BULACAN STATE UNIVERSITY

COLLEGE OF NURSING
City of Malolos

A REQUIREMENT ON CLINICAL DUTY AT:

SANTOS GENERAL HOSPITAL

DRUG STUDY
SUBMITTED BY:
JOHN PHILIP M. LACAS
(BSN 4D – GROUP 4)

SUBMITTED TO:
MR. MARLON ROBLES, RN
(CLINICAL INSTRUCTOR)

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 FARMAZOL
CONTENTS Omeprazole
INDICATIONS Duodenitis, duodenal erosions, duodenal ulcers, gastritis, gastric erosions, gastric ulcers,
symptomatic GERD w/ or w/ out erosive esophagitis, Zollinger-Ellison syndrome & in the
eradication of H. pylori.
DOSAGE 20 mg once daily. Gastric ulcers & erosive esophagitis 40 mg once daily.Eradication of H. pylori 20
mg bid. Zollinger-Ellison syndrome 60 mg once daily.
ADMINISTRATION Should be taken with food (Take immediately before a meal.).
CONTRAINDICATIONS Hypersensitivity to omeprazole.
SPECIAL
Infants <2 yr.
PRECAUTIONS
ADVERSE DRUG
Headache, diarrhea, constipation, abdominal pain, nausea, vomiting, dizziness, rash.
REACTIONS
DRUG INTERACTIONS Warfarin, phenytoin, cyclosporine, disulfiram, benzodiazepine, ketoconazole, ampicillin esters,
iron salts.
PREGNANCY Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or
CATEGORY (US FDA) embryocidal or other) and there are no controlled studies in women or studies in women and
animals are not available. Drugs should be given only if the potential benefit justifies the potential
risk to the foetus.
ATC CLASSIFICATION A02BC01 - Omeprazole ; Belongs to the class of proton pump inhibitors. Used in the treatment of
peptic ulcer and gastro-oesophageal reflux disease (GERD).
NURSING Give before meals.
RESPONSIBILITY Do not crush or chew tablets, swallow whole.
Evaluate for therapeutic response like relief of gastrointestinal symptoms.

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 ACETAMINOPHEN
CONTENTS Paracetamol
INDICATIONS Pyrexia of unknown origin. Fever & pain associated w/ common childhood disorders,tonsillitis,
upper resp tract infections post-immunization reactions, after tonsillectomy & other conditions.
Prevention of febrile convulsion. Headache, cold,sinusitis, muscle pain, arthritis & toothache.
DOSAGE Adult & childn ≥10 yr 2-3 mL, ≤10 yr 1-2 mL. Depending on severity of case, dose may be
repeated 4 hrly. In severe cases, dose may be administered by IV very slowly.
SPECIAL PRECAUTIONS Renal & hepatic failure.
ADVERSE DRUG
Hematological, skin & other allergic reactions.
REACTIONS
DRUG INTERACTIONS Coumarin anticoagulants. Concomitant treatment with aminophenazone may lead to an increase
of the effects of both medicines. Paracetamol potentiates effects of the anticoagulant medicines.
Phenobarbital increases the harming effect of Paracetamol on the liver. Contraceptive
preparations and rifampicin reduce the effectivity of Paracetamol. Cimetidin reduces toxicity
and potentiates the analgesic effect of the preparation. Paracetamol potentiates the action of the
Chloramphenicol. Concomitant usage of alcohol and medicines harming the liver, enhances the
risk of severe liver disorders. 
PREGNANCY CATEGORY Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there
(US FDA) are no controlled studies in pregnant women or animal-reproduction studies have shown an
adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in
women in the 1st trimester (and there is no evidence of a risk in later trimesters).
SPECIAL WARNING AND The preparation should be used with care in patients with liver and renal diseases. The
PRECAUTION treatment with Paracetamol may change the laboratory tests of uric acid and blood glucose
analysis. In severe renal failure the interval between two consecutive takings should not be
shorter than 8 hours. The treatment with the preparation is not advisable during the first
trimester of the pregnancy. In nursing women the preparation should be used with strictly
observation of the therapeutic dose and duration of the treatment. 

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ATC CLASSIFICATION N02BE01 - Paracetamol ; Belongs to the class of anilide preparations. Used to relieve pain and
fever.
NURSING
Monitor liver function study; always have acetylceistine on bed side as an antidote.
CONSIDERATION

PELNDIL
CONTENTS Felodipine

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INDICATIONS All grades of HTN. Angina pectoris.
DOSAGE HTN Initially 5 mg once daily. Maintenance 5-10 mg once daily. Elderly Initial: 2.5 mg
daily. Angina pectoris Initially 5 mg once daily increases to 10 mg once daily if needed. Severely
impaired liver function Lower dose. Dose titration: 2.5 mg.
OVERDOSAGE Feeling like you might pass out; feeling short of breath, swelling in your hands or feet; fast or
pounding heartbeats; numbness or tingly feeling; or chest pain or heavy feeling, pain spreading to
the arm or shoulder, nausea, sweating, general ill feeling, headache, dizziness, drowsiness,
weakness; feeling restless or nervous; nausea, upset stomach, constipation, diarrhea, stomach
pain; sleep problems (insomnia);joint pain or muscle cramps; warmth, redness, or tingly feeling
under your skin; mild rash; urinating more than usual; or cold symptoms such as stuffy nose
ADMINISTRATION May be taken with or without food (Take without food or following a light meal not rich in fat or
carbo. Swallow whole, do not chew/crush.).
CONTRAINDICATIONS Pregnancy, uncompensated heart failure, acute MI, unstable angina pectoris.
ADVERSE DRUG
Flushing, headache, palpitations, dizziness, fatigue, peripheral oedema.
REACTIONS
DRUG INTERACTIONS Cimetidine, erythromycin, itraconazole, ketoconazole, certain flavonoids in grapefruit
juice. Phenytoin, carbamazepine, barbiturates, rifampicin, tacrolimus.
PREGNANCY Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or
CATEGORY (US FDA) embryocidal or other) and there are no controlled studies in women or studies in women and
animals are not available. Drugs should be given only if the potential benefit justifies the potential
risk to the foetus.
MIMS CLASS Anti-Anginal Drugs / Calcium Antagonists
ATC CLASSIFICATION C08CA02 - Felodipine ; Belongs to the class of dihydropyridine derivative selective calcium-
channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.
NURSING Have patient swallow tablet whole; do not chew or crush.
RESPONSIBILITY Monitor patient carefully (BP, cardiac rhythm and output) while drug is being adjusted to
therapeutic dose.
Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-

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 term therapy.
Administer drug without regard to meals.

CO-AMOXICLAV
CONTENTS Per 600-mg vial Co-amoxiclav: Amoxicillin Na 500 mg, clavulanate K 100 mg. Per 1.2-g vial Co-
amoxiclav: Amoxicillin Na 1 g, clavulanate K 200 mg
INDICATIONS Bacterial infections caused by amoxicillin-resistant β-lactamase producing strains.These
include actinomycosis, biliary tract infections, bronchitis, endocarditis,gastroenteritis, typhoid &

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 para typhoid fever & UTI.
DOSAGE 500 mg IM or slow IV 8 hrly. Severe infections 1 g 6 hrly slow IV over 3-4 min or by infusion over
30-60 min. Childn ≤10 yr 50-100 mg/kg body wt daily by inj in divided doses.
SPECIAL
Pregnancy & lactation. Elderly & neonates. Severe renal impairment.
PRECAUTIONS
ADVERSE DRUG Diarrhea, hepatitis & cholestatic jaundice. Erythema multiforme, Stevens-Johnson syndrome, toxic
REACTIONS epidermal necrolysis & exfoliative dermatitis.
PREGNANCY Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are
CATEGORY (US FDA) no controlled studies in pregnant women or animal-reproduction studies have shown an adverse
effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in
the 1st trimester (and there is no evidence of a risk in later trimesters).
MIMS CLASS Penicillins
ATC CLASSIFICATION J01CR02 - Amoxicillin and enzyme inhibitor; Belongs to the class of penicillin combinations,
including beta-lactamase inhibitors. Used in the systemic treatment of infections.
NURSING Assess bowel pattern before and during treatment as pseudomembranous colitis may occur.
CONSIDERATION Report haematuria or oliguria as high doses can be nephrotoxic.
Assess respiratory status.
Ensure that the patient has adequate fluid intake during any diarrhoea attack.

BLOPERS
CONTENTS Candesartan cilexetil
INDICATIONS Hypertension.
DOSAGE Adult 8 or 16 mg once daily.
ADMINISTRATION May be taken with or without food

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CONTRAINDICATIONS Pregnancy. Severe or end-stage renal impairment. Childn.
SPECIAL Renal artery stenosis, severe intravascular vol depletion. Lactation. May affect ability to drive or
PRECAUTIONS operate machinery.
ADVERSE DRUG
Headache, upper resp tract infection, back pain, dizziness, nausea.
REACTIONS
DRUG INTERACTIONS K-sparing diuretics, K supplements, diuretics, lithium, angiotensin converting enzyme, β-blockers,
NSAIDs,indomethacin.
PREGNANCY Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or
CATEGORY (US FDA) embryocidal or other) and there are no controlled studies in women or studies in women and
animals are not available. Drugs should be given only if the potential benefit justifies the potential
risk to the foetus.
MIMS CLASS Angiotensin II Antagonists
ATC CLASSIFICATION C09CA06 - Candesartan ; Belongs to the class of angiotensin II antagonists. Used in the treatment
of cardiovascular disease.
NURSING Antihypertensive drugs should took from the small dose, and then gradually increase the volume.
RESPONSIBILITY At the same time, the curative effects must been observed closely. If blood pressure fell too fast,
the dosage should be adjusted. After the blood pressure keeping Stable for a long term, the
patients should reduce dosage step by step according to the doctors’ advice, and can not stop
medicine randomly. Some antihypertensive drugs can cause orthostatic hypotension, after patients
take this kind of drug, they should have a rest in bed for 2 ~ 3 hours. If necessary, nursing care
worker should help patients to get up, and then waiting a few minutes, finding no abnormalities,
the patients are allowed to get out of bed.

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 PRITOR
CONTENTS Telmisartan
INDICATIONS Treatment of essential HTN.
DOSAGE 20-40 mg once daily. Max: 80 mg once daily. Severe HTN Monotherapy: 160 mg daily. Combination
w/ hydrochlorothiazide: 12.5-25 mg daily. Hepatic impairmentMax: 40 mg once daily.
ADMINISTRATION May be taken with or without food
CONTRAINDICATIONS 2nd-3rd trimester of pregnancy, lactation. Biliary obstructive disorders. Severe hepatic or renal
impairment. Fructose intolerance.

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SPECIAL Renovascular HTN, renal & hepatic impairment & kidney transplant, intravascular vol depletion,
PRECAUTIONS other conditions w/ stimulation of the renin-angiotensin-aldosterone system, primary
aldosteronism, aortic & mitral valve stenosis, obstructive hypertrophic cardiomyopathy,
hyperkalemi. Monitor serum lithium level.
ADVERSE DRUG UTI, upper resp tract infections, anxiety, insomnia, depression, visual disturbance, vertigo, GI
REACTIONS disorders, eczema, athralgia, back pain, leg cramps/pain, myalgia, tendinitis like symptoms, chest
pain, influenza-like symptoms. Dyspnea, anemia, thrombocytopenia, eosinophilia. Bradycardia,
tachycardia, hypotension, orthostatic hypotension.
DRUG INTERACTIONS Digoxin, warfarin, hydrochlorthiazide, glibenclamide, ibuprofen, paracetamol &
amlodipine. Lithium.
PREGNANCY Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or
CATEGORY (US FDA) embryocidal or other) and there are no controlled studies in women or studies in women and
animals are not available. Drugs should be given only if the potential benefit justifies the potential
risk to the foetus.
MIMS CLASS Angiotensin II Antagonists
ATC CLASSIFICATION C09CA07 - Telmisartan ; Belongs to the class of angiotensin II antagonists. Used in the treatment of
cardiovascular disease.
NURSING Hypertension patients should eat low-salt, low energy, low-fat, low cholesterol and easily digested
RESPONSIBILITY diet. Nursing care worker should encourage patients to eat more fruits and vegetables, persuade
them to quit smoking and control alcohol, coffee, strong tea and some other stimulating beverages.
Obese hypertension patients must restricted calorie intake, and keep weight control at a ideal
range.
For the hypertension patients, whose blood pressure continued to increase, should measurement
the blood pressure for two or three times a day, and keep entire records in order to know blood
pressure changes well. If the fluctuation of blood pressure is too excessive, it is necessary to guard
against the occurrence of cerebral hemorrhage. If blood pressure increases rapidly, at the same
time accompanying with headache、indistinct vision, nausea, vomiting, convulsions and other
symptoms, hypertensive encephalopathy may occur. If the above symptoms happened, the
hypertension patients should be sent to hospital for emergency treatment at once.

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 FUROSEMIDE
INDICATION Listed in Dosage.
DOSAGE Adult: PO HTN 40-80 mg/day. Oedema Initial: 20 mg/day. Max: 600 mg/day in severe
cases. IV Pulmonary oedema 40 mg, if response is inadequate w/in 1 hr, a further dose of 80 mg
may be given. Oliguria in acute or chronic renal failureFor GFR: 5-20 mL/min: Infuse 250 mg over
1 hr. If urine output is insufficient w/in the next hr, may follow by 500 mg infused over 2 hr. If
urine output is still unsatisfactory w/in 1 hr after the 2nd infusion, a 3rd dose of 1 g may be
infused over 4 hr. Rate of infusion: ≤4 mg/min. If the response is satisfactory, may repeat the
effective dose (of up to 1 g) every 24 hr. IM/IV Oedema 20-50 mg, may increase in steps of 20 mg 2
hrly if needed. Doses >50 mg must be given as IV infusion.
ADMINISTRATION May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.)
CONTRAINDICATIONS Severe sodium and water depletion, hypersensitivity to sulphonamides and furosemide,
hypokalaemia, hyponatraemia, precomatose states associated with liver cirrhosis, anuria or renal

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 failure. Addison's disease.
SPECIAL Prostatic hyperplasia. Hepatic or renal impairment, gout, DM, impaired micturition. Infusion rate
PRECAUTIONS should not exceed 4 mg/min to reduce the risk of ototoxicity. Monitor fluid and electrolyte balance
and renal function. May lower serum levels of calcium and magnesium, thus serum levels should
be monitored. Pregnancy and lactation.
ADVERSE DRUG Fluid and electrolyte imbalance. Rashes, photosensitivity, nausea, diarrhoea, blurred vision,
REACTIONS dizziness, headache, hypotension. Bone marrow depression (rare), hepatic dysfunction.
Hyperglycaemia, glycosuria, ototoxicity.
Potentially Fatal: Rarely, sudden death and cardiac arrest. Hypokalaemia and magnesium
depletion can cause cardiac arrhythmias.
DRUG INTERACTIONS Analgesics reduce natriuretic action of furosemide. Antagonises hypoglycaemic agents and drugs
used for gout. Hyperglycaemia with antihypertensive agent diazoxide. Antagonises muscle
relaxants. Increased risk of ototoxicity when used with aminoglycosides especially in renal
impairment. May enhance nephrotoxicity of cephalosporins. Effects of antihypertensives
enhanced. Action antagonised by corticosteroids. Phenytoin and indometacin may reduce effects
of furosemide.
Potentially Fatal: May provoke severe hypotensive response with ACE inhibitors. NSAIDs inhibit
diuretic and antihypertensive effects. Increased incidence of premature beats with cardiac
glycosides.
PREGNANCY Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or
CATEGORY (US FDA) embryocidal or other) and there are no controlled studies in women or studies in women and
animals are not available. Drugs should be given only if the potential benefit justifies the potential
risk to the foetus.
MIMS CLASS Diuretics
NURSING People who have certain medical conditions or who are taking certain other medicines may have
RESPONSIBILITY problems if they take diuretics. Before taking these drugs, be sure to let the physician know about
any of these conditions:
ALLERGIES. Anyone who has had unusual reactions to diuretics or sulfonamides (sulfa drugs) in
the past should let his or her physician know before using a diuretic. The physician should also be
told about anyallergies to foods, dyes, preservatives, or other substances.

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 PREGNANCY. Diuretics will not help the swelling of hands and feet that some women have during
pregnancy. In general, pregnant women should not use diuretics unless a physician recommends
their use. Although studies have not been done on pregnant women, studies of laboratory animals
show that some diuretics can cause harmful effects when taken during pregnancy.
BREASTFEEDING. Some diuretics pass into breast milk, but no reports exist of problems in nursing
babies whose mothers use this medicine. However, thiazide diuretics may decrease the flow of
breast milk. Women who are breastfeeding and need to use a diuretic should check with their
physicians.

ISELPIN
CONTENT Sucralfate
INDICATIONS Duodenal & gastric ulcers, chronic gastritis.
DOSAGE Adult 1 g qid.
ADMINISTRATION Should be taken on an empty stomach (Take on an empty stomach 1 hr before or 2 hr after meals,
& at bedtime.).
CONTRAINDICATIONS Patients on dialysis.
ADVERSE DRUG Constipation, diarrhea, nausea, GI discomfort, indigestion; dry mouth; rash, pruritus; back pain;
REACTIONS dizziness, drowsiness & vertigo.
DRUG INTERACTIONS May inhibit absorption of ciprofloxacin HCl, norfloxacin & other new quinolones.
PREGNANCY Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are
CATEGORY (US FDA) no controlled studies in pregnant women or animal-reproduction studies have shown an adverse
effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in

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 the 1st trimester (and there is no evidence of a risk in later trimesters).
MIMS CLASS Antacids, Antireflux Agents & Antiulcerants
NURSING Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for
RESPONSIBILITY longer than recommended. Follow the directions on your prescription label.
Take sucralfate with a full glass of water.
Take sucralfate on an empty stomach, at least 1 hour before or 2 hours after a meal.
Shake the oral suspension (liquid) well just before you measure a dose (To be sure you get the
correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a
regular table spoon).

AMIKACID
CONTENTS Amikacin sulfate
INDICATIONS Bacterial septicemia including neonatal sepsis. Serious infections of the resp tract. Infections of the
bone & joints. Intra-abdominal infections including peritonitis. Burns& post-op infections. Serious
& complicated UTI due to susceptible organisms. As initial therapy in suspected gm-ve infections
before the results of susceptibility testing are obtained. In mixed, gm-ve, staph infections & other
gm+ve organism eg Strep & pneumococci.
DOSAGE Adult, childn & older infant 7.5 mg/kg 12 hrly or 5 mg/kg 8 hrly.
CONTRAINDICATIONS Hypersensitivity to aminoglycosides.
SPECIAL
Dehydration, renal dysfunction, neuromuscular disorders, premature & neonatal infants.
PRECAUTIONS
ADVERSE DRUG Auditory, vestibular, renal toxicity & neuromuscular blockade. Rash, drug fever, headache,
REACTIONS paresthesia, tremor, nausea & vomiting, eosinophilia, arthralgia, anemia & hypotension.
DRUG INTERACTIONS Avoid concurrent use of other ototoxic or nephrotoxic agents.
PREGNANCY
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 Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant
women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation
or for a serious disease for which safer drugs cannot be used or are ineffective).
MECHANISM OF Amikacin is a semisynthetic derivative of Kanamycin. It is an aminogylcoside antibiotic that is
ACTION considered bactericidal, and concentration dependent. It acts on susceptible bacteria by binding,
irreversibly, to the 30S ribosomal subunit and inhibiting protein synthesis.
Amikacin has the same spectrum of activity as gentamicin and tobramycin, but it is less susceptible
to enzymatic inactivation. This makes amikacin valuable in managing infections caused by Gram-
negative bacilli resistant to gentamicin and tobramycin.
Amikacin’s use can include coverage against some aerobic Gram-positive bacteria,which include
E.coli, klebsiella, proteus, pseudomonas, salmonella, enterobacter, serratia and mycoplasma.
MIMS CLASS Aminoglycosides
ATC CLASSIFICATION J01GB06 - Amikacin ; Belongs to the class of other aminoglycosides. Used in the systemic
treatment of infections.
NURSING Encourage patient to increase fluid intake to 2,000 to 3,000 mL/day, unless contraindicated.
RESPONSIBILITY Warn patient that diarrhea and abdominal bloating are common side effects of antibiotics.
Inform patient that improvement should be seen in 3 to 5 days.
Instruct patient to report the following signs to health care provider: Hypersensitivity, tinnitus,
vertigo, hearing loss.
Teach patient to look for signs of renal failure and to notify health care provider immediately if
these signs occur.

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 DICLOFENAC Na
CONTENTS Diclofenac Na

INDICATION & Adult: PO Pain and inflammation As Na: 75-150 mg/day. Max: 150 mg/day.Migraine As K: Initial:
DOSAGE 50 mg taken at 1st sign of attack, repeat 2 hr later if needed and subsequently 4-6 hrly if needed.
Prophylaxis of post-op pain As Na: 25-50 mg via infusion after surgery followed by 5 mg/hr.
Renal colic As Na: 75 mg, may repeat 30 mins later if needed.Max: 150 mg/day.
Rectal Post-op pain 75-150 mg/day in divided doses. Max: 150 mg/day (inclusive of other
routes of administration).
Allergic conjunctivitis As 0.1% soln: As Na: Instill 1 drop up to 4 times/day. Pain and discomfort
after radial keratectomy As 0.1% soln: As Na: Instill 1 drop before surgery followed by 1 drop
immediately after surgery, then 1 drop 4 times/day up to 2 days.
Topical Local relief of pain and inflammation As 1% gel: As Na: Apply 3-4 times/day.
Osteoarthritis As 1.6% soln: As Na: Apply 4 times/day. Actinic keratosis As 3% gel: As Na: Apply
twice daily for 60-90 days.

PREGNANCY Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are
CATEGORY (US FDA) no controlled studies in pregnant women or animal-reproduction studies have shown an adverse

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 effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in
the 1st trimester (and there is no evidence of a risk in later trimesters).
MIMS CLASS (Nonsteroidal Anti-Inflammatory Drugs (NSAIDs))
ATC CLASSIFICATION M01AB05 - Diclofenac ; Belongs to the class of acetic acid derivatives and related substances of
non-steroidal antiinflammatory and antirheumatic products.
NURSING Do not use any other over-the-counter cold, allergy, or pain medication without first asking your
CONSIDERATION doctor or pharmacist. Many medicines available over the counter contain aspirin or other
medicines similar to diclofenac (such as ibuprofen, ketoprofen, or naproxen). If you take certain
products together you may accidentally take too much of this type of medication. Read the label of
any other medicine you are using to see if it contains aspirin, ibuprofen, ketoprofen, or naproxen.
Do not drink alcohol while taking diclofenac. Alcohol can increase the risk of stomach bleeding
caused by diclofenac.
Avoid prolonged exposure to sunlight. Diclofenac may increase the sensitivity of the skin to
sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

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