Republic of the Philippines

Cebu Normal University

Osmeña Blvd. Cebu City, 6000 Philippines

College of Nursing
Center of Excellence (COE) | Level IV Re-Accredited (AACCUP)
Telephone No.: (032) 254 4837
Email: cn@cnu.edu.ph/secretary@cnunursing.org
DRUG STUDY

Patient’s Initials: D. P. Date of Admission: May 10, 2021 ____________ Diagnosis: Schizophrenia_________________________________________
Age: 34 years old Height: N/S ______ Weight: N/S Clinical Intervention: N/S_________________________________________
Sex: Male Ward: Psychiatric Ward Bed No.: 8 Name of Physician: N/S__________________________________________

Name of Mechanism of Nursing

Classification Indication Contraindication Side Effects
Drug Action Responsibilities
Generic Pharmacologic Selectively inhibits General Indications: Contraindicated CNS: Before:
Name: Class: the reuptake of Depression. in: NEUROLEPTIC ● Check doctor’s order.
Citalopram Selective serotonin in the Hypersensitivity; MALIGNANT SYNDROME, ● Check medication,
serotonin CNS. Unlabeled Use: Concurrent use of SUICIDAL THOUGHTS, medication’s expiration
Trade Name: reuptake Premenstrual dysphoric MAO inhibitors or apathy, confusion, date and dosage before
CeleXA inhibitors Therapeutic disorder (PMDD). MAO-like drugs drowsiness, insomnia, administering drug. 
(SSRIs) Effects: Obsessive-compulsive (linezolid or weakness, agitation, ● Monitor mood changes
Minimum Antidepressant disorder (OCD). Panic methylene blue); amnesia, anxiety, during therapy.
dose: Therapeutic action. disorder. Generalized Concurrent use of decreased libido, ● Assess for suicidal
10 mg Class: anxiety disorder (GAD). pimozide; Congenital dizziness, fatigue, tendencies, especially
Antidepressants Pharmacokinetic Posttraumatic stress long QT syndrome, impaired concentration, during early therapy and
Maximum s Absorption: disorder (PTSD). Social bradycardia, increased depression, dose changes. Restrict
dose: Pregnancy 80% absorbed anxiety disorder (social hypokalemia, migraine headache. amount of drug available
40 mg Category: after oral phobia). hypomagnesemia, to patient. Risk may be
C administration. recent myocardial EENT: increased in children,
Patients’ Patient’s Indication:  infarction, abnormal adolescents, and adults
Dose Distribution: Not applicable to decompensated accommodation. 24 yr. After starting
Not indicated Enters breast milk. patient. heart failure therapy, children,
(increased risk of QT Resp: adolescents, and young
Route: Metabolism and interval cough. adults should be seen by
PO Excretion: prolongation); health care professional at
Mostly metabolized Concurrent use of CV: least weekly for 4 wk,
Frequency: by the liver (10% QT interval TORSADE DE POINTES, every 3 wk for the next 4
Not indicated by CYP3A4 and prolonging drugs. postural hypotension, QT wk, and on advice of
2C19 enzymes); interval prolongation, health care professional
Form: excreted Use Cautiously in: tachycardia. thereafter.
Tablet unchanged in History of mania; ● Assess for sexual
urine. History of suicide GI: dysfunction (erectile
Availability: attempt/ideation abdominal pain, dysfunction; decreased
(generic Half-life: (increased risk anorexia, diarrhea, dry libido).
available) 35 hr. during early therapy mouth, dyspepsia, ● Assess for serotonin
Tablets: 10 and during dose flatulence, increased syndrome (mental
mg, 20 mg, adjustment); History saliva, nausea, altered changes [agitation,
40 mg. Cost: of seizure disorder; taste, increased appetite, hallucinations, coma],
Generic—10 Illnesses or vomiting. autonomic instability
mg conditions that are [tachycardia, labile BP,
$7.11/100, 20 likely to result in GU: hyperthermia],
mg altered metabolism amenorrhea, neuromuscular
$9.73/100, 40 or hemodynamic dysmenorrhea, aberrations [hyperreflexia,
mg responses; Severe ejaculatory delay, erectile incoordination], and/or GI
$10.83/100. renal or hepatic dysfunction, polyuria. symptoms [nausea,
Oral solution impairment vomiting, diarrhea]),
(peppermint (maximum dose of Derm: especially in patients
flavor): 10 20 mg/day in sweating, taking other serotonergic
mg/5 mL. patients with hepatic photosensitivity, pruritus, drugs (SSRIs, SNRIs,
Cost: Generic impairment); Poor rash. triptans).
—10 mg/5 mL metabolizers of ● Lab Test
$117.50/240 CYP2C19 (increased Metab: Considerations: Monitor
mL. risk of QT interval weight loss, weight gain. electrolytes (potassium
prolongation) F and E: hyponatremia. and magnesium) in
(maximum dose of MS: arthralgia, myalgia. patients at risk for
20 mg/day); electrolyte imbalances
Concurrent use of Neuro: prior to and periodically
CYP2C19 inhibitors tremor, paresthesia. during therapy
(increased risk of QT
interval Misc: During:
prolongation) SEROTONIN SYNDROME, ● Verify client’s identity.
(maximum dose of fever, yawning. ● Inform client of the
20 mg/day); OB: purpose of the drug.
Use during third Interactions ● Make sure to administer
trimester may result Drug-Drug: adhering to the patient’s
in neonatal May cause serious, rights in medication
serotonin syndrome potentially fatal reactions administration such as
requiring prolonged when used with MAO right drug, dosage,
hospitalization, inhibitors; concurrent use patient, route, and time.
respiratory and contraindicated; allow at • Observe proper hand
nutritional support; least 14 days between hygiene and aseptic
Lactation: Present in citalopram and MAO techniques.
breast milk and may inhibitors. Concurrent use ● Do not confuse with
result in lethargy with MAO-inhibitor like Celebrex (celecoxib),
with decreased drugs, such as linezolid Cerebyx (fosphenytoin),
feeding in infants; or methylene blue, may or Zyprexa (olanzapine).
weigh risk/benefits; increase risk of serotonin ● PO: Administer as a
Pedi: May increase syndrome; concurrent single dose in the
risk of suicide use contraindicated; do morning or evening
attempt/ideation not start therapy in without regard to food.
especially during patients receiving
early treatment or linezolid or methylene After:
dose adjustment in blue; if linezolid or ● Make sure the drug is
children/adolescents methylene blue need to taken by the patient as
(unlabeled for be started in a patient directed.
pediatric use); Geri: receiving citalopram, ● Instruct patient to take
decreased doses immediately discontinue citalopram as directed.
recommended citalopram and monitor Take missed doses as
(maximum dose of for signs/symptoms of soon as remembered
20 mg/day in serotonin syndrome for 2 unless almost time for
patients 60 yr). wk or until 24 hr after next dose; do not double
last dose of linezolid or doses. Do not stop
methylene blue, abruptly; may cause
whichever comes first anxiety, irritability, high or
(may resume citalopram low mood, feeling restless
therapy 24 hr after last or changes in sleep
dose of linezolid or habits, headache,
methylene blue). sweating, nausea,
Concurrent use with dizziness, electric shock-
pimozide may result in like sensations, shaking,
prolongation of the QTc and confusion. Advise
interval and is patient to read the
contraindicated. QT Medication Guide prior to
interval prolonging drugs starting therapy and with
may increase the risk of each refill in case of
QT interval prolongation changes.
and torsade de pointes ● May cause drowsiness,
(concurrent use should dizziness, impaired
be avoided). CYP2C19 concentration, and
inhibitors, including blurred vision. Caution
cimetidine may increase patient to avoid driving
levels and the risk of and other activities
toxicity (maximum dose requiring alertness until
20 mg/day). Drugs that response to the drug is
affect serotonergic known.
neurotransmitter ● Instruct patient to
systems, including notify health care
tricyclic antidepressants, professional of all Rx or
SNRIs, fentanyl, OTC medications,
buspirone, tramadol and vitamins, or herbal
triptans increased risk of products being taken and
serotonin syndrome. Use to consult health care
cautiously with other professional before taking
centrally acting drugs any other Rx, OTC, or
(including alcohol, herbal products,
antihistamines, opioid especially alcohol or other
analgesics, and CNS depressants.
sedative/hypnotics; ● Caution patient to
concurrent use with change positions slowly to
alcohol is not minimize dizziness.
recommended). ● Advise patient, family,
Serotonergic effects may and caregivers to look for
be increased by lithium suicidality, especially
(concurrent use should during early therapy or
be carefully monitored). dose changes. Notify
Ketoconazole, health care professional
itraconazole, immediately if thoughts
erythromycin, and about suicide or dying,
omeprazole may increase attempts to commit
levels. Carbamazepine suicide, new or worse
may decrease blood depression or anxiety,
levels. May increase agitation or restlessness,
levels of metoprolol. Use panic attacks, insomnia,
cautiously with tricyclic new or worse irritability,
antidepressants due to aggressiveness, acting on
unpredictable effects on dangerous impulses,
serotonin and mania, or other changes
norepinephrine reuptake. in mood or behavior or if
Increased risk of symptoms of serotonin
bleeding with aspirin, syndrome occur.
NSAIDs, clopidogrel, or ● Advise patient to use
warfarin. sunscreen and wear
protective clothing to
Drug-Natural prevent photosensitivity
Products: reactions.
increased risk of ● Inform patient that
serotonergic side effects frequent mouth rinses,
including serotonin good oral hygiene, and
syndrome with St. John’s sugarless gum or candy
wort and SAMe. may minimize dry mouth.
 If dry mouth persists for
more than 2 wk, consult
health care professional
regarding use of saliva
substitute.
● Instruct female patients
to inform health care
professional if pregnancy
is planned or suspected,
or if they plan to breast
feed. If used during
pregnancy should be
tapered during third
trimester to avoid neontal
serotinin syndrome.
● Emphasize the
importance of follow-up
exams to monitor
progress.
• Document the medicine
administered.  
References: References: References: References: References: References: References:

Vallerand, Vallerand, A.H., Vallerand, A.H., Vallerand, A.H., Sanoski, Vallerand, A.H., Vallerand, A.H., Sanoski, Vallerand, A.H., Sanoski,
A.H., Sanoski, Sanoski, C.A., & Sanoski, C.A., & C.A., & Deglin, J.H. Sanoski, C.A., & C.A., & Deglin, J.H. C.A., & Deglin, J.H.
C.A., & Deglin, J.H. Deglin, J.H. (2017). (2017). Davis’s Drug Deglin, J.H. (2017). (2017). Davis’s Drug (2017). Davis’s Drug
Deglin, J.H. (2017). Davis’s Davis’s Drug Guide Guide for Nurses, 15th Davis’s Drug Guide Guide for Nurses, 15th Guide for Nurses, 15th ed.
(2017). Drug Guide for for Nurses, 15th ed. Philadelphia: F.A. for Nurses, 15th ed. ed. Philadelphia: F.A. Philadelphia: F.A. Davis
Davis’s Drug Nurses, 15th ed. ed. Philadelphia: Davis Company. Philadelphia: F.A. Davis Company. Company.
Guide for Philadelphia: F.A. Davis Davis Company.
Nurses, 15th F.A. Davis Company. MIMS. (n. d.). MIMS. (n. d.). MIMS. (n. d.). Citalopram.
ed. Company. Citalopram. Retrieved MIMS. (n. d.). Citalopram. Retrieved Retrieved from
Philadelphia: MIMS. (n. d.). from Citalopram. from https://www.mims.com/p
F.A. Davis MIMS. (n. d.). Citalopram. https://www.mims.com/ Retrieved from https://www.mims.com/p hilippines/drug/info/citalo
Company. Citalopram. Retrieved from philippines/drug/info/cit https://www.mims.c hilippines/drug/info/citalo pram?mtype=generic
Retrieved from https://www.mims. alopram?mtype=generic om/philippines/drug/ pram?mtype=generic
MIMS. (n. d.). https://www.mi com/philippines/dr info/citalopram?
Citalopram. ms.com/philippin ug/info/citalopram? mtype=generic
Retrieved es/drug/info/cital mtype=generic
from opram?
https://www. mtype=generic
mims.com/phil
ippines/drug/i
nfo/citalopram
?
mtype=generi
c

PRODUCT ASSESSMENT RUBRICS FOR DRUG

STUDY
Student Name: Rose Leen T. Year/Section: BSN-3B Date: May 10, 2021 Score: /30
Rosell
Directions: Please select the appropriate rating using the following descriptions.

Elemen Very Satisf Needs Comme

t Satisfacto actory Improveme nts
ry nt
Drug ☐ Accurately presented all of the patient ☐ Accurately presented most of the ☐ Accurately presented some of the patient
Infor and drug information (name [brand & patient and drug information related to and drug information related to the case. 2
matio generic], dosage [patient’s dose; min. & the case. 1 missing information or error or more missing information or errors
n max], frequency, route, availability, noted. [2] noted. [1]
(10% contents) related to the case. [3]
)
Classifi ☐ Accurately presented the classification ☐ Accurately presented the classification ☐ Inaccurately presented the classification
catio (therapeutic and pharmacologic) related to related to the drug but with 1 irrelevant related to the drug. Classification is not
n the drug. [3] information or error noted. [2] relevant to the drug. [1]
(10
%)
☐ Accurately presented the indication/s ☐ Accurately presented the indication/s ☐ Inaccurately presented the indication/s
Indication
(general & patient- specific) related to the related to the drug but with 1 irrelevant related to the drug. Indication is not
(10%)
drug. [3] information or error noted. [2] relevant to the drug. [1]
Mechan ☐ Accurately presented the ☐ Accurately presented the mechanism ☐ Inaccurately presented the mechanism of
ism of mechanism of action of action of the drug but with 1 irrelevant action of the drug. Mechanism of action is
Action
(pharmacokinetics, pharmacodynamics) of information or error noted. [2] not relevant to the drug. [1]
(10%)
the drug. [3]
☐ Accurately presented all of the common ☐ Accurately presented most of the ☐ Accurately presented some of the
Contraind
contraindications related to the drug. [3] common contraindications related to the common contraindications related to the
icatio
drug. 1 missing information or error drug. 2 or more missing information or
n
noted. [2] errors noted. [1]
(10%
)
Side ☐ Accurately presented all of the common ☐ Accurately presented most of the ☐ Accurately presented some of the
Effe side effects related to the drug. [3] common side effects related to the drug. common side effects related to the drug. 3
cts 1-2 missing information or errors noted. or more missing information or errors
(10
%) [2] noted. [1]
Nursing ☐ Accurately presented all of the ☐ Accurately presented most of the ☐ Accurately presented some of the
Respons common nursing responsibilities (before, common nursing common nursing
ibilities during, and after) related to the drug. [9] responsibilities related to the drug. 1-2 responsibilities related to the drug. 3 or
(30%)
missing information or errors noted. [7] more missing information or errors noted.
 [3]
Refer ☐ Presented at least 2 sources that are ☐ Presented only one source that is ☐ No source was presented. Sources are not

enc updated (within 5 years), relevant, and updated (within 5 years), relevant, and updated (more than 5 years), relevant, and
es credible. [3] credible. Other sources are not updated, credible. [1]
(10 credible or relevant. [2]
%)
Sub-score = = =

Evaluated by:

Signature over Printed Name of Clinical Instructor