DRUG STUDY (Lidocaine)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON
Brand Name: Dosage: IV, IM: Suppresses automaticity IV: Ventricular arrhythmias. Contraindicated in: Adverse Reactions (Serious, life- o When Lidocaine is
and spontaneous depolarization of Hypersensitivity; cross-sensitivity threatening) administered as an
Xylocaine , Glydo , Recommended: the ventricles during diastole IM: Self-injected or when IV may occur; Third-degree heart antiarrhythmic the nurse should
Lidoderm by altering the flux of sodium unavailable (during transport to block; Wolff-Parkinson-White monitor the ECG continuously.
Infiltration Anesthesia ions across cell membranes hospital facilities) syndrome; Blood pressure and respiratory
Generic Name: with little or no effect on heart Life-threatening: status should be monitored
Percutaneous: 1-60 mL of 0.5-1% solution (5-300 rate. Pedi: Children 3 yr (increase risk frequently during the drug
Local:Infiltration/ mucosal/topical
mg total dose)
Local: Produces local anesthesia anesthetic. of seizures, cardiac arrest and Seizures, Cardiac Arrest, administration.
Lidocaine
by inhibiting transport of ions death with viscous lidocaine; Anaphylaxis. o When administered as an
IV regional: 10-60 mL of 0.5% solution (50-300 mg
across neuronal membranes, there Transdermal: Pain due to post- viscous lidocaine should not be anesthetic, the numbness of the
Classification: total dose)
by preventing initiation and herpetic neuralgia. used for teething pain; should affected part should be
Peripheral Nerve Blocks conduction of normal nerve only be used for other assessed.
Pharmacologic: indications when safer
impulses. Black box warning: Do Not Use o Serum Lidocaine levels
Brachial: 15-20 mL of 1.5% solution (225-300 mg alternatives are not available Lidocaine to Treat Teething
Anesthetics or have failed. should be monitored
total dose) Pain in Children. Excessive
frequently during prolonged
dosage, or short intervals
Dental: 1-5 mL of 2% solution (20-100 mg total between doses, can result in use. Therapeutic serum lidocaine
dose) high plasma levels and serious levels range from 1.5 to 5
Therapeutic:
adverse effects. Patients should mcg/ml.
Intercostal: 3 mL of 1% solution (30 mg total dose) be instructed to strictly adhere
anesthetics (topical/local
o If signs of overdose occur
antiarrhythmics) to the recommended dosage stop the infusion immediately
Paravertebral: 3-5 mL of 1% solution (30-50 mg and administration guidelines as
total dose) and monitor the patient closely.
set forth in this package
insert. The management of o For throat sprays, make sure
Pudendeal (each side): 10 mL of 1% solution (100
serious adverse reactions that the patient’s gag reflex
mg total dose)
may require the use of is intact before allowing the
Paracervical obstetrical analgesia (each side): 10 resuscitative equipment, oxygen, patient to eat or drink.
mL of 1% solution (100 mg total dose) and other resuscitative drugs. o When IM injections are used,
the medication should be
Sympathetic Nerve Blocks
administered in the deltoid
Cervical (stellate ganglion: 5 mL of 1 solution (50 muscle only while frequently
mg total dose) aspirating to prevent IV
injection.
Lumbar: 5-10 mL of 1% solution (50-100 mg total o For direct IV injection only
dose)
1% and 2% solutions are
Central Neural Blocks/Epidural used.
o Undiluted IV loading dose of
General: 2-3 mL/dermatome for anesthesia Lidocaine is administered at 1
mg/kg at a rate of 25 to
Thoracic: 20-30 mL of 1% solution (200-300 mg
total dose) 50 mg over 1 minute. The
dose may be repeated after
Lumbar analgesia: 25-30 mL of 1% solution (250- 5 minutes.
300 mg total dose)

Lumbar anesthesia: 15-20 mL of 1.5 solution (225-

300 mg, or 10-15 mL of 2% solution (200-300 mg
total dose)
 Dosing Considerations

Use preservative-free preparations for spinal or

epidural anesthesia

May be buffered 9:1 with sodium bicarbonate, to

reduce pain on injection (e.g. remove 2 mL of 1%
lidocaine from 20 mL vial, and add 2 mL of sodium
bicarbonate solution to vial)

Maximum dose: 4.5 mg/kg, up to 300 mg lidocaine

without epinephrine; or 7 mg/kg, up to 500 mg
lidocaine with epinephrine.

DRUG STUDY (Hepatitis B Vaccine)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON
Brand Name: Dosages of Hepatitis B Vaccine: Active immunization with ENGERIX-B is a vaccine Severe allergic reaction The most common solicited -Provide immunization schedule
hepatitis B vaccine stimulates indicated for immunization (e.g., anaphylaxis) after a adverse reactions were to client (Vaccination requires
Energix B, Recombivax Intramuscular suspension (adult formulation)
injection-site soreness (22%)
the immune system to against infection caused by previous dose of any three IM injections at prescribed
HB produce anti-HBs without hepatitis B containing intervals.)
all known subtypes of hepatitis
10 mcg/ml (Recombivax HB) exposing the patient to the vaccine, or to any and fatigue (14%).
Generic Name: B virus.
20 mcg/ml (Engerix B)
risks of active infection. component of ENGERIX-B, -Administer dosage correctly.
including yeast. (Vaccine must be administered
Hepatitis B Vaccine
40 mcg/ml (Recombivax HB [dialysis intramuscularly.)
formulation])
-Monitor for allergic response.
Classification: Intramuscular suspension (Anaphylactic reactions have been
(pediatric[adolescent formulation]) known to occur.)
Vaccines, Inactivated,
Viral 5 mcg/0.5 ml (Recombivax HB) - Additional doses may be required
for individuals with a suppressed
10 mcg/0.5 mg (Engerix B) immune system.

- Correct cold chain vaccine

Dosage Considerations – Should be Given as storage should be ensured.
Follows:

Hepatitis B Vaccination
- The injection site batch number
Adult Dosage: and expiry date should be
recorded in the patient record.
Engerix B: 1 mL (20 mcg) intramuscularly at
0, 1, and 6 months - Monitor temperature. Some
patients develop a temperature
Recombivax HB: 1 mL (10 mcg)
elevation of 38.3° C (101° F)
intramuscularly at 0, 1, and 6 months
following vaccination that may last
Adults receiving dialysis or other 1 or 2 d.
immunocompromising conditions

Recombivax HB (40 mcg/mL): 40 mcg

intramuscularly at 0, 1, and 6 months, OR

Engerix-B (20 mcg/mL): 40 mcg

intramuscularly at 0, 1, and 6 months.
 DRUG STUDY (Oxytocin)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON
Brand Name: Route/Dosage Induction/Stimulation of Stimulates uterine smooth IV: Induction of labor at term. Hypersensitivity to oxytocin; Maternal adverse reactions are -Start flow charts to record maternal BP and
muscle, producing uterine significant cephalopelvic noted for IV use only. other vital signs, I&O ratio, weight,
Labor IV (Adults) : 0.5– 1 strength, duration, and frequency of
Pitocin contractions similar to those disproportion, unfavorable fetal
milliunits/min; increase by 1– 2 IV: Facilitation of threatened contractions, as well as fetal heart tone and
position or presentations that are CNS: maternal—COMA,
in spontaneous labor. Has abortion. rate, before instituting treatment.
Generic Name: milliunits/min increase 30– 60 min vasopressor and antidiuretic
undeliverable without conversion
SEIZURES; fetal,
until desired contraction pattern before delivery, obstetric
effects. IV, IM: Postpartum control of emergencies in which benefit- INTRACRANIAL -Monitor fetal heart rate and maternal BP and
Oxytocin established; dose may be decrease pulse at least increase 15min during infusion
bleeding after expulsion of the to-risk ratio for mother or HEMORRHAGE.
after desired frequency of contractions Therapeutic Effects: Induction of fetus favors surgical intervention,
period; evaluate tonus of myometrium during
and between contractions and record on flow
Classification: is reached and labor has progressed labor. Control of postpartum placenta. fetal distress in which delivery Resp: fetal—ASPHYXIA, chart. Report change in rate and rhythm
to 5– 6 cm dilation. bleeding. is not imminent, prematurity, immediately.
Pharmacologic: hypoxia.
placenta previa, prolonged use in
Postpartum Hemorrhage IV (Adults): 10 severe toxemia or uterine inertia,
CV: maternal— hypotension; fetal,
-Stop infusion to prevent fetal anoxia, turn p
oxytocics units infused at 20– 40 milliunits/min. hypertonic uterine patterns, atient on her side, and notify physician if
arrhythmias. contractions are prolonged (occurring at less
previous surgery of uterus or
than 2-min intervals) and if monitor records
cervix including cesarean section,
IM (Adults): 10 units after delivery of conditions predisposing to F and E: maternal— contractions about 50 mm Hg or if contractions
last 90 seconds or longer. Stimulation will wane
placenta. thromboplastin or amniotic fluid hypochloremia, hyponatremia,
Therapeutic: water intoxication.
rapidly within 2–3 min. Oxygen administration
embolism (dead fetus, abruptio may be necessary.

hormones Incomplete/Inevitable Abortion IV placentae), grand multiparity,

invasive cervical carcinoma,
(Adults): 10 units at a rate of 20– 40
primipara> 35 y of age, past
milliunits/min. history of uterine sepsis or of
traumatic delivery, intranasal route
Availability (generic available) Solution during labor, simultaneous
for injection: 10 units/mL. administration of drug by two
routes.
Misc: maternal—quterine motility,
painful contractions, abruptio
placentae,puterine blood flow,
hypersensitivity.
-If local or regional (caudal, spinal) anesthesia
is being given to the patient receiving
oxytocin, Be alert to the possibility of
hypertensive crisis (sudden intense occipital
headache, palpitation, marked hypertension, stiff
neck, nausea, vomiting, sweating, fever,
photophobia, dilated pupils, bradycardia or
tachycardia, constricting chest pain).

-Monitor I&O during labor. If patient is

receiving drug by prolonged IV infusion,
Watch for symptoms of water intoxication
(drowsiness, listlessness, headache, confusion,
anuria, weight gain). Report changes in
alertness and orientation and changes in I&O
ratio (i.e., marked decrease in output with
excessive intake).

-Check fundus frequently during the first few

postpartum hours and several times daily
there after.

-Incidence of hypersensitivity or allergic

reactions is higher when oxytocin is given
by IM or IV injection rather than by IV
infusion (diluted solution).
 DRUG STUDY (Terramycin Ophthalmic Ointment)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON

Intramuscular Ad Oxytetracyc
Brand Name:
Terramycin is These Immune -Monitor for
Terramycin

line is indicated for the products are System S&S of

Generic Name:
ministration: prophylaxis and contraindicate Disorders: H superinfection.
oxytetracycline primarily
Classification:
Adults:  The bacteriostatic local treatment of d in persons ypersensitivit
-Lab test:
Ophthalmic anti-
usual daily dose and is superficial ocular who have y.
nfectives
Baseline renal
is 250 mg infections shown
thought to hypersensitivi
function tests.
administered once exert its due to Nervous Dosage may
every 24 hours or oxytetracycline ty to
antimicrobial and polymyxin- Oxytetracycli System need to be
300 mg given in Disorders:  reduced in the
divided doses at 8
effect by the sensitive ne HCl, Burning presence of
to 12 hour inhibition of organisms, Polymyxin B sensation.
protein Sulfate and renal
intervals. including
impairment.
synthesis.  infections due to any of their
For children Oxytetracyc streptococci, components. Eye -Discontinue
above eight years line is active Disorders: La drug and notify
rickettsiae, E.
of age:  15-25 crimation physician at the
mg/kg of body
against a coli, and
increased.
 wide range A. aerogenes, first sign of a
weight up to a such as hypersensitivity
maximum of 250 of gram- conjunctivitis,
Skin &
response.
mg per single negative and Subcutaneous
gram- keratitis, pink
daily injection. Tissue
eye, corneal
Dosage may be positive Disorders: D
ulcer, blepharitis ermatitis
divided and given organisms.
in dogs, cats, contact.
at 8 to 12 hour
cattle, sheep, and
intervals.
horses;
Intramuscular ocular infections General
therapy should be due to secondary
Disorders
reserved for bacterial
and
situations in Administratio
complications of
which oral n Site
distemper in
therapy is not Conditions: P
dogs, and
feasible. ain, Sensation
bacterial
of foreign
The intramuscular inflammatory
body.
administration of conditions which
oxytetracycline  may occur
produces secondary to
lower blood level other infectious
s than oral diseases in the
administration in above species.
the recommended
dosages. Patients
placed on
intramuscular
oxytetracycline
should be
changed to the
oral dosage form
as soon as
possible. If rapid,
high blood levels
are needed,
oxytetracycline
should be
administered
intravenously.
In patients
with renal impair
ment: Total
dosage should be
decreased by
reduction of
recommended
individual doses
 and/or by
extending time
intervals between
doses.

DRUG STUDY (Calcium Gluconate)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON
Brand Name: Dose: Calcium Gluconate acts like Negative calcium balance (As in Ventricular fibrillation, Body as a Whole: -Assess for cutaneous burning
digitalis on the heart, increasing neonatal tetany, hypoparathyroidism, metastatic bone disease, tingling sensation. With rapid IV, sensations and peripheral
Calgonate cardiac muscle tone and force vitamin D deficiency, alkalosis). injection into myocardium; sensations of heatwaves vasodilation, with moderate
1ampule (peripheral vaso dilation),
of systolic contractions (positive Also to overcome cardiac toxicity renal calculi , hypercalcemia,  fall in BP, during direct IV
Generic Name: fainting.
Route: inotropic effect). of  hyperkalemia, for  cardio pulmonary predisposition to injection.
hypercalcemia GI: PO preparation: constipation,
resuscitation, to  prevent hypocalcemia
Calcium Gluconate increased gastric acid secretion.
Rapidly and effectively restores during transfusion of citrated blood. (hyperparathyroidism, certain
IV serum calcium levels in acute Also as antidote for magnesium malignancies) ;digitalis CV : -Monitor ECG during IV
Classification: (with rapid in fusion) hypotension, administration to detect evidence
hypocalcemia of  various sulfate, For acute symptoms of toxicity.
Electrolyte and Water bradycardia, cardiac of hypercalcemia: decreased QT
Balance
Frequency: origins; also effective as a lead colic, To decrease capillary arrhythmias,cardiac arrest.
cardiac stabilizer  under permeability in sensitivity Skin: interval associated with inverted
Over 20minutes. conditions of hyperkalemia reactions, and to relieve muscle  pain and burning at IV site, T wave.
or resuscitation. cramps from insect  bites or stings. severe Vegasthrombosis, necrosis
Oral calcium may  be used to and sloughing (withextravasation). -Observe IV site closely.
maintain normal calcium balance Extravasation may result in
during pregnancy, Lactation, and tissue irritation and necrosis.
childhood growth and to prevent
primary osteoporosis. Also an -Monitor for hypocalcemia
osteoporosis, osteomalacia, chronic and hypercalcemia .
hypoparathyroidism, rickets, and as
adjunct in treatment of myasthenia Lab tests: Determine levels of
gravis and Eaton-Lambert syndrome. calcium and phosphorus (tend to
vary inversely and magnesium
frequently, During sustained
therapy. Deficiencies in other
ions, particularly magnesium,
frequently coexist with calcium
ion depletion.

DRUG STUDY (Magnesium Sulfate)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
 ON
Brand Name: Treatment of Deficiency (Expressed as mg of
Magnesium)
Essential for the activity of Treatment/ prevention of Hypermagnesemia; Hypocalcemia; CNS: drowsiness. -Observe constantly when given IV.
many enzymes. Plays an Anuria; Heart block; OB: Avoid Check BP and pulse increase 10–15 min
hypomagnesemia. Treatment of using for more than 5– 7 days for Resp: prespiratory rate.
MgSO4 important role in or more often if indicated.
IM, IV (Adults): Severe deficiency—8– 12 g/day hypertension. Prevention of preterm labor (may increase risk of
in divided doses; mild deficiency—1 g q 6 hr for 4 neurotransmission and
Generic Name: seizures associated with severe hypocalcemia and bone changes CV: arrhythmias, bradycardia, -Lab tests: Monitor plasma magnesium
doses or 250 mg/kg over 4 hr. muscular excitability. in newborn); avoid continuous use
eclampsia, pre-eclampsia, or acute hypotension. levels in patients receiving drug
during active labor or within 2 hr
Magnesium Sulfate IM, IV (Children 1 mo): 25– 50 mg/kg/dose nephritis. of delivery due to potential for parenterally (normal: 1.8–3.0 mEq/L).
increase 4– 6 hr for 3– 4 doses, maximum single GI: diarrhea.
Classification: dose: 2 g. magnesium toxicity in newborn. Plasma levels in excess of 4 mEq/Lare
MS: muscle weakness. reflected in depressed deep tendon
IV (Neonates): 25– 50 mg/kg/dose increases 8– 12
Pharmacologic: reflexes and other symptoms of
hr for 2– 3 doses
Derm: flushing, sweating. magnesium intoxication
Minerals/electrolytes
Seizures/Hypertension Metab: hypothermia. Cardiac arrest occurs at levels in excess
of 25 mEq/L. Monitor calcium and
IM, IV (Adults): 1 g q 6 hr for 4 doses as phosphorus levels also.
Therapeutic: needed.
-Early indicators of magnesium
mineral and electrolyte IM, IV (Children): 20– 100 mg/kg/dose toxicity (hypermagnesemia ) include
replacements/supplemen increases 4– 6 hr as needed, may use up to cathartic effect, profound thirst, feeling
ts 200 mg/kg/dose in severe cases. of warmth, sedation, confusion,
depressed deep tendon reflexes, and
Torsade de Pointes muscle weakness.

IV (Infants and Children): 25– 50 mg/kg/dose, -Monitor respiratory rate closely.

maximum dose: 2 g. Bronchodilation Report immediately if rate falls below
12.
IV (Adults): 2 g single dose. IV
-Test patellar reflex before each
(Children): 25 mg/kg/dose, maximum dose: 2 g. repeated parenteral dose. Depression or
absence of reflexes is a useful index of
early magnesium intoxication.
Eclampsia/Pre-Eclampsia
-Check urinary output, especially in
IV, IM (Adults): 4– 5 g by IV infusion, patients with impaired kidney function.
concurrently with up to 5 g IM in each Therapy is generally not continued if
buttock; then 4– 5 g IM q 4 hr or 4 g by IV urinary output is less than 100 mL
infusion followed by 1– 2 g/hr continuous during the 4 h preceding each dose.
infusion (not to exceed 40 g/day or 20 g/48
hr in the presence of severe renal -Observe newborns of mothers who
received parenteral magnesium sulfate
insufficiency).
within a few hours of delivery for signs
of toxicity, including respiratory and
Part of Parenteral Nutrition IV (Adults ): 4– neuromuscular depression.
24 mEq/day. IV (Children): 0.25– 0.5
-Observe patients receiving drug for
mEq/kg/day.
hypomagnesemia for improvement
in these signs of deficiency:
Irritability, choreiform movements,
tremors, tetany, twitching, muscle
cramps, tachycardia, hypertension,
psychotic behavior.

-Have calcium gluconate readily

available in case of magnesium
 sulfate toxicity.

DRUG STUDY (Mefenamic Acid)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON

Hypersensitiv CNS:Drowsine
Brand Name: Mefenamic acid binds the For the treatment of rheumatoid -Assess patients who develop
prostaglandin synthetase arthritis, osteoarthritis, severe diarrhea and vomiting for
Ponstel , Ponstan
Mild to Moderate
receptors COX-1 and COX-2,
Inhibiting the action of
dysmenorrhea, and mild to
moderate pain, inflammation, and ity to drug; ss, insomnia, dehydration and electrolyte
imbalance.
Generic Name:
Pain
prostaglandin synthetase. As
these receptors have a role fever.
GI dizziness, -Lab tests: With long-term
as a major mediator of
nervousness,
Mefenamic Acid therapy (not recommended) obtain

adult: PO
Classification:
inflammation and/or a role for
prostanoid signaling in
inflammation,
confusion,
periodic complete blood counts,
Hct and Hgb, and kidney function

entral Loading Dose 

activity-dependent plasticity,
the symptoms of pain are or headache.
tests.

nervous 500 mg
temporarily reduced.
ulceration.Saf GI:Severe
system PO Maintenance ety in diarrhea,
agent; anal children <14 ulceration, and
gesic; Dose 250 mg q6h
y, during bleeding;
NSAID; prn.
pregnancy nausea,
antipyretic (category C), vomiting,
or lactation is abdominal
Administration cramps, flatus,
not
Oral constipation,
established. hepatic
-Give with meals,
food, or milk to toxicity.
minimize GI Hematologic:
adverse effects. Prolonged
prothrombin
-Do not use drug time, severe
for a period autoimmune
exceeding 1 wk hemolytic
(manufacturer's anemia (long-
warning). term use),
leukopenia,
eosinophilia,
agranulocytosis
,
thrombocytope
nic purpura,
megaloblastic
anemia,
pancytopenia,
bone marrow
hypoplasia.
Urogenital:
Nephrotoxicity,
dysuria,
albuminuria,
hematuria,
elevation of
BUN.
Skin: Urticaria,
rash, facial
edema.
Spec Senses:
Eye irritation,
loss of color
vision
(reversible),
blurred vision,
ear pain.
BodyWhole:
Perspiration.
CV:
Palpitation.
Respiratory:
Dyspnea; acute
exacerbation of
asthma;
bronchoconstri
ction (in
patients
sensitive to
aspirin).
 DRUG STUDY (Buscopan)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON
Brand Name: Scopolamine butylbromide binds to Buscopan Tablets are indicated Buscopan and Buscopan Forte are Side ffects: -Drug compatibility should be
muscarinic M3 receptors in the contraindicated in myasthenia monitored closely in patients
gastrointestinal tract. This prevents for the relief of spasm of the gravis, mechanical stenosis in the requiring adjunctive therapy.
Buscopan Constipation, dry mouth,
Intravenous (IV) acetycholine from binding to and genito-urinary tract or gastro- gastrointestinal tract, paralytical trouble urinating, or nausea
Generic Name: activating the receptors which or obstructive ileus, megacolon -Avoid driving & operating
would result in contraction of the
intestinal tract and for the and in patients who have could occur. If these
 20mg in 1ml (solution) continue or are bothersome, machinery after parenteral
 Dilute required dose to 10ml with
smooth muscle. The inhibition of symptomatic relief of Irritable demonstrated prior administration.
Hyoscine butylbromide notify your doctor promptly.
contraction reduces spasms and Bowel Syndrome . hypersensitivity to hyoscine
normal saline. Inject slowly over 3-5 Very unlikely but report: rash,
their related pain during butylbromide or any other
Classification: minutes. -Avoid strict heat
abdominal cramping. component of the products. In i tching, swelling of the
 Compatible with the following IV addition , Buscopan should not hands or feet, trouble
antispasmod 
fluids:
Normal saline, 5% glucose and
be administered parenterally in
the following disorders:
breathing, increased pulse,
-Raise side rails as a precaution
because some patients become
dizziness, diarrhea, vision
ics 
sodium chloride
May be given into the side arm when
untreated narrow angle
glaucoma; tachycardia and problems, eye pain.
temporarily excited or disoriented
and some develop amnesia or
the above IV fluids are being infused. hypertrophy of the prostate with become drowsy.
Store at room temperature. Protect urinary retention. By
from light. intramuscular injection . -Reorient patient, as needed,
IM or SC: Tolerance may develop when
Buscopan is contraindicated in therapy  is prolonged
 Inject undiluted into a large muscle patients being treated with
mass or subcutaneously anticoagulant drugs since -Atropine-like toxicity may cause
intramuscular haematoma may dose related adverse reactions.
Per-orem
occur. In these patients, the Individual tolerance varies greatly
subcutaneous or intravenous routes
 Buscopan 10mg (white) may be used. In case of rare - Overdose may cause curare-like
 Gastro-Soothe 10mg (white) hereditary conditions that may be
effects, such as respiratory
incompatible with an excipient
paralysis. Keep emergency
of the product the use of the
product is contraindicated. equipment available
 DRUG STUDY (BCG)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON

BCG vaccine Hypersensitiv Significant:

Brand Name: Indicated for the prevention of  -Monitor for S&S of systemic BCG
infection: Fever, chills, severe
tuberculosis  in persons not malaise, or cough.
TheraCys®, and
TICE® BCG Indications and is an previously infected with
ity. Impaired Risk of -Culture blood and urine, if
M. Tuberculosis  who are at
Dosage attenuated immune
systemic infection is suspected.
Generic Name:
Bacillus Calmette- Intradermal
high risk for exposure. As
with any vaccine, bladder -Assess for regional lymph node
Guerin (BCG) strain of
Active immunisation against tuberculosis
Adult:  0.1 mL via slow injection into the
deltoid muscle.
immunization with BCG response, contracture
enlargement and report fistula
formation.
Classification:
bacillus
Child: <12 months 0.05 mL via slow VACCINE may not protect
congenital or
(intravesical
-Review potential adverse effects.
injection into the deltoid muscle. 100% of susceptible
anticancer biologic
response modifier. Calmette- individuals. acquired -Keep vaccination site clean until

Intravesical ), malaise,
local reaction has subsided.

Guérin immune -Do not breast feed until cleared to

Adult: As freeze- fever and do so by physician
Mycobacteriu deficiencies
dried BCG chills, flu-
m bovis used (e.g. HIV-
containing 1 to 16 like
as biologic infection,
x 108 colony
response leukaemia, symptoms.
forming units of
modifier. It is lymphoma,
live attenuated
also used as an cancer Blood and
strain of
active therapy, lymphatic
Mycobacterium
immunotherap Hodgkin’s system
bovis: Induction:
y for the disease), disorders:
Instill 50 mL
treatment of active
solution into the Anaemia.
bladder tuberculosis,
bladder, once
carcinoma in acute severe
weekly for 6 Gastrointest
situ by febrile illness,
consecutive inal
causing a generalised
weeks, beginning local, chronic infected skin disorders:
min 14 days after inflammatory conditions, Abdominal
biopsy or response current or pain, nausea,
transurethral involving previous diarrhoea.
resection (TUR). macrophage evidence of
Retain solution and leukocyte BCG
General
for up to 2 hours infiltration of infection,
for Max effect. the bladder, urinary tract disorders
Patient may be resulting in infection, and
repositioned the destruction gross administrati
every 15 minutes of superficial haematuria, on site
for Max area tumour cells <14 days of conditions:
contact. of the biopsy, TUR, Rigors.
Maintenance: urothelium. or traumatic
Instill 50 mL catheterisatio Musculoskel
once weekly for 3 n. etal and
consecutive Concomitant connective
weeks at 3, 6, 12 therapy with
tissue
months after immunosuppr
initiation of essive agents, disorders:
treatment. bone marrow Arthralgia,
depressants, arthritis,
antibiotics, myalgia.
radiation
therapy. Renal and
urinary
disorders:
Cystitis,
dysuria,
pollakuria,
haematuria,
UTI, urinary
incontinence
.
Respiratory,
thoracic and
mediastinal
disorders:
Pneumonitis
.

Potentially
Fatal:
Rarely,
systemic
granulomato
us illness.
 DRUG STUDY (Methergin)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON
Brand Name: Dosage and Administration Methergine (methylergonovine mal Following delivery of placenta, Hypertension; toxemia; The most common adverse -Monitor vital signs (particularly
eate) acts directly on the pregnancy; and reaction is hypertension BP) and uterine response during
for routine management of
Methergine associated in several cases and after parenteral administration

Generic Name:
Parenteral drug smooth muscle of the uterus
and increases the tone, rate,
uterine atony, hemorrhage and
subinvolution of the uterus. For
hypersensitivity.
with seizure and/or headache.
Hypotension has also been
of methylergonovine until partum
period is stabilized (about 1–2

products should and amplitude of rhythmic hour).

Methylergonovine control of uterine hemorrhage reported. Abdominal pain
contractions. Thus, it induces
a rapid and sustained (caused by uterine
in the second stage of -Notify physician if BP suddenly
Classification:

ergot alkaloids
be inspected tetanic uterotonic effect
which shortens the third stage
labor following delivery of
contractions), nausea and
vomiting have occurred
increases or if there are frequent
periods of uterine relaxation.
visually for of labor and reduces blood
loss. The onset of action after
the anterior shoulder. occasionally. Rarely observed
reactions have included: -Report severe cramping for

particulate matter I.V. acute myocardial infarction,

transient chest pains,
increased bleeding.

-Report any of the following: Cold

and discoloration vasoconstriction, vasospasm,
coronary arterial spasm, or numb fingers or toes, nausea or
vomiting, chest or muscle pain.
bradycardia, tachycardia,
prior to dyspnea, hematuria,
thrombophlebitis, water
-Do not breast feed while taking this
drug
administration. intoxication, hallucinations,
leg cramps, dizziness, tinnitus,
Intramuscularly 1 nasal congestion, diarrhea,
diaphoresis, palpitation, rash,

mL, 0.2 mg, after and foul taste.

delivery of the
anterior shoulder,
after delivery of
the placenta, or
during the
puerperium. May
be repeated as
required, at
intervals of 2-4
 hours.
Intravenously 1
mL, 0.2 mg,
administered
slowly over a
period of no less
than 60 seconds

Orally One tablet,

0.2 mg, 3 or 4
times daily in the
puerperium for a
maximum of 1
week.

DRUG STUDY (Vitamin K)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON
Brand Name: Fat-soluble naphthoquinone -Hypoprothrombinemia secondary to Contraindicated in patients CNS: headache, dizziness -Monitor patient constantly. Severe
derivative chemically identical vitamin K malabsorption or drug hypersensitive to drug. cramplike pain, convulsive reactions, including fatalities, have
Mephyton to and with similar activity therapy, or when oral movements. occurred during and immediately
Anticoagulant Overdose
after IV injection
as naturally occurring vitamin administration is desired and bile
Generic Name: /
Adult: PO/SC IM 2.5–10 mg; rarely K. Vitamin K is essential secretion is inadequate. CV: transient hypotension after Lab tests: Baseline and frequent
phytonadione up to 50 mg/d, may repeat parenteral for hepatic biosynthesis of I.V. administration, rapid and
weak pulse, arrhythmias, PT/INR.
blood clotting Factors II, VII,
dose after 6–8 h if needed or PO -Hypoprothrombinemia secondary to
Frequency, dose, and therapy
dose after 12–24 h IV Emergency only: vitamin K malabsorption, drug therapy, flushing.
IX, and X.
or excess vitamin A. duration are guided by PT/IN R
Classification:
10–15 mg at a rate of 1 mg/min, may GI: nausea, vomiting. clinical response.
Pharmacologic be repeated in 4 h if bleeding -Hypoprothrombinemia secondary to
classification: vitamin K continues. effect of oral anticoagulants. Hematologic: fatal kernicterus, - Monitor therpeutic effectiveness
severe hemolytic anemia in which is indicated by shortened
Hemorrhagic Disease of Newborns neonates.
Therapeutic -Prevention of hemorrhagic disease in PT, INR, bleeding, and clotting
Infant: IM/SC 0.5–1 mg immediately
classification: blood neonates. times , as well as decreased
coagulation modifier Hepatic: hyperbilirubinemia.
after delivery, may repeat in 6–8 h if hemorrhagic tendencies.
necessary. -Prevention of hypoprothrombinemia - Be aware that patients on large
related to vitamin K deficiency in long- Respiratory: bronchospasm, doses may develop temporary
term parenteral nutrition. dyspnea. resistance to coumarin-type
Other Prothrombin Deficiencies anticoagulants. If oral
Adult: IM/SC 2–25 mg Skin: diaphoresis; erythema; anticoagulant is reinstituted,
larger than former doses may be
Child: IM/SC 5–10 mg urticaria; pruritus; allergic rash;
needed. Some patients may
pain, swelling, hematoma at
Infant: IM/SC 1 mg require change to heparin.
injection site.
-Maintain consistency in diet
Other: anaphylaxis and and avoid significant increases in
anaphylactoid reactions daily intake of vitamin K–rich
(usually after too-rapid I.V. foods when drug regimen is
administration). stabilized. Know sources rich in
vitamin K: Asparagus, broccoli,
cabbage, lettuce, turnip greens,
pork or beef liver, green tea,
spinach, watercress, and tomatoes.
 DRUG STUDY (Multivitamins iron with Folic Acid)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON

It is used to Constipation, 
Brand Name:
Instruct and advise client not to
Adavite, Certagen, double dose unless prescribed by
Dayalets, Hexavitamin,
LKV Drops, Multi-75
Recommended Dosage: 1 Capsule
daily, or as perscribed by a treat or
Prevention and treatment of
mega loblastic and
Contraindicat diarrhea, the physician.

ed if you are or upset

Advise client not to use the drug
physician
prevent low macrocytic anemias. after the expiry date on the label.

Route: PO Given during pregnancy to allergic to stomach may Remind the client to consult a
Generic Name:
Multivitamins, Folic iron in the promote normal fetal
doctor if the client have taken more

Acid & Iron Capsules any occur. These then the recommended dosage.

body. development.
Classification:
component of effects are
Vitamins
the product usually
It is also temporary and
used to help may disappear
growth and as your body
good health. adjusts to
It may be this medicatio
given to the n.
client for
other An allergic
reasons. reaction to this
Required for drug is
protien unlikely, but
seek immediate
synthesis & medical
RBC
 functions. attention if it
Stimulates occurs.
Symptoms of
the an allergic
production of reaction include
RBC, WBC, : rash, itching/s
and platelets. welling
(especially of
Necessary the
for normal face/tongue/thr
development. oat),severe dizzi
ness, trouble
breathing.
DRUG STUDY (Dexamethason)

BRAND NAME Prescribed and Recommended Mechanism

GENERIC dosage, frequency, route of Of
NAME administration Action Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATI
ON
Brand Name:
Decadron, Dexasone,
Allergies, Inflammation, Neoplasias
Diodex, Hexadrol, Maxidex
Adult: PO 0.25–4 mg b.i.d. to
Generic Name: q.i.d. IM 8–16 mg q1–3 wk or 0.8–1.6
Dexamethason
mg intralesional q1–3 wk
Classification: Child: PO/IV/IM 0.08–0.3 mg/kg/d
divided q6–12h
glucocorticoids
Cerebral Edema
Adult: IV 10 mg followed by 4 mg q4h,
reduce dose after 2–4 d then taper over
5–7 d
Child: PO/IV/IM 1–2 mg/kg loading
dose, then 1–1.5 mg/kg/d divided q4–6h
(max: 16 mg/d)
Shock
Adult: IV 1–6 mg/kg as a single dose or
40 mg repeated q2–6h if needed.
Dexamethasone Suppression Test
Adult: PO 0.5 mg increase 6h for 48 h
Inflammation
Adult/Child: Ophthalmic/Topical/Inhala
tion/Intranasal
Long-acting synthetic
adrenocorticoid with intense
antiinflammatory
(glucocorticoid) activity and
minimal mineralocorticoid
activity.
Antiinflammatory action:  breathing problems, bowel
Prevents accumulation of
inflammatory cells at sites of
infection; inhibits
phagocytosis, lysosomal
enzyme release, and synthesis
of selected chemical mediators
of inflammation; reduces
capillary dilation and
permeability.
Immunosuppression:
Not clearly understood, but
may be due to prevention or
suppression of delayed
hypersensitivity immune
reaction.
Dexamethasone is used to
treat conditions such as
arthritis, blood/hormone
disorders, allergic reactions,
skin diseases, eye problems,
disorders, cancer, and
immune system disorders. It
is also used as a test for an
adrenal gland disorder
(Cushing's syndrome).
Systemic fungal infection,
acute infections, active or
resting tuberculosis, vaccinia,
varicella, administration of live
virus vaccines (to patient,
family members), latent or
active amebiasis.
Ophthalmic use: Primary
open-angle glaucoma, eye
infections, superficial ocular
herpes simplex, keratitis and
tuberculosis of eye. Safe use
during pregnancy (category
C), lactation, or in children is
not established.
Aerosol therapy: Nasal -Monitor and report S&S of
irritation, dryness, epistaxis, Cushing's syndrome or other
rebound congestion, bronchial systemic adverse effects.
asthma, anosomia, perforation
of nasal septum. -Monitor neonates born to a
mother who has been receiving
Systemic Absorption—CNS: a corticosteroid during pregnancy
for symptoms of
Euphoria, insomnia, hypoadrenocorticism.
convulsions, increased ICP,
vertigo, headache, psychic -Monitor for S&S of a
disturbances. hypersensitivity reaction.
The acetate and sodium phosphate
CV: CHF, hypertension, edema. formulations may contain
bisulfites, parabens, or both;
Endocrine: Menstrual these inactive ingredients are
irregularities, hyperglycemia; allergenic to some individuals.
cushingoid state; growth
suppression in children; hirsutism.
Special Senses: Posterior
subcapsular cataract, increased
IOP, glaucoma, exophthalmos.
GI: Peptic ulcer with possible
perforation, abdominal distension,
nausea, increased appetite,
heartburn, dyspepsia, pancreatitis,
bowel perforation, oral candidiasis.
Musculoskeletal: Muscle
weakness, loss of muscle mass,
vertebral compression fracture,
pathologic fracture of long bones,
tendon rupture. Skin: Acne,
impaired wound healing, petechiae,
ecchymoses, diaphoresis, allergic
dermatitis, hypo- or
hyperpigmentation, SC and
cutaneous atrophy, burning and
tingling in perineal area (following
IV injection).