FATHER SATURNINO URIOS UNIVERSITY

San Francisco St. Butuan City 8600, Region XIII Caraga, Philippines
Nursing Program

Name of Student: Kathleen P. Josol BSN III – Section: N31 Date: July 17, 2021

Name of Supervising Clinical Instructor: Oliva L. Asendente, RN, MAN

Name of Drug Classification Indication Mechanism of Contraindication Side Effect Adverse Effect Nursing considerations
Action
Chlordiazepoxide Therapeutic: For the Acts at many Hypersensitivity, Drowsiness, CNS: Monitor daytime
antianxiety agents, management levels of the CNS those with pre- dizziness, dizziness, drowsiness and,
sedative/hypnotics of anxiety to produce existing CNS nausea, drowsiness, “hangover” symptoms
disorders or anxiolytic effect. depression, constipation, hangover, (headache, nausea,
Pharmacologic: for the short- Depresses the Long--acting blurred headache, irritability, dysphoria).
benzodiazepines term relief of CNs, probably by benzodiazepines vision, or mental Repeated or excessive
symptoms of potentiating cause prolonged headache depression, symptoms may require
anxiety, gamma- sedation in the paradoxical change in dose or
withdrawal aminobutyric acid elderly. Appears excitation, medication.
symptoms of (GABA), an on Beers list and sedation.
acute inhibitory is associated Assess dizziness that might
alcoholism, neurotransmitter. with increased EENT: affect gait, balance, and
and Therapeutic risk of falls (↓ blurred other functional activities.
preoperative Effects: Sedation. dose required or vision. Report balance problems
apprehension Relief of anxiety. consider short- and functional limitations
and anxiety. acting GI: to the physician, and
Chlordiazepoxide benzodiazepine.) constipation, caution the patient and
binds to diarrhea, family/caregivers to guard
stereospecific nausea, against falls and trauma.
benzodiazepine vomiting,
(BZD) binding weight gain. Guard against falls and
sites on GABA (A) trauma (hip fractures,
receptor Derm: head injury, and so forth).
complexes at rashes. Local: Implement fall- prevention
several sites pain at IM strategies, especially in
within the central site. older adults or if
 nervous system, drowsiness and dizziness
including the carry over into the
limbic system and daytime
reticular
formation. This Instruct patients on
results in an prolonged treatment not
increased binding to discontinue medication
of the inhibitory without consulting their
neurotransmitter physician. Prolonged use
GABA to the can cause tolerance and
GABA(A) dependence, and abrupt
receptor. BZDs, withdrawal can cause
therefore, insomnia, unusual
enhance GABA- irritability or nervousness,
mediated chloride and seizures.
influx through
GABA receptor Advise patient to avoid
channels, causing alcohol and other CNS
membrane depressants because of
hyperpolarization. the increased risk of
The net neuro- sedation and adverse
inhibitory effects effects.
result in the
observed Instruct patient to report
sedative, other bothersome side
hypnotic, effects such as severe or
anxiolytic, and prolonged headache,
muscle relaxant blurred vision, skin rash,
properties. or GI problems (nausea,
vomiting, diarrhea,
constipation)

Name of Drug Classification Indication Mechanism of Contraindication Side Effect Adverse Effect Nursing
Action considerations
Lorazepam Therapeutic: Management of Binds to Contraindicated Dizziness, CNS: Discuss patient
anesthetic anxiety disorders stereospecific in: drowsiness, Sedation not to drive or
adjuncts, or short-term benzodiazepine Hypersensitivity; lethargy, Confusion, engage in other
antianxiety agents, relief of the receptors on the Cross-sensitivity hangover dizziness, hazardous
sedative/hypnotics symptoms of postsynaptic with other headache, akathisia, activities for a
 anxiety or anxiety GABA neuron at benzodiazepines mental unsteadiness, least 24–48 h
Pharmacologic: associated with several sites may exist; depression, headache, after receiving
benzodiazepines depressive within the Comatose blurred vision, depression, IM injection of
symptoms, Status central nervous patients or those respiratory disorientation, lorazepam. IM
epilepticus, system, including with pre-existing depression, amnesia or IV lorazepam
preanesthesia the limbic CNS depression; constipation, injection of 2–4
system, reticular Uncontrolled diarrhea, RS: mg is usually
formation. severe pain; nausea, Respiratory followed by a
Enhancement of Angle-closure vomiting, apnea, depression depth of
the inhibitory glaucoma; cardiac arrest, Nasalcongestion, drowsiness or
effect of GABA Severe bradycardia, hyperventilation, sleepiness that
on neuronal hypotension; hypotension, apnea permits patient
excitability Sleep apnea rashes to respond to
results by CVS: simple
increased Hypotension instructions
neuronal Dermatologic: whether patient
membrane Dermatitis, rash appears to be
permeability to asleep or awake.
chloride ions. GI:
This shift in Weight gain or Supervise
chloride ions loss, nausea, patient who
results in changes in exhibits
hyperpolarization appetite depression with
(a less excitable anxiety closely;
state) and Neuromuscular the possibility of
stabilization. &skeletal: suicide exists,
Weakness particularly
when there is
apparent
improvement in
mood.

Educate patient
not drink large
volumes of
coffee.
Anxiolytic
effects of
lorazepam can
 significantly be
altered by
caffeine

References:

MedlinePlus. (2021). Chlordiazepoxide. Retrieved from: https://medlineplus.gov/druginfo/meds/a682078.html

Nursing.com (2021). Lorazepam (Ativan) Nursing Pharmacology Considerations. Retrieved from: https://nursing.com/blog/lorazepam-ativan-nursing-pharmacology-
considerations/