San Beda College

COLLEGE OF NURSING
P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc. 4131

GENERIC NAME:MIDAZOLAM BRAND NAME: Versed

Route of Administration: IV Dosage: 1mg/IV
DRUG MODE OF INDICATIONS/ ADVERSE DRUG NURSING HEALTH
CLASS ACTION CONTRA REACTIONS TO INTERACTION CONSIDERAT TEACHINGS
INDICATIONS WATCH OUT S IONS
FOR
Anxiolytics Midazolam is a INDICATION: Physical and Increased • Assess level Do not drive or
/ short-acting HIV protease psychological depression of sedation engage in
benzodiazepine. It inhibitors, nefazod dependence with alcohol, and level of potentially
Hypnotics exerts sedative one, sertraline, gra with withdrawal opioids, consciousness hazardous
& and hypnotic, pefruit symptoms; barbiturates, throughout activities until
Sedatives / muscle relaxant, juice, fluoxetine, er decreased tidal other sedatives and for 2-6 hr response to
anxiolytic and ythromycin, diltiaz volume and and following drug is known.
Anticonvul anticonvulsant em, clarithromycin respiration rate; anaesthetics. administration You may feel
sants actions. While the inhibit the apnoea; Increased . drowsy, weak,
probable anxiolytic metabolism of headache; respiratory or tired for 1–2
action might be as midazolam, leading hiccup; nausea, depression • Monitor BP, d after drug
a result of the to a prolonged increased with pulse and has been
drug's ability to action. St John's appetite, opiates, pheno respiration given.
increase glycine wort, rifapentine, ri vomiting; cough; barbital, other continuously
inhibitory fampin, rifabutin, p oversedation; benzodiazepin during IV Be prepared for
neurotransmitter henytoin enhance seizure-like es. Plasma administration amnesia to
level, the the metabolism of activity concentrations . Oxygen and prevent an
hypnotic/anaesthet midazolam leading (paediatrics); increased by resuscitative upsetting
ic action may be to a reduced paradoxical CYP3A4 equipment postoperative
due to the action. Sedating reactions; inhibitors such should be period.
occupation of the antidepressants, kernicterus; as cimetidine, immediately
benzodiazepine antiepileptic drugs nystagmus; skin erythromycin, available. Review written
and GABA such rash, pruritus; clarithromycin, instructions to
receptors leading as phenobarbital, reduced diltiazem, vera • If overdose assure future
to membrane phenytoin alertness, pamil, ketocon occurs, understanding
hyperpolarisation and carbamazepin confusion, azole and itrac monitor pulse, and
and neuronal e, euphoria, onazole, respiration , compliance.
inhibition, and sedative antihista hallucinations, antiretroviral and BP Patient
further interfering mines, opiates, anti fatigue, agents, quinup continuously. teaching
with the re-uptake psychotics and alco dizziness, ristin with dalfo Maintain during
of GABA at the hol enhance the ataxia, post- pristin. patent airway amnestic
synapses. sedative effects of operative Midazolam and assist period may not
midazolam. Midazo sedation, concentration ventilation as be
Absorption: Rapid lam is metabolized anterograde decreased needed. If remembered.
ly absorbed (any almost completely amnesia; by phenytoin, c hypotension Even if dose is
route); peak by cytochrome jaundice; arbamazepine, occurs, small and
plasma P450-3A4. Atorvast cardiac arrest, phenobarbital, treatment depth of
concentrations atin administration heart rate rifampicin. Hal includes IV amnesia is
after 20-60 min along with changes, othane, fluids, unclear,
(depending on midazolam results thrombosis; thiopental repositioning relearn
route). in a reduced anaphylaxis; requirements and information.
elimination rate of laryngospasm, may be vasopressors.
Distribution: Cros midazolam. St bronchospasm. reduced during
ses the placenta; John's wort Potentially concurrent • The effects
enters breast milk. decreases the Fatal: Respirato use. of midazolam
Protein-binding: blood levels of ry depression, can be
96% midazolam. Grapef respiratory reversed with
ruit juice reduces arrest; flumazenil
Metabolism: Exte intestinal 3A4 and hypotension. (Romazicon).
nsively hepatic via results in less
CYP3A4 isoenzyme; metabolism and
converted to higher plasma
hydroxymethylmid concentrations
azolam.
CONTRAINDICATIO
Excretion: Urine N:
(as glucuronide Acute narrow-angle
conjugates); 2 hr glaucoma; coma or
(elimination half- patients in shock;
 life), prolonged in acute alcohol
neonates, elderly intoxication;
and hepatic intrathecal and
impairment. epidural admin.
Acute pulmonary
insufficiency or
marked
neuromuscular
respiratory
weakness including
unstable
myasthenia gravis;
severe respiratory
depression.

CHAVEZ, KATELENE B.
4DCN
GROUP 10 6: 00 am
–2:00 pm

San Beda College

COLLEGE OF NURSING
P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc. 4131
GENERIC NAME: FENTANYL BRAND NAME: SUBLIMAZE
Route of Administration: IV Dosage: 50mcg/IV
DRUG CLASS MODE OF INDICATIONS/ ADVERSE DRUG NURSING HEALTH
ACTION CONTRA REACTIONS INTERACTIONS CONSIDERATI TEACHINGS
INDICATIONS TO WATCH ONS
OUT FOR
Analgesics Fentanyl is a INDICATION: Nausea, Depressant - Repeated - Medication
(Opioid) potent opioid - The treatment vomiting; effects may be intraoperative should be kept
analgesic that of breakthrough bradycardia, enhanced by doses can out of reach of
increases pain cancer pain in oedema, CNS other CNS cause children and in
threshold, alters patients depression, depressants respiratory its original
pain reception and receiving opioid confusion, e.g. alcohol, depression to packaging.
inhibits ascending therapy. dizziness,dro anaesthetics, persist into the
- Avoid
pain pathways by wsiness, anxiolytics, postoperative
- Analgesia activities that
binding to headache, hypnotics, TCAs period.
during require
stereospecific sedation, and
operations, - Fentanyl alertness if
receptors within transient antipsychotics.
enhancement of interferes with patient is
the CNS. hypotension, Ammonium
anaesthesia. respiratory affected by
Onset: Rapid. peripheral chloride may
function and drowsiness.
vasodilation; increase
Duration: Short. pupil reaction,
CONTRAINDICAT increased excretion of - Lozenges
both of which
ION: intracranial fentanyl. should be
Distribution: Rapi are essential
- Acute pressure. Phenothiazines removed from
dly into tissues; parts of
respiratory High IV dose may increase foil just before
appears in the CSF, neurological
depression. may cause hypotensive administration
crosses the assessment.
chest wall effect of opioid and sucked
placenta and small - Acute
rigidity. analgesics. - Assess the over a 15-
amounts enter the alcoholism.
Transdermal: Serum levels therapeutic minute period,
breast milk. - Raised Rash, may be response and not chewed.
Protein-binding: intracranial erythema and increased by in
80% - Patches
pressure such as itching. CYP3A4 inhibitors breakthrough
should be
in head injury. (e.g. azole cancer pain
Metabolism: Hep applied to dry,
Potentially antifungals, clarit consider
intact skin,
 atic via N- Fatal: Respir hromycin, adjustment of non-irradiated
dealkylation and atory diclofenac, background non-hairy skin
hydroxylation. depression, doxycycline, analgesia on the torso or
trunk rigidity, erythromycin, where this is upper arm.
Excretion: Urine laryngospasm imatinib, appropriate. Replacement
(as metabolites , isoniazid, patches should
and unchanged - Excessive
bronchoconst nefazodone, be sited on a
drug); 4 hrs heat may
riction. nicardipine, prop different area.
(elimination half- increase
ofol, protease
life). absorption
inhibitors, quinidi
from patches
ne, telithromycin
so local heat
and verapamil).
should not be
May reduce the
applied and
efficacy of
patients with
pegvisomant.
fever should
Serum levels
be carefully
may be reduced
monitored.
by rifamycinderiv
atives. May
increase
serotonergic
effect of SSRIs
and sibutramine.

CHAVEZ, KATELENE B.
4DCN
GROUP 10 6: 00 am
–2:00 pm
 San Beda College
COLLEGE OF NURSING
P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc. 4131

GENERIC NAME: Prednisolone BRAND NAME: Pred Forte

Route of Administration: Eyes Dosage: 1-2 drops bid-qid.
DRUG CLASS MODE OF INDICATIONS/ ADVERSE DRUG NURSING HEALTH
ACTION CONTRA REACTIONS INTERACTIONS CONSIDERATI TEACHINGS
INDICATIONS TO WATCH ONS
OUT FOR
Eye Prednisolone INDICATION: Increased IOP CYP3A enzyme Do not If inflammation
Corticosteroid acetate is a w/ optic nerve substrate; administer or pain persists
s glucocorticoid. Steroid- damage, inducer of acetate or longer than 48
Glucocorticoids responsive visual field cytochrome P- tebutate salt hours or
inhibit the edema, inflammation of defects. 450 enzymes I.V. becomes
fibrin deposition, the palpebral & Posterior aggravated,
capillary dilation bulbar subcapsular Barbiturates, the patient
and phagocytic conjunctiva, cataract phenytoin, should be
migration of the cornea & formation rifampin advised to
acute inflammatory anterior (heavy or decrease discontinue use
response as well as segment of the protracted corticosteroid of the
capillary globe. use), effectiveness medication and
proliferation, secondary consult a
deposition of CONTRAINDICAT ocular Decreases physician.
collagen and scar ION: infection from salicylates This product is
formation. Acute untreated fungi or sterile when
purulent ocular viruses Decreases packaged. To
infections, acute liberated vaccines prevent
superficial from ocular contamination,
herpes simplex tissues & Decreases care should be
(dendritic perforation of toxoids taken to avoid
keratitis), the globe effectiveness touching the
vaccinia, when there is bottle tip to
varicella & most thinning of eyelids or to
other viral the cornea or any other
diseases of the sclera. surface. The
cornea & Systemic side use of this
conjunctiva, effects may bottle by more
ocular TB & occur w/ than one
fungal diseases extensive use person may
of the eye. of steroids. spread
infection.
As the Keep bottle
possibility of tightly closed
adverse when not in
effects on the use. Keep out
corneal of the reach of
permeability children.
and danger of
disruption of
the corneal
epithelium
with
prolonged or
repeated
usage of
benzalkonium
chloride
preserved
preparations
cannot be
excluded,
regular
ophthalmolog
ical
examination
is required.
Caution
should be
exercised in
the use of
benzalkonium
chloride
preserved
topical
medication
over an
extended
period in
patients with
 extensive
ocular surface
disease.

CHAVEZ, KATELENE B.
4DCN
GROUP 10 6: 00 am
–2:00 pm