College of Nursing: Cebu Normal University

Republic of the Philippines
CEBU NORMAL UNIVERSITY

Osmeña Blvd., Cebu City, 6000, Philippines
College of Nursing
Telephone No.: (+63 32) 254
4837 Email: cn@cnu.edu.ph
Website: www.cnu.edu.ph
DRUG STUDY
Patient’s Initials: __not indicated____ Date of Admission: November 19, 2021 Diagnosis: Multi Organ Dysfunction Syndrome_
Age: 60 years old Height/Weight: BMI: 40.2________________________ Clinical Intervention: _____________________
Sex: Female ______Ward: _________ Bed No.: Name of Physician: ________ ______________
Drug Information Classification Mechanism of Action Indication Contraindications Side Effects Nursing Responsibilities
Generic Name: Pharmacologic Pharmacodynamics or General Indication/s: Contraindicated in: (per system preferably) Before Drug Administration:
Levothyroxine Classification: Mechanism of Action:  To treat mild  Hypersensitivity - Inform patient that levothyroxine
Sodium Synthetic Synthetically prepared levo- hypothyroidism to levothyroxine CNS: Fatigue, replaces a hormone that is
1 Thyroxine (T4) isomer of thyroxine (T4,  To treat severe  Thyrotoxicosis headache, insomnia, normally produced by the thyroid
Levothyroxine principal component of thyroid hypothyroidism  severe somnolence gland and that she’ll probably need
Sodium Therapeutic gland secretions, determines  To treat myxedema cardiovascular to take drug for life.
Classification: normal thyroid function). coma conditions ENDO: - Monitor HR and BP. Report
Trade Name: Thyroid Principal effects include  acute MI Hyperthyroidism (with promptly tachycardia or suspected
Synthroid Hormone diuresis, loss of weight and Patient’s Indication:  obesity treatment overdose) arrhythmias.
Replacement puffiness, increased sense of This drug is used to treat  adrenal - Monitor PT of patient who is
Minimum Dose: well-being and activitypatient’s severe insufficiency GI: Dysphagia receiving anticoagulants; she may
PO: 75 mcg/day Pregnancy tolerance, plus rise of T3 and hypothyroidism leading require a dosage adjustment.
IV: 200 mcg/day Category: T4 serum levels toward normal. to myxedema coma Interactions: MS: Muscle weakness,
A By replacing decreased or which caused decreased DRUG myalgia, slipped During Drug Administration:
Maximum Dose: absent thyroid hormone, it T4 levels- this will serve  beta capital femoral For PO:
blockers:
PO: 200 mcg/day restores metabolic rate of a as hormone replacement. epiphysis - Administer levothyroxine tablets
Possibly impaired
IV: 500 mcg/day hypothyroid individual. as a single daily dose 30 to 60
action of beta
blockers and SKIN: Alopecia minutes before breakfast to
Patient’s Dose: Pharmacokinetics: (transient), rash, increase drug absorption. Give
decreased
PO: 175 mcg Onset: 3-5 days urticaria consistently with respect to meals.
conversion of T4
IV: loading dose of - If patient has difficulty
to (T3)
300 to 600 mcg; Absorption: Variable and Other: Weight gain swallowing, crush tablet and
 oral antidiabetic
Certification Date: 1 February 2021

Recertification due date: 24 January 2024
SDF-CON-304-071-00
For verification of the certificate please
access www.gcl-intl.com (Certification Page 1 of 4
check and type the registration number)
Registration No. 52Q18778

College of Nursing
followed by a daily incompletely absorbed from GI drugs: Possibly suspend in a small amount of water
IV dose of 50 to tract (50– 80%). uncontrolled or food.
100 mcg diabetes mellitus, - Emphasize the need to take
Peak: 3–4 wk. requiring levothyroxine with a full glass of
Route: increased dosage water to avoid choking, gagging,
PO Duration: 1–3 wk. of insulin or oral having tablet stick in throat, and
IV antidiabetic drug developing heartburn afterward.
Distribution: Gradually released  ketamine:
Frequency: into tissue cells. Possibly For IV:
OD hypertension and - Reconstitute drug by adding 5 ml
Half-Life: 6–7 days. tachycardia of normal saline solution. Shake
Availability/Form  epinephrine, until clear.
Tablet Solution for norepinephrine: - Administer over 2 to 3 minutes.
Injection increase risk of The rate should not to exceed 100
cardiac mcg per minute.
Content: insufficiency
-active ingredient:  Oral After Drug Administration:
levothyroxine anticoagulants: - Expect patient to undergo thyroid
sodium may potentiate function tests regularly during
-Acacia hypoprothrombine levothyroxine therapy.
-Sucrose mia. - Advise patient not to stop drug or
-Lactose change dosage unless instructed by
-Magnesium FOOD prescriber.
stearate  dietary fiber, - Instruct patient to report signs of
-Povidone soybean flour, hyperthyroidism, such as diarrhea,
walnuts: Possibly excessive sweating, heat
decreased intolerance, insomnia, palpitations,
absorption of weight loss, chest pain, shortness
levothyroxine of breath, leg cramps, headache,
nervousness, irritability, tremors,

SDF-CON-304-071-00

College of Nursing
from GI tract changes in appetite, vomiting, and

fever.
References:
Doenges,M.E,Moorhouse M.F.,&Murr,A.C.(2010) Nurses Pocket Guide.12th Ed.FA:Davis Company: Pennsylvania.

JONES & BARTLETT LEARNING. (2018). Nurses Drug Handbook. SUDBURY.
Schull, P. D. (2013). McGraw-Hill nurses drug handbook. New York: McGraw-Hill Medical.
Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2019). Davis’s Drug Guide for Nurses, 16th ed. Philadelphia: F.A. Davis Company.

SDF-CON-304-071-00

CEBu NORMAL UNIvERSITy
College of Nursing
PRODUCT ASSESSMENT RUBRICS FOR DRUG STUDY
Student Name: Segarra. Louie Danielle S Year/Section: BSN-4B Date: Nov 22, 2021 Score: /30
Directions: Please select the appropriate rating using the following descriptions.
Element Very Satisfacto Needs Comments

Satisfactory ry Improvement
Drug ☐ Accurately presented all of the patient and drug ☐ Accurately presented most of the patient and ☐ Accurately presented some of the patient and
Informati information (name [brand & generic], dosage drug information related to the case. 1 missing drug information related to the case. 2 or more
on (10%) [patient’s dose; min. & max], frequency, route, information or error noted. [2] missing information or errors noted. [1]
availability, contents) related to the case. [3]
Classificati ☐ Accurately presented the classification ☐ Accurately presented the classification ☐ Inaccurately presented the classification
on (therapeutic and pharmacologic) related to the related to the drug but with 1 irrelevant related to the drug. Classification is not relevant
(10%) drug. [3] information or error noted. [2] to the drug. [1]
☐ Accurately presented the indication/s (general ☐ Accurately presented the indication/s related ☐ Inaccurately presented the indication/s related
Indication
& patient- specific) related to the drug. [3] to the drug but with 1 irrelevant information or to the drug. Indication is not relevant to the drug.
(10%)
error noted. [2] [1]
Mechanism Accurately ☐ presented the ☐ Accurately presented the mechanism of ☐ Inaccurately presented the mechanism of action
of Action mechanism of action action of the drug but with 1 irrelevant of the drug. Mechanism of action is not relevant to
(10%)
(pharmacokinetics, pharmacodynamics) of the information or error noted. [2] the drug. [1]
drug. [3]
☐ Accurately presented all of the common ☐ Accurately presented most of the common ☐ Accurately presented some of the common
Contraindicat
contraindications related to the drug. [3] contraindications related to the drug. 1 missing contraindications related to the drug. 2 or more
ion
information or error noted. [2] missing information or errors noted. [1]
(10%)
Side ☐ Accurately presented all of the common side ☐ Accurately presented most of the common ☐ Accurately presented some of the common side
Effects effects related to the drug. [3] side effects related to the drug. 1-2 missing effects related to the drug. 3 or more missing
(10%)
SDF-CON-304-071-00

CEBu NORMAL UNIvERSITy
College of Nursing
information or errors noted. [2] information or errors noted. [1]

Nursing ☐ Accurately presented all of the common ☐ Accurately presented most of the ☐ Accurately presented some of the
Responsibili nursing responsibilities (before, during, and after) common nursing common nursing
ties (30%) related to the drug. [9] responsibilities related to the drug. 1-2 missing responsibilities related to the drug. 3 or more
information or errors noted. [7] missing information or errors noted. [3]
☐ Presented at least 2 sources that are updated ☐ Presented only one source that is updated ☐ No source was presented. Sources are not
Referenc
es (within 5 years), relevant, and credible. [3] (within 5 years), relevant, and credible. Other updated (more than 5 years), relevant, and
(10%) sources are not updated, credible or relevant. credible. [1]
[2]
Sub-score = = =
Evaluated by:
Signature over Printed Name of Clinical Instructor

SDF-CON-304-071-00

College of Nursing: Cebu Normal University

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Republic of the Philippines

CEBU NORMAL UNIVERSITY

Certification Date: 1 February 2021

Registration No. 52Q18778

Certification Date: 1 February 2021

Registration No. 52Q18778

from GI tract changes in appetite, vomiting, and

Doenges,M.E,Moorhouse M.F.,&Murr,A.C.(2010) Nurses Pocket Guide.12th Ed.FA:Davis Company: Pennsylvania.

Certification Date: 1 February 2021

Registration No. 52Q18778

PRODUCT ASSESSMENT RUBRICS FOR DRUG STUDY

Element Very Satisfacto Needs Comments

Registration No. 52Q18778

information or errors noted. [2] information or errors noted. [1]

Signature over Printed Name of Clinical Instructor

Certification Date: 1 February 2021

Registration No. 52Q18778

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