DRUG MECHANISM OF INDICATIONS ADVERSE EFFECTS CONTRAINDICATIONS NURSING

ACTION RESPONSIBILITIES
GENERIC NAME: Fat-soluble naphthoquinone Drug of choice as antidote Body as a Whole: > Lack of parental consent Monitor patient constantly.
Vitamin K derivative chemically for overdosage of coumarin Hypersensitivity to • Delay IM reaction; Severe reactions, including
BRAND NAME: identical to and with similar and indandione oral AquaMEPHYTON doubling of the fatalities, have occurred
Phytonadione activity as naturally anticoagulants. anaphylaxis-like administration rash during and immediately
CLASSIFICATION: occurring vitamin Also reverses reaction: facial flushing, dose. in infants at risk of after IV injection
Vitamins K. Vitamin K is essential hypoprothrombine mia • Severe liver disease HIV as per Lab tests:
ROUTE: for hepatic biosynthesis of secondary to administration cramp-like pains, • Observe for guidelines Baseline and frequent
IM blood clotting of oral antibiotics, convulsive movements, • non-vitamin K bleeding. PT/INR.
DOSAGE: Factors II, VII, IX, and X. quinidine, quinine, chills, fever, diaphoresis, • Observe for • Frequency, dose, and
1mg after birth (term salicylates, sulfonamides, weakness, dizziness, shock. dependent bleeding therapy duration are guided
babies) excessive vitamin cardiac arrest. CNS: disorders by PT/INR clinical
<1000g, 0.5mg soon after A, and secondary to Headache (after oral dose), • Parenteral administration response.
birth (preterm babies) inadequate absorption and brain damage, death. Gl: may increase risk of
synthesis of vitamin K (as Gastric upset kernicterus
in obstructive jaundice,
biliary fistula, ulcerative
colitis, intestinal resection,
prolonged
hyperalimentation).
Also prophylaxis of and
therapy for neonatal
hemorrhagic disease
GENERIC NAME: By direct action on Initiation or improvement of CV: - hypersensitive to drug • Continuously monitor
Oxytocin myofibrils. uterine contractions to Hypertension, increased when vaginal delivery is contractions, fetal and
BRAND NAME: produces phasic achieve early vaginal heart rate, systemic venous advised maternal heart rate, and
Pitocin, Syntocinon contractions characteristic delivery for maternal or return, cardiac output -cephalopelvic maternal blood pressure and
CLASSIFICATION: of normal delivery fetal reasons GI: Nausea, vomiting disproportion is present ECG.
Uterine Active Agent Promotes milk ejection (IV) RESPIRATORY: -when delivery requires • Discontinue infusion if
ROUTE: (letdown reflex in nursing -as adjunctive therapy in the Anoxia, asphyxia conversion as in transverse I uterine hyperactivity
IV, IM mother, thereby increasing management of inevitable OTHERS: occUrs.
DOSAGE: flow (not volume) of milk; incomplete abortion (IV) Low APGAR score at 5 • Monitor patient extremely
10 units/ml in 1 ml ampule also facilitates flow of milk
during
period of breast
engorgement.
Uterine sensitivity to
oxytocin increases during
gestation period and peaks
sharply before parturition.
Not used for elective
induction of labor.
GENERIC NAME: Carbetocin binds to
Carbetocin oxytocin receptors present
BRAND NAME: on the smooth musculature
Duratocin of the uterus, resulting in
CLASSIFICATION: rhythmic
oxytocin receptor analogue contractions of the uterus,
ROUTE: increased frequency of
IV existing contractions, and
DOSAGE: increased uterine tone. The
100mcg oxytocin receptor content of
the uterus is very low in the
non-pregnant state, and
increases during pregnancy,
reaching a peak at the time
of delivery.
-stimulation of uterine mins
contractions during third
stage of labor (IV)
I - control of postpartum
bleeding o hemorrhage (IV,
IM)
Prevention of uterine atony
and postpartum hemorrhage
following elective caesarian
section under epidural or
spinal anesthesia.
Headache, dizziness,
tremor, anxiety;
tachycardia, hypotension,
flushing, sweating;
dyspnea, pruritus; chest and
back pain, chills, feeling of
warmth; nausea, vomiting,
abdominal pain, metallic
taste; anaemia.
closely during first and
second stages of labor
because of risk of cervical
laceration, uterine rupture
and maternal and fetal
death.
• Assess fluid intake and
output. Watch for signs and
symptoms of water
intoxication.
Patients with a history of • Start flow charts to record
hypersensitivity to oxytocin maternal BP and other vital
or carbetocin; vascular signs, I&O ratio, weight,
disease, especially coronary strength, duration, and
artery disease, except with frequency of contractions,
extreme caution; renal or as well as fetal heart tone
hepatic disease. and rate, before instituting
treatment.
Use in pregnancy: •Monitor fetal heart rate and
Because of its long duration maternal BP and pulse at
of action relative to least q15min during
oxytocin, uterine infusion period;
contractions produced by evaluate tonus of
carbetocin cannot be myometrium during and
stopped by simply between contractions and
discontinuing the record on flow chart.
medication. Report change in rate and
Therefore, carbetocin rhythm immediately.
should not be administered • Stop infusion to prevent
prior to delivery of the fetal anoxia, turn patient on
infant for any reason, her side, and notify
physician if contractions are
prolonged (occurring at less
 than 2-min intervals) and if
monitor records
contractions about 50 mm
Hg or if contractions last 90
GENERIC NAME: Tranexamic acid General: CNS: Dizziness > Hypersensitivity Before:
Tranexamic Acid competitively inhibits > treatment of excessive EENT: Visual abnormalities > Active Intravascular > check the doctor's order
BRAND NAME: activation of plasminogen bleeding resulting from CV: Hypotension, Clotting > Observe the 15 rights of
Hemostan, Lysteda, (via binding to the kringle systemic or local thromboembolism, > Acquired defective color drug administration
Cyklokapron domain), thereby reducing hyperfibrinolysis thrombosis vision > Do skin testing
CLASSIFICATION: conversion of plasminogen > prophylaxis in patients GI: Diarrhea, nausea, >Subarachnoid Hemorrhage > Tell patient to inform the
antifibrinolytic to plasmin (fibrinolysin) an with coagulopathy vomiting healthcare provider if color
ROUTE: enzyme that degrades fibrin undergoing surgical Precautions: blind, have a history of
IV clots, fibrinogen, and other procedures Use cautiously with renal stroke, and blood clot, or
DOSAGE: plasma proteins, including impairment, hematuria bleeding in your brain.
0.5 g the procoagulant factors Patient's actual indication: originating in the upper > Caution patient to avoid
V and VIII Treatment of excessive urinary tract; and conditions products containing aspirin
bleeding resulting from associated with increased or NSAIDs
systemic or local thrombus formation > For women who are
hyperfibrinolysis taking to control heavy
bleeding, the medication
should only be taken during
the menstrual period

During:
> administer the drug at the
right dosage and route in the
right time
> check the patency of the
IV site and IV line
> Do not use this
medication without telling
your doctor if you are
breastfeeding a baby

GENERIC NAME: Inhibits protein synthesis in
Erythromycin susceptible organisms by
BRAND NAME: binding to 50S
ilotycin opthalmic ribosomal subunits, thereby
CLASSIFICATION: inhibiting translocation of
Anti bacterial aminoacyltransfer-
ROUTE: RNA and inhibiting
topical/ ointment polypeptide synthesis
DOSAGE:; Exerts effect only against
1 cm length in each lower multiplying organisms;
conjunctival sac penetrates cell wall of
gram-positive bacteria more
After:
> Advise patient to take
medication exactly as
directed
> Unusual change in
bleeding pattern should be
reported to the physician
> Report severe allergic
reactions such as rash,
hives, itching, dyspnea,
tightness in the chest,
swelling of the mouth, face,
lips or tongue
> If the patient missed a
dose, let patient take when
remembered, then take next
dose at least 6 hours later.
> Store this medication at
room temperature away
from moisture and heat
Treatment of superficial -minor eye irritations, - hypersensitivity to BEFORE
ocular infections caused by stinging,burning, redness, erythromycin •cleanse the infants eyes aS
susceptible strains of temporary blurred vision, - Hepatic impairment. needed before application.
microorganisms; and hypersensitivity Concomitant administration • Hold the tube in a
prophylaxis of ophthalmia reactions. with ergot derivatives. horizontal procedure rather
neonatorum caused by N. than a vertical position
gonorrhoeae or C.
trachomatis During:
•Do not touch the tip of the
tube to any part of the eye
• Administer from the inner
canthus to the outer canthus
readily than that of After:
gram-negative bacteria, and • Observe for any irritation
thus, gram-positive • document
organisms may accumulate
100 times more
erythromycin than
gram-negative organisms do