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COLLEGE OF NURSING
DRUG NAME MECHANISM OF
ACTION
Generic Name: Interferes with bacterial
Ceftriaxone cell wall synthesis and
division by binding to
Therapeutic Class: the cell wall, causing
Anti-infective the cell to die. Active
against gram-negative
and gram-positive
Pharmacologic Class:
Third-generation bacteria, with
expanded activity
cephalosporin
against gram-negative
bacteria. Exhibits
Dosage:
700 mg IVTT via drop minimal
OD immunosuppressant
activity.
A.Y. 2023-2024
1st Semester
PHARMACOLOGICAL SHEET
INDICATION CONTRAINDICATION SIDE EFFECT/ ADVERSE NURSING RESPONSIBILITIES
EFFECT
• Lower • Contraindicated with CNS: headache, confusion, Before:
respiratory allergy to hemiparesis, lethargy, 1. Consider the different rights
infections cephalosporin or paresthesia, syncope, to drug administration:
caused by penecillins seizures
CV: hypotension, • Right Assessment
streptococcus
palpitations, chest pain, • Right Patient
pneumonia
• Right Drug
• acute bacterial vasodilation
Precaution: EENT: hearing loss • Right Dose
otitis media
Use cautiously with renal
• UTIs caused by failure
GI: nausea, vomiting,
diarrhea, abdominal cramps, 2. Assess patient any known
E. coli
allergies.
• Gonorrhea oral candidiasis,
3. Assess for other
• intra-abdominal pseudomembranous colitis,
pancreatitis, Clostridium contraindications.
infections Interactions: 4. Perform physical
• PID caused by difficile–associated diarrhea
> drug-drug: increased examination for baseline
N. gonorrhea Hematologic: lymphocytosis,
nephrotoxicity with status before beginning
• skin and skin eosinophilia,
aminoglycosides; therapy to determine any
structure bleeding tendency, hemolytic
increased bleeding effects potential adverse effects
infections anemia,
with anticoagulants 5. introduce drug to the
hypoprothrombinemia,
• septicemia patient’s mother and
neutropenia,
• bone and joint educate her about its
thrombocytopenia,
infections purpose and importance
agranulocytosis,
• meningitis bone marrow depression 6. assess for hepatic and
• Lyme disease Hepatic: jaundice, renal impairment
hepatomegaly 7. assess skin status, LFTs,
Musculoskeletal: arthralgia renal function tests, culture
Respiratory: dyspnea of affected area, sensitivity
Skin: urticaria, tests
maculopapular or
erythematous rash
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Other: chills, fever,

superinfection, pain at I.M.
injection site, anaphylaxis,
serum sickness
During:
1. Consider the different rights
to drug administration:
• Right Approach
• Right Route
• Right Dose
• Right Time
• Right Principle of Care

2. check the patency of the IV

site and IV line
3. have vitamin K ready in
case
hypoprothrombinaemia
occurs
4. do not mix ceftriaxone with
any other antimicrobial
drug
5. discontinue if a
hypersensitivity reaction
occurs

After:
1. Consider the different rights
to drug administration:
• Right Education
• Right Evaluation
• Right Documentation

2. monitor ceftriaxone blood

levels in patients with
severe renal impairment
and in patients with renal
and hepatic impairment
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COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

3. advise the mother to report

severe diarrhea, difficulty
breathing, unusual
tiredness or fatigue, and
pain at the injection site
4. document and record.

Generic name: • Block • Hypertension • Contraindicated in CNS: BEFORE:

Losartan vasoconstrictor, • Diabetic patient’s • Obtain B/P , apical pulse
aldosterone- nephropathy hypertensive to • Headache immediately before each
Brand name: secretin effects • Stroke drug • Fatigue dose, in addition to
Cozaar of angiotensin prevention • Use cautiously in • Dizziness regular monitoring (bealert
II, inhibiting • Renal and patients with to fluctuations)
Therapeutic class: binding of hepatic impaired renal and CV: • Question for possibility
Antihypertensive angiotensin II impairment. hepatic function. of pregnancy.
to AT1 • Edema • Assess medication histo
Pharmacologic class: receptor Drug to drug • Chest pain (esp. diuretics).
ARBS s interactions:
GI: DURING:
Dosage: Therapeutic effect: • NSAIDs (e.g., • Maintain hydration (offer
5o mg 1 tab OD Causes vasodilation, ibuprofen, fluids frequently).
• Nausea
decrease peripheral ketorolac, • Abdominal pain
resistance, decreases naproxen) may • Assess for evidence of
• Dyspepsia
B/P. decrease effects. upper respiratory infection,
• diarrhea
• Potassium- cough.
sparing diuretics Respiratory: • Monitor B/P pulse.
(e.g., Assist with
spironolactone, ambulation if dizziness
• Cough occurs.
triamterene),
• bronchitis • Monitor daily pattern of
potassium
supplements may bowel activity, stool
increase serum SKIN: consistency
potassium. AFTER:
• Cellulitis • Caution patient to report all
Diuretics (e.g., adverse reactions and
furosemide, HCTZ),
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antihypertensive Musculoskeletal: continue taking a drug,

medications (e.g., even when feeling better.
amlodipine, Lisinopril, • Muscle cramps
valsartan) may • Myalgia
produce additive • Back or leg pain
hypotension. May
increase levels/effects of
lithium.

Generic Name: Elevates blood plasma • used to reduce • Hypersensitivity, • CNS: Headache, BEFORE:
Mannitol osmolality, resulting in swelling anuria, severe tremor, convulsions, 1. Check the name on the order
enhanced flow of water • reduce pulmonary edema di and verify patient using two
Brand Name: from tissues, including pressure or heart failure, • zziness, transient identifiers (as per hospital
Osmitrol the brain and around the severe dehydration, muscle rigidity. protocol)
cerebrospinal fluid, into brain (high ICP) metabolic edema, • CV: Edema, CHF, 2. Check the medication label and
Classification: interstitial fluid and progressive renal angina-like pain, order, the right dose of
Diuretics, Osmotic plasma. disorder, active hypotension, medication, the right route, and
Agents intracranial bleeding hypertension, the right time of administration.
Dosage and Route (except during thrombophlebitis. 3. Ask the patient about history of
150 cc IV q4H craniotomy) • Eye: Blurred vision. any drug allergies
• GI: Dry mouth, 4. Perform physical examination
DRUG-DRUG nausea, vomiting. to assess baseline status,
INTERACTIONS • Urogenital: Marked including weight, before
diuresis, urinary beginning therapy and to
Increases urinary retention, nephrosis, determine any potential
excretion of lithium, uricosuria. adverse reactions
SALICYLATES, • Metabolic: Fluid and 5. Provide a thorough patient
BARBITURATES, electrolyte education regarding:
imipramine, potassium. imbalance, • Drug and its mechanism
especially of action
hyponatremia; • Dosage of drug
dehydration, • Adverse effects of drug
acidosis. (headache, blurred
vision, and dizziness)
• Warning signs
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1st Semester

Other: With extravasation
(local edema, skin necrosis;
chills, fever, allergic
reactions).
• Safety precautions
6. Careful evaluation must be
made of the circulatory and renal
reserve prior to and during
administration of mannitol – check
for the blood pressure.
7. Measure I&O accurately
and record to achieve proper fluid
balance.
8. Prepare the medication
DURING:
1. Administer drug considering the
drug rights: route, drug, dose,
timing.
2.
3. Administer over 30-60 minutes
4. Administer IV using sterile,
filter-type administration set to
ensure against infusion of
mannitol crystals

4. When administered
peripherally, infuse slowly through
a small bore needle, placed well
within the lumen of a large vein to
minimize venous irritation; carefully
avoid infiltration
5. Do not admix with other
drugs
6. Provide comfort measures
to help the patient cope with
drug effects.
7. Provide patient education
about drug effects and warning
signs to report to enhance patient
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1st Semester

knowledge and to promote

compliance.

AFTER:
1. Report any of the following:
Thirst, muscle cramps or
weakness, paresthesia,
dyspnea, or headache.
2. Family members should
immediately report any
evidence of confusion.
3. Be alert to the possibility that a
rebound increase in ICP
sometimes occurs about 12 h
after drug administration.
Patient may complain of
headache or confusion.
4. Document administration after
giving the ordered medication.
Chart the time, route, and any
other specific information as
necessary.
5. Monitor for adverse effects (e.g.
infections, skin changes,
fatigue).
6. Evaluate patient understanding
on drug therapy by asking the
patient to name the drug, its
indication, and adverse effects
to watch for.
7. Monitor patient compliance to
drug therapy.

Generic name: It blocks two enzymes, Relief of mild to • Allergy to NSAIDs SIDE EFFECTS BEFORE
Ketorolac namely moderate pain or salicylate. Prevent CNS: headache, dizziness, • Assess for possible
cyclooxygenase (COX) adverse effects. somnolence, fatigue contraindications and
Brand name 1 and 2 present in all CV: hypertension cautions: history of allergy to
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Toradol tissues and seems to • Allergy to
be involved in many sulfonamides.
Drug Classification: body functions, like Contraindication with
NSAIDS blood clotting, stomach celecoxib.
lining, and sodium- • CV dysfunction or
Dose: water balance in the hypertension.
30 g IVTT kidney. COX-1 turns Varying effects of
arachidonic acid into prostaglandins
prostaglandins as • Peptic ulcer or
needed. COX-2 is known GI bleeding.
active at sites of trauma Potential to
or injury when more exacerbate GI
prostaglandins are bleeding.
needed. Therefore, • Pregnancy or
NSAIDs block lactation. Potential
inflammation before all adverse effects on
of the signs and the neonate or
symptoms can develop. mother.
• Renal or hepatic
dysfunction. Can
alter metabolism and
excretion of the drug.
• Any other known
allergies. Indicate
increased sensitivity.
DRUG:
• Loop diuretics:
decreased diuretic
effect
• Beta-blockers:
decreased
antihypertensive
effect
• Ibuprofen: potential
for lithium toxicity
GI: nausea, dyspepsia, GI
pain, constipation, diarrhea,
flatulence
Hema: bleeding, platelet
inhibition, bone marrow
depression
ADVERSE EFFECTS/
TOXIC REACTIONS
Respiratory: rhinitis,
hemoptysis, dyspnea
GI: GI pain, diarrhea,
vomiting, nausea
CNS: dizziness, fatigue,
insomnia, headache
Hematologic: neutropenia,
leukopenia, decreased Hgb
or Hct, bone marrow
depression
Dermatologic: sweating,
dry mucous membrane,
pruritus
DURING
• Proper
a NSAID drugs to reduce the
risk of hypersensitivity
reaction and current status of
pregnancy or lactation
because of the potential for
adverse effects on the fetus
or nursing baby.
• Perform a physical
examination to establish
baseline data before
beginning therapy to
determine the effectiveness
of the therapy and to evaluate
for the occurrence of any
adverse effects associated
with drug therapy.
• Assess neurological status,
including level of orientation,
affect and reflexes to
evaluate for CNS effects of
the drug.
• Keep an emergency
equipment readily available at
time of initial administration of
drug, in case of
hypersensitivity reaction.
administration. Administer
drug considering the drug
rights: route, drug, dose,
timing. Should be given prior
to surgery at 6am. Patients on
prolonged corticosteroid
therapy should have their
therapy tapered slowly if a
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• Oral anticoagulants: decision is made to

increased bleeding discontinue corticosteroids.
with acetaminophen • Safety and comfort
Chronic ethanol measures. Provide
ingestion: risk of toxicity appropriate safety and comfort
with acetaminophen measures if CNS effects occur
to prevent patient injury.
• Ensure follow-up. Arrange for
medical follow-up if symptoms
are not resolved after 4 to 8
weeks of therapy because
serious underlying conditions
could be causing the
symptoms.
• Provide patient
support. Offer support and
encouragement to help the
patient cope with the disease
and the drug regimen.
• Educate the patient and
significant others. Provide
thorough patient teaching,
including the drug name and
prescribed dosage; the
importance of taking the drug
whole without opening,
chewing, or crushing it; signs
and symptoms of possible
adverse effects and measures
to minimize or prevent them.

AFTER
• Inspect the skin for lesions,
rash, pruritus, and dryness to
identify possible adverse
effects.
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• Monitor for adverse effects (GI

effects, CNS changes,
dermatological effects,
respiratory effects).
• Monitor the effectiveness of
comfort and safety measures
and compliance with the
regimen.
• Evaluate the effectiveness of
the teaching plan (patient can
name the drug and dosage and
describe adverse effects to
watch for, specific measures to
avoid them, and measures to
take to increase the
effectiveness of the drug).

Generic name: Inhibits HMG-CoA Adjunct to diet for • Hypersensitivity to CNS: amnesia, abnormal Patient Monitoring
Atorvastatin reductase, which controlling LDL, total drug or its dreams,
catalyzes first step in cholesterol, components emotional lability, headache, • Monitor patient for signs
Brand name cholesterol synthesis. apolipoprotein B, and • Active hepatic hyperactivity, poor and symptoms of allergic
Lipitor this action reduces triglyceride levels and disease or coordination, malaise, response.
concentrations of to increase HDL levels unexplained, paresthesia, peripheral • Evaluate for muscle
serum cholesterol and in patients with primary persistent serum neuropathy, drowsiness, weakness (a
Drug Classification: low-density lipoproteins hypercholesterolemia transaminase syncope, weakness symptom of myositis and
HMG-CoA (LDLs), linked to and mixed elevations CV: orthostatic hypotension, possibly
reductase inhibitor increased dyslipidemia; primary • Pregnancy or palpitations, phlebitis, rhabdomyolysis).
risk of coronary artery dysbetalipoproteinemia breastfeeding vasodilation, arrhythmias • Be aware that reduction in
disease (CAD). in patients EENT: amblyopia, altered dosage and periodic
Dose: Also moderately unresponsive to diet refraction, glaucoma, eye monitoring of creatine
Tablets: 10 mg, 20 mg, increases alone; adjunct to hemorrhage, dry eyes, kinase level may be
40 mg, 80 mg concentration diet to reduce elevated considered for patients
triglyceride levels
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of high-density hearing loss, tinnitus,
lipoproteins (HDLs), epistaxis, sinusitis,
associated with pharyngitis
decreased risk of CAD. GI: nausea, vomiting,
diarrhea, constipation,
abdominal cramps,
abdominal
or biliary pain, colitis,
indigestion, dyspepsia,
flatulence, stomach ulcers,
gastroenteritis, melena,
tenesmus, glossitis,
mouth sores, dry mouth,
dysphagia, esophagitis,
pancreatitis, rectal
hemorrhage
GU: hematuria, nocturia,
dysuria, urinary frequency or
urgency, urinary retention,
cystitis, nephritis, renal
calculi,
abnormal ejaculation
decreased libido, erectile
dysfunction,
epididymitis
Hematologic: anemia,
thrombocytopenia
Hepatic: jaundice, hepatic
failure,
hepatitis
Metabolic: hyperglycemia,
hypoglycemia
Musculoskeletal: bursitis,
joint pain, back pain, leg
cramps, gout,muscle pain or
aches,myositis,myasthenia
taking drugs that may
increase atorvastatin level.
• Monitor liver function test
results
and blood lipid levels.
Patient Teaching
• Tell patient he may take
drug with or without food.
• Advise patient to
immediately report allergic
response, irregular
heartbeats, unusual
bruising or bleeding,
unusual tiredness,
yellowing of skin or eyes, or
muscle weakness.
• Caution patient to avoid
driving and other
hazardous activities until he
knows how drug affects
concentration,
alertness, and vision.
• Inform patient taking
hormonal contraceptive
that drug increases
estrogen levels. Instruct her
to tell all prescribers she’s
taking drug.
• Tell men that drug may
cause erectile
dysfunction and abnormal
ejaculation.
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gravis, neck rigidity, Encourage them to discuss

torticollis,
rhabdomyolysis
Respiratory: dyspnea,
pneumonia, bronchitis
Skin: alopecia, acne, contact
dermatitis, eczema, dry skin,
pruritus, rash, urticaria, skin
ulcers, seborrhea,
photosensitivity,
diaphoresis, toxic epidermal
necrolysis
Other: taste loss, gingival
bleeding, fever, facial
paralysis, facial or
generalized
edema, flulike symptoms,
infection, appetite changes,
weight gain, allergic reaction,
Stevens-Johnson syndrome
these issues with
prescriber.
• Tell patient he’ll undergo
regular
blood testing during
therapy.
• As appropriate, review all
other significant and life-
threatening adverse
reactions and interactions,
especially those related to
the drugs, tests, foods, and
herbs mentioned above.

Generic Name: Eperisone is a centrally • Relief of muscle BEFORE

• Hypersensitivity to 1. Central Nervous
Eperisone acting muscle relaxant spasms and • Assess for possible
eperisone or any System:
that exerts its stiffness contraindications and
of its components
Therapeutic Class: therapeutic effects • Treatment of • Drowsiness cautions: history of allergy to
Muscle relaxant through multiple musculoskeletal • Severe hepatic a NSAID drugs to reduce the
• Dizziness
mechanisms of action. conditions such impairment risk of hypersensitivity
Pharmacologic Class: Primarily, it acts by as low back • Headache reaction and current status of
• Severe renal
Centrally acting muscle modulating calcium ion pain, neck pain, impairment • Fatigue pregnancy or lactation
relxant influx into skeletal and other because of the potential for
muscle cells. This related • Active peptic ulcer 2. Gastrointestinal adverse effects on the fetus
Dosage: modulation leads to disorders disease System: or nursing baby.
50 – 150 mg/day TID inhibition of calcium ion • Adjunctive • Perform a physical
• Concurrent use • Nausea
channels, resulting in therapy in the with alcohol or examination to establish
muscle relaxation. management of • Vomiting baseline data before
other CNS
Additionally, eperisone spasticity depressants beginning therapy to
may also enhance the associated with determine the effectiveness
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inhibitory neurological • Pregnancy and • Abdominal of the therapy and to evaluate

neurotransmission conditions like lactation without discomfort for the occurrence of any
mediated by gamma- multiple physician's advice adverse effects associated
3. Cardiovascular
aminobutyric acid sclerosis or with drug therapy.
System:
(GABA) in the central spinal cord • Assess neurological status,
nervous system, further injury • Palpitations including level of orientation,
contributing to its (rapid or affect and reflexes to
muscle relaxant irregular evaluate for CNS effects of
properties. Moreover, heartbeats) the drug.
eperisone has been • Keep an emergency
• Fluctuations in
shown to possess weak equipment readily available at
blood pressure
analgesic effects, time of initial administration of
(hypotension
possibly through its drug, in case of
or
interaction with opioid hypersensitivity reaction.
hypertension)
receptors. Overall, the
combined actions of 4. Allergic Reactions: DURING
eperisone on calcium • Proper
• Rash
channels, GABA administration. Administer
neurotransmission, and • Itching drug considering the drug
potentially opioid rights: route, drug, dose,
• Hives
receptors contribute to timing. Should be given prior
its efficacy in relieving • Swelling of the to surgery at 6am. Patients on
muscle spasms and face, lips, prolonged corticosteroid
associated symptoms. tongue, or therapy should have their
throat therapy tapered slowly if a
(angioedema) decision is made to
• Difficulty discontinue corticosteroids.
• Safety and comfort
breathing
measures. Provide
5. Others: appropriate safety and comfort
measures if CNS effects occur
• Dry mouth
to prevent patient injury.
• Blurred vision • Ensure follow-up. Arrange for
medical follow-up if symptoms
are not resolved after 4 to 8
weeks of therapy because
serious underlying conditions
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COLLEGE OF NURSING
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could be causing the

symptoms.
• Provide patient
support. Offer support and
encouragement to help the
patient cope with the disease
and the drug regimen.
• Educate the patient and
significant others. Provide
thorough patient teaching,
including the drug name and
prescribed dosage; the
importance of taking the drug
whole without opening,
chewing, or crushing it; signs
and symptoms of possible
adverse effects and measures
to minimize or prevent them.

AFTER
• Inspect the skin for lesions,
rash, pruritus, and dryness to
identify possible adverse
effects.
• Monitor for adverse effects (GI
effects, CNS changes,
dermatological effects,
respiratory effects).
• Monitor the effectiveness of
comfort and safety measures
and compliance with the
regimen.
• Evaluate the effectiveness of
the teaching plan (patient can
name the drug and dosage and
describe adverse effects to
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COLLEGE OF NURSING
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1st Semester

watch for, specific measures to

avoid them, and measures to
take to increase the
effectiveness of the drug).

Generic Name: Tamsulosin:

• Treatment of • Hypersensitivity to Central Nervous System:
Tamsulosin + Finasteride Tamsulosin is a 1. Assessment:
benign prostatic tamsulosin or
selective alpha-1 • Headache
hyperplasia finasteride
Therapeutic Class: adrenergic antagonist.
(BPH) • Dizziness • Conduct a thorough
Combination drug for the It works by blocking • Use in women and
patient assessment,
treatment of benign alpha-1 adrenergic • Reduction in children • Fatigue
including medical
prostatic hyperplasia receptors in the smooth symptoms
• Concomitant use • Somnolence history, allergies,
(BPH) muscle of the prostate associated with
with alpha- current medications,
gland, bladder neck, BPH, such as Cardiovascular System:
blockers or and vital signs.
Pharmacologic Class: and urethra. By doing urinary
phosphodiesterase • Orthostatic
• Tamsulosin: so, it relaxes these frequency, • Assess the patient's
type 5 inhibitors hypotension
Selective alpha-1 muscles, leading to urgency, weak symptoms related to
(e.g., sildenafil, (particularly with
adrenergic improved urine flow stream, benign prostatic
tadalafil, Tamsulosin)
antagonist and reduced symptoms hesitancy, and hyperplasia (BPH),
vardenafil) due to
• Finasteride: 5- of BPH such as urinary nocturia • Palpitations such as urinary
the potential for
alpha-reductase hesitancy, weak • Tachycardia
hesitancy,
• Improvement in additive
inhibitor stream, and incomplete frequency, urgency,
urinary flow rate hypotensive
bladder emptying. Gastrointestinal System: nocturia, and
effects
Dosage: • Reduction in incomplete bladder
• Nausea
0.4/5 mg Finasteride: the risk of acute • Patients with emptying.
Finasteride is a 5- urinary severe hepatic • Diarrhea
alpha-reductase retention and impairment (for
• Constipation 2. Education:
inhibitor. It works by the need for finasteride)
inhibiting the enzyme 5- BPH-related • Abdominal pain
• Patients with renal • Educate the patient
alpha-reductase, which surgery
impairment Genitourinary System: about the purpose
is responsible for the (careful monitoring of the medication,
conversion of • Erectile dysfunction
is necessary) its expected effects,
testosterone to
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dihydrotestosterone • • Decreased libido potential side

(DHT) in the prostate effects, and the
• Ejaculation disorders
gland. DHT is a potent importance of
(including retrograde
androgen that compliance with the
ejaculation)
contributes to prostate prescribed regimen.
gland enlargement in • Testicular pain
• Provide instructions
BPH. By inhibiting its • Breast enlargement or on how to take the
production, Finasteride tenderness medication,
helps to reduce the size (gynecomastia, including dosage,
of the prostate gland, associated with frequency, and any
relieving urinary Finasteride) special
symptoms associated
considerations (e.g.,
with BPH and Endocrine System:
take with food or
potentially preventing
• Hormonal imbalances water).
disease progression.
(associated with
• Emphasize the
Finasteride)
The combination of need to avoid
Tamsulosin and Dermatologic System: crushing or chewing
Finasteride provides extended-release
• Rash
complementary formulations and to
mechanisms of action, • Pruritus swallow them
leading to improved • Alopecia (hair loss,
whole.
efficacy in reducing associated with
symptoms and slowing Finasteride) 3. Administration:
the progression of BPH
compared to Ocular System:
• Administer
monotherapy with
• Blurred vision Tamsulosin +
either drug alone. Finasteride
• Intraoperative Floppy
according to the
Iris Syndrome (IFIS)
prescribed dosage
during cataract
and schedule.
surgery (associated
with Tamsulosin) • Ensure accurate
calculation and
Respiratory System:
measurement of
• Nasal congestion doses, especially
for pediatric or
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• Rhinitis elderly patients who

may require dose
Musculoskeletal System:
adjustment.
• Back pain
• Administer the
• Muscle weakness or medication orally
pain with a full glass of
water, as directed,
Psychiatric System:
and monitor the
• Anxiety patient for any signs
of difficulty
• Depression
swallowing.
Hepatic System: • Document the
• Abnormal liver administration of the
function tests medication,
(associated with including the dose,
Finasteride) route, time, and any
observed adverse
reactions.

4. Monitoring:

• Monitor the patient's

response to
treatment, including
improvement in
BPH symptoms and
any adverse effects.
• Assess urinary
function regularly to
evaluate the
medication's
effectiveness in
relieving urinary
symptoms.
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• Monitor for potential

drug interactions
with other
medications the
patient is taking
concurrently.
• Monitor vital signs,
including blood
pressure, especially
during initial therapy
or dosage
adjustments.

5. Safety Precautions:

• Emphasize the
importance of
avoiding activities
that require mental
alertness, such as
driving or operating
machinery, until the
patient's response
to the medication is
known.
• Monitor for
orthostatic
hypotension,
especially in elderly
patients, by
assessing blood
pressure and
symptoms when
changing positions.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

• Educate the patient

about the risk of
dizziness or fainting
upon standing up
quickly and advise
them to rise slowly
from a sitting or
lying position.

6. Documentation:

• Document all
assessments,
interventions, and
patient education in
the medical record
accurately and
promptly.
• Record any adverse
reactions, changes
in symptoms, or
deviations from the
prescribed regimen.

Generic Name: BEFORE

• Hypertension • Hypersensitivity to
Nicardipine Nicardipine belongs to 1. Cardiovascular • Assess for possible
(high blood nicardipine or any
the class of System: contraindications and
pressure) component of the
Therapeutic Class: medications known as cautions: history of allergy to
formulation
Antihypertensive/Calcium calcium channel • Management of a NSAID drugs to reduce the
• Hypotension
Channel Blocker blockers. Its angina pectoris • Advanced aortic risk of hypersensitivity
(low blood
mechanism of action (chest pain) stenosis reaction and current status of
pressure)
Pharmacologic Class: involves blocking due to coronary pregnancy or lactation
• Cardiogenic shock
Dihydropyridine calcium calcium ion influx artery disease • Palpitations because of the potential for
channel blocker through voltage-gated (irregular adverse effects on the fetus
calcium channels in heartbeat) or nursing baby.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

Dosage: the cell membrane of • Recent myocardial • Tachycardia • Perform a physical

20 - 40 mg/day TID vascular smooth infarction (within (rapid heart examination to establish
muscle and cardiac the last month) rate) baseline data before
muscle. By inhibiting beginning therapy to
• Concurrent use • Edema
calcium influx, determine the effectiveness
with strong (swelling) of
nicardipine prevents of the therapy and to evaluate
CYP3A4 inhibitors the lower
calcium-dependent for the occurrence of any
(e.g., extremities
smooth muscle adverse effects associated
clarithromycin,
contraction, leading to • Flushing with drug therapy.
ketoconazole)
vasodilation of (redness of the • Assess neurological status,
peripheral arterioles, • Pregnancy and skin) including level of orientation,
particularly in the breastfeeding affect and reflexes to
• Bradycardia
coronary and systemic (unless benefits evaluate for CNS effects of
(slow heart
vascular beds. outweigh risks and the drug.
rate)
under close • Keep an emergency
This vasodilatory effect medical equipment readily available at
supervision) 2. Nervous System: time of initial administration of
reduces peripheral
vascular resistance, • Severe drug, in case of
which subsequently • Headache hypersensitivity reaction.
hypotension
decreases blood • Dizziness
pressure. Nicardipine's DURING
action on coronary • Weakness • Proper
arteries can also • Fatigue administration. Administer
increase coronary drug considering the drug
blood flow. • Nervousness rights: route, drug, dose,
Additionally, its effects • Tremor timing. Should be given prior
on cardiac muscle can to surgery at 6am. Patients on
lead to a decrease in prolonged corticosteroid
3. Gastrointestinal
cardiac contractility, therapy should have their
System: therapy tapered slowly if a
heart rate, and oxygen
demand, which may be decision is made to
beneficial in certain • Nausea discontinue corticosteroids.
cardiovascular • Vomiting • Safety and comfort
conditions. measures. Provide
• Abdominal appropriate safety and comfort
discomfort measures if CNS effects occur
to prevent patient injury.
DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

• Diarrhea • Ensure follow-up. Arrange for

medical follow-up if symptoms
• Constipation
are not resolved after 4 to 8
weeks of therapy because
4. Respiratory System: serious underlying conditions
could be causing the
• Dyspnea symptoms.
(shortness of • Provide patient
breath) support. Offer support and
• Cough encouragement to help the
patient cope with the disease
and the drug regimen.
5. Dermatologic • Educate the patient and
System: significant others. Provide
thorough patient teaching,
• Rash including the drug name and
prescribed dosage; the
• Sweating
importance of taking the drug
whole without opening,
6. Metabolic System: chewing, or crushing it; signs
and symptoms of possible
• Hypokalemia adverse effects and measures
(low potassium to minimize or prevent them.
levels)
• Hyperglycemia AFTER
• Inspect the skin for lesions,
(high blood
sugar levels) rash, pruritus, and dryness to
identify possible adverse
effects.
7. Musculoskeletal
System: • Monitor for adverse effects (GI
effects, CNS changes,
• Muscle dermatological effects,
cramps respiratory effects).
• Monitor the effectiveness of
comfort and safety measures
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

and compliance with the

8. Other: regimen.
• Evaluate the effectiveness of
• Visual the teaching plan (patient can
disturbances name the drug and dosage and
describe adverse effects to
• Gingival
watch for, specific measures to
hyperplasia
avoid them, and measures to
(overgrowth of
take to increase the
gum tissue)
effectiveness of the drug).

Generic Name: Clonidine is a

• Hypertension • Hypersensitivity to
Clonidine medication primarily 1. Central Nervous 1. Assessment:
(High Blood Clonidine or any
used to treat high System (CNS)
Pressure) component of the
Therapeutic Class: blood pressure
formulation • Conduct a thorough
Antihypertensive Agent (hypertension), but it's • Attention deficit
• Drowsiness assessment of the
also prescribed for hyperactivity • Severe
patient's medical
Pharmacologic Class: other conditions like disorder bradycardia • Fatigue
history, including
Alpha-2 Adrenergic ADHD, anxiety (ADHD) (abnormally slow
• Dizziness any allergies or
Agonist disorders, and heart rate)
• Anxiety previous adverse
withdrawal symptoms • Headache
disorders • Hypotension (low reactions to
Dosage: from opioid addiction. • Insomnia
blood pressure) clonidine or similar
0.1 mg PO BID Its mechanism of • Tourette
•
medications.
action involves syndrome • Cardiogenic shock Nervousness
stimulating certain • Assess baseline
• Alcohol • Concurrent use • Agitation
receptors in the brain, vital signs, including
withdrawal with monoamine
resulting in various • Depression blood pressure,
symptoms oxidase inhibitors
effects on the • Hallucinations heart rate, and
(MAOIs) or within
cardiovascular and • Opioid temperature.
14 days of • Confusion
central nervous withdrawal
discontinuing • Evaluate the
systems. symptoms • Vivid dreams
MAOIs patient's current
• Nightmares medications to
DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

• Smoking • Patients with a • Sedation check for potential

cessation aid history of syncope drug interactions.
(off-label use) (fainting) or severe 2. Gastrointestinal (GI)
cardiovascular System 2. Patient Education:
• Menopausal
disease
symptoms (off-
label use) • Use in patients • Dry mouth • Educate the patient
with severe about the purpose
• Constipation
coronary of clonidine, its
insufficiency, • Nausea potential side
recent myocardial effects, and the
• Vomiting
infarction, importance of
cerebrovascular • Diarrhea compliance with the
disease, or chronic • Abdominal prescribed regimen.
renal failure may
pain or • Instruct the patient
be contraindicated discomfort on proper
or require cautious
administration
use under close
3. Cardiovascular techniques,
supervision.
System including dosage,
• Use in patients frequency, and any
with depression or special instructions
• Bradycardia
other psychiatric (e.g., taking with
(slow heart
disorders may be food).
rate)
contraindicated or
• Advise the patient
require cautious • Hypotension
to avoid sudden
use under close (low blood
discontinuation of
supervision. pressure)
clonidine to prevent
• Orthostatic rebound
hypotension hypertension.
(drop in blood
pressure upon 3. Administration:
standing)
• Palpitations • Administer clonidine
• Edema (fluid orally as prescribed,
retention)
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COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

typically two to
4. Dermatological three times daily.
• Follow the
• Pruritus
prescribed dosage
(itching)
carefully, as the
• Rash dosing may vary
depending on the
• Sweating
patient's condition
and response to
5. Endocrine treatment.
• Monitor for adverse
• Sexual
reactions during
dysfunction
and after
(e.g.,
administration, such
impotence,
as dizziness,
decreased
drowsiness, dry
libido)
mouth, and
• Changes in constipation.
libido
• Erectile 4. Monitoring:
dysfunction
• Regularly monitor
6. Respiratory System the patient's blood
pressure and heart
• Dryness or rate to assess the
irritation of the effectiveness of
clonidine therapy.
nasal mucosa
• Monitor for signs of
• Nasal
hypotension,
congestion
especially during
the initial titration
7. Ocular period or dosage
adjustments.
• Blurred vision
DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

• Dry eyes • Assess for central

nervous system
• Conjunctivitis
(CNS) side effects,
such as sedation or
8. Other confusion,
particularly in
• Weight gain elderly patients.
• Tinnitus
(ringing in the 5. Safety Precautions:
ears)
• Warn the patient
• Muscle or joint
pain about the potential
for drowsiness or
• Withdrawal dizziness while
symptoms taking clonidine,
upon abrupt especially when
discontinuation standing up from a
(especially lying or sitting
after position.
prolonged use)
• Advise against
activities requiring
mental alertness or
coordination until
the patient's
response to
clonidine is known.
• Caution the patient
to avoid alcohol
consumption, as it
may exacerbate
CNS depressant
effects.

6. Documentation:
DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
A.Y. 2023-2024
1st Semester

• Document the
administration of
clonidine accurately
in the patient's
medical records,
including the date,
time, dosage, route,
and any observed
adverse reactions.
• Record vital signs
before and after
administration,
noting any
significant changes.