Generic and Brand Classification/s Indication / Specific Dosage, Frequency Side Effects and Actual Desired Nursing

Name Action / Mechanism and Preparation Adverse Reactions Effects Considerations

of Action

Carboprost Therapeutic Class: Indication: Pregnant women: Initial Vomiting, diarrhea, Encourage the patient to
tromethamine Abortifacient Failure of expulsion of dose is 1 mL then Nausea, Flushing, report any side effects
(Hemabate) the fetus throughout the increased to 250 warmth, Cough, Hiccups, especially rashes, or any
Pharmacologic Class: treatment. In the micrograms IM, in the Headaches, Menstrual other forms of adverse
Oxytoxics, presence of a pre-viable intervals of 1 ½ to 3 ½ Cramps, Chills reactions
Prostaglandins fetus and in the absence depending in uterine
of appropriate activity response.
for evacuation,
membranes rupture
inadvertently or
spontaneously. It is also
used to treat
postpartum hemorrhage
caused by uterine atony
that hasn’t responded to
traditional treatment
options.

Mechanism of Action:
Promotes uterine
contractions by
inhibiting Prostaglandins
that result into expulsion
of placenta and its
contents.
 Generic and Brand Classification/s Indication / Specific Dosage, Frequency Side Effects and Actual Desired Nursing
Name Action / Mechanism and Preparation Adverse Reactions Effects Considerations
of Action

Misoprostol Therapeutic Class: Indication: Intravaginal: 800 mcg Side Effects: Question for possibility
(Cytotec, Novo- Antisecretory, gastric Replaces protective once; may repeat 3 or Frequent (40%–20%): of pregnancy before
misoprostol) protectant prostaglandins more hrs after first dose Abdominal pain, initiating therapy.
Pharmacologic Class: consumed with and within 7 days of no diarrhea.
Oxytoxics, prostaglandin-inhibiting response to initial dose. Avoid magnesium-
Prostaglandins therapies (e.g., NSAIDs). Occasional (3%–2%): containing antacids
Induces uterine Incomplete Abortion, Nausea, flatulence, (minimizes potential for
contractions. Postpartum Hemorrhage dyspepsia, headache. diarrhea).
PO: 600 mcg as a single
Mechanism of Action: dose. Rare (1%): Vomiting, Women of childbearing
Reduces acid secretion constipation. potential must not be
from gastric parietal Labor Induction or pregnant before or
cells, stimulates Cervical Ripening Adverse Reactions: during medication
bicarbonate production Intravaginal: 25 mcg q3– Overdosage may therapy (may result in
from gastric/duodenal 6 hrs. Some pts may produce sedation, hospitalization, surgery,
mucosa. require 50 mcg q6 hrs. tremor, seizures, infertility, fetal death).
Maximum: 50 mcg/dose dyspnea, palpitations,
hypotension, Incidence of diarrhea
bradycardia may be lessened by
taking immediately
following meals
 Generic and Brand Classification/s Indication / Specific Dosage, Frequency Side Effects and Actual Desired Nursing
Name Action / Mechanism and Preparation Adverse Reactions Effects Considerations
of Action

Oxytocin Therapeutic Class: Indication: Induction or Stimulation Side Effects: Baseline assessment
(Pitocin) Oxytocic agent. Uterine smooth muscle of Labor IV: ADULTS: Occasional: Tachycardia, Assess baselines for vital
stimulant. 0.5–1 milliunit/min. May premature ventricular signs, B/P, fetal heart
Pharmacologic Class: gradually increase in contractions, rate. Determine
Uterine smooth muscle Mechanism of Action: increments of 1–2 hypotension, nausea, frequency, duration,
stimulant. Stimulates uterine milliunits/min q30–60 vomiting. strength of contractions.
contractions. minutes until desired
contraction pattern is Rare: Nasal: Intervention/evaluation
established. Rates Lacrimation/tearing, Monitor B/P, pulse,
greater than 9–10 nasal irritation, respirations, fetal heart
milliunits/min are rarely rhinorrhea, unexpected rate, intrauterine
required. uterine pressure, contractions
bleeding/contractions. (duration, strength,
Control of Postpartum frequency) q15min.
Bleeding IV Infusion: Fetal: Bradycardia, Notify physician of
ADULTS: 10–40 units in CNS/brain damage, contractions that last
1,000 mL IV fluid at rate trauma due to rapid longer than 1 min, occur
sufficient to sustain propulsion, low Apgar more frequently than
uterine contractions and score at 5 min, retinal every 2 min, or stop.
control uterine atony. hemorrhage occur Maintain careful I&O; be
IM: ADULTS: 10 units rarely. Prolonged IV alert to potential water
(total dose) after infusion of oxytocin with intoxication. Check for
delivery. excessive fluid volume blood loss.
has caused severe water
intoxication with Patient/family teaching •
seizures, coma, death Keep pt, family informed
of labor progress.
 Generic and Brand Classification/s Indication / Specific Dosage, Frequency Side Effects and Actual Desired Nursing
Name Action / Mechanism and Preparation Adverse Reactions Effects Considerations
of Action

Methylergonovine Therapeutic Class: Indication: Prevention/Treatment of Frequent: Nausea, Baseline assessment.

maleate Oxytocic agent and Shortens third stage of Postpartum, uterine cramping, Determine baseline serum
(methergine) uterine stimulant labor, reduces blood Postabortion vomiting. calcium level, B/P, pulse.
loss. Hemorrhage PO: Assess for any evidence of
bleeding before
Pharmacologic Class: ADULTS: 0.2 mg 3–4 Occasional: Abdominal
administration.
Ergot alkaloid Mechanism of Action: times daily. Continue for pain, diarrhea, dizziness,
Increases tone, rate, up to 7 days. diaphoresis, tinnitus, Intervention/evaluation
amplitude of contraction bradycardia, chest pain. Monitor uterine tone,
of uterine smooth IV, IM: ADULTS: Initially, bleeding, B/P, pulse
muscle. 0.2 mg after delivery of Rare: Allergic reaction q15min until stable (about
anterior shoulder, after (rash, pruritus), dyspnea, 1–2 hrs). Assess extremities
delivery of placenta, or severe or sudden for color, warmth,
during puerperium. May hypertension. movement, pain. Report
repeat q2–4h as needed. chest pain promptly.
Provide support with
ambulation if dizziness
occurs.

Patient/family teaching
•Avoid smoking: causes
increased vasoconstriction.

• Report increased
cramping, bleeding, foul-
smelling lochia.

• Report pale, cold

hands/feet (possibility of
diminished circulation)..
 Generic and Brand Classification/s Indication / Specific Dosage, Frequency Side Effects and Actual Desired Nursing
Name Action / Mechanism and Preparation Adverse Reactions Effects Considerations
of Action

Hydralazine Therapeutic Class: Indication: PO: ADULTS, ELDERLY: Side Effects: Baseline assessment
(Apresoline) Antihypertensive. Direct vasodilating Initially, 10 mg 4 Occasional: Headache, Obtain B/P, pulse
effects on arterioles. times/day for first 2–4 anorexia, nausea, immediately before each
Pharmacologic Class: days. May increase to 25 vomiting, diarrhea, dose, in addition to
Vasodilator. Mechanism of Action: mg 4 times/day balance palpitations, regular monitoring (be
Decreases B/P, systemic of first wk. May increase tachycardia, angina alert to fluctuations)
vascular resistance. by 10–25 mg/dose pectoris
gradually q2–5 days to Intervention/evaluation
50 mg 4 times/day. Rare: Constipation, ileus, Monitor B/P, pulse.
Usual range: 25–100 mg edema, peripheral Monitor for headache,
in 2–3 divided doses. neuritis (paresthesia), palpitations,
Maximum: 300 mg/day dizziness, muscle tachycardia. Assess for
in divided doses cramps, anxiety, peripheral edema of
hypersensitivity hands, feet.
IV, IM: ADULTS, reactions (rash, urticaria,
ELDERLY: Initially, 10–20 pruritus, fever, chills, Patient/family teaching
mg/dose q4–6h. May arthralgia), nasal • To reduce hypotensive
increase to 40 mg/dose. congestion, flushing, effect, go from lying to
conjunctivitis. standing slowly.
• Report muscle/joint
aches, fever (lupus-like
reaction), flu-like
symptoms.
• Limit alcohol use.
 Generic and Brand Classification/s Indication / Specific Dosage, Frequency Side Effects and Actual Desired Nursing
Name Action / Mechanism and Preparation Adverse Reactions Effects Considerations
of Action

Nifedipine Therapeutic Class: Indication: Prinzmetal’s Variant Side Effects: Baseline assessment
(Adalat XL, Apo-Nifed) Antianginal, Increases heart rate, Angina, Chronic Stable Frequent: Concurrent therapy with
antihypertensive. myocardial oxygen (Effort-Associated) Peripheral edema, sublingual nitroglycerin
delivery, cardiac output. Angina PO (Immediate- headache, flushed skin, may be used for relief of
anginal pain. Record onset,
Pharmacologic Class: Decreases systemic Release): ADULTS, dizziness.
type (sharp, dull,
Calcium channel blocker, vascular resistance, B/P. ELDERLY: Initially, 10 mg squeezing), radiation,
dihydropyridine. 3 times/day. Increase at Occasional: Nausea, location, intensity, duration
Mechanism of Action: 7- to 14-day intervals. shakiness, muscle of anginal pain;
Inhibits calcium ion Maintenance: 10 mg 3 cramps/pain, precipitating factors
movement across cell times/day up to 30 mg 4 drowsiness, palpitations, (exertion, emotional
membranes, depressing times/day. Maximum: nasal congestion, cough, stress). Check B/P for
contraction of cardiac, 180 mg/day. PO dyspnea, wheezing. hypotension immediately
vascular smooth muscle. (Extended-Release): before giving medication.
ADULTS, ELDERLY: Rare: Hypotension, rash,
Intervention/evaluation
Initially, 30–60 mg/day. pruritus, urticaria,
Assist with ambulation if
May increase at 7- to 14- constipation, abdominal light-headedness, dizziness
day intervals. Maximum: discomfort, flatulence, occurs. Assess for
120 mg/day. sexual dysfunction. peripheral edema. Assess
skin for flushing. Monitor
Hypertension LFT. Observe for
PO (Extended-Release): signs/symptoms of HF.
ADULTS, ELDERLY:
Initially, 30–60 mg/day. Patient/family teaching
May increase at 7- to 14- • Go from lying to standing
slowly. • Report
day intervals. Maximum:
palpitations, shortness of
90–120 mg/day breath, pronounced
dizziness, nausea,
exacerbations of angina. •
Avoid alcohol; concomitant
grapefruit product use.
 Generic and Brand Classification/s Indication / Specific Dosage, Frequency Side Effects and Actual Desired Nursing
Name Action / Mechanism and Preparation Adverse Reactions Effects Considerations
of Action

Cephalexin Therapeutic Class: Indication: PO: ADULTS, ELDERLY: Side Effects: Baseline assessment
(Apo-Cephalex) First-generation Bactericidal 250–1,000 mg q6h or Occasional: Nausea, Obtain CBC, renal
cephalosporin. 500 mg q12h. Maximum: serum sickness–like function tests. Question
Mechanism of Action: 4 g/day. reaction (fever, joint for history of allergies,
Pharmacologic Class: Binds to bacterial cell . pain; usually occurs after particularly
Antibiotic. membranes, inhibits cell second course of cephalosporins,
wall synthesis therapy and resolves penicillins.
after drug is
discontinued) Intervention/evaluation
Assess oral cavity for
Frequent: Oral white patches on
candidiasis, mild mucous membranes,
diarrhea, mild tongue (thrush). Monitor
abdominal cramping, daily pattern of bowel
vaginal candidiasis. activity, stool
consistency. Mild GI
Rare: Allergic reaction effects may be tolerable
(rash, pruritus, urticaria). (increasing severity may
indicate onset of
antibiotic-associated
colitis). Monitor I&O,
renal function tests for
nephrotoxicity. Be alert
for superinfection: fever,
vomiting, diarrhea,
anal/genital pruritus,
oral mucosal changes
(ulceration, pain,
erythema). With
prolonged therapy,
monitor renal/hepatic
function tests.

Patient/family teaching
Doses should be evenly
spaced.
• Continue therapy for
full length of treatment.
• May cause GI upset
(may take with food,
milk).
• Refrigerate oral
suspension.
• Report persistent
diarrhea.
.
 Generic and Classification/s Indication / Specific Dosage, Frequency and
Brand Name Action / Mechanism
of Action
Mefenamic Acid Therapeutic Class: Indication:
(Dolfenal, Antianginal,
Ponstel) antihypertensive. For the treatment of
rheumatoid arthritis,
Pharmacologic osteoarthritis,
Class: dysmenorrhea, and
Calcium channel mild to moderate
blocker,
pain, inflammation,
dihydropyridine.
and fever.
Mechanism of Action:
Mefenamic acid binds
the prostaglandin
synthetase receptors
COX-1 and COX-2,
inhibiting the action of
prostaglandin
synthetase. As these
receptors have a role
as a major mediator of
inflammation and/or a
role for prostanoid
signaling in activity-
dependent plasticity,
the symptoms of pain
are temporarily
reduced.
Side Effects and Actual Desired Effects Nursing Considerations
Preparation Adverse Reactions
• Oral cl=21.23 Side Effects: Baseline assessment
L/hr [Healthy >CNS:Drowsiness,in Concurrent therapy with
adults (18-45 somia,dizziness,ner sublingual nitroglycerin may be
vousness,confusion, used for relief of anginal pain.
yrs)]
headache.>GI: Record onset, type (sharp, dull,
Severediarrhea,ulce squeezing), radiation, location,
intensity, duration of anginal
ration,
pain; precipitating factors
andbleeding;nausea,
(exertion, emotional stress).
vomiting, Check B/P for hypotension
abdominalcramps,fl immediately before giving
atus,constipation, medication.
hepatictoxicity.>He
matologic:prolonge Intervention/evaluation
dprothrombin. Assist with ambulation if light-
headedness, dizziness occurs.
Assess for peripheral edema.
Assess skin for flushing. Monitor
LFT. Observe for signs/symptoms
of HF.
Patient/family teaching
• Go from lying to standing
slowly. • Report palpitations,
shortness of breath, pronounced
dizziness, nausea, exacerbations
of angina. • Avoid alcohol;
concomitant grapefruit product
use.
 Generic and Classification/s Indication / Specific Dosage, Frequency and Side Effects and Actual Desired Effects Nursing Considerations
Brand Name Action / Mechanism Preparation Adverse Reactions
of Action

Ferrous Sulfate Therapeutic Class: Indication: ADULTS, ELDERLY: 60 Side Effects: Baseline assessment
(Apo-Ferrous Iron preparation. Prevents iron deficiency. mg/day. Occasional: Mild, Assess nutritional status,
Sulfate) transient nausea. dietary history. Question
Pharmacologic Mechanism of Action: history of hemochromatosis,
Class: Promotes effective Rare: Heartburn, hemolytic anemia, ulcerative
Enzymatic erythropoiesis and anorexia, colitis. Question use of
mineral. transport, utilization of constipation, antacids, calcium supplements
oxygen. diarrhea.
Intervention/evaluation
Monitor serum iron, total
iron-binding capacity,
reticulocyte count, Hgb,
ferritin. Monitor daily pattern
of bowel activity, stool
consistency. Assess for clinical
improvement, record relief of
iron deficiency symptoms
(fatigue, irritability, pallor,
paresthesia of extremities,
headache).

Patient/family teaching
• Expect stool color to darken.
• Oral liquid may stain teeth. •
To prevent mucous
membrane and teeth staining
with liquid preparation, use
dropper or straw and allow
solution to drop on back of
tongue. • If GI discomfort
occurs, take after meals or
with food. • Do not take
within 2 hrs of other
medication or eggs, milk, tea,
coffee, cereal. • Do not take
antacids or OTC calcium
supplements.
 Generic and Classification/s Indication / Specific Dosage, Frequency and
Brand Name Action / Mechanism
of Action
Acetaminophen Therapeutic Class: Indication:
(Paracetamol, Non-narcotic Results in antipyresis.
Abenol) analgesic, Produces analgesic
antipyretic effect.
Pharmacologic
Class: Mechanism of Action:
Central analgesic.. Appears to inhibit
prostaglandin synthesis
in the CNS and, to a
lesser extent, block pain
impulses through
peripheral action. Acts
centrally on
hypothalamic heat-
regulating center,
producing peripheral
vasodilation (heat loss,
skin erythema,
diaphoresis).
Acetaminophen Overdose
It is essential to initiate
Side Effects and Actual Desired Effects Nursing Considerations
Preparation Adverse Reactions
• Inhalation, Side Effects: Baseline assessment
Nebulization Rare: Mucolytic: Assess
Bronchodilators Hypersensitivity pretreatment respirations for
should be given reaction. rate, depth, rhythm. IV
10–15 min before antidote: Obtain baseline LFT,
acetylcysteine. PT/INR and drug screen. For
ADULTS, ELDERLY, use as antidote, obtain
CHILDREN: 3–5 mL acetaminophen level to
(20% solution) 3–4 determine need for treatment
times/day or 6–10 with acetylcysteine..
mL (10% solution)
3–4 times/day. Intervention/evaluation
Range: 1–10 mL If bronchospasm occurs,
(20% solution) q2– discontinue treatment, notify
6h or 2–20 mL physician; bronchodilator may
(10% solution) q2– be added to therapy. Monitor
6h. INFANTS: 1–2 rate, depth, rhythm, type of
mL (20%) or 2–4 respiration (abdominal,
mL (10%) 3–4 thoracic). Observe sputum for
times/day. color, consistency, amount. IV
Intratracheal: antidote: Administer within 8
ADULTS, hrs of acetaminophen
CHILDREN: 1–2 mL ingestion for maximal hepatic
of 10% or 20% protection; ideally, within 4
solution instilled hrs after immediate-release
into tracheostomy and 2 hrs after liquid
q1–4h. acetaminophen formulations.
Patient/family teaching
• Slight, disagreeable sulfuric
odor from solution may be
treatment as soon as noticed during initial
possible after overdose administration but disappears
and, in any case, within 24 quickly. • Adequate hydration
hrs of ingestion. PO is important part of therapy. •
(Effervescent Tablets, Oral Follow guidelines for proper
Solution 5%): ADULTS, coughing and deep breathing
ELDERLY, CHILDREN: techniques. • Auscultate lung
Loading dose of 140 sounds.
mg/kg, followed in 4 hrs
by maintenance dose of
70 mg/kg q4h for 17
additional doses (or until
acetaminophen assay
reveals nontoxic level).
Repeat dose if emesis
occurs within 1 hr of
administration.
IV:ADULTS, ELDERLY,
CHILDREN: (Consists of 3
doses. Total Dose: 300
mg/kg.) 150 mg/kg
infused over 60 min, then
50 mg/kg infused over 4
hrs, then 100 mg/kg
infused over 16 hrs (see
Administration/Handling
for dilution). GREATER
THAN 100 KG: (Consists of
3 doses. Total Dose: 30 g.)
15 g over 60 min; 5 g over
4 hrs; 10 g over 16 hrs.
Duration of administration
may vary depending on
acetaminophen levels and
LFTs obtained during
treatment. Pts who still
have detectable levels of
acetaminophen or
elevated LFT results
continue to benefit from
additional acetylcysteine
administration beyond 24
hrs. Diagnostic Bronchial
Studies Inhalation,
Nebulization: ADULTS: 1–2
mL of 20% solution or 2–4
mL of 10% solution 2–3
times before the
procedure