Continuously
monitor patient,
including children
 taking syrup form,
for life threatening
respiratory
depression.
 Monitor BP, HR
and rhythm,
respirations,
airway integrity,
and pulse oximetry
during procedure.

NAME AND DOSE, MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE NURSING

CLASSIFICATION FREQUENCY, ACTION EFFECTS RESPONSIBILITY
OF DRUG ROUTE,
DURATION OF
ADMINISTRATION
 ENOXAPARIN AVAILABLE Accelerates • To prevent PE • Contraindicated in CNS: confusion, Nursing
FORMS: formation of and DVT after patients fever, pain Consideration
Generic Name: Syringes (graduated antithrombin III- hip or knee hypersensitive to CV: edema, • It is important
Enoxaparin prefilled): 60 thrombin, complex replacement drug, heparin, pork peripheral edema to achieve
mg/0.6mL, and deactivates surgery. products, or benzyl GI: nausea, hemostasis at
Brand Name: 80mg/0.8mL, thrombin, • To prevent PE alcohol; in those with diarrhea the puncture
Lovenox 120mg/0.8mL, preventing and DVT after active major Hematologic: site after PCI.
50mg/mL conversion of abdominal bleeding; heparin- thrombocytopenia, The vascular
Therapeutic Class: Syringes (prefilled): fibrinogen to fibrin. surgery. induced hemorrhage, access sheath
Anticoagulant 30mg/0.3mL Drug has a higher • To prevent thrombocytopenia ecchymoses, for
antifactory-Xa- ischemic within the past 100 bleeding instrumentation
Pharmacologic Dosage: 4,000 units, toantifactor-IIa complications days or in the complications, should remain
Class: SQ, OD activity ratio than of unstable presence of hypochromic anemia in place for 6
Lowmolecular- heparin. angina and non- circulating antibodies. Skin: irritation, hours after
weight heparin Q-wave MI • Use cautiously in pain, hematoma, enoxaparin
with oral aspirin patients with history and erythema at dose if manual
therapy. of aneurysms, injection site; rash; compression m
• Acute cerebrovascular urticaria method is used;
Stsegment haemorrhage, spinal Other: angioedema, give next dose
elevation MI. or epidural puncture, anaphylaxis. 6 to 8 hours
• Inpatient uncontrolled HTN, or after sheath
treatment of threatened abortion. removal.
acute DVT with • Use cautiously in Monitor VS
and without PE patient with and site for
when given prosthetic heart hematoma and
with warfarin valves with regional bleeding.
sodium. or lumbar block
anesthesia,
To prevent PE block dyscraisias, • Monitor anti-
and DVT in recent childbirth, Xa
general surgery pericarditis or levels in
patients. pericardial effusion, pregnant
renal insufficiency or women with
severe CNS trauma. mechanical
heart valve
and in patients
with
significant
renal
impairment.
• Draw blood to
establish
baseline
coagulation
parameters
before
therapy.

Patient Teaching
• Tell patient to
avoid OTC
drug
containing
aspirin or
another
salicylate
unless ordered
by prescriber.
• Instruct
patient and
family to
watch for
signs of
bleeding or
abnormal
bruising and
to notify
prescriber
immediately.
Assessment
● Assess for signs
of bleeding and
hemorrhage
(bleeding gums;
nosebleed; unusual
bruising; black,
tarry stools;
hematuria; fall in
hematocrit or BP;
guaiac-positive
stools); bleeding
from surgical site.
Notify health care
professional if
these occur.
● Assess patient
for evidence of
additional or
increased
thrombosis.
Symptoms depend
on area of
involvement.
●Toxicity and
Overdose: For
enoxaparin
overdose,
protamine sulfate 1
mg for each mg of
enoxaparin should
be administered by
slow IV injection.
Implementation
● High Alert:
Unintended
concomitant use of
two heparin
products
(unfractionated
heparin and low
molecular weight
heparins) has
resulted in serious
harm and death.
Review patients’
recent and current
medication
administration
records before
administering any
heparin or low-
molecular-weight
heparin
product.
● To avoid the loss
of drug, do not
expel the air bubble
from the syringe
before the
injection.

Patient/Family
Teaching
● Instruct patient in
correct technique
for self injection,
care and disposal
of equipment.
● Advise patient to
report any
symptoms of
unusual bleeding or
 bruising, dizziness,
itching, rash, fever,
swelling, or
difficulty breathing
to health care pro-
fessional
immediately.
● Instruct patient
not to take aspirin
or NSAIDs without
consulting health
care professional
while on therapy

NAME & DOSAGE,

CLASSIFICATION FREQUENCY, MECHANISM ADVERSE EFFECT NURSING
OF DRUG DURATION OF OF ACTION INDICATION CONTRAINDICATION RESPONSIBILITY
ACTION,
ROUTE
ONDANSETRON Dosage: 2mg/Ml May block 5-  To prevent Contraindicated in CNS: dizziness,  Monitor LFT
Route: IV HT3 in the nausea, patients hypersensitive tofatigue, headache, results.
Generic Name: CNS in the vomiting drug malaise, sedation,
Ondansetron chemoreceptor from highly fever, agitation,  Don’t exceed
trigger zone emetogenic ECG changes, including anxiety, pain to 8mg in
Brand name: and in the chemotherapy prolonged QT interval CV: arrhythmias, chest patients with
Zuplenz peripheral and torsades de pointes, pain hepatic
nervous system  To prevent have been reported. GI: constipation, impairment
Therapeutic Class: on nerve nausea and Avoid use in patients with diarrhea
Antiemetics terminals of the vomiting congenital long QT GU: gynecological  Monitor ECG
vagus nerve from syndrome. Monitor disorders, urine in patients with
Pharmacologic moderately patient carefully retention congenital long
Class: Selective emetogenic Respiratory: hypoxia QT syndrome
serotonin (5-HT3) chemotherapy Skin: pruritus, rash
receptor antagonists Other: chills,  Correct
 To prevent injection-site reaction electrolyte
postoperative abnormalities
nausea and (hypokalemia
vomiting or
hypomagnesia)
 To prevent before infusing
nausea and drug
vomiting
from  Tell patient
radiation that an ECG
therapy in may be
patients necessary to
receiving monitor HR
total body and rhythm
irradiation,
single high-  Instruct patient
dose fraction to immediately
radiation report
therapy to difficulty
abdomen, or breathing after
daily drug
fractioned  administration
radiation
therapy to  Tell patient
abdomen receiving drug
IV to report
discomfort at
injection site
 NAME & DOSAGE,
CLASSIFICATION FREQUENCY, MECHANISM ADVERSE EFFECT NURSING
OF DRUG DURATION OF OF ACTION INDICATION CONTRAINDICATION RESPONSIBILITY
ACTION,
ROUTE
AMIODARONE Dose: 150 mg It is a primarily Indicated for Contraindicated in CNS: fatigue, tremor, • Verify doctor’s order
Route: IV class III the treatment of patients hypersensitive to ataxia, headache, to ensure accuracy of
Generic Name: antiarrhythmic. Atrial drug or to iodine. dizziness the name, dosage,
Amiodarone Like other Fibrillation CV: hypotension, route and frequency of
antiarrhythmic Contraindicated in those edema, flushing drug administration.
Brand Name: drugs of this with cardiogenic shock, EENT: visual
Pacerone class, second or third degree disturbances, optic • Observe 10 Rights to
amiodarone AV block, and in those neuropathy, abnormal prevent medication
Therapeutic Class: works primarily for whom bradycardia smell error.
Antiarrhythmics by blocking has caused syncope. GI: nausea, vomiting,
potassium abnormal taste, • Beware of the high
Pharmacologic rectifier currents constipation, diarrhea risk of adverse
Class: that are Hematologic: reactions.
Benzofuran responsible for coagulation
derivatives the abnormalities • Monitor BP and HR
repolarization of Hepatic: hepatic and rhythm
the heart during failure, hepatic frequently.
phase 3 of the dysfunction
cardiac action Metabolic: • Monitor patient for
skin burning or
potential hypothyroidism, tingling, followed by
hyperthyroidism redness and blistering.
Respiratory: ARDS,
severe pulmonary • Advise patient to
toxicity, pulmonary keep follow-up
edema appointments
Skin: photosensitivity, including blood tests.
solar dermatitis, blue-
gray skin • Tell patient to report
Other: decreased vision changes,
libido weakness, numbness,
poor coordination and
neck swelling.
 NAME & DOSAGE,
CLASSIFICATION FREQUENCY, MECHANISM ADVERSE EFFECT NURSING
OF DRUG DURATION OF OF ACTION INDICATION CONTRAINDICATION RESPONSIBILITY
ACTION,
ROUTE
CODEINE AVAILABLE Codeine may bind • Relief of • Contraindicated with CNS: Sedation, Nursing
PHOSPHATE FORMS: with opioid milf to hypersensitivity to clamminess, sweating, Consideration
Tablets: 15, 30, receptors in the moderate opioids, physical headache, vertigo, • Name
Generic name: 60mg CNS, altering pain in dependence on an floating feeling, confusion has
Oral solution: perception and adults and opioid analgesic (drug dizziness, lethargy, occurred between
Codeine Phosphate
15mg/5ml emotional children. may precipitate confusion, light- codeine and
Injection: 15, response to pain. • Suppression withdrawal) headedness, Cardene
Brand Name: Nalex
30mg/24hr of coughing • Use cautiously with nervousness, unusual (nicardipine) and
AC
induced by pregnancy, labor, dreams, agitation, Lodine
Dosage: 60 mg chemical or lactation, bronchial euphoria, hallucinations, (etodolac); use
Therapeutic Class:
PO Q6 mechanical asthma, COPD, delirium, insomnia, caution.
acts at opioid
irritation of respiratory depression, anxiety, fear, • Give to nursing
receptors in the CNS
the anoxia, increased disorientation, impaired women 4-6 hours
to produce analgesia,
respiratory intracranial pressure, mental and physical before scheduled
euphoria, sedation;
system. acute MI, ventricular performance, coma, feeding to
acts in the medullary
failure, coronary mood changes, minimize drug in
cough center to
insufficiency, weakness, tremor, milk.
depress cough reflex
hypertension, biliary seizures. • Use the smallest
tract surgery, renal or CV: palpitation, effective dose for
Pharmacologic increase or decrease in
hepatic impairment. the shortest period.
Class: Antitussive, BP, circulatory
Opioid agonist • Use caution when
depression, cardiac
analgesic injecting
arrest, shoch,
subcutaneously
tachycardia,
into chilled body
bradycardia, arrythmia.
areas or in patients
EENT: diplopia, blurred
vision
Respiratory: slow,
shallow respiration, apnea,
suppression of cough
reflex; laryngopasm;
bronchospasm
with hypotension
or in shock;
impaired perfusion
may delay
absorption; with
repeated doses,