Jawood, Kedren Kent G.

BSN 4B/Sherwin G. Maputol, RN, MAN

Drug Study

Date and Drug Name/ Classifications/ Indications/ Adverse Nursing Actions

Time Dosage/Frequency/ Mechanism of Contraindications Reaction
Ordered Route/Timing Action

March 23, Generic: Keterolac - Nonsteroidal anti- - Short term CNS: - Monitor BP upon
2023 Brand: Toradol inflammatory management of - drowsiness administration.
9:00 AM agents, nonopioid pain (not to exceed - abnormal < 90/80never
1 amp IVTT STAT analgesics 5 days total for all thinking administer. Refer to
routes combined - dizziness doctor.
- Inhibits - euphoria
prostaglandin Contraindicated - headache - Patients who have
synthesis, with: asthma, aspirin-induced
producing - Hypersensitivity RESP: allergy, and nasal polyps
peripherally - Cross-sensitivity - asthma are at increased risk
mediated with other NSAIDs - dyspnea for developing
analgesia may exist hypersensitivity reactions.
CV: Assess for rhinitis,
- antipyretic and Pre or - edema asthma, and urticaria
anti-inflammatory perioperative use: - pallor
properties. - Known alcohol - vasodilation - Assess pain (note type,
intolerance location, and intensity)
- Therapeutic GI: prior to and1-2 hrs
effect: Decreases Use cautiously in: - GI Bleeding following administration.
pain - History of GI - abnormal
bleeding taste - Ketorolac therapy should
- Renal impairment - diarrhea always be given initially by
(dosage reduction - dry mouth the IM or IV route. Oral
may be required) - dyspepsia therapy should be used
- Cardiovascular - GI pain only as a continuation
disease - nausea of parenteral therapy.
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
GU: - Caution patient to avoid
- oliguria concurrent use of alcohol,
- renal toxicity aspirin, NSAIDs,
- urinary acetaminophen, or other
frequency OTC medications
without consulting
DERM: health care professional.
- pruritis
- purpura - Advise patient to
- sweating consult if rash, itching,
- urticaria visual disturbances,
tinnitus, weight gain,
HEMAT: edema, black stools,
- prolonged persistent headche, or
bleeding time influenza-like
syndromes
LOCAL: (chills,fever,muscles
- injection site aches, pain) occur.
pain
- Effectiveness of
NEURO: therapy can be
- paresthesia demonstrated by
decrease in severity of
MISC: pain. Patients who do
- allergic not respond to one
reaction, NSAIDs may respond to
anaphylaxis another.
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN

Drug Study

Date and Drug Name/ Classifications Indications/ Adverse Nursing Actions

Time Dosage/Frequency/ Mechanism of Contraindications Reaction
Ordered Route/Timing Action

March 23, Generic: Cefazolin - First-generation - Respiratory tract CNS: Patient monitoring:
2023 Brand: Ancef cephalosporin infections caused - headache - If patient is receiving
9:00 AM antibiotic, Anti- by group A beta- - lethargy high doses, monitor for
1 g IVTT STAT infective hemolytic - confusion extreme confusion,
streptococci, - hemiparesis tonicclonic seizures,
- Interferes with Klebsiella species, - paresthesia and mild hemiparesis.
bacterial cell-wall Haemophilus - syncope
synthesis, causing influenzae, and - seizures - Monitor CBC,
cell to rupture and Staphylococcus prothrombin time, and
die aureus CV: kidney and liver
- hypotension function test results.
- Skin infections - palpitations
caused by S. - chest pain - Watch for signs and
aureus and beta- - vasodilation symptoms of
hemolytic superinfection and
streptococci EENT other serious adverse
- hearing loss reactions.
- Biliary tract
infections caused GI - Be aware that cross-
by Escherichia - nausea sensitivity to penicillins
coli, Klebsiella - vomiting may occur.
species, Proteus - diarrhea
mirabilis, and S. - abdominal Patient teaching:
aureus cramps - Tell patient to report
- oral reduced urinary
candidiasis output, persistent
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
- Bone and joint - pseudomem- diarrhea, bruising, or
infections caused branous colitis bleeding.
by S. aureus; - Instruct patient to
GU: take drug exactly as
- Genital infections - vaginal prescribed and to
caused by E. coli, candidiasis complete full course of
Klebsiella species, - nephrotoxicity therapy even when he
P. mirabilis, and feels better.
strains of Hematologic:
enterococci - lymphocytosis - As appropriate,
- eosinophilia review all other
- Septicemia - bleeding significant and life-
caused by E. coli, tendency threatening adverse
Klebsiella species, - hemolytic reactions and
P. mirabilis, S. anemia interactions, especially
aureus, and S. - those related to the
pneumoniae hypoprothrombi- drugs, tests, and
nemia behaviors mentioned
- Endocarditis - neutropenia, above.
caused by S. - thrombocyte-
aureus or penia
betahemolytic - agranulocyto-
streptococci sis
- bone marrow
Contraindicated depression
with:
- Hypersensitivity Hepatic:
to cephalosporins - hepatic failure
or penicillins - hepatomegaly

Use cautiously in: Musculoskeletal:

- Renal - arthralgia
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
impairment, Respiratory:
phenylketonuria - dyspnea
- History of GI
disease (especially Skin:
colitis) - urticaria,
- Emaciated maculopapular
patients or erythematous
- Elderly patients rash
- Pregnant or
breastfeeding Other:
patients - chills
- Children - fever
- superinfection
- anaphylaxis
- serum
sickness
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN

Drug Study

Date and Drug Name/ Classifications/ Indications/ Adverse Nursing Actions

Time Dosage/Frequency/ Mechanism of Contraindications Reaction
Ordered Route/Timing Action

March 23, Generic: - Proton pump - Gastroesopha- CNS: Patient monitoring:

2023 Omeprazole inhibitor, antiulcer geal reflux - dizziness - Assess vital signs.
9:00 AM Brand: Prilosec drug disease, erosive - headache - Check for abdominal
esophagitis, short- - asthenia pain, emesis, diarrhea,
40 mg IV OD - Reduces gastric term treatment of or constipation.
acid secretion and active duodenal GI: - Evaluate fluid intake
increases gastric ulcer, reduce risk - nausea and output.
mucus and of duodenal ulcers - vomiting - Watch for elevated
bicarbonate caused by - diarrhea liver function test results
production, Helicobacter pylori, - constipation (rare).
creating protective gastric ulcers, - abdominal - Monitor magnesium
coating on gastric pathologic pain level before starting
mucosa and hypersecretory drug and periodically
easing discomfort conditions, Metabolic: thereafter in patients
from excess including Zollinger- - hypomagne- expected to be on long-
gastric acid Ellison syndrome, semia term treatment or who
and frequent take proton pump
heartburn (two or Musculoskele inhibitors with other
more episodes a tal: drugs such as digoxin or
week) - back pain; drugs that may cause
fractures of hypomagnesemia.
Contraindicated hip, wrist,
with: spine (with Patient teaching:
- Hypersensitivity long-term - Tell patient to take 30
to drug or its daily use) to 60 minutes before a
components
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
Respiratory: meal, preferably in
Use cautiously to: - cough morning.
- Hepatic disease - upper - Instruct patient to
- Hypomagnese- respiratory swallow capsules or
mia tract infection tablets whole and not to
- Concurrent use chew or crush them. If
of clopidogrel Skin: he can’t swallow
(avoid use) - rash capsule, tell him he may
- Pregnant or open it, carefully
breastfeeding sprinkle and mix entire
patients contents into 1 tbsp of
- Children (safety cool applesauce, and
not established). swallow immediately
with glass of water.

- Instruct patient on how

to use delayed-release
oral suspension: Empty
contents of a 2.5-mg
packet of powder into a
container with 5 ml of
water or 10-mg packet
of powder into a
container with 15 ml of
water; don’t use other
liquids or foods. Stir and
allow drug to thicken for
2 to 3 minutes. Stir well
and drink within 30
minutes. If any drug
remains after drinking,
add more water to
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
container, stir, and drink
immediately.

- Inform patient taking

OTC delayed release
tablets for heartburn that
full effect may take 1 to
4 days. Advise him not
to take tablets for more
than 14 days without
consulting health care
professional.
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN

Drug Study

Date and Drug Name/ Classifications/ Indications/ Adverse Nursing Actions

Time Dosage/Frequency/ Mechanism of Contraindications Reaction
Ordered Route/Timing Action

March 23, Generic: Amlodipine - Calcium channel - Essential CNS: Patient monitoring:
2023 Brand: Norvasc blocker, hypertension, - headache - Monitor patient for
9:00 AM antihypertensive chronic stable - dizziness worsening angina.
5 mg/tab PO OD angina pectoris, - drowsiness
- Inhibits influx of and vasospastic - lightheaded- - Monitor heart rate and
extracellular angina ness rhythm and blood
calcium ions, (Prinzmetal’s - fatigue pressure, especially at
thereby decreasing angina) - weakness start of therapy.
myocardial - lethargy
contractility, Contraindicated - Assess for heart
relaxing coronary with: CV: failure; report signs and
and vascular - Hypersensitivity - peripheral symptoms (peripheral
muscles, and to drug edema edema, dyspnea) to
decreasing - angina prescriber promptly.
peripheral Use cautiously in: - bradycardia
resistance - aortic stenosis, - hypotension - Give sublingual
severe hepatic - palpitations nitroglycerin, as
impairment, heart prescribed, if patient has
failure GI: signs or symptoms of
- elderly patients - nausea acute myocardial
- pregnant or - abdominal infarction (especially
breastfeeding discomfort when dosage is
patients increased).
- children
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
Musculoskel- Patient teaching:
etal: - If patient also uses
- muscle sublingual nitroglycerin,
cramps tell him he can take
- muscle pain nitroglycerin as needed
or for acute angina.
inflammation
- Caution patient to
Respiratory: avoid driving and other
- shortness of hazardous activities until
breath he knows how drug
- dyspnea affects concentration
- wheezing and alertness.

Skin: - As appropriate, review

- rash all other significant
- pruritus adverse reactions,
- urticaria especially those related
- flushing to the drugs and
behaviors mentioned
above.
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN

Drug Study

Date and Drug Name/ Classifications/ Indications/ Adverse Nursing Actions

Time Dosage/Frequency/ Mechanism of Contraindications Reaction
Ordered Route/Timing Action

March 23, Generic: Metformin - Biguanide, - Adjunct to diet GI: Patient monitoring:
2023 Brand: Glucophage, hypoglycemic and exercise to - diarrhea - When switching from
9:00 AM Glucophage XR improve glycemic - nausea chlorpropamide, stay
- Increases insulin control in type 2 - vomiting alert for hypoglycemia
500 mg/tab PO BID sensitivity by (non-insulin- - abdominal during first 2 weeks of
decreasing dependent) bloating metformin therapy;
glucose production diabetes mellitus chlorpropamide may
and absorption in Metabolic: stay in body for
liver and intestines - Concurrent use - lactic prolonged time.
and enhancing with sulfonylurea acidosis Conversion from other
glucose uptake or insulin in type 2 standard oral
and utilization diabetes mellitus Other: hypoglycemics requires
- unpleasant no transition period.
- Concurrent use metallic taste
with insulin in type - decreased - Monitor blood glucose
2 diabetes mellitus vitamin B12 level closely. If it isn’t
level controlled after 4 weeks
Contraindicated at maximum dosage,
with: oral sulfonylurea may be
- Hypersensitivity added.
to drug
- Acute or chronic - Monitor kidney and
metabolic acidosis liver function tests,
(including diabetic particularly in elderly
ketoacidosis) with patients.
or without coma
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
- Underlying renal - Assess hematologic
dysfunction parameters and vitamin
- Heart failure B12 levels at start of
requiring drug therapy and periodically
therapy thereafter.
- Watch for signs and
Use cautiously in: symptoms of lactic
- Renal acidosis. Stop drug if
impairment, acidosis occurs. To aid
myocardial differential diagnosis,
infarction, check electrolyte,
cerebrovascular ketone, glucose, blood
accident, hypoxia, pH, lactate, and
sepsis, pituitary metformin blood levels.
deficiency or
hyperthyroidism, - Periodically monitor
dehydration, glucose and
hypoxemia, glycosylated
chronic alcohol hemoglobin levels to
use evaluate drug efficacy.
- Elderly or
debilitated patients Patient teaching:
- Pregnant or - Teach patient about
breastfeeding diabetes and
patients importance of proper
- Children (safety diet, exercise, weight
not established) control, and blood
glucose monitoring.

- Inform patient that

drug may cause
diarrhea, nausea, and
upset stomach. Advise
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
him to take it with meals
to reduce these effects,
and tell him that adverse
effects often subside
over time.

- Teach patient to
recognize and
immediately report signs
and symptoms of
acidosis, such as
weakness, fatigue,
muscle pain, dyspnea,
abdominal pain,
dizziness, light-
headedness, and slow
or irregular heartbeat.

- Advise patient to report

changes in health status
(such as infection,
persistent vomiting and
diarrhea, or need for
surgery). These may
warrant dosage
decrease or drug
withdrawal.

- As appropriate, review
all other significant and
life-threatening adverse
reactions and
interactions, especially
Jawood, Kedren Kent G.
BSN 4B/Sherwin G. Maputol, RN, MAN
those related to the
drugs, tests, herbs, and
behaviors mentioned
above.