PATIENT: Sta.

Rita, Gelica ROOM: 3

AGE: 30 years’ old
BIRTHDATE: October 22, 1992
ADMISSION DIAGNOSIS: Dengue Fever with Warning Signs

DRUG STUDY
MECHANISM INDICATION CONTRAINDICATION NURSING
DRUG ORDER ADVERSE EFFECTS
OF ACTION S S RESPONSIBILITIES
Generic Name: The bactericidal For the It is contraindicated in Local Reactions  Watch for seizures; notify
Cefoxitin action of treatment of patients who have shown  Thrombophlebitis physician immediately if
cefoxitin results serious hypersensitivity to patient develops or
Brand Name: from inhibition infections cefoxitin and the Allergic Reactions increases seizure activity.
Mefoxin of cell wall caused by cephalosporin group of  Rash  Monitor signs of
synthesis. susceptible antibiotics.  Urticaria pseudomembranous colitis,
Classification: strains  Flushing including diarrhea,
Beta-lactam microorganisms  Pruritus abdominal pain, fever, pus
antibiotics / . or mucus in stools, and
 Eosinophilia
Cephamycin other severe or prolonged
 Fever
Antibiotics Gi problems (nausea,
 Dyspnea
vomiting, heartburn).
Dosage:  Anaphylaxis
Notify physician or nursing
1 gram q6 - q8  Interstitial Nephritis staff immediately of these
 Angioedema signs.
Route:  Monitor signs of allergic
IV (Intravenous) Cardiovascular
reactions and anaphylaxis,
 Hypotension including pulmonary
Skin Test: symptoms (tightness in the
(-) Negative Gastrointestinal
throat and chest, wheezing,
 Diarrhea cough dyspnea) or skin
 Pseudomembranous colitis reactions (rash, pruritus,
 Nausea and Vomiting urticaria). Notify physician
or nursing staff
immediately if these
reactions occur.
Neuromuscular  Monitor signs of blood
dyscrasias, including
 Possible exacerbation
eosinophilia (fatigue,
of myasthenia gravis.
weakness, myalgia),
thrombocytopenia
Blood
 Leukopenia
 Granulocytopenia
 Neutropenia
 Anemia
 Hemolytic anemia
 Thrombocytopenia
 Bone marrow depression
Liver Functions
 Transient elevations
in SGOT, SGPT, serum
LDH, and serum alkaline
phosphatase
 Jaundice
Renal Function
 Elevations in serum
creatinine and/or blood
urea nitrogen levels have
been observed.
(bruising, nose bleeds,
bleeding gums, other
bleeding problems),
hemolytic anemia (malaise,
dizziness, jaundice,
abdominal pain), and
leukopenia (fever, sore
throat, mucosal lesions,
signs of infection). Report
these signs to the
physician.
 Monitor injection site for
pain, swelling, and
irritation. Report prolonged
or excessive injection-site
reactions to the physician.
 Instruct patient to notify
physician immediately of
signs of superinfection,
including black, furry
overgrowth on tongue,
vaginal itching or
discharge, and loose or
foul-smelling stools.
 Instruct patient and
family/caregivers to report
other troublesome side
effects such as severe or
prolonged skin problems
(rash, hives) or GI
problems (nausea,
vomiting, diarrhea).
 Always wash hands
thoroughly and disinfect
equipment to help prevent
the spread of infection.
Employ universal
precautions or isolation
procedures as indicated for
 specific patients.

MECHANISM INDICATION CONTRAINDICATIO NURSING

DRUG ORDER ADVERSE EFFECTS
OF ACTION S NS RESPONSIBILITIES
Generic Name: It has a central It is used for the Contraindications to Significant adverse reactions  Routinely monitor the
Paracetamol analgesic effect treatment of using Paracetamol associated with intravenous effectiveness of
that is mediated mild to include hypersensitivity paracetamol are extremely paracetamol by assessing
Brand Name: through moderate pain to acetaminophen, severe rare. Typically reported pain levels and fever
Panadol, Calpol, activation of and reduction of hepatic impairment, or adverse events include: reduction.
Tylenol, Alvedon descending fever. It is severe active hepatic  IV paracetamol should be
serotonergic available over disease.  Hypotension infused over 15 minutes.
Classification: pathways. the counter in  Malaise  For patients who are at risk
Analgesic & various forms,  Hypersensitivity reaction for hepatotoxicity or renal
Antipyretic Its primary site the most  Liver enzyme elevation toxicity, the nurse should
of action, common being  Thrombocytopenia closely monitor AST and
Dosage: Include oral forms.  Nausea ALT levels and BUN and
300 mg q4 (above inhibition of
 Vomiting creatinine.
37.8 C) prostaglandin Paracetamol
 Constipation  Acetaminophen can cause
(PG) synthesis injection is hematologic reactions. The
Route: or through an indicated for the  Pruritus
IV (Intravenous)  Abdominal pain. nurse should monitor for
active management of anemia and decreased red
metabolite mild to and white blood counts.
influencing moderate pain,  The antidote for
cannabinoid the management paracetamol overdose is N-
receptors. of moderate to acetylcysteine given either
severe pain with orally or IV.
adjunctive
opioid
analgesics, and
the reduction of
fever.
 Because of its
low risk of
causing allergic
reactions, this
drug can be
administered in
patients who are
intolerant to
salicylates and
those with
allergic
tendencies,
including
bronchial
asthmatics.
Specific dosing
guidelines
should be
followed when
administering
paracetamol to
children.

MECHANISM CONTRAINDICATION ADVERSE NURSING

DRUG ORDER INDICATIONS
OF ACTION S EFFECTS RESPONSIBILITIES
Generic Name: Omeprazole  Treatment of active  PRILOSEC is  Headache  Monitor improvements
Omeprazole belongs to a class duodenal ulcer in contraindicated in  Abdominal pain in GI symptoms
of antisecretory adults patients with known  Constipation (gastritis, heartburn,
Brand Name: compounds, the hypersensitivity to  Diarrhea and so forth) to help
Prilosec substituted  Eradication of substituted  Flatulence determine if drug
benzimidazoles, Helicobacter pylori to benzimidazoles or to  Nausea or therapy is successful.
Classification: that suppress reduce the risk of any component of the vomiting
Proton Pump gastric acid duodenal ulcer formulation.  Assess dizziness that
Inhibitors secretion by recurrence in adults Hypersensitivity might affect gait,
specific inhibition reactions may include balance, and other
Dosage: of the H+/K+  Treatment of active anaphylaxis, functional activities.
40 mg OD ATPase enzyme benign gastric ulcer in anaphylactic shock, Report balance
system at the adults angioedema, problems and
Route: secretory surface bronchospasm, acute functional limitations
IV (Intravenous) of the gastric  Treatment of tubulointerstitial to the physician, and
parietal cell. symptomatic nephritis, and urticaria. caution the patient and
Because this gastroesophageal family/caregivers to
enzyme system is reflux disease guard against falls and
regarded as the (GERD) in patients 1 trauma.
acid (proton) year of age and older
pump within the  Monitor other CNS
gastric mucosa,  Treatment of erosive side effects
omeprazole has esophagitis (EE) due (drowsiness, fatigue,
been characterized to acid-mediated weakness, headache),
as a gastric acid- GERD in patients 1 and report severe or
pump inhibitor, in month of age and prolonged effects.
that it blocks the older
final step of acid  Monitor any chest pain
production. This  Maintenance of and attempt to
effect is dose- healing of EE due to determine if pain is
related and leads acid-mediated GERD drug induced or caused
to inhibition of in patients 1 year of by cardiovascular
both basal and age and older dysfunction (e.g.,
stimulated acid angina that occurs
secretion  Pathologic during exercise).
irrespective of the hypersecretory
stimulus. conditions in adults
 MECHANIS
CONTRAINDICATIO NURSING
DRUG ORDER M OF INDICATIONS ADVERSE EFFECTS
NS RESPONSIBILITIES
ACTION
Generic Name: It acts as an  Relief of  Documented Common Adverse Effects  Assess blood pressure
Diphenhydramine inverse agonist allergic hypersensitivity to  Drowsiness periodically and compare to
at the H1 symptoms diphenhydramine  Dizziness normal values. Report a
Brand Name: receptor, caused by  Premature infants and  Impaired coordination sustained or symptomatic
Benadryl thereby histamine neonates  Headache decrease in blood pressure
reversing the release,  Breastfeeding  Epigastric discomfort (hypotension) or other
Classification: effects of including mothers  Thickened bronchial cardiac symptoms
Antihistamines histamine on Anaphylaxis,  Pregnancy Category secretions (palpitations).
capillaries, Seasonal and B - used only if  Dry mucous
Dosage: reducing perennial membranes  Monitor respiratory
clearly needed
allergic allergic  Diphenhydramine has  CNS stimulation, function at rest and during
reaction rhinitis, additive effects with paradoxical exercise. Notify physician if
Route: symptoms. Allergic  Constipation patient experiences any
alcohol and other
dermatoses. CNS depressants  Euphoria troublesome wheezing,
Parkinson's (hypnotics, sedatives,  Ataxia tightness in the throat or
disease, and tranquilizers)  Dysuria chest, or abnormal
dystonic  Urinary retention bronchial secretions.
 Monoamine oxidase
reactions from  Hypotension
A inhibitors prolong
medications.  Blurred vision  Monitor symptoms of
and intensify the
 Mild nighttime  Diplopia seasonal allergies (sneezing,
anticholinergic
sedation.  Palpitations rhinitis, itching eyes,
effects of
 Prevention of  Tachycardia cough) or allergic skin
antihistamines
motion  Photosensitivity reactions (rash, hives,
sickness  Diaphoresis itching) to help document
 Erectile dysfunction benefits of this drug in
 Early menses treating these disorders.
 Anorexia
 When treating anaphylaxis,
Serious Reactions assess for signs of
 Anaphylaxis/ successful treatment,
anaphylactoid reaction including decreased skin
 QT prolongation reactions (rash, urticaria)
 Anemia, hemolytic and increased airway
 Thrombocytopenia patency and ventilation
 Agranulocytosis (decreased dyspnea,
 Leukopenia wheezing, shortness of
 Pancytopenia breath).
 Arrhythmias
 Seizures  Assess dizziness and
 Toxic psychosis drowsiness that might affect
 Labyrinthitis, acute gait, balance, and other
 Heatstroke functional activities. Report
balance problems and
functional limitations to the
physician, and caution the
patient and
family/caregivers to guard
for any reactions.