DRUG ACTION INDICATIONS CONTRAINDICATION ADVERSE NURSING

S REACTIONS RESPONSIBILITIES
Brand Name: Amlodipine is a Hypertension: Hypersensitivity to CV: Palpitations, BEFORE:
Norvasc calcium channel Indicated for amlodipine Flushing Tachycardia,  Check the
blocking agent that hypertension, to Peripheral or Facial Doctor’s order.
Generic Name: selectively blocks lower blood pressure. Edema, Bradycardia,  Observe for the
Amlodipine calcium ion reflux Lowering blood Chest Pain, Syncope, 10 rights of drug
across cell pressure reduces the Postural Hypotension. administration.
Classification: membranes and risk of fatal and  Obtain patient’s
Cardiovascular vascular smooth nonfatal CNS: Light- history to allergy
Agent; Calcium muscle without cardiovascular headedness, Fatigue, of amlodipine.
Channel Blocker; changing serum events, primarily Headache Rationale: To
Anti-Hypersensitive calcium strokes and indicate if the
Agent concentrations. It myocardial GI: Abdominal Pain, patient can have
predominantly acts infarctions. Nausea, Anorexia, this medication.
Pregnancy on the peripheral Constipation,  Assess vital signs
Category: C circulation, Angina & Coronary Dyspepsia, before therapy.
decreasing peripheral Artery Disease: Dysphagia, Diarrhea, Rationale: To
Route: PO vascular resistance, Treatment of chronic Flatulence, Vomiting obtain baseline
and increases cardiac stable angina, data.
Dosage: 10mg OD output. vasospastic angina UROGENITAL:
(Prinzmetal or variant Sexual Dysfunction, DURING:
angina), and Frequency, Nocturia  Administer the
angiographically right drug to the
documented CAD in RESPIRATORY: right patient at
patients without heart Dyspnea the right time.
failure or EF <40%  Explain to the
SKIN: Flushing, patient about the
Rash importance and
purpose of the
OTHER: Arthralgia, drug.
Camps, Myalgia
 Instruct the
patient to take
drug with meals
if abdominal
discomfort
occurs.
AFTER:
 Monitor BP for
therapeutic
effectiveness.
Rationale: BP
reduction is
greatest after
peak levels of
amlodipine are
achieved 6-9
hours following
oral doses.
 Monitor for any
adverse effects.
Rationale: To
establish proper
precautionary
measures.
 Instruct the
patient to avoid
task require
alertness and
motor skills.
 Monitor for signs
and symptoms of
dose-related
peripheral or
facial edema that
may not be
accompanied by
weight gain.
Rationale:
Rarely, severe
edema may cause
discontinuation of
drug.
 Monitor heart
rate R: Dose-
 related
palpitations may
occur.
 Document and
record

PATIENT AND
FAMILY
EDUCATION
 Report significant
swelling of face
or extremities.
 Take care to have
support when
standing &
walking due to
possible dose-
related light-
headedness/dizzi
ness.
 Report shortness
of breath,
palpitations,
irregular
heartbeat, nausea,
or constipation to
physician.
DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING
REACTIONS RESPONSIBILITIES
Brand Name: Ceftin, Semisynthetic Oral: Hypersensitivity to BODY AS A BEFORE:
Zinacef second-generation  Pharyngitis, cephalosporins and WHOLE:  Check the
cephalosporin tonsillitis related antibiotics thrombophlebitis (IV Doctor’s order.
Generic Name: antibiotic with caused site); pain, burning  Observe for the
Cefuroxime structure similar to by Streptococc cellulitis (IM site); 10 rights of
that of the penicillins. us pyogenes superinfections, drug
Classification: Anti- Resistance against  Otitis media positive Coombs’ test administration.
infective; Antibiotic; beta-lactamase- caused  Determine
Second-Generation producing strains by Streptococc CNS: Headaches, history of
Cephalosporin exceeds that of first us dizziness, Lethargy, hypersensitivity
generation pneumoniae, S. Paresthesias reactions to
Pregnancy cephalosporins. pyogenes, cephalosporins,
Category: B Antimicrobial Haemophilus GI: Diarrhea, nausea, penicillins, and
spectrum of activity influenzae, antibiotic-associated history of
Route: PO resembles that of Moraxella colitis allergies,
cefonicid. catarrhalis particularly to
Dosage: 500mg BID Preferentially binds  Lower GU: Nephrotoxicity drugs.
to one or more of the respiratory  Therapy may be
penicillin-binding infections SKIN: Rash, instituted
proteins (PBP) caused by S. Pruritus, Urticaria pending test
located on cell walls pneumoniae, results. Monitor
of susceptible Haemophilus Urogenital: periodically
organisms. This parainfluenzae, Increased serum BUN and
inhibits third and H. influenzae creatinine and BUN, creatinine
final stage of  UTIs caused Decreased creatinine clearance.
bacterial cell wall by Escherichia clearance
synthesis, thus killing coli, Klebsiella DURING:
the bacterium. Partial pneumoniae
cross-allergenicity  Uncomplicated  Administer the
between other beta- gonorrhea right drug to the
lactam antibiotics and (urethral and right patient at
cephalosporins has endocervical) the right time.
been reported.  Dermatologic
 Explain to the
infections, patient about
including the importance
impetigo and purpose of
caused the drug.
by Streptococc
 Inspect IM and
us aureus, S.
 pyogenes IV injection
 Treatment of sites frequently
early Lyme for signs of
disease phlebitis.
 If the patient
Parenteral: has difficulty
 Lower swallowing, tell
respiratory him that it may
infections be crushed or
caused by S. dissolved but
pneumoniae, S. warn her about
aureus, E. coli, its bitter taste
Klebsiella, H. that is hard to
influenzae, S. mask, even
pyogenes with food.
 Dermatologic
infections
caused by S. AFTER:
aureus, S.
pyogenes, E.  Report onset of
coli, loose stools or
Klebsiella, diarrhea.
Enterobacter Although
 UTIs caused pseudomembra
by E. coli, nous colitis (see
Klebsiella Signs &
 Uncomplicated Symptoms,
and Appendix F)
disseminated rarely occurs,
gonorrhea this potentially
caused by N. life-threatening
gonorrhoeae complication
 Septicemia should be ruled
caused by S. out as the cause
pneumoniae, S. of diarrhea
aureus, E. coli, during and after
Klebsiella, H. antibiotic
influenzae therapy.
 Meningitis
 caused by S.  Monitor for
pneumoniae, manifestations
H. influenzae, of
S. aureus, N. hypersensitivity
meningitidis  Monitor I&O
 Bone and joint rates and
infections pattern:
caused by S. Especially
aureus important in
 Perioperative severely ill
prophylaxis patients
 Treatment of receiving high
acute bacterial doses.
maxillary  Report any
sinusitis in significant
patients 3 mo– changes.
12 yr

PATIENT AND
FAMILY
EDUCATION

 Report loose
stools or
diarrhea
promptly.
 Report any
signs or
symptoms of
hypersensitivity

DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING

REACTIONS RESPONSIBILITIES
Brand Name: Analgesics and anti-  To relieve Severe hepatic CNS: Fatigue, BEFORE:
Celebrex inflammatory signs and impairment; anxiety, depression,  Observe 10
activities related to symptoms of hypersensitivity to nervousness, rights of
Generic Name: inhibition of the osteoarthritis celecoxib; asthmatic paresthesia, dizziness, medication.
Celecoxib COX-2 enzyme, patients with aspirin insomnia, headache  Check doctors
which is activated in  To relieve triad; advanced renal
order.
Classification: inflammation to cause signs and disease; concurrent use CV: Stroke, MI,
Central Nervous the signs and of diuretics and ACE tachycardia, CHF,  Assess pain
symptoms of
System Agent, symptoms associated inhibitors; anemia; angina, palpitations, score.
rheumatoid
Analgesic, NASID, with inflammation ; pregnancy (category D) dysrhythmias,  Assess history
arthritis
Cyclooxygenase-2 does not affect the in third trimester; hypertension, fluid of allergies.
Inhibitor, Antipyretic COX-1 enzyme,  To relieve lactation. retention  Explain about
which protects the signs and the importance
Pregnancy lining of the GI tract symptoms of EENT: Tinnitus, and purpose of
Category: C first and & has blood clotting juvenile hearing loss, blurred the drug to
second trimesters; D and renal functions rheumatoid vision, glaucoma, patient
third trimester cataract,
arthritis  Assess skin
conjunctivitis, eye
Route: PO pain color and
 To relieve pain
lesions,
from
Dosage: 400mg OD GI: Nausea, anorexia, reflexes,
ankylosing
vomiting, sensations,
spondylitis
constipation, dry edema, serum
 To manage mouth, diverticulitis, electrolytes.
acute pain, to gastritis,
gastroenteritis, DURING
treat primary  Administer
dysmenorrhea hemorrhoids, hiatal
hernia, stomatitis, GI medication
Management of acute bleeding/ulceration with a right
pain patient, right
GU: Nephrotoxicity: dosage at a
dysuria, right time.
hematuria, azotemia,  Administer
cystitis, drug with food
UTI, renal papillary or after meals
necrosis
if GI upset
HEMA: Blood occurs.
dyscrasias,  Establish
 epistaxis, anemia safety
measures if
INTEG: Purpura, CNS or visual
rash, pruritus, disturbance
sweating, erythema, occur.
petechiae,
photosensitivity, AFTER
alopecia, bruising, hot  Take note for
flashes, side effects
serious sometimes  Documents
fatal and Record
Stevens-Johnson
 Provide
syndrome,
toxic epidermal positioning and
necrolysis environmental
control to
RESP: Pharyngitis, reduce pain.
shortness of  Provide
breath, pneumonia, warmth,
coughing positioning and
rest to reduce
inflammation.
 Of overdose
occurs,
institute gastric
lavage,
induction of
emesis and
supportive
therapy.
 Monitor
patient’s VS.

DRUG ACTION INDICATIONS CONTRAINDICATION ADVERSE NURSING

 S REACTIONS RESPONSIBILITIES
Brand Name: Ferrous To correct simple iron Peptic ulcer, regional GI: Nausea, BEFORE:
Femiron, Hemocyte, sulfate: Standard iron deficiency and to treat enteritis, ulcerative Heartburn, Anorexia,
Ircon preparation against iron deficiency colitis; hemolytic Constipation,  Check the
which other oral iron (microcytic, anemias (in absence of Diarrhea, Epigastric Doctor’s order.
Generic Name: preparations are hypochromic) iron deficiency), pain, Abdominal  Observe for
Ferrous Sulfate usually measured. anemias. Also may be hemochromatosis, distress, Black stools the 10 rights of
Corrects used prophylactically hemosiderosis, patients drug
Classification: Blood erythropoietic during periods of receiving repeated SPECIAL SENSES: administration.
Formers; Coagulators abnormalities induced increased iron needs, transfusions, pyridoxine- Yellow-brown  Determine
and Anticoagulants; by iron deficiency but as in infancy, responsive anemia; discoloration of eyes history of
Iron Preparation does not stimulate childhood, and cirrhosis of liver. and teeth hypersensitivit
erythropoiesis. May pregnancy. y reactions to
Pregnancy reverse gastric, LARGE CHRONIC this medication
Category: A esophageal, and other DOSES IN  Assess bowel
tissue changes caused INFANTS: Rickets movements as
Route: PO by lack of iron. (due to interference constipation is
with phosphorus a common
Dosage: 1 Tab Ferrous absorption) adverse effect.
gluconate: Claimed to  Assess for
cause less gastric MASSIVE Signs and
irritation and be better OVERDOSAGE: symptoms of
tolerated than ferrous Lethargy, drowsiness, iron deficiency
sulfate. nausea, vomiting, anemia; e.g.,
abdominal pain, pallor,
diarrhea, local tachycardia,
corrosion of stomach dyspnea, and
and small intestines, fatigue
pallor or cyanosis,
metabolic acidosis,
shock, cardiovascular DURING:
collapse, convulsions,
liver necrosis, coma,  Administer the
renal failure, death right drug to
the right
patient at the
right time.
 Explain to the
patient about
 the importance
and purpose of
the drug.
 Instruct the
patient to do
not crush, cut
or chew tablets
 Make sure that
the patient had
taken the drug
 Administer
liquid
preparations in
water or juice
to mask the
taste and
prevent
staining of
teeth.
 Instruct the
patient to do
not take this
drug with
antacids nor
tetracyclines
unless
prescribed

AFTER:
 Inform the
patient that
stool may be
colored dark or
green
 Monitor for
Hgb and
reticulocyte
values.
  Notify the
physician if
adverse effects
occur
 Document and
record

PATIENT AND
FAMILY
EDUCATION

 Note: Ascorbic
acid increases
absorption of
iron.
Consuming
citrus fruit or
tomato juice
with iron
preparation
(except the
elixir) may
increase its
absorption.
 Be aware that
milk, eggs, or
caffeine
beverages
when taken
with the iron
preparation
may inhibit
absorption.
 Be aware that
iron
preparations
cause dark
green or black
 stools.
 Report
constipation or
diarrhea to
physician;
symptoms may
be relieved by
adjustments in
dosage or diet
or by change
to another iron
preparation.
 DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING
REACTIONS RESPONSIBILITIES
Brand Name: It fills in nutritional Vitamins are Hypersensitivity to  Constipation BEFORE:
gaps, and provides indicated to treat or preservatives,, colorants,  Diarrhea  Check the
Generic Name: only a hint of the prevent vitamin or additives, including Doctor’s order.
Multivitamins vast array of deficiency due to tartrazine, saccharin, and  GI upset
 Observe for
healthful nutrients poor diet, certain aspartame; Some products  Dark stools the 10 rights of
Classification: and chemicals illnesses, or during contain alcohol and should  Nausea drug
Vitamin naturally found in pregnancy. Vitamins be avoided in patients  Vomiting administration.
food. It cannot offer are important with known intolerance.  Abdominal pain  Assess the
Pregnancy fiber or the flavor building blocks of the patient for
Category: and enjoyment of body and help keep signs and
foods so key to an an individual in good These gut-related
symptoms of
Route: PO optimal diet. health. adverse effects are vitamin
generally minor and deficiency
Dosage: 1 Tab` often temporary. They before
tend to disappear as the beginning
body gets used to vitamin
therapy
taking the
because
multivitamins vitamin
therapy could
result in a
toxic effect if
the patient
does not have
a vitamin
deficiency.
 Assess the
patient for
debilitating
diseases and
GI disorders
that may
disrupt the
absorption,
metabolism,
and excretion
 of vitamins
used to treat
vitamin
deficiency.
 Assess the
patient’s
dietary and
drug history

DURING:

 Administer the
right drug to
the right
patient at the
right time.
 Explain to the
patient about
the importance
and purpose of
the drug.
 Make sure that
the patient had
taken the
medication

AFTER:
 Monitor
therapeutic
effectiveness.
 Notify the
physician for
any signs of
adverse effects
 Document and
record
 Monitor I&O
 rates and
pattern

PATIENT AND
FAMILY
EDUCATION
 Encourage
patient to
comply with
recommendati
ons of health
care
professional.
 Explain that
the best source
of vitamins is a
well-balanced
diet with foods
from the 4
basic food
groups
 DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING
REACTIONS RESPONSIBILITIES
Brand Name: Orally: Acts as a It is indicated to Myocardial damage; heart BODY AS A BEFORE:
Magnesium Sulfate laxative by osmotic prevent seizures due block; cardiac arrest WHOLE:  Check the
retention of fluid, to worsening except for certain  Flushing, sweating, Doctor’s order.
Generic Name: which distends colon, preeclampsia, to slow arrhythmias; IV extreme thirst,  Observe for
Magnesium Sulfate increases water or stop preterm labor, administration during the sedation, confusion, the 10 rights of
content of feces, and and to prevent injuries 2 h preceding delivery; PO depressed reflexes or drug
Classification: causes mechanical to a preterm baby's use in patients with no reflexes, muscle  Observe
Gastrointestinal stimulation of bowel brain. abdominal pain, nausea, weakness, flaccid constantly
Agent; Saline activity. vomiting, fecal impaction, paralysis, when given
Cathartic; or intestinal irritation, hypothermia. IV. Check BP
Replacement Agent;  Parenterally: Acts obstruction, or perforation. and pulse q10–
Anticonvulsant as a CNS depressant CNS: Drowsiness, 15 min or
and also as a depress reflexes, more often if
Pregnancy depressant of placid paralysis, indicated.
Category: A smooth, skeletal, and hypothermia  Take an
cardiac muscle appropriate
Route: IV function. CV: Hypotension, seizure
Anticonvulsant depressed cardiac precaution
Dosage: 20g properties thought to function, complete
be produced by CNS heart block, DURING:
depression, circulatory collapse.
principally by  Administer the
decreasing the RESPIRATORY: right drug to
amount of  Respiratory the right
acetylcholine paralysis. patient at the
liberated from motor right time.
nerve terminals, thus METABOLIC:  Explain to the
producing peripheral  Hypermagnesemia, patient about
neuromuscular hypocalcemia, the importance
blockade. dehydration, and purpose of
electrolyte imbalance the drug.
including  Check
hypocalcemia with magnesium
repeated laxative use. level repeated
doses.
 Test knee jerk
reflex; if
 absent,
discontinue
magnesium.

AFTER:
 Monitor
plasma
magnesium
levels in
patients
receiving drug
parenterally
(normal: 1.8–
3.0 mEq/L).
Plasma levels
in excess of 4
mEq/L are
reflected in
depressed deep
tendon reflexes
and other
symptoms of
magnesium
intoxication.
 Monitor
respiratory rate
closely.
 Test patellar
reflex before
each repeated
parenteral
dose.
Depression or
absence of
reflexes is a
useful index of
early
magnesium
 intoxication.
 Observe
newborns of
mothers who
received
parenteral
magnesium
ehaviou within
a few hours of
delivery for
signs of
toxicity,
including
respiratory and
neuromuscular
depression.
 Observe
patients
receiving drug
for
hypomagnese
mia for
improvement
in these signs
of deficiency:
Irritability,
choreiform
movements,
tremors,
tetany,
twitching,
muscle
cramps,
tachycardia,
hypertension,
psychotic
behaviour.

PATIENT AND
 FAMILY
EDUCATION:

 Drink
sufficient
water during
the day when
drug is
administered
orally to
prevent net
loss of body
water.
 Recommended
daily
allowances of
magnesium are
obtained in a
normal diet.
Rich sources
are whole-
grain cereals,
legumes, nuts,
meats,
seafood, milk,
most green
leafy
vegetables, and
bananas.

DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING

REACTIONS RESPONSIBILITIES
Brand Name: Works by increasing To initiate or improve Hypersensitivity to BODY AS A BEFORE:
Pitocin the concentration of uterine contraction at oxytocin; significant WHOLE: Fetal  Check the
calcium inside term only in carefully cephalopelvic trauma from too rapid Doctor’s order.
Generic Name: muscle cells that selected patients and disproportion, unfavorable propulsion through  Observe for
Oxytocin control contraction only after cervix is fetal position or pelvis, fetal death, the 10 rights of
of the uterus; dilated and presentations that are anaphylactic reactions, drug
Classification: Synthetic, water- presentation of fetus undeliverable without postpartum  Observe
Hormones and soluble polypeptide has occurred; used to conversion before hemorrhage, constantly
Synthetic Substitutes; consisting of eight stimulate letdown delivery, obstetric precordial pain, before giving
Oxytocic amino acids, reflex in nursing emergencies in which edema, cyanosis or via IV.
identical mother and to relieve benefit-to-risk ratio for redness of skin.  Assess for
Pregnancy pharmacologically to pain from breast mother or fetus favors significant
Category: X the oxytocic engorgement. Uses surgical intervention, fetal CV: Fetal bradycardia cephalopelvic
principle of posterior include management distress in which delivery and arrhythmias, disproportion,
Route: IV pituitary. of inevitable, is not imminent, maternal cardiac unfavourable
incomplete, or missed prematurity, placenta arrhythmias, fetal positions
Dosage: 10 Units abortion; stimulation previa, prolonged use in hypertensive or
of uterine severe toxemia or uterine episodes, subarachnoid presentations,
contractions during inertia, hypertonic uterine hemorrhage, increased severe
third stage of labor; patterns, previous surgery blood flow, fatal toxaemia,
stimulation to of uterus or cervix afibrinogenemia, ECG uterine inertia,
overcome uterine including cesarean changes, hypertonic
inertia; control of section, conditions PVCs, cardiovascular uterine
postpartum predisposing to spasm and collapse. patterns,
hemorrhage and thromboplastin or previous
promotion of amniotic fluid embolism GI: Neonatal jaundice, caesarean
postpartum uterine (dead fetus, abruptio maternal nausea, section
involution. Also used placentae), grand vomiting.  Ensure
to induce labor in multiparity, invasive absence of
cases of maternal cervical carcinoma, Endocrine: ADH complications
diabetes, primipara >35 y of age, effects leading to DURING:
preeclampsia, past history of uterine severe water  Administer the
eclampsia, and sepsis or of traumatic intoxication and right drug to
erythroblastosis delivery, intranasal route hyponatremia, the right
fetalis. during labor, simultaneous hypotension. patient at the
administration of drug by right time.
two routes. CNS:  Explain to the
Fetal intracranial patient about
hemorrhage, anxiety. the importance
and purpose of
Respiratory: Fetal the drug.
hypoxia, maternal  Infuse via
dyspnea. constant
 infusion pump
Urogenital: Uterine to ensure
hypertonicity, tetanic accurate
contractions, uterine control of rate;
rupture, pelvic rate
hematoma. determined by
uterine
response;
begin with 1-
2mL/min and
increase at 16-
60 mins
intervals

AFTER:
 Monitor
maternal BP
 Monitor
neonate for
jaundice
 Document and
record that
drug has been
given.
 Educate the
client on the
side effects of
the medication
and what to
expect
 Discontinue
drug and
notify
physician at
any sign of
hypertensive
emergency.
 PATIENT AND
FAMILY
EDUCATION:

 Be aware of
purpose and
anticipated
effect of
oxytocin.
 Report sudden,
severe
headache
immediately to
healthcare
providers.

DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING

REACTIONS RESPONSIBILITIES
Brand Name: Reduces BP mainly Most commonly in Coronary artery disease, Body as a Whole: BEFORE:
Apresoline by direct effect on stepped-care mitral valvular rheumatic Hypersensitivity (rash,  Check the
vascular smooth approach to treat heart disease, MI, urticaria, pruritus, Doctor’s order.
Generic Name: muscles of arterial- moderate to severe tachycardia, SLE. Safe fever, chills, arthralgia,  Observe for
Hydralazine resistance vessels, hypertension. Also in use during pregnancy eosinophilia, the 10 rights of
resulting in early malignant (category C) or lactation is cholangitis, hepatitis, drug
Classification: vasodilation. Has hypertension and established. obstructive jaundice).  Take the
Cardiovascular little effect on resistant hypertension client’s BP
Agent; Nonnitrate venous-capacitance that persists after CNS:  Check the
Vasodilator; vessels. sympathectomy. Headache, dizziness, patency of the
Antihypertensive Hypotensive effect Conjunctively with tremors. IV line
may be limited by cardiac glycosides  Make baseline
Pregnancy sympathetic and other CV: Palpitation, and periodic
Category: C reflexes, which vasodilators in short- angina, tachycardia, determinations
increase heart rate, term treatment of flushing, paradoxical of BUN,
Route: IV stroke volume, and acute CHF; pressor response. creatinine
cardiac output. unexplained Overdose: clearance, uric
Dosage: 5mg PRN pulmonary arrhythmia, shock. acid, serum
for BP hypertension. potassium,
>160/100mmHg Special Senses: blood glucose,
Lacrimation, and ECG.
conjunctivitis.

GI: Anorexia, nausea, DURING:

vomiting, diarrhea,  Administer the
constipation, abdominal right drug to
pain, paralytic ileus. the right
patient at the
Urogenital: Difficulty right time.
in urination,  Explain to the
glomerulonephritis. patient about
the importance
Hematologic: and purpose of
Decreased hematocrit the drug.
and hemoglobin,  Advice the
anemia, agranulocytosis patient to get
(rare) up slowly
when rising
Other: Nasal from sitting or
congestion, muscle lying position
cramps, SLE-like  Use parenteral
syndrome, fixed drug drug
eruption, edema. immediately
after opening
ampule

AFTER:
 Discontinue if
blood
dyscrasias
occur
 Monitor for
S&S of SLE,
especially with
prolonged
therapy.
 Monitor BP
 and HR
closely. Check
every 5 min
until it is
stabilized at
desired level,
then every 15
min thereafter
throughout
hypertensive
crisis.
 Report
persistent or
severe
constipation,
unexplained
fever or
malaise,
muscle or joint
aching, chest
pain, rash,
numbness,
tingling
 Do proper
documentation

PATIENT AND
FAMILY
EDUCATION:

 Monitor
weight, check
for edema, and
report weight
gain to
physician.
 Note: Some
patients
experience
 headache and
palpitations
within 2–4 h
after first PO
dose;
symptoms
usually
subside
spontaneously.
 Make position
changes
slowly and
avoid standing
still, hot
baths/showers,
strenuous
exercise, and
excessive
alcohol intake.
 Do not drive
or engage in
other
potentially
hazardous
activities until
response to
drug is known.

DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING

REACTIONS RESPONSIBILITIES
Brand Name: Produces analgesia Fever reduction. Hypersensitivity to Body as a Whole: BEFORE:
Tylenol by unknown Temporary relief of acetaminophen or Negligible with  Check the
mechanism, perhaps mild to moderate phenacetin recommended Doctor’s order.
Generic Name: by action on pain. Generally as dosage; rash.  Observe for
Paracetamol peripheral nervous substitute for aspirin the 10 rights of
system. Reduces when the latter is not CNS: Headache drug
Classification: fever by direct action tolerated or is  Assess the
Central Nervous on hypothalamus contraindicated. CV: Chest pain, patient’s fever
System Agent; heat-regulating dyspnea, myocardial or pain; type of
Nonnarcotic center with damage when doses pain, location,
Analgesic, consequent of 5-8g/day are intensity,
Antipyretic peripheral ingested daily for duration,
vasodilation, several weeks or temperature,
Pregnancy sweating, and when doses of 4g/day nd diaphoresis.
Category: B dissipation of heat. are ingested for 1yr  Asees allergic
Unlike aspirin, reactions: rash,
Route: IV acetaminophen has Acute Poisoning: urticarial
little effect on Anorexia, Nausea,  Do not exceed
Dosage: 900mg q8h platelet aggregation, Vomiting, dizziness, the
for 6 doses does not affect Lethargy, recommend
bleeding time, and Diaphoresis, Chills, dosage
generally produces Epigastric or
no gastric bleeding. abdominal pain,
Diarrhea; onset of DURING:
hepatotoxicity-
elevation of serum  Administer the
transaminases right drug to
(ALT,AST) and the right
bilirubin; patient at the
hypoglycaemia, right time.
hepatic coma, acute  Explain to the
renal failure (rare) patient about
the importance
Chronic Ingestion: and purpose of
Neutropenia, the drug.
Pancytopenia,  Reduce dosage
Leukopenia, with hepatic
Thrombocytopenic impairment
purpura,  Avoid using
hepatotoxicity in multiple
alcoholics, renal preparations
failure containing
acetaminophen

AFTER:
 Monitor for
S&S of:
hepatotoxicity,
even with
moderate
acetaminophen
doses,
especially in
individuals
with poor
nutrition or
who have
ingested
alcohol over
prolonged
periods;
poisoning,
usually from
accidental
ingestion or
suicide
attempts;
potential abuse
from
psychological
dependence
(withdrawal
has been
associated with
restless and
excited
responses).
 Discontinue
drug if
hypersensitivit
y reaction
occur
 Monitor
 patient for any
untoward
effect of the
drug, if any
untoward
effect occurs,
report
immediately to
the physician
 Document and
record the date
and time of
medication

PATIENT AND
FAMILY
EDUCATION:

 Do not take
other
medications
(e.g., cold
preparations)
containing
acetaminophen
without
medical
advice;
overdosing and
chronic use
can cause liver
damage and
other toxic
effects.
 Do not self-
medicate
adults for pain
more than 10 d
(5 d in
 children)
without
consulting a
physician.
 Do not use this
medication
without
medical
direction for:
fever
persisting
longer than 3
d, fever over
39.5° C (103°
F), or recurrent
fever.
 Do not give
children more
than 5 doses in
24 h unless
prescribed by
physician.

DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING

REACTIONS RESPONSIBILITIES
Brand Name: It inhibits synthesis Short-term Hypersensitivity to CNS: Drowsiness, BEFORE:
Toradol, Acular of prostaglandins and management of pain; ketorolac; individuals with dizziness, headache.
is a peripherally ocular itching due to complete or partial  Check the
Generic Name: acting analgesic. seasonal allergic syndrome of nasal polyps, Respiratory: Doctor’s order.
Ketorolac Ketorolac does not conjunctivitis, angioedema, and Asthma, Dyspnea  Observe for
have any known reduction of post- bronchospastic reaction to the 10 rights of
Classification: effects on opiate operative pain and aspirin or other NSAIDs; GI: Nausea, drug
Central Nervous receptors. photophobia after during labor and delivery; dyspepsia, GI  Instruct the
System Agent; refractive surgery. patients with severe renal pain, hemorrhage. patient to
NSAID, Analgesic; impairment or at risk for avoid
Antipyretic renal failure due to GU: Oligouria, renal concurrent use
volume depletion; patients toxicity, urinary of alcohol,
Pregnancy with risk of bleeding; frequency aspirin,
Category: B active peptic ulcer disease; NSAIDs,
pre- or intraoperatively; OTHER: Edema, acetaminophen
Route: IV intrathecal or epidural sweating, pain at , or other OTC
administration; in injection site. medications
Dosage: 30mg q6h combination with without
for 6 doses other NSAIDs; lactation. consulting
health care
professional
 Advice patient
to consult if
rash, itching,
visual
disturbances,
tinnitus,
weight gain,
edema, black
stools,
persistent
headache, or
influenza-like
syndromes
occur

DURING:
 Administer the
right drug to
the right
patient at the
right time.
 Explain to the
patient about
the importance
and purpose of
the drug.
 Check the
expiration date
of the
medication and
 discard the
medication if it
is out of date

AFTER:

 Monitor for
S&S of GI
distress or
bleeding
including
nausea, GI
pain, diarrhea,
melena, or
hematemesis.
GI ulceration
with
perforation can
occur anytime
during
treatment.
Drug decreases
platelet
aggregation
and thus may
prolong
bleeding time.

 Monitor for
fluid retention
and edema in
patients with a
history of
CHF.
 Monitor for
signs of pain
relief, such as
an increased
appetite and
 activity
 Inform patient
that the
medication
may cause
drowsiness,
dizziness, or
fatigue

PATIENT AND
FAMILY
EDUCATION:

 Watch for S&S

of GI
ulceration and
bleeding (e.g.,
bloody emesis,
black tarry
stools) during
long-term
therapy.
 Note: Possible
CNS adverse
effects (e.g.,
light-
headedness,
dizziness,
drowsiness).
 Do not drive or
engage in
potentially
hazardous
activities until
response to
drug is known.
  Do not use
other NSAIDs
while taking
this drug.

DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING

REACTIONS RESPONSIBILITIES
Brand Name: Tranexamic acid Tranexamic acid is Hypersensitivity to CNS: Dizziness BEFORE:
Cyklokapron, Lysteda competitively and indicated for the tranexamic acid; Active  Check the
reversibly inhibits treatment of thromboembolic disease; EENT: Visual Doctor’s order.
Generic Name: the activation of hereditary History or intrinsic risk of abnormalities  Observe for
Tranexamic Acid plasminogen via angioedema, cyclic thrombosis or the 10 rights of
binding at several heavy menstrual thromboembolism, CV: Hypotension, drug
Classification: distinct sites, bleeding in including retinal vein or thromboembolism,  Perform skin
Antifibrinolytic; including four or five premenopausal artery occlusion thrombosis testing
Hemostatic Agent low-affinity sites and females, and other  Instruct the
one high-affinity site, instances of GI: Diarrhea, nausea, patient to
Pregnancy the latter of which is significant bleeding in vomiting inform the
Category: B involved in its the context of healthcare
binding to fibrin. The hyperfibrinolysis. provider if
Route: IV binding of Given intravenously, color blind,
plasminogen to fibrin tranexamic acid is have a history
Dosage: 500mg q8h induces fibrinolysis - indicated for short- of stroke, and
by occupying the term use (2-8 days) in blood clot, or
necessary binding patients with bleeding in
sites tranexamic acid hemophilia to prevent brain.
prevents this or reduce bleeding  Assess vital
dissolution of fibrin, following tooth signs as
thereby stabilizing extraction. indicated by
the clot and severity of
preventing bleeding
haemorrhage.  Asses for
thromboemboli
c
complications
DURING:
 Administer the
right drug to
the right
patient at the
right time.
 Explain to the
patient about
the importance
and purpose of
the drug.
 Check the
patency of the
IV site and IV
line
 Stabilize IV
catheter to
minimize
thrombophlebit
is
 Monitor site
closely

AFTER:
 Instruct the
patient to
avoid products
containing
aspirin or
NSAIDs
 Instruct the
patient to
report any
unusual
change in
bleeding
pattern.
 Report severe
allergic
 reactions such
as rash, hives,
itching,
dyspnea,
tightness in the
chest, swelling
of the mouth,
face, lips, or
tongue.
 Document and
record the date
and time of
administration.

PATIENT AND
FAMILY
EDUCATION:
 Instruct the
patient to make
position
changes slowly
to avoid
orthostatic
hypotension
 Instruct to
report any
signs of
allergic
reaction
immediately,
and any
changes in
vision or
ocular
discomfort

DRUG ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING

REACTIONS RESPONSIBILITIES
Brand Name: Semisynthetic, broad- Infections caused by Hypersensitivity to Body as a Whole: BEFORE:
Mefoxin spectrum beta-lactam susceptible organisms cephalosporins and related Drug fever,  Check the
antibiotic derivative in the lower antibiotics; pregnancy eosinophilia, Doctor’s order.
Generic Name: of cephamycin C respiratory tract, (category B), lactation. superinfections, local  Observe for
Cefoxitin (produced urinary tract, skin and Safe use in children <3 mo reactions: pain, the 10 rights of
by Streptomyces skin structures, bones not established. tenderness, and drug
Classification: lactamdurans). and joints; also intra- induration (IM site),  Assess for the
Antiinfective; Classified as second abdominal thrombophlebitis (IV vital signs as a
Antibiotic; Second- generation endocarditis, site). baseline data
Generation cephalosporin; gynecological  Determine
Cephalosporin structurally and infections, GI: Diarrhe, previous
pharmacologically septicemia, pseudomembranous hypersensitivit
Pregnancy related to uncomplicated colitis y to
Category: B cephalosporins and gonorrhea, and cephalosporins
penicillins. perioperative SKIN: , penicillins,
Route: IV Antimicrobial prophylaxis in Rash, exfoliative and other drug
spectrum of activity prosthetic dermatitis, pruritus, allergies
Dosage: 1g q8h resembles that of arthroplasty or urticaria. before therapy
cefonicid. cardiovascular is initiated.
Considerably less surgery. May be HEMATOLOGIC:  Inspect
active than most cephalosporin of Transient injection sites
cephalosporins choice for mixed neutropenia, regularly.
against Staphylococci. aerobic-anaerobic eosinophilia, Report
Preferentially binds to infections haemolytic anemia, evidence of
one or more of the (e.g., Bacteroides anemia, inflammation
penicillin-binding fragilis). thrombocytopenia, and patient's
proteins (PBP) leukopenia, bone complaint of
located on cell walls marrow suppression pain.
of susceptible
organisms. UROGENITAL:
Nephrotoxicity,
interstitial nephritis. DURING:

OTHER:  Administer the

Hypersensitivity right drug to
reactions (serum the right
sickness, patient at the
anaphylaxis), right time.
elevated temperature  Explain to the
 patient about
the importance
and purpose of
the drug.
 Check the
patency of the
IV site and IV
line

AFTER:
o Advise the
patient to
report signs of
superinfection
and allergy
 Instruct patient
to notify health
care
professional if
ever and
diarrhea
develop,
especially if
stool contains
blood, pus, or
mucus
 Instruct the
patient that
alcohol and
alcohol-
containing
medications
should be
avoided during
and for several
days after
therapy.
 Advise patient
 not to treat
diarrhea
without
consulting
health care
professional
 Encourage
patient to
report any
unsual effects
of medication

PATIENT AND
FAMILY
EDUCATION:

 Report
promptly S&S
of
superinfection
 Report watery
or bloody
loose stools or
severe
diarrhea.
 Report severe
vomiting or
stomach pain.
 Report
infusion site
swelling, pain,
or redness.

References:
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/A049.html

https://www.scribd.com/document/235379347/Amlodipine-drug-study

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/C051.html

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/C052.html

https://www.scribd.com/document/264889167/Celecoxib-Drug-Study

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/F010.html

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/O031.html

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/O031.html

https://www.scribd.com/doc/22828278/Oxytocin

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/H014.html

http://robholland.com/Nursing/Drug_Guide/data/monographframes/K005.html

https://www.google.com/search?
q=tranexamic+acid+robholland&rlz=1C1ASRM_enPH965PH965&oq=Tranexamic+acid+ro&aqs=chrome.1.69i57j0i512l9.12501j0j4&sourceid=chr
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https://www.google.com/search?q=cefoxitin+drug+study+scribd&tbm=isch&ved=2ahUKEwi2ttL6ldn-AhXimVYBHSn9BsIQ2-
cCegQIABAA&oq=cefoxitin+drug+study+scribd&gs_lcp=CgNpbWcQAzIHCAAQGBCABDoGCAAQBxAeUN0eWN-
XAWCynAFoAHAAeACAAYwFiAG3GZIBCzAuMS42LjAuMS4ymAEAoAEBqgELZ3dzLXdpei1pbWfAAQE&sclient=img&ei=blZSZLbHEuK
z2roPqfqbkAw&bih=590&biw=664&rlz=1C1ASRM_enPH965PH965&hl=en#imgrc=79lqnILWfQ57nM