Name of Drug Mechanism of Dosage Indications Contraindications Adverse Nursing

Action Effect Management

Generic Name: The short-term 7.5/75 - Anaphylaxis - Untreated Blistering, - Monitor
Hydrocortisone effects of 0 mg. - Acute asthma serious burning, signs of
corticosteroids 1-2 - infections crusting, thrombo
Brand Name: are decreased tabs Adrenocortical (except dryness, phlebitis
Cortef vasodilation every 4 insufficiency tuberculous or flaking (lower
and hours - Tendonitis meningitis or of the skin extremit
permeability of as - Small Joint septic shock) irritation y
capillaries, as needed arthritis for - Idiopathic itching, swelling,
well as local infiltration thrombocyto scaling, warmth,
decreased - Juvenile penic severe erythem
leukocyte idiopathic purpura redness, a,
migration to arthritis - Intrathecal soreness, tenderne
sites of - Inflammation administratio or ss) and
inflammation. - Replacement n (injection) swelling thrombo
Corticosteroids Therapy - Documented of the skin embolis
binding to the hypersensitiv redness m
glucocorticoid ity and (shortnes
receptor - Administrati scaling s of
mediates on of live or around breath,
changes in live, the mouth chest
gene attenuated thinning pain,
expression that vaccines is of the skin cough,
lead to multiple contraindicat with easy bloody
downstream ed in bruising, sputum).
effects over patients especially Notify
hours to days. receiving when physician
Glucocorticoids immunosupp used on or
inhibit ressive doses the face nursing
neutrophil of the drug or where staff
apoptosis and the skin immedia
demarginating; folds tely, and
they inhibit together request
phospholipase (e.g., objective
A2, which between tests
decreases the the (Doppler
formation of fingers) ultrasou
arachidonic thinning, nd, lung
acid weakness, scan,
derivatives; or wasting others) if
they inhibit NF- away of thrombo
Kappa B and the skin sis is
other suspecte
inflammatory d.
transcription - Monitor
factors; they signs of
promote anti- hypersen
inflammatory sitivity
genes like reactions
interleukin-10 or
Lower doses of anaphyla
corticosteroids xis,
provide an anti- including
inflammatory pulmona
effect, while ry
higher doses symptom
are s
immunosuppre (tightnes
ssive. High s in the
doses of throat
glucocorticoids and
for an chest,
extended wheezing
period bind to , cough,
the dyspnea)
mineralocortico or skin
id receptor, reactions
raising sodium (rash,
levels and pruritus,
decreasing urticaria)
potassium . Notify
levels. physician
or
nursing
staff
immedia
tely if
these
reactions
occur.
- Monitor
and
report
signs of
peptic
ulcer,
includin
g
heartbur
 n,
nausea,
vomitin
g blood,
tarry
stools,
and loss
of
appetite.

- Assess
any
muscle
or joint
pain.
Report
persisten
t or
increase
d
musculos
keletal
pain to
determin
e
presence
of bone
or joint
patholog
y (aseptic
necrosis,
fracture).
- Assess
any
muscle
or joint
pain.
Report
persisten
t or
increase
d
musculos
keletal
pain to
 determin
e
presence
of bone
or joint
patholog
y (aseptic
necrosis,
fracture).

Name of Drug Mechanism of Dosage Indications Contraindication Adverse Nursing

Action s Effect Management
Generic Name: The short-term Initially Arthritis, Contraindicated fluid Monitor signs of
Dexamethason effects of , 0.75 blood/hormon in systemic retention thrombophlebitis
e corticosteroids are to 9 e disorders, fungal infections (swelling in (lower extremity
decreased mg/da allergic and patients your hands swelling, warmth,
Brand Name: vasodilation and y PO, reactions, skin with known or ankles). erythema,
Decadron permeability of given diseases, eye hypersensitivity increased tenderness) and
capillaries, as well in 2 to problems, to the product appetite. thromboembolis
as decreased 4 breathing and its mood m (shortness of
leukocyte divided problems, consituents. changes, breath, chest
migration to sites doses. bowel trouble pain, cough,
of inflammation. disorders, sleeping. bloody sputum).
Corticosteroids cancer, and skin rash, Notify physician
binding to the immune bruising or or nursing staff
glucocorticoid system discoloration immediately, and
receptor mediates disorders. It is . request objective
changes in gene also used as a acne, tests (Doppler
expression that test for an increased ultrasound, lung
lead to multiple adrenal gland sweating, scan, others) if
downstream disorder. increased thrombosis is
effects over hours hair growth. suspected.
to days. headache,
dizziness. Monitor and
Glucocorticoids nausea, report signs of
inhibit neutrophil vomiting, peptic ulcer,
apoptosis and upset including
demarginating; stomach. heartburn,
they inhibit changes in nausea, vomiting
phospholipase A2, your blood, tarry
which decreases menstrual stools, and loss of
the formation of periods; or appetite.
arachidonic acid changes in
derivatives; they the shape or Monitor signs of
inhibit NF-Kappa B location of allergic reactions,
and other body fat including
inflammatory (especially in pulmonary
transcription your arms, symptoms
factors; they legs, face, (tightness in the
promote anti- neck, throat and chest,
inflammatory breasts, and wheezing, cough,
genes like waist). dyspnea) or skin
interleukin-10. reactions (rash,
pruritus,
Lower doses of urticaria). Notify
corticosteroids physician or
provide an anti- nursing staff
inflammatory immediately if
effect, while higher these reactions
doses are occur.
immunosuppressiv
e. High doses of Assess any
glucocorticoids for muscle or joint
an extended period pain. Report
bind to the persistent or
mineralocorticoid increased
receptor, raising musculoskeletal
sodium levels and pain to
decreasing determine
potassium levels. presence of bone
or joint pathology
(aseptic necrosis,
fracture).

Assess muscle
strength
periodically to
determine
degree of muscle
wasting during
long-term use.

Measure blood
pressure
periodically and
compare to
normal values
(See Appendix F).
Report a
sustained
increase in blood
pressure
(hypertension) to
the physician.

Assess peripheral
edema using
girth
measurements,
volume
displacement,
and
measurement of
pitting edema
(See Appendix N).
Report increased
swelling in feet
and ankles or a
sudden increase
in body weight
due to fluid
retention.

Monitor
personality
changes,
including
depression,
euphoria,
restlessness,
hallucinations,
and psychosis.
Notify physician if
these changes
become
problematic.

Be alert for signs

of low potassium
levels
(hypokalemia)
Name of Mechanism of Dosag Indications Contraindications Adverse Nursing Management
Drug Action e Effect
Generic Morphine-6- Oral: Pain - Respiratory Severe - Monitor
Name: glucuronide is Short- managemen depression respiratory blood
Morphine responsible acting t - Hypersensitivi depression pressure prior
for oral ty (can lead to to
Brand approximately dose- - Paralytic ileus, death in administratio
Name: 85% of the severe and delayed acute n. Hold if
MS Contin, response , gastric poisoning. systolic BP <
Astramorph, observed by chroni emptying 100 mm Hg or
Depodur, morphine c pain - Obstructive Vomiting, 30 mm Hg
Duramorph, administratio in airway disease dysphoria, below
Infumorph, n. Morphine adults: - Acute hepatic allergy, baseline.
Kadian, and its 10 to disease vasodilation - Monitor
MorphaBon metabolites 30 mg - MAO inhibitor , patient's
d, and act as 4hrs administration hypotensio respiratory
Arymo ER. agonists of - Pregnancy and n, increase rate prior to
the mu and IM/SC: lactation in intracranial administratio
kappa opioid 5 to children pressure n.
receptors. The 20 mg particularly - Reassess pain
mu-opioid in head after
receptor is IV: injury administratio
integral to initial n of
morphine's dose 4 Urinary morphine.
effects on the mg to retention in - Monitor for
ventral 10 mg prostate respiratory
tegmental slowly hypertroph depression
area of the over y and
brain. 4-5 hypotension
Morphine's min Pts with frequently up
activation of 4hr. adrenal to 24 hours
the reward Daily insufficiency after
pathway is dose and administratio
mediated by range myxedema n of
agonism of 12- may morphine.
the delta- 120mg experience - Place call light
opioid extended signal close to
receptor in and patient.
the nucleus increased Accompany
accumbent, effects. patient if
while need to get
modification out of bed to
of the minimize risk
respiratory of falls.
system and
addiction
disorder are
 mediated by
agonism of
the mu-opioid
receptor.

Name of Mechanism Dosage Indications Contraindications Adverse Nursing

Drug of Action Effect Management

Generic One theory Oral: Minor - caloric nausea, - Do not

Name: is that Immedi aches and undernutri stomac exceed 4g
Acetaminop acetaminoph ate pains due tion h pain, of
hen en increases release: to - acute liver loss of acetamino
the pain 325 mg headache, failure appetit phen per
Brand threshold by to 1 g backache, - liver e, day to limit
Name: inhibiting orally the problems itching, risk for
Tylenol two isoforms every 4 common - severe rash, liver, renal,
of to 6 cold, renal headac and cardiac
cyclooxygen hours minor pain impairmen he, damage
ase, COX-1 Minimu of t dark - overdose
and COX-2, m arthritis, - a condition urine, will lead to
which are Dosing toothache, where the clay- hepatotoxi
involved in Interval: premenstr body is colored city
prostaglandi every 4 ual and unable to stools, - Acetadote
n (PG) hours menstrual maintain or is the
synthesis. Maximu cramps, adequate jaundic antidote
Prostaglandi m Single and blood flow e for
ns are Dose: muscular called (yellowi overdose
responsible 1000 mg aches, and shock ng of may
for eliciting Maximu temporaril - acetamino skin or increase
pain m Dose: y reduces phen eyes). risk for
sensations. 4 g per fever. overdose bleed with
Acetaminop 24 hours - acute warfarin
hen does not inflammati therapy
inhibit on of the may alter
cyclooxygen liver due to blood
ase in hepatitis C glucose
peripheral virus measurem
tissues and, ents
therefore,
has no
peripheral
anti-
inflammator
y effects.
Though
acetylsalicyli
c acid
(aspirin) is
an
irreversible
inhibitor of
COX and
directly
blocks the
active site of
this enzyme,
studies have
shown that
acetaminoph
en
(paracetamo
l) blocks COX
indirectly.
Studies also
suggest that
acetaminoph
en
selectively
blocks a
variant type
of the COX
enzyme that
is unique
from the
known
variants
COX-1 and
COX-2. This
enzyme has
been
referred to
as COX-3.
The
antipyretic
actions of
acetaminoph
en are likely
attributed to
direct action
on heat-
regulating
centers in
the brain,
 resulting in
peripheral
vasodilation,
sweating,
and loss of
body heat.
The exact
mechanism
of action of
this drug is
not fully
understood
at this time,
but future
research
may
contribute to
deeper
knowledge.

References:

Dexamethasone. Ciccone C.D.(Ed.), (2016). Davis's Drug Guide for Rehabilitation Professionals. McGraw
Hill. https://fadavispt.mhmedical.com/content.aspx?bookid=1873&sectionid=139007808

Dexamethasone: Uses, Interactions, Mechanism of Action | DrugBank Online. (2005). DrugBank.

https://go.drugbank.com/drugs/DB01234

Hydrocortisone. Ciccone C.D.(Ed.), (2016). Davis's Drug Guide for Rehabilitation Professionals. McGraw
Hill. https://fadavispt.mhmedical.com/content.aspx?bookid=1873&sectionid=139013654

Dexamethasone: Uses, Interactions, Mechanism of Action | DrugBank Online. (2005). DrugBank.

https://go.drugbank.com/drugs/DB01234

Morphine: Generic, Uses, Side Effects, Dosages, Interactions & Warnings. (2021, August 13). RxList.
https://www.rxlist.com/consumer_morphine_duramorph_arymo_er/drugs-condition.htm

Morphine: Uses, Interactions, Mechanism of Action | DrugBank Online. (2005). DrugBank.

https://go.drugbank.com/drugs/DB00295

Morphine Sulfate |. (2021). Hemodynamic Medications / Morphine Sulfate.

http://shadwige.sites.truman.edu/cardiac-medications/hemodynamic-medications/morphine-sulfate/

Acetaminophen: Uses, Interactions, Mechanism of Action | DrugBank Online. (2005). DrugBank.

https://go.drugbank.com/drugs/DB00316
Side Effects of Tylenol (Acetaminophen), Warnings, Uses. (2021, September 15). RxList.
https://www.rxlist.com/tylenol-side-effects-drug-center.htm