Table 12

Drug Study: Epoetin Alfa

NAME OF MECHANISM OF ADVERSE NURSING

CLASSIFICATION INDICATION CONTRAINDICATION
DRUG ACTION EFFECT RESPONSIBILITIES
Generic Name: General Erythropoietin is Anemia caused Contraindicated in CNS: asthenia, BEFORE:
Epoetin Alfa Classification: one factor by reduction patient hypersensitivity dizziness, 1. Evaluate patient’s
Recombinant controlling rate of endogenous to products derived from fatigue, iron status. Patient
Human red blood cells erythropoietin mammal cells or albumin headache, should receive
Erythropoietin (RBC) production; production (human) and in those paresthesia, adequate iron
drug is developed primarily end with uncontrolled seizures. supplementation.
by recombinant stage renal hypertension. 2. Monitor BP before
Trade Name: Functional DNA technology disease; CV: edema, therapy. Blood
Eposino Classification: to correct hypertension, pressure may
Anti-anemics hemostatic increased increase, especially
defect in clotting of when hematocrit
Patient Dose: uremia. arteriovenous increases in the early
6,000 IU grafts. part of therapy
3. Monitor blood
Pt’s GI: abdominal counts.
Minimum Indication: pain and
Dose: Produce constipation (in DURING:
2,000 IU erythropoietin children) 1. Assess patient
hormone to the diarrhea, during dialysis for
bone marrow nausea, bruits, thrills of
Maximum vomiting. shunts; drug
Dose: prevents severe
40,000 IU MS: arthralgia anemia in chronic
renal failure; clotting
RESPI: cough may need to be
shortness of treated with
breath. anticoagulant.

SKIN: infection AFTER:

site reactions, 1. Tell patient to
rash, urticaria. monitor blood
pressure at home
and to adhere to
dietary restrictions.

Source: Spratto, G.R., Woods, A.L. (2010). Delmar Nurse’s Drug Handbook: The information standard for prescription drugs and nursing
considerations. Florence, United States. DLC

38
 Table 13
Source: Karch, A.M., (2003). Lippincott’s Nursing Drug Guide. Lippincott Williams & Wilkins.
Drug Study: Allopurinol

NAME OF MECHANISM OF ADVERSE NURSING

CLASSIFICATION INDICATION CONTRAINDICATION
DRUG ACTION EFFECT RESPONSIBILITIES
Generic Name: General Inhibits xanthine Management of Hypersensitivity to CNS: dizziness, BEFORE:
Allopurinol Classification: oxidase, an the signs and allopurinol, blood headache, 1. Monitor uric acid
Xanthine oxidase enzyme involved in symptoms of dyscrasias. Use paresthesia, levels every 2 weeks
inhibitors the synthesis of primary and cautiously with liver peripheral 2. Monitor renal
uric acid without secondary disease, and renal neuropathy. function; check
disrupting the gout. failure. intake-output ratio.
Trade Name: Functional biosynthesis of Management CV: flushing, 3. Monitor CBC and
Aloprim Classification: essential purine. with hypertension, hepatic function at
Antigout, Results in malignancies hypotension, the start of therapy
Antihyperuricemic decreased acid that results in bradycardia,
Patient Dose: level. elevation of heart failure. DURING:
100mg/tab OD serum and 1. Increase
urinary uric GI: diarrhea, fluids to 2 L/day to
acid. hepatitis, prevent stone
Minimum nausea and formation, toxicity,
Dose: vomiting. BUN, creatinine
100mg Pt’s 2. Advice patient to
Indication: GU: renal calculi avoid taking large
Used for and renal failure dose of vitamin C, it
Maximum reducing the may cause kidney
Dose: production of HEMA: anemia, stone formation.
200mg uric acid in the agranulocytosis,
kidney and bone marrow AFTER:
helps to depression. 1. Be alert for
excrete these adverse reaction and
waste products SKIN: rash drug interaction.
called urea in 2. Maintain a diet
the urine. MUSCULO: enhancing urine
arthralgia, alkalinity, and if
myopathy taking drug for
calcium oxalate
stones, reduce dairy
products, refined
sugar, sodium, and
meat.

Source: Karch, A.M. (2003). Lippincott’s Nursing Drug Guide. Lippincott Williams & Wilkins.

39
Table 14
Drug Study: Clopidogrel

NAME OF MECHANISM OF ADVERSE NURSING

CLASSIFICATION INDICATION CONTRAINDICATION
DRUG ACTION EFFECT RESPONSIBILITIES
Generic Name: General Inhibits platelet Treatment for Hypersensitivity to drug, CNS: BEFORE:
Clopidogrel Classification: aggregation by at risk for use cautiously to depression, 1. Assess patient for
Adenosine blocking ADP ischemic bleeding disorders, and dizziness, symptoms of stoke,
diphosphate (ADP) receptors on events, history severe hepatic fatigue, peripheral vascular
receptor antagonist platelet preventing of MI, ischemic impairment. headache. disease.
clumping of stroke, 2. Monitor CBC with
platelets. peripheral EENT: epistaxis differential and
Trade Name: Functional artery disease. platelet count
Plavix Classification: CV: chest pain, periodically.
Antiplatelet agent edema, 3. Monitor vital signs
Pt’s hypertension. especially BP.
Patient Dose: Indication:
75mg/tab Used for GI: abdominal DURING:
preventing pain, diarrhea. 1. Advise patient to
bleeding take medication with
Minimum tendencies. MS: arthralgia, meals.
Dose: back pain 2. Provide small
75mg frequent meals if GI
RESPI: cough upset occurs (not as
shortness of common as with
Maximum breath. aspirin)
Dose: 3. Provide comfort
300mg HEMA: measures and
bleeding, arrange for analgesic
neutropenia. if headaches occurs

METABOLIC: AFTER:
hyper- 1. Instruct patient to
cholesterolemia report any side
effects or adverse
reactions such as
skin rash, chest pain,
fainting, severe
headache and
abnormal bleeding.

Source: Karch, A.M. (2003). Lippincott’s Nursing Drug Guide. Lippincott Williams & Wilkins.

40
 Table 15
Drug Study: Vitamin B complex

NAME OF MECHANISM OF ADVERSE NURSING

CLASSIFICATION INDICATION CONTRAINDICATION
DRUG ACTION EFFECT RESPONSIBILITIES
Generic Name: General A coenzyme that To treat and Hypersensitivity to CNS: headache, BEFORE:
Vitamin B Classification: stimulate metabolic prevent vitamin vitamin B12 or cobalt dizziness, 1. Determine
complex Multivitamins function and is deficiency and insomnia, reticulocyte count,
needed for cell pernicious fatigue, HCT, Vit.B12, iron,
replication, anemia. tiredness. folate levels.
hematopoiesis, and 2. Obtain a sensitivity
nucleoprotein, and SKIN: rash, test history
myelin synthesis. pruritus, 3. Avoid IVF
Trade Name: Functional Pt’s sweating. administration
Nephro-vite Classification: Indication: because faster
Anti-anemics, Used for GI: dyspepsia, systemic elimination
Food supplement production of gastrointestinal will reduce
Patient Dose: vitamin B12 pain, diarrhea, effectiveness of
1 tab/OD vomiting, vitamin.
constipation.
DURING:
Minimum MS: arthralgia, 1. Don’t give large
Dose: back, limp, or doses routinely; drug
250mg neck pain. is lost through
excretion.
GU: dysuria, 2. Don’t mix the drug
Maximum renal with other drug.
Dose: impairment.
500mg AFTER:
1. Monitor patient for
hypokalemia for first
48 hours as anemia
correct itself. Give
potassium
supplements as
needed.
th
Source: Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2016). Davis’ Drug Guide for Nurses (15 ed.). Philadelphia. Penn.; F.A. Davis

41
Table 16
Drug Study: Calcium carbonate

NAME OF MECHANISM OF ADVERSE NURSING

CLASSIFICATION INDICATION CONTRAINDICATION
DRUG ACTION EFFECT RESPONSIBILITIES

Generic Name: General Essential element Dietary Contraindicated with CV: slowed BEFORE:
Calcium Classification: of the body helps supplement allergy to calcium, renal heart rate, 1. Do not administer
Carbonate Antacid maintain the when calcium calculi use cautiously tingling, oral drugs within 1-2
functional integrity intake is with renal impairment. peripheral hours of antacid
of the nervous and inadequate. vasodilation, fall administration.
muscular system Prevention of in blood 2. Monitor vital signs,
Trade Name: Functional helps maintain hypocalcemia pressure. intake and output.
Calci-Aid Classification: cardiac function, during 3. Assess for blood
Dietary supplement neutralize or exchange CNS: headache, studies.
reduce gastric transfusions. dizziness,
Patient Dose: acidity. Prophylaxis of insomnia, DURING:
1 tab/OD GI bleeding, fatigue, 1. Instruct patient not
stress ulcer, tiredness. to take with oral drug
and aspiration absorption of those
Minimum pneumonia. METABOLIC: medication can be
Dose: hypercalcemia. blocked, take oral
250mg medication at least
Pt’s GI: abdominal 1-2 hours after.
Indication: pain, nausea 2. Take drug between
Maximum Used a and vomiting. meals and at
Dose: replacement bedtime. Chew
500mg of calcium in GU: polyuria, tablets thoroughly
deficiency. renal damage. before swallowing
Controls of and follow up with a
hyperphospha glass of water or milk.
temia in end-
stage renal AFTER:
disease. 1. Instruct patient to
report loss of
appetite, nausea and
vomiting, abdominal
pain, constipation,
increase thirst, and
increase voiding.

th
Source: Vallerand, A.H., Sanoski, C.A., & Deglin, J.H. (2016). Davis’ Drug Guide for Nurses (15 ed.). Philadelphia. Penn.; F.A. Davis

42