Name of Drug

Generic
(Brand)
Classification Dose
Frequency
Route
Mechanism
of Action
Specific
Indication
Side Effects Nursing Implications
Vitamin B
complex
Vitamins
and
Minerals
A coenzyme that
stimulate
metabolic
function and is
needed for cell
replication,
hematopoiesis,
and nucleoprotein
and myelin
synthesis.
Pernicious
anemia
CONTRA:
~ hypersen-
sitive to
vitamin B12
or cobalt.
~ early
Lebers
disease
CV: peripheral
vascular
thrombosis,
heart failure.
GI: transient
diarrhea.
Respi:
pulmonary
edema.
Skin: itching,
transitory
exanthema,
urticaria.
Other:
anaphylaxis,
anaphylactoid
reactions with
parenteral
administration
, pain or
burning at
injection site.
BEFORE:
~ Determine reticulocyte
count, hct, Vit. B12, iron,
folate levels before
beginning therapy.
~ Obtain a sensitivity test
history before
administration
~ Avoid I.V. administration
bec. faster systemic
elimination will reduce
effectiveness of vitamin.
DURING:
~ Dont give large doses of
vitamin B12 routinely; drug
is lost through excretion.
~ Dont mix parenteral
preparation in same
syringe with other drugs.
AFTER:
~ Protect Vit. B12 from
light. Dont refrigerate or
freeze.
~ Monitor patient for
hypokalemia for first 48
hours, as anemia correct
itself. Give potassium
supplements, as needed.
Name of Drug
Generic
(Brand)
Classification Dose
Frequency
Route
Mechanism
of Action
Specific
Indication
Side Effects Nursing Implications
Acetaminophen
(Paracetamol)
antipyretics,
nonopioid
analgesics
1.2 mL
q 4 hr PRN
od
Inhibits the
synthesis of
prostaglandin
s that may
serve as
mediators of
pain and
fever,
primarily in
the CNS
Mild pain
Fever
Hema: hemolytic
anemia,
neutropen
ia,
leukopeni
a,
pancytope
nia.
Hepa: jaundice
Metabolic:
hypoG
GI: HEPATIC
FAILURE,
HEPATOT
OXICITY
(overdose)
GU: renal
failure
(high
doses/chro
nic use).
Derm:
rash,
urticaria.
BEFORE:
~ Advise parents or
caregivers to check
concentrations of liquid
preparations. Errors
have resulted in serious
liver damage.
~ Assess fever; note
presence of associated
signs (diaphoresis,
tachycardia, and
malaise).
DURING:
~ Adults should not take
acetaminophen longer
than 10 days and
children not longer than
5 days unless directed
by health care
professional.
~ Advise mother or caregiver
to take medication
exactly as directed and
not to take more than
the recommended
amount.
AFTER:
~ Advise patient to consult
health care professional
if discomfort or fever is
not relieved by routine
doses of this drug or if
fever is greater than
39.5C (103F) or lasts
longer than 3 days.
DRUG
ORDER
TRAD
E/
BRAN
D
NAME
PHARMAC
OLOGIC
ACTION
OF DRUG
INDICATIONS AND CONTRA-
INDICATIONS
ADVERSE
EFFECTS OF
THE DRUG
DESIRED
ACTION ON THE
CLIENT
Nursing Implications
Omepra
zole
20mg
tab OD
Omep
ron
Gastric
acid-pump
inhibitor:
Suppresse
s gastric
acid
secretion
by specific
inhibition of
the
hydrogen-
potassium
ATPase
enzyme
system at
the
secretory
surface of
the gastric
parietal
cells;
blocks the
final step of
acid
production.
INDICATIONS:
Short-term treatment of active
duodenal ulcer; First-line
therapy in treatment of
heartburn or symptoms of
gastroesophageal reflux
disease (GERD); Short-term
treatment of active benign
gastric ulcer; GERD, severe
erosive esophagitis, poorly
responsive symptomatic GERD;
Long-term therapy: Treatment
of pathologic hypersecretory
conditions (Zollinger-Ellison
syndrome, multiple adenomas,
systemic mastocytosis);
Eradication of H. pylori with
amoxicillin or metronidazole and
clarithromycin; Prilosec OTC:
Treatment of frequent heartburn
(2 or more days per wk);
Unlabeled use: Posterior
laryngitis; enhance efficacy of
pancreatin for the treatment of
steatorrhea in cystic fibrosis
CONTRAINDICATIONS:
Contraindicated with
hypersensitivity to omeprazole
or its components;
Use cautiously with pregnancy,
lactation.
CNS: Headache,
dizziness,
asthenia, vertigo,
insomnia, apathy,
anxiety,
paresthesias,
dream
abnormalities
Dermatologic:
Rash,
inflammation,
urticaria, pruritus,
alopecia, dry skin
GI: Diarrhea,
abdominal pain,
nausea, vomiting,
constipation, dry
mouth, tongue
atrophy
Respiratory: URI
symptoms, cough,
epistaxis
Other: Cancer in
preclinical studies,
back pain, fever
Treatment of
active benign
gastric ulcer
Assessment
History: Hypersensitivity to omeprazole or any of
its components; pregnancy, lactation
Physical: Skin lesions; T; reflexes, affect; urinary
output, abdominal exam; respiratory auscultation
Interventions
Administer before meals. Caution patient to
swallow capsules wholenot to open, chew, or
crush them.
Arrange for further evaluation of patient after 8 wk
of therapy for gastroreflux disorders; not intended
for maintenance therapy. Symptomatic
improvement does not rule out gastric cancer,
which did occur in preclinical studies.
Administer antacids with omeprazole, if needed.
Teaching points
Take the drug before meals. Swallow the
capsules whole; do not chew, open, or crush
them. This drug will need to be taken for up to 8
wk (short-term therapy) or for a prolonged period
(> 5 yr in some cases).
Have regular medical follow-up visits.
These side effects may occur: Dizziness (avoid
driving or performing hazardous tasks); headache
(request medications); nausea, vomiting, diarrhea
(maintain proper nutrition); symptoms of upper
respiratory tract infection, cough (do not self-
medicate; consult with your health care provider if
uncomfortable).
Report severe headache, worsening of
symptoms, fever, chills.