DRUG STUDY

NAME AND DOSE, MECHANISM OF INDICATIONS ADVERSE NURSING

EFFECT
CLASSIFICATION FREQUENCY, ACTION CONTRAINDICATI RESPONSIBILITIES
OF DRUG ROUTE, ONS
DURATION OF
ADMINISTRATION
 Ceftriaxone Dose:  Semisynthetic  Treatment of  Hypersensitivity  CNS: seizures  Ask the name of
 Therapeutic:  2 gms third- Skin and skin to (HIGH the client and
Anti-infectives, Frequency: generation structure cephalosporins DOSES). check his/her ID
Antibiotic  OD (once a cephalosporin infections, and related  GI: band before
 Pharmacologic: day) antibiotic. Bone and antibiotics. pseudomembr giving the
Third-generation Route: Preferentially joint anous colitis , medication for
cephalosporins  IV ANST ( ) binds to one infections, diarrhea, verification.
or more of Complicated cholelithiasis,  Check the name
the penicillin- and sludging in the of the
binding uncomplicate gallbladder. medication,
proteins d urinary tract  Derm: rashes, brand names
(PBP) located infections, urticaria. should be
on cell walls Uncomplicate  Hemat: avoided.
of susceptible d gynecologic bleeding,  Check the
organisms. infections, eosinophilia, medication
This inhibits including hemolytic sheet and the
 third and final gonorrhea, anemia, doctor’s order
stage of Lower leukopenia, before
bacterial cell respiratory thrombocytosi medicating.
wall tract s. Local: pain  Confirm that the
synthesis, infections, at IM site, patient can take
thus killing intra- phlebitis at IV or receive the
the abdominal site. medication by
bacterium. infections,  Misc: allergic the ordered
 Binds to the septicemia, reactions route.
bacterial cell Meningitis, including  Document the
wall otitis media. anaphylaxis time and any
membrane, Perioperative superinfection. remarks on the
causing cell prophylaxis. chart correctly.
death.  Watch for
seizures; notify
physician
immediately if
patient develops
or increases
seizure activity.
 Monitor signs
of
 pseudomembran
ous colitis,
including
diarrhea,
abdominal pain,
fever, pus or
mucus in stools,
and other severe
or prolonged GI
problems
(nausea,
vomiting,
heartburn).
Notify
physician or
nursing staff
immediately of
these signs.
 Monitor signs
of allergic
reactions and
anaphylaxis,
 including
pulmonary
symptoms
(tightness in the
throat and chest,
wheezing,
cough dyspnea)
or skin reactions
(rash, pruritus,
urticaria).
Notify
physician or
nursing staff
immediately if
these reactions
occurs.
 Monitor for
manifestations
of
hypersensitivity
Report their
appearance
 promptly and
discontinue
drug.
 Instruct patient
and SO to report
any signs of
bleeding.
 Instruct patient
and SO to report
loose stools or
diarrhea
promptly.

DRUG STUDY

NAME AND DOSE, MECHANISM OF INDICATIONS ADVERSE NURSING

EFFECT
CLASSIFICATION FREQUENCY, ACTION CONTRAINDICATI RESPONSIBILITIES
OF DRUG ROUTE, ONS
DURATION OF
 ADMINISTRATION
 Azithromycin Dose:  A macrolide  Treatment of  Hypersensitivity  CNS:  Ask the name of
 Therapeutic:  500 mg tab antibiotic that the following to azithromycin, dizziness, the client and
Agents for Frequency: reversibly infections due erythromycin, or seizures, check his/her ID
Atypical
 OD (once a binds to the to susceptible any of the drowsiness, band before
Mycobacterium,
day) 50S organisms: macrolide fatigue, giving the
Anti-infectives
Route: ribosomal Upper antibiotics. headache. medication for
 Pharmacologic:
 Oral subunit of respiratory  History of  CV: chest verification.
Macrolides
susceptible tract hepatic pain,  Check the name
organisms infections, dysfunction/chol hypotension, of the
and including estatic jaundice palpitations, medication,
consequently streptococcal following QT brand names
inhibits pharyngitis, previous prolongation should be
protein acute antibiotic use. (rare). GI: avoided.
synthesis. bacterial pseudomembr  Check the
exacerbations anous colitis, medication
of chronic abdominal sheet and the
bronchitis, pain, diarrhea, doctor’s order
and nausea, before
tonsillitis; cholestatic medicating.
Lower jaundice,  Confirm that the
respiratory elevated liver patient can take
tract enzymes, or receive the
infections, dyspepsia, medication by
including flatulence, the ordered
bronchitis and melena, oral route.
pneumonia candidiasis.  Document the
 GU: nephritis, time and any
vaginitis. remarks on the
 Hemat: chart correctly.
anemia,  Monitor for and
leukopenia, report loose
thrombocytope stools or
nia. Derm: diarrhea, since
photosensitivit pseudomembran
y, Stevens- ous colitis must
Johnson be ruled out.
syndrome,  Monitor patient
rashes. EENT: for signs of
ototoxicity. angioedema,
 F and E: including
hyperkalemia. rashes, raised
 Misc: patches of red
angioedema or white skin
 (welts),
burning/itching
skin, swelling in
the face, and
difficulty
breathing.
Notify
physician of
these signs
immediately.
 Monitor rashes
or other skin
reactions such
as hives, acne,
dermatitis,
abnormal
sweating, and
exfoliation.
Notify
physician
immediately
because certain
 skin reactions
may indicate
serious
hypersensitivity
reactions
(Stevens-
Johnson
syndrome).
 Monitor
symptoms of
high plasma
potassium levels
(hyperkalemia),
including
bradycardia,
fatigue,
weakness,
numbness, and
tingling. Notify
physician
because severe
cases can lead
 to life-
threatening
arrhythmias and
paralysis.

Name and Dose, Mechanism of Action Indications Contraindications Adverse effects Nursing Responsibility
Classification Frequency,
of Drug Route,
Duration of
Administratio
n
GENERICNA Dosage: Ipratropium is a To treat clients with Hypersensitivity to CNS: dizziness, Before Administration:
ME: 25/250 MDI 2 nonselective chronic obstructive salbutamol, vertigo, insomnia, Verify Doctor’s order prior
SALBUTAM puffs competitive pulmonary disease ipratropium or drowsiness, to administering the drug.
OL+ antimuscarinic agent. It on a regular aerosol fenoterol, atropine lightheadedness
IPRATROPIU Frequency: causes bronchodilation bronchodilator who or its derivatives. CVS: hypertension, Introduce self to patient,
M BID by blocking the action continue to have arrhythmia, and verify patient’s
of acetylcholine – evidence of hypotension, identity.
Route: induced stimulation of bronchospasm and tachycardia, angina
BRAND Inhalation guanyl cyclase, hence who require a EENT: sinusitis, Provide information about
NAME: reducing formation of second blurred vision, taste the drug, and any adverse
Combivent cyclic guanosine bronchodilator. perversion, dry effects. Answer any
monophosphate mouth, paradoxical questions the client may
(cGMP) at bronchospasm, have.
CLASSIFICA parasympathetic site. bronchitis
TION: Salbutamol activates GIT: abdominal pain, Provide baseline
Bronchodilator adenyl cyclase, the dyspepsia, assessment including past
enzyme that stimulates gastrointestinal distress, history of allergies to
the production of vomiting, diarrhea, salbutamol, ipratropium or
cyclic adenosine – 3’, constipation fenoterol, atropine or its
5’ – monophosphate GUT: dysuria, urinary derivatives. Assess if the
(cAMP). Increased retention, urinary client has cardiomyopathy,
cAMP leads to difficulty tachyarrhythmia. Take into
activation of MS: fatigue, weakness consideration any special
proteinkinase A, which Others: alopecia, precautions as well.
inhibits itching, rash, flushing,
phosphorylation of edema Auscultate patient’s lung
myosin and lowers sounds.
intracellular ionic Ca
concentrations, During Administration:
resulting in smooth Wash hands.
muscle relaxation.
Assist the client in
administering medication,
such as how to use an
inhaler, or a nebulizer.

Administer the correct

dosage as ordered by the
physician. Make sure to
space out dosages
accurately.

After Administration:
Monitor FEV1, and other
pulmonary function tests,
blood pressure, heart rate,
CNS stimulation, serum
 glucose, serum K; signs
and symptoms of
glaucoma, hypersensitivity
reactions, urinary retention,
shortness of breath.

Further monitor for rate,

depth, rhythm, type of
respirations, quality, rate of
pulse. Assess lung sounds
for ronchi and wheezing.
Monitor ABG’s. Observe
for retractions, hand
tremor. Evaluate for
clinical improvement.

Document the procedure,

and any interventions
performed on the client.

Name and Dose, Mechanism of Indications Contraindication Adverse effects Nursing Responsibility
Classification of Frequency, Action s
Drug Route, Duration
of
Administration
GENERIC NAME: Dosage: Budesonide is a Used for the Contraindicated CNS: headache, Do not use more often
BUDESONIDE 1 neb man-made control of with fatigue, than prescribed; do not
glucocorticoid asthma in hypersensitivity to dizziness, stop without consulting
BRAND NAME: Frequency: steroid related to the persons drug or for relief nervousness, the health care provider.
Pulmicort Q 20 minutes x 3 naturally – requiring of acute asthma or paresthesias,
Turbuhaler, cycle occurring hormone, continuous, bronchospasm. lethargy It may take several days
Pulmicort Respules cortisol or prolonged Dermatologic: to achieve good effects;
hydrocortisone treatment. Use cautiously rash, edema, do not stop if effects are
Route: which is produced with TB and pruritus, not immediate.
CLASSIFICATION Nasal/Inhalation in the adrenal systemic alopecia
: glands. It is used for infections. Endocrine: Use decongestant nose
 Corticosteroids treating asthma by HPA drop first if nasal
inhalation. suppression, passages are blocked.
Glucocorticoid Cushing’s
steroids such as syndrome with Patient may experience
cortisol or overdosage and local irritation, dry
budesonide have systemic mouth.
potent anti – absorption
inflammatory action GI: nausea, Report sore mouth, sore
that reduces dyspepsia, dry throat, worsening of
inflammation and mouth symptoms, severe
hyper – reactivity Local: nasal sneezing, exposure to
(spasm) of the irritation, fungal chicken pox or measles,
airways caused by infection eye infections.
asthma. When used Respiratory:
as an inhaler, the epistaxis,
budesonide goes rebound
directly to the inner congestion,
lining of the pharyngitis,
inflamed airways to cough
exert its effects. Other: chest
pain, asthenia,
moon face,
 acne, bruising,
back pain

NAME AND DOSE, MECHANISM OF INDICATION/ ADVERSE REACTION NURSING

DRUG FREQUENCY, ACTION CONTRAINDICATION INTERVENT
CLASSIFICATIO ROUTE,
N DURATION OF
ADMINISTRATI
ON
Generic Name: Dose:  Enters target cells and Indications: CNS: Advise
binds to cytoplasmic  Replacement therapy in Vertigo, headache, paresthesia’s, patient
 Hydrocortisone  10 mg tab receptor; initiates many adrenal cortical insomnia, seizures, psychosis take ora
Frequency: complex reactions that insufficiency CV: medica
are responsible for its  Allergic states – severe Hypotension, shock, HPN and with fo
Brand Name: anti-inflammatory, heart failure secondary to fluid minimi
 Q6 or incapacitating
Route: immunosuppressive allergic conditions retention, thromboembolism, GI upse
 Hydrocortone (glucocorticoid), and thrombophlebitis, fat embolism, Warn
 Hematologic disorders
Classification: salt-retaining cardiac arrhythmias patient
 PO  Ulcerative colitis
Pharmacologic (mineralocorticoid) Dermatologic: to stop
class: actions. Some actions Thin, fragile skin, petichiae, taking d
Contraindications:
may be undesirable,  Untreated serious ecchymosis, purpura, striae, abruptly
 Adrenal depending on drug use. subcutaneous fat atrophy Caution
infections (except
cortical steroid diabetic
tuberculous meningitis
 Corticosteroid or septic shock) patients
 Glucocorticoid  Idiopathic EENT: insulin
Therapeutic class: thrombocytopenic Cataracts, glaucoma, increased oral
purpura IOP hypogly
 Hormone  Intrathecal
Endocrine: ic agen
Amenorrhea, irregular needs m
 administration menstruation, growth
(injection) retardation, decreased increase
 Documented carbohydrate tolerance and DM, Instruct
hypersensitivity cushingoid state, HPA elderly
 Administration of live suppression systemic, patient
or live, attenuated hyperglycemia have BP
vaccines is GI: blood
contraindicated in Peptic or esophageal ulcer, glucose
patients receiving pancreatitis, abdominal electrol
immunosuppressive distention, nausea, vomiting, monitor
doses of the drug increased appetite and weight at least
gain months
Hematologic: Advise
Na and fluid retention, patient
hypoglycemia, increased blood sunglas
sugar, increased serum may red
cholesterol, decreased T3 and T4 sensitiv
levels to sunli
Hypersentivity: that occ
Anaphylactoid or with op
hypersensitivity reactions adminis
Musculoskeletal: on
Muscle weakness, steroid Caution
myopathy and loss of muscle patient
mass, osteoporosis, spontaneous against
fractures contact
Other: topical
Immunosuppression, agents
aggravation or masking of Instruct
infections, impaired wound patient
healing
wash or
soak ar
for trop
adminis
on on p
to
adminis
on to
increase
absorpt
Advise
patient
apply
topical
agents
sparing
rubbing
lightly
Caution
against
coverin
topicall
treated
areas un
specific
prescrib
by heal
care
provide
Advise
against
mixing
topical
agents w
other
product
unless
advised
health c
provide
Instruct
patient
topical
is apply
soon as
rememb
d, but d
not to
double
doses.
NAME AND DOSE, MECHANISM OF INDICATION/ ADVERSE REACTION NURSING
DRUG FREQUENCY, ACTION CONTRAINDICATION INTERVENTION
CLASSIFICA ROUTE,
TION DURATION OF
ADMINISTRAT
ION
Generic Dose: Relaxes bronchial smooth Indication: CNS: Caution patient not to
name: muscle, causing Broncho  Symptomatic relief Irritability(especially chew or crush enteric-
 6.3 mg/kg dilation and increasing or prevention of bronchial children);restlessness, dizziness, coated timed-release
 Aminophyl vital capacity, which has asthma and reversible muscle twitching, seizures, forms.
line been impaired by bronchospasm associated severe depression, stammering Give immediate-release,
Brand name: Frequency: bronchospasm and air with chronic bronchitis and speech; abnormal liquid dosage forms with
trapping; in emphysema behavior characterized by food if GI effects occur.
 Norphyl  Once a day higher concentrations, it withdrawal, mutism, and Do not give timed-release
also inhibits the release of Contraindication: unresponsiveness alternating forms with food; these
 Phylloconti Route:
slow-reacting substance with hyperactive periods should be given on an
n
of anaphylaxis(SRS-A)  Contraindicated with CV: empty stomach 1 hr
 Quibron-T  PO and histamine hypersensitivity to any Palpitations, sinus tachycardia, before or 2 hr after meals.
xanthine ventricular tachycardia, life- Maintain adequate
Classification: or to ethylenediamine, threatening hydration
peptic ulcer, active ventricular arrhythmias, Monitor results of serum
 Bronchodil gastritis; rectal or colonic circulatory failure theophylline levels
ator irritation or infection (use GI: carefully, and arrange for
rectal preparations). Loss of appetite, hematemesis, reduced dosage if serum
 Use cautiously with cardiac Epigastric pain, gastro levels exceed therapeutic
arrhythmias, acute esophageal reflux. range of 10–20mcg/mL.
 myocardial injury, CHF,
cor pulmonale, severe
hypertension, severe
hypoxemia, renal or hepatic
disease, hyperthyroidism,
alcoholism, labor, lactation,
pregnancy.
GU:
Proteinuria, increased excretion Take serum samples to
of renal tubular cells and RBCs; determine peak
diuresis (dehydration),urinary theophylline
retention in men with prostate concentration drawn 15–
enlargement 30 min after an IV
Respiratory: loading dose.
Tachypnea, respiratory arrest Monitor for clinical signs
of adverse effects,
particularly if serum
theophylline levels are not
available.

DRUG STUDY

NAME AND DOSE, MECHANISM INDICATIONS ADVERSE NURSING

CLASSIFICATION FREQUENCY, OF ACTION CONTRAINDICAT EFFECT RESPONSIBILITI
OF DRUG ROUTE, IONS ES
DURATION OF
ADMINISTRATI
ON
Prednisone  PO  Immediate-  May be used  Systemic fungal  CNS:  Establish
 Classifications:  50 mg tablets acting as a single infections and Euphoria, baseline and
HORMONES AND synthetic agent or known headache, continuing data
SYNTHETIC analog of conjunctively hypersensitivity; insomnia, regarding BP,
SUBSTITUTES; hydrocortison with pregnancy confusion, I&O ratio and
ADRENAL e. Effect antineoplastic (category C), psychosis. pattern, weight,
CORTICOSTEROID depends on s in cancer lactation.  CV: CHF, fasting blood
; biotransforma therapy; also edema. glucose level,
GLUCOCORTICOI tion to used in  GI: Nausea, and sleep
D prednisolone, treatment of vomiting, pattern. Start
a conversion myasthenia peptic ulcer. flow chart as
that may be gravis and  Musculoskelet reference for
impaired in inflammatory al: Muscle planning
patient with conditions weakness, individualized
liver and as an delayed wound pharmacotherap
dysfunction. immunosuppr healing, eutic patient
Less essant. muscle care.
mineralocorti wasting,  Check and
coid activity osteoporosis, record BP
than aseptic during dose
hydrocortison necrosis of stabilization
e, but sodium bone, period at least 2
retention and spontaneous times daily.
potassium fractures. Report an
depletion can  Endocrine: ascending
occur. Cushingoid pattern.
features,  Monitor patient
growth for evidence of
suppression in HPA axis
children, suppression
carbohydrate during long-
intolerance, term therapy by
hyperglycemia determining
. plasma cortisol
 Special levels at weekly
Senses: intervals.
Cataracts.  Lab tests:
 Hematologic: Obtain fasting
Leukocytosis. blood glucose,
 Metabolic: serum
Hypokalemia. electrolytes, and
routine
laboratory
studies at
regular intervals
 during long-
term steroid
therapy.
 Be aware that
older adult
patients and
patients with
low serum
albumin are
especially
susceptible to
adverse effects
because of
excess
circulating free
glucocorticoids.
 Be alert to signs
of hypocalcemia
(see Appendix
F). Patients with
hypocalcemia
have increased
 requirements for
pyridoxine
(vitamin B6),
vitamins C and
D, and folates.
 Be alert to
possibility of
masked
infection and
delayed healing
(antiinflammato
ry and
immunosuppres
sive actions).
Prednisone
suppresses early
classic signs of
inflammation.
When patient is
on an extended
therapy
regimen,
 incidence of
oral Candida
infection is
high. Inspect
mouth daily for
symptoms:
white patches,
black furry
tongue, painful
membranes and
tongue.
 Monitor bone
density.
Compression
and spontaneous
fractures of long
bones and
vertebrae
present hazards,
particularly in
long-term
corticosteroid
 treatment of
rheumatoid
arthritis or
diabetes, in
immobilized
patients, and
older adults.
 Be aware of
previous history
of psychotic
tendencies.
Watch for
changes in
mood and
behavior,
emotional
stability, sleep
pattern, or
psychomotor
activity,
especially with
long-term
 therapy, that
may signal
onset of
recurrence.
Report
symptoms to
physician.
 If a patient is
receiving
aspirin
concomitantly
with a
corticosteroid,
salicylism may
be induced
when the
corticosteroid
dosage is
decreased or
discontinued.
 Be aware that
long-term
 corticosteroid
therapy is
ordinarily not
interrupted
when patient
undergoes
major surgery,
but dosage may
be increased.
 Monitor for
withdrawal
syndrome (e.g.,
myalgia, fever,
arthralgia,
malaise) and
hypocorticism
(e.g., anorexia,
vomiting,
nausea, fatigue,
dizziness,
hypotension,
hypoglycemia,
 myalgia,
arthralgia) with
abrupt
discontinuation
of
corticosteroids
after long-term
therapy.

DRUG STUDY

NAME AND DOSE, MECHANISM INDICATIONS ADVERSE NURSING

CLASSIFICATION FREQUENCY, OF ACTION CONTRAINDICAT EFFECT RESPONSIBILITI
OF DRUG ROUTE, IONS ES
DURATION OF
ADMINISTRATI
ON
 Tiotropium  18 mcg  A long-  Bronchodilati  Hypersensitivity  Body as a  Withhold drug
Bromide capsules with acting, on after to tiotropium, Whole: and notify
 Classifications: powder for antispasmodi inhalation of atropine, or Nonspecific physician if
AUTONOMIC inhalation c agent. In the tiotropium is ipratropium; chest pain, S&S of
NERVOUS bronchial predominantl pregnancy dependent angioedema
SYSTEM airways, it y a site- (category C); edema, occurs.
AGENT; exhibits specific children <18 y. infection,  Monitor for
ANTICHOLIN inhibition of effect. moniliasis, flu- anticholinergic
ERGIC; muscarinic like syndrome, effects (e.g.,
PARASYMPA receptors of cough, allergic tachycardia,
THOLYTIC; the smooth reactions. CNS urinary
ANTIMUSCAR muscle : Dysphonia, retention).
INIC; resulting in paresthesia,
ANTISPASMO bronchodilati depression.
DIC on. The drug GI :
effect can last Abdominal
up to 24 h. pain,
constipation,
dry mouth ,
dyspepsia,
vomiting,
reflux,
stomatitis.
Metabolic :
Hypercholeste
rolemia,
hyperglycemia
.
Musculoskelet
al : Myalgia,
skeletal pain.
Respiratory :
Epistaxis,
pharyngitis,
rhinitis,
laryngitis,
sinusitis, upper
respiratory
tract infection .
Skin : Rash.
Special
Senses:
Cataract.
Urogenital :
Urinary tract
infection.