DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration

Generic: Prescribed: Action Binds to -opioid Moderate to moderately severe Hypersensitivity: CV: vasodilation Baseline assessment:
----- receptors. Inhibits reuptake of pain (extended-release Cross-sensitivity with  Assess type,
Tramadol serotonin and norepinephrine formulations indicated for opioids may occur; EENT: visual location, and
Recommended: in the CNS. Therapeutic patients who require around- Patients who are disturbances intensity of pain
Brand: 50-100 mg PO q 4-6 hr; Effects: Decreased pain. the-clock pain management) acutely intoxicated before and 2– 3 hr
ConZip do not exceed 400 with alcohol, CNS: dizziness, (peak) after
mg/day sedatives/hypnotics, headache, somnolence administration.
centrally acting  Assess BP and
Classification: analgesics, opioid GI: constipation, nausea respiratory rate
analgesics, or before and
Therapeutic: psychotropic agents; periodically
Analgesics Patients who are during
physically dependent administration.
on opioid analgesics Respiratory
(may precipitate depression has not
withdrawal). occurred with
recommended
doses.
 Assess bowel
function routinely.
Prevention of
constipation
should be
instituted with
increased intake of
fluids and bulk
and with laxatives
to minimize
 constipating
effects.
 Prolonged use
may lead to
physical and
psychological
dependence and
tolerance,
although these
may be milder
than with opioids.
This should not
prevent patient
from receiving
adequate
analgesia. Most
patients who
receive tramadol
for pain do not
develop
psychological
dependence. If
tolerance develop

DRUG STUDY
 BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration

Generic: Prescribed: A hemostatic agent and is a For treatment of cyclic Contraindicated in Headache, backpain,  Monitor blood
synthetic derivative of the menorrhagia (heavy menstrual patients with a known abdominal pain, myalgia, pressure, pulse, and
Tranexamic Acid amino acid lysine. Binds to bleeding), treatment of hypersensitivity to muscle cramps, dizziness, respiratory status as
Recommended: the lysine binding site for symptomatic intracranial bleeding tranexamic acid or any sinusitis, migraine, indicated by
Brand: fibrin on the plasmonigen/ occurring within 24 hrs after of the ingredients. anemia, dyspnea, severity of
Lysteda PO: (Postsurgical) 25mg plasmin molecule. administration of IV alteplase for Contraindicated with hypotension, bleeding.
per kg of body weight Tranexamic acid is about 10× treatment of acute ischemic patients with active  Monitor for overt
anaphylactoid,
Classification: every 6 to 8 hrs for two more potent in vitro than stroke, and treatment of active intravascular clotting, bleeding every 15-
anaphylactic shock,
to eight days after aminocaproic acid, binding hemorrhage in trauma patients. thromboembolic 30 min.
Therapeutic: hemostatic surgery more strongly to both the Also treatment of hereditary disease, embolism, thrombosis,
 Monitor neurologic
agents high and low affinity binding angioedema. subarachnoid thromboembolism
status (pupils, level
sites of plasminogen. hemorrhage. of consciousness,
Pharmacologic: motor activity) in
Synthetic patients with
Antifibrinolytics or subarachnoid
fibrinolysis inhibitors hemorrhage.
 Assess for
thromboembolic
complications.
Notify physician of
positive Homan’s
sign, leg pain,
hemorrhage,
edema, hemoptysis,
dyspnea, or chest
pain.
 Monitor platelet
count and clotting
factors prior to and
periodically
 throughout therapy
in patients with
systematic
fibrinolysis.
 Stabilize IV
catheter to
minimize
thrombophlebitis.
Monitor site
closely.
 Instruct patient to
notify the nurse
immediately if
bleeding recurs or
if thromboembolic
symptoms develop.
 Caution patient to
make position
changes slowly to
avoid orthostatic
hypotension.

DRUG STUDY
 BRAND NAME; Prescribed and
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration
Generic: Prescribed:
Ketorolac Recommended:
Brand: PO (Adults ≤ 65 yr): 20
mg initially, followed by
Toradol 10 mg q 4– 6 hr (not to
exceed 40 mg/day).
Classification: PO (Children 2– 16 yr, ≤
50 kg): 1 mg/kg as a single
Therapeutic: dose. No data available for
nonsteroidal anti- multiple doses. IM (Adults
inflammatory agents, 65 yr): Single dose—60
nonopioid analgesics mg. Multiple dosing—30
Pharmacologic: mg q 6 hr (not to exceed
pyrroziline carboxylic 120 mg/day).
acid
Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
Inhibits prostaglandin Short-term management of pain Contraindications/ CNS: drowsiness,  Assess for rash
synthesis, producing (not to exceed 5 days total for all Precautions abnormal thinking, periodically during
peripherally mediated routes combined). Contraindicated in: dizziness, euphoria, therapy. May cause
analgesia. Also has Hypersensitivity; headache. Stevens-Johnson
antipyretic and anti- Cross-sensitivity with EENT:qlacrimation syndrome or toxic
inflammatory properties. other NSAIDs may (spray), nasal discomfort epidermal
exist; Preoperative (spray), throat irritation necrolysis.
use; Active or history (spray). Resp: asthma, Discontinue
of peptic ulcer disease dyspnea. CV: HF, therapy if severe or
or GI bleeding; MYOCARDIAL if accompanied
Known alcohol INFARCTION, with fever, general
intolerance (injection STROKE, edema, pallor, malaise, fatigue,
only); Coronary artery vasodilation. muscle or joint
bypass graft (CABG) GI: GI BLEEDING, aches, blisters, oral
surgery; abnormal taste, diarrhea, lesions,
Cerebrovascular dry mouth, dyspepsia, GI conjunctivitis,
bleeding; Advanced pain. GU: oliguria, renal hepatitis and/or
renal impairment or at toxicity, urinary eosinophilia.
risk for renal failure frequency. Derm:  Monitor BP during
due to volume EXFOLIATIVE initiation and
depletion; Concurrent DERMATITIS, periodically during
use of pentoxifylline STEVENS-JOHNSON therapy. May cause
or probenecid; SYNDROME, TOXIC fluid retention and
EPIDERMAL edema leading to
NECROLYSIS, pruritus, new onset or
purpura, sweating, worsening
urticaria. F and E: hypertension.
hyperkalemia.  Pain: Assess pain
(note type, location,
and intensity) prior
to and 1– 2 hr
 following
administration.

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration
Generic: Prescribed:
Cefoxitin
Recommended:
Brand: IM, IV (Adults): Most
infections—1 g every 6– 8
Mefoxin hr. Severe infections—1 g
every 4 hr or 2 g every 6–
Classification: 8 hr. Life-threatening
infections—2 g every 4 hr
Therapeutic: anti- or 3 g every 6 hr.
infectives Perioperative prophylaxis
—2 g 30– 60 min before
Pharmacologic: second- initial incision, then 2 g
generation every 6 hr for up to 24 hr.
cephalosporins IM, IV (Children and
Infants ≥ 3 mo): Most
infections—13.3– 26.7
mg/kg every 4 hr or 20–
40 mg/kg every 6 hr.
Perioperative prophylaxis
—30– 40 mg/ kg within 60
min of initial incision, then
30– 40 mg/kg every 6 hr
for up to 24 hr.
Bind to bacterial cell wall
membrane, causing cell
death. Therapeutic Effects:
Bactericidal action against
susceptible bacteria.
Spectrum: Similar to that of
first-generation
cephalosporins but have
activity against several other
gram-negative pathogens
including: Haemophilus
influenzae, Escherichia coli,
Klebsiella pneumoniae,
Morganella morganii,
Neisseria gonorrhoeae
(including penicillinase-
producing strains), Proteus,
Providencia, Serratia
marcescens, Moraxella
catarrhalis. Not active against
methicillin resistant
staphylococci or enterococci.
Cefotetan and cefoxitin:
Active against Bacteroides
fragilis.
Indications Treatment of the Contraindicated in: CNS: SEIZURES (high  Assess for infection
following infections caused by Hypersensitivity to doses). GI: (vital signs;
susceptible organisms: cephalosporins; CLOSTRIDIUM appearance of
Respiratory tract infections, Skin Serious DIFFICILE- wound, sputum,
and skin structure infections, hypersensitivity to ASSOCIATED urine, and stool;
Bone and joint infections (not penicillins. DIARRHEA (CDAD), WBC) at beginning
cefaclor or cefprozil), Urinary and during therapy.
diarrhea, cramps, nausea,
tract infections (not cefprozil).  Before initiating
vomiting. Derm: rashes,
Cefotetan and cefoxitin: Intra- therapy, obtain a
abdominal and gynecologic urticaria. Hemat:
history to
infections. Cefuroxime: agranulocytosis, bleeding determine previous
Meningitis, gynecologic (q with cefotetan and use of and reactions
infections, and Lyme disease. cefoxitin), eosinophilia, to penicillins or
Cefaclor, cefprozil, cefuroxime: hemolytic anemia, cephalosporins.
Otitis media. Cefoxitin and neutropenia, Persons with a
cefuroxime: Septicemia. thrombocytopenia negative history of
Cefotetan, cefoxitin, cefuroxime: penicillin
Perioperative prophylaxis. sensitivity may still
have an allergic
response.
 Obtain specimens
for culture and
sensitivity before
initiating therapy.
First dose may be
given before
receiving results.
 Observe patient for
signs and
symptoms of
anaphylaxis (rash,
pruritus, laryngeal
edema, wheezing).
Discontinue the
drug immediately if
 these symptoms
occur. Keep
epinephrine, an
antihistamine, and
resuscitation
equipment close by
in the event of an
anaphylactic
reaction.
 Monitor bowel
function. Diarrhea,
abdominal
cramping, fever,
and bloody stools
should be reported
to health care
professional
promptly as a sign
of Clostridium
difficile-associated
diarrhea (CDAD).
May begin up to
several wk
following cessation
of therapy.

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration
Generic: Prescribed: Bactericidal; interferes with Indicated in complicated intra- Contraindicated with CNS: headache,  Urge patient to
DNA replication in abdominal infection. Nosocomial allergy to dizziness, insomnia, finish full course of
Ciprofloxacin susceptible bacteria pneumonia, acute uncomplicated ciprofloxacin, fatigue treatment, even is
Recommended: preventing cell reproduction. cystitis, severe or complicated norfloxacin or other symptoms improve.
Brand: bone or joint infection, severe fluoroquinolones, CV: arrhythmias,  Tell patient to
200mg/ 100ml IV q6 hours respirator tract infection, severe pregnancy, lactation. hypotension, angina avoid excessive
Ciloxan Uncomplicated UTIs: 100- or skin structure infection. exposure to
200 mg PO q12 hr foe 3 EENT: dry eye, eye pain
sunlight or
Classification: days or 500 mg PO daily GI: nausea, vomiting, dry ultraviolet light.
(ER tablets) for 3 days.  Use drug only for
mouth, diarrhea,
Therapeutic: infections caused
abdominal pain
Antibacterial/ by susceptible
Antibiotic Hematologic: elevated bacteria.
BUN, AST, ALT  Don’t exceed
Pharmacologic: recommended
Fluoroquinolone dosage because of
increased risk of
prolonging the QTc
interval.
 Serious,
occasionally fatal,
hypersensitivity
reactions may
occur. Stop drug
immediately if
hypersensitivity
reaction occurs.

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration
Generic: Prescribed: Binds to mu-opioid receptors Management of moderate to Hypersensitivity. Nausea, dizziness,  Assess patient’s
and inhibits the reuptake of severe pain. Acute intoxication somnolence. pain before starting
Tramadol HCl norepinephrine and serotonin; with alcohol, therapy and
Recommended: causes many effects similar to hypnotics, narcotics, CNS: headache, tremor regularly thereafter
Brand: Adults and children ≥ 16 the opioids – dizziness, centrally acting to monitor the
GI: abdominal pain,
years: maximum single somnolence, nausea, analgesics, opioids or drug’s
Dolcet dose - 1 to 2 tabs every 4-6 constipation – but does not psychotropics, severe constipation, diarrhea,
effectiveness.
hrs as needed for pain have the respiratory hepatic impairment. dyspepsia
 Assess patient’s
Classification: relief up to maximum of 8 depressant effects. Skin and Appendages: therapy:
tabs/day. hypersensitivity to
pruritus, rash, increased
Opioid agonist drug, acute
sweating
intoxication with
alcohol opioids.
 Monitor V/S.
 Monitor the
patient’s mental
status
 Inform the patient
that she or he may
experience side
effects such as
dizziness, sedation,
drowsiness,
impaired visual
acuity: nausea and
loss of appetite.
 Give the drug
before the onset of
intense pain

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
 CLASSIFICATION frequency; route of
administration

Generic: Prescribed: Stimulates collagen formation Used to treat vitamin C Tartrazine sensitivity, CNS: faintness, dizziness  Check urine pH to
and tissue repair, involved in deficiency, scurvy, delayed a high amount of ensure efficacy.
Ascorbic acid oxidation-reduction reactions. wound and bone healing, urine oxalic acid in urine GI: diarrhea, heartburn,  Protect solution
Recommended: acidification, and in general as an iron metabolism nausea, vomiting from light and
Brand: Adult and teenage females antioxidant. It has also been disorder causing refrigerate ampule.
GU: acid urine, oxaluria,
– 50 to 60 mg/day suggested to be an effective increased iron storage  Ask the patient if
Ascorbic acid antiviral agent. sickle cell anemia renal calculi
she is pregnant
To treat deficiency: from pyruvate kinase because high doses
Classification: Adult and teenagers – and G6PD deficiencies of vitamin C are
treatment dose is and hypersensitivity. not recommended
Therapeutic: determined by prescriber during pregnancy.
Vitamins for each individual based  Monitor for S/S of
on the severity of acute hemolytic
deficiency. The ff. dose anemia, sickle cell
has been determined for crisis.
scurvy: 500mg a day for at  Inform the patient
least 2 wks. about the possible
side effects of the
drugs.
 Instruct the patient
about the
contraindications of
the drugs.

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
 CLASSIFICATION frequency; route of
administration

Generic: Prescribed: Omeprazole irreversibly - Gastroesophageal Reflux - Hypersensitivity to - Common: Headache,  - Assess patient's
inhibits the H+/K+ ATPase Disease (GERD) Omeprazole or any nausea, abdominal pain, medical history,
Omeprazole Recommended: enzyme system, also known - Peptic Ulcers (duodenal and component of the diarrhea, flatulence allergies, and
- Dosage varies as the proton pump, in the gastric) formulation current
Brand: based on the gastric parietal cells. This - Zollinger-Ellison Syndrome - Severe hepatic - Uncommon: Rash, medications.
condition being inhibition reduces gastric acid - Erosive Esophagitis impairment dizziness, constipation,  - Educate patients
Omesec treated and secretion, making it effective - Helicobacter pylori vomiting about proper
whether it's for in treating acid-related Eradication (in combination with administration,
Classification: adult or pediatric disorders. antibiotics) - Rare but Serious: potential side
patients. Typical Hypomagnesemia, effects, and the
Proton-pump inhibitor adult doses range vitamin B12 deficiency, importance of
from 20 mg to 40 osteoporosis-related compliance.
mg once daily. fractures, acute interstitial  - Monitor for
Dosages for nephritis adverse reactions
children are and signs of
weight-based. complications,
especially with
long-term use.
 - Watch for
potential drug
interactions,
especially in
patients on multiple
medications.

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
 GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration

Generic: Prescribed: Cefuroxime inhibits bacterial - *Respiratory Tract *Hypersensitivity:* - *Common:* Diarrhea,  - Assess patient's
cell wall synthesis by binding Infections:* Cefuroxime is nausea, rash. medical history,
Cefuroxime Recommended: to specific penicillin-binding - Cefuroxime is effective against contraindicated in especially for
- Dosage varies proteins, leading to cell lysis pathogens commonly causing patients with known - *Uncommon:* allergies to
Brand: based on the type and death of susceptible respiratory infections, such as hypersensitivity to Vomiting, abdominal antibiotics.
and severity of the bacteria. Streptococcus pneumoniae and cephalosporins due to pain, headache.  - Monitor for
Ceftin, Zinacef infection, as well Haemophilus influenzae. the risk of severe signs of allergic
as the patient's age allergic reactions. - *Rare but Serious:*
reactions, such as
Classification: and renal function. - *Skin and Skin Structure Clostridium difficile- rash, itching,
- Usually Infections:* - *Severe Allergic associated diarrhea swelling, or
Therapeutic: administered It covers a range of bacteria Reactions: * (CDAD), severe allergic difficulty breathing.
Antibiotic orally with or associated with skin infections, Patients with a history reactions (including  - Educate patients
without food. For including Staphylococcus aureus of severe allergic anaphylaxis), renal about the
Pharmacologic: severe infections and Streptococcus pyogenes. reactions to penicillins impairment. importance of
Second-generation or when oral or other beta-lactam completing the full
cephalosporin antibiotic administration is - *Urinary Tract Infections:* antibiotics should course of
not feasible, Cefuroxime is active against avoid cefuroxime due antibiotics even if
intravenous or Escherichia coli and other to the potential for symptoms improve.
intramuscular bacteria frequently causing cross-reactivity and  - Encourage
routes can be used. urinary tract infections. severe allergic adequate fluid
responses. intake to prevent
- *Otitis Media:* crystalluria
Effective against common (presence of
pathogens causing middle ear crystals in urine)
infections, including associated with
Streptococcus pneumoniae and some
Haemophilus influenzae. cephalosporins.
- *Gonorrhea:*
Cefuroxime is used to treat
uncomplicated cases of
gonorrhea, primarily caused by

BRAND NAME; Prescribed and
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration
Generic: Prescribed:
Calcium Carbonate Recommended:
*Calcium Supplement:*
Brand: Dosage varies based on
age, gender, and specific
Tums, Caltrate, Os-cal calcium needs. Typically
taken with meals for better
Classification: absorption.
Mineral and electrolyte *Antacid:* Taken as
replacement/supplemen needed, usually after meals
t or at the onset of
symptoms. Chewable
tablets should be chewed
thoroughly before
Mechanism of Action
- *Calcium Supplement:*
Calcium carbonate provides
elemental calcium essential
for various physiological
functions, including bone
formation, blood clotting, and
nerve transmission. Adequate
calcium intake is crucial for
maintaining bone density and
preventing osteoporosis.
- *Antacid:* As an antacid,
calcium carbonate neutralizes
gastric acid by reacting with
hydrochloric acid in the
stomach. This reaction forms
Neisseria gonorrhoeae.
DRUG STUDY
Indication Contraindication Adverse Reaction Nursing Responsibilities
- *Calcium Supplement:* - *Hypercalcemia:* - *Common:*  - *Assessment:*
Used to prevent or treat calcium Patients with high Constipation, flatulence, Assess the patient's
deficiencies, particularly in levels of calcium in belching. medical history,
individuals with osteoporosis, the blood should avoid especially for
rickets, or malabsorption calcium carbonate - *Uncommon:* kidney problems,
syndromes. supplements. Nausea, vomiting, loss of history of kidney
- *Antacid:* appetite, unusual stones, allergies,
Provides relief from symptoms of - *Hypercalciuria:* tiredness. and current
acid indigestion, heartburn, and Individuals with medications,
upset stomach due to excess excessive urinary - *Rare but Serious:* especially other
stomach acid. calcium excretion Allergic reactions such as supplements or
should use calcium rash, itching, swelling, medications that
supplements severe dizziness, and may interact with
cautiously and under difficulty breathing. calcium carbonate.
medical supervision.  - *Patient
swallowing. calcium chloride, water, and Education:*
carbon dioxide, thereby Educate the patient
raising the gastric pH and about the correct
providing relief from acid dosage, timing, and
indigestion and heartburn. duration of calcium
carbonate
supplementation.
Advise patients to
take the supplement
with food to
enhance absorption.
Inform about
potential drug
interactions and
side effects.
 *Administration:*
Administer with
care, especially to
patients who have
difficulty
swallowing. Ensure
they can chew or
crush the tablets if
applicable. Provide
water or juice to aid
swallowing.
 - *Monitoring:*
Regularly monitor
calcium levels in
patients at risk of
calcium
imbalances, such as
those with kidney
problems, to
prevent
hypercalcemia or
 hypocalcemia.
 - *Special
Populations:*
Assess the need for
calcium
supplementation in
pregnant or
breastfeeding
women, elderly
patients, and
individuals with
osteoporosis.
Monitor elderly
patients closely, as
they are more prone
to calcium
deficiency and
related conditions
such as
osteoporosis.

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
 CLASSIFICATION frequency; route of
administration

Generic: Prescribed: Pantoprazole is a proton - *Gastroesophageal Reflux - *Hypersensitivity:* - *Common:* Headache,  *Assess Symptom
pump inhibitor that Disease (GERD):* Pantoprazole Patients with known diarrhea, nausea, Relief:*
Pantoprazole Recommended: suppresses gastric acid is indicated for the short-term and hypersensitivity to abdominal pain. - Monitor the
- The dosage and secretion by specific maintenance treatment of erosive pantoprazole or any patient’s response
Brand: duration of inhibition of the H+/K+- esophagitis associated with component of the - *Uncommon:* to Pantoprazole
pantoprazole ATPase enzyme system at the GERD. formulation should Dizziness, rash, therapy. Evaluate if
Protonix, Pantolox, treatment depend secretory surface of the - *Peptic Ulcers:* It is used for avoid this medication. flatulence. symptoms such as
Somac on the specific gastric parietal cell. This the treatment of active duodenal heartburn, acid
condition being action leads to a reduction in and gastric ulcers, as well as for - *Rare but Serious:* reflux, or
Classification: treated. Typical gastric acid production, maintenance therapy after healing Clostridium difficile- abdominal pain are
doses range from making it effective for acid- of erosive esophagitis. associated diarrhea improving.
Proton-pump inhibitor 20 mg to 40 mg related disorders such as - *Zollinger-Ellison (CDAD), severe allergic Document any
daily, usually gastroesophageal reflux Syndrome:* Pantoprazole is reactions (including changes in the
taken before a disease (GERD) and peptic indicated for the long-term anaphylaxis), vitamin frequency and
meal. ulcers. treatment of pathological B12 deficiency with severity of
hypersecretory conditions, long-term use. symptoms.
including Zollinger-Ellison
syndrome.  *Vital Signs and
General Health:*
Regularly check
vital signs,
especially if the
patient has a history
of hypertension.
Monitor for any
signs of
dehydration or
electrolyte
imbalance, such as
dizziness or
irregular heartbeat.

 *Electrolyte
 Levels:*
Pantoprazole can
affect magnesium
levels in the body.
Monitor
magnesium levels,
especially in
patients at risk of
magnesium
deficiency.
Symptoms of low
magnesium include
muscle spasms,
irregular heartbeat,
and seizures.

 *Bone Health:*
Long-term use of
proton pump
inhibitors (PPIs)
like Pantoprazole
has been associated
with an increased
risk of
osteoporosis-
related fractures.
Monitor patients,
especially elderly
individuals, for
signs of decreased
bone density or
fractures.
 *Kidney Function:*
Evaluate kidney
function regularly,
as PPIs might affect
 renal function.
Monitor serum
creatinine levels
and assess for signs
of kidney
impairment, such as
changes in
urination patterns
or edema.

 *Clostridium
difficile Infection:*
Watch for signs of
Clostridium
difficile-associated
diarrhea (CDAD),
which can be
associated with the
use of
Pantoprazole.
Symptoms include
severe diarrhea,
abdominal pain,
and fever.

 *Vitamin B12
Levels:*
Long-term use of
PPIs like
Pantoprazole may
lead to vitamin B12
deficiency. Monitor
vitamin B12 levels
in patients on
extended therapy.
Symptoms of B12
 deficiency include
fatigue, anemia,
and neurological
symptoms.

 *Liver Function:*
Assess liver
function regularly,
especially in
patients with pre-
existing liver
conditions. Monitor
liver enzyme levels
to detect any
abnormalities.

 *Patient
Compliance and
Adverse
Reactions:*
Ensure patients are
taking Pantoprazole
as prescribed.
Monitor for adverse
reactions such as
rash, itching, or
difficulty breathing.
Encourage patients
to report any
unusual symptoms
promptly.

 *Follow-Up and
Education:*
Schedule regular
follow-up
 appointments to
assess the patient's
progress and adjust
the treatment plan
if needed. Provide
ongoing education
about the
importance of
compliance, dietary
and lifestyle
modifications, and
potential risks
associated with
long-term PPI use.

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration
  Monitor the
Generic: Prescribed: Domperidone acts as a - *Gastrointestinal Motility - *Hypersensitivity:* - *Common:* Dry patient’s
dopamine receptor antagonist, Disorders:* Patients with known mouth, headache, gastrointestinal
Domperidone Recommended: primarily on the D2 receptors Domperidone is used to treat hypersensitivity to dizziness, diarrhea. symptoms,
- The typical oral in the chemoreceptor trigger conditions characterized by domperidone or any of including nausea,
Brand: dose for adults is zone (CTZ) and the gastric delayed gastric emptying and its components should - *Uncommon:* Rash, vomiting, and
10 mg taken 15-30 muscles. By blocking impaired motility, such as avoid this medication. breast tenderness, abdominal
Motilium, minutes before dopamine, it increases gastric gastroesophageal reflux disease irregular menstrual discomfort. Assess
Domperidone Maleate meals and, if motility, promotes gastric (GERD), gastroparesis, and - *Prolactinoma:* periods. the frequency and
necessary, before emptying, and prevents functional dyspepsia. Patients with a history severity of
Classification: bedtime. The nausea and vomiting. It does of pituitary prolactin- - *Rare but Serious:* symptoms to
maximum daily not readily cross the blood- - *Nausea and Vomiting:* secreting tumor QT interval prolongation, evaluate the
Dopamine receptor dose should not brain barrier, reducing the It is prescribed for the prevention (prolactinoma) should ventricular arrhythmias medication's
antagonist, Prokinetic exceed 30 mg. likelihood of central nervous and relief of nausea and vomiting, not use domperidone (torsades de pointes), effectiveness.
agent system side effects. including that caused by due to its potential to neuroleptic malignant
chemotherapy, radiotherapy, and increase prolactin syndrome-like reactions  Evaluate the
anti-parkinsonian medications. levels. (in high doses). patient's medical
history, allergies,
and current
medications,
especially those
that may interact
with domperidone.
Consider conditions
such as liver or
kidney impairment,
which might
require dosage
adjustments.
 Monitor blood
pressure and heart
rate regularly,
especially in
patients at risk of
cardiovascular
issues, as
 domperidone can
prolong the QT
interval.

 Monitor electrolyte
levels, particularly
potassium and
magnesium, as
domperidone may
affect these levels,
leading to potential
complications.

 Watch for signs of

extrapyramidal
symptoms
(involuntary muscle
movements) that
can occur,
especially at higher
doses.

 Be vigilant for
signs of
arrhythmias such as
palpitations,
dizziness, or
fainting, as
domperidone may
prolong the QT
interval.

 Ensure the patient

understands the
purpose of the
medication, correct
 dosage,
administration,
potential side
effects, and the
importance of
compliance.

 Confirm that the

patient is taking the
medication as
prescribed. Non-
compliance can
affect treatment
effectiveness.

DRUG STUDY

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration
Generic: Prescribed: - *Mucolytic Action:* - *Respiratory Conditions:* - *Hypersensitivity:* - *Common (inhaled  Monitor lung
Acetylcysteine is a mucolytic Acetylcysteine is indicated for Patients with a known form):* Bronchospasm, sounds regularly to
Acetylcysteine Recommended: agent that works by breaking patients with thick, viscous hypersensitivity to nasal congestion, assess changes in
- The typical dosage down disulfide bonds in mucus in conditions such as acetylcysteine or any rhinorrhea. respiratory status.
Brand: for adults is 600 mucus, reducing its viscosity. COPD, asthma, and cystic component of the Note the presence
mg to 1200 mg This action makes it easier for fibrosis, facilitating mucus formulation should - *Common (oral of wheezing,
Mucomyst, Parvolex, taken once or patients to clear mucus from clearance and improving airflow. avoid this medication. form):* Nausea, crackles, or other
Acetadote twice daily. The their airways, aiding in the vomiting, stomatitis. abnormal sounds.
dosage for treatment of respiratory - *Acetaminophen Overdose:*
Classification: children is weight- conditions like chronic It is used as an antidote for - *Uncommon  Monitor respiratory
based and usually obstructive pulmonary acetaminophen overdose, (intravenous form):* rate and pattern. An
Mucolytic agent, lower. disease (COPD) and cystic particularly in cases of acute Hypersensitivity increase in
Antidote (for - The typical dosage fibrosis. ingestion or when an overdose is reactions, rash, fever, respiratory rate or
acetaminophen for adults is 600 suspected. bronchospasm. signs of respiratory
overdose) mg to 1200 mg - *Antidote Action:* distress could
taken once or Acetylcysteine serves as an indicate worsening
twice daily. The antidote for acetaminophen lung function.
dosage for (paracetamol) overdose. It
children is weight- replenishes hepatic stores of  Monitor the color,
based and usually glutathione, a key consistency, and
lower. antioxidant, preventing or amount of mucus
reversing liver damage produced by the
caused by the toxic patient. Changes in
metabolite of acetaminophen. mucus
characteristics can
indicate the
effectiveness of the
medication.

 Monitor vital signs

regularly,
especially during
nebulization
therapy. Changes in
blood pressure,
 heart rate, or
oxygen saturation
levels may indicate
respiratory distress.

 Watch for signs of

hypersensitivity
reactions, such as
rash, itching,
swelling, or
difficulty breathing.
Be prepared to
intervene promptly
if an allergic
reaction occurs.

 Monitor for nausea,

vomiting, or other
gastrointestinal
disturbances,
especially in
patients receiving
oral acetylcysteine.

 For patients
receiving
acetylcysteine as an
antidote, monitor
liver function tests
regularly to assess
hepatic function
and the resolution
of acetaminophen
toxicity.
 BRAND NAME; Prescribed and
GENERIC NAME; Recommended dosage;
CLASSIFICATION frequency; route of
administration
Generic: Prescribed:
Lactulose Recommended:
Dosage: The usual adult
dosage for lactulose to
Brand:
treat constipation is 15-30
milliliters (ml) (or 2-4
tablespoons) once a day.
Duphalac, Enulose,
For hepatic
Kristalose, and encephalopathy (a liver
Generlac, disorder), the dosage
might be higher and is
determined by the
Classification: healthcare provider.
Mechanism of Action
Lactulose is a synthetic sugar
that is not absorbed by the
body. When taken orally, it
reaches the colon unchanged.
In the colon, lactulose is
broken down by bacteria into
organic acids. These acids
lower the pH in the colon,
creating an osmotic effect.
This osmotic effect draws
water into the colon,
softening the stool and
increasing bowel movements.
By increasing the water
content and softening the
stool, lactulose helps to
relieve constipation and
promote regular bowel
Indication
- Lactulose is commonly
prescribed to treat constipation by
softening stools and increasing
bowel movements. It is also used
to treat hepatic encephalopathy, a
condition where the liver is not
able to remove toxins from the
blood, leading to confusion,
tremors, and decreased level of
consciousness. In this case,
lactulose helps by reducing the
absorption of ammonia, a toxin
produced in the intestines, and
promoting its excretion from the
body, thereby improving
symptoms associated with hepatic
encephalopathy.
Contraindication Adverse Reaction Nursing Responsibilities
Galactosemia: Assessment: Nurses should
Lactulose contains assess the patient's medical
galactose and should - Gastrointestinal history, allergies, current
not be used by Distress: This can medications, and overall
individuals with include cramps, gas, health status before
galactosemia, a rare and bloating. administering lactulose.
genetic metabolic They should also assess the
Diarrhea: Lactulose can
disorder that affects patient's bowel patterns,
cause loose stools,
the body's ability to including frequency and
especially when taken in
process galactose, a consistency.
excessive amounts.
sugar found in
lactulose.
Electrolyte Imbalance:
Prolonged use or high Education: Provide clear
doses of lactulose may and comprehensive
Intestinal Obstruction: education to the patient and
lead to electrolyte
Lactulose should not their caregivers about the
be used if there is a imbalances, such as low medication, including its
potassium levels in the
suspected or known purpose, dosage,
intestinal obstruction, blood. administration instructions,
as it may worsen the potential side effects, and
Osmotic laxative Frequency: Lactulose is movements.
usually taken once a day.
However, the frequency
and dosage can be adjusted
by the healthcare provider
based on the individual's
needs and response to the
medication.
Route of Administration:
Lactulose is taken orally.
It can be taken with or
without food. The syrup
form of lactulose should
be measured with a proper
measuring device, and it's
important to follow the
dosing instructions
provided by the healthcare
provider or pharmacist.
condition Dehydration: Excessive what to do in case of
diarrhea can lead to missed doses or adverse
dehydration if not reactions.
Allergy: Individuals managed properly.
Administration: Administer
with a known allergy lactulose according to the
or hypersensitivity to Hypokalemia: Lactulose
can cause low levels of prescribed dosage and
lactulose should avoid schedule. Ensure that the
using this medication potassium in the blood,
patient understands how to
which can affect heart
take the medication,
function and other whether it should be taken
Diabetes: People with bodily processes. with food or on an empty
diabetes should use stomach, and any specific
lactulose with caution instructions provided by the
as it contains sugar healthcare provider.
and can affect blood
sugar levels. They
should consult their
Monitoring: Regularly
healthcare provider for monitor the patient's bowel
appropriate dosing and
movements and assess the
monitoring. effectiveness of lactulose in
Unexplained relieving constipation.
Abdominal Monitor for signs of
Symptoms: If the dehydration, electrolyte
cause of abdominal imbalances, or other
symptoms is not adverse reactions.
diagnosed, lactulose Hydration: Encourage
should not be used patients to maintain
until the underlying adequate fluid intake while
cause is determined. taking lactulose to prevent
dehydration, especially if
diarrhea occurs as a side
effect.
Documentation: Accurately
document the
administration of lactulose,
including the dosage given,
the time of administration,
the patient's response, and
any observed side effects.
Proper documentation
ensures continuity of care
and provides essential
information for healthcare
providers.

Patient Safety: Ensure that

lactulose is stored properly,
and check the expiration
date before administration.
Verify the patient's identity
before giving the
medication to prevent
medication.
Communication: Maintain
open communication with
the healthcare team,
including physicians and
pharmacists, regarding the
patient's response to
lactulose, any concerns, or
changes in the patient's
condition.

Follow-Up: Schedule
follow-up assessments to
monitor the patient's

BRAND NAME; Prescribed and
GENERIC NAME;
CLASSIFICATION
Recommended Dosage:
The typical starting dose
Generic: for tamsulosin is 0.4
milligrams (mg) once
daily.
Tamsulosin
Frequency: Tamsulosin is
Brand: usually taken once daily,
approximately 30 minutes
after the same meal each
Flomax, Urimax, day. This consistency
Contiflo, Omnic, and helps maintain the drug's
Flomaxtra. effectiveness.
Classification:
Alpha Blockers Route of Administration:
Tamsulosin is taken orally,
with a full glass of water.
It's important not to crush,
chew, or open the
capsules, as they should be
swallowed whole.
Mechanism of Action
Tamsulosin is an alpha-
adrenergic blocker that
primarily acts on alpha-1A
and alpha-1D adrenergic
receptors in the prostate
gland, the prostatic capsule,
prostatic urethra, and bladder
neck. Its mechanism of action
involves selective blockade of
these receptors.
By blocking alpha-1
adrenergic receptors,
tamsulosin inhibits the effects
of norepinephrine and other
neurotransmitters that
normally cause smooth
muscle contraction in the
prostate and bladder neck.
This blockade leads to
relaxation of the smooth
muscles in these areas,
reducing the dynamic
Indication
Tamsulosin is indicated for the
treatment of signs and symptoms
of benign prostatic hyperplasia
(BPH). Specifically, it is used to
improve symptoms associated
with urinary obstruction caused
by an enlarged prostate gland,
such as:
Urinary Hesitancy: Difficulty in
initiating the urinary stream.
Weak Urinary Stream: Reduced
strength of the urinary flow.
Straining During Urination:
Needing to push or strain to start
urination.
Frequent Urination: Increased
frequency of urination,
particularly at night (nocturia).
Urgency: Sudden and urgent need
to urinate.
progress, adjust the dosage
if necessary, and address
any concerns or questions
the patient may have.
Contraindication Adverse Reaction Nursing Responsibilities
Hypersensitivity: Dizziness: Tamsulosin can Assessment: Conduct a
Tamsulosin is cause dizziness, thorough patient
contraindicated in especially when standing assessment, including
individuals with a medical history, allergies,
up from a sitting or lying
known current medications, and
position, due to a drop in
hypersensitivity or blood pressure. any existing conditions,
allergic reaction to especially related to kidney
tamsulosin or any of and liver function.
its components.
Orthostatic Hypotension:
A sudden drop in blood
Education: Provide clear
pressure upon standing,
Severe Liver and detailed instructions to
leading to
Impairment: the patient about the
lightheadedness or
Tamsulosin is medication, including
fainting.
contraindicated in dosage, timing, potential
patients with severe side effects (especially
liver impairment as the dizziness and orthostatic
pharmacokinetics of Retrograde Ejaculation: hypotension), and the
the drug may be Tamsulosin may cause importance of compliance.
significantly altered in semen to travel backward Advise patients about the
these individuals. possibility of retrograde
into the bladder instead of
ejaculation.
being ejaculated out of
the body during sexual
Orthostatic
component of urinary
obstruction caused by benign
prostatic hyperplasia (BPH).
As a result, tamsulosin
improves urinary flow rates
and decreases BPH-related
symptoms, such as difficulty
urinating, frequent urination,
and nocturia.
Tamsulosin's selectivity for
alpha-1A and alpha-1D
receptors in the prostate and
bladder neck, without
significant action on alpha-1B
receptors in blood vessels,
helps minimize the potential
for side effects related to
blood pressure changes. This
targeted mechanism makes
tamsulosin particularly
effective in relieving urinary
symptoms associated with
BPH.
Hypotension: climax. This is usually Administration: Administer
Tamsulosin can cause harmless but can affect tamsulosin as prescribed,
orthostatic fertility. ensuring the correct dosage
hypotension (a sudden and route. Monitor the
decrease in blood patient's response and
pressure upon observe for any adverse
standing), especially Headache: Some people reactions, especially during
during the initiation of may experience the initial doses when
therapy. It should be headaches while taking dizziness is more common.
used cautiously in tamsulosin.
patients with a history
of orthostatic Monitoring: Regularly
hypotension and Nasal Congestion: monitor vital signs,
avoided in individuals Tamsulosin may cause especially blood pressure
prone to significant nasal congestion or a and heart rate. Keep an eye
blood pressure drops. on the patient for signs of
runny nose.
dizziness, lightheadedness,
or fainting, especially when
Intraoperative Floppy changing positions.
Iris Syndrome (IFIS): Fatigue: Feeling
Tamsulosin use is unusually tired or weak.
contraindicated in Hydration: Encourage
patients who are patients to maintain
undergoing or Abnormal Ejaculation: adequate fluid intake,
planning to undergo Apart from retrograde especially if they
cataract or glaucoma ejaculation, some experience dizziness or
surgery due to the risk individuals might lightheadedness, to prevent
of intraoperative dehydration.
experience other changes
floppy iris syndrome.
in ejaculation, including
reduced semen during
ejaculation. Patient Interaction: Address
Combination with any concerns or questions
Strong CYP3A4 the patient might have
Inhibitors: Concurrent regarding the medication.
use of tamsulosin with Infection: Tamsulosin can Monitor for signs of
strong cytochrome increase the risk of compliance and
P450 3A4 inhibitors respiratory tract understanding, especially
(such as ketoconazole, infections. regarding the importance of
ritonavir) is continuing the medication
contraindicated due to even if symptoms improve.
the potential for
Gastrointestinal
increased tamsulosin
levels, which can lead Disturbances: Such as
stomach pain, nausea, Medication Reconciliation:
to adverse effects. Ensure that tamsulosin does
vomiting, and diarrhea.
not interact negatively with
other medications the
Combination with patient is taking.
Alpha-Adrenergic Hypersensitivity
Antagonists: Reactions: Rarely,
Tamsulosin should not allergic reactions such as Documentation: Accurately
be used concomitantly rash, itching, and document the
with other alpha- swelling of the face, administration, patient
adrenergic antagonists tongue, or throat can response, and any observed
due to the increased occur. side effects. Document any
risk of hypotension changes in the patient's
(low blood pressure). condition and report them
to the healthcare team.
Cataract Complications:
Intraoperative floppy iris
syndrome (IFIS) has been
Fall Prevention: Due to the
observed during cataract
potential for dizziness and
surgery in patients taking orthostatic hypotension,
tamsulosin. implement fall prevention
measures, especially in
elderly patients. Advise
patients to stand up slowly
to minimize the risk of
falls.

Patient Follow-Up:
 Schedule follow-up
assessments to monitor the
patient's progress, check for
resolution of symptoms,
and assess for any side
effects or complications.

BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME;
CLASSIFICATION
 For Androgenic Alopecia
(Male-Pattern Baldness):
Generic:
Dosage: The typical
Finasteride
dosage for androgenic
alopecia is 1 milligram
(mg) of finasteride once
Brand: daily.
Frequency: Finasteride is
usually taken once a day,
Propecia and Proscar..
with or without food.
Classification:
Route of Administration:
5-alpha-reductase Finasteride is taken orally
inhibitor; antiandrogen with a full glass of water.
For Benign Prostatic
Hyperplasia (BPH):
Dosage: The usual dosage
for BPH is 5 mg of
finasteride once daily.
Frequency: Finasteride is
typically taken once a day,
with or without food.
Route of Administration:
Finasteride is taken orally
with a full glass of water.
Finasteride is a 5-alpha-
reductase inhibitor. It works
by inhibiting the enzyme 5-
alpha-reductase, which
converts testosterone, a male
sex hormone, into
dihydrotestosterone (DHT).
DHT is a potent androgen
that contributes to the
development and enlargement
of the prostate gland (in
benign prostatic hyperplasia)
and is also a factor in the
miniaturization of hair
follicles in androgenic
alopecia (male-pattern
baldness).
In the context of benign
prostatic hyperplasia (BPH):
By inhibiting the conversion
of testosterone to DHT,
finasteride reduces the levels
of DHT in the prostate gland.
This results in a decrease in
prostate volume,
improvement in urinary flow,
and reduction in symptoms
associated with an enlarged
prostate, such as difficulty
urinating.
In the context of androgenic
Androgenic Alopecia (Male-
Pattern Baldness): Finasteride is
used to treat male-pattern
baldness, a hereditary condition
that leads to hair loss in men. It
promotes hair regrowth and
prevents further hair loss in
individuals experiencing thinning
hair or baldness at the top of the
scalp.
Benign Prostatic Hyperplasia
(BPH): Finasteride is also
indicated for the treatment of
benign prostatic hyperplasia, a
condition in which the prostate
gland becomes enlarged. It helps
reduce symptoms associated with
an enlarged prostate, such as
difficulty urinating, by shrinking
the prostate gland, improving
urinary flow, and decreasing the
risk of urinary retention and the
need for surgery related to BPH..
Pregnancy and Sexual Dysfunction: Assessment: Conduct a
Breastfeeding: Including erectile thorough patient
Finasteride is dysfunction, decreased assessment, including
contraindicated in medical history, allergies,
libido, and reduced
women, especially and any existing conditions,
those who are ejaculatory volume. In
to ensure the medication is
pregnant or may some cases, these effects
safe for the individual.
become pregnant. It may persist after
can cause harm to a discontinuation of the
developing male fetus medication.
if a pregnant woman is Education: Provide clear
exposed to it. It should and detailed instructions to
not be handled or the patient about the
touched by pregnant Breast Enlargement or medication, including
women, and women Tenderness: Some dosage, timing, potential
should not take it. individuals may side effects (especially
experience breast sexual dysfunction), and
enlargement or the importance of
Children: Finasteride tenderness, a condition compliance. Inform
is not intended for use known as gynecomastia. patients, particularly
in children and should women of childbearing age,
be kept out of their about the risks of exposure
reach. to finasteride during
Allergic Reactions: Such
pregnancy.
as rash, itching, swelling
of the lips and face, and
Hypersensitivity:
Individuals with a difficulty breathing. Administration: Administer
known Severe allergic reactions finasteride as prescribed,
hypersensitivity or are rare but can be ensuring the correct
allergy to finasteride serious. dosage and route. Monitor
or any of its
components should the patient's response and
not use this observe for any adverse
medication. Depression: Some reactions.
patients have reported
feelings of depression
alopecia (male-pattern
baldness):
Finasteride decreases DHT
levels in the scalp, which
helps to reverse the
miniaturization of hair
follicles and increases hair
regrowth and prevents further
hair loss in men experiencing
male-pattern baldness.
By inhibiting the action of 5-
alpha-reductase and reducing
DHT levels, finasteride
addresses the underlying
causes of both benign
prostatic hyperplasia and
androgenic alopecia, leading
to improved symptoms and
hair regrowth, respectively.
Prostate Cancer: and anxiety while taking Monitoring: Regularly
Finasteride is finasteride. monitor vital signs and
generally not used in assess for signs of adverse
individuals with reactions, especially
prostate cancer. It may related to sexual function.
interfere with the Testicular Pain:
Encourage patients to
detection of prostate Discomfort or pain in the
report any unusual
cancer during testicles.
symptoms promptly.
screenings due to its
effect on prostate-
specific antigen (PSA)
Urinary Tract Infections: Hydration: Encourage
levels.
Some individuals may patients to maintain
experience urinary tract adequate fluid intake.
Liver Dysfunction: infections.
Individuals with
severe liver Patient Interaction:
impairment should use Address any concerns or
Palpitations: Some
finasteride cautiously, patients have reported questions the patient might
if at all, as the drug is irregular heartbeat or have regarding the
metabolized in the
palpitations. medication. Monitor for
liver. signs of compliance and
understanding.
Urinary Tract Muscle Weakness or
Obstruction: Fatigue: Unusual
Medication Reconciliation:
Finasteride should be weakness or fatigue can Ensure that finasteride
used cautiously in occur. does not interact
individuals with a
urinary tract negatively with other
obstruction, as it can medications the patient is
affect the evaluation of taking.
the obstruction during
diagnostic tests.
Documentation: Accurately
document the
Genetic Deficiency: administration, patient
Finasteride is not response, and any
effective in individuals observed side effects.
with a genetic Document any changes in
deficiency of 5-alpha- the patient's condition and
reductase enzymes. report them to the
healthcare team.

Patient Counseling:
Counsel patients about the
importance of regular
follow-up appointments
with their healthcare
provider and adherence to
the prescribed medication
regimen.

Pregnancy Prevention: For

healthcare providers
involved in women's
health, it's crucial to
educate women of
childbearing potential
about the potential risks of
finasteride exposure during
pregnancy and the
importance of effective
contraception during the
treatment period.
 BRAND NAME; Prescribed and Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME;
CLASSIFICATION
 Dosage: The usual dosage
of potassium chloride
Generic: supplements ranges from
20 to 100 mEq
(milliequivalents) per day,
Potassium Chloride divided into several doses.
The specific dosage
depends on the severity of
Brand: the potassium deficiency
and the patient's medical
condition.
K-Dur, Micro-K, and
Klor-Con
Frequency: Potassium
Classification: chloride supplements are
typically taken multiple
Electrolyte supplement
times a day to maintain
consistent potassium levels
in the blood. The
frequency of
administration will be
determined by the
healthcare provider based
on the individual's needs.
Route of Administration:
Potassium chloride
supplements are usually
taken orally with a full
glass of water or with food
to minimize stomach
upset. Extended-release
forms of potassium
chloride should be
swallowed whole, without
Cellular Electrolyte Balance:
Potassium is a key
intracellular cation, meaning
it is primarily found inside
cells. It helps maintain the
electrochemical balance
across cell membranes, which
is critical for normal cellular
function, including nerve
impulse transmission and
muscle contraction.
Nerve Signal Transmission:
Potassium ions are involved
in the generation and
transmission of nerve
impulses. They help maintain
the resting membrane
potential of nerve cells,
allowing them to respond to
stimuli and propagate signals.
Muscle Contraction:
Potassium ions are essential
for muscle contraction. They
interact with sodium ions to
regulate muscle contraction
and relaxation. Proper
potassium levels ensure
normal muscle function,
including the contraction of
the heart muscle (cardiac
muscle) and skeletal muscles.
Potassium chloride is indicated
for the treatment and
prevention of potassium
deficiency (hypokalemia).
Hypokalemia can occur due to
various factors, including
certain medical conditions,
medications, or an inadequate
diet. Potassium chloride
supplements are used to restore
or maintain normal potassium
levels in the body. Maintaining
proper potassium levels is
essential for the normal
functioning of cells, nerves,
muscles, and organs, including
the heart.
Hyperkalemia: Potassium Gastrointestinal Assessment: Conduct a
chloride is Disturbances: Such as thorough patient
contraindicated in nausea, vomiting, assessment, including
individuals with high medical history, current
diarrhea, or abdominal
levels of potassium in the medications, kidney
blood (hyperkalemia). discomfort. These
symptoms are more function, and potassium
Using potassium levels, to determine the
supplements in the likely to occur with solid
appropriate dosage and
presence of elevated or liquid oral potassium
monitor for potential
potassium levels can lead supplements.
to further complications, contraindications or
including dangerous interactions.
heart rhythm
disturbances. Ulceration or Stenosis:
Potassium chloride Education: Provide clear
tablets or capsules may and detailed instructions to
the patient about the
Acute Dehydration: cause ulcers or strictures
Potassium chloride (narrowing) in the medication, including
should be used with gastrointestinal tract if dosage, timing, and the
caution, or avoided, in they lodge in the importance of taking the
individuals with acute supplement with food or a
esophagus before
dehydration. Adequate full glass of water to
fluid status should be reaching the stomach.
minimize gastrointestinal
restored before potassium discomfort. Educate
supplementation. patients about signs and
Hyperkalemia: Excessive symptoms of hyperkalemia
potassium levels in the and the importance of
Chronic Kidney Disease: blood (hyperkalemia) can reporting them promptly.
Individuals with severe occur, especially in
kidney impairment or individuals with impaired
end-stage renal disease
kidney function. Administration: Administer
may have difficulty
excreting excess Hyperkalemia can lead to potassium chloride
potassium and are at an dangerous heart rhythm supplements as prescribed,
increased risk of disturbances and other ensuring the correct
hyperkalemia. Potassium dosage and route. Ensure
crushing or chewing, to
ensure gradual release in
the digestive system. Acid-Base Balance:
Potassium ions play a role in
maintaining the body's acid-
base balance, helping to
regulate the pH of bodily
fluids.
Fluid Balance: Potassium, as
an electrolyte, contributes to
the balance of fluids and
electrolytes in and out of
cells. This balance is crucial
for maintaining normal blood
pressure and preventing
dehydration.
In the context of potassium
deficiency (hypokalemia),
potassium chloride
supplements are used to
replenish low potassium
levels in the body. By
providing the body with the
necessary potassium ions,
potassium chloride helps
restore normal cellular and
physiological functions,
particularly in nerve and
muscle cells.
chloride should be used complications. that potassium
cautiously, if at all, in supplements are not
these patients. crushed or chewed,
Cardiac Arrhythmias: Too especially extended-release
much potassium in the forms, to prevent irritation
Addison's Disease: or ulcers in the esophagus.
blood can lead to
Potassium chloride may
interfere with potassium abnormal heart rhythms,
levels in individuals with which can be life-
Monitoring: Regularly
Addison's disease, a threatening.
monitor serum potassium
condition where the
levels to assess the
adrenal glands do not
produce enough effectiveness of the
Muscle Weakness or supplementation and to
hormones, including
aldosterone, which Paralysis: High potassium prevent hyperkalemia.
regulates potassium levels can affect muscle Monitor for signs and
levels. Caution is needed function, leading to symptoms of hyperkalemia,
in these cases. including irregular
weakness or even
paralysis. heartbeats, muscle
weakness, or numbness,
Untreated Adrenal and report any changes
Insufficiency: Potassium promptly.
Numbness or Tingling:
chloride should be used
with caution in Elevated potassium levels
individuals with may cause numbness or
Hydration: Encourage
untreated adrenal tingling in the patients to maintain
insufficiency, a condition extremities.
adequate fluid intake
where the adrenal glands unless contraindicated due
do not produce enough
to an underlying medical
hormones, including
Confusion or Mental condition. Proper hydration
aldosterone.
Impairment: Severe supports kidney function
hyperkalemia can affect and potassium excretion.
Severe Hemolysis: brain function, leading to
Potassium supplements confusion, mental
should be avoided in Dietary Counseling: Advise
cases of severe hemolysis
(destruction of red blood
cells), as this condition
can release excess
potassium into the
bloodstream.
Potassium-Sparing
Diuretics: Concurrent use
of potassium-sparing
diuretics (e.g.,
spironolactone,
amiloride, triamterene)
can lead to excessive
potassium levels and
should be done
cautiously, if at all, under
close medical
supervision.
impairment, or seizures. patients to follow a
potassium-balanced diet
and to avoid excessive
consumption of high-
Low Blood Pressure
potassium foods, especially
(Hypotension): In some
if they are on potassium
cases, potassium
supplements.
supplements can cause a
drop in blood pressure.
Patient Education: Educate
patients about the
importance of regular
follow-up appointments
with their healthcare
provider for potassium
level monitoring and
adjustment of the dosage if
necessary. Instruct them
about the risks of taking
too much or too little
potassium.
Patient Safety: Be aware of
potential drug interactions,
especially with medications
such as potassium-sparing
diuretics or angiotensin-
converting enzyme (ACE)
inhibitors, which can
increase the risk of
hyperkalemia.
 Documentation: Accurately
document the
administration, patient
response, serum potassium
levels, and any observed
side effects. Document any
changes in the patient's
condition and report them
to the healthcare team.

DRUG STUDY

BRAND NAME; Prescribed and

GENERIC NAME;
CLASSIFICATION
recommended dosage;
Mechanism of action Indication Contraindication Adverse Reaction Nursing Responsibilities
frequency; route of
Administration
Brand Name: PRESCRIBE:
Blocks the effects of Prevention of Contraindicated: CNS: headache, dizziness,  Assess the patient for
ONDANSETRON serotonin at 5-HT, - nausea and hypersensitivity; orally drowsiness, fatigue, nausea, vomiting, ab-
PO (Adults and dominal distention.
receptor sites (selective vomiting associated disintegrating tablets weakness.
Children >: And bowel sounds
antagonist) located in with chemotherapy contain aspartame and
Prevention of prior to and follow-
Generic Name: vagal nerve terminals or radiation should not be used in
chemotherapy-induced ing administration.
and the chemoreceptor therapy. patients with
Zofran nausea/vomiting- 8mg  Assess patient for ex-
trigger zone in the phenylketonuria.
30 min prior to GI: constipation, diarrhea, trapyramidal effects
CNS.
chemotherapy and abdominal pain dry mouth, (involuntary move-
IM,IV; prevention ments, facial grimac-
Therapeutic repeated 8 hr later; 8 increased liver enzymes.
and treatment of Pharmacokinetics: ing, rigidity, shuf-
Classification: mg q12hr may be given
postoperative fling walk, trembling
for 1-2 days following
antiemtics nausea and of hands)
chemotherapy.
vomiting A: IV administration  Lab test considera-
Prevention of
radiation-induced results in complete NEURO: extrapyramidal tions: may cause
bioavailability; 50% reactions. transient increase in
nausea/vomiting- 8mg
absorbed following oral serum bilirubin,
1-2hr prior to radiation; AST< and ALT lev-
may be repeated q8hr, administration.
els.
depending on type, D: unknown
location, and extent of
radiation. Prevention M&E: extensively
of postoperative metabolized by the liver;
nausea/vomiting- 5% excreted unchanged by
16mg 1 hr before the kidneys.
induction od Half-life: 3.5-5.5hr
anesthesia.
PO (Children 4-11yr): Route: PO, IV
Prevention of
Onset: rapid
chemotherapy-induced
nausea/vomiting: 4mg Peak: 15-30 min
30 min prior to
chemotherapy and Duration: 4 hr- 8 hr
repeated 4 and 8 hr
later; 4mg q8hr may be
giver for 1-2 days
following
chemotherapy.

IV (adults):
prevention of
chemotherapy-induced
nausea/vomiting:
0,15mg/kg 15-30 min
prior to chemotherapy,
repeated 4 and 8 hr
later, or 32mg single
dose 30 min prior to
chemotherapy (lower
doses have been used).

IM, IV (ADULTS):
prevention of
postoperative
nausea/vomiting- 4mg
before induction of
anesthesia or
postoperatively.

IV (Children 4-18yr):
prevention of
chemotherapy-induced
nausea/vomiting- 0.15
mg/kg 15-30 min prior
to chemotherapy,
repeated 4 and 8 hr
later.

IV (Children 2-12yr
and < 40kg):
prevention of
postoperative
nausea/vomiting-
0.15mg/kg.

IV (Children >40kg):
prevention of
postoperative
nausea/vomiting- 4mg.
 DRUG STUDY

BRAND NAME; Prescribed and

GENERIC NAME;
CLASSIFICATION
recommended dosage;
Mechanism of action Indication Contraindication Adverse Reaction Nursing Responsibilities
frequency; route of
administration
Brand Name: ANALGESIA:

NALBUPHINE Binds to opiate receptors in Moderate to severe pain. Hypersensitivity to nalbuphine CNS: dizziness, headache, sedation,  Assess type, location, ad
the CNS. Alters the Also provides; analgesia or bisulfites; patients who are confusion, dysphoria, euphoria, intensity of pain before
IM, SUBCUT, IV perception of and response during labor, sedation physically dependent on opioid floating feeling, hallucinations, and 1hr after IM or 30
(ADULTS): usual dose is to painful stimuli while before surgery, and have not been detoxified unusual dreams. min (peak) after adminis-
Generic Name: 10mg q3-6hr (single dose producing generalized CNS supplement to balanced (may precipitate in tration.
NUBAIN not exceed 20mg; tota; daily depression. In addition, has anesthesia. withdrawal)  An equianalgesic chart
dose not to exceed 160mg). partial antagonist should be used when
EENT: blurred vision, diplopia, changing routes and or
properties, which may miosis (high doses) when changing from one
Therapeutic result in opioid withdrawal
opioid to another.
Classification: SUPPLEMENT TO in physically dependent
 Assess blood pressure,
BALANCED patients PHARMACOKINETICS:
RESP: respiratory depression pulse, and respiration’s
ANESTHESIA: before and periodically
Opioid analgesics CV: hypertension, orthostatic during administration. If
A: well absorbed adter IM and hypotension, palpitations. respiratory rate is <10/
IV (ADULTS): Initial – subcut administration min, assess level of seda-
0.3-3 mg/kg over 10-15 tion.
Pharmacologic: D: probably crosses the placenta  Assess previous analgesic
min. maintenance- 0.25- GI: dry mouth, nausea, vomiting,
0.5mg/kg as needed. and ebters breast milk history. Antagonistic
constipation, ileus properties may induce
M&E: mostly metabolized by withdrawal symptoms
Opioid agonists/
the liver and eliminated in the (vomiting, restlessness,
analgesics
feces via biliary excretion. GU: urinary urgency abdominal cramps, and
Minimal amounts excreted increased blood pressure
unchanged by the kidneys. and temperature) in pa-
tients physically depen-
HALF-LIFE: 5hr DERM: clammy feelings, sweating. dent to opioids.
MISC: physical dependence,  Lab test considerations:
may cause increase
psychological dependence,
serum amylase and lipase
tolerance. concentrations.
Route: IM
Onset: <15min

Peak: 60 min

Duration: 3-6hr

Route: subcut

Onset: <15 min

Peak: unknown

Duration: 3-6hr

Route: IV

Onset: 2-3 min

Peak: 30 min

Duration: 3-6 hr
 DRUG STUDY

BRAND NAME; Prescribed and recommended

GENERIC NAME; dosage; frequency; route of
CLASSIFICATION administration Mechanism of action Indication Contraindication Adverse Reaction Nursing Responsibilities

Brand Name: Prevention of Chemotherapy-
Induced Vomiting
metoclopramide
PO, IV (Adults and Children): 1– 2
mg/kg 30 min before chemotherapy.
Additional doses of 1– 2 mg/kg may
be given q 2– 4 hr, pretreatment with
Generic name: diphenhydramine willpthe risk of
extrapyramidal reactions to this dose.
Metonia, Metozolv
ODT, Reglan
Facilitation of Small Bowel
Intubation
Therapeutic:
antiemetics
IV (Adults and Children 14 yr): 10
mg over 1– 2 min.
IV (Children 6– 14 yr): 2.5– 5 mg
Blocks dopamine receptors Prevention of Contraindicated in:
in chemoreceptor trigger chemotherapy-induced Hypersensitivity; Possible GI
zone of the CNS. emesis. Treatment of obstruction or hemorrhage; CNS: drowsiness, extrapyramidal ● Assess for nausea, vomiting,
Stimulates motility of the postsurgical and diabetic History of seizure disorders; reactions, restlessness, abdominal distention, and
NEUROLEPTIC MALIGNANT
upper GI tract and gastric stasis. Pheochromocytoma; bowel sounds before and after
accelerates gastric Facilitation of small Parkinson’s disease. SYNDROME, anxiety,
administration.
emptying. bowel intubation in depression, irritability, tardive
dyskinesia.
radiographic procedures. ● Assess for extrapyramidal
Management of Pharmacokinetics side effects (parkinsonian—
gastroesophageal reflux. difficulty speaking or
Treatment and CV: arrhythmias swallowing, loss of balance
prevention of (supraventricular tachycardia, control, pill rolling, mask-like
postoperative nausea and Absorption: Well absorbed bradycardia), hypertension,
face, shuffling gait, rigidity,
vomiting when from the GI tract, from hypotension.
tremors; and dystonic—
nasogastric suctioning is rectal mucosa, and from IM
undesirable muscle spasms, twisting
sites. Distribution: Widely
motions, twitching, inability to
distributed into body tissues GI: constipation, diarrhea, dry
mouth, nausea.
move eyes, weakness of arms
and fluids. Crosses blood-
or legs) periodically
brain barrier and placenta.
throughout course of therapy.
Enters breast milk in
(dose should not exceed 0.5 mg/kg)
over 1– 2 min.
IV (Children 6 yr): 0.1 mg/kg over
1– 2 min.
Diabetic Gastroparesis
PO, IV (Adults): 10 mg 30 min
before meals and at bedtime for 2– 8
weeks.
Gastroesophageal Reflux
concentrations greater than
plasma.
Metabolism and
Excretion: Partially
metabolized by the liver;
25% eliminated unchanged
in the urine.
Half-life: 2.5– 6 hr.
Route: IV
Onset: 1–3 min
Peak: immediate
Endo: gynecomastia. May occur wk to mo after
initiation of therapy and are
reversible on discontinuation.
Hemat: methemoglobinemia,
Dystonic reactions may occur
neutropenia, leukopenia, within minutes of IV infusion
agranulocytosis and stop within 24 hr of
discontinuation of
metoclopramide. May be
treated with 50 mg of IM
diphenhydramine or
diphenhydramine 1 mg/kg IV
may be administered
prophylactically 15 min before
metoclopramide IV infusion.

Duration: 1–2 hr ● Monitor for tardive

PO, IM, IV (Adults): 10– 15 mg 30 dyskinesia (uncontrolled
min before meals and at bedtime (not rhythmic movement of mouth,
to exceed 0.5 mg/kg/day). A single face, and extremities; lip
Route: PO
dose of 20 mg may be given
smacking or puckering;
preventively. Some patients may Onset: 30–60 min puffing of cheeks;
respond to doses as small as 5 mg.
uncontrolled chewing; rapid or
Peak: unknown
worm-like movements of
Duration: 1–2 hr tongue). Usually occurs after a
PO, IM, IV (Neonates , Infants, and
Children): 0.4– 0.8 mg/kg/day in 4 year or more of continued
divided doses. therapy; risk of tardive
Route: IM dyskinesia increases with total
cumulative dose. Report
Onset 10–15 min immediately and discontinue
Postoperative Nausea/Vomiting
metoclopramide; may be
Peak: unknown
irreversible.
IM, IV (Adults and Children 14 Duration: 1–2 hr
 yr): 10 mg at the end of surgical
procedure, repeat in 6– 8 hr if needed.
● Monitor for neuroleptic
IM, IV (Children 14 yr): 0.1– 0.2 malignant syndrome
mg/kg/dose, repeat in 6– 8 hr if (hyperthermia, muscle rigidity,
needed.
altered consciousness,
irregular pulse or BP,
tachycardia, and diaphoresis).
Treatment of Hiccups

● Assess for signs of

PO, IM (Adults): 10– 20 mg 4 times
daily PO; may be preceded by a depression periodically
single 10-mg dose IM (unlabeled) throughout therapy.
● Lab Test Considerations:
May alter hepatic function test
results.
● May causeqserum prolactin
and aldosterone concentrations

DRUG STUDY

BRAND NAME; GENERIC

NAME; CLASSIFICATION Prescribed and
recommended dosage;
frequency; route of Mechanism of action Indication Contraindication Adverse Reaction Nursing Responsibilities
administration

 Drug compatibility
should be monitored
Brand Name: Intravenous (IV) : 20mg Hyoscine-N-butylbromide
closely in patients requir-
in 1ml (solution); Dilute (HNBB) acts by interfering
Buscopan Tablets are Buscopan Tablets should not ing adjunctive therapy
required dose to 10ml with with the transmission of CNS: dizziness, anaphylactic
indicated for the relief be administered to patients  Avoid driving & operat-
Buscopan normal saline. Inject nerve impulses by reactions, anaphylactic shock,
of spasm of the genito- with myasthenia gravis, ing machinery after par-
slowly over 3-5 minutes. acetylcholine in the increased ICP,
urinary tract or gastro- megacolon and narrow angle enteral administration.
Compatible with the parasympathetic nervous disorientation, restlessness,
intestinal tract and for glaucoma. In addition, they  Avoid strict heat
following IV fluids: system. irritability, dizziness,
Generic Name: Hyoscine-N- the symptomatic relief should not be given to patients  Raise side rails as a pre-
Normal saline, 5% glucose drowsiness, headache,
butylbromide Buscopan exerts a of Irritable Bowel with a known hypersensitivity caution because some pa-
glucose and sodium
spasmolytic action on the Syndrome to hyoscine-N-butylbromide or confusion, hallucination, tients become temporar-
chloride; May be given
into the side arm when the smooth muscle of the any other component of the delirium, impaired memory ily excited or disoriented
Classification: Antispasmodic; gastrointestinal, biliary and product. and some develop amne-
above IV fluids are being CV: hypotension, tachycardia,
urinary tracts. As a sia or become drowsy.
Anticholinergic infused. Store at room
quaternary ammonium palpitations, flushing  Reorient patient, as
temperature. Protect from
light. derivative, hyoscine-N- needed, Tolerance may
GI: Dry mouth, constipation,
butylbromide does not develop when therapy is
enter the central nervous nausea, epigastric distress prolonged
system. Therefore, DERM: flushing, dyshidrosis  Atropine-like toxicity
IM or SC: Inject anticholinergic side effects may cause dose related
undiluted into a large at the central nervous GU: Urinary retention, urinary adverse reactions. Indi-
muscle mass or system do not occur. hesitancy vidual tolerance varies
subcutaneously Peripheral anticholinergic greatly
Per-orem effects result from a Resp: dyspnea, bronchial  Overdose may cause cu-
ganglion-blocking action plugging, depressed respiration rare-like effects, such as
Buscopan 10mg (white) within the visceral wall as respiratory paralysis.
well as from anti- EENT: mydriasis, dilated Keep emergency equip-
Gastro-Soothe 10mg pupils, blurred vision,
muscarinic activity. ment available.
(white) photopobia, increased
intraocular pressure, difficulty
of swallowing.
 DRUG STUDY

BRAND NAME; Prescribed and

GENERIC NAME; recommended dosage;
CLASSIFICATION frequency; route of Mechanism of action Indication Contraindication Adverse Reaction Nursing Responsibilities
administration

Brand Name: Contraindications and cautions for the use

of NSAIDs include:
Ponstel Oral Inhibition of Relief of signs and CNS: headache, dizziness,  Assess patients
prostaglandin symptoms of rheumatoid Allergy to NSAIDs or salicylate. Prevent somnolence, fatigue
Give with meals, who develop se-
synthesis thereby arthritis and osteoarthriti adverse effects.
food, or milk to CV: hypertension
Generic Name: exerting its anti- s vere diarrhea and
minimize GI adverse Allergy to sulfonamides. Contraindicatio
Mefenamic Acid effects. inflammatory, vomiting for de-
Relief of mild to n with celecoxib.
analgesic, and hydration and
moderate pain GI: nausea, dyspepsia, GI
Do not use drug for a antipyretic effects. CV dysfunction or hypertension. Varying
period exceeding 1 Treatment of primary effects of prostaglandins pain, constipation, diarrhea, electrolyte imbal-
Therapeutic
Classification: wk (manufacturer’s dysmenorrhea flatulence ance.
NSAID’s warning) Peptic ulcer or known
Fever reduction GI bleeding. Potential to exacerbate  Lab tests: With
GI bleeding. long-term therapy
Hema: bleeding, platelet
Pregnancy or lactation. Potential adverse inhibition, bone (not recom-
effects on the neonate or mother. marrow depression mended) obtain
Renal or hepatic dysfunction. Can alter periodic complete
metabolism and excretion of the drug. blood counts, Hct
Any other known allergies. Indicate and Hgb, and kid-
increased sensitivity.
ney function tests.

Pharmacokinetics
T1/2: -1.8 – 2.5 hrs.
Metabolism: liver
Excretion: urine

Route: PO

Onset: 30 min

Peak: 1-2hr

Duration: 4-6 hr

Route: IV

Onset: start of infusion

Peak: minutes

Duration: 4-6 hr
 DRUG STUDY

BRAND NAME; Prescribed and recommended

GENERIC NAME; dosage; frequency; route of
CLASSIFICATION administration
 Mechanism of action Indication Contraindication Adverse Reaction Nursing Responsibilities

 Assess BP, pulse, and

respirations before
Brand Name:
and periodically dur-
HYDROcodone/ibuprofen PO (Adults): Analgesic—2.5– 10 Bind to opiate Extended-release Hypersensitivity to CNS: confusion, dizziness, ing administration. If
mg q 3– 6 hr as needed; if using receptors in the CNS. product: hydrocodone (cross- sedation, euphoria, respiratory rate is
combination products, Alter the perception Management of sensitivity may exist to other hallucinations, headache, 10/min, assess level
Generic Name: acetaminophen dosage should not of and response to pain that is severe opioids); Significant unusual dreams. of sedation. Physical
exceed 4 g/day and should not painful stimuli while enough to warrant respiratory depression; stimulation may be
Reprexain EENT: blurred vision, sufficient to prevent
exceed 5 tablets/day of ibuprofen- producing generalized daily, around-the- Paralytic ileus; Acute or
diplopia, miosis. significant hypoventi-
containing products; Antitussive— CNS depression. clock, long-term severe bronchial asthma or
lation. Dose may need
5 mg q 4– 6 hr as needed; Suppress the cough opioid treatment hypercarbia; Congenital long Resp: respiratory to be decreased by
Extended-release (Zohydro ER)— reflex via a direct where alternative QT syndrome (Hysingla depression. 25– 50%. Initial
10 mg q 12 hr; mayqas needed in central action treatment options only); Hypersensitivity to drowsiness will dimin-
Therapeutic: allergy, increments of 10 mg q 12 hr q 3– are inadequate acetaminophen/ibuprofen ish with continued
cold, and cough remedies 7 days; Extendedrelease (for combination products); CV: hypotension, use.
(antitussive), opioid (Hysingla)—20 mg once daily; Ibuprofen-containing bradycardia, QT interval  Assess bowel func-
analgesics mayqas needed in increments of products should be avoided prolongation (Hysingla tion routinely. Preven-
Pharmacologic: opioid 10– 20 mg/day q 3– 5 days. in patients with bleeding tion of constipation
only).
agonists/nonopioid disorders or should be instituted
analgesic combinatio thrombocytopenia; with increased intake
Acetaminophen-containing of fluids and bulk, and
PO (Children): Analgesic (1– 13 GI: constipation, dyspepsia, laxatives to minimize
yr)—0.1– 0.2 mg/ kg q 3– 4 hr. products should be avoided nausea, choking, constipating effects.
Antitussive —0.6 mg/kg/day in patients with severe dysphagia, esophageal Stimulant laxatives
divided q 6– 8 hr; (maximum hepatic or renal disease; obstruction, vomiting. should be adminis-
doses 2 yr: 1.25 mg/dose; 2– 12 Ibuprofen-containing tered routinely if opi-
yr: 5 mg/dose; 12 yr: 10 mg/dose). products should be avoided oid use exceeds 2– 3
in patients undergoing days, unless con-
GU: urinary retention.
coronary artery bypass graft traindicated.
Endo: adrenal insufficiency.
surgery; OB, Lactation:  Pain: Assess type, lo-
Avoid chronic use; Products cation, and intensity
containing alcohol, of pain prior to and 1
Derm: sweating. hr (peak) following
aspartame, saccharin, sugar,
or tartrazine (FDC yellow administration. When
dye #5) should be avoided in titrating opioid doses,
patients who have Misc: physical dependence, increases of 25– 50%
psychological dependence, should be adminis-
hypersensitivity or
tolerance tered until there is ei-
intolerance to these
ther a 50% reduction
compounds in the patient’s pain
rating on a numerical
or visual analogue
scale or the patient
Pharmacokinetics reports satisfactory
pain relief. A repeat
dose can be safely ad-
ministered at the time
Absorption: Well absorbed of the peak if previous
following oral dose is ineffective and
administration. side effects are mini-
mal.
 Patients taking ex-
Distribution: Unknown. tended-release hy-
drocodone may re-
quire additional short-
acting or rapid-onset
Metabolism and Excretion:
opioid doses for
Mostly metabolized by the breakthrough pain.
liver; eliminated in the urine Doses of short-acting
(50– 60% as metabolites, opioids should be
10% as unchanged drug). equivalent to 10– 20%
of 24 hr total and
given every 2 hr as
needed.
 Half-life: 2.2 hr; Extended-
release—8 hr.
 Prolonged use may
 Assess risk for opioid
 An equianalgesic
chart (see Appendix J)
should be used when
changing routes or
when changing from
one opioid to an-
other.
lead to physical and
psychological depen-
dence and tolerance.
This should not pre-
vent patient from re-
ceiving adequate
analgesia. Most pa-
tients who receive
opioids for pain do
not develop psycho-
logical dependence. If
progressively higher
doses are required,
consider conversion
to a stronger opioid.
addiction, abuse, or
misuse prior to ad-
ministration. Abuse or
misuse of extended-
release preparations
by crushing, chewing,
snorting, or injecting
dissolved product will
result in uncontrolled
delivery of hy-
 drocodone and can
result in overdose and
death. Hysingla ER
and Zohydro ER are
abuse deterrent for-
mulations that are
difficult to crush and,
if crushed, result in a
gel.
 Cough: Assess cough
and lung sounds dur-
ing antitussive use.
 Lab Test Considera-
tions: May causeq-
plasma amylase and
lipase concentrations.
 Toxicity and Over-
dose: If an opioid an-
tagonist is required to
reverse respiratory
depression or coma,
naloxone is the anti-
dote. Dilute the 0.4-
mg ampule of nalox-
one in 10 mL of 0.9%
NaCl and administer
0.5 mL (0.02 mg) by IV
push every 2 min. For
children and patients
weighing 40 kg, dilute
0.1 mg of naloxone in
10 mL of 0.9% NaCl
for a concentration of
10 mcg/mL and ad-
 minister 0.5 mcg/kg
every 2 min. Titrate
dose to avoid with-
drawal, seizures, and
severe pain

DRUG STUDY

BRAND NAME; Prescribed and

GENERIC NAME;
CLASSIFICATION
recommended dosage;
Mechanism of action Indication Contraindication Adverse Reaction Nursing Responsibilities
frequency; route of
administration
Brand Name:
CELECOXIB PO (Adults):
Osteoarthritis—200 mg
once daily or 100 mg
twice daily. Rheumatoid
Generic Name:
arthritis—100– 200 mg
CeleBREX twice daily. Ankylosing
spondylitis—200 mg once
daily or 100 mg twice
daily; dose may be
Therapeutic:
increase after 6 wk to 400
antirheumatics,
mg daily. Acute pain,
nonsteroidal anti-
including dysmenorrhea
inflammatory — 400 mg initially, then a
agents 200-mg dose if needed on
Pharmacologic:
the first day; then 200 mg
COX-2 inhibitors
twice daily as needed.
Hepatic Impairment
PO (Adults): Moderate
hepatic impairment
(ChildPugh Class B)—
decrease dose by 50%.
PO (Children >2 yr, >10
kg, <25 kg): Juvenile
rheumatoid arthritis—50
mg twice daily. PO
(Children >2 yr, >25 kg):
Inhibits the enzyme COX- Relief of signs and Contraindicated in:
2. This enzyme is required symptoms of Hypersensitivity; Cross-
for the synthesis of osteoarthritis, sensitivity may exist with
prostaglandins. Has rheumatoid arthritis, other NSAIDs, including
analgesic, anti- ankylosing spondylitis, aspirin; History of allergic-
inflammatory, and and juvenile type reactions to
antipyretic properties. rheumatoid arthritis. sulfonamides; History of
Management of acute asthma, urticaria, or allergic-
pain including primary type reactions to aspirin or
dysmenorrhea. other NSAIDs, including the
aspirin triad (asthma, nasal
polyps, and severe
hypersensitivity reactions to
aspirin); Advanced renal
disease; Severe hepatic
dysfunction; Coronary artery
bypass graft (CABG) surgery;
OB: Should not be used in
late pregnancy (may cause
premature closure of the
ductus arteriosus).
CNS: dizziness, headache, ● Assess range of motion,
insomnia. degree of swelling, and pain in
affected joints before and
periodically throughout therapy.
CV: HF, MYOCARDIAL
INFARCTION, STROKE,
THROMBOSIS, edema, ● Assess patient for allergy to
sulfonamides, aspirin, or
hypertension.
NSAIDs. Patients with these
allergies should not receive
celecoxib.
GI: GI BLEEDING, abdominal
pain, diarrhea, dyspepsia,
flatulence, nausea.
● Assess patient for skin rash
frequently during therapy.
Discontinue at first sign of rash;
Derm: EXFOLIATIVE may be lifethreatening. Stevens-
DERMATITIS, STEVENS- Johnson syndrome may develop.
JOHNSON SYNDROME, TOXIC Treat symptomatically; may
EPIDERMAL NECROLYSIS, rash. recur once treatment is stopped.
● Lab Test Considerations: May
F and E: hyperkalemia.
causeqAST and ALT levels.
● May cause hypophosphatemia,
hyperkalemia, andq BUN
Juvenile rheumatoid Pharmacokinetics
arthritis—100 mg twice
daily

Absorption: Bioavailability
unknown.

Distribution: 97% bound to

plasma proteins; extensive
tissue distribution.

Metabolism and Excretion:

Mostly metabolized by the
hepatic CYP2C9 isoenzyme;
the CYP2C9 enzyme system
exhibits genetic
polymorphism; poor
metabolizers may have
significantlyqcelecoxib
concentrations and anqrisk of
adverse effects; 3% excreted
unchanged in urine and
feces. Half-life: 11 hr.

Route: PO
Onset: 24–48 hr

Peak: unknown

Duration: 12–24 hr†