DRUG STUDY 1

MEDICATION CLASSIFICATION/ INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS NURSING

ACTION RESPONSIBILITIES
Classification Penicillin is one of the Hypersensitivity or history Common side effects of Common adverse effects Before
Generic Name: Ampicillin is in a class of most used antibiotics of hypersensitivity (e.g., Penicillin are follows: of Penicillin are follows:  Check and verify
Ampicillin medications called globally; it has a wide anaphylaxis) to ampicillin,  Nausea doctor’s order
penicillin. It works by range of clinical or other β-lactam  Vomiting Significant: regarding the
Brand Name: killing bacteria. indications. Penicillin is antibiotics (e.g.,  pain, swelling, or Seizures (rapid infusion); medication.
Principen effective against many penicillins, redness in the area bacterial or fungal  Observe 10 rights:
Action different infections cephalosporins, where the superinfection (prolonged Right patient, drug,
Usual Route: Ampicillin prevents involving gram-positive carbapenems, medication was use); Stevens-Johnson dose, time, and route.
Oral, IM, IV bacterial cell wall cocci, gram-positive rods monobactams). syndrome, toxic epidermal
injected  Make a medication
synthesis by binding to 1 (e.g., Listeria), most  rash necrolysis, erythema card with the
Dosage/Frequency: or more of the penicillin- anaerobes, and gram- multiforme.
 hives complete doctor’s
Adults binding proteins resulting negative cocci (e.g.,  itching order, name of the
Orally: 250-500 mg every in the inhibition of the final Neisseria). Importantly, Blood and lymphatic
 difficulty breathing patient, bed number
6 hours transpeptidation step of certain bacterial species system disorders:
or swallowing and room/ward
peptidoglycan synthesis in have obtained penicillin Leucopenia, neutropenia,  Obtain and record
IV/IM: 1-2 g every 4-6 the bacterial cell walls.  swelling of the face,
resistance, including thrombocytopenia, vital signs.
hours or 50-250 throat, tongue, lips,
enterococci. hemolytic anemia,  Secure a copy of the
mg/kg/day divided every Pharmacokinetics: eyes, hands, feet,
coagulation disorders. client’s health history
4-6 hours, not to exceed Absorption: Moderately ankles, or lower
12 g/day. legs for contraindications
well absorbed from the Gastrointestinal and drug interactions
gastrointestinal tract.  hoarseness disorders:
Drug Order:  fever (notify the physician if
Decreased absorption rate Diarrhea, nausea, any).
2 g ampicillin then 1 g/6 h with food.  muscle or joint pain vomiting, indigestion,
for 48 h)  stomach pain  Ask the client’s full
epigastric discomfort, sore name to verify his
Time to peak plasma  severe diarrhea mouth, black hairy tongue.
identity..
concentration: Approx 1- (watery or bloody
2 hours (oral); approx 1 stools) with or General disorders and  Educate and explain
hour (IM). without fever and administration site the medication to the
stomach cramps conditions: client, how it works,
Distribution: Widely that may occur up Fever; inj site pain or why it is given to him,
distributed throughout the to 2 months or phlebitis. and the possible side
body and can be found in more after your effects
ascitic, pleural, and joint treatment Hepatobiliary disorders: During:
fluids. Crosses the  unusual bleeding or Rarely, hepatitis,
placenta and enters breast  Administer ampicillin
bruising cholestatic jaundice.
milk (small amounts). in the right time and
 blood in the urine
Penetrates the CSF with route with desire
 seizures dosage and as per
inflamed meninges.  weakness Immune system
doctor order
 fast, slow, or disorders:  Penicillin should be
Plasma protein binding: irregular heartbeat Serum sickness-like
15-18%.  return of fever, sore reaction. used with caution in
Metabolism: Metabolised throat, chills, or individuals with
into penicilloic acid. other signs of Musculoskeletal and histories of significant
Excretion: Via urine infection connective tissue allergies and/or
(approx 90%, as disorders: asthma. Care should
unchanged drug within 24 Joint pain. be taken to avoid
hours); faeces. intravenous or intra-
Elimination half-life: 1- Nervous system arterial administration,
1.8 hours. disorders: or injection into or
Encephalopathy; near major peripheral
paraesthesia (prolonged nerves or blood
use). vessels, since such
injections may
Renal and urinary produce
disorders: neurovascular
Nephropathy, interstitial damage
nephritis.
After:
Skin and subcutaneous  Monitor signs of
tissue disorders: allergic reactions and
Pruritus, purpura. anaphylaxis, including
pulmonary symptoms
(tightness in the
throat and chest,
wheezing, cough
dyspnea) or skin
reactions (rash,
prurits, urticaria).
Notify physician or
nursing staff
immediately if these
reactions occur.
 Monitor B/P
(standing, sitting,
supine).
 Monitoring its
effectiveness and
educating the patient.
 Wash your hands
properly
 Document the time,
location, dose,
medication given to
the patient.
 DRUG STUDY 2
MEDICATION CLASSIFICATION/ INDICATIONS CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS NURSING
ACTION RESPONSIBILITIES
Generic Name: Classification: Azithromycin is indicated Hypersensitivity to Common side effects of Common adverse effects Before
Azithromycin Azithromycin belongs to for the treatment of macrolide antibiotics. azithromycin are of azithromycin are  Check and verify
the class of drugs known patients with mild to History of hepatic follows: follows: doctor’s order
Brand Name: as macrolide antibiotics. It moderate infections dysfunction/cholestatic  Feeling sick regarding the
Zithromax. works by killing bacteria or caused by susceptible jaundice following (nausea) Stick to Significant:  medication.
preventing their growth. strains of the previous antibiotic use simple meals and Myasthenia gravis.  Observe 10 rights:
Usual Route: However, this medicine microorganisms do not eat rich or Right patient, drug,
Oral will not work for colds, flu, spicy food while Ear and labyrinth dose, time, and
or other virus infections. Azithromycin should be you're taking this disorders:  route.
Usual This medicine is available used only to treat or medicine. Deafness.  Make a medication
Dosage/Frequency: only with your doctor's prevent infections that are  Diarrhoea card with the
Adults prescription. proven or strongly  Being sick Eye disorders:  complete doctor’s
Orally: 500 to 2000 suspected to be caused Pruritus, burning, stinging
(vomiting) order, name of the
milligrams (mg) once a Action by susceptible bacteria in of the eye or ocular
 Losing your patient, bed
day, taken as a single Azithromycin is a order to prevent the discomfort, sticky eye
appetite number and
dose. macrolide antibiotic under development antimicrobial sensation, foreign body
 Headaches room/ward
the azalide group. It resistance and maintain sensation (ophthalmic).  Obtain and record
Drug Order:  Feeling dizzy or
inhibits RNA-dependent the efficacy of vital signs.
oral azithromycin (1 g protein tired
synthesis by azithromycin Gastrointestinal  Secure a copy of
azithromycin in binding  Changes to your
to the 50s disorders:  the client’s health
monodosis), sense of taste.
ribosomal subunit, Diarrhoea, vomiting, history for
preventing the abdominal pain, nausea, contraindications
translocation of peptide flatulence, dyspepsia, and drug
chains. dysgeusia. interactions (notify
Pharmacokinetics: the physician if
Absorption: Rapidly General disorders and any).
absorbed from the admin site conditions:   Ask the client’s full
gastrointestinal tract. Injection site pain, fatigue. name to verify his
Bioavailability: Approx
identity.
37%. Time to peak Metabolism and  Educate and
plasma concentration: nutrition disorders:  explain the
Approx 2-3 hours (oral, Anorexia. medication to the
immediate release).
client, how it works,
Distribution: Extensively Musculoskeletal and why it is given to
distributed in the tissues connective tissue him, and the
(skin, lungs, tonsils, disorders:  possible side
cervix) and sputum. Arthralgia. effects
Present in breastmilk.
Volume of distribution: 31- Nervous system
33 L/kg. Plasma protein- disorders:  During:
binding: 7-51%. Headache, dizziness,  Communicate with
Metabolism: Metabolised paraesthesia. the client and
in the liver to inactive advise her that you
metabolites. Skin and subcutaneous will administer
Excretion: Via bile (50%, tissue disorders:  azithromycin
as unchanged drug); urine Pruritus, rash.  Administer 1g of
(6-14%, as unchanged azithromycin,
drug). Terminal administer on an
elimination half-life: 68- empty stomach 1 hr
72 hours (conventional before or 2–3 hr
preparations); 59 hours after meals. Food
(extended release). affects the
absorption of this
drug.

After:
 Observe for signs
and symptoms of
anaphylaxis (rash,
pruritus, laryngeal
edema, wheezing).
 Monitor B/P
(standing, sitting,
supine).
 Remind the client
to avoid tasks that
require alertness,
motor skills until
response to drug is
established.
 Wash your hands
properly
 Document the time,
location, dose,
medication given to
the patient.

MEDICATION CLASSIFICATION/
ACTION
Generic Name: Classification
Betamethasone Betamethasone is in a
class of medications
Brand Name: called corticosteroids; it
Celestone usually uses to pregnancy
Celestone Soluspan, for maturity lung of the
Betajec fetus.
Betamethasone IM/PO.
Action
Usual Route: Betamethasone is a
IM corticosteroid with
primarily glucocorticoid
Usual activity. It induces
Dosage/Frequency: phospholipase
0.6-7.2 mg orally divided A2 inhibitory proteins
twice daily/four times daily (lipocortins) and
or 0.6-9 mg/day sequentially inhibits the
intramuscularly each day release of arachidonic
divided twice daily.
acid, thereby depressing
the formation, release,
Drug Order: and activity of
betamethasone 12mg/IM
prostaglandins,
Q 24 hrs x 2 doses histamines, and other
endogenous inflammatory
chemical mediators.
Pharmacokinetics:
Absorption: Readily
absorbed from the
gastrointestinal tract (oral);
absorbed percutaneously
(topical).
Time to peak plasma
concentration: 10-36
minutes (IV).
Distribution: Crosses the
placenta and enters breast
milk.
Plasma protein binding:
64%.
DRUG STUDY 3
INDICATIONS CONTRAINDICATIONS
A single course of Untreated systemic
betamethasone is infections (oral,
recommended for parenteral); idiopathic
pregnant women between thrombocytopenic purpura
34 0/7 weeks and 36 6/7 (IM); perforated tympanic
weeks of gestation at risk membrane (otic).
of preterm birth within 7 Ophthalmic: Bacterial,
days, and who have not fungal, viral, tuberculous
received a previous or purulent eye infections;
course of antenatal glaucoma, herpetic
corticosteroids keratitis (e.g. dendritic
ulcer), undiagnosed red
eye. Topical: Untreated
fungal, tubercular or
bacterial skin infections;
viral skin lesions (e.g.
herpes simplex, varicella,
vaccinia), acne vulgaris,
rosacea, perianal and
genital pruritus, perioral
dermatitis, pruritus without
inflammation; infants <1
year (betamethasone
valerate). Concomitant
administration with live
vaccines (in patients
receiving
immunosuppressive
doses).
SIDE EFFECTS ADVERSE EFFECTS NURSING
RESPONSIBILITIES
Common side effects of Common adverse effects Before
betamethasone are of betamethasone are  Check and verify
follows: follows: doctor’s order
regarding the
 burning, itching, Significant:  medication.
irritation, stinging, Adrenal suppression (e.g.  Observe 10 rights:
redness, or dryness suppression of Right patient, drug,
of the skin hypothalamic-pituitary- dose, time, and route.
 acne adrenal [HPA] axis,  Make a medication
 unwanted hair hypercortisolism, adrenal card with the
growth cortical atrophy); visual complete doctor’s
 skin color changes disturbances (e.g. blurred order, name of the
 bruising or shiny vision, glaucoma, posterior patient, bed number
subcapsular cataract,
skin and room/ward
central serous
 tiny red bumps or  Obtain and record
rash around the chorioretinopathyleft vital signs.
ventricular free wall
mouth  Secure a copy of the
rupture. Rarely,
 small white or red client’s health history
anaphylactoid reactions. for contraindications
bumps on the skin
and drug interactions
Gastrointestinal
(notify the physician if
disorders:  any).
Abdominal distension,
 Ask the client’s full
dyspepsia, nausea,
name to verify his
oesophageal ulceration,
identity..
peptic ulcer with
 Educate and explain
perforation and
the medication to the
haemorrhage; acute
client, how it works,
pancreatitis; taste
why it is given to him,
disturbance (nasal).
and the possible side
effects
General disorders and
administration site
During:
conditions: 
 Give daily dose
Malaise.
before 9 AM to mimic
normal peak
corticosteroid blood
Metabolism and levels.
nutrition disorders:   Increase dosage
Metabolism: Metabolised Hypokalaemic alkalosis, when patient is
primarily in the liver. impaired carbohydrate subject to stress.
Excretion: Via urine (<5% tolerance.  Taper doses when
as unchanged drug). discontinuing high-
Elimination half-life: 6.5 Musculoskeletal and dose or long-term
hours. connective tissue therapy.
disorders:   Do not give live virus
Osteoporosis, tendon vaccines with
rupture, vertebral and long immunosuppressive
bone fractures, avascular doses of
osteonecrosis. corticosteroids.
 Examine area for
Nervous system infections and skin
disorders:  integrity before
Headache. application.
 Administer cautiously
Psychiatric disorders:  to pregnant patients;
Irritability, mania, topical corticosteroids
delusions, hallucinations, have caused
behavioural disturbances, teratogenic effects
anxiety, sleep and can be absorbed
disturbances, confusion. from systemic site.
 WARNING: Use
Reproductive system caution when
and breast disorders:  occlusive dressings or
Menstrual irregularity, tight diapers cover
amenorrhoea. affected area; these
can increase systemic
Respiratory, thoracic absorption of the
and mediastinal drug.
disorders:   Avoid prolonged use
Nasal irritation and near eyes, in genital
dryness, epistaxis, and rectal areas, and
rebound congestion, in skin creases.
bronchial asthma,
perforation or ulceration of
nasal septum, anosmia, After:
parosmia, sneezing. 
 Observe any signs of
Skin and subcutaneous side and adverse
tissue disorders:  effect and notify the
Atrophy, bruising, acne, physician if any.
telangiectasia, striae,  Monitor B/P
hypertrichosis, Stevens- (standing, sitting,
Johnson syndrome; supine).
pruritus, burning or
 Remind the client to
stinging sensation, pain avoid tasks that
(topical). require alertness,
Vascular motor skills until
response to drug is
established.
 Wash your hands
properly
 Document the time,
location, dose,
medication given to
the patient

MEDICATION CLASSIFICATION/
ACTION
Generic Name: Classification:
Ferrous Sulfate Belongs to the class of
oral iron bivalent
Brand name: preparations. Used in the
Slow FE, treatment of anemia.
Fer-In-Sol
Feratab, Iron Action:
Mol-Iron ferrous sulfate facilitates
Feosol, oxygen transport via Hb. It possesses fewer side
MyKidz Iron 10. is used as iron source as it effects and guarantees
replaces iron found in Hb, better compliance in this
Usual Route: myoglobin and other
Oral enzymes.
Onset: Haematologic
Usual dosage/Frequency response: Approx 3-10
325 mg (65 mg of days (oral). Peak effect:
elemental iron) orally three Reticulocytosis: 5-10
times a day, lower doses days; increased Hb:
(eg, 15-20 mg of Within 2-4 weeks.
elemental iron daily) may
Pharmacokinetics:
be as effective and cause Absorption: Absorbed
fewer side effects. mainly in the duodenum
and upper jejunum. Food
Drug order:
and achlorhydria may
Ferrous Sulfate 1 capsule decrease absorption.
OD Distribution: Majority
binds to transferrin and
transported to the bone
marrow.
Excretion: Via urine,
sweat, sloughing of the
intestinal mucosa, and
menses.
Half-life:
The half-life of orally
administered iron is not
readily available in the
literature, with total effects
lasting 2-4 months
(congruent with the red
blood cell life span)11 with
INDICATIONS CONTRAINDICATIONS
ferrous sulphate is as Ferrous sulfate is
effective as twice daily contraindicated with
(130 mg elemental iron)
dose regimen in
prevention of Anaemia in
pregnancy in a developing
economy like Nigeria.
Once daily dose
study.
DRUG STUDY 3
SIDE EFFECTS ADVERSE EFFECTS NURSING
RESPONSIBILITIES
Most common side effect Most common adverse Before:
of Ferrous sulfate are: reactions:
 Haemochromatosis ● feeling or being sick ● Check and verify
, other iron (nausea or Gastrointestinal doctor’s order
overload vomiting), stomach disorders:  regarding the
syndromes. pain or heartburn.  Gastrointestinal medication.
 Blood disorders ● loss of appetite. irritation ● Observe 10 rights:
(e.g., paroxysmal Right patient, drug,
● constipation.  Nausea dose, time, and route.
nocturnal ● diarrhea.
haemoglobinuria,
 Vomiting ● Make a medication
● dark or black poo.  epigastric pain card with the
haemolytic
● black stained teeth complete doctor’s
anaemia,  diarrhoea
haemosiderosis, (from the drops) order, name of the
 constipation patient, bed number
other anaemias)
 blackening of stool and room/ward
 active peptic ulcer
 tooth discolouration ● Obtain and record
 regional enteritis
 abdominal vital signs.
and ulcerative
● Secure a copy of the
colitis. discomfort.
client’s health history
 Patient receiving
frequent blood Immune system for contraindications
and drug interactions
transfusions. disorders: 
(notify the physician if
 Concomitant  Hypersensitivity.
any).
parenteral iron
● Ask the client’s full
therapy.
name to verify his
identity
● Educate and explain
the medication to the
client, how it works,
why it is given to him,
and the possible side
effects
During:
● Position patient
appropriately for
medication
an onset of action of 4
days and peak activity at
7-10 days
After:
administration
● Place at the bed side
of the client
● Administer Ferrous
Sulfate tablet
● Give 1 cup of water to
the client after
administration
● Ensure proper body
mechanics for health
care provider
● Be alert to neurologic
effects (headache,
lethargy, mental
confusion, agitation).
● Monitor B/P
(standing, sitting,
supine).
● Remind the client to
avoid tasks that
require alertness,
motor skills until
response to drug is
established.
● Wash your hands
properly
● Document the time,
location, dose,
medication given to
the patient