ARAO, JUAN KARLO

PHARMACOLOGY BSN 2-A-9

OCTOBER 24, 2022

Make a drug study on the individual drugs discussed in this course unit. Type them in word and submit them here.

Search for 2 new drugs for each classification of Respiratory drugs not discussed in this course unit and include them in the drug study.
DRUG STUDY

DRUG
DOSAGE
THERAPEUTIC ACTION
ADVERSE EFFECTS
CONTRAINDICATION
NURSING CONSIDERATIONS
Antihistamines

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Diphenhydramine Capsules, tablets: 25 Competes for H1-  CNS: Drowsiness, dizziness, headache, Contraindicated in Adjust dose according to
mg, 50 mg. receptor sites on effector fatigue, disturbed coordination, tingling patients hypersensitive to coagulation test results Monitor
cells, thus blocking  CV: Palpitation, tachycardia, mild drug as well as in those cardiovascular status especially with
Syrup: 6.25 mg/5 mL, histamine release hypotension with acute asthma, pre-existing cardiovascular disease.
12.5 mg/5 mL  Special Senses: Tinnitus, vertigo, dry narrow-angle glaucoma,
nose, throat prostatic hypertrophy, Monitor for adverse effects
Injection: 50 mg/mL  GI: Dry mouth, nausea, epigastric bladder neck obstruction especially in children and the older
distress, anorexia, vomiting, constipation and GI obstruction adult.
 Urogenital: Urinary frequency or
retention, dysuria. Supervise ambulation and use side-
 Body as a Whole: Hypersensitivity, rails as necessary. Drowsiness is
urticaria, photosensitivity, anaphylactic most prominent during the first few
shock). days of therapy and often
 Respiratory: Thickened bronchial disappears with continued therapy.
secretions, wheezing, sensation of chest Older adults are especially likely to
tightness manifest dizziness, sedation, and
 hypotension
Chlorpheniramine Tablets: 2 mg, 4 mg. Effective antihistamine  Body as a Whole: Sensation of chest Contraindicated in Monitor for CNS depression and
reaction resulting in tightness. patients hypersensitive to sedation, especially when
Sustained-release decreasing allergic  CV: Palpitation, tachycardia, mild drug as well as in those chlorpheniramine is given in
tablets: 8 mg, 12 mg. symptomatology hypotension or hypertension. with acute asthma, combination with other CNS
Syrup: 2 mg/5 mL  GI: Epigastric distress, anorexia, nausea, narrow-angle glaucoma, depressants.
vomiting, constipation, or diarrhea. prostatic hypertrophy,
 CNS: Drowsiness, sedation, headache, bladder neck obstruction Monitor BP in hypertensive patients
dizziness, vertigo and GI obstruction since chlorpheniramine may elevate
 Special Senses: Dryness of mouth, nose, BP.
and throat, tinnitus, vertigo, acute
labyrinthitis, thickened bronchial
secretions, blurred vision, diplopia.
 Urogenital: Urinary frequency or
retention, dysuria
Upper Respiratory System

2 new Drugs of Antihistamines

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Hydroxyzine Tablets: 10 mg, 25 mg, 50 mg, 100 Tranquilizes  CNS: Drowsiness (usuall Contraindicated in patients Evaluate alertness. Drowsiness may occur
mg depression of y transitory), sedation, hypersensitive to drug as well as and usually disappears with continued
hypothalamus and dizziness, headache.  in those with psychoses or therapy or following reduction of dosage.
Syrups: 10 mg/5 mL brain-stem reticular  CV: Hypotension.  depression.
formation, rather  GI: Dry mouth.  Monitor condition of oral membranes daily
Injection: 25 mg/mL, 50 mg/mL than cortical areas.  Body as a when patient is on high dosage of
In addition, it is an Whole: Urticaria, hydroxyzine.
effective agent for dyspnea, chest tightness,
pruritus wheezing, involuntary Reevaluate usefulness of drug periodically.
motor activity (rare). 
Reduce dosage of the depressant up to
 Hematologic: Phlebitis, 50% when CNS depressants are
hemolysis, thrombosis.  prescribed concomitantly
 Skin: Erythematous
macular eruptions,
erythema multiforme,
digital gangrene from

Promethazine Tablets: 12.5 mg, 25 mg, 25 mg
Oral solution: 6.25 mg/5 mL, 10
mg/5
Solution for injection: 25 mg/mL, 50
mg/mL.
Suppositories: 12.5 mg, 25 mg, 50
mg
inadvertent IV or
intraarterial injection,
injection site reactions.
Competes with  CNS: Akathisia, CNS Contraindicated in patients Monitor patient’s hematologic status as
histamine for H1 - stimulation, confusion, hypersensitive to drug as well as ordered because promethazine may cause
receptor sites, dizziness in those with prostatic bone marrow depression
thereby antagonizing  CV: Bradycardia, hypertrophy and bladder neck
many histamine hypertension, obstruction. Tell patient to use a calibrated device to
effects and reducing hypotension, tachycardia ensure accurate doses of promethazine
allergy signs and  EENT: Blurred vision; syrup.
symptoms. diplopia; dry mouth, nose,
Urge patient to avoid alcohol and other
and throat; nasal
CNS depressants during therapy.
congestion; tinnitus;
vision changes
 ENDO: Hyperglycemia
 GI: Anorexia, cholestatic
jaundice
 HEME: Agranulocytosis,
leukopenia

Nasal and Systemic Decongestants

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

Pseudoephedrin Tablets: 30 mg, 60 mg.
e decongestant.
Sustained release tablets: 120
mg, 240 mg.
Liquid: 15 mg/5 mL, 30 mg/5 mL.
Drops: 7.5 mg/0.8 mL.
ACTION
Effective as a nasal  Body as a Whole: Transient Contraindicated in patients Take baseline BP and other vital signs
stimulation, tremulousness, hypersensitive to drug as well
difficulty in voiding.  as in those with coronary artery Monitor HR and BP, especially in those
 CV: Arrhythmias, disease, glaucoma, and with a history of cardiac disease. Report
palpitation, tachycardia.  hyperthyroidism. tachycardia or hypertension.
 CNS: Nervousness, dizziness
, headache, sleeplessness,
numbness of extremities. 
 GI: Anorexia, dry mouth,
nausea, vomiting.
 Ephedrine Capsules: 25 mg.
Injection: 50 mg/mL.
Nasal spray: 0.25%.
Nasal gel: 1%.
It contracts dilated 
CNS: Headache, insomnia, Contraindicated in patients Check BP repeatedly during first 5 min,
arterioles of nasal nervousness hypersensitive to drug as well then q3–5min until stabilized.
mucosa, thus  CV: Palpitation, tachycardia, as in those with pregnancy
reducing precordial pain Monitor I&O ratio and pattern, especially
engorgement and  GU: Difficult or painful in older male patients. Encourage patient
edema and urination, acute urinary to void before taking medication.
facilitating retention
ventilation and  GI: Nausea, vomiting, Monitor for systemic effects of nose
drainage anorexia.  drops that can occur because of
excessive dosage from rapid absorption
 Body as a Whole: Sweating,
of drug.
thirst
2 new Drugs of Nasal and Systemic Decongestants

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Oxymethazoline Solution: 0.025%, 0.05% Constricts smaller  Special Senses: Burning, stinging, Contraindicated in patients Monitor for S&S of excess use. If
arterioles in nasal dryness of nasal mucosa, sneezing.  hypersensitive to drug as well noted, discuss possibility of rebound
passages and has  Body as a Whole: Headache, light- as in those with children <2 y. congestion.
prolonged headedness, drowsiness, insomnia,
decongestant palpitations, rebound congestion. Take baseline BP and other vital
effect signs.
Tetrahydrozoline Ophthalmic solution: 0.05% Effective for  Special Senses: Transient Contraindicated in patients Monitor patient’s hematologic status
allergic reactions of stinging, irritation, sneezing, dryness hypersensitive to drug as well as ordered Monitor for S&S of excess
Nasal solution: 0.1% the eye and nose. , headache, tremors, drowsiness, as in those with glaucoma or use. If noted, discuss possibility of
light-headedness, insomnia, other serious eye diseases. rebound congestion.
palpitation. 
 Body as a Whole: With overdose: Take baseline BP and other vital
marked drowsiness, sweating, coma, signs.
hypotension, shock, bradycardia

Expectorants

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Guaifenesin Syrup: 100 mg/5 mL Reduces viscosity  CNS: drowsiness, headache, Contraindicated in patients Advise patient to notify health care

Oral solution: 100 mg/5 mL
Capsules: 200 mg
Tablets: 100 mg, 200 mg
Extended-release tablets: 600 mg,
120
of tenacious weakness, depression, hypersensitive to drug as well professional of all Rx or OTC
secretions by dizziness, fatigue, insomnia, as in those with medications, vitamins, or herbal products
increasing irritability. phenylketonuria. being taken and to consult with health
respiratory tract  EENT: tinnitus. Resp: care professional before taking other
fluid. Mobilization dyspnea. medications, especially cough, cold, or
and subsequent  CV: bradycardia, chest pain, allergy remedies
expectoration of hypotension, palpitations
mucus. Advise patient to notify health care
 GI: constipation, dry mouth,
professional if dry mouth or constipation
abdominal pain
persists. Frequent mouth rinses, good
oral hygiene, and sugarless gum or candy
may minimize dry mouth
Instruct patient and family on proper
technique for

BP monitoring. Advise them to check BP

at least weekly and to report significant
changes

2 new Drugs of Expectorants

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

Potassium Iodide Oral solution: Adults and children.
50 to 250 mg three times a day for
10 to 14 days before surgery.
Oral: Adults. 50 to 250 mg three
times a day or 500 mg every 4 hr.
Tablets: Adults and adolescents.
100 to 150 mg
Tablets: Children age 1 and over.
130 mg
Tablets: Children under age 1. 65
mg
Guaifenesin- Tablets: 60mg, 375mg
pseudoephedrin
ACTION
Inhibits release of  CNS: Confusion, fatigue, Acute bronchitis, Addison’s Be aware that potassium iodide
thyroid hormone headache, heaviness or disease, dehydration, heat shouldn’t be given to patients with
into circulation, thus weakness in legs, paresthesia cramps, hyperkalemia, tuberculosis because drug may cause
alleviating  CV: Irregular heartbeat hypersensitivity to iodides or pulmonary irritation and increased
symptoms caused  EENT: Burning in mouth or their components, secretions.
by excessive throat, increased salivation, hyperthyroidism, iodism, renal
thyroid hormone metallic taste, sore teeth or impairment, tuberculosis Monitor serum potassium level regularly
gums in patients with renal impairment
stimulation.
 GI: Diarrhea, epigastric pain, because of the risk of hyperkalemia
Potassium iodide
also blocks thyroid indigestion, nausea, vomiting
Monitor thyroid function test results
uptake of  HEME: Eosinophilia
periodically to assess drug’s
radioactive iodine  MS: Arthralgia
effectiveness.
isotopes released  SKIN: Acneiform lesions,
as a result of urticaria Advise patient taking potassium iodide
radiation exposure  Other: Angioedema, oral solution or syrup to use a calibrated
lymphadenopathy. measuring device to ensure accurate
doses.
Increases fluid and  CNS: Insomnia, headache, Contraindicated in patients with Monitor patient’s reaction to drugs.
mucus removal dizziness, and irritability. hypersensitivity to guaifenesin
 e from the  CV: Tachycardia Monitor vital signs.
upper respiratory  EENT: Swelling (tongue. Patients should take care to avoid
tract by increasing Throat) irritants that stimulate their cough.
the  GI: Nausea
volume of  Urogenital: problems in Do not take more or less of it or take it
secretions and urinating more often than prescribed by your
doctor
reducing their
adhesiveness and
surface tension.

Mucolytic

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Acetylcystein Effervescent tablets: 500 mg, 2.5 g. Liquefies abnormal,  CNS: Chills, dizziness,
e thickened, or viscid drowsiness, fever, headache
Solution for inhalation: 10%, 20% mucus secretions in  CV: Edema, hypertension,
chronic pulmonary hypotension, tachycardia
Solution for injection: 20% disorders.  EENT: Rhinorrhea, stomatitis,
stridor, tooth damage
 GI: Anorexia, constipation,
hepatotoxicity, nausea,
vomiting
 RESP: Bronchospasm, chest
tightness, cough.
Contraindicated in patients
hypersensitive to drug as well
as in those with respiratory
insufficiency, asthma, or
history of bronchospasm
Be aware that it may be necessary to dilute
20% inhalation or instillation solution with
normal saline solution or sterile water
when acetylcysteine is used to liquefy
secretions.
Watch for signs of hepatotoxicity
Assess type, frequency, and
characteristics of patient’s cough.
Particularly note sputum.
Monitor patient for tachycardia

Instruct patient to notify prescriber

immediately about nausea, rash, or
vomiting, as well as feeling dizzy or
 lightheaded, shortness of breath, or
wheezing
Carbocisteine Syrup: 250mg/5ml Carbocisteine is a  Endo: Hypothyroidism Contraindicated in patients Advise the patient to take small, frequent
mucolytic agent for  GI: Nausea, vomiting, hypersensitive to the active meals to alleviate some of the GI
the adjunctive diarrhea, gastrointestinal substance; patients with active discomfort associated with these drugs.
therapy of bledding peptic ulceration.
respiratory tract  CNS: Headache, dizziness, Advise the patient to avoid driving or
disorders urinary incontinence, performing dangerous tasks if dizziness
characterized by palpitations. and drowsiness occur to prevent
excessive, viscous  Resp: Shortness of breath, patient injury.
mucus, including bronchorrhea
chronic obstructive Alert the patient that these drugs may be
 Derm: Stevens-Johnsons
airways disease. found in OTC preparations and that care
syndrome, erythema
should be taken to avoid excessive doses.
multiforme
Offer support and encouragement to help
the patient cope with the disease and with
the drug regimen.

2 new Dugs of Mucolytic

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Ambroxol Tablet: 30mg Improvement of  GI: Nausea, vomiting, Contraindicated in patients Monitor for S&S of aspiration of excess
mucociliary diarrhoea, dyspepsia, dry hypersensitive to drug as well secretions, and for bronchospasm;
clearance and mouth or throat, abdominal as in those with gastric withhold drug and notify physician
enhancement of pain, heartburn, oral or ulceration immediately if either occur.
fluid secretion pharyngeal hypoaesthesia,
which facilitates Lab test: monitor ABGs, pulmonary
dysgeusia.
expectoration and functions and pulse oximetry as indicated.
eases cough.  Derm: Stevens-Johnson
syndrome, toxic epidermal
necrolysis (TEN), erythema Have suction apparatus immediately
multiforme. available. Increased volume of respiratory
 Other: anaphylactic reactions tract fluid maybe liberated; suction or
endotracheal aspiration may be
necessary to establish and maintain an
open airway

Report difficulty with clearing the airway

 or any other respiratory distress
Dornase Alfa Inhalation; 1 mg/mL solution Hydrolyzes the  Respiratory: Hoarseness, sore Contraindicated in patients Monitor for improvement in dyspnea and
DNA in sputum of throat, voice alterations, hypersensitive to drug sputum clearance.
CF patients and pharyngitis, laryngitis, cough,
reduces sputum rhinitis.  Monitor for S&S of hypersensitivity.
viscosity. Use of  Other: Conjunctivitis, chest Patients with a history of hypersensitivity
dornase pain, rash to bovine pancreatic dornase are at high
significantly risk.
reduces number of
upper respiratory Monitor for adverse effects; rarely,
infections acquired dosage adjustments may be required.
by patients with CF.

Antitussives

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Dextromethorpha Capsules: 30 mg. Controls cough  CNS: Dizziness, drowsiness, Contraindicated in patients Take baseline BP and other vital signs
n spasms by CNS depression with very hypersensitive to drug as well
Lozenges: 2.5 mg, 5 mg, 7.5 mg, depressing cough large doses; excitability, as in those with children <2 y, Monitor for dizziness and drowsiness,
15 mg. center in medulla. especially in children.  asthma, productive cough, especially when concurrent therapy with
Temporarily  GI: GI upset, constipation, persistent or chronic cough. CNS depressant is used.
Liquid: 10 mg/15 mL, 3.5 mg/5 relieves coughing abdominal discomfort.
mL spasm

Syrup: 15 mg/15 mL, 10 mg/5 mL

2 new Dugs of Antitussives

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Benzonatate Capsules: 100 mg Decreases  Body as a Whole: Low incidence.  Contraindicated in patients Auscultate lungs anteriorly and

Codeine Tablets: 15 mg, 30 mg, 60 mg
Injection: 15 mg/5 mL
frequency and  CNS: Drowsiness, sedation hypersensitive to drug as well posteriorly at scheduled intervals.
intensity of headache, mild dizziness.  as in those with pregnancy
nonproductive  GI: Constipation, nausea.  Observe character and frequency of
cough  Skin: Rash, pruritus. coughing and volume and quality of
sputum. Keep physician informed
Potentiates about  CV: Palpitation, hypotension, Contraindicated in patients Record relief of pain and duration of
one-sixth that of orthostatic hypotension, hypersensitive to drug as well analgesia.
morphine; bradycardia, tachycardia, as in those with acute asthma.
antitussive activity circulatory collapse.  Evaluate effectiveness as cough
is also a little less  GI: Nausea, vomiting, constipation.  suppressant. Treatment of cough is
than that of  CNS: Dizziness, light-headedness,  directed toward decreasing frequency
morphine. drowsiness, sedation, lethargy, and intensity of cough without abolishing
euphoria, agitation; restlessness, cough reflex, need to remove bronchial
exhilaration, convulsions, narcosis, secretions.
respiratory depression. 
 Urogenital: Urinary retention. Supervision of ambulation and use other
safety precautions as warranted since
drug may cause dizziness and light-
headedness.

Monitor for nausea, a common side

effect. Report nausea accompanied by
vomiting. Change to another analgesic
may be warranted

2 new Dugs of Antitussives

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

Benzonatate Capsules: 100 mg
Codeine Tablets: 15 mg, 30 mg, 60 mg
Injection: 15 mg/5 mL
ACTION
Decreases  Body as a Whole: Low incidence.  Contraindicated in patients Auscultate lungs anteriorly and
frequency and  CNS: Drowsiness, sedation hypersensitive to drug as well posteriorly at scheduled intervals.
intensity of headache, mild dizziness.  as in those with pregnancy
nonproductive  GI: Constipation, nausea.  Observe character and frequency of
cough  Skin: Rash, pruritus. coughing and volume and quality of
sputum. Keep physician informed
Potentiates about  CV: Palpitation, hypotension, Contraindicated in patients Record relief of pain and duration of
one-sixth that of orthostatic hypotension, hypersensitive to drug as well analgesia.
morphine; bradycardia, tachycardia, as in those with acute asthma.
antitussive activity circulatory collapse.  Evaluate effectiveness as cough
is also a little less  GI: Nausea, vomiting, constipation.  suppressant. Treatment of cough is
than that of  CNS: Dizziness, light-headedness,  directed toward decreasing frequency
morphine. drowsiness, sedation, lethargy, and intensity of cough without abolishing
euphoria, agitation; restlessness, cough reflex, need to remove bronchial
exhilaration, convulsions, narcosis, secretions.
respiratory depression. 
 Urogenital: Urinary retention. Supervision of ambulation and use other
safety precautions as warranted since
drug may cause dizziness and light-
headedness.
 Monitor for nausea, a common side
effect. Report nausea accompanied by
vomiting. Change to another analgesic
may be warranted

Lower Respiratory System

Sympathomimetics

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

Albuterol Tablets: 2 mg, 4 mg
Extended-release tablets: 4
mg, 8 mg.
Syrup: 2 mg/5 mL.
Capsules for inhalation: 200
mcg.
Solution for inhalation
0.083%, 0.5%.
ACTION
Decreases airway  Body as a Whole: Hypersensitivity Contraindicated in patients Monitor therapeutic effectiveness
resistance, reaction.  hypersensitive to drug as well which is indicated by significant
facilitates mucus  CNS: Tremor, anxiety, nervousness, as in those with pregnancy. subjective improvement in pulmonary
drainage, and restlessness, convulsions, weakness, function within 60–90 min after drug
increases vital headache, hallucinations.  administration.
capacity.  CV: Palpitation, hypertension,
hypotension, bradycardia, reflex Monitor for: S&S of fine tremor in
fingers, which may interfere with
tachycardia.
precision handwork; CNS stimulation,
 Special Senses: Blurred vision, dilated
pupils.  particularly in children 2–6 y,
(hyperactivity, excitement,
 GI: Nausea, vomiting. 
nervousness, insomnia), tachycardia,
 Other: Muscle cramps, hoarseness
GI symptoms.

Consult physician about giving last


Metaproterenol Tablet: 10 mg, 20 mg.
Syrup: 10 mg/5 mL.
Metered dose inhaler: 75 mg,
150
mg.
Solution for inhalation: 0.4%,
0.6%, 5%.
albuterol dose several hours before
bedtime, if drug-induced insomnia is
a problem.
Bronchodilator;  CNS: Nervousness, weakness, Contraindicated in patients Monitor respiratory status. Auscultate
controls drowsiness, tremor (particularly after hypersensitive to drug as well lungs before and after inhalation to
bronchospasm in PO administration), headache, fatigue.  as in those with cardiac determine efficacy of drug in
asthmatics.  CV: Tachycardia, hypertension, cardia arrhythmias associated with decreasing airway resistance.
c arrest, palpitation.  tachycardia, hyperthyroidism
 GI: Nausea, vomiting, bad taste.  and pregnancy. Monitor cardiac status. Report
 Urogenital: Occasional difficulty in tachycardia and hypotension.
micturition and muscle cramps. 
Monitor Vital signs.
 Respiratory: Throat irritation, cough,
exacerbation of asthma.

2 new drugs of Sympathomimetics

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Epinephrine Inhalation: 1:100, 1:1000, Constricts bronchial
2.25% arterioles and inhibits
histamine release, thus
Spray: 0.35 mg, 0.2 mg reducing congestion and
edema and increasing
Nasal Solution 0.1%, tidal volume and vital
0.5%, 1%, 2% capacity. Relaxes
uterine smooth
musculature and inhibits
uterine contractions.
Imitates all actions of
sympathetic nervous
system except those on
arteries of the face and
sweat glands.
 GI: Nausea, vomiting.  Contraindicated in patients Monitor BP, pulse, respirations, and
 CV: Precordial hypersensitive to drug as urinary output and observe patient closely
pain, palpitations, hypertension, MI well as in those with following IV administration. Epinephrine
, tachyarrhythmias narrow-angle glaucoma; may widen pulse pressure. If disturbances
including ventricular fibrillation.  hemorrhagic, traumatic, or in cardiac rhythm occur, withhold
 RESP: Bronchial and pulmonary cardiogenic shock epinephrine and notify physician
edema.  immediately.
 Urogenital: Urinary retention. 
 Skin: Tissue necrosis with Keep physician informed of any changes in
repeated injections.  intake-output ratio.
 Metabolic: Metabolic acidoses,
Use cardiac monitor with patients receiving
elevated serum lactic acid,
epinephrine IV. Have full crash cart
transient elevations of blood
immediately available.
glucose. 
 Nervous System: Altered state of Check BP repeatedly when epinephrine is
perception and thought, psychosis. administered IV during first 5 min, then q3–
5min until stabilized.

Monitor blood glucose & HbA1c for loss of

glycemic control if diabetic
Terbutaline Tablets: 2.5 mg, 5 mg Relieves bronchospasm  CNS: Nervousness, Contraindicated in patients Assess vital signs: Baseline pulse and BP
 tablets in chronic obstructive tremor, headache, light- hypersensitive to drug as and before each dose. If significantly
pulmonary disease headedness, drowsiness, fatigue, well as in those with altered from baseline level, consult
Aerosol 0.2 mg aerosol (COPD) and significantly seizures.  severe hypertension and physician.
increases vital capacity.  CV: Tachycardia, hypotension or coronary artery disease.
Injection: 1 mg/mL Promotes relaxation of hypertension, palpitation, maternal Most adverse effects are transient;
injection vascular smooth muscle, and fetal tachycardia.  however, rapid heart rate may persist for a
contraction of GI and  GI: Nausea, vomiting.  relatively long time.
urinary sphincters,  Body as a Whole: Sweating,
increase in renin, muscle cramps. Be aware that muscle tremor is a fairly
pancreatic beta-cell common adverse effect that appears to
secretion, and serum subside with continued use.
HDL-cholesterol
concentration. Increases Monitor for symptoms of hypoglycemia in
uterine relaxation neonates born of a mother who used
(thereby preventing or terbutaline during pregnancy.
abolishing high
intrauterine pressure). Monitor patient being treated for premature
labor for CV S&S for 12 h after drug is
discontinued. Report tachycardia promptly.

Monitor I&O ratio. Fluid restriction may be

necessary. Consult physician.

Anticholinergics

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Ipratropium Solution for inhalation: Inhibits acetylcholine  Special Senses: Blurred vision Contraindicated in patients Monitor respiratory status;
0.02%. at its receptor sites, (especially if sprayed into eye), hypersensitive to drug auscultate lungs before and after
thereby blocking difficulty in accommodation, acute eye inhalation.
Inhaler: 18 mcg. cholinergic broncho pain, worsening of narrow-angle
motor tone glaucoma.  Report treatment failure
Nasal spray: 0.03%, 0.06%. (bronchoconstriction);  GI: Bitter taste, dry oropharyngeal (exacerbation of respiratory
also abolishes membranes. With higher doses: symptoms) to physician.
vagally mediated nausea, constipation. 
reflex bronchospasm  Respiratory: Cough, hoarseness,
triggered by such exacerbation of symptoms, drying of
nonspecific agents as bronchial secretions, mucosal ulcers,
cigarette smoke, inert epistaxis, nasal dryness. 
dusts, cold air, and a  Skin: Rash, hives. 
range of  Urogenital: Urinary retention. 
inflammatory  CNS: Headache
mediators (e.g.,
histamine).
 2 new drugs of Anticholinergics

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

Tiotropium Dry powder capsules for Prevents
inhalation: 18 mcg.
Inhalation solution: 1.25 mcg muscarinic
Aclidinium Dry powder metered-dose
inhaler: 400 mcg
ACTION
 CNS: CVA, depression, difficulty Contraindicated in patients Monitor patient’s renal function, as
acetylcholine from speaking, dizziness, insomnia, hypersensitive to drug or in ordered, especially in patients with
attaching to paresthesia those with prostatic moderate to severe renal
 CV: Angina, atrial fibrillation, chest hyperplasia and bladder neck impairment, because tiotropium is
receptors on pain, hypercholesterolemia, obstruction excreted mainly by the kidneys.
membranes of hypertension, palpitations
smooth-muscle  EENT: Application site irritation, Monitor patient with renal dysfunction
cells. By blocking blurred vision, cataract, dry mouth, closely for anticholinergic effects.
acetylcholine’s dysphonia, epistaxis, eye pain, Monitor patient’s pulmonary function,
effects in the glaucoma as ordered, to evaluate the
bronchi and  RESP: Cough, paradoxical effectiveness of tiotropium
bronchioles, bronchospasm, upper respiratory tract
tiotropium relaxes infection Instruct patient on the proper use of
smooth muscles the HandiHaler inhalation device, if
and causes prescribed.
bronchodilation
Tell patient to place the capsule into
the center chamber of the inhalation
device and then to press and release
the button on the side of the
inhalation device to pierce the
capsule
Acts as an  CNS: headache. Contraindicated in patients Instruct patient in proper use of
anticholinergic by  EENT: worsening of narrow-angle hypersensitive to drug or it inhaler and to take medication as
inhibiting the M3 glaucoma. components. directed. Omit missed doses and
 receptor in  Resp: paradoxical bronchospasm. take next dose at the usual time; do
bronchial smooth  GU: urinary retention not double doses.
muscle, which
causes Advise patient to have a rapid-acting
bronchodilatation. bronchodilator available for use at all
times to treat sudden symptoms.
Notify health care professional
immediately if sudden shortness of
breath occurs immediately after
using aclidinium inhaler

Explain need for pulmonary function

tests prior to and periodically during
therapy to determine effectiveness of
medication

Methylxanthine Derivatives

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Aminophylline Tablets: 100 mg, 200 mg. Respiratory  CNS: Nervousness, restlessness, Contraindicated in patients Monitor for S&S of toxicity (generally
smooth muscle depression hypersensitive to drug as well related to theophylline serum levels
Sustained release tablets: relaxant that  CV: Cardiac arrhythmias, tachycardia as in those with cardiac over 20 mg/mL).
225 mg. results in (with rapid IV), hyperventilation, chest arrhythmias
bronchodilation. pain, severe hypotension, cardiac Observe patients receiving parenteral
Oral liquid: 105 mg/5 mL. arrest.  drug closely for signs of hypotension,
 GI: Nausea, vomiting, anorexia, arrhythmias, and convulsions until
Injection: 250 mg/10 mL. hematemesis, diarrhea, epigastric serum theophylline stabilizes within
pain. the therapeutic range.
Suppositories: 250 mg, 500
mg. Monitor & record vital signs and I&O.
A sudden, sharp, unexplained rise in
heart rate may indicate toxicity.
Caffeine Tablets: 100 mg, 150 mg, 200 Effective in  CV: Tingling of face, flushing, Contraindicated in patients Monitor vital signs closely as large
mg managing neonatal palpitation, tachycardia or bradycardia, hypersensitive to drug as well doses may cause intensification
apnea, and as an ventricular ectopic beats.  as in those with acute MI, rather than reversal of severe drug-
Solution: 250 mg/mL adjuvant for pain  GI: Nausea, vomiting; epigastric symptomatic cardiac induced depressions.
control in discomfort, gastric irritation arrhythmias, palpitations and
Caffeine citrate injection: 20 headaches and  CNS: Nervousness, peptic ulcer Observe children closely following
mg/mL following dural insomnia, restlessness administration as they are more
puncture. Relief of  Respiratory: Tachypnea.  susceptible than adults to the CNS
headache is  Special Senses: Scintillating scotomas, effects of caffeine.
perhaps due to tinnitus. 
mild cerebral  Urogenital: Increased urination,
 vasoconstriction diuresis.
action and
increased vascular
tone. It acts as a
bronchodilator in
asthma and may
improve
psychomotor
performance
through CNS
stimulation

2 new Drugs of Methylxanthine Derivatives

DRUGS DOSAGE THERAPEUTIC ACTION ADVERSE EFFECTS CONTRAINDICATIO NURSING CONSIDERATIONS

NS
Dyphylline Tablet: 200 mg, 400 mg Drug has bronchodilator effects.  CNS: Headache, irritability, Contraindicated in Monitor therapeutic effectiveness;
restlessness, dizziness, insomnia, patients usually occurs at a blood level of at
Elixir: 100 mg/15 mL, light-headedness, muscle hypersensitive to least 12 mcg/mL.
160 mg/15 mL twitching, convulsions.  xanthine compounds;
 CV: Palpitation, tachycardia, extrasyst apnea in newborns. Take medication consistently with or
Injection: 250 mg/mL oles, flushing, hypotension.  Safe use during without food at the same time each
 GI: Nausea, vomiting, diarrhea, pregnancy (category day.
anorexia, epigastric distress.  C) or lactation is not
 Respiratory: Tachypnea.  established. Avoid alcohol and also large amounts
 Other: Albuminuria, fever, dehydration of coffee and other xanthine-
containing beverages (e.g., tea,
cocoa, cola) during therapy.

Consult physician before taking OTC

preparations. Many OTC drugs for
coughs, colds, and allergies contain
ephedrine or other sympathomimetics
and xanthines (e.g., caffeine,
theophylline, aminophylline).
Doxofylline Capsule (oral): 300mg There is evidence that doxofylline  CNS: Irritability, insomnia, and Contraindicated in Monitor vital signs.
may exert anti-inflammatory headache. patient who have
 Solution (oral): 2g actions by reducing the pleurisy
induced by the inflammatory
Powder for solution mediator platelet activating factor
(Oral): 200mg (PAF) according to a rat study. It
is suggested that doxofylline may
Injection, solution play an important role in
(IV): 300mg/100ml attenuating leukocyte diapedesis,
supported by mouse preclinical
studies where doxofylline
administration was associated
with inhibited leukocyte migration
across vascular endothelial cells
in vivo and in vitro. Unlike
theophylline, doxofylline does not
inhibit tumor necrosis factor-
induced interleukin (IL)- secretion
in ASM cells
 CV: Tachycardia heart problems, Doxofylline should not be
 GI: Nausea, vomiting, and stomach pregnant, and low administered together with other
pain blood pressure. xanthine derivatives, including
beverages and foods containing
caffeine.
Daxofylline should be given to a
pregnant woman only if clearly
needed.
Use with caution in patients with
hypertension, heart disease,
hypoxemia, hyperthyroidism, chrome
right ventricular failure, congestive
heart failure, liver disease, renal
disease, in those with history of
peptic ulcer and in elderly.

Intranasal Glucocorticoids

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Budesonide Inhalation: 32 Inhibit against  CNS: Dizziness, emotional lability, facial Contraindicated in patients Monitor closely for S&S of
mcg/inhalation multiple cell types edema, nervousness, headache, agitation, hypersensitive to drug as hypercorticism if concomitant
(e.g., neutrophils, confusion, insomnia, drowsiness.  well as in those with ongoing doses of ketoconazole or other
Capsule: 3 mg macrophages) and  CV: Chest pain, hypertension, palpitations, lactation. CYP3A4 inhibitors
mediators (e.g., sinus tachycardia. 
histamine,  GI: Abdominal pain, dyspepsia, gastroenteritis Monitor patients with moderate
cytokines) involved  Hematologic: Epistaxis.  to severe liver disease for
in allergic and  Metabolic: Hypokalemia, weight gain.  increased S&S of
nonallergic/irritant-  Respiratory: Bronchospasms, infections, cough hypercorticism.
mediated , rhinitis, sinusitis, dyspnea, hoarseness,
inflammation.
 wheezing. 
 Urogenital: Intermenstrual bleeding, dysuria
Dexamethasone Tablets: 0.25 mg, 0.5 mg, Inhibits anti-  CNS: Euphoria, insomnia, convulsions, Contraindicated in patients Monitor and report S&S of
0.75 mg, 1 mg, 1.5 mg, 2 inflammatory and increased ICP, vertigo, headache, psychic hypersensitive to drug as Cushing's syndrome or other
mg, 4 mg, 6 mg immunosuppressio disturbances.  well as in those with acute systemic adverse effects.
n properties.  CV: CHF, hypertension, edema.  infections, active or resting
Oral solution: 0.5 mg/5  Endocrine: Menstrual tuberculosis, vaccinia, or Monitor neonates born to a
mL, 0.5 mg/0.5 mg. irregularities, hyperglycemia; cushingoid state; varicella mother who has been receiving
growth suppression in children; hirsutism.  a corticosteroid during
Topical aerosol: 0.01%,  GI: Peptic ulcer with possible perforation, pregnancy for symptoms of
0.04%. abdominal distension, nausea, increased hypoadrenocorticism.
appetite, heartburn, dyspepsia,
pancreatitis, bowel perforation, oral Monitor for S&S of a
candidiasis.  hypersensitivity reaction. The
acetate and sodium phosphate
formulations may contain
bisulfites, parabens, or both;
these inactive ingredients are
allergenic to some individuals

2 new Drugs of Intranasal Glucocorticoids

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Budesonide Inhalation: 32 Inhibit against  CNS: Dizziness, emotional lability, facial Contraindicated in patients Monitor closely for S&S of
mcg/inhalation multiple cell types edema, nervousness, headache, agitation, hypersensitive to drug as hypercorticism if concomitant
(e.g., neutrophils, confusion, insomnia, drowsiness.  well as in those with ongoing doses of ketoconazole or other
Capsule: 3 mg macrophages) and  CV: Chest pain, hypertension, palpitations, lactation. CYP3A4 inhibitors
mediators (e.g., sinus tachycardia. 
histamine,  GI: Abdominal pain, dyspepsia, gastroenteritis Monitor patients with moderate
cytokines) involved  Hematologic: Epistaxis.  to severe liver disease for
in allergic and  Metabolic: Hypokalemia, weight gain.  increased S&S of
nonallergic/irritant- hypercorticism.
 mediated  Respiratory: Bronchospasms, infections, cough
inflammation. , rhinitis, sinusitis, dyspnea, hoarseness,
wheezing. 
 Urogenital: Intermenstrual bleeding, dysuria
Dexamethasone Tablets: 0.25 mg, 0.5 mg, Inhibits anti-  CNS: Euphoria, insomnia, convulsions, Contraindicated in patients Monitor and report S&S of
0.75 mg, 1 mg, 1.5 mg, 2 inflammatory and increased ICP, vertigo, headache, psychic hypersensitive to drug as Cushing's syndrome or other
mg, 4 mg, 6 mg immunosuppressio disturbances.  well as in those with acute systemic adverse effects.
n properties.  CV: CHF, hypertension, edema.  infections, active or resting
Oral solution: 0.5 mg/5  Endocrine: Menstrual tuberculosis, vaccinia, or Monitor neonates born to a
mL, 0.5 mg/0.5 mg. irregularities, hyperglycemia; cushingoid state; varicella mother who has been receiving
growth suppression in children; hirsutism.  a corticosteroid during
Topical aerosol: 0.01%,  GI: Peptic ulcer with possible perforation, pregnancy for symptoms of
0.04%. abdominal distension, nausea, increased hypoadrenocorticism.
appetite, heartburn, dyspepsia,
pancreatitis, bowel perforation, oral Monitor for S&S of a
candidiasis.  hypersensitivity reaction. The
acetate and sodium phosphate
formulations may contain
bisulfites, parabens, or both;
these inactive ingredients are
allergenic to some individuals

Leukotriene Receptor Antagonists

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Zafirlukast Tablets: 10 mg, 20 mg. Inhibits airway edema,  Body as a Whole: Generalized pain, asthenia, myalgia, Contraindicated in patients Assess respiratory status and airway
smooth muscle fever, back pain.  hypersensitive to drug as well as function regularly.
constriction, and cellular  CNS: Headache, dizziness.  in those with acute asthma
activity.  GI: Nausea, diarrhea, abdominal pain, vomiting, attacks. Monitor closely PT and INR with
dyspepsia; liver dysfunction, increased liver function concurrent warfarin therapy.
tests, hepatic failure. 
 Other: Churg-Strauss syndrome (fever, muscle aches Monitor closely phenytoin level with
and pains, weight loss). concurrent phenytoin therapy.
Zileuton Tablets: 600 mg. Decreased frequency  Body as a Whole: Pain, asthenia, myalgia Contraindicated in patients Assess respiratory status and airway
and severity of acute  CNS: Headache, dizziness, insomnia, nervousness, hypersensitive to drug as well as function regularly.
asthma attacks somnolence.  in these with active liver disease
 CV: Chest pain.  Reduce theophylline dose and closely
 GI: Abdominal pain, dyspepsia, nausea, constipation monitor theophylline levels; closely
 Skin: Pruritus.  monitor PT and INR with warfarin
therapy; closely monitor phenytoin level
 Other: Conjunctivitis, hypertonia, lymphadenopathy,
with phenytoin therapy
vaginitis, UTI, leukopenia.
Closely monitor HR and BP for
excessive beta blockade with
propranolol therapy.
Lung Sulfucant

DRUGS DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS

ACTION
Beractant Suspension: 25 mg/mL Lowers minimum
surface tension and
restores pulmonary
compliance and
oxygenation in
premature infants
DRUGS DOSAGE THERAPEUTIC
ACTION
Poractant Vial: 120 mg/1.5 mL, 240 mg/3 mL Alleviates respiratory
distress syndrome
(RDS) in premature
infants caused by
deficiency of surfactant
Calfactant Suspension: 35mg/mL Effectively relieves and
prevents RDS in
neonates
 CV: Transient bradycardia.  Contraindicated in patients Monitor heart rate, color, chest
 Respiratory: Oxygen desaturation.  hypersensitive to drug as well as expansion, facial expressions, oximeter,
 Other: Increased probability of posttreatment nosocomial in those with nosocomial and endotracheal tube patency and
sepsis in surfactant-treated infants was observed in the infections. position, during administration. Most
controlled clinical trials but was not associated with adverse effects occur during dosing.
increased mortality.
Monitor frequently with arterial or
transcutaneous measurement of
systemic oxygen and CO2.
2 new Drugs of Lung Sulfucant
ADVERSE EFFECTS CONTRAINDICATIONS NURSING CONSIDERATIONS
 CV: Bradycardia, hypotension.  Contraindicated in patients Stop administration of poractant alfa and
 Respiratory: Intratracheal tube blockage, hypersensitive to porcine or take appropriate measures if any of the
oxygen desaturation poractant alpha. following occur: Transient episodes of
bradycardia, decreased oxygen saturation,
reflux of poractant alfa into endotracheal
tube, or airway obstruction. Dosing may
resume after stabilization.
Do not suction airway for 1 h after poractant
alfa instillation unless there is significant
airway obstruction
 CV: Bradycardia.  Contraindicated in patients with Monitor closely during and after
 Respiratory: Cyanosis, airway obstruction, nosocomial infections. administration adjustments in oxygen
reflux of surfactant into endotracheal tube. therapy and ventilator pressures are usually
needed.
This drug will help baby to breathe properly
and support normal respiratory function.