Republic of the Philippines

Cebu Normal University Osmeña

Blvd., Cebu City, 6000, Philippines

College of Nursing
Telephone No.: (+63 32) 254 4837
Email: cn@cnu.edu.ph
Website: www.cnu.edu.ph

DRUG STUDY

Patient’s Initials: _J.C._______________ Date of Admission: _March 1, 2022 _____ Diagnosis: Osteoporosis_ Age: _66 years old_ Height: 5’2”_ Weight.: __110 lbs___ Clinical Intervention:
_______________ Sex: ___Female___________________ Ward: Oncology Bed No.: _2_ Name of Physician: Dr. Arnold Gerrard Suarez__________________________________________
Drug Information Classification Mechanism of Action Indication Contraindications Side Effects Nursing Responsibilities

Generic Name: Pharmacologic Pharmacodynamics or
Calcium + Vitamin Classification: Mechanism of Action:
D Antacid; Vitamin
D analog Calcium Citrate:
Decreases gastric
Trade Name:
Citracal plus D Therapeutic acidity, thereby inhibiting
proteolytic action of
Classification:
pepsin on gastric
Maximum Dose: Fluid and
2000mg of Ca Electrolyte mucosa. Also increases
lower esophageal
Balance Agent;
sphincter tone. Although
Minimum Dose: Replacement or
classified as a
600mg of Ca BID synthetic nonsystemic antacid, a
substitutes slight to moderate
Patient’s Dose: alkalosis usually
1 tab
develops with prolonged
therapy. Acid rebound,
Route:
which may follow even
PO low doses, is thought to
be caused by release of
gastrin triggered by
action of calcium in
small intestines.
Vitamin D: Primary
action leads to
regulation of serum
calcium, which is
affected also by the
activity of other vitamin
D analogs (e.g.,
General
Indication/s:
This combination
medication is used to
prevent or treat low blood
calcium levels in people
who do not get enough
calcium from their diets. It
may be used to treat
conditions caused by low
calcium levels such as
bone loss (osteoporosis),
weak bones
(osteomalacia/rickets),
decreased activity of the
parathyroid gland
(hypoparathyroidism), and
a certain muscle disease
(latent tetany). It may also
be used in certain
patients to make sure
they are getting enough
calcium (including women
who are pregnant,
nursing, or
Hypersensitivity to the
drug, to vitamin D
products, soy, or any of
its component; patients
with hypercalcemia,
hypervitaminosis D,
malabsorption syndrome.
Precautions: Use
cautiously in patients with
renal impairments, liver
diseases, diabetes,
phenylketonuria, or
conditions requiring
certain diet limitations as
the medication may
contain sugar,
aspartame, and alcohol.
Before having surgery,
tell your doctor or dentist
about all the products you
use (including
prescription drugs,
nonprescription drugs,
and herbal
GI: Constipation or Before Drug Administration:
laxative effect, acid
rebound, nausea,  If you are using the liquid form of this medication,
eructation, flatulence, carefully measure the dose using a special
vomiting, fecal measuring device/spoon. Do not use a household
concretions.
spoon because you may not get the correct dose. If
Metabolic:
you are taking the chewable form of this
Hypercalcemia with
alkalosis, metastatic medication, chew thoroughly before swallowing. If
you are taking capsules, swallow each capsule
calcinosis,
hypercalciuria, whole.
hypomagnesemia,  Instruct client to take this medication regularly and
hypophosphatemia
take it at the same time each day.
(when phosphate
intake is low).  Assess client and instruct client to report if they
CNS: Mood and have kidney concerns, heart diseases, cancer,
mental changes. hypercalcemia, circulatory problems, and
Urogenital: Polyuria, parathyroid gland disorder.
renal calculi.  Calcium and vitamin D may be only part of a
complete program of treatment that also includes
dietary changes. Educate client about the foods
that contain calcium and vitamin D.
 Take the medicine as soon as you can, but skip the
missed dose if it is almost time for your next dose.
Do not take two doses at one time.
 Inform patient on common side effects including
irregular heartbeat, weakness, drowsiness,
ergocalciferol),
parathyroid hormone,
and calcitonin.
Pharmacologic effects of
calcifediol are related to
its intrinsic vitamin D
activity as well as to the
properties of active
metabolites (e.g.,
calcitriol), which result
from renal metabolism.
Therapeutic Effects:
Effectively relieves
symptoms of acid
indigestion and useful as
a calcium supplement,
and helps to maintain
serum calcium
Pharmacokinetics:
Absorption:
Approximately 1/3 of dose
absorbed from small
intestine.
Distribution:
Crosses placenta.
Metabolism and Excretion:
Primarily excreted in feces;
small amounts excreted in
urine, pancreatic juice,
saliva, breast milk.
postmenopausal, people
taking certain medications
such as phenytoin,
phenobarbital, or
prednisone). Calcium
plays a very important
role in the body. It is
necessary for normal
functioning of nerves,
cells, muscle, and bone. If
there is not enough
calcium in the blood, then
the body will take calcium
from bones, thereby
weakening bones.
Vitamin D helps your
body absorb calcium and
phosphorus. Having the
right amounts of vitamin
D, calcium, and
phosphorus is important
for building and keeping
strong bones.
Patient’s
Indication:
Management of calcium
and vitamin D deficiency
products).During
pregnancy, doses of
vitamin D greater than
the recommended dietary
allowance should be
used only when clearly
needed. Discuss the risks
and benefits with your
doctor. This medication
passes into breast milk.
Consult your doctor
before breast-feeding.
Drug - Drug Interactions
Digoxin: May enhance
inotropic and toxic effects
of digoxin
Magnesium: May
compete for GI
absorption
Tetracyclines,
Quinolones: may
decrease their absorption
Bile Acid Sequestrants;
Cholestyramine/Colestipo
l, Mineral Oil, Orlistat:
decrease absorption of
vitamin D.
headache, dry mouth or metallic taste in the mouth,
muscle or bone pain
 Inform physician regarding concurrent use of
cholestyramine, oral anticoagulants, or
cyclosporine.
 Emphasize to client that it is potentially dangerous
to self-medicate. Do not take antacids longer than
2 wk without medical supervision. Inform them to
avoid taking calcium carbonate with cereals or
other foods high in oxalates, and with food high in
Vit D. Oxalates combine with calcium carbonate to
form insoluble, nonabsorbable compounds, and
high Vit D food concurrent intake may result to
milk-alkali syndrome (hypercalcemia, distaste for
food, headache, confusion, nausea, vomiting,
abdominal pain, metabolic alkalosis, hypercalciuria,
polyuria, soft tissue calcification,
hyperphosphatemia, and renal insufficiency).
Predisposing factors include renal dysfunction,
dehydration, electrolyte imbalance, and
hypertension.
 Inform client that certain medications (bile acid
sequestrants such as cholestyramine/colestipol,
mineral oil, orlistat) can decrease the absorption of
vitamin D. Take your doses of these medications
as far as possible from your doses of vitamin D (at
least 2 hours apart, longer if possible). It may be
easiest to take vitamin D at bedtime if you are also
taking these other medications.
During and After Drug Administration:
 Take this medication by mouth with food. If your
product contains calcium citrate, then it may be
taken with or without food.
 Take the regular tablet with a full glass of water,
and chewable tablet chewed before swallowing.
 Monitor signs of hypersensitivity reactions,
 including pulmonary symptoms (tightness in the
throat and chest, wheezing, cough, dyspnea) or
skin reactions (rash, pruritus, urticaria). Notify
physician immediately if these reactions occur.
 Report signs of gallstones (cholelithiasis), including
sudden intense pain in the abdomen or right side,
jaundice, chills, and fever.
 Discontinue therapy after 2 mo if adequate lipid
reduction is not achieved with the maximum dose
of 201 mg/d. Do not continue this medication
beyond 1–2 wk, since it may cause acid rebound,
which generally occurs after repeated use for 1 or 2
wk and leads to chronic use.
 Note number and consistency of stools. If
constipation is a problem, physician may prescribe
alternate or combination therapy with a magnesium
antacid or advise patient to take a laxative or stool
softener as necessary.
 Observe for S&S of hypercalcemia in patients
receiving frequent or high doses, or who have
impaired renal function

Certification Date: 1 February 2021 Recertification due date: 24 January 2024 For verification of the certificate please access www.gcl-intl.com
(Certification check and type the registration number)
SDF-CON-304-071-00

Page 1 of 3

Registration No. 52Q18778

Republic of the Philippines
Cebu Normal University
Osmeña Blvd., Cebu City, 6000, Philippines

College of Nursing
Telephone No.: (+63 32) 254 4837
Email: cn@cnu.edu.ph
Website: www.cnu.edu.ph

Frequency:
OD
 Availability/Form
and Contents:

Tablets and
Capsules

650 mg of calcium
per serving in the
form of calcium
citrate, and 25 mcg
(1000 IU) of Vitamin
D3 per serving to
help your body
absorb calcium. It
contains essential
micronutrients to
support bone health
including zinc,
copper and
manganese

References (at least 2):

Bayer. (n.d.). CITRACAL MAXIMUM PLUS. Retrieved March 1, 2022, from https://www.citracal.com/products/maximum-plus
Drugs.com. (n.d.). Citracal + D. Retrieved March 1, 2022, from https://www.drugs.com/mtm/citracal-d.html
Rob Holland. (n.d.). CALCIFEDIOL. Retrieved March 1, 2022, from http://robholland.com/Nursing/Drug_Guide/data/monographframes/C003.html
Rob Holland. (n.d.). CALCIUM. Retrieved March 1, 2022, from http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/C007.html
RxList. (n.d.). CITRACAL-PLUS-D. Retrieved March 1, 2022, from https://www.rxlist.com/fdb/drugs/1772/citracal-plus-d-brand.htm
RxList. (n.d.). CITRACAL PLUS D ORAL. Retrieved March 1, 2022, from https://www.rxlist.com/fdb/drugs/2217/citracal-plus-d-oral-drug.htm

Certification Date: 1 February 2021 Recertification due date: 24 January 2024 For verification of the certificate please access www.gcl-intl.com
(Certification check and type the registration number)
SDF-CON-304-071-00

Page 2 of 3

Registration No. 52Q18778

Republic of the Philippines
 Cebu Normal University Osmeña
Blvd., Cebu City, 6000, Philippines

College of Nursing
Telephone No.: (+63 32) 254 4837
Email: cn@cnu.edu.ph
Website: www.cnu.edu.ph

PRODUCT ASSESSMENT RUBRICS FOR DRUG STUDY

Student Name: ____Mendez, Mary April_____________________ Year/Section: ________BSN 4 - B____________ Date: ____March 1, 2022_____ Score: ___/30 Directions:

Please select the appropriate rating using the following descriptions.

Element Very Satisfactory Satisfactory Needs Improvement Comments

Drug ☐ Accurately presented all of the patient and drug ☐ Accurately presented most of the patient and drug ☐ Accurately presented some of the patient and drug
Information information (name [brand & generic], dosage [patient’s dose; information related to the case. 1 missing information or information related to the case. 2 or more missing information
(10%) min. & max], frequency, route, availability, contents) related error noted. [2] or errors noted. [1]
to the case. [3]

Classification ☐ Accurately presented the classification (therapeutic and ☐ Accurately presented the classification related to the ☐ Inaccurately presented the classification related to the drug.
(10%) pharmacologic) related to the drug. [3] drug but with 1 irrelevant information or error noted. [2] Classification is not relevant to the drug. [1]

Indication (10%) ☐ Accurately presented the indication/s (general & patient ☐ Accurately presented the indication/s related to the drug ☐ Inaccurately presented the indication/s related to the drug.
specific) related to the drug. [3] but with 1 irrelevant information or error noted. [2] Indication is not relevant to the drug. [1]

Mechanism of ☐ Accurately presented the mechanism of action ☐ Accurately presented the mechanism of action of the ☐ Inaccurately presented the mechanism of action of the drug.
Action (10%) (pharmacokinetics, pharmacodynamics) of the drug. [3] drug but with 1 irrelevant information or error noted. [2] Mechanism of action is not relevant to the drug. [1]

Contraindicati ☐ Accurately presented all of the common contraindications ☐ Accurately presented most of the common ☐ Accurately presented some of the common contraindications
on (10%) related to the drug. [3] contraindications related to the drug. 1 missing information related to the drug. 2 or more missing information or errors
or error noted. [2] noted. [1]

Side Effects ☐ Accurately presented all of the common side effects ☐ Accurately presented most of the common side effects ☐ Accurately presented some of the common side effects
(10%) related to the drug. [3] related to the drug. 1-2 missing information or errors noted. related to the drug. 3 or more missing information or errors
[2] noted. [1]

Nursing ☐ Accurately presented all of the common nursing ☐ Accurately presented most of the common nursing ☐ Accurately presented some of the common nursing
Responsibilit responsibilities (before, during, and after) related to the drug. responsibilities related to the drug. 1-2 missing information responsibilities related to the drug. 3 or more missing
ies (30%) [9] or errors noted. [7] information or errors noted. [3]

References ☐ Presented at least 2 sources that are updated (within 5 ☐ Presented only one source that is updated (within 5 ☐ No source was presented. Sources are not updated (more
(10%) years), relevant, and credible. [3] years), relevant, and credible. Other sources are not than 5 years), relevant, and credible. [1]
updated, credible or relevant. [2]

Sub-score = ____ = ____ = ____

Evaluated by:
 ______
Signature over Printed Name of Clinical Instructor

Certification Date: 1 February 2021 Recertification due date: 24 January 2024 For verification of the certificate please access www.gcl-intl.com
(Certification check and type the registration number)
SDF-CON-304-071-00

Page 3 of 3

Registration No. 52Q18778