CI:

DRUG NAME MECHANISM OF ACTION INDICATION/ ADVERSE EFFECTS NURSING RESPONSIBILITIES

CONTRAINDICATION
GENERIC: INDICATION:
Oxytocin - (Antepartum) Induction of labor
Activates receptors that trigger in pts with medical indication
BRAND: increase in intracellular calcium levels (e.g., at or near term), to
Pitocin in uterine myofibrils; increases stimulate reinforcement of labor,
prostaglandin production. This drug as adjunct in managing
CLASS: increases the amplitude and frequency incomplete or inevitable
Oxytocic hormone of uterine contractions, which abortion
transiently impede uterine blood flow - (Postpartum) To produce uterine
PHARMACOLOGIC: and decrease cervical activity, causing contractions during third stage
Uterine smooth muscle dilation and effacement of the cervix. of labor and to control
stimulant postpartum
Therapeutic Effect: Stimulates uterine bleeding/hemorrhage.
DOSAGE: contractions. CONTRAINDICATION:
0.5-1 milliunit/min - Hypersensitivity to oxytocin.
(Saunders Nursing drug handbook Adequate uterine activity that fails
ROUTE: 2019) to progress, cephalopelvic
IM disproportion, fetal distress without
imminent delivery, grand
multiparity
DRUG-DRUG INTERACTION:
- Caudal block anesthetics,
vasopressors may increase pressor
effects.
DRUG-FOOD INTERACTION:
- No known
Dx:
Central Nervous System: a) Identified indications for
CNS/brain damage, trauma due to treatment of therapy.
rapid propulsion b) Check and verify doctor's
order.
Cardiovascular; fetal – c) Noted any ongoing and
bradycardia previous medication intake.
d) Assessed for health status and
Gastrointestinal; nausea and noted baseline vital signs.
vomiting e) Check for history of allergies.
Tx:
Hematologic: bleeding, abruptio a) Maintain aseptic technique on
placenta IV medication site.
seizures b) Monitored and noted changes
Others: Prolonged IV infusion of in vital signs.
oxytocin with excessive fluid c) Monitored contractions that
volume has caused severe water last longer than 1 min and
intoxication with seizures, coma, notified the physician.
death d) Maintained careful Input and
Output monitoring.
Edx:
a) Educated on possible side
effects of the medication.
b) Instructed to monitor
frequency of urination and
report.
c) Promoted comfort and safety.

DRUG NAME MECHANISM OF ACTION INDICATION/ ADVERSE EFFECTS NURSING RESPONSIBILITIES

CONTRAINDICATION
GENERIC: INDICATION: Dx:
Terbutaline - Symptomatic relief of reversible - Too-frequent or excessive a) Identified indications for
Stimulates beta2 adrenergic receptors, bronchospasm due to bronchial use may lead to decreased treatment of therapy.
BRAND: resulting in relaxation of uterine and asthma, bronchitis, emphysema. drug effectiveness and/or b) Check and verify doctor's
Bricanyl bronchial smooth muscle. Therapeutic - OFF-LABEL: Delays premature severe, paradoxical order.
Effect: Inhibits uterine contractions. labor in pregnancies between 20 bronchoconstriction. c) Noted any ongoing and
CLASS: Relieves bronchospasm, reduces and 34 wks. - Excessive sympathomimetic previous medication intake.
 Beta2- adrenergic airway resistance.
agonist CONTRAINDICATION:
(Saunders Nursing drug handbook - Hypersensitivity to terbutaline.
PHARMACOLOGIC: 2019) Cardiac arrhythmias associated
Premature labor inhibitor, with tachycardia, tachycardia
bronchodilator caused by digoxin toxicity.
- (Additional) Injection: Prolonged
DOSAGE: prevention or management of
10mcg/min preterm labor.
- Oral: Prevention or treatment of
ROUTE: preterm labor.
IV
DRUG-DRUG INTERACTION:
- May decrease effects of beta
blockers (e.g., labetolol,
metoprolol).
- Digoxin, sympathomimetics (e.g.,
dopamine, norepinephrine) may
increase risk of arrhythmias.
- MAOIs (e.g., phenelzine,
selegiline) may increase risk of
hypertensive crisis.
- Tricyclic antidepressants (e.g.,
amitriptyline, nortriptyline) may
increase cardiovascular effects.
DRUG-FOOD INTERACTION:
- No known
DRUG NAME MECHANISM OF ACTION INDICATION/
CONTRAINDICATION
GENERIC: INDICATION:
Lidocaine - Antiarrhythmic: Rapid control
Anesthetic: Inhibits conduction of of acute ventricular arrhythmias
BRAND: nerve impulses. following MI, cardiac
xylocaine Therapeutic Effect: Causes temporary catheterization, cardiac surgery.
loss of feeling/ sensation. - Local anesthetic:
CLASS: Infiltration/nerve block for
Class 1B antiarrhythmic, Antiarrhythmic: Suppresses dental/surgical procedures,
anesthetic automaticity of conduction tissue; childbirth.
increases electrical stimulation CONTRAINDICATION:
PHARMACOLOGIC: threshold of ventricle, His- Purkinje - Hypersensitivity to lidocaine.
Amide anesthetic system; and spontaneous Adams-Stokes syndrome,
depolarization of ventricle during hypersensitivity to amide-type
DOSAGE: diastole. Blocks initiation/conduction local anesthetics, supraventricular
4.5 mg/kg or 300mg of nerve impulses by decreasing arrhythmias, Wolff-Parkinson-
stimulation may cause
palpitations, extrasystoles,
tachycardia, chest pain,
slight increase in B/P
followed by a substantial
decrease, chills, diaphoresis,
skin blanching.
ADVERSE EFFECTS
- Infiltration/Nerve Block:
Pain at injection site.
- Topical: Burning, stinging,
tenderness at application
site.
- Rare: Generally associated
with high dose: Drowsiness,
dizziness, disorientation,
light-headedness, tremors,
apprehension, euphoria,
sensation of heat, cold,
numbness; blurred or double
vision, tinnitus, nausea.
- Serious adverse reactions
d) Assessed for health status and
noted baseline vital signs.
e) Check for history of allergies.
Tx:
a) Maintain aseptic technique on
IV medication site.
b) Monitored and noted changes
in vital signs.
c) Offered emotional support.
d) Maintained careful monitoring
of rate, depth and type of
respirations.
Edx:
a) Educated on possible side
effects of the medication.
b) Instructed to report any
persistent signs of
palpitations, chest pain,
muscle tremors and headache.
c) Promoted comfort and safety.
NURSING RESPONSIBILITIES
Dx:
a) Identified client and
indications for this drug.
b) Check and verify doctor's
order.
c) Noted any ongoing and
previous medication intake.
d) Assessed for health status and
noted baseline vital signs.
e) Check for history of allergies.
Tx:
a) Maintain aseptic technique on
IV medication site.
b) Monitored and noted changes
in vital signs and therapeutic
 neuronal membrane’s permeability to
ROUTE: sodium ions.
IM or Site of laceration
Therapeutic Effect: Inhibits
ventricular arrhythmias.
(Saunders Nursing drug handbook
2019)
White syndrome.
- Severe degree of SA, AV, or
intraventricular heart block (except
in pts with functioning
pacemaker).
DRUG-DRUG INTERACTION:
- Class 1 antiarrhythmics (e.g.,
propafenone, quinidine) may
increase cardiac effects
DRUG-FOOD INTERACTION:
- No known
to lidocaine are uncommon,
but high dosage by any
route may produce
cardiovascular depression,
bradycardia, hypotension,
arrhythmias, heart block,
cardiovascular collapse,
cardiac arrest.
serum level.
c) Ensured safety measures.
d) Maintained careful monitoring
of pulse for rhythm, rate and
quality.
Edx:
a) Educated on possible side
effects of the medication.
b) Instructed to report any
persistent signs of dizziness,
double vision and respiratory
difficulty.
c) Reiterated to avoid eating,
drinking and chew gum for 1
hour after application.

DRUG NAME MECHANISM OF ACTION INDICATION/ ADVERSE EFFECTS NURSING RESPONSIBILITIES

CONTRAINDICATION
GENERIC: INDICATION:
Nalbuphine - Relief of moderate to severe
Agonist of kappa opioid receptors and pain, preop analgesia, obstetric
BRAND: partial antagonist of mu opioid analgesia, adjunct to anesthesia.
Nubain receptors - OFF-LABEL: Opioid-induced
within CNS, inhibiting ascending pain pruritus.
CLASS: pathways.
Opioid agonist CONTRAINDICATION:
Therapeutic Effect: Alters - Hypersensitivity to nalbuphine.
PHARMACOLOGIC: pain perception, emotional response to Cautions: Hepatic/renal
Opioid analgesic pain. impairment, respiratory depression,
recent MI, recent biliary tract
DOSAGE: (Saunders Nursing drug handbook impairment, pancreatitis,
10mg 2019) hypovolemia, head trauma,
increased intracranial pressure
ROUTE: (ICP), pregnancy, pts suspected of
IV being opioid dependent, obesity,
thyroid dysfunction
DRUG-DRUG INTERACTION:
- Alcohol, other CNS depressants
(e.g., LORazepam, morphine,
zolpidem) may increase CNS
effects, respiratory depression,
- GI, GU: Abrupt
withdrawal after prolonged
use may produce symptoms
of narcotic withdrawal
(abdominal cramping,
rhinorrhea, lacrimation,
anxiety, fever, piloerection
[goose bumps]).
- CNS, RESP: Overdose
results in severe respiratory
depression, skeletal muscle
flaccidity, cyanosis, extreme
drowsiness progressing to
seizures, stupor, coma.
- OTHERS: Tolerance to
analgesic effect, physical
dependence may occur with
chronic use.
Dx:
a) Identified client and
indications for this drug.
b) Check and verify doctor's
order.
c) Noted any ongoing and
previous medication intake.
d) Assess onset, type, location,
duration of pain.
e) Obtain vital signs before
giving medication.
f) Check for history of allergies.
Tx:
a) Maintain aseptic technique on
IV medication site.
b) Monitor for change in
respirations, B/P, rate/quality
of pulse.
c) Monitor daily pattern of
bowel activity, stool
consistency.
d) Ensured safety measures.
e) Maintained careful monitoring
of pulse for rhythm, rate and
 hypotension. quality.
Edx:
DRUG-FOOD INTERACTION: a) Educated on possible side
- No known effects of the medication.
b) Demonstrated proper deep
breathing, coughing Exercises
c) Instructed to avoid tasks that
require alertness, motor skills
until response to drug is
established
DRUG NAME MECHANISM OF ACTION INDICATION/ ADVERSE EFFECTS NURSING RESPONSIBILITIES
CONTRAINDICATION
GENERIC: INDICATION: Dx:
Bacillus Calmette-Guérin - for the prevention of tuberculosis Common side effects of BCG a) Identified right client and
BCG vaccination induces an innate in persons not previously infected vaccine live include: indications for this drug.
BRAND: immune training. BCG vaccination with M. tuberculosis who are at - increased urination, b) Noted any ongoing and
Onco activates the innate immune system high risk for exposure - painful urination, previous medication intake.
and induces changes in the pattern of - given at birth to infants to reduce - fever, and c) Assessed the intradermal site
CLASS: histone modifications of specific genes high risk of tuberculosis and - flu symptoms of injection.
Live Attenuated Vaccine in innate immune cells. This vaccine meningitis in newborn d) Check for allergies.
prevents the development of TB, and is CONTRAINDICATION: Serious side effects of BCG Tx:
PHARMACOLOGIC: very effective in preventing severe TB - should not be given to babies or vaccine live include: a) Maintain aseptic technique
Tuberculosis vaccine in young infants. children: receiving corticosteroids - hives, vaccine administration.
or other immune-suppressive - difficulty breathing, b) Monitor side effects of the
DOSAGE: (Saunders Nursing drug handbook treatment, including radiotherapy. - swelling of the face, lips, vaccine.
0.05 ml 2019, ncbi.nlm.nih.gov) DRUG-DRUG INTERACTION: tongue, or throat, c) Ensured safety measures.
- ibrutinib - fever, chills, d) Maintained careful monitoring
ROUTE: - ixekizumab - weakness, of pulse for rhythm, rate and
ID - lomustine - flu-like symptoms, cough, quality.
- mechlorethamine - a weak stream of urine, Edx:
- blood in the urine, a) Educated on possible side
DRUG-FOOD INTERACTION: - dark-colored urine, effects of the vaccine.
- No known - vomiting, b) Educated parents/significant
- upper stomach pain, other on the purpose and
- yellowing of the skin or therapeutic effect of the
eyes, vaccine.
- itching, odor, discharge, c) Instructed significant other to
pain, tenderness, redness, or report any side effects
swelling of the genital or specially fever and chills.
rectal area,
 DRUG NAME MECHANISM OF ACTION INDICATION/ ADVERSE EFFECTS NURSING RESPONSIBILITIES
CONTRAINDICATION
GENERIC: INDICATION: Dx:
Omeprazole - Short term treatment of active Gastrointestinal; diarrhea, nausea a) Identified indications for
A gastric pump-inhibitor will block duodenal ulcer and vomiting treatment of therapy.
BRAND: the final step of acid production by - reduce episodes of emesis pre- b) Check and verify doctor's
Losec inhibiting the H+ / K+ ATPhase system operatively intra-, and/or post- CNS: Dizziness, headache order.
at the secretory surface of the gastric operatively. c) Noted any ongoing and
CLASS: parietal cell. Both basal and stimulated CONTRAINDICATION: Others; upper respiratory tract previous medication
Proton Pump Inhibitor acid secretions are inhibited. - Hypersensitivity to omeprazole, infection, back pain, rash, cough. intake.
other proton pump inhibitors. - pancreatitis, hepatotoxicity, d) Assessed for health status.
PHARMACOLOGIC: This drug is acid-labile and it contains Concomitant use with products interstitial nephritis occur e) Check for history of
Benzimidazole an enteric coated granule formulation; containing rilpivirine. rarely. May increase risk of C. allergies.
rapidly absorbed. difficile infection. Tx:
DOSAGE: Therapeutic Effect: Increases DRUG-DRUG INTERACTION: a) Maintain aseptic technique
40 mg gastric pH, reduces gastric acid - May decrease concentration/effects on IV medication site.
production. of atazanavir, clopidogrel. b) Monitored and noted vital
ROUTE: - May increase concentration/effects signs and response to
IV (Saunders Nursing drug handbook of diazePAM, oral anticoagulants medication.
2019) (e.g., warfarin), phenytoin c) Administered medication
aseptically.
DRUG-FOOD INTERACTION: Edx:
- No known a) Educated on possible side
effects of the medication.
b) Encourage to report any
adverse effects
immediately like black
tarry stool and abdominal
pain.
c) Instructed to swallow the
capsule and do not chew to
attain optimal effect.
d) Promoted comfort and
safety.