Cebu Institute of Technology

University
N. Bacalso Ave., Cebu City Philippines

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

DRUG STUDY

IN PARTIAL FULFILLMENT OF THE COURSE RLE 402

SUBMITTED BY:

Dara Sophia N. Encarguez

BSN IV-N1

SUBMITTED TO:

Monette P. Cañete, RN, MAN, TM1

FACULTY
DRUG STUDY

MECHANISM OF
DOSAGE/FREQ/ NURSING RESPONSIBILITIES
NAME OF ACTION INDICATIONS/ ADVERSE
CLASSIFICATION SIDE EFFECTS
DRUG CONTRAINDICATIONS EFFECTS
ROUTE/SUPPLIED (Before, During, After)

GENERIC: PATIENT’S DOSE: Opiod analgesics/ Tramadol is a centrally INDICATIONS: SKIN: RARE: BEFORE:
Non-opiod acting opioid analgesic  Used to treat  Rash, itching  Bloody or 1. Checked and validated the doctor’s order
Tramadol HCL Tramadol 37.5 mg analgesics/ that binds to μ-opiate moderate to black, prior to the administration of the
and swelling
+ Paracetamol and Paracetamol Antipyretic receptors in the CNS, severe pain tarry tools medication.
325 mg film-coated (face, tongue,
leading to inhibited  Bloody or 2. Observed the Ten Rights of medication
tab ascending pain throat) administration.
CONTRAINDICATIONS: cloudy
pathways and altered  Hypersensitivity to urine 3. Ensured proper preparation of drug/s and
BRAND FREQUENCY: pain perception and tramadol, RESPIRATORY:  Fever with took note of the drug/s’ mechanism of
NAME:
response. It also paracetamol or to  Dyspnea or without action and side effects.
Every 4-6 hours if
Dolcet inhibits the reuptake any of the  Abnormal chills 4. Obtained a history on allergies or any
needed
of norepinephrine and excipients  Pain in the other drugs, foods or substances.
breath sounds
enhances the release  Acute intoxication lower back
of serotonin.  Wheezing and/or
with alcohol, DURING:
Paracetamol is a para- hypnotic drugs,  Coughing side 1. Identified patient and validated identity
ROUTE:
aminophenol centrally-acting  hypoxia  Yellow by checking the bed number and arm band.
Oral (PO) derivative with analgesics, opioids eyes or 2. Explained what the medication is for as
analgesic, antipyretic or psychotropic CARDIOVASCULAR: skin well as its possible side and adverse effects
and weak anti- drugs to the body.
 Tachycardia
inflammatory activity.  Tramadol GASTRO 3. Took patient’s vital signs.
SUPPLIED: The exact mechanism  Chest pain 4. Prepared the medication.
Hydrochloride/Par INTESTINAL:
of its analgesic action acetamol should  Diarrhea 5. Informed patient about the route of
Tablet is still unknown, but it not be BLOOD AND  Nausea or administration.
is believed to be by administered to LYMPHATIC SYSTEM vomiting 6. Made sure that the patient is aware that
activating the patients who are DISORDERS: he/she must not exceed the recommended
descending receiving MUSCULO dosage amount.
 Thrombocytope
serotonergic inhibitory monoamine SKELETAL: 7. Informed patient that the medication can
pathways in the CNS. nia be taken on an empty stomach.
oxidase inhibitors  Stomach
or within two  Leukopenia 8. Gave the whole tablet with a glass of
cramps
weeks of their  Neutropenia water; instructed patient to swallow it whole
Reference: withdrawal and not to chew for doing so can release all
 Severe hepatic GI: of the drug at once, increasing the risk of
Mims. (n.d.). impairment side effects.
 Nausea and
Tramadol +  Epilepsy not 9. Ensured that the patient has swallowed
vomiting and taken the medication.
Paracetamol. Retrived controlled by
from: treatment  Diarrhea
https://www.mims.co AFTER:
m/philippines/drug/inf MUSCULOSKELETAL: 1. Documented administration of
 o/tramadol%20+  Muscle spasm medication.
%20paracetamol? 2. Monitored vital signs.
mtype=generic 3. Monitored for signs and symptoms of
hypersensitivity reactions.
4. Informed patient that the medication may
cause drowsiness or dizziness, which may
be enhanced by alcohol or other central
nervous system (CNS) depressants.
Additionally, if affected, the patient should
not drive or operate any machinery.
5. Informed patient that prolonged use of
this product may lead to drug dependence
(addiction), even at therapeutic doses.
6. Instructed patient not to drink excessive
quantities of alcohol while taking the said
medication.

MECHANISM OF
DOSAGE/FREQ/ NURSING RESPONSIBILITIES
NAME OF ACTION INDICATIONS/
CLASSIFICATION SIDE EFFECTS ADVERSE EFFECTS
DRUG CONTRAINDICATIONS
ROUTE/SUPPLIED (Before, During, After)
GENERIC: ORAL: Stimulant laxative Bisacodyl is INDICATIONS: GASTROINTESTIN SIGNIFICANT: BEFORE:
TABLET: deacetylated to the  Used on a short- AL DISORDERS:  Fluid and 1. Checked and validated the doctor’s
Bisacodyl 5 to 15 mg orally active bis-(p- term basis to treat  Abdominal electrolyte order and/or medication order prior to the
once a day as hydroxyphenyl)- constipation cramps imbalance e.g. administration of the medication.
needed pyridyl-2-methane  Used to empty the and/or pain metabolic 2. Observed the Ten Rights of medication
(BHPM) by an bowels before  Diarrhea acidosis or administration.
BRAND
Duration of therapy: intestinal deacetylase. surgery and  Nausea alkalosis, 3. Ensured proper preparation of drugs and
NAME:
Up to 1 week BHPM can stimulate certain medical hypocalcaemia, took note of the drugs’ mechanism of
Dulcolax parasympathetic procedures NERVOUS hypokalaemia action and side effects.
RECTAL: nerves in the colon SYSTEM (prolonged 4. Obtained a history on allergies or any
ENEMA: directly to increase CONTRAINDICATION: DISORDERS: use) other drugs, foods or substances that the
10 mg rectally once motility and  Hypersensitivity  Faintness patient may be allergic to.
a day as needed secretions.  Obstruction or  Syncope GASTROINTESTINAL
severe impaction DISORDERS: DURING:
SUPPOSITORY: Bisacodyl stimulates  Symptoms of LOCAL:  Abdominal pain 1. Identified patient and validated patient’s
10 mg (1 adenylate cyclase, appendicitis or  Local rectal  Bloody diarrhea identity by checking the bed number and
suppository) rectally increasing cyclic AMP, acute surgical irritation  Nausea arm band.
once a day as leading to active abdomen  Rectal  Abdominal 2. Explained what the medication is for as
needed transport of chloride  Vomiting burning cramps well as its possible side and adverse effects
and bicarbonate out of  Rectal bleeding  Haematochezia to the body.
Duration of therapy: cells. Sodium ions, METABOLIC  Vomiting 3. Took patient’s vital signs.
Up to 1 week potassium ions, and DISORDER:  Abdominal 4. Prepared the medication and ensured
water passively leave  Dehydration discomfort whether the medication is within its expiry
the cell; while sodium  Anorectal date and is still intact.
and chloride ions are IMMUNULOGIC discomfort 5. Informed the patient of the route of the
unable to be DISORDER:  Rectal burning administration.
reabsorbed.  Slight (suppository) SUPPOSITORY ADMINISTRATION
indisposition  Colitis  Washed hands and donned plastic
Water is also be apron and gloves
transported from the METABOLISM AND  Positioned the patient lying on the
luminal side of cells NUTRITION left side with her or his knees
into the vasculature by DISORDERS: drawn up to the abdomen. This
aquaporin 3. Bisacodyl  Dehydration eases the passage of the
decreases expression suppository into the rectum
of aquaporin 3, NERVOUS SYSTEM (Dougherty and Lister, 2004).
preventing water from DISORDERS: Gravity and the anatomical
moving into the  Dizziness structure of the sigmoid colon also
vasculature, which indicate that inserting the
may contribute to suppository with the patient in this
increased water in the position will aid retention.
colon.  Positioned a plastic-backed
absorbent sheet underneath the
Bisacodyl directly patient.
stimulates  Assessed the area and performed
parasympathetic a digital rectal examination.
nerves in the colon,  Broke the suppository seal.
stimulating contraction  Lubricated the end of the
of longitudinal smooth suppository with lubricating gel.
muscle but not circular  Gently separated the buttocks,
smooth muscle. identifying the anus.
 Slowly inserted the lubricated
Reference: suppository into the rectum.
 Attended to perianal hygiene.
DRUGBANK Online.  Asked the patient to retain the
(n.d.). Bisacodyl. suppository as suggested in the
Retrieved from: manufacturer’s recommendations.
https://go.drugbank.c  Provided a bedpan, commode or
om/drugs/DB09020 nurse call system as indicated.
 Disposed of any waste.
 Removed apron and washed
hands.
ORAL ADMINISTRATION
 Gave the medication in the
evening or before breakfast
because of action time required.
 Gave enteric coated tablets whole
to avoid gastric irritation.
Instructed the patient not to cut or
crush. Patient should not chew
tablets.
 Gave the medication with a full
glass (240 mL) of water or other
liquid.

AFTER:
1. Recorded and documented the
administration of medication.
2. Evaluated periodically patient's need for
continued use of drug; bisacodyl usually
produces 1 or 2 soft formed stools daily.
3. Monitored patients receiving
concomitant anticoagulants. Indiscriminate
use of laxatives results in decreased
absorption of vitamin K.
4. Added high-fiber foods slowly to regular
diet to avoid gas and diarrhea. Adequate
fluid intake includes at least 6–8
glasses/day.
 5. Informed patient not to take the
medication within 1 hour of antacids or
milk. These substances may cause
premature dissolution of enteric coating;
early release of drug in stomach may result
in gastric irritation and loss of cathartic
action.
6. Instructed patient not to breast feed
while taking this drug without consulting
her physician.

MECHANISM OF
DOSAGE/FREQ/ NURSING RESPONSIBILITIES
NAME OF ACTION INDICATIONS/
CLASSIFICATION SIDE EFFECTS ADVERSE EFFECTS
DRUG CONTRAINDICATIONS
ROUTE/SUPPLIED (Before, During, After)
GENERIC: PATIENT’S DOSE: Laxative Osmotic Increases water INDICATIONS: GASTROINTESTINAL METABOLISM AND BEFORE:
content and softens  Adjunct in the DISORDERS: NUTRITION 1. Checked and verified doctor’s order
Lactulose 30cc/ml the stools. Lowers the management of  Burping gas DISORDERS: regarding the correct dosage, frequency,
pH of the colon, which portal- systemic  Nausea  Hyperglycemia and route.
BRAND inhibits the diffusion of Hepatic  Cramps 2. Assessed patient’s history for allergy
NAME: ammonia from the encephalopathy  Stomach to lactulose, low-galactose diet.
FREQUENCY:
colon into the blood, (PSE) discomfort or 3. Assessed patient for abdominal
Lilac
Every hour thereby reducing  Treatment of pain distention, presence of bowel sounds and
blood ammonia levels. chronic  Belching normal pattern of bowel function.
constipation  Distention 4. Prepared the medication as per
Reference:  Flatulence doctors’ order.
ROUTE: CONTRAINDICATION:  Diarrhea 5. Checked for the medication expiration
Nursing Central.  Patients on low- date.
Oral (PO) (n.d.). Lactulose. galactose diets 6. Practiced the 10 rights of medication
Retrieved from: administration
https://nursing.unbou
ndmedicine.com/nursi DURING:
SUPPLIED: 1. Introduced self to patient.
ngcentral/view/Davis-
Drug-Guide/51431/ 2. Verified patient’s identity.
Solution
all/lactulose 3. Observed proper hand hygiene.
4. Educated patient on the purpose of
the drug to be administered.
6. Emphasized to the patient the
importance of continuously taking the
medication.
7. Administered the drug in a full glass
(240 ml) of water or it can also be mixed
with fruit juice to improve flavor.

AFTER:
1. Recorded and documented the
administration of medication.
2. Assessed color, consistency and
amount of stool produced.

REFERENCES:

1. DRUGBANK Online. (n.d.). Bisacodyl. Retrieved from: https://go.drugbank.com/drugs/DB09020

2. Drugs.com. (2020). Bisacodyl Side Effects. Retrieved from: https://www.drugs.com/sfx/bisacodyl-side-effects.html
3. Drugs.com. (2021). Bisacodyl Dosage. Retrieved from: https://www.drugs.com/dosage/bisacodyl.html
4. EMC. (2021). Tramadol/Paracetamol 37.5mg / 325mg tablets. Retrived from: https://www.medicines.org.uk/emc/product/10547/smpc#CLINICAL_PRECAUTIONS
5. Higgins, D. (2007). Bowel care Part 6 – Administration of a suppository. Nursing Times; 103: 47:, 26-27.
6. MIMS. (n.d.). Bisacodyl. Retrieved from: https://www.mims.com/philippines/drug/info/bisacodyl?mtype=generic
7. Mims. (n.d.). Tramadol + Paracetamol. Retrived from: https://www.mims.com/philippines/drug/info/tramadol%20+%20paracetamol?mtype=generic
8. Nursing Central. (n.d.). Lactulose. Retrieved from: https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/51431/all/lactulose
9. Robholland. (n.d.). BISACODYL. Retrieved from: http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/B027.html
10. Stewart, J. (2021). Paracetamol. Retrieved from: https://www.drugs.com/paracetamol.html#:~:text=What%20is%20paracetamol%20%3F,toothaches%2C%20colds%2C%20and
%20fevers.
11. WebMD. (n.d.). Paracetamol Tablet. Retrieved from: https://www.webmd.com/drugs/2/drug-57595/paracetamol-oral/details#:~:text=This%20drug%20is%20used%20to,pains)
%20and%20to%20reduce%20fever.