DRUG STUDY

Nursing Considerations for all drugs:

1. Ensure medications is administered to right patient, with right dose, time and route.
2. Assess patient before and after administration of medication, vital signs, significant signs and symptoms.
3. Explain the desired effects of the medication and observe for side effects.
4. Document
5. Report any untoward side or adverse effect to physician.

Patient RVP

Generic Name, Dose, Action Indication for the Contraindication Side Effects Nursing Consideration
Frequency, Route patient
Tramadol + Nonopioid-derived As needed for pain Hypersensitivity CNS and GI 1. Assess for pain
Paracetamol synthetic opioid, (+) pain 5-7/10 at Obstetric disturbances, nausea, characteristics and scale
37.5/325mg/tab 1 tab centrally acting left chest postoperative or dizziness, prior and after
TID po as needed for analgesic, but may characterized as post-delivery somnolence, administration.
pain act at least partially stabbing pain analgesia asthenia, fatigue, hot 2. Assess for
Class: Analgesic, by binding to opioid Acute intoxication flushes, constipation, hypersensitivity
Opioid combos mu receptors. with alcohol, diarrhea, flatulence, 3. Assess for signs of
Paracetamol acts narcotics dry mouth, pruritus, dependency, addiction,
on the Children <12 years increased sweating, abuse and misuse
hypothalamus to old tinnitus 4. Assess for presence of
produce antipyresis Significant nausea
and analgesia. respiratory
depression
Concurrent use of
MAOIs/ within the
last 14 days
Oral Potassium Essential in To increase serum Hypersensitivity Arrythmias 1. Assess potassium
chloride 10% solution physiologic process potassium. Untreated Bleeding levels prior and after
30cc TID po x 3 doses Treatment of Addison’s disease Diarrhea administration
Class: Electrolyte hypokalemia Hyperkalemia Dyspepsia 2. Oral potassium chloride
supplements Hyperkalemia is irritant to the
 Serum K+: Concomitant use Nausea gastrointestinal tract and
2.9mmol/L with triamterene Rash high local concentrations
and amiloride Vomiting can lead to ulceration.
Renal failure Dilute the solution such as
20meq is contained in at
least 120ml of water or
juice.
3. Assess signs and
symptoms of hypokalemia
(ECG changes, prominent
u wave, weakness,
fatigue)
Potassium chloride Essential in To increase serum Hypersensitivity Arrythmias 1. Assess potassium
20meqs IV (in physiologic process potassium. Untreated Bleeding levels prior and after
PNSS1L) x 8 hours Treatment of Addison’s disease Diarrhea administration
infusion x 2 cycles hypokalemia. Hyperkalemia Dyspepsia 2. Assess signs and
Class: Electrolyte Serum K+: Concomitant use Hyperkalemia symptoms of hypokalemia
supplements 2.9mmol/L with triamterene Nausea (ECG changes, prominent
and amiloride Rash u wave, weakness,
Renal failure Vomiting fatigue)
3. Ensure that intravenous
potassium chloride should
be given via infusion
mixed with appropriate
intravenous fluids.
4. DO NOT GIVE IV
PUSH
5. Assess patency of
intravenous line prior to
administration
6. Ensure cardiac monitor/
ECG is attached to
patients chest
Magnesium sulfate 2.5 Depresses CNS, To increase serum Hypersensitivity Circulatory collapse 1. Assess magnesium
grams IV (in PNSS1L) blocks peripheral magnesium. Myocardial Respiratory paralysis levels prior and after
x 8 hours infusion x 2 neuromuscular Treatment of damage, diabetic Hypothermia administration
cycles transmission, hypomagnesemia. coma, heart block Pulmonary edema 2. Ensure that potassium
Class: Electrolyte produces Serum Mg++: Hypermagnesemia Depressed reflexes correction must be done, it
supplements/ Anti- anticonvulsant 0.64mmol/L Hypercalcemia Hypotension is usually associated with
dysrhythmia effects; decreases Flushing hypokalemia
amount of Drowsiness 3. Monitor renal function,
acetylcholine Depressed cardiac blood pressure,
release at end- function respiratory rate, deep
plate by motor Diaphoresis tendon reflex
nerve impulse. Hypocalcemia 4. Assess patency of
It slows rate of SA Hypophosphatemia intravenous line prior to
node impulse Hyperkalemia administration
formation in Visual changes 5. Ensure cardiac monitor/
myocardium and ECG is attached to
prolongs patients chest
conduction time.
Promotes
movement of
calcium, potassium
and sodium in and
out of cells and
stabilizes excitable
membranes

Ondansetron 8mg IV Selective 5-HT3 To prevent nausea/ Hypersensitivity Headache, fatigue, 1. Assess presence of
30 minutes before receptor vomiting constipation, hypoxia, nausea/ vomiting prior
chemotherapy antagonist; binds to drowsiness, diarrhea, administrating drug
Class: Anti-emetic 5-HT3 receptors fever, anxiety, urinary 2. Monitor fluid and
both in periphery retention, pruritus, electrolyte status, may
and in CNS, with paresthesia cold cause diarrhea leading to
sensation electrolyte imbalance
 primary effects in
GI tract
Dexamethasone 20mg Potent For chemotherapy- Systemic fungal Allergic reactions, 1. Assess for allergies
IV 30 minutes before glucocorticoid with induced nausea infection cardiovascular 2. Assess would healing
chemotherapy minimal to no and vomiting Documented problems 3. Monitor blood glucose
Class: Corticosteroids mineralocorticoid hypersensitivity levels, may elevate blood
activity Cerebral malaria sugar
It decreases Administration of 4. Monitor cholesterol and
inflammation by live or live lipid values, may increase
suppressing attenuated level
migration of vaccines 5. Monitor for CNS
polymorphonuclear changes
leukocytes and
reducing capillary
permeability;
stabilizes cell and
lysosomal
membranes,
inhibits
prostaglandin and
proinflammatory
cytokines,
improves
pulmonary
microcirculation
Metoclopramide 10mg Blocks dopamine To prevent nausea/ Hypersensitivity Extrapyramidal 1. Assess presence of
every 8 hours IV as receptors (at high vomiting History of tardive symptoms nausea/ vomiting prior,
needed for nausea and dose) and dyskinesia Fatigue, restlessness, during and after
vomiting serotonin receptors Stimulation of sedation, headache, chemotherapy
Class: Anti-emetic in chemoreceptor gastrointestinal dizziness, 2. Ensure availability of
trigger zone of motility somnolence, diphenhydramine in case
CNS; and Presence of of extrapyramidal
sensitizes tissues pheochromocytoma symptoms
 to acetylcholine; or other 3. Assess for presence of
increases upper GI catecholamine- involuntary movement of
motility but not releasing face, eyes, limbs, severe
secretions; paragangliomas depression and diarrhea
increases lower History of epilepsy 4. Instruct patient to avoid
esophageal use of alcohol, sleep
sphincter tone. remedies or sedatives
Etoposide 150mg IV Inhibit or alter DNA To slow down Hypersensitivity Leukopenia 1. Ensure that
(in PNSS500ml) x 1 replication, induces growth of cancer Nausea and vomiting chemotherapy protocol
hour infusion G2-phase arrest cells Thrombocytopenia were followed prior to
Class: Antineoplastic and preferentially Alopecia administration
Plant alkaloid kills cells in G2 and Anorexia 2. Ensure presence/
late S phases Diarrhea supervision of an
Anemia experienced oncologist in
Pancytopenia administrating
Stomatitis chemotherapeutic drugs
Hepatotoxicity 3. Use personal protective
Type I hypersensitivity equipment in handling
Orthostatic chemotherapeutic drugs
hypotension 4. Counter-check
Peripheral neuropathy chemotherapy drugs with
another nurse on duty
5. Monitor patient’s vital
signs every hour during
infusion
Carboplatin 600mg IV Platinum Stops cancer cell Severe Leukopenia 1. Ensure that
(in D5W500ml) x 30 coordination from multiplying. hypersensitivity to Neutropenia chemotherapy protocol
minutes infusion compound; carboplatin, other Nausea and vomiting were followed prior to
Class: Antineoplastic covalently binds to platinum Anemia administration
Alkylating agent DNA; cross-links compounds and Magnesium loss 2. Ensure presence/
strands of DNA mannitol Thrombocytopenia supervision of an
Alopecia experienced oncologist in
Asthenia
 Severe Elevated alkaline administrating
myelosuppression, phosphatase chemotherapeutic drugs
significant bleeding Central neurotoxicity 3. Use personal protective
Severe renal Elevated AST equipment in handling
dysfunction Peripheral neuropathy chemotherapeutic drugs
Pregnancy/ 4. Counter-check
lactation chemotherapy drugs with
another nurse on duty
5. Monitor patient’s vital
signs every hour during
infusion

Patient EGR

Generic Name, Dose, Action Indication for the Contraindication Side Effects Nursing Consideration
Frequency, Route patient
Ondansetron 8 mg IV Selective 5-HT3 To prevent nausea/ Hypersensitivity Headache, fatigue, 1. Assess presence of
30 minutes prior to receptor vomiting constipation, hypoxia, nausea/ vomiting prior
chemotherapy antagonist; binds to drowsiness, diarrhea, administrating drug
Class: Anti-emetic 5-HT3 receptors fever, anxiety, urinary 2. Monitor fluid and
both in periphery retention, pruritus, electrolyte status, may
and in CNS, with paresthesia cold cause diarrhea leading to
primary effects in sensation electrolyte imbalance
GI tract
Diphenhydramine Histamine H1- To prevent allergic Hypersensitivity Sedation, confusion, 1. Assess for allergic
25mg/tab 1 tab po 30 receptor antagonist reaction Lower respiratory anticholinergic effects, reaction
minutes prior to of effector cells n tract disease xerostomia, dry nasal 2. Monitor signs and
chemotherapy respiratory tract, Nursing mothers mucosa, pharyngeal symptoms of drowsiness
Class: Antihistamine blood vessels and dryness, thick 3. Ensure side rails are up
GI smooth muscle bronchial sputum, to prevent fall
agranulocytosis, 4. Assess for lung sounds
hemolytic anemia, for rhonchi, wheezing,
thrombocytopenia, rales
 convulsion,
tachycardia,
hypotension,
nervousness,
restlessness
Paracetamol Inhibits CNS To prevent fever Hypersensitivity Severe liver damage 1. Assess presence of
500mg/tab 1 tab as prostaglandin and pain with toxic doses pain or fever prior to
needed for fever and synthesis. It also administration
pain relieves fever by 2. Monitor for signs of
Class: Analgesic, Non- central action in the hepatotoxicity such as
opioid hypothalamic heat- bleeding, bruising and
regulating center. malaise

Decitabine 25mg IV (in Inhibits DNA Helps bone marrow Hypersensitivity Neutropenia 1. Ensure that
PNSS 250ml) x 1 hour methyltransferase, grow normal blood Thrombocytopenia chemotherapy protocol
infusion causing cells so that the Anemia were followed prior to
Class: Antineoplastic hypomethylation of patient will need Pyrexia administration
DNA Methylation DNA and cellular fewer blood Nausea 2. Ensure presence/
inhibitor differentiation or transfusions. It also Cough supervision of an
apoptosis kills abnormal Petechiae experienced oncologist in
blood cells that Constipation administrating
have grown too fast Diarrhea chemotherapeutic drugs
and do not work Hyperglycemia 3. Use personal protective
properly Febrile neutropenia equipment in handling
chemotherapeutic drugs
4. Counter-check
chemotherapy drugs with
another nurse on duty
5. Monitor patient’s vital
signs every hour during
infusion
6. Monitor complete blood
count levels
Folic acid 400mcg/tab Necessary for Nutritional Hypersensitivity Bronchospasm 1. Assess patient for signs
1 tab OD po formation of supplementation Erythema and symptoms of
Class: Vitamin coenzymes in Malaise malnutrition
metabolic systems, Pruritus 2. Encourage patient to
stimulates platelet Rash eat foods rich in vitamins
production in folate Slight flushing and minerals aside from
deficiency anemia taking supplement
3. Monitor patient
accordingly
Vitamin B complex tab, B-complex vitamins -Supplement, anti- Sensitivity to any of Headache, 1. Monitor reticulocyte
(thiamine, riboflavin, acts as coenzyme anemic the ingredients dizziness, count, hematocrit, vitamin
niacin, pyridoxine, and are essential -B6 is an essential included in the insomnia, b12, iron, folate levels
cobalamin, folic acid, for metabolism of building block of medication, B12 fatigue, May take with or without
pantothenic acid) proteins, red blood cell and cobalt tiredness, meals
100mg/5mg/50mcg 1 carbohydrates and formation and rash,
tab once a day per fatty acids synthesis of pruritus,
orem hemoglobin sweating,
Class: Anti anemic, -RBC: 3.14 dry mucous
supplement -Hgb: 78 membrane,
-Hct:0.23 stomatitis,
dyspepsia,
GI pain,
diarrhea,
vomiting,
constipation,
dysuria,
renal impairment,
arthralgia,
back limp or neck pain
Tranexamic acid Inhibits fibrinolysis To prevent Hypersensitivity Visual abnormalities 1. Monitor for signs and
500mg every 8 hours by displacing bleeding Acquired defective Hypotension symptoms of bleeding
IV as needed for plasminogen from color vision Nausea and vomiting 2. Monitor heart rate and
bleeding fibrin Diarrhea blood pressure
Class: Antifibrinolytic Reduces plasmin Subarachnoid Anaphylaxis 3. Monitor complete blood
agent activity, which in hemorrhage count levels
turn reduces Active intravascular 4. Document time
activation of clotting bleeding started and
complement and stopped. Take note of the
consumption of c1 estimated or if possible
esterase inhibitor the exact amount of blood
(C1-NH) and loss if any
subsequently
decreases
inflammation
associated with
hereditary
angioedema

Patient RDD

Generic Name, Dose, Action Indication for the Contraindication Side Effects Nursing Consideration
Frequency, Route patient
Potassium chloride Essential in To increase serum Hypersensitivity Arrythmias 1. Assess potassium
40meqs IV (in physiologic process potassium. Untreated Bleeding levels prior and after
PNSS1L) x 8 hours Treatment of Addison’s disease Diarrhea administration
infusion x 2 cycles hypokalemia. Hyperkalemia Dyspepsia 2. Ensure that intravenous
Class: Electrolyte Concomitant use Hyperkalemia potassium chloride should
supplements with triamterene Nausea be given via infusion
and amiloride Rash mixed with appropriate
Renal failure Vomiting intravenous fluids.
3. DO NOT GIVE IV
PUSH
4. Assess patency of
intravenous line prior to
administration
 5. Ensure cardiac monitor/
ECG is attached to
patients chest
Magnesium sulfate 2 Depresses CNS, To increase serum Hypersensitivity Circulatory collapse 1. Assess magnesium
grams IV (in PNSS1L) blocks peripheral magnesium. Myocardial Respiratory paralysis levels prior and after
x 8 hours infusion x 2 neuromuscular Treatment of damage, diabetic Hypothermia administration
cycles transmission, hypomagnesemia. coma, heart block Pulmonary edema 2. Ensure that potassium
Class: Electrolyte produces Hypermagnesemia Depressed reflexes correction must be done, it
supplements/ Anti- anticonvulsant Hypercalcemia Hypotension is usually associated with
dysrhythmia effects; decreases Flushing hypokalemia
amount of Drowsiness 3. Monitor renal function,
acetylcholine Depressed cardiac blood pressure,
release at end- function respiratory rate, deep
plate by motor Diaphoresis tendon reflex
nerve impulse. Hypocalcemia 4. Assess patency of
It slows rate of SA Hypophosphatemia intravenous line prior to
node impulse Hyperkalemia administration
formation in Visual changes 5. Ensure cardiac monitor/
myocardium and ECG is attached to
prolongs patients chest
conduction time.
Promotes
movement of
calcium, potassium
and sodium in and
out of cells and
stabilizes excitable
membranes

Dexamethasone Potent For chemotherapy- Systemic fungal Allergic reactions, 1. Assess for allergies
4mg/tab 1 tab BID po x glucocorticoid with induced nausea infection cardiovascular 2. Assess would healing
3 days minimal to no and vomiting Documented problems
Class: Corticosteroids hypersensitivity
 mineralocorticoid Cerebral malaria 3. Monitor blood glucose
activity Administration of levels, may elevate blood
It decreases live or live sugar
inflammation by attenuated 4. Monitor cholesterol and
suppressing vaccines lipid values, may increase
migration of level
polymorphonuclear 5. Monitor for CNS
leukocytes and changes
reducing capillary
permeability;
stabilizes cell and
lysosomal
membranes,
inhibits
prostaglandin and
proinflammatory
cytokines,
improves
pulmonary
microcirculation
Ondansetron 8mg/tab Selective 5-HT3 To prevent nausea/ Hypersensitivity Headache, fatigue, 1. Assess presence of
1 tab BID po x 3 days receptor vomiting constipation, hypoxia, nausea/ vomiting prior
Class: Anti-emetic antagonist; binds to drowsiness, diarrhea, administrating drug
5-HT3 receptors fever, anxiety, urinary
both in periphery retention, pruritus,
and in CNS, with paresthesia cold
primary effects in sensation
GI tract
Cisplatin 150mg IV (in Platinum To cause damage Hypersensitivity to Nausea 1. Ensure that
PNSS1L) x 6 hours coordination to cancer cells, cisplatin and other Vomiting chemotherapy protocol
infusion compound that blocking cell platinum Nephrotoxicity were followed prior to
Class: Antineoplastic inhibits DNA division and compounds Ototoxicity administration
Alkylating agent synthesis; cross- Myelosuppression
 links and denatures resulting in Severe Anaphylaxis 2. Ensure presence/
strands of DNA; apoptotic cell death myelosuppression, Alopecia supervision of an
disrupts DNA renal impairment, experienced oncologist in
function by hearing impairment administrating
covalently binding Pregnancy, chemotherapeutic drugs
to DNA bases; can lactation 3. Use personal protective
also produce DNA equipment in handling
intrastrand cross- chemotherapeutic drugs
linking and breakge 4. Counter-check
chemotherapy drugs with
another nurse on duty
5. Monitor patient’s vital
signs every hour during
infusion
6. Monitor complete blood
count levels
Furosemide 40mg IV Loop diuretic; To prevent Hypersensitivity, Dizziness, 1. Assess fluid status
after hydration of inhibits congestion anuria, hepatic encephalopathy, during therapy
PNSS 500ml x fast reabsorption of -patient at risk for coma, severe headache, 2. Monitor blood pressure
drip sodium and pleural effusion hypokalemia or insomnia, and heart rate
chloride ions at hyponatremia, nervousness, 3. Monitor weight, intake
proximal and distal hypovolemia with hearing loss, and output
renal tubules and or without tinnitus, 4. Monitor for presence of
loop of Henle; by hypotension, hypotension, edema, lung sounds, skin
interfering with photosensitivity, turgor, mucous
chloride-binding rashes, membranes
cotransport system, hyperglycemia, 5. Monitor electrolytes
causes increases dehydration, (sodium, potassium), renal
in water, calcium, hypokalemia, and hepatic function,
magnesium, hypomagnesemia, serum glucose and uric
sodium and hyponatremia, acid levels
chloride hypovolemia,
metabolic alkalosis,
 blood dyscrasias,
hyperglycemia,
hyperuricemia,
arthralgia,
muscle cramps,
myalgia,
increased BUN
5-Fluorouracil 1500mg Inhibits DNA Prevents cell Hypersensitivity Loss of appetite 1. Ensure that
IV (in PNSS1L) x 20 synthesis during S proliferation Poor nutritional Headache chemotherapy protocol
hours infusion phase by inhibition status Nausea and vomiting were followed prior to
Class: Antineoplastic of thymidylate Myelosuppresion Diarrhea administration
Antimetabolite synthetase Serious infection Mucositis 2. Ensure presence/
Recent surgery Myelosuppression supervision of an
Dihydropyrimidine Alopecia experienced oncologist in
dehydrogenase Photosensitivity administrating
deficiency Hand-foot syndrome chemotherapeutic drugs
Maculopapular 3. Use personal protective
eruption equipment in handling
chemotherapeutic drugs
4. Counter-check
chemotherapy drugs with
another nurse on duty
5. Monitor patient’s vital
signs every hour during
infusion
Metoclopramide 10mg Blocks dopamine To prevent nausea/ Hypersensitivity Extrapyramidal 1. Assess presence of
every 8 hours IV as receptors (at high vomiting History of tardive symptoms nausea/ vomiting prior,
needed for nausea and dose) and dyskinesia Fatigue, restlessness, during and after
vomiting serotonin receptors Stimulation of sedation, headache, chemotherapy
Class: Anti-emetic in chemoreceptor gastrointestinal dizziness, 2. Ensure availability of
trigger zone of motility somnolence, diphenhydramine in case
CNS; and Presence of of extrapyramidal
sensitizes tissues pheochromocytoma symptoms
 to acetylcholine; or other 3. Assess for presence of
increases upper GI catecholamine- involuntary movement of
motility but not releasing face, eyes, limbs, severe
secretions; paragangliomas depression and diarrhea
increases lower History of epilepsy 4. Instruct patient to avoid
esophageal use of alcohol, sleep
sphincter tone. remedies or sedatives

References:
Patient charts
Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2006) Pharmacology: A Nursing Process Approach- 5th Edition. Singapore:
Elsevier.
Medscape (2019). Medscape WebMD LLC. [Mobile application software]. Retrieved from http://play.google.com/store
MIMS Philippines (2018). MIMS Drug Refence: Concise Prescribing Information (155th ed.). Singapore