Gonzales, Abby B.

BSN 2-7
T1

Drug Name
Generic or Brand Dose, Mechanism of Indication Contraindication Side Effect Nursing Intervention
Name Route and Action
Frequency
Cefuroxime Pharyngitis, 1. Assess oral cavity for
Binds to tonsillitis, Contraindications: Frequent: Discomfort white patches on
bacterial cell infections of the History of with IM administration, mucous membranes,
1.5 g IV () membranes, urinary and lower hypersensitivity/anaph oral candidiasis (thrush), tongue (thrush).
ANST, then inhibits cell wall respiratory tracts ylactic reaction to mild diarrhea, mild 2. Monitor daily pattern
750 mg IV synthesis. and skin and skin cephalosporins. Use abdominal cramping, of bowel activity, stool
q8h structure with caution in vaginal candidiasis. consistency. Mild GI
Therapeutic infections caused breastfeeding women Occasional: Nausea, effects may be
Effect: by Stretoccocus serum sickness–like tolerable (increasing
Bactericidal. pnuemoniae and Cautions: Severe renal reaction (fever, joint pain; severity may indicate
S. pyogenes, impairment, history of usually occurs after onset of antibiotic-
Escherichia coli penicillin allergy. second course of therapy associated colitis).
and resolves after drug is 3. Monitor I&O, renal
discontinued). function tests for
Rare: Allergic reaction nephrotoxicity.
(rash, pruritus, urticaria), 4. Be alert for
thrombophlebitis (pain, superinfection: fever,
redness, swelling at vomiting, diarrhea,
injection site). anal/genital pruritus,
oral mucosal changes
(ulceration, pain,
erythema).
5. Report onset of loose
stools
6. Notify prescriber about
rashes or
superinfections
Mefenamic Acid 500 mg , Anthranilic acid Short term relief Hypersensitivity to stomach pain, nausea 1.Assess patients who
cap q8h derivative. Like of mild to drug; GI inflammation, vomiting, heartburn, develop severe
PRN for ibuprofen moderate pain or ulceration. Safety in constipation, diarrhea, diarrhea and vomiting
 pain inhibits including children <1/t y, during rash, dizziness, tinnitus for dehydration and
prostaglandin dysmenorrhea pregnancy or lactation (ringing in your ears) electrolyte imbalance
synthesis and is not established 2.Lab test: with long
affects platelet term therapy obtain
function. No periodic complete
evidence that is blood counts, Hct and
superior to Hgb, and kidney
aspirin function test
3.Discontinue drug
promptly if diarrhea,
dark stools or rash
occur and do not use
again. contact
physician
4.Do not drive or engage
in potentially
hazardous activities
until response to drug
is known
5.Monitor blood glucose
for loss of glycemic
control if diabetic

Tranexamic Acid 500 mg, Treatment of Hypersensitivity, active Nausea, vomiting, 1. Do skin testing before
cap q8h X 9 Tranexemic acid excessive bleeding intravascular clotting, diarrhea, and muscle pain administering this
doses completely resulting from acquired defective may occur. drug
inhibits action of systemic or local color vision, 2. Advise patient to take
plasminogen to hyperfibrinolysis. subarachnoid medication exactly as
the kringle, Prophylaxis in hemorrhage prescribed
thereby patients with 3. Uusual change in
reducing coagulopathy bleeding pattern
conversion of undergoing should be reported to
plasminogen to surgical the physician
plasmin an procedures 4. Report severe allergic
enzyme that reactiocs such as
degrades fibrin rash, hives, itching,
clots, finrinogen dyspnea, tightness in
and other the chest, swelling of
 plasma proteins the mouth, face, lips
including the or tongue
procoagulant 5. If the patient missed
factors V and a dose, let patient
VIII take when
remembered then
take the next dose at
least 6 hours late
6. Store the medication
at room temperature
away from moisture
and heat
Oxytocin Activates Indicated to Contraindications: Occasional: Tachycardia, 1. Monitor vital signs
10 “u”, IM, receptors that produce uterine Adequate uterine premature ventricular 2. Monitor intrauterine
Now trigger increase contractions activity that fails to contractions, pressure
in intracellular during the third progress, cephalopelvic hypotension, 3. Monitor contractions
calcium levels in stage of labor and disproportion, fetal nausea, vomiting. q15 minutes
uterine to control distress without Rare: Nasal: 4. Notify physician of
myofibrils; postpartum imminent delivery, Lacrimation/tearing, nasal contractions. that last
increases bleeding or grand multiparity, irritation, rhinorrhea, longer than 1 min,
prostaglandin hemorrhage. hyperactive or unexpected uterine occur more
production. hypertonic uterus, bleeding/contractions. frequently than every
Induction or obstetric emergencies 2 min, or stop.
Therapeutic Stimulation of that favor surgical 5. Maintain careful I&O;
Effect: Labor intervention, be alert to potential
Stimulates prematurity, water intoxication.
uterine Control of unengaged fetal head, 6. Check for blood loss.
contractions. Postpartum unfavorable fetal
Bleeding position/presentation,
IV Infusion: when vaginal delivery
ADULTS:10–40 is contraindicated,
units in (e.g., active genital
1,000 ml IV fluid at herpes infection,
rate sufficient to invasive cervical
control uterine cancer, placenta
atony. previa, cord
presentation).
IM: ADULT: 10
 units (total dose) Cautions:
after delivery. of labor should be for
medical, no elective,
reasons.
Methergine Maleate ACL 250mg A semi- Postpartum Contraindications: Frequent: Nausea, uterine 1. Monitor uterine tone,
(Methylergonovine) IV synthetic ergot hemorrhage and Hypertension, cramping, bleeding, B/P,
With BP alkaloid used for uterine atony, pregnancy, toxemia. vomiting. pulse q15min until
precaution the prevention subinvolution Occasional: Abdominal stable (about 1–2 hrs).
and control of Cautions: pain, 2. Assess extremities for
postpartum Renal/hepatic diarrhea, dizziness, color, warmth,
hemorrhage impairment, diaphoresis, tinnitus, movement, pain.
cardiovascular disease, bradycardia, chest pain. 3. Report chest pain
concurrent use with Rare: Allergic promptly.
CYP3A4 inhibitors (e.g., reaction (rash, pruritus), 4. Provide support with
protease inhibitors), dyspnea; severe or ambulation if
occlusive peripheral sudden hypertension dizziness occurs.
vascular disease, 5. Be alert of adverse
sepsis, second stage of drug reaction and
labor. drug interactions
6.
Magnesium Sulfate Antacid: Acts in IV or IM: Contraindications: Frequent:Antacid: Chalky Antacid:
4g SWP for stomach to preeclampsia or Antacid: Appendicitis, taste, diarrhea, laxative 1. Assess for relief of
30 min neutralize eclampsia symptoms of effect. Occasional: gastric distress.
then 5g gastric acid. To correct or appendicitis, ileostomy, Antacid: 2. Monitor renal
drip in Therapeutic prevent intestinal obstruction, Nausea, vomiting, function (esp. if
every 30 Effect: Increases hypomagnese mia severe renal stomach cramps. dosing is long term or
min for 2 pH. in patients or impairment. Antacid, laxative: frequent).
doses as Laxative: parenteral Laxative: Appendicitis, Prolonged Laxative:
loading Osmotic effect nutrition HF, use or large doses in renal 1. Monitor daily pattern
dose ; primarily in colostomy, impairment may cause of bowel activity,
toxicity small intestine hypersensitivity, hypermagnesemia stool consistency.
precaution draws water ileostomy, intestinal (dizziness, palpitations, 2. Maintain adequate
s then 5g In into intestinal obstruction, altered mental status, fluid intake
every 6 lumen. undiagnosed rectal fatigue, weakness).
hours in bleeding Laxative: Cramping,
alternating Therapeutic Systemic: Heart block, diarrhea, increased thirst, Systemic:
buttock for Effect: myocardial damage, flatulence. 1. Monitor renal
4 doses as Promotes renal failure function, magnesium
 MD peristalsis, Cautions: Safety in Systemic (dietary levels, EKG for
bowel children younger than supplement, cardiac function.
evacuation. 6 yrs. not known. electrolyte replacement): 2. Test patellar reflexes
Systemic Reduced respiratory rate, before giving
(dietary decreased reflexes, repeated, rapid
supplement flushing, hypotension, parenteral doses
replacement): decreased heart rate. (used as indication of
Found primarily CNS depression;
in intracellular suppressed reflexes
fluids. may be sign of
impending
Therapeutic respiratory arrest).
Effect: Essential 3. Patellar reflex must
for enzyme be present,
activity, nerve respiratory rate
conduction, should be 16/min or
muscle over before each
contraction. parenteral dose.
Maintains and 4. Initiate seizure
restores precautions.
magnesium
levels.
Diazepam 5mg IV, Depresses all Spasticity Contraindications: 1. Assess B/P, pulse,
Now levels of CNS by associated with Acute narrow-angle Frequent: Pain with IM respirations
enhancing cerebral palsy, glaucoma, severe injection, drowsiness, immediately before
Maximum: action of spinal cord injury; respiratory depression, fatigue, and ataxia. administration.
0.6 mg/ kg gamma- reflex severe hepatic 2. Anxiety: Assess
within 8-hr aminobutyric spasm due to insufficiency, sleep Occasional: Slurred autonomic response
period. acid, a major muscle, joint apnea syndrome, speech, orthostatic (cold, clammy, hands,
inhibitory trauma or myasthenia gravis. hypotension, headache, diaphoresis), motor
neurotransmitte inflammation Children less than 6 hypoactivity, response (agitation,
r in the brain. months of age. constipation, nausea, trembling, tension).
Therapeutic blurred vision. 3. Musculoskeletal
Effect: Cautions: patients spasm: Record onset,
Producesanxioly receiving other CNS Rare: Paradoxical CNS type, location, duration
tic effect, depressants or reactions of pain.
elevates seizure psychoactive agents, (hyperactivity/nervousnes 4. Check for immobility,
threshold, depression, history of s in children, stiffness, and swelling.
 produces drug and alcohol excitement/restlessness 5. Seizures: Review
skeletal muscle abuse, renal/hepatic in elderly/debilitated) history of seizure
relaxation. impairment, generally noted during disorder (length,
respiratory disease, first 2 wks of therapy, intensity, frequency,
impaired gag reflex, particularly in presence duration, LOC).
concurrent use of of uncontrolled pain. 6. Observe frequently for
strong CYP3A4 recurrence of seizure
inhibitors or inducers. activity. Initiate seizure
precautions.
Ranitidine 5 mg IV Inhibits Treatment and Contraindications: Occasional (2%): 1. Obtain history of
q8h X 3 histamine action prevention of None known. Diarrhea. epigastric/abdominal
doses at histamine heartburn, acid Cautions: pain.
2 receptors of indigestion and Renal/hepatic Rare (1%): 2. Obtain baseline renal
gastric parietal sour stomach. impairment, elderly, Constipation, headache function, LFT.
cells. Prophylaxis of GI history of acute (may be severe) 3. Monitor serum ALT,
Therapeutic hemorrhage from porphyria. AST levels, BUN,
Effect: Inhibits stress ulceration creatinine.
gastric acid 4. Assess mental status in
secretion. elderly.
Reduces gastric 5. Question present
volume, abdominal pain, GI
hydrogen ion distress.
concentration of 6. Patient/Family
gastric juice. teaching

Metoclopramide 10 mg IV Stimulates Postop Contraindications: 1. Monitor for anxiety,

q8h X 3 motility of Nausea/Vomiting Concurrent use of Doses of 2 mg/kg or restlessness,
doses upper GI tract. medications likely to greater, extrapyramidal
Blocks produce or increased length of symptoms (EPS)
dopamine/serot extrapyramidal therapy, may result during IV
onin receptors reactions, GI in a greater incidence of administration.
in hemorrhage, GI side effects. 2. Monitor daily
chemoreceptor obstruction/perforatio pattern of bowel
trigger zone. n, history of seizure Frequent (10%): activity, stool
Enhances disorder, Drowsiness, restlessness, consistency.
acetylcholine pheochromocytoma. fatigue, lethargy. 3. Assess skin for rash.
response in 4. Evaluate for
upper GI tract; Cautions: Renal Occasional (3%): therapeutic
 increases lower impairment, HF, Dizziness, anxiety, response from
esophageal cirrhosis, hypertension, headache, insomnia, gastroparesis
sphincter tone. depression, Parkinson’s breast tenderness, altered (nausea, vomiting,
Therapeutic disease, elderly. menstruation, bloating).
Effect: constipation, rash, dry 5. Monitor renal
Accelerates mouth, galactorrhea, function, B/P, heart
intestinal gynecomastia. rate.
transit, 6. Monitor for
promotes Rare (less than 3%): extrapyramidal
gastric Hypotension, reactions and
emptying. hypertension, consult physician if
Relieves nausea, tachycardia. they occur
vomiting
Ampicillin 2g as LD Inhibits cell wall Prophylaxis in Contraindications: Frequent: Pain at IM 1. Assess for allergies
then 1g IV synthesis in caesarean section Hypersensitivity to any injection site, GI to penicillins or
q6h susceptible in certain high risk penicillin. disturbances (mild other allergens
microorganisms. patients. Cautions: History of diarrhea, nausea, 2. Assess for renal
Therapeutic Prevention of allergies, vomiting), oral or vaginal disorders, lactation
Effect: bacterial esp. cephalosporins, candidiasis. 3. Check the patency of
Bactericidal in endocarditis renal impairment, Occasional: Generalized the IV site and IV line
susceptible following dental asthmatic pts, rash, urticaria, 4. Administer drug on
microorganisms. procedures or infectious phlebitis, an empty stomach
respiratory mononucleosis. thrombophlebitis (with IV 5. Check IV site for
procedures in very administration), thrombosis or drug
high risk patients headache. reaction
Rare: Dizziness, seizures 6. Report pain or
(esp. with IV therapy). unusual bleeding,
bruising mouth sores,
hives, fever or
difficulty breathing
Metronidazole 500 mg () Disrupts DNA, Anaerobic Contraindications: Frequent: Systemic: 1. Monitor daily pattern
ANST IV inhibiting Infections Pregnancy (first Anorexia, nausea, dry of bowel activity,
q8h nucleic acid trimester), use of mouth, metallic taste. stool consistency.
Maximum: synthesis. disulfiram within 2 wks, Vaginal: 2. Monitor I&O, assess
4 g/day use of alcohol during Symptomatic for urinary problems.
Therapeutic therapy or within 3 cervicitis/vaginitis, Be alert to neurologic
Effect: Produces days of discontinuing abdominal cramps, symptoms (dizziness,
bactericidal, metronidazole. uterine pain. paresthesia of
antiprotozoal, Occasional: Systemic: extremities).
amebicidal, Cautions: Blood Diarrhea, constipation, 3. Assess for rash,
trichomonacidal dyscrasias, severe vomiting, dizziness, urticaria.
effects. hepatic dysfunction; erythematous rash, 4. Monitor for onset of
Produces end-stage renal urticaria, reddish-brown superinfection
anti- disease, history of urine. (ulceration/change of
inflammatory, seizures, HF, other Topical: Transient oral mucosa, furry
immunosuppres sodium-retaining erythema, mild dryness, tongue, vaginal
sive states, elderly. burning, irritation, discharge,
effects when stinging, tearing when genital/anal pruritus).
applied topically applied too close to eyes.
Vaginal:
Vaginal, perineal, vulvar
itching; vulvar swelling.
Rare: Mild, transient
leukopenia;
thrombophlebitis with IV
therapy.

Gentamicin 240 mg () Irreversibly 1. Monitor I&O

ANST X 30 binds to protein Contraindications: Occasional: IM: Pain, (maintain hydration),
minutes of bacterial Hypersensitivity to induration at injection urinalysis (casts,
OD ribosomes. other aminoglycosides site. IV: Phlebitis, RBCs, WBCs, decrease
Therapeutic (cross-sensitivity) or thrombophlebitis, in specific gravity). Be
Effect: their components. hypersensitivity reactions alert to ototoxic,
Interferes with (fever, pruritus, rash, neurotoxic symptoms
protein Cautions: Elderly, urticaria). Ophthalmic: (see Adverse
synthesis of neonates due to renal Burning, tearing, itching, Effects/Toxic
susceptible insufficiency or blurred vision. Reactions).
microorganisms. immaturity; 2. Check IM injection
Bactericidal. neuromuscular Rare: Alopecia, site for induration.
disorders (potential for hypertension, fatigue. 3. Evaluate IV site for
respiratory phlebitis (heat, pain,
depression); vestibular red streaking over
or cochlear vein).
impairment; renal 4. Assess for rash
impairment, (Ophthalmic: redness,
hypocalcemia, burning, itching,
myasthenia gravis. tearing).
Pediatric pts on 5. Be alert for
extracorporeal superinfection
membrane (genital/anal pruritus,
oxygenation. changes in oral
mucosa, diarrhea).
6. When treating pts
with neuromuscular
disorders, assess
respiratory response