VASQUEZ, JULIANNE GABRIELLE G.
PHARMACOLOGY
BSN 2-A-7
Using your drug handbook, answer the following questions:
Look for the drug-drug interaction of the following drugs given and give nursing considerations
as you give the drugs together:
DRUG NAME
Celecoxib with ACE inhibitors
Amitriptyline hydrochloride
with barbiturates
Acetylcysteine with activated
charcoal
COURSE TASK 2
DRUG INTERACTIONS NURSING CONSIDERATIONS
 May reduce the  Use celecoxib cautiously in
antihypertensive patients with hypertension,
effects and monitor blood pressure
closely throughout therapy
because drug can start or
worsen hypertension
 Dosage should start at half
the lowest recommended
amount. For patients with
juvenile rheumatoid arthritis
who are also poor CYP2C9
metabolizers, alternative
management should be
considered.
 Should be avoided in
patients with a recent MI
because risk of reinfarction
increases with NSAID
therapy. If therapy is
unavoidable, monitor patient
closely for signs of cardiac
ischemia.
 Should not be given to
patients with severe heart
failure because risk of heart
failure increases with NSAID
use. If use is unavoidable,
monitor patient for
worsening of heart failure
 May increase  Monitor patients during
amitriptyline concurrent use.
metabolism.  Consider therapy
modification
 Use caution if patient has a
history of seizures, urine
retention, or angle-closure
glaucoma
 Possibly adsorption  Avoid using activated
and decreased charcoal before or with oral
effectiveness of oral acetylcysteine
acetylcysteine
 May limit
acetylcysteine’s
effectiveness.
VASQUEZ, JULIANNE GABRIELLE G.
BSN 2-A-7
Budesonide inhalation with
katoconazole
Clobazam with hormonal
contraceptives
Esmolol hydrochloride with
antidiabetic agents
PHARMACOLOGY
COURSE TASK 2
 Increased systemic  Monitor patient for adverse
exposure and side reactions and adjust dosage
effects with CYP3A4 as needed
inhibitors  Assess patient who switches
 May inhibit from a systemic
metabolism and corticosteroid to inhaled
increase level of budesonide for adrenal
budesonide. insufficiency (fatigue,
hypotension, lassitude,
nausea, vomiting,
weakness), which may be
life-threatening
 Closely monitor a child’s
growth pattern – once
administered; budesonide
may stunt growth
 Monitor patients with
conditions such as diabetes
mellitus, glaucoma or
cataracts, hypertension,
osteoporosis, or peptic ulcer,
as glucocorticosteroid
therapy may increase
adverse effects. Also
monitor patients with a
family history of diabetes or
glaucoma.
 Decreased serum  Patient should use
concentration nonhormonal contraceptives
 May diminish as needed.
contraceptive  Counsel women to also use
effectiveness. non-hormonal methods of
contraception when
clobazam is used with
hormonal contraceptives
and to continue these
alternative methods for 28
days after discontinuing
clobazam to ensure
contraceptive reliability.
 May increase blood  Closely monitor blood
glucose-lowering glucose concentration
effect of antidiabetic  Monitor ECG and BP
agent continuously during infusion.
Nearly half of patients will
develop hypotension.
Diaphoresis and dizziness
may accompany
hypotension. Monitor patient
closely, especially if he had
VASQUEZ, JULIANNE GABRIELLE G.
BSN 2-A-7
Indomethacin with
aminoglycosides
Isoniazid with
acetaminophen
Mesalamine with warfarin
Rifampicin with probenecid
PHARMACOLOGY
COURSE TASK 2
low BP before treatment.
 May enhance toxicity  Avoid using drugs together
of these drugs  May cause kidney damage
and increase that risk,
particularly if the latter is
used chronically for
prolonged periods.
 During coadministration,
plasma antibiotic
concentrations and renal
function should be closely
monitored, and the antibiotic
dosage further adjusted as
necessary
 May inhibit  Monitor patient closely for
acetaminophen hepatotoxicity
metabolism  Close attention should be
 Increased risk of paid to clinical and
hepatotoxicity laboratory evidence of
hepatotoxicity. Both drugs
should be discontinued if
evidence of hepatoxicity is
observed. Aspirin or
nonsteroidal inflammatory
agents may be safer
alternatives
 May decrease  Monitor effectiveness of
anticoagulation effect therapy closely.
 Patients should be advised
to promptly report any signs
of bleeding (e.g., headache,
dizziness, weakness,
prolonged bleeding from
cuts, increased menstrual
flow, vaginal bleeding,
nosebleeds, bleeding of
gums from brushing,
unusual bleeding or bruising,
red or brown urine, or red or
black stools) or blood clots
(e.g., chest pain, shortness
of breath, sudden loss of
vision, or pain, redness or
swelling in an extremity)
 May increase rifampin  Use together cautiously.
levels  Monitor hepatic function,
hematopoietic studies, and
uric acid levels. Drug’s
systemic effects may
asymptomatically raise LFT
VASQUEZ, JULIANNE GABRIELLE G. PHARMACOLOGY
BSN 2-A-7 COURSE TASK 2

results and uric acid level.

 May increase uric levels

Give the adverse reactions of the following drugs on the systems indicated:

DRUG NAME BODY SYSTEM ADVERSE REACTIONS

Cimetidine GI mild and transient
diarrhea.
Esterified estrogen CNS headache, dizziness,
chorea, depression,
stroke, seizures
Gentamicin sulfate RESPIRATORY apnea
Iloperidone EENT blurred vision,
conjunctivitis, dry mouth,
nasal congestion,
nasopharyngitis
Meropenem CNS seizures, headache
Simvastatin RESPIRATORY URI (Upper Respiratory
Infection)
Tropism chloride EENT dry eyes and nose
Desmopressin acetate GI nausea, abdominal
cramps
Ethambutol hydrochloride MUSCULOSKELETAL joint pain
Promethazine hydrochloride METABOLIC hyperglycemia

References:
Jones & Bartlett Learning., & Jones & Bartlett Publishers. (2021). Nurse's drug handbook.
Sudbury, MA: Jones and Bartlett Publishers.
Wolters Kluwer (Firm),. (2018). Nursing 2019 Drug Handbook.