JH CERILLES STATE COLLEGE

in consortium with
Western Mindanao State University
West Capitol Road, Balangasan District, Pagadian City

PATIENT INITIALS : __________________________

- DATE -
: __________________________
STUDENT NURSE N. Aranding & W. Catong
: __________________________ AREA of ROTATION ZDSMC – Ostetrics Ward
: __________________________
BSN-II, Batch Merakia
YEAR LEVEL and BATCH : __________________________ Odessa Bugarin, MN
CLINICAL INSTRUCTOR : __________________________

DRUG STUDY

Prescribed
Generic Name, Dosage,
Mechanism of
Brand Name, Frequency, Indication Contraindication Adverse Reaction Nursing Responsibilities
Action
Classification and Route of
Administration
- Assess for anginal pain,
Generic Name: Dosage: Inhibits calcium Management Cardiogenic CNS: headache, including location,
nifedipine (nye 10– 30 mg transport into of: shock; advanced abnormal dreams, intensity, duration, and
FED i peen) myocardial and Hypertension(e aortic stenosis; anxiety, confusion, alleviating and
vascular smooth xtended- acute angina; dizziness, drowsiness, aggravating factors.
Brand Names: Frequency: muscle cells, release only), porphyria; within jitteriness, nervousness,
Adalat CC, 3 times daily resulting in Angina a month of psychiatric disturbances, - Assess cardiac status
Afeditab CR, inhibition of pectoris, myocardial weakness. with BP, pulse,
Nifediac CC, excitation- Vasospastic infarction. respiration and ECG.
Nifedical XL, Route: contraction (Prinzmetal’s) EENT: blurred vision,
Procardia, Oral route coupling and angina. disturbed equilibrium, - Monitor potassium and
Procardia XL, subsequent Unlabeled Use: epistaxis, tinnitus. liver function tests

25
Adalat contraction. Prevention of Resp: cough, dyspnea, throughout treatment
migraine shortness of breath. with nifedipine.
Classification headache.
Therapeutic: Management CV: ARRHYTHMIAS,
antianginals, of HF or HF, peripheral edema,
antihypertensives cardiomyopath bradycardia, chest pain,
y. hypotension,
Pharmacologic: palpitations, syncope,
calcium channel tachycardia.
blockers
Pregnancy GI: liver enzymes,
Category C anorexia, constipation,
diarrhea, dry mouth,
dysgeusia, dyspepsia, GI
obstruction, nausea,
ulcer, vomiting.

GU: dysuria, nocturia,

polyuria, sexual
dysfunction, urinary
frequency.

Dermatologic: flushing,
dermatitis, erythema
multiforme, sweating,
photosensitivity,
pruritus/urticaria, rash.

Endocrine:
gynecomastia,
hyperglycemia.

26
 Hematologic: anemia,
leukopenia,
thrombocytopenia.

Metabolic: weight gain.

MS: joint stiffness,

muscle cramps. Neuro:
paresthesia, tremor.

Misc: STEVENS-
JOHNSON
SYNDROME, gingival
hyperplasia.

Prescribed
Generic Name, Dosage,
Mechanism of
Brand Name, Frequency, Indication Contraindication Adverse Reaction Nursing Responsibilities
Action
Classification and Route of
Administration

27
Generic name: PO (Adults Results in the Management Contraindicated CNS: nervousness, -Bronchodilator: Assess
terbutaline (ter- and Children accumulation of of reversible in: restlessness, tremor, lung sounds, respiratory
byoo-ta-leen) >15 yr): cyclic airway disease Hypersensitivity headache, insomnia. pattern, pulse, and BP
Bronchodilation adenosine due to asthma to adrenergic Resp: pulmonary edema. before administration and
Brand name: —2.5– 5 mg 3 monophosphate or COPD; amines. during peak of
Bricanyl times daily, (cAMP) at beta- inhalation and CV: angina, medication. Note amount,
given q 6 hr adrenergic sub-cut used Use Cautiously arrhythmias, color, and character of
Classification (not to exceed receptors. for short-term in: Cardiac hypertension, sputum produced, and
Therapeutic: 15 mg/24 hr). Produces control and disease; myocardial ischemia, notify health care
bronchodilators bronchodilation. oral agent as Hypertension; tachycardia professional of abnormal
PO (Children Inhibits the long-term Hyperthyroidism; findings.
Pharmacologic: 12– 15 yr): release of control. Diabetes; GI: nausea, vomiting.
adrenergics Bronchodilation mediators of Glaucoma; Endo: hyperglycemia. F -Assess maternal
— 2.5 mg 3 immediate Unlabeled and E: hypokalemia. respiratory status for
Pregnancy times hypersensitivity Use: Geriatric: symptoms of pulmonary
Category B daily(given q 6 reactions from Management More susceptible edema (increased rate,
hr) mast cells. of preterm to adverse dyspnea, rales/crackles,
(not to exceed Relatively labor reactions; may frothy sputum).
7.5 mg/24 hr). selective for (tocolytic) (the require dosep;
beta2(pulmonar FDA has Excessive use -Monitor mother and
PO(Children y)-adrenergic recommended may lead to neonate for symptoms of
<12 yr): receptor sites, that injectable tolerance and hypoglycemia (anxiety;
Bronchodilation with less effect terbutaline paradoxical chills; cold sweats;
—0.05 mg/kg 3 on should not be bronchospasm confusion; cool, pale
times daily; beta1(cardiac) used in (inhaler); skin; difficulty in
may gradually adrenergic pregnancy for concentration;
(not to exceed receptors. the prevention OB, Lactation: drowsiness; excessive
0.15 mg/kg 3– 4 or prolonged Pregnancy (near hunger; headache;
times daily or 5 treatment term) and irritability; nausea;
mg/24 hr. [<48– 72 hr] of lactation. nervousness; rapid pulse;

28
 preterm labor shakiness; unusual
Subcutaneous in either the tiredness; or weakness)
(Adults and inpatient or and mother for
Children -12 outpatient hypokalemia (weakness,
yr): settings fatigue, U wave on ECG,
Bronchodilation because of the arrhythmias).
—250 mcg; potential for
may repeat in serious -Monitor maternal serum
15– 30 min (not maternal heart glucose and electrolytes.
to exceed 500 problems and May cause hypokalemia
mcg/4 hr). death; oral and hypoglycemia.
terbutaline Monitor neonate’s serum
Subcutaneous should not be glucose, because
(Children 12 used for the hypoglycemia may also
yr): prevention or occur in neonates.
Bronchodilation any treatment
—0.005– 0.01 of preterm
mg/kg; may labor because
repeat in 15– 20 of a lack of
min. efficacy and
the potential
IV (Adults): for serious
Tocolysis— material heart
2.5– 10 problems and
mcg/min death).
infusion; q by 5
mcg/min q 10
min until
contractions
stop (not to
exceed 30

29
 mcg/min). After
contractions
have stopped
for 30 min,
perfusion rate to
lowest effective
amount and
maintain for 4–
8 hr
(unlabeled).

Prescribed
Generic Name, Dosage,
Mechanism of Nursing
Brand Name, Frequency, and Indication Contraindication Adverse Reaction
Action Responsibilities
Classification Route of
Administration
-
Generic name: Treatment of Essential for the Treatment/pre Contraindicated CNS: drowsiness. Hypomagnesemia/Anti

30
magnesium Deficiency activity of many vention of in: convulsant: Monitor
sulfate (IV, (Expressed as enzymes. Plays hypomagnese Hypermagnesemi Respiratory: pulse, BP, respirations,
parenteral)(9.9% mg of an important mia. a; Hypocalcemia; respiratory rate. and ECG frequently
Mg; 8.1 Magnesium) role in Treatment of Anuria; Heart throughout
IM, IV neurotransmissi hypertension. block; CV: arrhythmias, administration of
Brand name: (Adults): Severe on and Prevention of bradycardia, parenteral magnesium
mEq Mg/g) (mag- deficiency—8– muscular seizures OB: Avoid using hypotension. sulfate. Respirations
nee-zhumsul-fate) 12 g/day in excitability. associated for more than 5– should be at least
divided doses; with severe 7 days for GI: diarrhea. 16/min before each
Classification mild deficiency Therapeutic eclampsia, preterm labor dose.
Therapeutic: —1 g q 6 hr for Effects: pre- (may risk of MS: muscle weakness.
mineral and 4 doses or 250 Replacement in eclampsia, or hypocalcemia and - Monitor neurologic
electrolyte mg/kg over 4 hr. deficiency acute bone changes in Dermatologic: flushing, status before and
replacements/sup states. nephritis. newborn); avoid sweating. throughout therapy.
plements IM, IV Resolution of Unlabeled continuous use Institute seizure pre-
(Children 1 eclampsia. Use: Preterm during active Metabolic: cautions. Patellar reflex
Pharmacologic: mo): 25– 50 labor. labor or within hypothermia. (knee jerk) should be
minerals/electroly mg/kg/dose q 4– Treatment of 2hr of delivery tested before each
tes 6 hr for 3– 4 torsade de due to potential parenteral dose of
doses, maximum pointes. for magnesium magnesium sulfate. If
Pregnancy single dose: 2 g. Adjunctive toxicity in response is absent, no
Category D treatment for newborn. additional doses should
IV (Neonates): bronchodilatio be administered until
25– 50 n in moderate Use Cautiously positive response is
mg/kg/dose q 8– to severe in: Any degree of obtained.
12 hr for 2– 3 acute asthma. renal
doses. insufficiency; -Monitor newborn for
hypotension,
Seizures/Hypert Geriatric: May hyporeflexia, and
ension require dosage respiratory depression
IM, IV due to age-related if mother has received

31
 in renal function. magnesium sulfate.
(Adults): 1 g q 6
hr for 4 doses as -Monitor intake and
needed. output ratios. Urine
output should be
IM, IV maintained at a level of
(Children): 20– at least 100 mL/4 hr.
100 mg/kg/dose
q 4– 6 hr as -Lab Test
needed, may use Considerations:
up to 200 Monitor serum
mg/kg/dose in magnesium levels and
severe cases. renal function
periodically throughout
Torsade de administration of
Pointes parenteral magnesium
IV (Infants and sulfate.
Children): 25–
50 mg/kg/dose,
maximum dose:
2 g.

Bronchodilation
IV (Adults): 2 g
single dose.

IV (Children):
25 mg/kg/dose,
maximum dose:
2 g.

32
 Eclampsia/Pre-
Eclampsia
IV, IM
(Adults): 4– 5 g
by IV infusion,
concurrently
with up to 5 g
IM in each but-
tock; then 4– 5 g
IM q 4 hr or 4 g
by IV infusion
followed by 1– 2
g/hr continuous
infusion (not to
exceed 40 g/day
or 20 g/48 hr in
the presence of
severe renal
insufficiency)

Prescribed
Generic Name, Dosage,
Mechanism of Nursing
Brand Name, Frequency, and Indication Contraindication Adverse Reaction
Action Responsibilities
Classification Route of
Administration

33
Generic name: PO (Adults): In Used Contraindicated Adverse reactions/side -Indicated for many
predniSONE Most uses—5– pharmacologic systemically in: Active effects are much more conditions. Assess
(pred-ni-sone) 60 mg/day as a doses, and locally in untreated common with high- involved systems before
single dose or in suppresses a wide variety infections (may dose/long-term therapy and periodically during
Brand name: divided doses inflammation of chronic be used in therapy.
Rayos, Sterapred, (delayed release and the normal diseases patients being CNS: depression,
Winipred tablets should be immune including: treated for euphoria, headache, - Assess patient for
administered response. Has Inflammatory, tuberculous intracranial pressure signs of adrenal
Classification once daily). numerous Allergic, meningitis); (children only), insufficiency
Therapeutic: intense Hematologic, Some products personality changes, (hypotension, weight
anti- Multiple metabolic Neoplastic, contain alcohol psychoses, restlessness. loss, weakness, nausea,
inflammatories sclerosis—200 effects (see Autoimmune and should be vomiting, anorexia,
(steroidal) mg/day for 1 wk, Adverse disorders. avoided in EENT: cataracts, lethargy, confusion,
(intermediate then 80 mg every Reactions and Suitable for patients with intraocular pressure. restlessness) before and
acting), immune other day for 1 Side Effects). alternate-day known periodically during
modifiers mo. Suppresses dosing in the intolerance; CV: hypertension. therapy.
adrenal management
Pregnancy Adjunctive function at of chronic Lactation: Avoid GI: PEPTIC - Monitor intake and
Category C therapy of Pneu- chronic doses illness. chronic use. ULCERATION, output ratios and daily
mocystis of 5 mg/day. Unlabeled anorexia, nausea, weights. Observe patient
jirovecii Replaces Use: Use Cautiously vomiting. for peripheral edema,
pneumonia in endogenous Adjunctive in: Chronic steady weight gain,
AIDS patients— cortisol in therapy of treatment (leads Dermatologic: acne, rales/crackles, or
40 mg twice deficiency hypercalcemia to adrenal wound healing, dyspnea. Notify health
daily for 5 days, states. Has . Adjunctive suppression; use ecchymoses, fragility, care professional if these
then 40 mg once minimal management lowest possible hirsutism, petechiae. occur.
daily for 5 days, mineralocortic of nausea and dose for shortest
then 20 mg once oid activity. vomiting from period of time); Endocrine: adrenal
daily for 10 days. chemotherapy suppression,
Therapeutic . Pediatric: hyperglycemia. F and E:

34
 Effects: Chronic use will fluid retention (long-
Suppression of result in growth; term high doses),
inflammation use lowest hypokalemia,
and possible dose for hypokalemic alkalosis.
modification of shortest period of
the normal time; Stress Hematologic:
immune (surgery, THROMBOEMBOLIS
response. infections); M, thrombophlebitis.
supplemental
doses may be Metabolic: weight gain,
needed; Potential weight loss.
infections may
mask signs (fever, MS: muscle wasting,
inflammation); osteoporosis, avascular
necrosis of joints,
OB: Safety not muscle pain.
established.
Misc: cushingoid
appearance(moon face,
buffalo hump),
susceptibility to
infection.

Prescribed
Generic Name, Dosage,
Mechanism of Nursing
Brand Name, Frequency, and Indication Contraindication Adverse Reaction
Action Responsibilities
Classification Route of
Administration

35
Generic name: Topical Suppresses Management Contraindicated Dermatologic: allergic - Assess affected skin
dexamethasone (Adults): Apply normal of in: contact dermatitis, before and daily during
(deks-a-meth-a- to affected immune inflammation Hypersensitivity atrophy, burning, therapy. Note degree of
sone) area(s) 2– 4 response and and pruritis or known dryness, edema, inflammation and
times daily inflammation. associated intolerance to folliculitis, pruritus. Notify
Brand name: (depends on with various corticosteroids or hypersensitivity physician or other health
Aeroseb-Dex, preparation and Therapeutic allergic/immu components of reactions, care professional if
Decadron, condition being Effects: no-logic skin vehicles hypertrichosis, symptoms of infection
Decaspray treated). Suppression of problems. (ointment or hypopigmentation, (increased pain,
dermatologic cream base, irritation, maceration, erythema, purulent
Classification inflammation preservative, miliaria, perioral exudate) develop.
Therapeutic: and immune alcohol); dermatitis, secondary
anti- processes. Untreated infection, striae. -Lab Test
inflammatories bacterial or viral Considerations: Periodic
(steroidal) infections. Misc: adrenal adrenal function tests
Pharmacologic: suppression (use of may be ordered to assess
corticosteroids Use Cautiously occlusive dressings, degree of hypothalamic-
in: Hepatic long-term therapy). pituitary-adrenal (HPA)
dysfunction; axis suppression in
Diabetes mellitus, chronic topical therapy
cataracts, if suspected. Children
glaucoma, or and patients with dose
tuberculosis (use applied to a large area,
of large amounts using an occlusive
of high-potency dressing, or using high-
agents may potency products are at
worsen highest risk for HPA
condition); suppression.
Patients with pre-
existing skin - May cause increased
atrophy; serum and urine glucose

36
 Pregnancy, concentrations if
lactation, or significant ab-sorption
children (chronic occurs.
high-dose usage
may result in
adrenal
suppression in
mother, growth
suppression in
children; children
may be more
susceptible to
adrenal and
growth
suppression).

Prescribed
Generic Name, Dosage,
Mechanism of Nursing
Brand Name, Frequency, and Indication Contraindication Adverse Reaction
Action Responsibilities
Classification Route of
Administration

Generic name: Oral iron dosages An essential PO: Contraindicated CNS: dizziness, -Assess nutritional
ferrous sulfate are expressed as mineral found Treatment & in: Anemia not headache, syncope. status and dietary
(30% elemental mg of elemental in hemoglobin, prevention due to iron history to determine
iron) (fer-ussul- iron. Multiple myoglobin, and iron deficiency; GI: nausea, possible cause of anemia
fate) salt forms exist many enzymes. deficiency Hemochromatosis constipation, dark and need for patient
—see Enters the anemia. ; Hemosiderosis; stools, epigastric pain, teaching.
Brand name: approximate bloodstream Hypersensitivity GI bleeding, vomiting. -Assess bowel function
Apo-Ferrous equivalent doses and is to iron products. for constipation or
Sulfate, ED-IN- below or transported to Misc: temporary diarrhea. Notify

37
SOL, Fe50, consider % the organs of Use Cautiously staining of teeth (liquid physician or other health
Feosol, Feratab, elemental iron of the in: Peptic ulcer preparations). care professional and
Fer-gen-sol, Fer- each salt for dose reticuloendothe disease; use appropriate nursing
In-Sol, Fer-Iron, conversions. lial system Ulcerative colitis measures should these
Fero-Grad, (liver, spleen, or regional occur.
Novoferrosulfa, Approximate bone marrow) enteritis(condition
PMS Ferrous Equivalent where it may be -Lab Test
Sulfate, Slow FE Doses (mg of becomes part aggravated); Considerations:
iron salt): of iron stores. Alcoholism; Monitor hemoglobin,
Classification Ferrous fumarate Severe hepatic hematocrit, and
Therapeutic: —197; Ferrous Therapeutic impairment; reticulocyte values prior
antianemics gluconate—560; Effects: Severe renal to and every 3 wk
Ferrous sulfate— Resolution or impairment. during the first 2 mo of
Pharmacologic: 324; Ferrous prevention of therapy and periodically
iron supplements sulfate, iron deficiency thereafter. Serum ferritin
exsiccated—217. anemia. and iron levels may also
PO (Adults): be monitored to assess
Deficiency– 2– 3 effectiveness of therapy.
mg/kg/day in 2–
4 divided doses -Occult blood in stools
or 60– 100 mg may be obscured by
elemental iron black coloration of iron
twice daily. in stool. Guaiac test
Prophylaxis— results may occasionally
60– 100 mg be false-positive.
elemental iron Benzidine test results
daily. are not affected by iron
preparations.
PO (Infants and
Children):
Severe

38
 deficiency—4– 6
mg/kg/day in 3
divided doses.
Mild to moderate
deficiency—3
mg/kg/day in 1–
2 divided doses.
Prophylaxis—1–
2 mg/kg/day in
1– 2 divided dose
(maximum: 15
mg/day).

PO (Neonates ,
premature): 2–
4 mg/kg/day in
1– 2 divided
doses, maximum
of 15 mg/day.

39