DRUG CLASSIFICA ACTION INDICATI CONTRAINDICATI ADVERSE EFFECT NURSING

NAME TION ON ON CONSIDERATIONS

GENERIC Pharmacologi Unknown. It indicated  Hypersensitivit CNS: drowsiness, BASELINE
NAME: c class: Anxiolytic and to treat the y to agitation, dizziness, ASSESSMENT
Hydroxine Piperazine sedative symptoms of hydrOXYzine. headache, asthenia, Anxiety:
Hydrochlor derivative effects may anxiety, Early ataxia Offer emotional
ide Therapeutic stem from itching or pregnancy; SQ, GI: nausea, support. Assess
class: suppression of hives on the IV constipation, dry mouth motor responses
Anxiolytic, activity in skin and as administration; GU: urinary retention (agitation,
antihistamine, subcortical preoperative patients with Respiratory: wheezing trembling,
BRAND sedative- levels of CNS. sedation. prolonged QT Skin: flushing tension),
NAME: hypnotic Antihistamine interval. Other: bitter taste, autonomic
Vistaril effects may hypersensitivity responses (cold/
result from reaction, pain or clammy hands,
histamine abscess at I.M. diaphoresis).
suppression at injection site. Antiemetic:
cellular Assess for
receptor sites. dehydration (poor
skin turgor, dry
mucous
membranes,
longitudinal
furrows in tongue).

INTERVENTION
/EVALUATION
 For pts on long-
term therapy, CBC,
BMP,
LFT should be
performed
periodically.
 Monitor lung
sounds for signs of
hypersensitivity
reaction.
 Monitor serum
electrolytes in pts
with severe
vomiting.
 Assess for
paradoxical
reaction,
particularly during
early therapy.
 Assist with
ambulation if
drowsiness, light-
headedness
occur.
 Obtain ECG if
palpitations occur
or cardiac
arrhythmia is
suspected.
 Assess skin for
rash, pustules.
PATIENT/
FAMILY
TEACHING
 Marked discomfort
may occur with IM
injection.
 Sugarless gum,
 sips of water may
relieve dry mouth.
 Drowsiness usually
diminishes with
continued
therapy.
 Avoid tasks that
require
alertness, motor
skills until
response to
drug is established.
 Treatment may
cause life-
threatening heart
arrhythmias;
report chest pain,
difficulty
breathing,
palpitations,
passing out.
 Do not take
newly prescribed
medications unless
approved by
prescriber who
originally
started treatment.

DRUG CLASSIFICA ACTION INDICATI CONTRAINDICATI ADVERSE EFFECT NURSING

NAME TION ON ON CONSIDERATION
GENERIC Pharmacologi Produces Short-term  Hypersensitivit CNS: dizziness, BASELINE
NAME: c class: anxiolytic effect relief of y to drug, other drowsiness, lethargy, ASSESSMENT
Diazepam Benzodiazepin and CNS anxiety benzodiazepine depression, light-  Assess B/P, pulse,
e depression by symptoms, s, alcohol, or headedness, respirations
Therapeutic stimulating relief of tartrazine. disorientation, anger, immediately before
BRAND class: gammaaminobu acute alcohol  Coma or CNS manic or hypomanic administration.
NAME: Anxiolytic, tyric acid withdrawal. depression episodes, restlessness, Anxiety:
Valium anticonvulsant, receptors. Adjunct for  Narrow-angle paresthesia,  Assess autonomic
sedative- Relaxes relief of glaucoma headache, slurred response (cold,
hypnotic, skeletal muscles acute speech, dysarthria, clammy hands;
skeletal of spine by musculoskele stupor, tremor, diaphoresis), motor
muscle relaxant inhibiting tal dystonia, vivid dreams, response (agitation,
(centrally polysynaptic conditions, extrapyramidal trembling,
acting) afferent treatment of reactions, mild tension).
pathways. seizures. paradoxical excitation Musculoskeletal
Controls diazepam 361d spasm:
seizures by Reactions in bold are  Record onset, type,
enhancing life-threatening. location, duration
presynaptic 2Clinical alert of pain.
inhibition. CV: bradycardia,  Check for
tachycardia, immobility,
hypertension, stiffness, swelling.
hypotension, Seizures:
palpitations,  Review history of
cardiovascular collapse seizure disorder
EENT: blurred vision, (length, intensity,
diplopia, nystagmus, frequency,
nasal congestion duration, LOC).
GI: nausea, vomiting,  Observe frequently
diarrhea, constipation, for recurrence of
gastric disorders, seizure activity.
difficulty INTERVENTION/
swallowing, increased EVALUATION
salivation  Monitor heart rate,
GU: urinary retention respiratory rate,
or incontinence, B/P, mental status.
menstrual irregularities,  Assess children,
gynecomastia, elderly for
libido changes paradoxical
Hematologic: blood reaction,
dyscrasias including particularly during
eosinophilia, early therapy.
leukopenia,  Evaluate for
agranulocytosis, and therapeutic
thrombocytopenia response (decrease
Hepatic: hepatic in
dysfunction intensity/frequency
Musculoskeletal: of seizures; calm
muscle rigidity, facial expression,
muscular disturbances decreased
Respiratory: restlessness;
respiratory depression decreased intensity
Skin: dermatitis, rash, of skeletal muscle
pruritus, pain). Therapeutic
urticaria, diaphoresis serum level:0.5–2
Other: weight gain or mcg/mL; toxic
loss, decreased serum level:
appetite, edema, greater than 3
hiccups, fever, physical mcg/ml.
or psychological drug PATIENT/FAMILY
dependence TEACHING
or tolerance.  Avoid alcohol.
 Limit caffeine
May cause
 drowsiness;
 Avoid tasks that
require alertness,
motor skills until
response to drug is
established. May
be habit forming.
 Avoid abrupt
discontinuation
after prolonged
use.

DRUG CLASSIFICA ACTION INDICATI CONTRAINDICATI ADVERSE EFFECT NURSING

NAME TION ON ON CONSIDERATION
GENERIC Pharmacologi Binds to and Management Hypersensitivity to CNS: confusion, PATIENT
NAME: c class: Opioid depresses opiate of acute pain drug or bisulfites (with sedation, dysphoria, MONITORING
Meperidine agonist receptors severe some injectable euphoria, floating  Monitor vital
Hydrochlor Therapeutic in spinal cord enough to products) feeling, hallucinations, signs. Don’t give
ide class: and CNS, require an ● MAO inhibitor uses headache, unusual drug if patient has
Analgesic, altering opioid within past 14 days. dreams, significant
adjunct perception of analgesic and seizures respiratory or CNS
BRAND to anesthesia and response to for which CV: hypotension, depression.
NAME: pain. alternative bradycardia, cardiac  Reassess patient’s
Demerol treatments arrest, shock pain level after
are EENT: blurred vision, administration.
inadequate. diplopia, miosis 2Watch for
GI: nausea, vomiting, seizures, agitation,
constipation, irritability,
ileus, biliary tract nervousness,
spasms tremors, twitches,
GU: urinary retention and myoclonus in
Respiratory: respiratory patients at risk for
depression, normeperidine
respiratory arrest accumulation (such
Skin: flushing, as those with renal
sweating, induration or hepatic
Other: pain at injection impairment). 2Use
site, local irritation, with extreme
physical or caution in patients
psychological drug with head injury.
dependence, drug Drug may increase
tolerance ICP and cause
adverse reactions
that obscure
clinical course.
 Closely monitor
patients with acute
 abdominal pain.
Drug may obscure
diagnosis and
clinical course of
GI condition.
 Evaluate bowel
and bladder
function.
 With long-term or
repeated use,
watch for
psychological and
physical drug
dependence and
tolerance. 2With
pediatric patients,
stay alert for
increased risk of
seizures. Patient
teaching
PATIENT
TEACHING
 Tell patient using
oral solution or
syrup to take drug
with a half-glass of
water to minimize
local anesthetic
effect.
 Caution patient to
avoid driving and
other hazardous
 activities, because
drug may cause
dizziness or
drowsiness.
 Advise patient to
avoid alcohol.
 Instruct
ambulatory patient
to change position
slowly to avoid
orthostatic
hypotension.
 Tell female patient
to inform
prescriber if she is
pregnant or
breastfeeding.
 As appropriate,
review all other
significant and life-
threatening adverse
reactions and
interactions,
especially those
related to the
drugs, tests, herbs,
and behaviors
mentioned above.
DRUG CLASSIFICA ACTION INDICATI CONTRAINDICATI ADVERSE EFFECT NURSING
NAME TION ON ON CONSIDERATION
GENERIC Pharmacologi Interacts with Symptomatic  Hypersensitivit CNS: confusion, PATIENT
NAME: c class: Opioid opioid receptor relief of y to drug, sedation, dizziness, MONITORING
Morphine agonist sites, severe acute tartrazine, dysphoria, euphoria, ● Monitor vital signs.
Sulphate Therapeutic primarily in and chronic bisulfites, or floating feeling, Contact prescriber if
class: Opioid limbic system, pain after alcohol hallucinations, respiratory rate is 10
analgesic thalamus, nonnarcotic  Acute headache, nightmares breaths/
BRAND and spinal cord. analgesics bronchial minute or less.
NAME: CV: hypotension,
This interaction have failed asthma ● Assess pain character,
Astramorph bradycardia
alters and as  Upper airway location, and
PF, Avinza, EENT: blurred vision,
neurotransmitte preanesthetic obstruction intensity.
DepoDur, r release, medication; diplopia, miosis ● Monitor fluid intake and
 Respiratory GI: nausea, vomiting,
Duramorph altering also used to output.
depression
perception of relieve constipation, dry Stay alert for urinary
 GI
and tolerance dyspnea of mouth retention.
obstruction,
for pain. acute left GU: urinary retention ● Monitor bowel
paralytic ileus
ventricular Respiratory: apnea, elimination pattern.
failure and respiratory If constipation occurs,
pulmonary depression, respiratory intervene as
edema and arrest appropriate.
pain of MI. Skin: flushing, itching, ●Assess neurologic status.
sweating Implement
Other: physical or safety measures as needed
psychological drug to prevent
dependence, drug injury.
● Evaluate patient for
tolerance
signs and symptoms of
physical or psychological
dependence. Be watchful
for drug
hoarding.
Patient teaching
● Tell patient he may
crush immediate release
form and mix with food or
fluids.
● Advise patient not to
crush or break
extended-release form.
Instruct him to
swallow it whole.
● Tell patient he may open
sustained release capsule
(Kadian), sprinkle
entire contents of capsule
onto a small
amount of food (such as
applesauce),
and consume immediately.
Stress
importance of not
chewing, crushing,
or dissolving pellets.
● Advise patient to take
drug at the first
sign of pain, because
continuous dosing is more
effective than p.r.n.
dosing.
2Tell patient and caregiver
that
drug may cause
respiratory depression.
Instruct them to
immediately report
respiratory rate of 10
breaths/minute
or less.
● Inform patient that drug
may cause
constipation or urinary
retention.
Encourage high-fiber diet
and high
fluid intake.
● Stress importance of
taking drug
only as prescribed. Point
out that drug
may cause psychological
or physical
dependence.
● Caution patient to avoid
driving and
other hazardous activities
until he
knows how drug affects
concentration,
vision, and alertness.
● Teach patient and
caregiver about
appropriate safety
measures to prevent
injury.
● Caution patient to avoid
alcohol and
other CNS depressants
during and for
24 hours after therapy.
● Advise patient to avoid
herbs, which
may worsen adverse CNS
effects.
● As appropriate, review
all other significant and
life-threatening adverse
reactions and interactions,
especially
those related to the drugs,
tests, herbs,
and behaviors mentioned
above.