Drug Mechanism of action/Side effects Indication/Contraindication Nursing Responsibilities

Brand name: Mechanism of Action: Indication: Nursing Responsibilities:

Diazepam - Depress the CNS, probably by potentiating GABA,  Management of anxiety disorders, short-term
an inhibitory neurotransmitter. relief of anxiety symptoms, spasticity associated  Remember to apply the 10 rights of drug administration
with upper motor neuron disorders, adjunct before giving the appropriate drug to the client
Generic name: - Produces skeletal muscle relaxation by inhibiting therapy for muscle spasms. preoperatively.
Valium spinal polysynaptic afferent pathways. 1. Right drug
Contraindication: 2. Right patient
- Has anticonvulsant properties due to enhanced
 Contraindicated with hypersensitivity to 3. Right dose
presynaptic inhibition.
Classification: benzodiazepines; psychoses, acute narrow-angle 4. Right route
Anticonvulsant, Therapeutic effects: glaucoma, shock, coma, acute alcoholic
5. Right time and frequency
Sedative, Skeletal intoxication; pregnancy (cleft lip or palate,
(1) Relief of Anxiety 6. Right documentation
muscle relaxants inguinal hernia, cardiac defects, microcephaly,
(2) Sedation pyloric stenosis when used in first trimester; 7. Right history and assessment
(3) Amnesia neonatal withdrawal syndrome reported in 8. Drug approach and right to refuse
newborns); lactation. 9. Right drug-drug interaction and evaluation
Route: IV (4) Skeletal muscle relaxant
10.Right education and information
(5) Decreased seizure activity
Dosage: 3 mg  Monitor for adverse reactions.
Side Effects:  Monitor for therapeutic effectiveness. Maximum effect
Frequency: BID may require 1-2 weeks; patient tolerance to therapeutic
Body as a whole: throat and chest pain effects may develop after 4 weeks of treatment
 Observe necessary preventive precautions for suicidal
CNS: drowsiness, fatigue, ataxia, confusion,
tendencies that may be present in anxiety states
paradoxic rage, dizziness, vertigo, amnesia, vivid
accompanied by depression.
dreams, headache, slurred speech, and tremor
 Observe patient closely and monitor vital signs when
CV: Hypotension, tachycardia, edema, cardiovascular diazepam is given parenterally; hypotension, muscular
collapse weakness, tachycardia, and respiratory depression may
occur.
Special Senses: blurred vision, diplopia, nystagmus
 Lab tests: Periodic CBC and liver function tests during
GI: xerostomia, nausea, constipation, and hepatic prolonged therapy.
dysfunction
 Urogenital: incontinence, urinary retention,  Supervise ambulation. Adverse reactions such as
gynecomastia, menstrual irregularities, ovulation drowsiness and ataxia are more likely to occur in older
failure adults and debilitated or those receiving larger doses.
 Monitory I&O ration including urinary and bowel
Respiratory: hiccups, cough, and laryngospasm. -
Other: pain, venous thrombosis, phlebitis at injection elimination.
site

Drug Mechanism of action/Side effects Indication/Contraindication Nursing Responsibilities

Brand name: Mechanism of Action: Indication: Nursing Responsibilities:

Ipratropium Ipratropium acts as an antagonist of the muscarinic  Bronchodilators that relax muscles in the airways
acetylcholine receptor. This effect produces the and increase air flow to the lungs.  Remember to apply the 10 rights of drug administration
inhibition of the parasympathetic nervous system in before giving the appropriate drug to the client
Generic name: the airways and hence, inhibit their function. The Contraindication: preoperatively.
Atrovent function of the parasympathetic system in the airway  Contraindicated with hypersensitivity to atropine 1. Right drug
is to generate bronchial secretions and constriction or its derivatives, soy bean or peanut allergies 2. Right patient
and hence, the inhibition of this action can lead to (aerosol). 3. Right dose
bronchodilation and fewer secretions. 4. Right route
Classification:
Anticholinergics 5. Right time and frequency
Side Effects: 6. Right documentation
7. Right history and assessment
Body as a whole: headache, pain, influenza, chest 8. Drug approach and right to refuse
Route: Inhalation 9. Right drug-drug interaction and evaluation
pain
Dosage: 10. Right education and information
GI: Nausea
500mcg/2.5 mg
per 2.5ml Respiratory: Bronchitis, dyspnea, coughing,  Monitor respiratory status; auscultate lungs before and
pneumonia, bronchospasm, pharyngitis, sinusitis, after inhalation.
Frequency: Q6H
rhinitis
 Monitor signs of paradoxical bronchospasm (wheezing,
cough, dyspnea, tightness in chest and throat), especially
at higher or excessive doses. If condition occurs, advise
 patient to withhold medication and notify physician
immediately.

 Be alert for signs of allergic reactions, 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 occur.

 Assess blood pressure periodically and compare to

normal values. Report low blood pressure (hypotension),
especially if patient experiences dizziness or syncope.

 Report treatment failure (exacerbation of respiratory

symptoms) to physician.

 Teach patient proper use of inhaler.

Drug Mechanism of action/Side effects Indication/Contraindication Nursing Responsibilities

Brand name: Mechanism of Action: Indication: Nursing Responsibilities:

Phenytoin Has antiepileptic activity without causing general  Control of tonic-clonic(grandma) and complex
depression stabilizes neuronal membranes and partial (temporal lobe) seizures.  Observe ten rights in giving medication.
prevents hyper excitability caused by excessive  For patient requiring a loading dose. 1. Right drug
Generic name: stimulation, limits the spread of seizure activity from  Prevention and treatment of seizures occurring 2. Right patient
Dilantin an active focus, also effective in treating cardiac during neurosurgery. 3. Right dose
arrhythmias, especially those induced by digitalis,  Status Epilepticus 4. Right route
antiarrhythmic properties are very similar to those of 5. Right time and frequency
lidocaine, both are class IB antiarrhythmic. Contraindication: 6. Right documentation
Classification:
Anticonvulsant  Contraindicated in patient hypersensitive to 7. Right history and assessment
Side Effects: hydantoin and those with sinus bradycardia, SA 8. Drug approach and right to
CNS: ataxia, slurred speech, dizziness, insomnia, 9. refuse
 nervousness, twitching, headache, mental confusion, block, second or third degree AV block or 10. Right drug-drug interaction and evaluation
decreased coordination. Adams-Stokes syndrome. 11. Right education and information
Route: Oral  Use cautiously in patients with hepatic dysfunction,
CV: periarteritis nodosa hypotension, myocardial infarction, diabetes, or
Dosage: 100 mg
respiratory depression, in elderly or debilitated patients
EENT: nystagmus, diplopia, blurred vision
Frequency: TID and in those receiving other hydantoin derivatives.
GI: gingival hyperplasia, nausea, vomiting,  Elderly patients tend to metabolize phenytoin slowly and
constipation may need reduced dosages.
 Phenytoin requirements usually increase during
Hematologic: thrombocytopenia, leukopenia, pregnancy.
megaloblastic anemia, agrunolocytosis  Stop drug if rash appears.
 Use only clear solution for injection. A slight yellow
Hepatic: toxic hepatitis
color is acceptable. Don’t refrigerate.
Metabolic: hyperglycemia  Don’t give I.M. unless dosage adjustments are made;
drug may precipitate at injection site, cause pain, and be
Muscuskeletal: osteomalacia absorbed erratically.
 Divided doses given with or after meals may decrease
Skin: Purpuric dermatitis, photosensitivity reactions,
adverse GI reactions.
necrosis, inflammation at injection site, discoloration
 Advise patient to avoid alcohol.
of skin if given by IV push in back of hand
Other: hirsutism, lymphadenopathy  Warn patient not to stop drug abruptly because seizures
may worsen.
 Stress importance of good oral hygiene and regular dental
examinations.
 Caution patient that drug may have color pink, red or
reddish brown urine.

Drug Mechanism of action/Side effects Indication/Contraindication Nursing Responsibilities

Brand name: Mechanism of Action: Indication: Nursing Responsibilities:

Hydralazine Acts directly on vascular smooth muscle to cause  Hypertension
 vasodilation, primarily arteriolar, decreasing  Eclampsia  Observe ten rights in giving medication.
peripheral resistance; maintains or increases renal and 1. Right drug
Generic name:
cerebral flow. Contraindication: 2. Right patient
Apresoline
 Hypersensitivity 3. Right dose
Side Effects:  CAD 4. Right route
CNS: Headache, peripheral neuritis, dizziness,  Mitral valvular rheumatic heart disease 5. Right time and frequency
Classification: tremors, psychotic reactions characterized by
Antihypertensive 6. Right documentation
depression, disorientation, anxiety
7. Right history and assessment
CV: Palpitations, tachycardia, angina pectoris, 8. Drug approach and right to
Route: Oral hypotension, paradoxical press or 9. refuse
response, orthostatic hypotension 10. Right drug-drug interaction and evaluation
Dosage: 10 mg, 11. Right education and information
25 mg, 5 mg, 100 GI: Anorexia, nausea, vomiting, diarrhea,
mg constipation, paralytic ileus
 Before
GU: Difficult micturition, impotence - Check BP Arrange for CBC, LE cell preparations and
Hematologic: Blood Dyscrasias ANA titers beforetherapy.
Frequency: Q6H
- Assess for contraindicated conditions.
Hypersensitivity: Rash, urticaria, pruritus, fever, - Assess bowel sounds.
chills, arthralgia, eosinophilia, rarely, hepatitis, - Assess voiding pattern.
obstructive jaundice  During
Other: Nasal congestion, flushing, edema, muscle - Give oral drug with food.
cramps, splenomegaly, dyspnea, lupus-like syndrome, - Use parenteral drug immediately after opening ampule.
possible carcinogenesis. - Instruct to take drug exactly as prescribed.
 After
- Withdraw drug gradually.
- Discontinue if blood dyscrasias occur.
- Arrange for pyridoxine therapy if pt develops symptoms
of peripheral neuritis.
- Monitor for orthostatic hypotension.
- Report persistent or severe constipation, unexplained fever
or malaise, muscle or joint aching, chest pain, rash,
numbness, tingling.
 - Do proper documentation

Drug Mechanism of action/Side effects Indication/Contraindication Nursing Responsibilities

Brand name: Mechanism of Action: Indication: Nursing Responsibilities:

Sodium Sodium bicarbonate raises blood and urinary pH by  Treatment of metabolic acidosis, promotion of
Bicarbonate dissociation to provide bicarbonate ions, which gastric, systemic and urine alkalinization in the  Observe ten rights in giving medication.
neutralizes the hydrogen ion concentration. It also case of intoxication with weak organic acids. 12. Right drug
neutralizes gastric acid via production of carbon 13. Right patient
Generic name: dioxide. Contraindication: 14. Right dose
Sodium  Metabolic or respiratory alkalosis, hypernatremia, 15. Right route
Bicarbonate Side Effects: severe pulmonary edema, hypocalcaemia, 16. Right time and frequency
Metabolic alkalosis, mood changes, tiredness, hypochlorhydria 17. Right documentation
shortness of breath, muscle weakness, irregular
heartbeat, muscle hyper tonicity, twitching, 18. Right history and assessment
Classification: 19. Drug approach and right to
hypernatraemia, hyperosmolality, hypocalcaemia,
Antacids 20. refuse
hypokalemia, stomach cramps, flatulence.
21. Right drug-drug interaction and evaluation
22. Right education and information
Route: Oral
 Obtain patient history including drug history and any
Dosage: 325 mg hypersensitivity.
Frequency: TID  Assess respiratory and pulse rate, rhythm, depth, lung
sounds and notify the physician.
 Assess for carbon dioxide in GI tract, may lead to
perforation if ulcer is severe.
 Test and monitor urine pH, urinary output, during
beginning treatment.
 If patient has edematous tendency, notify physician.
 If patient is vomiting withhold medication and
immediately inform the physician.
 If the patient exhibits shortness of breath and hyperpnea,
immediately inform the physician.
 Inform physician if relief is not obtained or if the patient
demonstrate any symptoms suggest bleeding, such as
black tarry stools or coffee ground emesis.
 Caution patient to immediately report to physician if
symptoms such as nausea, vomiting and anorexia occurs.