Format, Drug Study

Republic of the Philippines
DONA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC,

College of Nursing
Calanipawan Road, Tacloban City, Leyte
MANNITOL
MECHANISM OF
DRUG NAME INDICATION CONTRAINDICATION ADVERSE EFFECT/S NURSING RESPONSIBILITIES
ACTION
Increases osmotic General: Contraindicated in patients CNS: seizures, dizziness, BEFORE:

Generic Name: pressure of glomerular For the reduction of hypersensitive to drugs. headache, fever.  Verify the doctor’s order.
Mannitol filtrate, thus inhibiting intracranial pressure,  Check the patient’s
tubular reabsorption of the treatment of Contraindicated in patients CV: edema, identity.
Brand Name: water and electrolytes. cerebral edema, and with anuria; severe thrombophlebitis,  Ensure the right
Osmitrol Drug elevates plasma the promotion of urinary pulmonary congestion; hypotension, HTN medication and the given
osmolality and excretion of toxic frank pulmonary edema; appropriate dose at the
Dosage: increase urine output. substances. active intracranial bleeding, EENT: blurred vision, right time
150 cc; 100 cc; 75 cc severe dehydration; rhinitis.  Check the expiration date
Specific: metabolic edema of the medicine.
Route: Given to treat high GI: thirst, dry mouth,  The nurse on duty should
IV intracranial pressure. nausea, vomiting, be the one to give the
Mannitol works by diarrhea. medication
Therapeutic Class: creating an osmotic  Assess the patient’s
Diuretics gradient across the GU: urine retention. condition before and
blood-brain barrier that starting therapy and
draws water into the Metabolic: dehydration, regularly thereafter to
Pharmacologic Class:
vascular space. This fluid and electrolyte monitor drug’s
Osmotic Diuretics
effect is used to reduce imbalance. effectiveness
intracranial pressure.  Measure I&O accurately
Respiratory: pulmonary and record to achieve
edema. proper fluid balance.
 Monitor vital signs closely.
Skin: local pain, urticaria, Assess in BP for
injection-site reaction hypotension before
(infection, phlebitis, administering drug.
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venous thrombosis).  Monitor for possible

indications of fluid and
Other: chills, thirst. electrolyte imbalance (e.g.,
thirst, muscle cramps or
weakness, paresthesia).
 Check patency at the
infusion site.
 Explain the purpose of
administering the drug
 If the patient refuses,
assess why the patient
does not want to take
medicine.
 Educate on what could
happen if they refuse to
take their medicine.
DURING:
 Check patency at the
infusion site.
 Ensure to observe and
follow the 15 rights of drug
administration
 Watch for signs and
symptoms of infiltration.
 Take care to avoid
extravasation. Observe
injection sites for signs of
inflammation or edema.
AFTER:
 Monitor any changes in
I&O.
 Monitor for any changes in
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the head circumference.

 Report if there are
manifestations of oliguria
 Instruct the patient to
report any of the following:
Thirst, muscle cramps or
weakness, paresthesia,
dyspnea, or headache.
 Instruct significant others
to immediately report any
signs of confusion.
 Be alert to the possibility
that a rebound increase in
ICP sometimes occurs
about 12 h after drug
administration. The patient
may complain of headache
or confusion.
 Check weight, renal
function, fluid balance, and
serum and urine sodium
and potassium levels daily.
 Document administration
after giving the ordered
medication. Chart the time,
route, and any other
specific information as
necessary.
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DEXAMETHASONE
MECHANISM OF
ACTION
Decreases General: Contraindicated in CNS: Dizziness, fainting, BEFORE:

Generic Name: inflammation, mainly Provides relief for patients who have shown lightheadedness, seizures,  Verify the doctor’s order.
Dexamethasone sodium by stabilizing leukocyte inflamed areas of the hypersensitivity to the drug sleepiness or unusual  Check the patient’s
phosphate injection lysosomal body. It is used to treat Contraindicated in patients drowsiness. identity. Ensure the right
membranes; a number of different with renal impairment medication and the given
Brand Name: suppresses immune conditions, such as CV: Fast, slow, or irregular appropriate dose at the
Dexamethasone Intensol response; stimulates inflammation severe heartbeat right time.
bone marrow; and allergies, adrenal  Check the expiration date
Dosage: influences protein, fat, problems, arthritis, Respiratory: chest tightness, of the medicine.
6mg IV q 8h and carbohydrate asthma, skin conditions, thickening of bronchial  The nurse on duty should
metabolism and flare-ups of multiple secretions, difficulty be the one to give the
Route: sclerosis. breathing medication
IV  Educate the patient about
Specific: EENT: Blurred or loss of the purpose of
Therapeutic Class: Reducing brain swelling vision, double vision, administering the drug.
Corticosteroids and relieve pressure on night blindness  Assess for hypersensitivity.
brain. Help reduce  Obtain VS for baseline
vasogenic edema. GI: upper right abdominal data.
Pharmacologic Class:
Glucocorticoids pain, vomiting, stomach pain,  If the patient refuses,
difficulty swallowing, nausea, assess why the patient
bloody diarrhea, mouth sores does not want to take
medicine.
GU: dark urine, painful or  Educate on what could
difficult urination happen if they refuse to
Musculoskeletal: joint
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pain, stiffness, muscle pains DURING:

 Let patient swallow tablets
Skin: blistering, peeling, or whole, do not crush, break,
loosening of skin dissolve or chew
 Observe adverse
reactions.
AFTER:
 Check for any
hypersensitivity reaction.
 Instruct patient to report
any side effects
immediately.
 Instruct patient not to drive
or operate any machinery
in the day of the treatment
or the following day due to
potential drug-induced
dizziness and drowsiness
 Inform physician if patient
develops a sustained
headache or high fever
necessary.
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PARACETAMOL
MECHANISM OF
ACTION
Thought to produce General: Hypersensitivity to CNS: agitation (IV), anxiety, BEFORE:

Generic Name: analgesia by inhibiting To relieve mild to medication. Patients fatigue, headache, insomnia,
Acetominophen prostaglandin and moderate pain. suffering from sever liver pyrexia.  Verify the doctor’s order.
(Paracetamol) other substances that Reduction of fever. disease. Patient with CV: HTN, hypotension,  Check the patient’s
sensitize pain alcohol abuse, G6PD peripheral edema, periorbital identity. Ensure the right
Brand Name: receptors. Drug may Specific: deficiency, renal impairment edema, tachycardia (IV). medication and the given
Acephen, ACET, Arthritis relieve fever through PRN for Mild to appropriate dose at the
Pain Relief, Atasol Forte, central action in the moderate pain relief GI: nausea, vomiting, right time.
Fortolin, Ofirmev, hypothalamic heat- abdominal pain, diarrhea,  Check the expiration date
Pediatrix, Rapid Action, regulating center constipation (IV). of the medicine.
Taminol, Triaminic,  The nurse on duty should
Fever Reducer: Tylenol GU:oliguria (IV). be the one to give the
medication
Dosage: Hematologic: hemolytic  Educate the patient about
600 mg IV q 6h PRN for anemia, leukopenia, the purpose of
headache neutropenia, administering the drug.
pancytopenia, anemia.  Assess for hypersensitivity.
Route:  Obtain VS for baseline
IV Hepatic: jaundice. data.
Therapeutic Class: Metabolic: hypoalbuminemia assess why the patient
Analgesics (IV), hypoglycemia, does not want to take
hypokalemia, hypervolemia, medicine.
Pharmacologic Class: hypomagnesemia,  Educate on what could
Para-aminophenol hypophosphatemia (IV). happen if they refuse to
derivatives Musculoskeletal: muscle take their medicine.
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spasms, extremity
pain (IV). DURING:
 Ensure accurate dosage
Respiratory: abnormal breath calculation and preparation
sounds, dyspnea, hypoxia, according to the prescribed
atelectasis, pleural effusion, order.
pulmonary edema, stridor,  Administer paracetamol
wheezing (IV). orally, intravenously, or
rectally, as ordered,
Skin: rash, urticaria; infusion- following aseptic technique
site pain (IV), pruritus. if necessary.
 Monitor the patient's vital
signs regularly, paying
particular attention to
temperature changes, as
paracetamol is also used
as an antipyretic.
 Assess the patient's
response to the medication
in terms of pain relief and
reduction in fever.
AFTER:
 Provide ongoing
monitoring and
assessment of the patient's
pain level and temperature
at regular intervals as per
institutional guidelines.
 Monitor for any signs of
adverse reactions, such as
allergic reactions or liver
toxicity, and report them
promptly to the healthcare
provider.
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 Educate the patient and

their family about the
proper use and potential
side effects of
paracetamol.
 Document the
administration, patient
response, vital signs, and
any other relevant
information accurately in
the patient's medical
records.
TRAMADOL
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MECHANISM OF
ACTION
Thought to bind to General: Patients hypersensitive to CNS: dizziness, headache, BEFORE:

Generic Name: opioid receptors and Management of drug or opioids, in patients somnolence, vertigo,  Verify the doctor’s order.
Tramadol hydrochloride inhibitor reuptake of moderate to severe with severe renal or hepatic seizures, anxiety, asthenia,  Check the patient’s
norepinephrine and pain in adults. impairment, suicidal identity. Ensure the right
Brand Name: serotonin patients, and in those with CNS stimulation, confusion, medication and the given
ConZip, Durela, Ralivia, Specific: acute intoxication from coordination disturbance, appropriate dose at the
Tridural, Ultram, Zytram Management of alcohol, hypnotics, centrally euphoria, malaise, right time.
XL moderate to severe acting analgesics, opioids, nervousness, sleep disorder,  Check the expiration date
pain in adults. or psychotropic drugs. fever, paresthesia, tremor, of the medicine.
Dosage: depression,  The nurse on duty should
50 mg IV q 8h agitation, apathy. be the one to give the
medication
Route: CV: vasodilation, HTN,  Educate the patient about
IV peripheral edema. the purpose of
administering the drug.
Therapeutic Class: EENT: visual  Assess for hypersensitivity.
Analgesics disturbances,  Obtain VS for baseline
nasopharyngitis, pharyngitis, data.
Pharmacologic Class: rhinitis, sinusitis.  If the patient refuses,
Synthetic centrally active assess why the patient
analgesics GI: does not want to take
constipation, nausea, medicine.
vomiting, abdominal pain,  Educate on what could
anorexia, diarrhea, dry happen if they refuse to
mouth, dyspepsia, flatulence. take their medicine.
GU: menopausal symptoms, DURING:
proteinuria,  Administer tramadol as
urinary frequency, urine prescribed, following the
retention, pelvic pain, UTI, appropriate dosage, route,
prostate disorder. and frequency.
 Ensure accurate
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calculations and use a

medication administration
record to document the
medication given.
 Follow the hospital's
protocols for controlled
substance administration
and proper documentation.
 monitor the patient's pain
levels documenting the
effectiveness of the
medication.
 Monitor vital signs
regularly
 Observe for potential side
effects
 Assess for any signs of
allergic reactions, such as
rash, itching, or swelling.
AFTER
 Inform the patient about
the expected analgesic
effects, potential side
effects, and precautions
related to tramadol use.
 Instruct the patient to
report any adverse
reactions or changes in
pain intensity promptly.
 Educate the patient on the
importance of adhering to
the prescribed dosage and
avoiding self-adjustment of
the medication.
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OMEPRAZOLE
MECHANISM OF
ACTION
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Inhibits proton pump General: Contraindicated in patient’s CNS: asthenia, dizziness, BEFORE:
Generic Name: activity by binding to Duodenal and gastric hypertensive to drug or its headache.  Verify the doctor’s order.
Omeprazole hydrogen-potassium ulcer. components and in patients  Check the patient’s
adenosine Gastroesophageal receiving rilpivirine- GI: abdominal pain, identity. Ensure the right
Brand Name: triphosphatase, reflux disease including containing products. constipation, diarrhea, medication and the given
Losec located at secretory severe erosive flatulence, nausea, vomiting, appropriate dose at the
surface or gastric esophagitis Use cautiously in patients acid regurgitation. right time.
Dosage: parietal cells, to with hypokalemia and  Check the expiration date
40 mg IV OD suppress gastric acid Specific: respiratory alkalosis and Musculoskeletal: back of the medicine.
secretion. To reduce the in patients on a low-sodium. pain, weakness.  The nurse on duty should
Route: production of stomach be the one to give the
IV acids and prevent ulcer, Respiratory: cough, URI. medication
heartburn, and acid  Educate patient about the
Therapeutic Class: reflux Skin: rash purpose of administering
Antiulcer drugs the drug.
 Assess for hypersensitivity.
Pharmacologic Class:  Obtain VS for baseline
PPI data.
medicine.
DURING:
 Observe for adverse
reactions
 Check IV site for redness
and swelling.
 Ensure to observe and
follow the 15 rights of drug
administration
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 Monitor patients for signs

and symptoms of low
magnesium level, such as
abnormal heart rate or
rhythm, palpitations,
muscle spasms, tremors,
or seizures
AFTER:
 Check for any
hypersensitivity reaction.
 Instruct patient to report
any side effects
immediately.
 Caution patients to avoid
hazardous activities of
dizziness.
 Report any changes in
urinary elimination such as
pain or discomfort
associated with urination,
or blood in urine.
 Report severe diarrhea;
drug may need to be
discontinued
 Monitor analysis for
hematuria and proteinuria.
Periodic liver function tests
with prolonged use.
necessary.
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NIMODIPINE
MECHANISM OF
ACTION
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Selectively inhibits To improve neurologic Hypersensitivity to drug. Reduction in systemic blood BEFORE:
Generic Name: calcium ion influx into deficits after Hypotensive patients, Acute pressure  Verify the doctor’s order.
Nimodipine smooth muscle cells in subarachnoid myocardial infarction Diarrhea  Check the patient’s
cerebral blood vessels. hemorrhage from Headache identity. Ensure the right
Brand Name: It dilates and relaxes ruptured intracranial Abdominal discomfort medication and the given
Nymalize the cerebral arteries, berry aneurysm Rash appropriate dose at the
leading to increased Heart failure right time.
Dosage: cerebral blood flow Arrhythmia  Check the expiration date
30 mg/tab 2 tabs q 4h and improved oxygen Anemia of the medicine.
delivery to ischemic ECG abnormalities  The nurse on duty should
Route: brain tissue. By GI hemorrhage be the one to give the
PO preventing Hepatitis medication
vasospasm, Jaundice  Educate patient about the
nimodipine helps to Thrombocytopenia purpose of administering
Therapeutic Class:
maintain cerebral Vomiting the drug.
Vasodilator
perfusion and prevent Thrombosis  Assess for hypersensitivity.
secondary brain injury Rebound vasospasm
Pharmacologic Class:  Obtain VS for baseline
following SAH.
Calcium channel data, especially BP and
blockers HR
 Confirm that the patient
has not ingested grapefruit
or grapefruit juice, as these
can interfere with the
metabolism of nimodipine.
medicine.
DURING:
 Administer nimodipine
orally as prescribed,
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ensuring accurate dosage

measurement.
signs, particularly blood
pressure and heart rate.
Be alert for signs of
hypotension and report
significant changes
promptly.
 Stay vigilant for any
adverse reactions, such as
dizziness, headache,
flushing, nausea, or
allergic reactions, and
promptly report any
concerns to the healthcare
team.
 Ensure the patient is in a
comfortable position during
administration, and provide
any necessary assistance
to aid swallowing or tube
placement.
AFTER:
 Document the
administration of
nimodipine
 Monitor the patient's blood
pressure and heart rate at
regular intervals as
ordered, especially during
the initial phase of
nimodipine therapy.
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 Continually assess the

patient's neurological
status.
 Provide ongoing education
and support to the patient
and family, addressing any
questions or concerns they
may have.
 Collaborate with the
healthcare team to ensure
appropriate follow-up care.
CITICOLINE
MECHANISM OF
ACTION
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Citicoline is a complex Prescribed to help Hypersensitivity Cardiac disorders: BEFORE:

Generic Name: organic molecule that improve neurological Patients with hypertonic of Bradycardia, tachycardia.  Verify the doctor’s order.
Citicoline stimulates the function and promote the parasympathetic Eye disorders: Diplopia.  Check the patient’s
biosynthesis of recovery following a Gastrointestinal disorders: identity.
Brand Name: structural stroke. Diarrhoea, epigastric  Ensure the right
Cognizing phospholipids of the distress, nausea, stomach medication and the given
neuronal membrane. It pain. appropriate dose at the
Dosage: preserves the neuronal General disorders and right time.
1 gram BID energetic reserve, administration site  Check the expiration date
inhibits apoptosis and conditions: Fatigue, malaise. of the medicine.
Route: stimulates the Investigations: Abnormal  Check VS.
PO synthesis of LFT.  Assess the patient for any
acetylcholine. It is also Metabolism and nutrition known allergies to
claimed to increase disorders: Anorexia. citicoline or related
Therapeutic Class:
blood flow and oxygen Nervous system disorders: medications.
Nootropic agent
consumption in the Headache, dizziness,
 Review the patient's
brain. convulsion.
Pharmacologic Class: laboratory results.
Psychiatric disorders:
Nucleotide derivative  The nurse on duty should
Insomnia, excitation.
be the one to give the
Skin and subcutaneous
medication
tissue disorders: Rash.
Vascular disorders:  Educate the patient and
Transient blood pressure family about the purpose,
changes, flushing. potential benefits, and
possible side effects of
citicoline.
DURING:
 Prepare the medication
according to the prescribed
dosage and route.
 Administer citicoline as
ordered, ensuring accurate
documentation of the
administration time, dose,
and route.
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signs, particularly blood
pressure.
 Observe the patient for
signs of an allergic
reaction
 Assess the patient's
neurological status.
AFTER:
 Continuously monitor the
patient's vital signs,
neurological status, and
overall response to
citicoline.
 Document any observed
changes in the patient's
condition
 Provide ongoing education
and support to the patient
and family regarding the
importance of adherence
to the medication regimen.
 Collaborate with the
interdisciplinary team to
ensure appropriate
rehabilitation therapies and
interventions are
implemented to maximize
the patient's recovery.
 Regularly reassess the
patient's response to
citicoline and communicate
any concerns or significant
changes to the healthcare
provider.
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LOSARTAN
MECHANISM OF
ACTION
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Inhibits General: Contraindicated in patients CNS: dizziness, asthenia, BEFORE:

Generic Name: vasoconstrictive and Reduce blood pressure, hypersensitive to drug. fatigue, headache, insomnia.  Verify the doctor’s order.
Losartan potassium aldosterone-secreting treat left ventricular Use cautiously in patients  Check the patient’s
action of angiotensin II hypertrophy and with impaired renal or CV: edema, chest identity.
Brand Name: by blocking diabetic neuropathy hepatic function pain.  Ensure the right
Cozaar angiotensin II receptor medication and the given
on the surface of Specific: EENT: nasal congestion, appropriate dose at the
Dosage: vascular smooth To reduce and treat sinusitis, pharyngitis, sinus right time
50 mg/tab OD muscle and other high blood pressure disorder.  Check the expiration date
tissue cells. and prevent recurrent of the medicine.
Route: stroke GI:  The nurse on duty should
PO abdominal pain, nausea, be the one to give the
diarrhea, dyspepsia. medication
Therapeutic Class:  Assess the patient’s
Antihypertensive Musculoskeletal: muscle condition before and
cramps, myalgia, back or leg starting therapy and
Pharmacologic Class: pain. regularly thereafter to
ARBs monitor drug’s
Respiratory: cough, URI. effectiveness
 Monitor vital signs closely.
Other: angioedema. Assess in BP for
hypotension before
administering drug.
 Explain the purpose of
administering the drug
medicine.
DURING:
 Administer losartan orally
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as prescribed, ensuring the

patient understands the
instructions for taking the
medication. Administer
with or without food, as
directed.
 Monitor the patient for any
adverse effects, such as
hypotension, dizziness,
headache, or
gastrointestinal
disturbances, and report
any significant changes to
the healthcare provider.
 Educate the patient on the
importance of adherence
to the prescribed
medication regimen and
the need for regular blood
pressure monitoring.
AFTER
 Document the
administration of losartan
 Monitor the patient's blood
pressure and other vital
signs at appropriate
intervals as per the
healthcare provider's
instructions.
 Evaluate the patient for
therapeutic response to
the medication
 Provide ongoing patient
education regarding the
importance of a healthy
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lifestyle
 Arrange follow-up
appointments for the
patient as scheduled.

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Republic of the Philippines

DONA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC,

Increases osmotic General: Contraindicated in patients CNS: seizures, dizziness, BEFORE:

venous thrombosis).  Monitor for possible

the head circumference.

Decreases General: Contraindicated in CNS: Dizziness, fainting, BEFORE:

pain, stiffness, muscle pains DURING:

Thought to produce General: Hypersensitivity to CNS: agitation (IV), anxiety, BEFORE:

 Educate the patient and

Thought to bind to General: Patients hypersensitive to CNS: dizziness, headache, BEFORE:

calculations and use a

 Monitor patients for signs

ensuring accurate dosage

 Continually assess the

Citicoline is a complex Prescribed to help Hypersensitivity Cardiac disorders: BEFORE:

 Monitor the patient's vital

Inhibits General: Contraindicated in patients CNS: dizziness, asthenia, BEFORE:

as prescribed, ensuring the

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