ILOILO DOCTORS’ COLLEGE

COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DRUG STUDY

Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects
 Blood dyscrasias,  Obtain baseline CBC,
Generic Name: Classifications Indications: Frequent:  Severe hepatic LFT.
Metronidazole  Amebiasis  Anorexia, dysfunction,  Question for history of
PHARMACOTHERAPE  Anaerobic Infections  Nausea,  End-stage renal disease, hypersensitivity to
UTIC:  Intra-abdominal  Dry mouth,  Seizure disorder, metronidazole, other
Nitroimidazole derivative. infections  Metallic taste  HF, nitroimidazole derivatives
 Pseudomembranous  Other sodium-retaining (and parabens with
Trade/ Brand Name: CLINICAL: Colitis Occasional: states, topical).
NidaGel Antibacterial, antiprotozoal  Bacterial Vaginosis Systemic:  Obtain specimens for
 Elderly.
 Rosacea  Diarrhea, diagnostic tests, cultures
 Constipation, before giving first dose
 Vomiting, (therapy may begin before
Dosage: results are known).
 Dizziness,
500mg  Monitor daily pattern of
 Erythematous rash,
 Urticaria, bowel activity, stool
Contraindications consistency.
 Reddish-brown urine.
 Hypersensitivity to Topical:  Monitor I&O, assess for
Route: Actions: urinary problems.
metronidazole.  Transient erythema,
IVTT Disrupts DNA, inhibiting  Be alert to neurologic
 Pregnancy (first  Mild dryness,
nucleic acid synthesis. symptoms (dizziness,
trimester with  Burning,
trichomoniasis), paresthesia of
Therapeutic Effect:  Irritation, extremities).
 Use of disulfiram
Frequency and Timing Produces bacteriacidal,  Stinging,  Assess for rash, urticaria.
Q8H/ TID for 7 days antiprotozoal, amebicidal, within 2 wks,
 Tearing when applied  Monitor for onset of
trichomonacidal effects.  Use of alcohol during
too close to eyes superinfection
Produces anti- therapy or within 3
days of discontinuing (ulceration/change of oral
inflammatory, Rare:
metroNIDAZOLE. mucosa, furry tongue,
immunosuppressive effects  Mild, transient vaginal discharge,
when applied topically. leukopenia; genital/anal pruritus).
 Thrombophlebitis
 with IV therapy. Patient/family teaching
• Urine may be red-brown or
Adverse effects/toxic dark.
reactions: • Avoid alcohol, alcohol-
 Oral therapy may containing preparations
result in furry tongue, (cough syrups, elixirs) for at
glossitis, cystitis, least 48 hrs after last dose.
dysuria, pancreatitis. • Avoid tasks that require
 Peripheral alertness, motor skills until
neuropathy response to drug is
(manifested as established.
numbness, tingling of • If taking metroNIDAZOLE
hands/feet) usually is for trichomoniasis, refrain
reversible if treatment from sexual intercourse
is stopped until full treatment is
immediately upon completed.
appearance of • For amebiasis, frequent stool
neurologic specimen checks will be
symptoms. necessary.
 Seizures occur
occasionally.

Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects
 Evaluate for therapeutic
Generic Name: Classifications Indications: Frequent (7%):  May increase risk of response (relief of GI
Omeprazole  Active Duodenal Ulcer  Headache. fractures, gastrointestinal symptoms).
PHARMACOTHERAPE  Symptomatic GERD infections.  Question if GI discomfort,
UTIC:  Erosive Esophagitis Occasional (3%–2%):  Hepatic impairment, pts nausea, diarrhea occurs.
Benzimidazole.  Pathologic  Diarrhea, of Asian descent.
Hypersecretory  Abdominal pain, Patient/family teaching
Trade/ Brand Name: CLINICAL: Conditions  Nausea.  Report headache, onset of
Prilosec Proton pump inhibitor.  H.Pylori Duodenal black, tarry stools,
Ulcer Rare (2%): diarrhea, abdominal pain.
 Gastric Ulcer  Dizziness,  Avoid alcohol.
 OTC Use (Frequent  Asthenia,  Swallow capsules whole;
Dosage: do not chew, crush,
Heartburn)  Vomiting,
40mg dissolve, or divide.
  Constipation,  Take before eating.
 Upper respiratory tract
Actions: infection,
Route: Inhibits hydrogen- Contraindications  Back pain,
IVTT potassium adenosine  Hypersensitivity to  Rash,
triphosphatase (H+ omeprazole, other  Cough.
/K+ ATP pump), an proton pump inhibitors.
enzyme on the surface of  Concomitant use with Adverse effects/toxic
Frequency and Timing gastric parietal cells. products containing reactions:
OD rilpivirine.  Pancreatitis,
Therapeutic Effect:
 Hepatotoxicity,
Increases gastric pH,
 Interstitial nephritis
reduces gastric acid
occur rarely
production.
 May increase risk of
C. difficile infection.

Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects
 Cardiac disease,  Assess for hypokalemia
Generic Name: Classifications Indications: Occasional:  Acid-base disorders, (weakness, fatigue,
Potassium Chloride  Treatment of  Nausea,  Potassium-altering polyuria, polydipsia).
PHARMACOTHERAPE Hypokalemia  vomiting, disorders,  PO should be given with
UTIC:  diarrhea,  Digitalized pts, food or after meals with
Electrolyte.  flatulence,  Concomitant therapy that full glass of water, fruit
 abdominal discomfort increases serum juice (minimizes GI
 with distention, potassium (e.g., ace irritation).
Trade/ Brand Name: CLINICAL:  phlebitis with IV inhibitors),  Monitor serum potassium
Apo-K Potassium replenisher. administration  Renal impairment. (particularly in renal
(particularly when  Do not administer IV impairment).
potassium undiluted.  If GI disturbance is noted,
concentration of dilute preparation further
Dosage: greater than 40 mEq/L or give with meals.
1 tab is infused).  Be alert to decreased
Contraindications urinary output (may be
Actions:  Renal failure, Rare: indication of renal
Necessary for multiple hyperkalemia,  Rash insufficiency).
Route: cellular metabolic conditions in which  Monitor daily pattern of
Oral processes. Primary action potassium retention is Adverse effects/toxic bowel activity, stool
is intracellular. present. reactions: consistency.
 Solid oral dosage form  Hyperkalemia (more  Assess I&O diligently
Therapeutic Effect: in pts in whom there is common in elderly, pts during diuresis, IV site for
Frequency and Timing Required for nerve impulse structural, pathologic with renal impairment) extravasation, phlebitis.
TID x 9 doses conduction, cause for delay in manifested as  Be alert to evidence of
contraction of cardiac, passage through GI paresthesia, hyperkalemia (skin
skeletal, smooth muscle; tract.  Feeling of heaviness pallor/coldness,
maintains normal renal in lower extremities, complaints of paresthesia,
function,  Cold skin, feeling of heaviness of
acid-base balance.  Grayish pallor, lower extremities).
 Hypotension,
 Confusion, Patient/family teaching
 Irritability,  Foods rich in potassium
 Flaccid paralysis, include beef, veal, ham,
 Cardiac arrhythmias. chicken, turkey, fish, milk
 Bananas, dates, prunes,
raisins, avocados,
watermelon, cantaloupe,
apricots,
 Molasses, beans, yams,
broccoli, brussels sprouts,
lentils, potatoes, spinach.
 Report paresthesia, feeling
of heaviness of lower
extremities, tarry or
bloody stools, weakness,
 unusual fatigue.

Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects
 Sensitivity to  If given for analgesia,
Generic Name: Classifications Indications: Rare: acetaminophen; severe assess onset, type,
Paracetamol/ Acetaminophen  Analgesia and  Hypersensitivity renal impairment; location, duration of pain.
PHARMACOTHERAPE Antipyresis reaction.  alcohol dependency,  Effect of medication is
UTIC:  hepatic impairment, or reduced if full pain
Central analgesic. Adverse effects/toxic active hepatic disease; response recurs prior to
reactions:  chronic malnutrition and next dose.
Trade/ Brand Name: CLINICAL: hypovolemia (Ofirmev);  Assess for fever.
Tylenol Non-narcotic analgesic, Early Signs of  G6PD deficiency  Assess LFT in pts with
antipyretic. Acetaminophen Toxicity: (hemolysis may occur). chronic usage or history of
 Anorexia,  Limit dose to less than hepatic impairment,
 Nausea, 4g/day. alcohol abuse.
Dosage:  Diaphoresis,  Assess for clinical
300mg/ 500mg 1 tab  Fatigue within first improvement and relief of
Contraindications 12–24 hrs. pain, fever.
 Hypersensitivity to  Consult physician for use
acetaminophen. Later Signs of Toxicity: in children younger than 2
Route: Actions: (Ofirmev): severe  Vomiting, yrs, oral use longer than 5
IVTT/ Oral Appears to inhibit hepatic impairment or  Right upper quadrant days (children) or longer
prostaglandin synthesis in severe active liver than 10 days (adults), or
tenderness,
the CNS and, to a lesser disease fever lasting longer than 3
 Elevated lfts within
extent, block pain impulses days.
48–72 hrs after
Frequency and Timing through peripheral action.
ingestion. Antidote:  Severe/recurrent pain or
STAT/ Q4H Acts centrally on
Acetylcysteine high/continuous fever may
hypothalamic heat-
indicate serious illness.
regulating center,
 Do not take more than 4
producing peripheral
g/day (3 g/day if using
vasodilation (heat loss,
OTC [over-the-counter]).
skin erythema,
diaphoresis).

Therapeutic Effect: Results

in antipyresis. Produces
analgesic effect.
 Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects
 Cardiovascular diseases  It should be taken before
Generic Name: Classifications Indications: Rare:  Electrolyte imbalance meals, according to your
Domperidone  Relief of the symptoms  Fast, irregular,  Prolactin deficiency doctor's instructions.
Dopamine antagonists of nausea and vomiting pounding, or racing  It can make you dizzy and
heartbeat or pulse sleepy. Do not drive or
 Swelling of face, engage in any activity that
hands, lower legs, or requires mental focus until
Trade/ Brand Name: feet you have determined how
it affects you.
Less common:  When taking
 Loss of balance or Domperidone, avoid
Actions: muscle control drinking alcohol as it may
Dosage: Domperidone is a  Swelling of the mouth cause excessive
10mg/ 1 tab peripheral dopamine- drowsiness.
receptor blocker. It  As a side effect, dry
increases oesophageal Contraindications mouth may occur.
peristalsis, lower  Pts with conditions Frequent mouth rinses,
Route: oesophageal sphincter where cardiac good oral hygiene,
Oral pressure, gastric motility conduction is, or could increased water
and peristalsis, and be, impaired. with consumption, and
enhances gastroduodenal underlying cardiac sugarless candy may be
coordination, thereby diseases such as beneficial.
Frequency and Timing facilitating gastric congestive heart  Inform your doctor if you
TID emptying and decreasing failure. receiving other develop watery diarrhea, a
small bowel transit time. medications known to fever, or persistent
prolong QT interval or stomach pain.
potent CYP3A4  Without consulting your
inhibitors. doctor, do not take it for
more than 7 days.
 Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects
 Assess for dehydration
Generic Name: Classifications Indications: Frequent (10%):  Renal impairment, (poor skin turgor, dry
Metoclopramide  Prevention of  Drowsiness,  HF, mucous membranes,
PHARMACOTHERAPE Chemotherapy-Induced  Restlessness,  Cirrhosis, longitudinal furrows in
UTIC: Nausea/Vomiting  Fatigue,  Hypertension, tongue).
DOPamine receptor  Postop  Lethargy.  Depression,  Assess for nausea,
antagonist. Nausea/Vomiting  Parkinson’s disease, vomiting, abdominal
Trade/ Brand Name:  Gastroparesis Occasional (3%): distention, bowel sounds.
 Elderly
Reglan CLINICAL:  GERD  Monitor for anxiety,
GI emptying adjunct,  Facilitate Small Bowel  Dizziness, restlessness,
peristaltic stimulant, Intubation  Anxiety, extrapyramidal
antiemetic. symptoms (EPS) during
 Headache,
Dosage: IV administration.
 Insomnia,
5mg  Monitor daily pattern of
 Breast tenderness,
 Altered menstruation, bowel activity, stool
consistency.
 Constipation,
 Assess skin for rash.
Route:  Rash,
 Evaluate for therapeutic
IVTT  Dry mouth,
Contraindications response from
Actions:  Galactorrhea,
 Hypersensitivity to gastroparesis (nausea,
Stimulates motility of metoclopramide.  Gynecomastia. vomiting, bloating).
upper GI tract. Blocks
 Concurrent use of  Monitor renal function,
Frequency and Timing dopamine/serotonin Rare (less than 3%):
medications likely to B/P, heart rate.
STAT receptors in
produce  Hypotension,
chemoreceptor trigger  Hypertension,
extrapyramidal Patient/family teaching
zone. Enhances  Tachycardia
reactions.  Avoid tasks that require
acetylcholine response in
 Situations in which GI alertness, motor skills
upper GI tract;
motility may be until response to drug is
increases lower esophageal
sphincter tone.
dangerous (e.g., GI  established.
hemorrhage, GI  Report involuntary eye,
perforation/obstruction facial, limb movement
Therapeutic Effect:
), history of seizure (extrapyramidal
Accelerates
disorder, reaction).
intestinal transit, promotes
pheochromocytoma.
gastric emptying. Relieves  • Avoid alcohol.
nausea, vomiting.