Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

COLLEGE of NURSING and ALLIED HEALTH SCIENCES

DRUG ANALYSIS
 NAME OF SPECIFIC INDICATION CONTRAINDI DRUG ADVERSE SPECIFIC NURSING
DRUG ACTION CATION INTERACTION REACTION PRECAUTION RESPONSIBILITIES
Generic Name: Produces It provides Hypersensitivit Cholestyramine Body as a Children <3 y Assessment & Drug
PARACETAM analgesia by temporary y to may decrease Whole: Negligibl unless directed by Effects
OL unknown analgesia for acetaminophen acetaminophen e with a physician;
mechanism, mild to moderate or phenacetin; absorption. With recommended repeated Monitor for S&S of:
pain. In addition,
perhaps by use with chronic dosage; administration to hepatotoxicity, even
acetaminophen
Brand action on lowers body alcohol. coadministration, rash. Acute patients with with moderate
Name:Ifimol peripheral temperature in BARBITURATES poisoning: Anore anemia or hepatic acetaminophen doses,
nervous individuals with , carbamazepine, xia, nausea, disease; arthritic especially in individuals
Dosage: system. a fever. phenytoin, and vomiting, or rheumatoid with poor nutrition or
Reduces fever rifampin may dizziness, conditions who have ingested
Full-term by direct Fever reduction. increase potential lethargy, affecting children alcohol over prolonged
neonates and action on Temporary relief for chronic diaphoresis, <12 y; periods; poisoning,
children ≤10 hypothalamus of mild to hepatotoxicity. chills, epigastric alcoholism; usually from accidental
moderate pain.
kg: 7.5 mg/kg heat- Chronic, excessive or abdominal malnutrition; ingestion or suicide
Generally as
(Max: 30 regulating substitute for ingestion of pain, diarrhea; thrombocytopeni attempts; potential abuse
mg/kg daily center with aspirin when the alcohol will onset a. Safety during from psychological
consequent latter is not increase risk of of hepatotoxicity pregnancy dependence (withdrawal
Route: peripheral tolerated or is hepatotoxicity. —elevation of (category B) or has been associated with
Intravenous vasodilation, contraindicated. serum lactation is not restless and excited
sweating, and transaminases established. responses).
dissipation of (ALT, AST) and
heat. Unlike bilirubin; Patient & Family
aspirin, hypoglycemia, he Education
acetaminophe patic coma, acute
Classification: n has little renal Do not take other
ENTRAL effect on failure (rare). Chr medications (e.g., cold
NERVOUS platelet onic preparations) containing
SYSTEM aggregation, ingestion: Neutro acetaminophen without
AGENT; does not penia, medical advice;
NONNARCOTI affect pancytopenia, overdosing and chronic
C bleeding leukopenia, use can cause liver
ANALGESIC, time, and thrombocytopenic damage and other toxic
ANTIPYRETIC generally purpura, hepatoto effects.
produces no xicity in
gastric alcoholics, renal Do not self-medicate
Reference: bleeding. damage. adults for pain more
Nursing Drug than 10 d (5 d in
Handbook children) without
consulting a physician.
 NAME OF SPECIFIC INDICATION CONTRAINDI DRUG ADVERSE SPECIFIC NURSING
DRUG ACTION CATION INTERACTION REACTION PRECAUTI RESPONSIBILITIES
ON
Generic Name: Potent anti- Short-term Hypersensitivit Drug: may reduce CNS: Headache, Use caution Assessment & Drug Effects
Ranitidine ulcer drug treatment of y to ranitidine; absorption malaise, in renal
that active duodenal acute of cefpodoxime, c dizziness, impairment;
competitively ulcer; porphyria; OTC efuroxime, delavi somnolence, adjust
maintenance
Brand Name: and reversibly administration rdine, ketoconazo insomnia, vertigo, dosage Potential toxicity results from
therapy for
inhibits duodenal ulcer in children <12 le, itraconazole. mental confusion, decreased clearance
Zantac histamine patient after y. agitation, Use caution (elimination) and therefore
action at H2- healing of acute depression, in hepatic prolonged action; greatest in
Dosage: receptor sites ulcer; treatment hallucinations in impairment the older adult patients or
on parietal of older those with hepatic or renal
IV 1.5 mg/kg/d cells, thus gastroesophageal adults. CV: Brady dysfunction.
divided q12h or blocking reflux disease; cardia (with rapid
short-term
0.04 mg/kg/h by gastric acid IV Lab tests: Periodic liver
treatment of
continuous secretion. active, benign push). GI: Consti functions. Monitor creatinine
infusion Indirectly gastric ulcer; pation, nausea, clearance if renal dysfunction
reduces treatment of abdominal pain, is present or suspected. When
pepsin pathologic GI diarrhea. Skin: Ra clearance is <50 mL/min,
secretion but hypersecretory sh. Hematologic:  manufacturer recommends
Route: appears to conditions (e.g., Reversible reduction of the dose to 150
have minimal Zollinger-Ellison decrease in WBC mg once q24h with cautious
syndrome,
effect on count, and gradual reduction of the
systemic
Intravenous fasting and thrombocytopenia interval to q12h or less, if
mastocytosis, and
postprandial postoperative . Body as a necessary.
serum gastrin hypersecretion); Whole: Hypersen
concentration heartburn. sitivity Be alert for early signs of
s or secretion reactions, anaphyl hepatotoxicity (though low
Classification: of gastric Blocks daytime axis (rare). and thought to be a
Histamine H2 intrinsic and nocturnal hypersensitivity reaction):
Antagonists basal gastric acid jaundice (dark urine, pruritus,
factor or
secretion
mucus. yellow sclera and skin),
stimulated by
histamine and elevated transaminases
reduces gastric (especially ALT) and LDH.
Reference: acid release in
Nursing Drug response to food, Long-term therapy may lead
Handbook pentagastrin, and to vitamin B12 deficiency.
insulin. Shown to
inhibit 50% of Patient & Family
the stimulated
Education
gastric acid
 NAME OF SPECIFIC INDICATION CONTRAINDI DRUG ADVERSE SPECIFIC NURSING
DRUG ACTION CATION INTERACTION REACTION PRECAUTION RESPONSIBILITI
ES
Generic Name: Antibiotic Effective against Hypersensitivit Drug: Allopurinol Drug: Allopurinol Use caution in Assessment & Drug
AMPICILLIN agent with both gram- y to penicillins; increases increases allergy to Effects
activity positive and mononucleosis. incidence of rash; incidence of rash; cephalosporins,
resulting from gram-negative effectiveness of effectiveness of carbapenems
bacteria
Brand Name: beta- the the
including those
Unasyn lactamase that produce AMINOGLYCOS AMINOGLYCOS Determine previous
inhibition. beta-lactamase IDES may be IDES may be hypersensitivity
Dosage: Sulbactam and nonbeta- impaired in impaired in Adjust dose in renal reactions to
inhibits beta- lactamase patients with patients with failure; evaluate rash penicillins,
IV 1 y, 300 lactamases producers. severe end stage severe end stage and differentiate cephalosporins, and
mg/kg/d (200 most Ampicillin renal disease; renal disease; from hypersensitivity other allergens prior
mg/kg frequently without chloramphenicol, chloramphenicol, reaction to therapy.
sulbactam is not
ampicillin and responsible erythromycin, erythromycin,
effective against
100 mg/kg for beta-lactamase tetracycline may tetracycline may Lab tests: Baseline
sulbactam) transferred producing reduce bactericidal reduce C&S tests prior to
divided q6h drug strains. effects of bactericidal Endocarditis initiation of therapy;
resistance. ampicillin—this effects of prophylaxis: Use start drug pending
Because of Treatment of interaction is ampicillin—this only for high-risk results.
this action, a infections due to primarily interaction is patients, per AHA
Route: wide range of susceptible significant when primarily Guidelines Report promptly
Intravenous beta- organisms in skin low doses are used significant when unexplained bleeding
and skin
lactamases low doses are (e.g., epistaxis,
structures,
found in intraabdominal used purpura,
organisms infections, and Prolonged use ecchymoses).
Classification: resistant to gynecologic associated with
ANTIINFECTI penicillins infections. fungal or bacterial Monitor patient
VE; and superinfection carefully during the
ANTIBIOTIC; cephalosporin first 30 min after
AMINOPENIC s have their initiation of IV
ILLIN growth therapy for signs of
inhibited. Rash has developed hypersensitivity and
during therapy in anaphylactoid
high percentage of reaction (see
Reference: patients with Appendix F). Serious
Nursing Drug infectious anaphylactoid
Handbook mononucleosis reactions require
receiving ampicillin immediate use of
class antibiotics; emergency drugs and
avoid therapy in airway management.
 NAME OF SPECIFIC INDICATION CONTRAINDI DRUG ADVERSE SPECIFI NURSING
DRUG ACTION CATION INTERACTION REACTION C RESPONSIBILITIES
PRECAU
TION
Generic Name: Effective Synthetic Blood Drug: ORAL Body as a Coexisten Assessment & Drug Effects
Metronidazole against Trich compound with dyscrasias; ANTICOAGULA Whole: Hypersen t
omonas direct active CNS NTS potentiate sitivity (rash, candidiasi  Discontinue therapy
vaginalis, trichomonacidal disease; first hypoprothrombine urticaria, pruritus, s; second immediately if
and amebicidal symptoms of CNS
Brand Name: Entamoeba trimester of mia; alcohol may flushing), fever, and third
activity as well as toxicity (see Appendix
Flagyl histolytica, an antibacterial pregnancy elicit disulfiram fleeting joint trimesters
d Giardia (category B), reaction; oral pains, overgrowth of F) develop. Monitor
activity against
Dosage:Child:  lamblia. lactation. solutions of Candida. CNS:  pregnancy especially for seizures
anaerobic
PO/IV 30 bacteria and and peripheral
Exhibits of citalopram, rit Vertigo, (category
some gram- neuropathy (e.g.,
mg/kg/d divided antibacterial onavir; lopinavir/ headache, ataxia, B);
negative bacteria numbness and
q6h (max: 4 g/d) activity ritonavir, and IV confusion, alcoholis
paresthesia of
Neonate: PO/IV  against formulations irritability, m; liver
extremities).
7.5–15 mg/kg/d obligate of sulfamethoxaz depression, disease.
 Lab tests: Obtain total
divided q12– anaerobic ole; trimethoprim restlessness, and differential WBC
48h bacteria, , SMX-TMP, nitr weakness, fatigue, counts before, during,
gram- oglycerin may drowsiness, and after therapy,
Route: negative elicit disulfiram insomnia, especially if a second
Intravenous anaerobic reaction due to the paresthesias, course is necessary.
bacilli, alcohol content of sensory  Monitor for S&S of
and Clostridi the dosage neuropathy sodium retention,
Frequency: a. form; disulfiram c (rare). GI: Nause especially in patients on
Microaerophi auses acute a, vomiting, corticosteroid therapy
lic Streptococ psychosis; phenob anorexia, or with a history of
ci and most arbital increases epigastric distress, CHF.
aerobic metronidazole abdominal  Monitor patients on
bacteria are metabolism; may cramps, diarrhea, lithium for elevated
resistant. increase lithium le constipation, dry lithium levels.
Classification: vels; fluorouracil,  mouth, metallic or  Report appearance of
ANTIINFECTI azathioprine may bitter taste, candidiasis or its
VE; ANTITRIC cause transient proctitis. Urogeni becoming more
HOMONAL; A neutropenia. tal: Polyuria, prominent with therapy
MEBICIDE; A to physician promptly.
dysuria, pyuria,
NTIBIOTIC  Repeat feces
incontinence,
examinations, usually
cystitis, decreased
up to 3 mo, to ensure
libido,
that amebae have been
dyspareunia,
eliminated.
Reference: dryness of vagina
Nursing Drug
STUDENT NURSE: Troy Albert N. Miranda CLINICAL INSTRUCTOR: PERLIN ZELLAINE T. LICAS, PhD, MAN