Drug Study

NAME OF PATIENT:T.S AGE:60 years old SEX: Female Name of Student: Castro, Sanrio Elaine V.
CIVIL STATUS: _ __RELIGION: ___________________________ RM/BED NO.________________________ Area: _______________Level / Block: III-A
ADDRESS:____________________________________________________________________________________________ Date Submitted: June 16, 2022
DATE OF ADMISSION: __________________________________ DIAGNOSIS: OSTEOPOROSIS Rating: __________________________________
Drug study No. 1

Drug Classification/ Indication Contraindication Side Effect Adverse Effect Nursing

Name/Dosage/ Mechanism of Consideration
Route Action
/Frequency/ Drug
Order

Generic Name: Pharmacological Class: Prevention and treatment This drug is • Abdominal pain CNS: BEFORE:
of osteoporosis in contraindicated to • Acid Headache - Check the 10 rights of
alendronate Bisphosphonate postmenopausal women, patients with: regurgitation medication
Paget's disease. • Constipation CV: administration.
Brand Name: Treatment of • Hypertension - Check the doctor’s
Therapeutic Class: Hypersensitivity • Diarrhea
Fosamax glucocorticoid-induced to Order.
osteoporosis. • Dyspepsia GI: - Verify client’s identity
Bone-resorption bisphosphonates (indigestion)
Usual • Hypocalcemia Nausea - Establish rapport.
inhibitor • Musculoskeletal
Dosage/Frequency: • Renal Vomiting - Check hypersensitivity
pain Constipation to medications.
Drug Action: insufficiency
• Nausea Diarrhea - Place the client in a
Adult: PO 10 -Decreases rate of bone • Esophageal
Acid regurgitation comfortable position.
mg/day or 70 resorption and may abnormalities
Esophageal ulcer
mg/wk directly block dissolution Flatulence Patient Monitoring:
Usual Route: of hydroxyapatite Cautious Use
Dyspepsia • Monitor for signs
crystals of bone; inhibits • Renal
Abdominal distention and symptoms of
P.O osteoclast activity insufficiency
Dysphagia GI irritation,
Therapeutic Effect: • Esophageal
including ulcers
disease
Drug Order: GU: • Monitor Blood
Pharmacokinetics: • GI ulcers Urinary Tract Infection
Fosamax® (alendronate pressure
sodium) 10 mg daily Absorption: • Gastritis
• Pregnant or Metabolic:
Protein Binding: breastfeeding
78%, rapidly cleared patients and also Hypophosphatemia • Evaluate Blood
from circulation, taken children Hypomagnesemia Calcium and
up mainly by bones, Hypokalemia phosphate level
Fluid overload
Distribution: Patient & Family
Rapid skeletal uptake Hematologic: Education
Metabolism: Anemia • Tell Pt to
Not metabolized. immediately
Excretion: Musculoskeletal: report serious
Eliminated primarily Bone or muscle pain vomiting, severe
through kidneys, bound chest or
to bone Skin: abdominal pain,
Up to 50% excreted Rash difficulty
unchanged in urine Redness swallowing or
Photosensitivity abdominal
Half Life: swelling
UP to 10h Other: • Instruct Pt to take
Abdominal taste drug first thing in
Pharmacodynamics: the morning on
Onset: 1 month an empty
Peak: 3-6 months stomach with 6oz
Duration: 3weeks to 7 to 8oz of water
months only
• Tell Pt not to lie
down, eat, drink,
or take other oral
DRUG- DRUG medications for
INTERACTION: 30 minutes after
Antacids, Calcium taking doses.
supplement: Decreased • Advise Pt to take
alendronate absorption only those pain
NSAIDS, salicylates: relivers suggested
Increased risk of GI by prescriber
upset • Inform her that
Ranitidine: increased some OTC pain
alendronate effect medications may
worsen drug’s
adverse effect
 As appropriate, •
review all other
significant and
life- threatening
adverse reactions
and interactions,
especially those
related to the
drugs, tests, and
food mentioned
above.
Reference: Nursing Spectrum Drug Handbook edition 2009 page, 41-42 and http://robholland.com/Nursing/Drug_Guide/data/monographframes/A023.html
Drug Study No.2

Drug Classification/ Indication Contraindication Side Effect Adverse Effect Nursing

Name/Dosage/ Mechanism of Consideration
Route Action
/Frequency/ Drug
Order

Generic Name: Pharmacological Class: Management of This drug is • Vaginal bleeding • CNS: BEFORE:
moderate to severe contraindicated to Breast Headache - Check the 10 rights of
Conjugated Estrogen Estrogen vasomotor patients with: pain/tenderness • Dizziness medication
symptoms Gynecomastia • Depression administration.
Therapeutic Class: associated with • Hypersensitivity to Headache • Libido changes - Check the doctor’s
Brand Name: Hormone menopause. estrogens. Hypertension • Order.
Premarin Prevention of • Breast cancer Intolerance to
- Verify client’s identity
Drug Action:
osteoporosis in • Hepatic disease contact lenses •
CV: - Establish rapport.
postmenopausal • Hypertension - Check hypersensitivity
Usual -Short-acting estrogen History of or Anorexia • Nausea
women. current Thromboembolic to medications.
Dosage/Frequency: mixture of conjugated • Loss of scalp hair disorders - Place the client in a
thrombophlebitis
estrogens including • Depression
0.625 mg, 0.9 mg, 1.25 sodium estrone sulfate • Undiagnosed comfortable position.
abnormal vaginal GI: -Question for
mg, 2.5 mg tablets and sodium equilin
bleeding Nausea hypersensitivity to
Usual Route: sulfate.
• Pregnancy Vomiting estrogen, hepatic
P.O Therapeutic Effect:
-Binds to intracellular • DVT or PE Diarrhea impairment,
(current or history Bloating thromboembolic
receptors that stimulate of) Cholestatic jaundice disorders associated with
Drug Order: DNA and RNA to • Angioedema or pregnancy, estrogen
Premarin® (conjugated synthesize proteins anaphylactic therapy
estrogens) 0.625 mg responsible for effects of reaction to Urogenital: -Educate and verify
daily estrogen. estrogens Mastodynia patient and SO’s
Pharmacokinetics: Cautious Use Spotting understanding about the
Absorption: Changes in menstrual medication
Well absorbed after oral • Asthma flow
administration. Readily • Epilepsy Dysmenorrhea DURING
absorbed through skin • Migraine Amenorrhea • Administer drug
and mucous • Headaches as ordered.
membranes • Diabetes Metabolic: • Position patient
Protein Binding: • Cardiac/renal Reduced carbohydrate appropriately for
50- 80% dysfunction tolerance medication
Distribution: • History of severe Fluid retention administration.
Widely distributed. hypocalcemia • Ensure proper
Crosses placenta and • Lupus erythematosus Other: body mechanics
enters breast milk • Porphyria Abdominal taste for health care
Metabolism: • Endometriosis provider.
• Gallbladder disease
Mostly metabolized by • Administer the
liver and other tissues. drug: Premarin
Enterohepatic (conjugated
recirculation occurs, with estrogens)
more absorption from GI 0.625mg daily, as
tract ordered by the
Excretion: physician.
Primarily excreted in • Administer with
urine or immediately
Half Life: after food to
27hrs reduce nausea
• Estrogens should
be used in the
Pharmacodynamics: lowest doses for
Onset: Rapid the shortest
Peak: Unknown period of time
Duration: 24 hours consistent with
desired
therapeutic
outcome.
 DRUG- DRUG • Follow dose with
INTERACTION: water.
• May alter requirement AFTER
for warfarin, oral • Monitor for
hypoglycemic agents, or side/adverse
insulins. effects
• Barbiturates, • Monitor weight
carbamazepine, or daily; asses for
rifampin may decrease edema.
effectiveness. • Monitor for loss
• Smoking increases risk of vision,
of adverse CV reactions diplopia,
• Erythromycin, migraine,
clarithromycin, thromboembolic
itraconazole, disorder, sudden
ketoconazole, and onset of
ritonavir may increase proptosis.
risk of adverse effects • Evaluate the
drug’s desired
therapeutic
effect: Resolution
of menopausal
vasomotor
symptoms;
prevention of
osteoporosis; and
relief of moderate
to severe
dyspareunia due
to menopause
• Document the
time, location,
dose, medication
given to the
patient.
Reference: http://robholland.com/Nursing/Drug_Guide/data/monographframes/E042.html
Drug Study No. 3

Drug Classification/ Indication Contraindication Side Effect Adverse Effect Nursing

Name/Dosage/ Mechanism of Consideration
Route Action
/Frequency/ Drug
Order

Generic Name: Pharmacological Class: This combination This drug is Constipation or stomach CNS: BEFORE:
medication is used to contraindicated to patients upset may occur. - Check the 10 rights of
calcium carbonate Calcium salts prevent or treat low with: Paresthesia medication
vitamin D3 blood calcium levels in (parenteral form) administration.
Therapeutic Class: people who do not get • Cardiac - Check the doctor’s
Antacid, enough calcium from resuscitation with CV: Order.
Brand Name: antihypermagnesemic, their diets. It may be risk of existing - Verify client’s identity
used to treat conditions digitalis toxicity or Hypotension, - Establish rapport.
antihyperphosphatemic,
Apo-Cal (CAN), Calci- caused by low calcium presence of irregular heartbeat - Check hypersensitivity
antihypocalcemic,
levels such as bone loss ventricular (parenteral form) to medications.
Mix, Calsan (CAN), calcium replacement, (osteoporosis), weak fibrillation (I.V.), - Place the client in a
LiquiCal, Liquid Cal- cardiotonic bones concurrent use of GI: comfortable position.
600, Titralac (osteomalacia/rickets), Nausea or
Usual calcium
Drug Action: decreased activity of the vomiting (parenteral DURING:
supplements,
Dosage/Frequency: -Increases levels of parathyroid gland form) • Administer the
hypercalcemia,
intracellular and (hypoparathyroidism), hypersensitivity to prescribed drug
Usual Route: extracellular calcium, and a certain muscle calcium salts or SKIN: in its right dosage
P.O which is needed to disease (latent tetany). their components, and route
maintain homeostasis, hypophosphatemia, Diaphoresis, • Monitor serum
especially in the nervous renal calculi flushing, or sensation calcium level, as
Drug Order: and musculoskeletal of warmth (parenteral ordered, and
calcium supplement systems. Also plays a form) evaluate
1200 mg with vitamin D role in normal cardiac therapeutic
daily and renal function, Other: response by
respiration, coagulation, Hypercalcemia; assessing for
and cell membrane and injection-site Chvostek’s and
capillary permeability. burning, pain, rash, Trousseau’s
Helps regulate the or redness (parenteral signs, which
release and storage of form shouldn’t appear.
neurotransmitters and
hormones. Oral forms
also neutralize or buffer
stomach acid to relieve
discomfort caused by
hyperacidity.
Therapeutic Effect:
Pharmacokinetics:
Absorption:
Calcium carbonate:
Absorbed from the
gastrointestinal tract,
predominantly in the
duodenum .
Vitamin D3: Well
absorbed from the
gastrointestinal tract (in
the presence of bile).
Protein Binding:
Enters breastmilk.
Calcium carbonate:
Primarily in bones and
teeth.
Distribution:
Metabolism:
Calcium carbonate: AFTER:
Converted into Ca
chloride by gastric acid.
Vitamin D3:
Metabolised in the liver
by vitamin D 25-
hydroxylase via
hydroxylation into active
metabolite, 25-
hydroxycolecalciferol;
further converted in the
• Urge patient to
chew chewable
tablets
thoroughly before
swallowing and
to drink a glass of
water afterward.
• Instruct patient to
take calcium
carbonate tablets
1 to 2 hours after
meals and other
forms with meals.
• Instruct patient to
avoid taking
calcium within 2
hours of another
oral drug because
of risk of
interactions.
• Urge patient to
ask prescriber
before taking
OTC drugs
because of risk of
interactions.
• Monitor blood
pressure, pulse,
fluid intake and
output, and
weight.
• Remind patient to
take calcium
separate from
other prescribed
drugs. For
 kidneys by vitamin D 1- example, tell the
hydroxylase to form the patient to take
active 1,25- fluoroquinolone
dihydroxycolecalciferol at least 2 hours
(calcitriol). before or 6 hours
Excretion: after calcium; if
Via faeces and urine prescribed
Half Life: levothyroxine to
take it at least 4
Pharmacodynamics: hours before or
Onset: after calcium; if
Peak: prescribed a
Duration: tetracycline to
take it at least 1
hour before
DRUG- DRUG calcium.
INTERACTION: • Document after
the drug is given,
including all the
assessments
Reference: https://www.webmd.com/drugs/2/drug-18856/calcium-carbonate-vitamin-d3-oral/details, http://robholland.com/Nursing/Drug_Guide/data/monographframes/C003.html

Drug Study No.4

Drug Classification/ Indication Contraindication Side Effect Adverse Effect Nursing

Name/Dosage/ Mechanism of Consideration
Route Action
/Frequency/ Drug
Order

Generic Name: Pharmacological Class: To treat and prevent This drug is Body as a Whole: BEFORE:
hemolytic anemia due to contraindicated to Skeletal muscle - Check the 10 rights of
VITAMIN E vitamin E deficiency in patients with: weakness, headache, medication
(TOCOPHEROL) premature neonates; to fatigue (with excessive administration.
Therapeutic Class: prevent retrolental No clinically significant doses). - Check the doctor’s
Brand Name: fibroplasia secondary to contraindications Order.
oxygen treatment in established. GI: - Verify client’s identity
 Aquasol E, Vita-Plus neonates, and in Caution use Nausea, diarrhea, - Establish rapport.
E, Vitec Drug Action: treatment of diseases Large doses may intestinal cramps - Check hypersensitivity
- A group of naturally with secondary exacerbate iron to medications.
Usual occurring fat-soluble erythrocyte membrane deficiency anemia. Urogenital: - Place the client in a
Dosage/Frequency: substances known as abnormalities (e.g., Gonadal dysfunction. comfortable position.
tocopherols. Alpha sickle cell anemia, and
100 IU, 200 IU, 400 IU, tocopherol, comprising G6PD deficiency and as Metabolic: Patient & Family
90% of the tocopherols, supplement in Increased serum creatine Education
500 IU, 800 IU
is the most biologically malabsorption kinase, cholesterol, • If taking a large
potent and has been syndromes). Used in triglycerides; decreased dose of iron, the
Usual Route: patients on diets serum thyroxine and RDA of vitamin
synthesized. An
P.O containing large amounts triiodothyronine; E may be
antioxidant, it prevents
peroxidation, a process of polyunsaturated fats increased urinary increased.
that gives rise to free for long periods and in estrogens, androgens; • Natural sources
Drug Order: radicals (highly reactive the patient, who abruptly creatinuria. of vitamin E are
calcium supplement chemical structures that discontinues such a diet. found in wheat
Vitamin
1200 mg E 400vitamin
with IU dailyD damage cell membranes Also used topically for Skin: germ (the richest
daily and alter nuclear dry or chapped skin and Sterile abscess, source) as well as
proteins). minor skin disorders. thrombophlebitis, contact in vegetable oils
Therapeutic Effect: dermatitis. (sunflower, corn,
-Prevents cell membrane soybean,
and protein damage and Special Senses: cottonseed),
is essential to the Blurred vision. green leafy
digestion and vegetables, nuts,
metabolism of dairy products,
polyunsaturated fats. eggs, cereals,
Maintains the integrity of meat, and liver.
cell membranes, protects
against blood clot
formation by decreasing
platelet aggregation,
enhances vitamin A
utilization, and promotes
normal growth,
development, and tone of
muscles. Deficiency
causes no specific
disease in humans but
 has been associated with
increased susceptibility
of RBC to hemolysis.

Pharmacokinetics:
Absorption:
20–60% absorbed from
GI tract if fat absorption
is normal; enters blood
via lymph.
Protein Binding:

Distribution:
Stored mainly in adipose
tissue; crosses placenta.
Metabolism:
Metabolized in liver.
Excretion:
Excreted primarily in
bile.
Half Life:

Pharmacodynamics:
Onset:
Peak:
Duration:

DRUG- DRUG
INTERACTION:
Herbal:
Mineral
oil, cholestyramine may
decrease absorption of
vitamin E; may enhance
anticoagulant activity
of warfarin.
Reference: http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/V022.html