DRUG STUDY

MECHANISM OF
DRUG NAME INDICATION CONTRAINDICATION ADVERSE EFFECT/S NURSING RESPONSIBILITIES
ACTION

Generic Name: Increases osmotic Indicated to Contraindicated in CNS: chills, dizziness, BEFORE:
Mannitol pressure of glomerular reduce intraocular patients hypersensitive fever, headache, - Verify doctor’s order.
filtrate, thus inhibiting or intracranial to drug or its ingredients. seizures - Check the patient’s identity. Use two patient identifiers
Dosage: tubular reabsorption of pressure. at all times. Always follow agency policy for patient
100 cc q 8 hours water and electrolytes. identification.
Contraindicated in CV: chest pains, heart
Drug elevates plasma - Ensure the right medication and the given appropriate
patients with active failure, hypotension,
osmolality and dose at the right time.
Route: intracranial bleeding tachycardia,
increases urine output. - Check the expiration date of the medicine.
IV (except during thrombophlebitis - Obtain VS for baseline data.
craniotomy), anuria, - Explain to patient the purpose of medication
Pharmacologic hepatic failure, severe EENT: blurred vision, dry administration as well as its expected therapeutic
Class: dehydration, severe mouth, rhinitis effects and possible side effects.
Osmotic diuretics heart failure, severe - Check frequency of ordered medication. Double check
pulmonary congestion, that you are giving ordered dose at the right time, and
GI: diarrhea, nausea,
Therapeutic Class: sever renal insufficiency. confirm when the last dose was given.
Diuretics thirst, vomiting.
- Observe IV site closely for extravasation or skin
rashes.
GU: polyuria, urine - Check the patency of IV line by ensuring the tube is not
retention kinked or by flushing 1 ml of PNSS before and after
administering the drug.
RESP: pulmonary DURING
edema - Monitor for signs and symptoms of hypersensitivity
reactions.
- Check IV insertion site for signs and symptoms of
SKIN: extravasation with
phlebitis or infection. Check for fluid leaking. IV site
edema and tissue
should be free from pain, tenderness, redness or
necrosis, rash, uritcaria swelling.
AFTER
Other: dehydration, - Document administration after giving the ordered
hyperkalemia, medication. Chart the time, route, and any other
hypernatremia, specific information as necessary.
hypervolemia, metabolic - Evaluate therapeutic response.
acidosis, water - Monitor effectiveness, ensure comfort and safety
intoxication measures.
- Monitor vital signs, including central venous pressure
and fluid intake and output hourly. Report increasing
oliguria. Check weight, renal function, fluid balance,
and serum and sodium urine and K levels daily.
- To relieve thirst, give frequent mouth care or fluids.
Generic Name: Unclear. Decreases Indicated for Contraindicated in CNS: euphoria, insomnia,
Dexamethasone inflammation, mainly by inflammatory patients with systemic psychotic behavior, BEFORE:
stabilizing leukocyte conditions, fungal and those with pseudotumor cerebri, - Verify doctor’s order.
Dosage: lysosomal membranes; neoplasia, known hypersensitivity vertigo, headache, - Check the patient’s identity. Use two patient identifiers
4 mg q 8 hours suppresses immune palliative with the product and its paresthesia, depression. at all times. Always follow agency policy for patient
response; stimulates management of constituents. identification.
bone marrow; and recurrent or CV: HF, HTN, edema, - Ensure the right medication and the given appropriate
Route:
influences protein, fat, inoperable brain arrhythmias, dose at the right time.
IV
and carbohydrate tumors. thrombophlebitis, - Check the expiration date of the medicine.
metabolism. thromboembolism. - Obtain VS for baseline data.
Pharmacologic
- Explain to patient the purpose of medication
Class:
Corticosteroids EENT: cataracts, glaucoma administration as well as its expected therapeutic
effects and possible side effects.
GI: peptic ulceration, GI - Check frequency of ordered medication. Double check
Therapeutic Class:
irritation, increased that you are giving ordered dose at the right time, and
Anti-inflammatory
appetite, pancreatitis, confirm when the last dose was given.
drugs
nausea, vomiting. - Observe IV site closely for extravasation or skin
rashes.
- Check the patency of IV line by ensuring the tube is not
GU: increased urine
kinked or by flushing 1 ml of PNSS before and after
glucose and calcium levels.
administering the drug.
DURING
Metabolic: hypokalemia, - Monitor for signs and symptoms of hypersensitivity
hyperglycemia, reactions.
carbohydrate intolerance, - Check IV insertion site for signs and symptoms of
hypercholesterolemia, phlebitis or infection. Check for fluid leaking. IV site
hypocalcemia, sodium should be free from pain, tenderness, redness or
retention, weight gain swelling.
AFTER
Musculoskeletal: muscle - Document administration after giving the ordered
weakness, osteoporosis, medication. Chart the time, route, and any other
tendon rupture. specific information as necessary.
- Evaluate therapeutic response.
Skin: delayed wound - Monitor effectiveness, ensure comfort and safety
healing, hirsutism measures.
Generic Name: Direct-acting Indicated for Contraindicated in patients CNS: headache, seizures, BEFORE:
Metronidazole trichomonacide and bacterial hypersensitive to drug or fever, vertigo, ataxia,
amebicide that works infections caused other nitroimidazole dizziness, syncope, - Verify the doctor’s order
inside and outside the by anaerobic derivatives. The use of incoordination, confusion, - Confirm the rationale for the ordered medication (e.g.
Dose: 500 mg q 8
intestines. It's thought microorganisms disulfiram within 2 weeks of laboratory results or patient’s health history)/
hrs irritability, depression,
to enter the cells of metronidazole therapy and - Check the
weakness, insomnia,
microorganisms that the use of alcohol or - name of the drug and the expiration date
Route: IV - Check the patient’s name using two identifiers, ask the
contain nitroreductase, propylene glycol products
 forming unstable during treatment and peripheral neuropathy. patient to identify himself/herself and the wrist band
Therapeutic Class: compounds that bind to for 3 days after treatment - Again, check the order, appropriate dose, time, and
Antiprotozoals DNA and inhibit ends are contraindicated. CV: flattened T wave, frequency.
synthesis, causing cell Use cautiously in patients edema, flushing,
death. with history of blood DURING:
Pharmacologic thrombophlebitis after IV
dyscrasia, CNS disorder,
Class: infusion.
or retinal or visual field - Monitor LFT results carefully in elderly patients.
Nitroimidazoles
changes. - Observe patient for edema, especially if patient is
EENT: rhinitis, sinusitis, receiving corticosteroids; Flagyl IV RTU may cause
pharyngitis. sodium retention
Use cautiously in patients
who take hepatotoxic drugs GI: nausea, abdominal
or have hepatic disease, pain, stomatitis, epigastric AFTER:
alcoholism, or renal - Tell patient that a metallic taste and dark or red-brown
distress, vomiting,
impairment. urine may occur.
anorexia, diarrhea,
- Tell patient to report signs and symptoms of candidal
constipation, proctitis, dry
overgrowth.
mouth, metallic taste. - Tell patient to report all adverse reactions immediately,
especially neurologic symptoms (seizures, peripheral
GU: vaginitis, darkened
neuropathy).
urine, polyuria, dysuria,
cystitis, dyspareunia

Hematologic: transient
leukopenia, neutropenia.

Musculoskeletal: transient
joint pains. Respiratory:
URI.

Skin: rash.

Other: decreased libido;

overgrowth of
nonsusceptible organisms,
candidiasis; flulike
symptoms.
Generic Name: Inhibits proton activity To prevent or treat Contraindicated to patients  Injection site pain BEFORE:
Oxacillin by binding to hydrogen- infections from with:  Nausea  Verify the doctor’s order.
potassium adenosine major trauma.  Hypersensitivity to  Muscle, joint, and bone  Check the patient’s identity. Ensure the right medication and
Dosage: triphosphate, located at drug or penicillin, pain the given appropriate dose at the right time
1 g q 6 hours secretory surface of cephalosporins  Headache  Check the expiration date of the medicine.
gastric parietal cells, to  Allergic to corn or  back pain  Obtain VS for baseline data.
suppress gastric acid corn products  Tiredness  Explain the purpose of the medication as well as its expected
Route: IV
 Pain in arms, hands, therapeutic effects and possible side effects.
Use cautiously in patients legs, or feet  Confirm appropriateness of the dose using a current drug
Therapeutic Class:  Hot flashes reference. If necessary, calculate the dose and have another
with:
Antibiotics  Vomiting nurse calculate the dose as well.
 Pregnancy
 Loss of appetite  Check the frequency of the ordered medication. Double-check
Pharmacologic  Weakness that you are giving the ordered dose at the correct time and
Class:  Cough confirm when the last dose was given.
Penicillins  Shortness of breath  Observe intravenous site closely for extravasation or skin
 Constipation rashes.
 Increased liver enzymes  Check the patency of the IV line by ensuring no the tube is not
 Diarrhea kinked or by flushing 1 ml of PNSS before and after
administering the drug.
 Perform skin Test

DURING
 Confirm negative skin test from the physician
 Monitor signs of hypersensitivity reactions
 Check IV insertion site for signs and symptoms of phlebitis or
infection. Check for fluid leaking, redness, pain, tenderness,
and swelling. IV site should be free from pain, tenderness,
redness, or swelling

AFTER
 Evaluate therapeutic response.
 Monitor the effectiveness, and ensure comfort and safety
measures.
 Document administration after giving the ordered medication.
Chart the time, route, and any other specific information as
necessary.
 Monitor vital signs

Generic Name: Cinnarizine, a piperazine Used to treat Contraindicated in patients ● CNS: fatigue, drowsiness,
Cinnarizine derivative, has balancing with known hypersensitivity new-onset or aggravation BEFORE:
antihistamine, sedative, problems that can to cinnarizine. of parkinsonian 1. Check the doctor's order.
and Ca channel blocking cause vertigo, symptoms, headache, 2. Ensure the client’s identity. Use two patient identifiers at all
Dosage:
activity. It selectively Meniere disease, Avoid use in a patient with depression, dizziness, and times. Always follow agency policy for patient identification.
20 g 1 tab TID
inhibits the Ca influx into ringing in the ears, porphyria, Parkinson’s incoordination
the depolarized cells in and hearing loss. disease, Renal and hepatic ● GI: Nausea, vomiting, dry
Route: the vascular smooth mouth, epigastric 3. Consider the different rights to drug administration:
impairment. ● Right Nurse Clinician
Oral muscle, thus decreasing discomfort, diarrhea or
the availability of free Ca constipation, loss of ● Right Assessment
ions for induction and Contraindicated for appetite or increased ● Right Patient
Therapeutic Class: newborns and pregnant ● Right Drug
Antivertigo maintenance of appetite and stomach pain
contraction. It has also women. ● Immune system ● Right Dosage
been shown to be a non- disorders: ● Right Frequency/Time
Pharmacologic competitive antagonist of Not recommended for use Hypersensitivity reaction 4. Explain to the patient the purpose of medication administration.
Class: smooth muscle during breastfeeding. ● Skin: Rash 5. Assess the patient for any possible contraindications and any
Peripheral contractions caused by Others: Weight gain, known allergy.
Vasodilators & various vasoactive perspiration or allergic 6. Perform physical examination for baseline status before
Cerebral Activators agents (including reactions and urinary beginning therapy to determine any potential adverse effects.
histamine). difficulty or retention
DURING:
1. Verify the patient’s identity.
2. Consider the different rights to drug administration:
 ● Right Approach
● Right Route
● Right Dose
● Right Time
● Right Principle of Care
3. Administer the right drug in the right dose and right route and at
the right time.
4. Provide comfort measures to help the patient cope with drug
effects.
5. Provide patient education about drug effects and warning signs
to report to enhance patient’s knowledge to promote
compliance. Encourage them to take it after meals to diminish
gastric irritation.

AFTER:
1. Consider the different rights to drug administration:
● Right Education
● Right Evaluation
● Right Storage
● Right Documentation
2. Instruct to report if there are any adverse reactions observed.
3. Notify the physician if any abnormalities occur.
4. Document and record.