LA SALLE UNIVERSITY

Ozamiz City, Misamis Occidental 7200

College of Arts and Sciences
NURSING DEPARTMENT

DRUG STUDY
SIDE EFFECTS /
DRUG NAME ROUTE/ INDICATIO MECHANISM OF CONTRAINDICATION / ADVERSE NURSING
DOSAGE/ N ACTION PRECAUTION EFFECTS / DRUG RESPONSIBILIT
FREQUENCY/ INTERACTION Y/
DRUG FORM PATIENT
TEACHING
Generic Name: Route: IV: Induction MOA: Contraindications: Side effects Intervention/
of labor at evaluation
OXYTOCIN IM and IV term. Oxytocin increases the  Significant  redness or
sodium permeability of cephalopelvic irritation at the  During
Dosage: IV: uterine myofibrils, indirectly disproportion. injection site, childbirth,
Brand Name: Facilitation of stimulating contraction of  Unfavorable fetal  loss of implement
injectable solution: threatened the uterine smooth muscle. positions or appetite, physical
PITOCIN abortion. The uterus responds to presentations, e.g.,  nausea, agents,
10 units/mL oxytocin more readily in the transverse lies,  vomiting, relaxation
Pharmacologic IV, IM: presence of high estrogen which are techniques,
 cramping,
Class: Frequency: Postpartum concentrations and with the undeliverable and manual
 stomach pain,
control of increased duration of without conversion therapies
OXYTOCICS The initial dose bleeding after  more intense
pregnancy. before delivery (massage,
should be 0.5–1 expulsion of or more
 Obstetric frequent others) as
Therapeutic Class: mU/min (equal to the placenta. Induction of labor at term; emergencies that needed to
3–6 mL of the contractions
control of postpartum favor surgery (this is an help reduce
HORMONES dilute oxytocin bleeding; adjunctive therapy  Fetal distress where pain during
solution per hour). expected
in management of abortion. delivery is not effect of uterine
At 30–60 minute Produces phasic imminent contraction
intervals the dose oxytocin),
contractions.  Where adequate s.
should be gradually  runny nose,
uterine activity fails  If
Availability (Form, increased in  sinus pain or
to achieve administere
Strength, Rx) increments of 1–2 irritation, or
LA SALLE UNIVERSITY COLLEGE OF NURSING : Drug Study 2020
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 mU/min until the satisfactory progress  memory d IV during
 Injectable desired contraction Therapeutic Effect:  Hyperactive or problems. childbirth,
Solution pattern has been hypertonic uterus be alert for
 10 milliunits established. Pitocin (oxytocin injection)  Contraindicated Adverse effects/toxic maternal
of is a natural hormone that vaginal delivery, reactions seizures or
oxytocin/mL; Drug Form: causes the uterus to contract e.g., invasive decreased
used to induce labor, cervical carcinoma,  High doses consciousn
Solution strengthen labor contractions active herpes can also lead ess that
during childbirth, control genitalis, total to uterine progresses
Picture: bleeding after childbirth, or placenta previa, vasa spasms, to coma.
to induce an abortion. previa, and cord hypertonicity, Report
presentation or or rupture. seizures or
Pharmacokinetics: prolapse of cord Oxytocin has coma-like
 Hypersensitivity antidiuretic responses
Onset Peak Durati  Fetal distress, properties, to the
Route
on
polyhydramnios, thus, high physician
IV Immed Unkno 1 hr
partial placenta daily doses (as or nursing
iate wn
IM 3-5 Unkno 30-60 previa, prematurity, a single dose staff
min. wn min
borderline or immediatel
Intrana Few Unkno 20 min
sal min wn cephalopelvic administered y.
Lifespan considerations disproportion, slowly over 24
previous major hours) may
Pregnancy/Lactation: surgery of cervix or lead to
uterus (including C- extreme water  Monitor
Oxytocin is recommended section), over- intoxication any signs
as an aid in the management distension of the resulting of fetal
of the following uterus, grand in maternal distress or
conditions: To precipitate multiparity, invasive seizures, asphyxia,
labor. To accelerate normal cervical carcinoma, coma, and such as
parturition. Postpartum history of uterine even death decreased
evacuation of uterine debris. sepsis, or traumatic fetal heart
delivery Interactions rate,
Children:  Hyperstimulation of arrhythmia
the uterus, with DRUG: s,
No information available strong (hypertonic) meconium
and/or prolonged No information discharge,
(tetanic) or

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 contractions, or a
Elderly: resting uterine tone available decreased
of 15-20 mm H2O or absent
No information available between contractions HERBAL: fetal
may occur, possibly movements
resulting in uterine No information . Report
rupture, cervical and available these signs
vaginal lacerations, to the
postpartum FOOD: physician
hemorrhage, or nursing
abruptio placentae, staff
High Blood Pressure
impaired uterine immediatel
(Hypertension)
blood flow, amniotic y.
fluid embolism, &
fetal trauma Moderate Potential
including Hazard, Moderate
intracranial plausibility
 Assess
hemorrhage maternal
 Not indicated for LAB VALUES:
blood
elective labor pressure
induction Electronically monitor
periodicall
the uterine activity and
y and
the fetal heart rate
compare to
throughout the
normal
Cautions: infusion of Pitocin.
values (See
Attention should be
Appendix
given to tonus,
 If uterine amplitude F). Report
and
hyperactivity occurs, frequency low blood
of
discontinue pressure
contractions, and to
immediately (hypotensio
the fetal heart rate in
 Intravenous n),
relation to uterine
preparations should contractions. especially
be administered by if patient
trained personnel experiences
 Risk of severe water dizziness,
intoxication on fatigue, or
prolonged other

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 administration due
to its antidiuretic symptoms.
effect
 Restricting fluid
intake may be
warranted  Monitor
 Uterine signs of
hypertonicity, maternal
spasm, rupture of the fluid and
uterus, and tetanic electrolyte
contractions may imbalances,
occur from high such as low
doses sodium
 Intramuscular (IM) levels
not recommended (hyponatre
for labor mia), low
induction/augmentat chloride
ion levels
(hypochlor
emia), or a
relative
increase in
body fluid
(water
intoxicatio
n). Signs
include
headache,
confusion,
lethargy,
irritability,
decreased
consciousn
ess, and
neuromusc
ular
abnormaliti

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 es (muscle
weakness
and
cramps).
Report
these signs
to the
physician
or nursing
staff.

Patient/family
teaching

If used intranasally
to facilitate breast-
feeding, make sure
patient uses proper
administration
technique and does
not exceed the
recommended dose
or frequency of
intranasal
applications.

DRUG NAME ROUTE/  INDICATI MECHANISM OF CONTRAINDICA SIDE EFFECTS / NURSING

DOSAGE/ ON ACTION TION / ADVERSE EFFECTS / RESPONSIBILITY/
FREQUENC PRECAUTION DRUG INTERACTION PATIENT
Y/ DRUG TEACHING
FORM
Generic Name:  Prevention MOA: Contraindications: Side effects Intervention/
Route: of evaluation
MISOPROSTOL NSAID(inc  Misoprostol is a  Contraindica GI:
Sublingual; luding synthetic ted with  Monitor

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 Brand Name: oral; vaginal aspirin)-
and vaginal induced prostaglandin E1 history of Nausea, diarrhea, improvements
CYTOTEC with addition gastric analog that allergy to abdominal pain, in GI
of water. ulcers in stimulates prostaglandi flatulence, vomiting, symptoms
Pharmacologic patients at ns; (gastritis,
prostaglandin E1 dyspepsia, constipation
Class: Dosage: high risk of pregnancy heartburn, and
complicatio receptors on parietal (abortifacien so forth) to
PROSTAGLANDIN  100 ns from a cells in the stomach t; advise
GU: help document
E1 ANALOGUE mcg gastric to reduce gastric women of whether drug
 200 ulcer (the acid secretion.3 childbearing Miscarriage, excessive therapy is
Therapeutic Class: mcg elderly; Mucus and age in bleeding, spotting, successful in
patients bicarbonate written and ramping, preventing
ANTIULCERATIV Pregnancy with oral form of hypermenorrhea, gastric damage
secretion are also
E, GASTRIC Termination concomitan use, have a menstrual disorders, or duodenal
MUCOSAL t increased along with negative ulcers.
dysmenorrhea
PROTECTANT See debilitating thickening of the serum  In cases of
mifepristone disease, mucosal bilayer so pregnancy NSAID-
CNS:
Availability (Form, (Mifeprex) history of the mucosa can test within 2 induced
Strength, Rx) drug ulcers) generate new cells. wk. prior to gastritis,
monograph for  With therapy, Headache implement
 100 mcg, FDA approved mifepriston provide appropriate
Therapeutic Effect: Adverse effects/toxic
200 mcg dosage e as an contraceptiv manual
tablets regimen abortifacien es, and reactions therapy
 0.1MG, , t (see  Inhibits basal and begin techniques,
0.2MG Induction of mifepriston nocturnal gastric therapy on  Patients physical
 Tablet Labor (off- e) acid secretion and the second experiencing an agents, and
label)  Unlabeled acid secretion in or third day overdose may therapeutic
Picture: use: response to a variety of the next present with exercises to
25 mcg (1/4 of Appears normal sedation, tremor, reduce
of stimuli, including
100 mcg oral effective in menstrual convulsions, musculoskelet
tablet) meals, histamine, dyspnea,
treating but period);lacta al pain and
intravaginally not pentagastrin, and tion. abdominal pain, decrease the
initially, then preventing coffee. Produces diarrhea, fever, need for
repeat at duodenal uterine contractions  Use palpitations, aspirin and
intervals not ulcers in that may endanger cautiously in hypotension, and other NSAIDs.
to exceed patient’s pregnancy and the elderly, bradycardia.11,13,
every 3-6 unresponsiv and with 14 Hemodialysis is Patient/family

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 hours e
Not to be used tohistamine cause a miscarriage. renal not expected to be teaching
in patients -2 impairment, useful in the
with previous antagonists; Pharmacokinetics: duodenal treatment of  Avoid using
cesarean cervical ulcers. misoprostol concurrent
delivery or ripening Onset Peak Durati  History of overdose13 but magnesium-
major uterine and labor Route
on
allergies to oral activated containing
surgery induction; PO 30 min 60-90 At prostaglandi charcoal may help antacids
min least 3
postpartum hrs. ns; reduce because of
Postpartum hemorrhage Lifespan considerations pregnancy absorption.14 In increased
Hemorrhage ; chronic (category the event of an incidence of
(off-label) idiopathic Pregnancy/Lactation: X), overdose, treat diarrhea.
constipatio lactation. symptoms with  Report
Prophylaxis: n. supportive postmenopaus
 Similar to
600 mcg Cautions: therapy.13 This al bleeding to
orally within 1 medication abortion,
may include physician; it
minute of cramping and removal of
 Can cause may be drug
delivery bleeding will occur undissolved tablets related.
birth
Treatment: with pregnancy from the vagina or  Avoid
defects,
800 mcg passage and side buccal cavity, pregnancy
abortion,
orally once; effects such as intravenous fluid during
premature
use caution if replacement, misoprostol
nausea, vomiting, birth or
prophylactic acetaminophen, therapy; use an
diarrhea, fever, and uterine
dose already diazepam, effective
chills may be rupture in
given and haloperidol, or contraception
pregnant
adverse effects experienced. Studies intramuscular
women. For method while
present or have shown, diclofenac taking drug.
women of
observed however, that depending on the
childbearing  Drug has
Use only in misoprostol is symptoms that
potential: abortifacient
settings where present
acceptable to most negative property.
oxytocin not
women for this serum Contact
available Interactions
indication. pregnancy physician and
test within 2 immediately
Treatment of  There are no data on DRUG:
weeks discontinue
Incomplete the direct effect of before drug if you
Abortion (off- mifepristone or starting  Enhances oxytocin, becomes
label)
misoprostol on the therapy; Avoid concomitant pregnant.

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 lactation process or  Do not breast
600 mcg on a breastfed infant begin on use. feed while
buccally 2nd or 3rd  MAGNESIUM- taking this
(dissolved in Children: day of next CONTAINING drug.
the mouth) menstrual ANTACIDS may
once period; increase diarrhea.
 Children under 8
maintain
Frequency: years: safety and
contraceptio HERBAL:
efficacy not
n during
Misoprostol is established
therapy; No information available
a proven  Children 8 years and
give oral
induction older: 100 mcg
and written FOOD:
agent in the orally every 6 hours
warnings on
second risks in
trimester for Elderly: No information available
pregnancy.
termination of Cardiovascu
pregnancy or  In the elderly the lar disease. LAB VALUES:
fetal death. gain in quality of Inflammator
One regimen life seems to offset y bowel  There were no
is 400 µg the uncertain disease. significant changes
vaginally reduction in quality Dehydration in laboratory
every 6 hours of life due to the . Labor & values in any of the
up to 48 adverse effects of delivery. subjects studied,
hours. For misoprostol. Nursing nor were any major
cervical mothers. side-effects
ripening and encountered.
induction of
labor for a
viable fetus,
25 µg of
vaginal
misoprostol
every 4 to 6
hours is
recommended.

Drug form:

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 Tablet

DRUG NAME ROUTE/DOSAGE/ INDICATION MECHANISM OF CONTRAINDICAT SIDE EFFECTS / NURSING

FREQUENCY/ ACTION ION / ADVERSE RESPONSIBILIT
DRUG FORM PRECAUTION EFFECTS / Y/
DRUG PATIENT
INTERACTION TEACHING
Generic Name: CERVIDIL is MOA: Contraindications: Side effects Intervention/
Route: indicated for the evaluation
DINOPROSTONE initiation and/or In preparation for inducing Acute pelvic  fever,
Endocervical & continuation of labor at the end of a inflammatory  nausea,  Observe
Brand Name: Intravaginal cervical ripening pregnancy. disease, history of  vomiting, patient
in pregnant carefully,
pelvic surgery,  diarrhea,
CERVIDIL Dosage: women at or Therapeutic Effect: after
near term in
uterine fibroids,  abdominal
insertion of
Pharmacologic Class: Induction of Labor whom there is a cervical stenosis, or
Contractions are the drug.
Adult: Endocervical  medical or active cardiac, stomach Rupture of
qualitatively similar to those
PROSTAGLANDINS Place Prepidil 0.5 obstetrical pulmonary, renal, or pain, the
that occur during term labor.
mg endocervically, indication for Has high success rate when hepatic disease,  back pain, membranes
Therapeutic Class: may repeat q6h the induction of used as abortifacient before pregnancy (category or. is not a
(max: of 1.5 mg); labor. twentieth week and for C).  a feeling contraindic
OXYTOCIC Place Cervidil insert stimulation of labor in cases of warmth ation to
10-mg transversely of intrauterine fetal death. Cautions: in the drug, but
Availability (Form, in the posterior vaginal be aware
Strength, Rx) fornix of the vagina, This drug should not that profuse
Pharmacokinetics: area.
remove on onset of be used if you are bleeding
active labor or 12 h carrying more than may result
 20 mg after insertion
Onset Peak Durati
Adverse
Route
on
one baby, if your effects/toxic in
suppository; Prepi IV 10 min Unkno 2- 3 labor has already expulsion
dil 0.5 mg Evacuation of wn hrs. reactions
started, or if your of the
gel; Cervidil 10 Uterus Lifespan considerations
water has broken. suppository
mg vaginal insert Adult: Intravaginal I CNS: headache, . Report
This medication
 Dinoprostone, the nsert suppository Pregnancy/Lactation: dizziness, anxiety wheezing,
should be used only
active ingredient is high in vagina, when clearly needed , hot flashes, chest pain,
within a plastic repeat q2–5h until This medication should be paresthesia, dyspnea,
during pregnancy.
(polyurethane) abortion occurs or used only when clearly
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 sustained release membranes rupture
insert which (max: total dose 240 needed during pregnancy. It Discuss the risks and weakness, and
contains: mg) prolonged contraction of the benefits with your syncope, fever. significant
hexanetriol/macrog uterus is detrimental to fetal doctor. CV: chest changes in
ol 8000/ isocyanate Frequency: safety or uterine integrity, BP and
pain, arrhythmia
cross-linked such as previous cesarean pulse to the
hydrogel Administer one
s.
section or major uterine physician.
copolymer CERVIDIL insert surgery, because of the risk  Monitor
 10 mg (10 mg) of uterine rupture and uterine
dinoprostone in a intravaginally for obstetrical complications EENT: blurred contraction
hydrogel polymer use up to 12 hours (e.g., need for hysterectomy vision, eye pain. s and
(NDC 0456- (approximately  and the occurrence of fetal observe for
412363). 0.3 mg of or neonatal death). and report
 Used to help dinoprostone is GI: nausea, excessive
prepare your cervix released per hour) Children: vomiting, vaginal
(the lower opening [see DOSAGE AND diarrhea. bleeding
of the womb) for ADMINISTRATIO No information available and
GU: vaginal
labor and delivery. N]. Monitor uterine cramping
activity, fetal status, pain, vaginitis,
Elderly: pain. Keep
Picture: and the progression endometritis.
pad count.
of cervical dilatation Save all
No information available
and effacement with clots and
the use of Musculoskeletal:  tissues for
CERVIDIL. nocturnal leg physician
cramps, backache inspection
Drug Form: , muscle cramps. and
laboratory
Dinoprostone, the analysis.
active ingredient is  Abortion
Respiratory:
within a plastic usually
(polyurethane) cough, dyspnea.
occurs
sustained release within 30
insert which h. When
contains: Skin: diaphoresis used in
hexanetriol/macrogo , rash. conjunction
l 8000/ isocyanate with
cross-linked oxytocin,

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 hydrogel copolymer. time may
Other: shivering, be
chills, breast shortened
tenderness. to 12–14 h.
 Monitor
vital signs.
Fever is a
Fetal physiologic
CNS: fetal response of
depression, hyper the
stimulation with hypothalam
or without fetal us to use of
distress. dinoprosto
ne and
occurs
CV: bradycardi within 15–
a. 45 min
after
insertion of
suppository
Metabolic: fetal .
acidosis. Temperatur
e returns to
normal
Other: ammonite within 2–6
s, Intrauterine fetal h after
sepsis. discontinua
tion of
Interactions medication.

DRUG:

OXYTOCICS used Patient/family

with extreme teaching
caution.

 Continue

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 taking your
HERBAL: temperatur
e (late
Herbal products afternoon)
for a few
FOOD: days after
discharge.
No interactions Contact
found. physician
with onset
of fever,
bleeding,
abdominal
LAB VALUES: cramps,
abnormal
No interactions or foul-
found. smelling
vaginal
discharge.
 Avoid
douches,
tampons,
intercourse,
and tub
baths for at
least 2 wk.
Clarify
with
physician.
 Note:
Dinoprosto
ne may
exacerbate
joint pain
and
limitation
due to its

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 effect on
the
inflammato
ry process.

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 Submitted by: Submitted to:

Name of Student: Jobert P. Rosillosa Mrs. MaryVic Regalado, MN

Year Level: BSN - 3 Name of Clinical Instructor
Date: November 9, 2021 Date: November 9, 2021

LA SALLE UNIVERSITY COLLEGE OF NURSING : Drug Study 2020

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