DRUG CLASSIFICAT ACTION INDICATI CONTRAINDIC ADVERSE NURSING

NAME ION ON ATION AFFECT CONSIDERA

TION
GENERIC Chemical Inhibits To Hepatic CNS: • Use
NAME: class: ascending provide disease; history Agitation, pentobarbit
Pentobar Barbiturate conductio daytime of addiction to anxiety, al with
bital n in sedation hypnotics or ataxia, extreme
Sodium Therapeutic reticular sedatives; confusion, caution in
class: formation, hypersensitivity delusions, patients
BRAND Anticonvuls which to depression, with
NAME: ant, controls pentobarbital, dizziness, depression,
Nembutal sedativehyp CNS barbiturates, or drowsiness, a history of
notic arousal to their fever, drug abuse,
produce components; hallucinatio or suicidal
drowsines nephritis; ns, tendencies.
s, porphyria; headache, • Use drug
hypnosis, severe insomnia, cautiously in
and respiratory irritability, elderly or
sedation. disease with nervousnes debilitated
Pentobarb airway s, patients and
ital also obstruction or nightmares those with
decreases dyspnea , acute or
spread of paradoxical chronic pain
seizure stimulation because it
activity in , seizures, may induce
cortex, syncope, paradoxical
thalamus, tremor CV: stimulation.
and limbic Orthostatic • When
system. It hypotensio using I.V.
promotes n EENT: route, inject
an Vision drug at 50
increased changes GI: mg/min or
threshold Anorexia, less to avoid
for constipatio adverse
electrical n, hepatic respiratory
stimulatio dysfunction and
n in the , nausea, circulatory
motor vomiting reactions.
cortex, HEME: • If patient
which may Agranulocy shows
contribute tosis MS: premonitory
to Arthralgia, signs of
anticonvul bone pain, hepatic
sant muscle coma,
effects. twitching withhold
or drug and
weakness notify
RESP: prescriber
Respiratory immediately
depression .
SKIN: • Monitor
Exfoliative I.V. site
derm closely and
Other: avoid
Physical extravasatio
and n. Drug is
psychologic highly
al alkaline and
dependenc may cause
e, weight local tissue
loss damage and
necrosis.

PATIENT
TEACHING
• Inform
patient that
pentobarbit
al is
habitformin
g, and stress
the
importance
of taking it
exactly as
prescribed.
• Instruct
patient who
takes elixir
form to use
a calibrated
measuring
device and
to close
container
tightly after
use.
• Instruct
patient who
uses
suppositorie
s to
refrigerate
them.
• Advise
patient to
avoid
hazardous
activities
until drug’s
CNS effects
are known.
 • Urge
patient to
avoid
alcohol and
other CNS
depressants
because
they may
increase
drug’s
adverse CNS
effects.

DRUG CLASSIFICAT ACTION INDICATI CONTRAINDICA ADVERSE NURSING

NAME ION ON TION AFFECT CONSIDERAT
ION
GENERIC Chemical Inhibits To History of CNS: • Be aware
NAME: class: upward induce barbiturate Anxiety, that
Secobarti Barbiturate conducti sedation addiction; clumsiness, prolonged
bol on of before hypersensitivity confusion, use of
sodium Therapeutic nerve surgery to secobarbital, depression, secobarbital
class: impulses other dizziness, may lead to
BRAND Sedative- to the barbiturates, or drowsiness, tolerance
NAME: hypnotic reticular their hangover, and physical
Secobarb formatio components; headache, and
itol n of the nephritis; insomnia, psychological
brain, porphyria; irritability, dependence.
thereby severe hepatic lethargy,
disruptin or respiratory nervousnes WARNING
g impulse impairment s, To avoid
transmiss nightmares withdrawal
ion to the , symptoms,
cortex. paradoxical expect to
This stimulation, taper drug
action syncope after long-
depresse CV: term
s the Hypotensio therapy.
CNS, n EENT: Withdrawal
producin Laryngospa symptoms
g sm GI: usually
Anorexia, appear 8 to
constipatio 12 hours
n, nausea, after
vomiting stopping
MS: drug and
Arthralgia, may include
muscle anxiety,
weakness insomnia,
RESP: muscle
Apnea, twitching,
bronchospa nausea,
sm, orthostatic
respiratory hypotension,
depression vomiting,
SKIN: weakness,
Jaundice and weight
Other: Drug loss. Severe
dependenc symptoms
e, weight may include
loss delirium,
hallucination
s, and
seizures.
Generalized
tonicclonic
seizures may
occur within
16 hours or
up to 5 days
after last
dose.

• Assess
patient for
signs and
symptoms of
barbiturate
toxicity,
including
dyspnea,
severe
confusion,
and severe
drowsiness.
Notify
prescriber
immediately
if they
appear
because
barbiturate
toxicity may
be life-
threatening
• Expect
prescriber to
provide
patient with
the least
possible
quantity of
secobarbital
to minimize
the risk of
acute or
chronic
overdosage.
For patients
who are
depressed,
suicidal, or
drug-
dependent
or who have
a history of
drug abuse,
institute
precautions
to prevent
drug
hoarding and
overdosage.

PATIENT
TEACHING
• Instruct
patient to
take
secobarbital
exactly as
prescribed
because of
the risk of
addiction.
• Inform
patient that
taking drug
with food
may reduce
adverse GI
effects.
• Advise
patient to
avoid alcohol
and caffeine
and
potentially
hazardous
activities
during
therapy.
• Inform
patient
 about
possible
hangover
effect.
• If patient
takes an oral
contraceptiv
e,
recommend
using an
additional
form of birth
control
during
therapy.
• Caution
patient not
to stop
taking drug
abruptly.
• Instruct
patient to
notify
prescriber of
bone pain,
muscle
weakness, or
unexplained
weight loss
during
therapy

DRUG CLASSIFICAT ACTION INDICATI CONTRAINDICA ADVERSE NURSING

NAME ION ON TION AFFECT CONSIDERA
TION
GENER Chemical Produces To Gastritis; CNS: • Administer
IC class: CNS prevent or hypersensitivity Ataxia, with full
NAME: Chloral depression suppress or idiosyncrasy disorienta glass of
Chloral derivative by an alcohol to chloral tion, water or
hydrat unknown withdraw hydrate or its hangover, juice to
e Therapeutic mechanism al components; incoherenc minimize GI
class: involving symptoms severe cardiac, e, distress from
BRAND Sedative- trichloroeth , act as an hepatic, or paranoia, chloral
NAME: hypnotic anol, the adjunct to renal disease somnolenc hydrate
Thorazi drug’s active opioids e GI: capsules.
ne metabolite and Gastric Dilute syrup
analgesics irritation, in a halfglass
to control nausea, of water,
postopera vomiting ginger ale,
tive pain SKIN: or fruit juice.
Rash, WARNING
urticaria Monitor
Other: carefully for
Drug hypersensiti
dependen vity reaction
ce in patients
with a
history of
tartrazine
sensitivity.
• Suspect
physical or
psychologica
l
dependence
if
withdrawal
of chloral
hydrate
produces
confusion,
hallucination
s, nausea,
nervousness
,
restlessness,
stomach
pain,
tremor,
unusual
excitement,
or vomiting.

PATIENT
TEACHING
• Instruct
patient to
take
capsules
with a full
glass of
water or
juice or to
mix syrup in
a half-glass
of water,
ginger ale,
or fruit juice.
• Advise
patient to
avoid
hazardous
 activities
until CNS
effects of
chloral
hydrate are
known.
• Caution
patient that
drug may be
habitforming
.
Advise
taking it
exactly as
prescribed
and not to
stop taking it
abruptly
because
withdrawal
symptoms
could occur.
• Instruct
patient to
notify
prescriber
right away
about
stomach
pains or
tarry stools.

DRUG CLASSIFIC ACTION INDICATI CONTRAINDI ADVERSE NURSING

NAME ATION ON CATION AFFECT CONSIDERA
TION
GENERIC Chemical Depresses To Comatose CNS: • Don’t
NAME: class: brain manage states; Drowsiness, open or
Chlorprom Propylami areas that symptom hypersensitivi extrapyramid crush E.R.
azine ne control s of ty to al reactions capsules.
hydrochlo derivative activity psychotic chlorpromazi (such as •
ride of and disorders ne, dystonia, Chlorproma
phenothiaz aggression or control phenothiazine fever, motor zine
BRAND ine , including manic s, or their restlessness, shouldn’t
NAME: the manifesta components; pseudoparkin be used to
Thoranzin Therapeuti cerebral tions of use of large sonism, and treat
e c class: cortex, manic- amounts of tardive dementia-
Antiemetic hypothala depressio CNS dyskinesia), related
, mus, and n in depressants neuroleptic psychosis in
antipsycho limbic outpatien malignant the elderly
tic, system, by ts syndrome, because of
tranquilize an seizures CV: an
r unknown ECG changes, increased
Pregnancy mechanis such as risk of
cat m. nonspecific, death.
Prevents usually • Use
nausea reversible Q- chlorproma
and and T-wave zine
vomiting changes; cautiously
by orthostatic in patients
inhibiting hypotension; (especially
or tachycardia children)
blocking EENT: Blurred with
dopamine vision, dry chronic
receptors mouth, nasal respiratory
in the congestion, disorders
medullary ocular (such as
228 changes (fine severe
chlorprom particle asthma or
azine deposits in emphysem
chemorec lens and a) or acute
eptor cornea) with respiratory
trigger long-term tract
zone and therapy infections
peripheral ENDO: because
ly by Gynecomastia drug has
blocking , CNS
the vagus hyperglycemi depressant
nerve in a, effect. Also
the GI hypoglycemia, use
tract. May lactation, cautiously
relieve moderate in patients
anxiety by breast with
indirect engorgement cardiovascu
reduction GI: lar, hepatic,
in arousal Constipation, or renal
and ileus, nausea disease
increased GU: because of
filtering of Amenorrhea, increased
internal ejaculation risk of
stimuli to disorders, developing
the impotence, hypotensio
reticular priapism, n, heart
activating urine failure, and
system in retention arrhythmia
the brain HEME: s.
stem. Agranulocytos • Because
is, aplastic of
anemia, chlorproma
eosinophilia, zine’s
hemolytic anticholiner
anemia, gic effects,
leukopenia, use it
pancytopenia, cautiously
thrombocytop in patients
enic purpura with
SKIN: glaucoma.
Exfoliative Also use it
dermatitis, cautiously
jaundice, p in those
who are
exposed to
extreme
heat or
organophos
phate
insecticides
and those
receiving
atropine or
related
drugs.
• Protect
concentrat
e from
light.
Refrigeratio
n isn’t
required.
• Dilute
concentrat
e in at least
60 ml of
diluent just
before
administeri
ng it. Use
tomato or
fruit juice,
milk, simple
syrup,
orange
syrup, a
carbonated
beverage,
coffee, tea,
water, or
semisolid
food, such
as pudding
and soup.
• Protect
parenteral
solution
from light.
Solution
should be
clear and
colorless to
pale yellow.
Discard
markedly
discolored
solution.
• Don’t
inject drug
by
subcutaneo
us route
because it
can cause
severe
tissue
necrosis.
• Wear
gloves
when
working
with liquid
or
injectable
form
because
parenteral
solution
may cause
contact
dermatitis.
• For I.V.
injection,
dilute
chlorproma
zine with
sodium
chloride to
a
concentrati
on of 1
mg/ml.
• Give I.M.
injection
slowly and
deep into
upper outer
quadrant of
buttocks,
such as in
the gluteus
maximus.
To
minimize
hypotensiv
e effects,
keep
patient
lying flat
and
monitor
blood
pressure
for 30
minutes
after
injection.

WARNING
Stay alert
for possible
suppressed
cough
reflex,
which
increases
the risk of
the
patient’s
aspirating
vomitus.

• Monitor
patient for
increased
sensitivity
to drug’s
CNS effects
if patient
has a
history of
hepatic
encephalop
athy from
cirrhosis.

WARNING
If
neuroleptic
malignant
syndrome
(hyperpyre
xia, muscle
rigidity,
altered
mental
status,
autonomic
instability)
develops,
notify
prescriber
immediatel
y and
expect to
stop drug
and start
intensive
treatment.
Watch for
recurrence
if patient
resumes
antipsycho
tic therapy.

PATIENT
TEACHING
• Instruct
patient to
swallow
E.R.
capsules
whole and
not to
crush,
break, or
chew them.
• Tell
patient not
to take
drug within
2 hours of
an antacid.
Allow him
to take
drug with
food or a
full glass of
milk or
water.
• If patient
uses
suppository
form, tell
him to chill
the
suppository
, moisten it
with cold
water, and
insert it
well into
rectum.
• Tell
patient to
store oral
concentrat
e at room
temperatur
e, away
from light,
to measure
it with the
dropper
provided,
and to
dilute it in 4
oz of fluid
just before
use.
• Because
of possible
drowsiness,
dizziness,
and blurred
vision
(especially
during the
first few
days of
therapy),
advise
patient to
avoid
hazardous
activities
until drug’s
CNS effects
are known.
• Tell
patient to
avoid
alcohol
because of
possible
additive
effects and
hypotensio
n.
• Advise
patient,
especially if
elderly, to
rise slowly
from a
supine or
seated
position to
avoid
dizziness,
light-
headedness
, and
fainting.
• Tell
patient to
inform
doctors and
dentists
that he’s
taking
chlorproma
zine before
he has
surgery,
medical
tests, or
dental
work.
• Explain
that drug
may reduce
the body’s
response to
heat and
cold; tell
patient to
avoid
temperatur
e extremes,
as in a
sauna, hot
tub, or very
cold or hot
shower.
Remind
patient to
dress
warmly in
cold
weather.
• Warn
patient not
to take OTC
drugs for a
cold or an
allergy
because
they can
increase
the risk of
heatstroke
and other
unwanted
effects.
• Inform
patient that
drug
increases
sensitivity
to sunlight;
tell him to
stay out of
the sun as
much as
possible
and to
protect his
skin.
• If patient
has dry
mouth,
suggest
sugarless
chewing
gum, hard
candy, and
fluids.
• Urge
patient to
report
sudden