Drug Study Number 3 Repro Respi and Gastrointestinal

Drugs Affecting the Female
Reproductive System
Classification Common Generic and Indication Pharmacokinetics & Adverse Reactions Nursing Considerations
Brand Names Pharmacodynamics
Sex Hormones and o estradiol Palliation of moderate to Oral estrogens are well breakthrough bleeding, Assess:
Estrogen Receptor o estrogens, severe vasomotor absorbed through the menstrual irregularities, For possible contraindications
Modulators conjugated symptoms associated with gastrointestinal dysmenorrhea, or cautions: allergy to any
GROUP o estrogens, menopause; prevention of (GI) tract and undergo amenorrhea, and changes estrogen receptor modulators
esterifi ed postmenopausal extensive hepatic in libido. Perform a physical assessment
Sex Hormones o estropipate osteoporosis. metabolism. to establish a baseline
Estrogens fluid retention, electrolyte status before beginning
treatment of female They are excreted in the disturbances, therapy and during therapy
hypogonadism, female urine. Estrogens cross the headache, dizziness,
castration, female ovarian placenta and enter breast mental changes, weight Assess abdomen, including
failure; palliation of milk. changes, and edema. auscultation of bowel
inoperable and sounds and palpation of the
progressing breast GI effects also are fairly liver
cancer and inoperable common
prostatic cancer. and include nausea, Assess skin color, lesions, and
vomiting, abdominal texture; affect, orientation,
cramps mental status, and reflexes;
and bloating, and colitis, and blood pressure,
acute pancreatitis, pulse, cardiac auscultation,
cholestatic jaundice, and edema, and perfusion
hepatic adenoma
Complete or assist with pelvic
Actions Contraindications Drug to Drug and breast examinations.
Interactions Ensure specimen collection for
The most potent Known allergies,idiopathic barbiturates, Pap smear;
endogenous female sex vaginal bleeding, rifampin, tetracyclines, obtain a history of the
hormone, responsible for breast cancer, or any phenytoin. patient’s menstrual cycle
estrogen effects on the estrogen-dependent Nicotine, Grapefruit juice
body. cancer,thromboembolic Arrange for ophthalmic
disorders and hepatic examination (particularly if
dysfunction the patient wears contact
lenses)
Monitor the results of
laboratory tests, including
urinalysis and renal and/or
hepatic function tests
Sex Hormones and o desogestrel Treatment of progestins are well local skin irritation, Assess:
Estrogen Receptor o drospirenone amenorrhea, abnormal absorbed, undergo headache, nervousness, For possible
Modulators o etonogestrel uterine hepatic metabolism, constipation, contraindications or cautions:
o levonorgestrel bleeding due to and are excreted in the breast enlargement, and allergy to any Estrogen
GROUP o medroxyprogesterone hormonal imbalance; urine. perineal pain, Receptor Modulators
o norethindrone treatment Perform a physical
acetate of endometriosis; known to assessment to establish a
o norgestrel component of some cross the placenta and to baseline
Sex Hormones
o progesterone hormonal enter breast milk. status before beginning
Progestins contraceptives. therapy and during therapy
o ulipristal
Actions Contraindications Drug to Drug Assess abdomen, including
Interactions auscultation of bowel
Progesterone derivative Known allergies, renal or Interaction with sounds and palpation of the
that transforms hepatic disease, infl barbiturates, liver
the proliferative ammatory disease carbamazepine,
endometrium into a (PID), sexually phenytoin, Assess skin color, lesions, and
secretory transmitted diseases, griseofulvin, penicillins, texture; affect, orientation,
endometrium endometriosis, or tetracyclines, or rifampin mental status, and refl exes;
pelvic surgery, and blood pressure,
inhibits the secretion of hyperkalemia, epilepsy, pulse, cardiac auscultation,
pituitary migraine headaches, edema, and perfusion
follicle-stimulating asthma, or cardiac
hormone and luteinizing dysfunction. Complete or assist with pelvic
hormone, which and breast examinations.
prevents ovulation; Ensure specimen collection
inhibits uterine for Pap smear;
contractions. obtain a history of the
patient’s menstrual cycle
Arrange for ophthalmic

examination (particularly if
the patient wears contact
lenses)
Sex Hormones and o raloxifene Prevention and treatment Administered orally GI upset, nausea, Assess:
Estrogen Receptor o toremifene of osteoporosis in and vomiting. For possible contraindications
Modulators postmenopausal women. well absorbed from the or cautions: allergy to any
GI tract and is Changes in fluid balance Estrogen Receptor Modulators
metabolized in the liver. may also cause
headache, dizziness, Perform a physical assessment
Excretion occurs visual changes, and to establish a baseline
through the feces. It is mental changes. status before beginning
known to cross the therapy and during therapy
placenta and Hot flashes, skin rash,
GROUP enter into breast milk. edema, and vaginal Assess abdomen, including
bleeding auscultation of bowel
Estrogen Receptor sounds and palpation of the
Modulators liver
Assess skin color, lesions, and

texture; affect, orientation,
mental status, and refl exes;
and blood pressure,
pulse, cardiac auscultation,
edema, and perfusion
Actions Contraindications Drug to Drug
Interactions Complete or assist with pelvic
Increases bone mineral Known allergies, venous diazepam (Valium), and breast examinations.
density without thrombosis or ibuprofen (Motrin), Ensure specimen collection for
stimulating the smoking,pregnant and indomethacin (Indocin), Pap smear;
endometrium; modulates lactating women and naproxen obtain a history of the
effects of (Naprosyn) and Warfarin patient’s menstrual cycle
endogenous estrogen at
specifi c receptor sites. Arrange for ophthalmic
examination (particularly if
the patient wears contact
lenses)
o cetrorelix treat infertility in women well absorbed and are greatly increased risk of Assess:
o chorionic with functioning treated like endogenous multiple births and birth For possible
gonadotropin ovaries whose partners hormones within the defects; contraindications or
o chorionic are fertile. body, undergoing hepatic ovarian overstimulation cautions: allergy to any
gonadotropin metabolism and renal (abdominal pain, Fertility Drugs
o alpha excretion. distention,
o clomiphene ascites, pleural effusion); Perform a physical
o follitropin alfa Available in injectable and and headache, fluid assessment
GROUP o follitropin beta oral retention,
o ganirelix nausea, bloating, uterine Assess skin and lesions;
Fertility Drugs
o lutropin alfa bleeding, ovarian orientation, affect, and
o menotropins enlargement, reflexes; and blood
gynecomastia, and febrile pressure, pulse, respiration,
o urofollitropin
reactions and
adventitious sounds
Complete or assist with

pelvic and breast
Actions Contraindications Drug to Drug examinations
Interactions and ensure collection of
Fertility drugs work either ovarian failure, thyroid or specimen for Pap smear
directly to adrenal dysfunction,
stimulate follicles and idiopathic uterine Monitor the results of
ovulation or stimulate the bleeding, allergy laboratory tests, such as
hypothalamus to any fertility renal and hepatic function
to increase FSH and LH drug,pregnant and studies
levels, leading to ovarian lactating mother
follicular development
and maturation of ova.
Uterine Motility Drugs o ergonovine To initiate or improve rapidly absorbed after uterine Assess:
o methylergonovine uterine contractions for parenteral hypertonicity and For possible contraindications or
o oxytocin early vaginal delivery; to or oral administration, spasm, uterine cautions: allergy to any Oxytocics
GROUP stimulate or reinforce metabolized in the liver, rupture, postpartum Perform a physical assessment
labor in and excreted in urine and hemorrhage, Assess the patient’s neurological
Oxytocics selected cases of uterine feces decreased fetal heart status, including
inertia rate level of orientation, affect, reflexes,
They cross the placenta and papillary
to manage inevitable and GI upset, nausea, response.
or incomplete abortion; enter breast milk. headache, and
for second-trimester dizziness also are Monitor vital signs, including pulse
abortion; administered common. Ergonovine and blood pressure;
to control postpartum intramuscularly or and auscultate lungs for evidence of
bleeding or hemorrhage; intravenously methylergonovine adventitious
to treat can produce sounds.
lactation defi ciency. ergotism, manifested
by nausea, blood Assess labor pattern, including
pressure changes, uterine contractions,
weak pulse, dyspnea, cervical dilation and effacement, and
chest pain, fetal
numbness and status, including fetal heart rate,
coldness in rhythm, and
extremities, position. Institute electronic fetal
confusion, monitoring as
excitement, delirium, appropriate.
convulsions, and
even Evaluate uterine tone, noting any
coma. indications
of atony; assess fundal height and
uterine involution,
and amount and characteristics of
vaginal
bleeding.
Interactions Monitor the results of laboratory
Synthetic form Known allergies, renal or tests, including
stimulates the uterus, hepatic disease, coagulation studies and complete
especially cephalopelvic blood count
the gravid uterus; disproportion,
causes myoepithelium unfavorable fetal
of the lacteal glands to position,
contract, resulting in complete uterine atony,
milk ejection in or early pregnancy,
lactating women. coronary disease and
hypertension
Uterine Motility Drugs o carboprost These drugs are approved well absorbed when abdominal cramping, Assess:
o dinoprostone for use to administered. They heavy uterine bleeding, For possible
o mifepristone terminate pregnancy at are metabolized in the perforated contraindications or
12 to 20 weeks from the liver and excreted in the uterus, and uterine cautions: allergy to any
date of urine. rupture Abortifacients
the last menstrual period.
administered orally, Other adverse effects Perform a physical
GROUP intramuscular include headache, nausea assessment
Abortifacients injection or intravaginal and vomiting, diarrhea,
suppository diaphoresis (sweating), Confi rm date of last
backache, menstrual period and
and rash. estimated
duration of pregnancy
Assess vital signs, including
Actions Contraindications Drug to Drug skin and lesions; orientation
Interactions and affect; and blood
stimulate uterine activity, Known allergies, with pressure, pulse, and
dislodging active PID or acute respiration; and auscultate
any implanted cardiovascular,pregnant lung sounds
trophoblasts and and lactating
preventing implantation hepatic, renal, or Assist with or complete a
of any fertilized egg. pulmonary disease, pelvic examination, observe
asthma, for vaginal discharge, and
hypertension, or adrenal evaluate uterine tone
disease, with acute
vaginitis Monitor the results of
(inflammation of the laboratory tests, including
vagina) or scarred uterus complete blood count,
including leukocyte count,
hemoglobin, and hematocrit
Drugs Affecting the Male
Drug affecting male o danazol used to treat long-acting and is acne, edema, hirsutism Assess:
reproductive system o fluoxymesterone endometriosis, available in several (increased hair For possible
o methyltestosterone fibrocystic breast disease, forms, including depot distribution), deepening contraindications or
and hereditary (deep, slow-release) of the voice, oily cautions: allergy to any
GROUP o testosterone angioedema. injections, skin and hair, weight Androgens
Because it is an androgen, buccal systems, topical gain, decrease in breast
Androgens and hereditary gels, topical sprays, size, and Perform a physical
angioedema. urethral pellets, and a testicular atrophy. assessment
dermal patch.
Replacement therapy in flushing, sweating, Assess skin color, lesions,
hypogonadism, well absorbed and widely vaginitis, nervousness, texture, and hair
inoperable breast cancer distributed throughout and emotional lability distribution
the
body. headache (possibly Monitor affect, orientation,
related and peripheral sensation
metabolized in the liver to fluid and electrolyte
and excreted in changes), dizziness, sleep Perform abdominal
the urine. It is not known disorders examination and serum
whether androgens enter and fatigue, rash, and electrolytes,
breast altered serum serum cholesterol, and liver
milk electrolytes function tests
Interactions Arrange for radiographs of
They act to increase the Known allergies, renal or the long bones in children
retention of hepatic disease,pregnant
nitrogen, sodium, and lactating women,
potassium, and presence of prostate or
phosphorus and to breast cancer in men,
decrease the urinary thromboembolic events,
excretion of calcium. fetal abnormalities,
hepatitis,
Inhibit the hypothalamic– and intracranial
pituitary–adrenal and hypertension
gonadotropinreleasing
hormone, leading to a
drop in follicle-stimulating
hormone and luteinizing
hormone.
Drug affecting male o oxandrolone used to treat anemias, available orally prepubertal males, Assess:
reproductive system o oxymetholone certain cancers, and adverse effects include For possible
angioedema and to well virilization contraindications or
GROUP promote weight absorbed and widely (e.g., phallic enlargement, cautions: allergy to any
gain and tissue repair in distributed throughout hirsutism, increased skin Anabolic Steroids
Anabolic Steroids debilitated patients and the body. pigmentation).
protein Perform a physical
anabolism in patients who metabolized in the liver Postpubertal males may assessment
are receiving long-term and excreted in the experience inhibition
corticosteroid urine. of testicular function, Assess skin color, lesions,
therapy. gynecomastia, testicular texture, and hair
It is atrophy, priapism (a distribution
not known whether painful and continual
anabolic steroids enter erection of Monitor affect, orientation,
breast milk, the penis), baldness, and and peripheral sensation
but because of the change in libido
potential for adverse (increased or Perform abdominal
effects, another decreased). examination and serum
method of feeding the electrolytes,
baby should be used if Women may experience serum cholesterol, and liver
these drugs hirsutism, hoarseness, function tests
are needed during deepening of the voice,
lactation. clitoral enlargement, Arrange for radiographs of
baldness, the long bones in children
and menstrual
irregularities.
Interactions
promote body tissue- Known allergies, renal or oral anticoagulants and
building processes, hepatic disease, antidiabetic agents
reverse catabolic or pregnancy and lactation
tissue-destroying
processes,
and increase hemoglobin
and red blood cell mass.
Drug affecting male lprostadil Treatment of erectile metabolized to inactive pain at the injection site, Assess:
reproductive system sildenafil dysfunction in compounds infection, priapism, fi For possible
tadalafil the presence of sexual in the lungs and excreted brosis, and rash, contraindications or
vardenafi stimulation, treatment of in the urine. headache, cautions: allergy to any
pulmonary arterial flushing (related to Drugs for Treating Penile
hypertension well absorbed from the relaxation of vascular Erectile Dysfunction
gastrointestinal tract, smooth
undergo metabolism in muscle), dyspepsia, Assess baseline status
the liver, and are excreted urinary tract infection, before beginning therapy
GROUP in the diarrhea,
Drugs for Treating Penile feces. dizziness Assess skin and lesions
Erectile Dysfunction
Monitor orientation, affect,
and reflexes
Assess blood pressure,

pulse, respiration, and
adventitious
Sounds
Interactions When using alprostadil,
Inhibits presence of any organic nitrates or alpha- perform a local inspection
phosphodiesterase type 5 anatomical obstruction or adrenergic blockers, of
receptors, condition that might ketoconazole, the penis
leading to a release of predispose itraconazole, or
nitrous oxide, which to priapism, bleeding erythromycin, indinavir or Evaluate laboratory tests for
activates disorders, coronary artery ritonavir bleeding time and liver
cyclic guanosine disease, active function
monophosphate to cause peptic ulcer, retinitis
a prolonged pigmentosa, optic
smooth muscle relaxation, neuropathy,
allowing the fl ow of hypotension or severe
blood hypertension, congenital
into the corpus prolonged
cavernosum and QT interval, or severe
facilitating erection hepatic or renal disorders
Drugs Affecting the
Renal System
Diuretics agents o bendrofl treatment of well absorbed from the GI GI upset, fluid and Assess:
umethiazide hypertension as tract after electrolyte imbalances, For possible contraindications
GROUP o chlorothiazide monotherapy or in oral administration, with hypotension, and or cautions: allergy to any
o hydrochlorothiazide combination with onset of action ranging electrolyte disturbances. Thiazide Diuretics and
Thiazide Diuretics and o hydrofl umethiazide other antihypertensives. from 1 to 3 hours Thiazide-Like Diuretics
Thiazide-Like Diuretics o methyclothiazide Dizziness, vertigo,
They have peak effects orthostatic Thiazide Diuretics
Thiazide Diuretics within 4 to hypotension, nausea, Perform a physical
6 hours and duration of anorexia, vomiting, dry assessment
effects of 6 to 12 hours. mouth,
diarrhea, polyuria, Inspect the skin carefully for
They nocturia, muscle cramps, signs and symptoms of
are metabolized in the or edema; note the extent and
liver and excreted in the spasms. degree of edema
urine.
antidiabetic agents Assess cardiopulmonary
These diuretics cross the status, including blood
Actions Contraindications placenta and enter breast Drug to Drug pressure and pulse, and
milk. Interactions auscultate heart and lung
act to block the chloride Known allergies, renal or cholestyramine or sounds for abnormalities
pump. Blocking of the hepatic disease, systemic colestipol, and serum
chloride pump keeps the lupus erythematosus potassium, antidiabetic Obtain an accurate body
chloride and the sodium (SLE),pregnant and agents weight
in lactating women
the tubule to be excreted Monitor intake and output
in the urine, thus and assess voiding patterns
preventing the
reabsorption of both Evaluate liver status
chloride and sodium in
the vascular Monitor the results of
system laboratory tests, including
serum
electrolyte levels, especially
potassium and calcium
Diuretics agents o chlorthalidone treatment of well absorbed from the GI GI upset, fl uid and Assess:
o indapamide hypertension as tract after electrolyte imbalances, For possible contraindications or
GROUP o metolazone monotherapy or in oral administration, with hypotension, and cautions: allergy to any Thiazide
combination with onset of action ranging electrolyte disturbances. Diuretics and
Thiazide Diuretics and other antihypertensives. from 1 to 3 hours Thiazide-Like Diuretics
Thiazide-Like Diuretics Dizziness, vertigo, Thiazide-Like Diuretics
They have peak effects orthostatic Perform a physical assessment
Thiazide-Like Diuretics within 4 to hypotension, nausea,
6 hours and duration of anorexia, vomiting, dry Inspect the skin carefully for
effects of 6 to 12 hours. mouth, signs and symptoms of
diarrhea, polyuria, edema; note the extent and
They nocturia, muscle cramps, degree of edema
are metabolized in the or
liver and excreted in the spasms. Assess cardiopulmonary status,
urine. including blood
antidiabetic agents pressure and pulse, and
These diuretics cross the auscultate heart and lung
Actions Contraindications placenta and enter breast Drug to Drug sounds for abnormalities
milk Interactions
act to block the chloride Known allergies, renal or cholestyramine or Obtain an accurate body weight
pump. Blocking of the hepatic disease, systemic colestipol, and serum
chloride pump keeps the lupus erythematosus potassium, antidiabetic Monitor intake and output and
chloride and the sodium (SLE),pregnant and agents assess voiding patterns
in lactating women
the tubule to be excreted Evaluate liver status
in the urine, thus
preventing the Monitor the results of
reabsorption of both laboratory tests, including
chloride and sodium in serum
the vascular electrolyte levels, especially
system potassium and calcium
Diuretics agents o bumetanide indicated for the available for oral or IV Dizziness, vertigo, Assess:
o ethacrynic acid treatment of acute HF, use. Furosemide paresthesias, orthostatic For possible contraindications or
GROUP o furosemide acute pulmonary edema, may also be given IM. hypotension, rash, cautions: allergy to any Loop
o torsemide edema urticaria, nausea, Diuretics
Loop Diuretics associated with HF or with They reach peak levels in anorexia,
renal or liver disease, and 60 to vomiting, glycosuria, Perform a physical assessment
hypertension. 120 minutes (orally) or 30 urinary bladder spasm.
minutes (parenterally) Inspect the skin carefully for
and signs and symptoms of
are metabolized with a edema; note the extent and
half-life of 30 to 60 degree of edema
minutes and
Actions Contraindications excreted primarily Drug to Drug Assess cardiopulmonary status,
through urine. Interactions including blood
block the chloride pump Known allergies, renal or aminoglycosides or pressure and pulse, and
in the ascending hepatic disease, pregnant cisplatin, anticoagulants, auscultate heart and lung
loop of Henle, where and lactating women indomethacin, ibuprofen, sounds for abnormalities
normally 30% of all fi salicylates, or
ltered sodium is other nonsteroidal anti- Obtain an accurate body weight
reabsorbed. This action infl ammatory agents
decreases the Monitor intake and output and
reabsorption of assess voiding patterns
sodium and chloride.
Evaluate liver status

serum
Diuretics agents o acetazolamide Adjunctive treatment of well absorbed after oral hyperkalemia, which can Assess:
o methazolamide open-angle administration, cause lethargy, confusion, For possible contraindications
glaucoma, secondary are protein bound, and ataxia, muscle cramps, or cautions: allergy to any
glaucoma; preoperative are widely distributed. and cardiac arrhythmias. Carbonic Anhydrase
use in Inhibitors
acute angle-closure metabolized in the liver signs of increased Perform a physical assessment
glaucoma when delay of and primarily excreted in potassium
surgery is urine. Inspect the skin carefully for
GROUP indicated; edema caused Dizziness, headache, signs and symptoms of
by heart failure; and These diuretics cross the drowsiness, rash, edema; note the extent and
Carbonic Anhydrase druginduced placenta and enter breast cramping, diarrhea, degree of edema
Inhibitors edema. milk. hyperkalemia, hirsutism,
gynecomastia, deepening Assess cardiopulmonary
of the voice, irregular status, including blood
menses. pressure and pulse, and
auscultate heart and lung
sounds for abnormalities
Obtain an accurate body

Actions Contraindications Drug to Drug weight
Interactions
hibits carbonic anhydrase, Known allergies, renal or salicylates Monitor intake and output
which decreases hepatic disease,pregnant and assess voiding patterns
aqueous humor formation and lactating women
in the eye, intraocular Evaluate liver status
pressure, and hydrogen
secretion by the renal Monitor the results of
tubules. laboratory tests, including
serum
Diuretics agents o amiloride Prevention and treatment of available for intravenous sudden drop Assess:
o spironolactone the oliguric use. in fluid levels. For possible contraindications
phase of renal failure; Nausea, vomiting, or cautions: allergy to any
GROUP o triamterene reduction of intracranial It is freely filtered at the hypotension, Potassium-Sparing
pressure and treatment of renal glomerulus, poorly lightheadedness, Diuretics
Potassium-Sparing cerebral edema; reduction reabsorbed by the renal confusion, and Perform a physical assessment
Diuretics of elevated intraocular tubule, not secreted by headache can be
pressure (IOP); promotion the accompanied Inspect the skin carefully for
of urinary excretion of toxic tubule, and resistant to by cardiac signs and symptoms of
substances; diagnostic metabolism. decompensation and edema; note the extent and
use for measurement of even shock. degree of edema
glomerular fi ltration
rate; also available as an Assess cardiopulmonary
irrigant in transurethral status, including blood
prostatic resection and other pressure and pulse, and
transurethral auscultate heart and lung
procedures.eatment of serious sounds for abnormalities
infections caused by
susceptible bacteria Obtain an accurate body
weight
Interactions Monitor intake and output
In used intravenously to Renal or hepatic disease, and assess voiding patterns
increase hearing loss, pulmonary
the volume of fluid congestion, intracranial Evaluate liver status
produced by the bleeding,dehydration,pregnant
kidneys. Mannitol is a and lactating women Monitor the results of
sugar that is not well laboratory tests, including
reabsorbed by the serum
tubules; it acts to pull electrolyte levels, especially
large amounts of fl uid potassium and calcium
into the urine due to
the osmotic pull exerted
by the large sugar
molecule.hibits protein
synthesis in susceptible
strains of gram-negative
bacteria causing cell
death
Diuretics agents o mannitol Treatment of serious Poorly absorbed from the Ototoxicity and Assess:
infections caused by GI tract, but rapidly nephrotoxicity are the For possible
susceptible bacteria absorbed after IM most significant contraindications or
GROUP injection, reaching peak cautions: allergy to any
Osmotic Diuretics levels within 1 hour Osmotic Diuretics
Widely distributed
throughout the body, Perform a physical
crossing the placenta and assessment
entering breast milk Perform culture and
Excreted unchanged in sensitivity tests
the urine and have an
average half-life of 2 to 3 Note respiratory rate and
Actions Contraindications hours Drug to Drug auscultate lungs for
Depend on the kidney for Interactions adventitious
Inhibits protein synthesis Known allergies, renal or excretion and are toxic to sounds
in susceptible strains of hepatic disease, hearing the kidney
gram-negative bacteria loss
causing cell death
Drug affecting urinary o cinoxacin used to treat chronic UTIs, taken orally, is rapidly nausea, Assess:
tract and bladder o fosfomycin as adjunctive absorbed, undergoes vomiting, diarrhea, For possible
o methenamine therapy in acute cystitis hepatic metabolism, and anorexia, bladder contraindications or
and pyelonephritis, and as is excreted in urine. irritation, and cautions: allergy to any
o methylene blue prophylaxis with urinary dysuria Infrequent Urinary Tract
o nitrofurantoin tract anatomical used in symptoms include Anti-Infectives
o norfl oxacin abnormalities lower doses in the pruritus,
and residual urine presence of renal urticaria, headache, Perform a physical
disorders. impairment because dizziness, nervousness, assessment
GROUP it is not excreted properly and confusion.
if the kidney is impaired. Inspect the skin
Urinary Tract
Anti-Infectives Assess level of
consciousness and monitor
orientation
and reflexes
Assess urinary elimination

patterns, including amount
and episode frequency, and
Actions Contraindications Drug to Drug for complaints of frequency,
Interactions urgency, pain, or difficulty
act specifi cally within the Known allergies, renal or Because these drugs are voiding
urinary tract to destroy hepatic disease,pregnant from several different
bacteria, either through a and lactating women chemical Monitor laboratory test
direct classes, the drug–drug results, including urinalysis
antibiotic effect or interactions that can and urine culture and
through acidifi cation of occur are sensitivity
the urine. very specific to the drug
being used.
Drug affecting urinary o darifenacin Relief of symptoms of administered orally with nausea, vomiting, dry Assess:
tract and bladder o fesoterodine bladder instability the mouth, nervousness, For possible
o flavoxate associated with exception of oxybutynin, tachycardia, and vision contraindications or
uninhibited neurogenic which is given not only changes. cautions: allergy to any
GROUP o oxybutynin and refl ex orally Urinary Tract
o solifenacin neurogenic bladder; but is also available as a Antispasmodics
Urinary Tract o tolterodine treatment of signs and dermal patch and a
Antispasmodics o trospium symptoms topical gel. Perform a physical
of overactive bladder. assessment
These drugs are rapidly
absorbed, have a slow Inspect the skin
onset of
action, and have a Assess level of
duration of action of 6 to consciousness, orientation,
Actions Contraindications 12 hours. Drug to Drug and reflexes
Interactions
Acts directly to relax Known allergies, renal or metabolized in the Oxybutynin, antifungals or Assess urinary elimination
smooth muscle in the hepatic disease, pyloric or liver and excreted in antiviral agents, QT pattern, including
bladder; inhibits the duodenal obstruction or urine. They cross the interval amount and frequency of
effects of acetylcholine at recent surgery, glaucoma, placenta and (antihistamines, episodes, and for any
muscarinic receptors. myasthenia gravis, are found in breast milk. antipsychotics), complaints of frequency,
or acute ketoconazole or other urgency, pain, or difficulty
haemorrhage,pregnant cytochrome voiding
and lactating women. P450 (CYP) 3A4 inhibitors,
digoxin, morphine, Arrange for
metformin, and tenofovir ophthalmological
examination, including
intraocular pressure
Assess vital signs, including

pulse,

laboratory tests, such as
urinalysis
and urine culture and
sensitivity
Drug affecting urinary phenazopyridine Symptomatic relief of available for oral use and GI Assess:
tract and bladder pain, urgency, burning, has a very upset, headache, rash, For possible
frequency, and discomfort rapid onset of action. and a reddish-orange contraindications or
related to lower urinary coloring of cautions: allergy to any
tract irritation caused by It is widely distributed, the urine Urinary Tract Analgesic
infection, trauma, crossing
surgery, or the placenta and entering Perform a physical
various procedures. breast milk. assessment
GROUP t is metabolized Inspect the skin

Other Drugs Used That in the liver and excreted
Affect the Urinary Tract in urine. Assess gastrointestinal (GI)
and Bladder and hepatic function,
including auscultating bowel
Urinary Tract Analgesic
sounds
Assess urinary elimination

patterns, including color,
amount, and complaints of
frequency, dysuria, or
Actions Contraindications Drug to Drug difficulty voiding
Interactions
Has a direct, topical Known allergies, renal or antibacterial agents Monitor the results of
analgesic effect on the hepatic disease,pregnant laboratory tests, including
urinary tract mucosa; and lactating women urinalysis and urine culture
mechanism of action is and sensitivity
not
known.
Drug affecting urinary o pentosan Relief of bladder pain After oral administration, bleeding that may Assess:
tract and bladder polysulfate associated with very little of this drug is progress to hemorrhage For possible
interstitial cystitis. absorbed (3%). (related to contraindications or
o sodium the drug’s heparin cautions: allergy to any
GI tract, liver, effects), headache, Bladder Protectant
spleen, skin, bone alopecia (seen with
marrow, and periosteum. heparin-type drugs), and Perform a physical
It undergoes GI disturbances related to assessment
GROUP metabolism in the liver local Inspect the skin for color
and spleen and is irritation of the GI tract and note any evidence
Bladder Protectant excreted in of petechiae or bruising
urine. It has a half-life of
4.8 hours. Assess vital signs for
changes
It is not known
whether the drug crosses Assess the urinary
the placenta or enters elimination pattern
breast
Actions Contraindications milk due to the lack of Drug to Drug Monitor laboratory test
adequate studies of the Interactions results, including liver
Adheres to the bladder surgery, pregnancy, effects anticoagulants, aspirin, or function
wall mucosal membrane anticoagulation, of the drug during nonsteroidal tests and coagulation
and acts as a buffer to hemophilia pregnancy or lactation anti-infl ammatory drugs studies
control cell permeability, (NSAIDs)
preventing irritating
solutes in the urine from
reaching
the bladder wall cells.
Drug affecting urinary o alfuzosin Treatment of benign Well absorbed after oral Headache, fatigue, Assess:
tract and bladder o doxazosin prostatic hypertrophy. administration, reaching dizziness, postural For possible
GROUP o tamsulosin peak levels in 2 to 8 dizziness, lethargy, contraindications or
o terazosin hours, and undergo vertigo, tachycardia, cautions: allergy to any
Drugs for Treating Benign extensive hepatic palpitations, Drugs for Treating Benign
Prostatic Hyperplasia metabolism. nausea, dyspepsia, Prostatic Hyperplasia
Alpha-Adrenergic Blockers diarrhea, sexual Alpha-Adrenergic Blockers
They are excreted in dysfunction, rash.
urine. Perform a physical
assessment
Inspect the skin
Assess cardiopulmonary
Actions Contraindications Drug to Drug status, including vital signs
Interactions especially blood pressure
Blocks postsynaptic Known allergies, renal or antihypertensives. and pulse rate, and
alpha1-adrenergic hepatic disease, heart auscultate
receptors, failure or known heart sounds and assess
which results in a dilation coronary disease, tissue perfusion
of arterioles and veins
and Assess urinary elimination
a relaxation of pattern and renal function
sympathetic effects on
the bladder and Assist with prostate
urinary tract. examination and palpation
Monitor laboratory test

results, including urinalysis,
to evaluate for possible
changes; renal and hepatic
function tests
Drug affecting urinary o dutasteride use of these drugs was rapidly absorbed from the decreased libido, Assess:
tract and bladder o finasteride associated with the GI tract after oral impotence, and sexual For possible
development of an administration, undergo dysfunction, all of which contraindications or
aggressive form of hepatic metabolism, and are related to decreased cautions: allergy to any
prostate cancer. The are excreted in feces and levels of DHT Drugs That Block
incidence was small, but urine. Testosterone Production
led to the
recommendation that this Perform a physical
information be assessment
GROUP considered when
Drugs That Block selecting an appropriate Inspect the skin
Testosterone Production drug to treat BPH.
status, including vital signs
especially blood pressure
and pulse rate, and
auscultate
heart sounds and assess
tissue perfusion
Interactions Assess urinary elimination
inhibit the intracellular Known allergies, renal or pattern and renal function
enzyme that converts hepatic disease, heart
testosterone to the failure or known Assist with prostate
potent androgen coronary disease, examination and palpation
dihydrotestosterone
(DHT), which the prostate Monitor laboratory test
gland depends on for its results, including urinalysis,
development and to evaluate for possible
maintenance changes; renal and hepatic
function tests
Drugs Acting on the Upper
and lower
Respiratory Tract
Drugs affecting upper o benzonatate Control of nonproductive rapidly drying effect on the Assess:
respiratory system o codeine cough. absorbed, metabolized in mucous membranes and For possible
o dextromethorphan the liver, and excreted in can increase the viscosity contraindications or
urine. of cautions: allergy to any
o hydrocodone respiratory tract Antitussives
They cross the placenta secretions.
and enter breast milk. Perform a physical
(GI) assessment
GROUP These drugs should not be upset, headache, feelings
used in pregnancy and of congestion, and Monitor temperature
Antitussives Lactation. sometimes
dizziness Provide other measures to
help relieve cough (e.g.,
humidity, cool
temperatures, fluids, use of
topical
lozenges) as appropriate.
Actions Contraindications Drug to Drug Provide thorough patient

Interactions teaching, including the
Depresses the cough asthma and emphysema, monoamine drug name and prescribed
center in the medulla to oxidase (MAO) inhibitors dosage, measures to help
control cough spasms. avoid adverse effects,
warning signs that may
indicate
problems, and the need for
periodic monitoring and
evaluation
Offer support and

encouragement
Drugs affecting upper o ephedrine used to relieve the applied topically, the local stinging and burning Assess:
respiratory system o oxymetazoline discomfort of nasal onset of For possible
o phenylephrine congestion that action is almost rebound contraindications or
o tetrahydrozoline accompanies the immediate and there is congestion. (Rebound cautions: allergy to any
common cold, sinusitis, less chance of systemic congestion occurs when
o xylometazoline and allergic rhinitis. effects the nasal Decongestants
passages become Topical Nasal
used when dilation of the topical decongestants congested as the drug Decongestants
GROUP nares is desired to that is absorbed is effect wears off.
facilitate medical metabolized in the liver Perform a physical
Decongestants examination or to relieve and excreted in urine assessment
the pain and
Topical Nasal
congestion of otitis media. Assess skin color and
Decongestants
temperature
Evaluate orientation and

reflexes
Monitor pulse, blood

pressure, and cardiac
Actions Contraindications Drug to Drug auscultation
Interactions
sympathomimetics, Lesion or erosion cyclopropane or Evaluate respirations and
meaning in the mucous halothane anesthesia, adventitious breath sounds
that they imitate the membranes, glaucoma, sympathomimetic
effects of the sympathetic hypertension, diabetes, drug or sympathetic- Perform bladder percussion
nervous thyroid disease, coronary blocking drug
system to cause disease, or prostate Evaluate nasal mucous
vasoconstriction, leading problems, pregnancy membrane
to decreased or lactation.
edema and infl ammation
of the nasal membranes.
Drugs affecting upper o pseudoephedrine Temporary relief of nasal generally well absorbed rebound congestion Assess:
respiratory system congestions caused and reaches feelings of anxiety, For possible
by the common cold, hay peak levels quickly—in 20 tenseness, restlessness, contraindications or
fever, sinusitis; promotion to 45 minutes. tremors, hypertension, cautions: allergy to any Oral
of nasal and sinus arrhythmias,
drainage; relief of It is widely sweating, and pallor. Decongestants
eustachian tube distributed in the body,
congestion. metabolized in the liver, Perform a physical
and primarily assessment
GROUP excreted in urine.
Assess skin color and lesions
Oral Decongestants
Evaluate orientation,
reflexes,
Monitor blood pressure,

pulse, and auscultation
Evaluate respiration and

Actions Contraindications Drug to Drug adventitious sounds
Interactions
Sympathomimetic effects, glaucoma, hypertension, cold remedies, allergy Monitor urinary output
causes diabetes, thyroid disease, medications, and flu
vasoconstriction in coronary remedies
mucous membranes of disease, and prostate
nasal problems,pregnant and
passages resulting in their lactating women.
shrinkage, which
promotes
drainage and
improvement in
ventilation.
Drugs affecting upper o beclomethasone treatment of allergic onset of action is not local burning, Assess:
respiratory system o budesonide rhinitis and to relieve immediate, and these irritation, stinging, For possible
o dexamethasone inflammation after the drugs may actually require dryness of the mucosa, contraindications or
o flunisolide removal of nasal polyps. up to 1 week to cause any and headache. cautions: allergy to any
o fluticasone changes. Topical Nasal Steroid
o triamcinolone If no effects are seen after Decongestants
3 weeks, the drug should
be discontinued.
GROUP Perform a physical
drugs are not generally assessment
Topical Nasal Steroid absorbed systemically
Decongestants Perform an intranasal
If they were to be examination
absorbed systemically,
they would have the Assess respiration and
same pharmacokinetics as adventitious sounds
other steroids
Monitor temperature

Interactions
anti-inflammatory action Acute infections,
results from their ability pregnancy
to produce or lactation.
a direct local effect that
blocks many of the
complex
reactions responsible for
the infl ammatory
response.
Drugs affecting upper o first-generation Symptomatic relief of well absorbed orally, with drying of Assess:
respiratory system o brompheniramine perennial and seasonal an the respiratory and GI For possible
o carbinoxamine rhinitis, vasomotor onset of action ranging mucous membranes, GI contraindications or
o chlorpheniramine rhinitis, allergic from 1 to 3 hours. upset and cautions: allergy to any
o clemastine conjunctivitis, nausea, arrhythmias, Antihistamines
urticaria, and They are generally dysuria, urinary
o cyclizine angioedema; also used metabolized in the liver, hesitancy, and skin
o cyproheptadine for treating with excretion in feces eruption and itching
o dexchlorpheniramine motion sickness and and associated with dryness. Assess the skin color,
GROUP o dimenhydrinate parkinsonism and as a urine. texture, and lesions
Antihistamines o diphenhydramine nighttime
o hydroxyzine sleep aid and to suppress These drugs cross the Evaluate orientation,
o meclizine coughs. placenta and enter breast affect, and reflexes
o promethazine milk
o triprolidine Assess respirations and
adventitious sounds
Evaluate liver and renal

Actions Contraindications Drug to Drug function tests
Interactions
Competitively blocks the renal or hepatic disease, anticholinergic effects,
effects of histamine at history of arrhythmias monoamine inhibitor,
H1-receptor sites; has or prolonged QT and the interaction of
atropine-like antipruritic intervals, pregnancy fexofenadine with
and or lactation ketoconazole
sedative effects or erythromycin
Drugs affecting upper o azelastine Symptomatic relief of well absorbed orally, with drying of Assess:
respiratory system o cetirizine perennial and seasonal an the respiratory and GI For possible
o desloratadine rhinitis, vasomotor onset of action ranging mucous membranes, GI contraindications or
o fexofenadine rhinitis, allergic from 1 to 3 hours. upset and cautions: allergy to any
o levocetirizine conjunctivitis, nausea, arrhythmias, Second-Generation
o loratadine urticaria, and They are generally dysuria, urinary hesitancy, (nonsedating)
angioedema; also used for metabolized in the liver, and skin
treating with excretion in feces eruption and itching
motion sickness and and associated with dryness.
GROUP parkinsonism and as a urine. Assess the skin color,
Second-Generation nighttime texture, and lesions
(nonsedating) sleep aid and to suppress These drugs cross the
coughs. placenta and enter breast Evaluate orientation, affect,
milk and reflexes
Assess respirations and

adventitious sounds
Evaluate liver and renal

Actions Contraindications Drug to Drug function tests
Interactions
Competitively blocks the renal or hepatic disease, anticholinergic effects,
effects of histamine at history of arrhythmias monoamine inhibitor,
H1-receptor sites; has or prolonged QT intervals, and the interaction of
atropine-like antipruritic pregnancy fexofenadine with
and or lactation ketoconazole
sedative effects or erythromycin
Drugs affecting upper o guaifenesin Symptomatic relief of rapidly absorbed, with an GI symptoms (e.g., Assess:
respiratory system respiratory conditions onset of nausea, vomiting, For possible
characterized by dry, 30 minutes and a duration anorexia). contraindications or
nonproductive cough of 4 to 6 hours. Some patients experience cautions: allergy to any
headache, dizziness, or Expectorant
Sites of both; occasionally, a mild
metabolism and excretion rash develops. Perform a physical
have not been reported. assessment
GROUP Assess the skin
Monitor temperature
Expectorant
Assess respirations and
adventitious sounds
Monitor orientation and

affect to monitor central
nervous system
Actions Contraindications Drug to Drug (CNS)
Interactions
Enhances the output of Known allergies,
respiratory tract fl uid by persistent
reducing the adhesiveness coughs,pregnant and
and surface tension of the lactating women.
fl uid, facilitating the
removal of viscous mucus
Drugs affecting upper o acetylcysteine Mucolytic adjunctive administered by mucolytic Assess:
respiratory system o dornase alfa therapy for abnormal, nebulization or drugs include GI upset, For possible
viscid, or inspissated by direct instillation into stomatitis, rhinorrhea, contraindications or
mucous secretions in the trachea via an bronchospasm, and cautions: allergy to any
acute and endotracheal occasionally a rash. Mucolytics
chronic tube or tracheostomy.
bronchopulmonary Perform a physical
disorders; to lessen metabolized in the liver
hepatic and assessment
GROUP injury in cases of excreted somewhat in
acetaminophen toxicity. urine. It is not known
Mucolytics whether it Assess skin color and lesions
crosses the placenta or
enters breast milk Monitor blood pressure and
pulse
long duration of action,
and its fate in the body is Evaluate respirations and
not known. adventitious sounds

Interactions
Splits links in the acute bronchospasm,
mucoproteins peptic ulcer, and
contained esophageal varices,
in the respiratory pregnancy or
mucus secretions, lactation.
decreasing the
viscosity of the
secretions; protects
liver cells from
acetaminophen effects.
Drugs affecting lower o aminophylline usual indications for these rapidly absorbed from the GI upset, nausea, Assess:
respiratory system o caffeine drugs. Unlabeled uses gastrointestinal irritability, and For possible
o dyphylline include (GI) tract when given tachycardia to seizures, contraindications or
o theophylline) stimulation of respirations orally, reaching peak brain damage, cautions: allergy to any
in Cheyne–Stokes levels within 2 hours. and even death Xanthines
respiration,
an abnormal pattern of given IV, reaching
breathing characterized peak effects within Perform a physical
by apneic minutes. They are widely assessment
GROUP periods followed by distributed
Bronchodilators/ periods of tachypnea that and metabolized in the Perform a skin examination,
Antiasthmatics may refl ect liver and excreted in urine including color and the
delayed blood fl ow presence of lesions
Xanthines
through the brain, and the cross the placenta and
treatment of enter breast milk Monitor blood pressure,
apnea and bradycardia in pulse, cardiac auscultation,
premature infants. peripheral perfusion, and
baseline electrocardiogram
Assess bowel sounds and do

Actions Contraindications Drug to Drug a liver evaluation and
Interactions monitor liver and renal
inhibit the release of GI problems, Nicotine function tests
slowreacting coronary disease,
substance of anaphylaxis respiratory dysfunction, Evaluate serum
(SRSA) and histamine, renal or theophylline levels
decreasing the bronchial hepatic disease,
swelling and narrowing alcoholism, or
that hyperthyroidism
occurs as a result of these
two chemicals.
Drugs affecting lower o arformoterol used as bronchodilators Sympathomimetics stimulation, include Assess:
respiratory system o ephedrine are beta2-selective available only as an central nervous For possible
o epinephrine adrenergic agonists. inhalant include system stimulation, GI contraindications or
GROUP That means that the arformoterol, upset, cardiac cautions: allergy to any
Sympathomimetics o formoterol at therapeutic levels formoterol, indacaterol, arrhythmias, Sympathomimetics
o indacaterol their actions are specifi isoetharine,levalbuterol hypertension,
o isoetharine c to the beta2- , pirbuterol, and bronchospasm, Perform a physical
o isoproterenol receptors found in the salmeterol. sweating, pallor, and fl assessment
o levalbuterol bronchi ushing
o metaproterenol duration of action, long- Assess reflexes and
o pirbuterol acting beta adrenergics orientation
Actions o salmeterol Contraindications have half-lives between Drug to Drug
o terbutaline 45 and 126 hours. Interactions Monitor respirations and
dilation of the bronchi cardiac disease, anesthetics adventitious sounds
with increased rate and vascular disease, These drugs are rapidly cyclopropane and
depth of respiration. arrhythmias, diabetes, distributed after halogenated Evaluate pulse, blood
This is and hyperthyroidism, injection;they are hydrocarbons. pressure, and, in certain
the desired effect when pregnancy transformed in the liver cases, a
selecting a and lactation to metabolites that are baseline
sympathomimetic as excreted in the urine. electrocardiogram
a bronchodilator
The inhaled drugs are Evaluate liver function
rapidly absorbed tests
into the lung tissue.
Isoproterenol
is available for
intravenous use.
Ephedrine is used orally
and in parenteral form
(for IV, IM, and
subcutaneous use)
They are known to cross

the placenta and to
enter breast milk
Drugs affecting lower o ipratropium Maintenance treatment available for inhalation, dizziness, headache, Assess:
respiratory system o tiotropium of bronchospasm using an inhaler fatigue, nervousness, dry For possible
associated with chronic device. mouth, sore throat, contraindications or
obstructive pulmonary palpitations, and urinary cautions: allergy to any
disease; onset of action of retention. Anticholinergics
treatment of seasonal 15 minutes when inhaled.
allergic rhinitis as a nasal Perform a physical
spray. peak effects occur in 1 to assessment
2 hours, and it has a
GROUP duration of effect of 3 to 4 Assess the skin color and
Anticholinergics hours lesions
It is generally Evaluate orientation, affect,

not absorbed and refl exes
systemically.
Assess pulse and blood
It is excreted pressure
unchanged in urine.
Actions Contraindications Drug to Drug Evaluate respirations and
Interactions adventitious sounds
Anticholinergic that blocks narrow-angle glaucoma, combined with any other
vagally mediated bladder neck obstruction anticholinergics Evaluate urinary output and
refl exes by antagonizing or prostatic hypertrophy, prostate palpation
the action of pregnancy and lactation
acetylcholine.
Drugs affecting lower o beclomethasone treatment for rapidly absorbed from the Sore throat, hoarseness, Assess:
respiratory system o budesonide bronchospasm respiratory coughing, dry mouth, For possible
o ciclesonide tract, but they take from 2 and pharyngeal and contraindications or
o fluticasone to 3 weeks to reach laryngeal fungal infection cautions: allergy to any
o triamcinolone effective Inhaled Steroids
levels, and so patients
must be encouraged to Perform a physical
take them assessment
to reach and then
GROUP maintain the effective Assess temperature
levels.
Drugs Affecting Monitor blood pressure,
Infl ammation metabolized by natural pulse, and auscultation
Inhaled Steroids systems, mostly within
the Assess respirations and
liver, and are excreted in adventitious sounds
urine.
Examine the nares to
cross the placenta and to evaluate
enter breast milk

Interactions
Decreases the acute asthma attack or
inflammatory response in status asthmaticus,
the airway; this action will pregnancy or lactation
increase airflow and
facilitate respiration in an
airway narrowed by infl
ammation.
Drugs affecting lower o montelukast Prevention and long-term These drugs are given headache, dizziness, Assess:
respiratory system o zafi rlukast treatment of orally nausea, diarrhea, For possible
o zileuton asthma in adults and abdominal pain, elevated contraindications or
children 5 years of age or They are rapidly absorbed liver enzyme cautions: allergy to any
older. from the GI tract. concentrations, Leukotriene Receptor
GROUP vomiting, generalized Antagonists
indicated for treating Zafi rlukast and pain, fever, and myalgia.
Leukotriene Receptor acute asthma attacks montelukast are Perform a physical
Antagonists extensively metabolized in assessment
the liver by the
cytochrome
P450 system and are Evaluate temperature
primarily excreted in
feces. Assess orientation and
affect
Zileuton is metabolized
Actions Contraindications and cleared through the Drug to Drug Evaluate respirations and
liver. Interactions adventitious breath sounds
act more specifi cally at Renal or hepatic propranolol, theophylline,
the site disease,pregnant and These drugs cross the terfenadine, or Evaluate liver and renal
of the problem associated lactating women. placenta and enter breast warfarin. function tests
with asthma. milk
calcium channel blockers, Perform an abdominal
Specifi cally blocks cyclosporine, evaluation
receptors for or aspirin
leukotrienes,
which are components of
slow-reacting substance
of anaphylaxis, blocking
airway edema and
processes of
inflammation in the
airway.
Drugs affecting lower o beractant Prophylactic treatment of instilled directly into the Patent ductus arteriosus, Assess:
respiratory system o calfactant infants at high risk trachea and begin intraventricular For possible
o poractant for developing respiratory to act immediately on hemorrhage, contraindications or
distress syndrome (RDS); instillation hypotension, bradycardia, cautions: allergy to any
rescue treatment of pneumothorax, Lung Surfactants
infants who have metabolized pulmonary air leak,
developed RDS. in the lungs by the normal pulmonary Perform a physical
surfactant metabolic hemorrhage, apnea, assessment
pathways. sepsis, infection.
GROUP Assess the skin temperature
and color
Lung Surfactants
Monitor respirations,
adventitious sounds,
endotracheal
tube placement and
patency, and chest
movements
Evaluate blood pressure,

Actions Contraindications Drug to Drug pulse, and arterial pressure
Interactions
Natural bovine compound Because lung surfactants Evaluate blood gases and
of lipoproteins that are used as emergency oxygen saturation
reduce the surface drugs in
tension and allow the newborn, there are no Assess temperature and
expansion of contraindications. complete blood count
the alveoli; replaces the
surfactant that is missing
in
infants with RDS.
Drugs Acting on the
Gastrointestinal System
Drugs Affecting o cimetidine Short-term treatment of available in GI effects of diarrhea Assess:
Gastrointestinal o famotidine active duodenal ulcer or oral and parenteral forms. or constipation; central For possible
Secretions o nizatidine benign gastric ulcer nervous system contraindications or
metabolized cautions: allergy to any
GROUP o ranitidine Treatment of pathological mainly in the liver; it can (CNS) effects of Histamine-2 Antagonists
hypersecretory conditions slow the metabolism of dizziness, headache,
Drugs Used to Treat such as Zollinger–Ellison many somnolence, confusion, or Perform a physical
Gastroesophageal Refl ux syndrome (blocking the other drugs that use the even hallucinations assessment
Disease and Ulcer overproduction of same metabolizing
Disease hydrochloric acid that is enzyme system. Inspect the skin for
Histamine-2 Antagonists associated evidence of lesions or rash
with these conditions).
Evaluate neurological
Prophylaxis of stress- status, including orientation
induced ulcers and acute and
upper GI bleeding affect,
Treatment of erosive Assess cardiopulmonary

gastroesophageal reflux status, including pulse,
blood
Relief of symptoms of pressure, and
heartburn, acid electrocardiogram (if
indigestion, intravenous (IV)
and sour stomach (OTC use is needed)
preparations).
Perform abdominal
Actions Contraindications Drug to Drug assessment
Interactions of liver
The H2 antagonists Known allergies, pregnant warfarin anticoagulants,
selectively block H2 women phenytoin, beta- Monitor the results of
receptors located adrenergic blockers, laboratory tests, including
on the parietal cells. alcohol, liver
Blocking these receptors quinidine, lidocaine, and renal function tests
prevents theophylline, chloroquine,
the release of gastrin, a benzodiazepines,
hormone that causes local nifedipine, pentoxifylline,
release tricyclic antidepressants
of histamine (due to (TCAs), procainamide, and
stimulation of histamine carbamazepine.
receptors),
ultimately blocking the
production of
hydrochloric acid.
Drugs Affecting o aluminum salts Symptomatic relief of Available OTC, and many The adverse effects Assess:
Gastrointestinal o calcium salts upset stomach from patients use them to self- associated with these For possible
Secretions o magaldrate hyperacidity; prophylaxis treat a variety drugs relate contraindications or
o magnesium salts for GI bleeding and stress of GI symptoms. to their effects on acid– cautions: allergy to any
o sodium ulcers; adjunctive base and electrolyte Antacids
bicarbonate treatment of severe crossing the placenta and balance
diarrhea; also entering Perform a physical
used for treatment of breast milk. Gastric rupture, systemic assessment
GROUP metabolic acidosis; may alkalosis
also be It is excreted in urine and (headache, nausea, Inspect the abdomen.
Antacids used to treat certain drug can cause irritability, weakness, Auscultate bowel sounds
intoxications to minimize serious electrolyte tetany,
uric acid crystallization. imbalance in people with confusion), hypokalemia Assess mucous membrane
renal (secondary to intracellular status
impairment. shifting of potassium),
gastric acid rebound. Monitor laboratory test
minutes. results, including serum
Many of these antacids electrolyte
Actions Contraindications are available in Drug to Drug levels and renal function
combination Interactions tests
Neutralizes or reduces Known allergies, any forms to take advantage
gastric acidity, resulting electrolyte imbalance, GI of the acid-neutralizing
in an increase in gastric obstruction,renal effect and block adverse
pH, which inhibits the dysfunction, pregnancy effects.
proteolytic activity of and lactation
pepsin.
Drugs Affecting o dexlansoprazole recommended available CNS effects of dizziness Assess:
Gastrointestinal o esomeprazole for the short-term in delayed-release oral and For possible
Secretions o lansoprazole treatment of active forms and as IV headache are commonly contraindications or
o omeprazole duodenal ulcers, preparations. seen; asthenia (loss of cautions: allergy to any
o pantoprazole GERD, erosive esophagitis, strength), Proton Pump Inhibitors
o rabeprazole and benign active gastric acid labile and are rapidly vertigo, insomnia, apathy,
ulcer; for the long-term absorbed and dream abnormalities Perform a physical
treatment of pathological from the GI tract, reaching assessment
hypersecretory peak levels in 3 to 5 GI effects can include
GROUP conditions; as hours. diarrhea, abdominal Inspect the skin for lesions,
maintenance therapy for pain, nausea, vomiting, rash, pruritus, and dryness
Proton Pump Inhibitors healing undergo extensive dry mouth, and tongue
of erosive esophagitis and metabolism in the liver atrophy. Assess neurological status,
ulcers; and in combination and are Upper respiratory tract including level of
with amoxicillin and excreted in urine. symptoms, including orientation,
clarithromycin for the cough, affect, and refl exes
treatment of no adequate studies stuffy nose, hoarseness,
H. pylori infection about whether these and epistaxis Inspect and palpate the
drugs cross the placenta abdomen
or enter less common adverse
breast milk. effects Assess respiratory status,
include rash, alopecia, including respiratory rate
pruritus, dry skin, back and rhythm; note evidence
pain, and of cough, hoarseness, and
fever. In preclinical epistaxis
studies, long-term effects
of proton
pump inhibitors included
the development of
gastric
cancer
Interactions
inhibiting Known allergies, benzodiazepines,
the hydrogen– pregnant or lactating phenytoin, and
potassium adenosine women warfarin, ketoconazole
triphosphatase and
(H+, K+-ATPase) theophylline, Sucralfate
enzyme system on the and clopidogre
secretory surface
of the gastric parietal
cells. This action blocks
the
final step of acid
production, lowering
the acid levels in
the stomach
Drugs Affecting o sucralfate Short-term treatment and rapidly absorbed after Constipation is the most Assess:
Gastrointestinal maintenance oral administration, frequently seen adverse For possible
Secretions treatment of active metabolized in the liver, effect. Diarrhea, nausea, contraindications or
duodenal ulcer; treatment and excreted in feces. indigestion, cautions: allergy to any GI
of oral gastric discomfort, and Protectant
and esophageal ulcers It crosses dry mouth
due to radiation, the placenta and may Perform a physical
chemotherapy, enter breast milk. dizziness, sleepiness, assessment
or sclerotherapy. vertigo, skin rash, and
GROUP back pain. Inspect the skin for color
and evidence of lesions or
GI Protectant Rash
Assess the patient’s

neurological status,
including
level of orientation, affect,
and refl exes
Actions Contraindications Drug to Drug Examine the abdomen;

Interactions auscultate bowel sounds to
Forms an ulcer-adherent Known allergies, renal or Sucralfate, phenytoin, evaluate gastrointestinal
complex at the hepatic disease, pregnant fluoroquinolone
duodenal ulcer site, or lactating antibiotics (e.g., ciprofl Assess mucous membrane
protecting the ulcer from oxacin, norfl oxacin), or status
acid, bile penicillamine
salts, and pepsin, Monitor the results of
promoting healing of the laboratory tests such as
ulcer; also renal
inhibits pepsin activity in function studies
gastric juices.
Drugs Affecting o misoprostol used to prevent NSAID- given orally. It is rapidly GI effects—nausea, Assess:
Gastrointestinal induced absorbed from the diarrhea, abdominal For possible
Secretions gastric ulcers in patients GI tract, metabolized in pain, fl atulence, contraindications or
who are at high risk for the liver, and excreted in vomiting, dyspepsia, and cautions: allergy to any
complications urine. constipation Prostaglandin
from a gastric ulcer (e.g.,
elderly or debilitated crosses the placenta and related to the actions
patients, patients with a enters breast milk of prostaglandins on the Perform a physical
past history of ulcer) uterus, include examination
miscarriages,
GROUP excessive bleeding, Examine the abdomen for
spotting, cramping, possible changes
Prostaglandin hypermenorrhea,
dysmenorrhea, and other Perform a pregnancy test
menstrual disorders. and assess normal
menstrual

renal and hepatic function
Actions Contraindications Drug to Drug tests
Interactions
inhibits gastric acid Known allergies, renal or
secretion and hepatic disease, pregnant
increases bicarbonate and and lactating women
mucous production in the
stomach,
thus protecting the
stomach lining
Drugs Affecting o pancrelipase Replacement therapy in available as a solution, in The adverse effects that Assess:
Gastrointestinal o saliva substitute patients with lozenge most For possible
Secretions defi cient exocrine form, and on swab sticks often occur with contraindications or
pancreatic secretions for oral administration in pancreatic enzymes are cautions: allergy to any
the related to GI Drugs Used to Treat
mouth. irritation and include Digestive Enzyme
nausea, abdominal Dysfunction
not generally absorbed cramps, and
systemically. It works diarrhea. Perform a physical
when applied to the examination
GROUP mouth.
Perform an abdominal
Drugs Used to Treat examination
Digestive Enzyme
Dysfunction Monitor mucous
membranes
status, including blood
pressure and cardiac rate
and rhythm
Actions Contraindications Drug to Drug Monitor the results of

Interactions laboratory tests, including
Replaces pancreatic Known allergies, renal or renal function tests
enzymes to aid in the hepatic disease, heart
digestion and absorption failure, hypertension,
of fats, proteins, and pregnancy and lactating
carbohydrates. women
Drugs Affecting o bisacodyl To evacuate the bowel for only minimally absorbed GI effects such as Assess:
Gastrointestinal Motility o cascara diagnostic and diarrhea, abdominal For possible
o castor oil procedures; to remove exert their therapeutic cramping, contraindications or
o senna ingested poisons from the effect directly in the GI and nausea. cautions: allergy to any
lower tract
Laxatives
gastrointestinal (GI) tract; (CNS) effects, including
an adjunct in anthelmintic Changes in absorption, dizziness, headache, and Chemical Stimulants
therapy when it is water balance, and weakness, are not
GROUP desirable to fl ush electrolytes uncommon
helminths from the resulting from GI changes and may relate to loss of
Laxatives GI tract. fluid and electrolyte Perform a physical
Chemical Stimulants imbalances examination
Sweating, palpitations,
Inspect the skin for rash
flushing, and even fainting

including level of
Actions Contraindications Drug to Drug orientation and affect
Interactions
Directly stimulates the Known allergies, renal or Obtain a baseline pulse
nerve plexus in the hepatic disease, acute rate
intestinal wall, causing abdominal disorders,
increased movement and heart block, coronary Assess bowel elimination
the artery disease (CAD), patterns, including the
stimulation of local refl or debilitation,pregnant
patient’s perception of
exes. and lacating women
normal frequency, actual
frequency, and stool
characteristics
Investigate the patient’s

nutritional intake,
including fluid intake and
ingestion of fiber-
containing foods
Assess the patient’s level

of activity
inspecting abdomen for
distention, palpating for
masses, and
auscultating for bowel
sounds
Monitor results of
laboratory tests,
including serum
electrolyte levels
Drugs Affecting o lactulose Short-term relief of all taken orally GI effects such as Assess:
Gastrointestinal Motility o magnesium constipation; to diarrhea, abdominal For possible
citrate prevent directly effective cramping, and nausea contraindications or
o magnesium straining when it is within the GI tract and cautions: allergy to any
hydroxide clinically undesirable; are not generally CNS effects, Bulk Stimulants
o magnesium to evacuate absorbed including dizziness,
sulfate the bowel for systemically. headache, and
o polycarbophil diagnostic procedures; weakness, are not Perform a physical
GROUP o polyethylene to remove rapidly acting, causing uncommon and may examination
glycolelectrolyte ingested poisons from effects as relate to loss of fl uid
Bulk Stimulants o solution the lower they pass through the and electrolyte Inspect the skin for rash
o psyllium gastrointestinal (GI) GI tract. imbalances
tract; as an adjunct in Assess the patient’s
anthelmintic therapy Sweating, palpitations, neurological status,
when it is fl ushing, including level of
desirable to fl ush and even fainting orientation and affect
helminths from the GI
tract. Obtain a baseline pulse
Actions Contraindications Drug to Drug rate
Interactions
increase the motility of Known allergies, acute nondepolarizing Assess bowel elimination
the GI tract abdominal disorders, neuromuscular junction patterns, including the
by increasing the fl uid heart block, CAD and blockers with patient’s perception of
in the intestinal debilitation, pregnancy magnesium salts normal frequency, actual
contents, which and lactation frequency, and stool
enlarges bulk, characteristics
stimulates local stretch
receptors, and Investigate the patient’s
activates nutritional intake,
local activity. including fluid intake and
ingestion of fiber-
containing foods
of activity
masses, and
sounds
Monitor results of
laboratory tests,
including serum
electrolyte levels
Drugs Affecting o docusate Short-term relief of are not absorbed GI effects such as Assess:
Gastrointestinal Motility o glycerin constipation; to systemically and are diarrhea, For possible
o mineral oil prevent straining when excreted in the feces. abdominal cramping, contraindications or
it is clinically and nausea. cautions: allergy to any
undesirable; Available in oral and Lubricants
to remove ingested suppository CNS effects, including
poisons from the lower dizziness, headache,
gastrointestinal (GI) and weakness
tract; an adjunct in Perform a physical
GROUP anthelmintic therapy loss of fl uid and examination
when it is desirable to fl electrolyte imbalances
Lubricants ush Inspect the skin for rash
helminths from the GI Sweating, palpitations,
tract. fl ushing, Assess the patient’s
and even fainting neurological status,
including level of
orientation and affect
Interactions Obtain a baseline pulse
Forms a slippery coat Known allergies, acute fat-soluble vitamins A, rate
on the contents of the abdominal disorders, D, E, and K.
intestinal tract; less heart block, CAD and Assess bowel elimination
water is absorbed out debilitation, pregnancy patterns, including the
of the and lactation patient’s perception of
bolus, and the bolus is normal frequency, actual
less likely to become frequency, and stool
hard or characteristics
impacted.
nutritional intake,
ingestion of fiber-
containing foods

of activity
masses, and
sounds
Monitor results of
laboratory tests,
including serum
electrolyte levels
Drugs Affecting o methylnaltrexone treatment of opioid- given by daily Patients may Assess:
Gastrointestinal Motility
induced constipation in subcutaneous experience abdominal For possible
patients with advanced injections. pain, flatulence, contraindications or
disease nausea, dizziness, cautions: allergy to any
It reaches peak levels in and diarrhea. Severe or Other Laxatives
1/2 hour and is continued diarrhea
eliminated primarily
unchanged in the urine. Perform a physical
GROUP examination
The
Other Laxatives half-life of the drug is Inspect the skin for rash
about 8 hours.
including level of
orientation and affect
Actions Contraindications Drug to Drug Obtain a baseline pulse

Interactions rate
Opioids bind to various Known allergies, renal
receptors in or hepatic disease, Assess bowel elimination
the body, including the hearing loss patterns, including the
mu-receptors, which patient’s perception of
leads to normal frequency, actual
decreased GI motility frequency, and stool
and constipation characteristics

nutritional intake,
ingestion of fiber-
containing foods

of activity
masses, and
sounds
Monitor results of
laboratory tests,
including serum
electrolyte levels
Drugs Affecting o dexpanthenol Relief of acute and Available in oral,IV,and GI stimulants Assess:
Gastrointestinal Motility o metoclopramide chronic diabetic IM include nausea, For possible
gastroparesis; short- vomiting, diarrhea, contraindications or
term treatment of They are metabolized in intestinal spasm, and cautions: allergy to any
gastroesophageal the liver and cramping. Gastrointestinal
refl ux disorder in excreted in feces and Stimulants
adults who cannot urine. declining blood
tolerate standard pressure and heart
GROUP therapy; prevention of crosses the rate, weakness, and Perform a physical
postoperative or placenta and enters fatigue, may be examination
Gastrointestinal chemotherapyinduced breast milk; related to
Stimulants nausea and vomiting; dexpanthenol may parasympathetic
facilitation of small cross stimulation, Perform an abdominal
bowel intubation; the placenta and enter extrapyramidal examination, including
stimulation of gastric breast milk. effects, and Parkinson- inspecting
emptying; like syndrome. for distention, palpating
promotion of intestinal for masses, and checking
transit of barium. bowel
Actions Contraindications Drug to Drug sounds
Interactions
stimulating Known allergies, GI Digoxin, cyclosporine,
parasympathetic obstruction immunosuppressant, Assess cardiopulmonary
activity within the GI or perforation, alcohol or other CNS status, including pulse
tract, these drugs pregnancy or lactation sedative drugs and
increase GI secretions blood pressure
and motility on
a general level Inspect skin for color and
throughout the tract evidence of lesions or
rash
Drugs Affecting o bismuth indicated for the relief absorbed from the GI constipation, Assess:
Gastrointestinal Motility subsalicylate of tract distention, abdominal For possible
o loperamide symptoms of acute and after oral discomfort, contraindications or
o opium chronic diarrhea, administration, nausea, vomiting, dry cautions: allergy to any
derivatives) reduction of metabolized in the mouth, and even toxic Antidiarrheals
volume of discharge liver, and excreted in megacolon
from ileostomies, and urine
prevention and fatigue, weakness, Perform a physical
GROUP treatment of traveler’s dizziness, and skin rash. examination
diarrhea It crosses the placenta,
Antidiarrheals but it is not sedation, euphoria, Inspect the skin for color
known whether it hallucinations, and and evidence of lesions
enters breast milk. respiratory or
depression related to Rash
Loperamide is effect on the opioid
slowly absorbed after receptors Perform an abdominal
oral administration, examination, including
Actions Contraindications metabolized Drug to Drug inspecting
Interactions
Antidiarrheal agents Known allergies, renal in the liver, and antidiarrheal for distention, palpating
slow the motility of the or hepatic disease, GI excreted in urine and agent. for masses, and
GI tract obstruction; acute feces. auscultating
through direct action abdominal conditions bowel sounds, to
on the lining of the GI It may cross evaluate GI function
tract to the placenta and enter
inhibit local refl exes breast milk. Assess bowel elimination
(bismuth subsalicylate), pattern, including
through frequency
direct action on the and characteristics of
muscles of the GI tract stool
to slow activity
(loperamide), or Assess the patient’s
through action on CNS neurological status,
centers that including level
cause GI spasm and of orientation and affect
slowing (opium
derivatives;
Drugs Affecting o alosetron Use for irritable bowel has very nausea Assess:
Gastrointestinal Motility o lubiprostone syndrome little systemic For possible
GROUP o hyoscyamine (IBS) with diarrhea absorption. contraindications or
being the predominant cautions: allergy to any
Irritable Bowel complaint. taken orally with plenty Irritable Bowel Syndrome
Syndrome of Drugs
Drugs water and food at a
dose of 8 mcg twice a
day for IBS or Perform a physical
24 mcg twice a day for examination
chronic constipation
Inspect the skin for color
and evidence of lesions
or
Actions Contraindications Drug to Drug Rash
Interactions
blocks specific
serotonin receptors in Perform an abdominal
the enteric examination, including
nervous system of the inspecting
GI tract, which leads to for distention, palpating
decreased for masses, and
perception of auscultating
abdominal pain and bowel sounds, to
discomfort, decreased evaluate GI function
GI motility, and
increased colon transit Assess bowel elimination
time pattern, including
frequency
and characteristics of
stool

including level
of orientation and affect
Antiemetic Agents o chlorpromazine treatment of nausea available as tablets or normal CNS stimulation Assess:
o perphenazine and vomiting, as syrup for oral or response. For possible
GROUP o prochlorperazine including that specifi administration, as Drowsiness, dizziness, contraindications or
cally associated with rectal suppositories, weakness, tremor, and cautions: allergy to any
o promethazine
anesthesia, and as solution headache are Antiemetic Agents
Antiemetic Agents
severe vomiting, and for intramuscular (IM) common adverse Phenothiazines
Phenothiazines
intractable hiccoughs, or intravenous (IV) use. effects. Other, not
which occur uncommon adverse Perform a physical
with repetitive rapid onset of action of effects include examination
stimulation of the 5 to 20 minutes and hypotension,
diaphragm and lead a duration of action of hypertension, and Assess the patient’s
to persistent 3 to 12 hours, cardiac neurological status,
diaphragm spasm depending on route arrhythmias. including level
of administration. of orientation, affect, and
dry mouth, nasal reflexes,
metabolized in the liver congestion, anorexia,
and pallor, sweating, and Assess cardiopulmonary
excreted in the urine. urinary retention status, including baseline
often occur with pulse and blood pressure
known to cross the phenothiazines
placenta and evidence of lesion or
and enter breast milk. Rash
Actions Contraindications Drug to Drug Examine the abdomen,

Interactions including the liver, and
centrally acting coma or severe central CNS depressants, auscultate bowel sounds
antiemetics that nervous system (CNS) including alcohol.
change the depression Assess complaints of
nausea and evaluate
responsiveness or or in those who have
emesis; note
stimulation of the CTZ experienced brain color, amount, and
in damage or injury, frequency of vomiting
the medulla hypotension or episodes
hypertension
Mechanism of action and severe liver Monitor laboratory test
not understood; dysfunction, pregnancy results, including liver and
depresses various areas and renal function tests
of the central nervous lactation
system,
including the
chemoreceptor trigger
zone in the
medulla.
Antiemetic Agents o metoclopramide Slows gastrointestinal Available on Oral,IV and Drowsiness, fatigue, Assess:
activity, sedating. IM restlessness, For possible
extrapyramidal contraindications or
symptoms, diarrhea. cautions: allergy to any
Nonphenothiazine
Perform a physical
GROUP examination

Nonphenothiazine
including level
of orientation, affect, and
reflexes,
status, including baseline
Actions Contraindications Drug to Drug pulse and blood pressure
Interactions
Prevention of nausea Known allergies CNS depressants,
and evidence of lesion or
and vomiting ,pregnancy and including Rash
associated lactation alcohol.
with emetogenic Examine the abdomen,
cancer chemotherapy, including the liver, and
prevention of auscultate bowel sounds
postoperative nausea
and vomiting. Assess complaints of nausea
and evaluate emesis; note
color, amount, and
frequency of vomiting
episodes

results, including liver and
renal function tests
Antiemetic Agents o buclizine Prevention and given orally, reaching dry mouth, nasal Assess:
o cyclizine treatment of nausea peak levels in congestion, For possible
o meclizine and 1 to 2 hours and lasting anorexia, pallor, contraindications or
vomiting, motion 6 to 24 hours, sweating, and urinary cautions: allergy to any
sickness. depending on the drug retention often Anticholinergics/
being used occur. Drowsiness, Antihistamines
confusion, hypotension,
metabolized in the liver and respiratory
GROUP and are excreted in depression Perform a physical
urine and feces. examination
Anticholinergics/
Antihistamines known to cross Assess the patient’s
the placenta and enter neurological status,
breast milk. including level
reflexes,
Actions Contraindications Drug to Drug status, including baseline
Interactions pulse and blood pressure
act as antihistamines Known allergies CNS depressants,
and block the narrow-angle including Inspect the skin for color
transmission of glaucoma, benign alcohol. and evidence of lesion or
impulses to the prostatic hyperplasia, Rash
CTZ. They are peptic ulcer disease,
recommended for the bronchial asthma, and Examine the abdomen,
nausea and vomiting hypotension,pregnancy including the liver, and
associated with motion and lactation auscultate bowel sounds
sickness or vestibular
(inner Assess complaints of
ear) problems. nausea and evaluate
emesis; note
color, amount, and
episodes

results, including liver
and
Antiemetic Agents o dolasetron Control of severe rapidly absorbed, Ototo headache, Assess:
o granisetron nausea and vomiting reaching peak levels dizziness, and myalgia For possible
o ondansetron associated with within 1 hour. related to their contraindications or
emetogenic cancer CNSxicity and cautions: allergy to any 5-
o palonosetron chemotherapy, metabolized nephrotoxicity are the HT3 Receptor Blockers
radiation therapy; in the liver and most significant
treatment of excreted in urine.
postoperative nausea Perform a physical
and vomiting. Available in Oral and IV Pain at the injection examination
GROUP
site, rash, constipation,
5-HT3 Receptor hypotension, neurological status,
Blockers and urinary retention including level
reflexes,
pulse and blood pressure
Interactions and evidence of lesion or
Blocks specifi c receptor Known allergies, Rash
sites associated pregnancy and
with nausea and lactation Examine the abdomen,
vomiting, peripherally including the liver, and
and in the auscultate bowel sounds
chemoreceptor trigger
zone Assess complaints of nausea
color, amount, and
episodes

Antiemetic Agents o aprepitant use in treating the metabolized in the liver GI Assess:
nausea and and excreted in effects of diarrhea, For possible
vomiting associated urine and feces. constipation, and contraindications or
with highly emetogenic gastritis, nausea; cautions: allergy to any
antineoplastic known to cross the anorexia; headache; Substance P/Neurokinin
chemotherapy, placenta and fatigue. 1
including cisplatin and to enter breast Receptor Antagonist
therapy. milk.
GROUP
Perform a physical
examination
Substance
P/Neurokinin 1 Assess the patient’s
Receptor Antagonist neurological status,
including level
reflexes,
pulse and blood pressure
Interactions
acts directly in the CNS Known allergies, Pimozide, warfarin, and and evidence of lesion or
to block receptors pregnancy and hormonal Rash
associated with nausea lactation contraceptives
and vomiting with little Examine the abdomen,
to no including the liver, and
effect on serotonin, auscultate bowel sounds
dopamine, or
corticosteroid Assess complaints of nausea
receptors.
color, amount, and
episodes

Antiemetic Agents o dronabinol used for nausea and oral, parenteral, and Assess:
o hydroxyzine vomiting before or suppository form For possible
o nabilone after obstetrical delivery contraindications or
o trimethobenzamide or surgery. rapidly absorbed, cautions: allergy to any
metabolized in the liver, Miscellaneous Agents
and excreted in urine
crosses Perform a physical

GROUP the placenta and enters examination
breast milk
Miscellaneous Agents Assess the patient’s
including level
reflexes,
Actions Contraindications Drug to Drug pulse and blood pressure
Interactions
suppress cortical areas Known allergies, Inspect the skin for color
of the pregnancy and and evidence of lesion or
Rash
CNS; and lactation.
trimethobenzamide Examine the abdomen,
including the liver, and
auscultate bowel sounds
Assess complaints of
nausea and evaluate
emesis; note
color, amount, and
episodes


Drug Study Number 3 Repro Respi and Gastrointestinal

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Drug Study Number 3 Repro Respi and Gastrointestinal

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Drugs Affecting the Female

Arrange for ophthalmic

Assess skin color, lesions, and

Complete or assist with

Assess blood pressure,

Monitor the results of

Obtain an accurate body

Assess urinary elimination

Assess vital signs, including

Monitor the results of

GROUP t is metabolized Inspect the skin

Assess urinary elimination

Inspect the skin

Monitor laboratory test

Actions Contraindications Drug to Drug Provide thorough patient

Offer support and

Evaluate orientation and

Monitor pulse, blood

Monitor blood pressure,

Evaluate respiration and

Actions Contraindications Drug to Drug

Evaluate liver and renal

Assess respirations and

Evaluate liver and renal

GROUP Assess the skin

Monitor orientation and

Actions Contraindications Drug to Drug

Assess bowel sounds and do

They are known to cross

It is generally Evaluate orientation, affect,

Actions Contraindications Drug to Drug

Evaluate blood pressure,

Treatment of erosive Assess cardiopulmonary

Assess the patient’s

Actions Contraindications Drug to Drug Examine the abdomen;

Monitor the results of

Actions Contraindications Drug to Drug Monitor the results of

Assess the patient’s

Investigate the patient’s

Assess the patient’s level

Assess the patient’s level

Actions Contraindications Drug to Drug Obtain a baseline pulse

Investigate the patient’s

Assess the patient’s level

Assess the patient’s

Actions Contraindications Drug to Drug Examine the abdomen,

Assess the patient’s

Monitor laboratory test

Monitor laboratory test

Monitor laboratory test

Monitor laboratory test

crosses Perform a physical

Monitor laboratory test

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