DRUG MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING

ACTION RESPONSIBILITY

BETAHISTINE Acts as both partial  Used to treat  Pheochromocytoma  Rash, pruritus,  Assess history of
Generic Name histamine H1-receptor dizziness (vertigo)  Special Precaution: Stevens-Johnson peptic ulcer disease,
agonist and histamine in those who have Patient w/ active or syndrome, urticaria, bronchial asthma,
H3-receptor antagonist Meniere’s disease history of peptic ulcer dyspepsia, nausea, CV disease.
Brand Name: Serc in neuronal tissue. It disease, bronchial headache,  Should be taken with
improves the asthma, CV disease. confusion, food to decrease GI
Dose: 24 mg, 1 tab microcirculation in the Hepatic impairment. convulsions, upset
labyrinth, thus reducing Pregnancy and drowsiness,  Report severe
Frequency: BID endolymphatic lactation. hallucination, headache,
pressure. paraesthesia, convulsions,
Route: PO hypotension hallucination,
(including orthostatic abdominal pain,
Classification: and postural), dyspnea, vomiting.
Antivertigo tachycardia,
abdominal
distension and pain,
bloating, peptic
ulcer, vomiting,
dyspnoea.
 DRUG MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION RESPONSIBILITY

METOCLOPRAMIDE Stimulates motility of  Prevention of  Contraindicated with  CNS: Restlessness, Assessment

Generic Name upper GI tract without nausea and allergy to drowsiness, fatigue,  History: Allergy to
stimulating gastric, vomiting metoclopramide; GI lassitude, insomnia, metoclopramide, GI
Brand Name: Reglan biliary, or pancreatic hemorrhage, extrapyramidal hemorrhage,
secretions; appears to mechanical reactions, mechanical
Dose: 1 amp sensitize tissues to obstruction or parkinsonism-like obstruction or
action of acetylcholine; perforation; reactions, akathisia, perforation,
Frequency: q 8h relaxes pyloric pheochromocytoma dystonia, depression,
sphincter, which, when (may cause myoclonus, pheochromocytoma,
Route: IVTT combined with effects hypertensive crisis); dizziness, anxiety epilepsy, lactation,
on motility, accelerates epilepsy.  CV: Transient previously detected
Classification: gastric emptying and  Use cautiously with hypertension breast cancer.
intestinal transit; little previously detected  GI: Nausea,  Physical: Orientation,
Therapeutic Class: GI effect on gallbladder or breast cancer; fluid diarrhea reflexes, affect; Pulse,
Stimulants colon motility; overload; renal blood pressure; bowel
increases lower impairment. sounds, normal output
Pharmacologic Class: esophageal sphincter Interventions
Dopamine Antagonists pressure; has sedative  Monitor BP carefully
properties; induces during IV
release of prolactin. administration.
 Monitor for
extrapyramidal
reactions, and consult
physician if they
occur.
Teaching Points
 Do not use alcohol,
sleep remedies, or
sedatives; serious
sedation should occur.
 You may experience
these side effects:
Drowsiness,
 dizziness;
restlessness, anxiety,
depression,
headache, insomnia;
nausea, diarrhea.
 Report involuntary
movement of the face,
eyes, or limbs, severe
depression, severe
diarrhea.

DRUG MECHANISM OF INDICATION CONTRAINDICATION ADVERSE NURSING

ACTION EFFECTS RESPONSIBILITY
 LEVETIRACETAM Mechanism of  Adjunctive  Contraindicated  CNS: Dizziness, Assessment
Generic Name action not well therapy in with headache,  History:
understood; treatment of hypersensitivity to vertigo, Hypersensitivity to
Brand Name: Keppra antiepileptic activity primary levetiracetam nervousness, levetiracetam;
may be related to generalized fatigue, renal impairment
Dose: 500 mg/tab its ability to inhibit tonic-clonic  Use cautiously with somnolence,  Physical: Body
polysynaptic seizures renal impairment ataxia, diplopia weight; body
Frequency: BID responses and  Dermatologic: temperature; skin
block post tetanic  Adjunctive  Use cautiously in Pruritus color, lesions;
Route: Oral potentiation. treatment for patients with history  GI: Dyspepsia, orientation, affect,
partial onset of psychiatric vomiting, nausea, reflexes; Pulse,
Classification: seizures in symptoms, constipation, Respiratory rate,
Therapeutic Class: patients with especially psychotic anorexia adventitious
Anticonvulsant epilepsy symptoms and  Respiratory: sounds; bowel
behaviors. Rhinitis, sounds, normal
Pharmacologic pharyngitis output, renal
Class: Pyrrolidine  Don’t abruptly  Other: Weight function tests
derivatives discontinue the gain, facial Interventions
drug because edema,  Give drug with
withdrawal seizure impotence food to prevent GI
may occur. upset
 If CNS, vision, or
coordination
changes occur,
establish safety
precautions (use
side rails,
accompany
patient when
ambulating)
Teaching points
 Take this drug
exactly as
prescribed
 Do not discontinue
 this drug abruptly
or change dosage,
except on the
advice of your
health care
provider
 You may
experience these
side effects:
Dizziness, blurred
vision; GI upset;
headache,
nervousness;
fatigue
 Report severe
headache,
sleepwalking,
rash, severe
vomiting, chills,
fever, difficulty
breathing
 DRUG MECHANISM INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
OF ACTION RESPONSIBILITY

VALPROIC Directly  Simple and  Preexisting or  Headache, nausea, vomiting,  Assess history
ACID increases complex family history of diarrhoea, anorexia, increased of hepatic
Generic Name concentration of absence hepatic appetite, wt gain, nystagmus, dysfunction,
inhibitory seizures, dysfunction, active somnolence, dizziness, fatigue, active liver
Brand Name: neurotransmitte mixed seizure liver disease, hyperammonaemic disease,
Depacon, r gamma- types porphyria; encephalopathy, hypothermia, hepatic
Depakene, aminobutyric mitochondrial and hallucinations. impairment.
Encorate, Epival acid (GABA). urea cycle Thrombocytopenia (dose  Should be
disorders. Hepatic related), tremors, LFT elevation. taken with food
Dose: 500 mg 1 Therapeutic impairment. Chronic use may lead to to decrease GI
tab Effect: Pregnancy. carnitine deficiency. upset.
Produces  You may
Frequency: OD anticonvulsant experience
effect, stabilizes these side
Route: Oral mood, prevents effects:
migraine Headache,
Classification: headache. nausea, fatigue,
increased
Therapeutic appetite.
class:  Report severe
Anticonvulsant headache,
nausea and
Pharmacologic vomiting,
Class: hallucinations,
Carboxylic Acid tremors.
Derivatives
 DRUG MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION RESPONSIBILITY

CEFUROXIME Inhibits bacterial cell  Susceptible  Hypersensitivity to  Rash, fever, pruritus,  Assess history of
Generic Name wall synthesis by infections cefuroxime or to erythema, urticaria, Stevens- hypersensitivity to
binding to one 1 or  UTI other cephalosporins Johnson syndrome, penicillin, GI
Brand Name: Altacef, more of the penicillin-  Special precations: erythema multiforme, toxic disease and renal
Axet, Axetine, binding proteins History of epidermal necrolysis, serum impairment.
Cefosan, Cefumax, (PBPs) which in turn hypersensitivity to sickness-like reactions,  May be taken with
Cefarez inhibit the final penicillin, and GI angioedema; mild to or without food.
transpeptidation step disease (particularly moderate hearing loss  You may
Dose: 500 mg of peptidoglycan colitis). Renal (childn); nausea, vomiting, experience these
synthesis in bacterial impairment. gagging, epigastric burning, side effects:
Frequency: BID cell walls, thus Pregnancy and GI bleeding and infection, Nausea, headache,
inhibiting cell wall lactation. abdominal pain, flatulence, flatulence, thirst
Route: Oral biosynthesis and ptyalism, indigestion, mouth  Report severe
arresting cell wall ulcers, swollen tongue, nausea and
assembly resulting in anorexia, thirst, dyspepsia, vomiting, abdominal
Classification: bacterial cell death. stomach cramps, diarrhoea; pain, diarrhea,
decreased Hb and swollen tongue,
Pharmacologic class: haematocrit, thrombocytosis, mouth ulcers,
Second Generation lymphocytosis, haemolytic dysuria.
Cephalosporins anaemia, increased
prothrombin time; transient
Therapeutic class: increase in serum AST
Antibiotic (SGOT), ALT (SGPT),
alkaline phosphatase, LDH
and bilirubin levels; transient
increase in BUN and/or
serum creatinine
concentration, decreased
CrCl, bilateral renal cortical
necrosis; UTI, kidney pain,
urethral pain or bleeding,
dysuria, vaginitis, vag
candidiasis, vulvovaginal
 pruritus, vag discharge or
irritation; Jarisch-Herxheimer
reaction; neck muscle
spasm, muscle cramps or
stiffness, chest pain or
tightness, shortness of
breath, tachycardia, chills,
lockjaw-type reaction, viral
illness, upper resp infection,
sinusitis, cough, joint
swelling, arthralgia; pain at
inj site, thrombophlebitis (IV).
Rarely, transient eosinophilia
and neutropenia,
pancytopenia, leucopenia,
thrombocytopenia;
headache, somnolence or
sleepiness, dizziness,
hyperactivity, irritable
behaviour, myoclonic jerks,
seizures, generalised
hyperexcitability; jaundice;
acute renal failure, interstitial
nephritis.
 Potentially
Fatal: Anaphylaxis,
pseudomembranous colitis.
 DRUG MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTON RESPONSIBILITY
OMEPRAZOLE
Generic Name Inhibits proton pump  Vomiting  Contraindicated with  CNS: Headache, Assessment
activity by binding to hypersensitivity to dizziness, asthenia,  History:
Brand Name: Prilosec hydrogen-potassium omeprazole or its vertigo, insomnia, Hypersensitivity to
adenosine components apathy, anxiety, omeprazole or any of
Dose: 20 mg triphosphatase located paresthesias, dream its components;
at secretory surface of abnormalities pregnancy, lactation
Frequency: OD gastric parietal cells, to  Dermatologic: Rash,  Physical: Skin
suppress gastric acid inflammation, lesions;
Route: IVTT secretion. urticarial, pruritus, Temperature;
alopecia, dry skin reflexes, affect;
Classification:  GI: Diarrhea, urinary output,
Therapeutic class: abdominal pain, abdominal
Antiulcer drugs nausea, vomiting, examination;
constipation, dry respiratory
Pharmacologic class: mouth, tongue auscultation
Proton pump inhibitor atrophy Interventions
 Respiratory: URI  Administer before
symptoms, cough, meals
epistaxis Teaching points
 Other: Cancer in  You may experience
preclinical studies, these side effects:
back pain, fever Dizziness; headache,
nausea, vomiting,
diarrhea; symptoms
pf URI, cough
 Report severe
headache, worsening
of symptoms, fever
chills
 DRUG MECHANISM INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
OF ACTION RESPONSIBILITY

CINNARIZINE A non-  Vertigo and  Patient w/  Somnolence, weight gain,  Assess patient
Generic Name competitive vestibular hypotension (high nausea, vomiting, dyspepsia, with
antagonist of disorders dose), Parkinson's lethargy, upper abdominal pain, hypotension,
Brand Name: smooth muscle disease, porphyria. hyperhidrosis, lichenoid renal and
Stugeron, contractions Renal and hepatic keratosis (e.g. lichen planus), hepatic
Stunarone, caused by impairment. fatigue. Rarely, extrapyramidal impairment
Arlevert, Diznil- various Pregnancy and symptoms.  Should be
25 vasoactive lactation. taken with food
agents (e.g.  Report if severe
Dose: 75 mg/tab histamine). It nausea and
selectively vomiting, upper
Frequency: OD inhibits Ca abdominal pain,
influx into extrapyramidal
Route: Oral depolarized symptoms.
cells, thereby
Classification: reducing free
Antivertigo Ca ions
available for the
induction and
maintenance of
contraction.
 DRUG MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION RESPONSIBILITY

POTASSIUM Acts as an  Hypokalaemia  Hyperkalaemia and  Significant: Hypersensitivity/infusion  Assess

CHLORIDE electrolyte associated diseases reactions (e.g. anaphylaxis, chills). hyperkalemia,
Generic Name replenisher of K (e.g. adrenal  GI disorders: Nausea, vomiting, dehydration,
ions. It is used as a insufficiency, flatulence, abdominal pain or severe renal
Brand Name: K- source of K cation, dehydration, acute discomfort, diarrhoea, impairment,
Chlor, K-Lyte, the major cation of dehydration, heat gastrointestinal haemorrhage, cardiac disease.
Kaligen, Sylvite the intracellular cramps, severe ulceration, perforation (oral).  Should be taken
fluid, essential for tissue breakdown  Injury, poisoning and procedural with food to
Dose: 1 tab maintenance of from trauma or complications: Inj site reactions decrease GI upset
acid-base and fluid burns), (e.g. pain, phlebitis).  Report severe
Frequency: TID and electrolyte hyperchloraemia,  Potentially Fatal: Severe nausea and
balance of the cell. plasma-K hyperkalaemia. vomiting,
Route: Oral It also plays a vital concentration >5 abdominal pian,
role in the mEq/L. diarrhea
Classification: conduction of nerve Gastrointestinal
Electrolytes impulses, obstruction (tab,
contraction of cap). Severe renal
cardiac, smooth impairment.
and skeletal Concomitant use
muscles, gastric with potassium-
secretion, normal sparing diuretics
renal function and (e.g. amiloride,
carbohydrate spironolactone,
metabolism. triamterene).
 Special precations:
Patient with acid-
base imbalance,
cardiac disease (e.g.
heart failure, cardiac
arrhythmias, atrio-
ventricular block),
cirrhosis. Mild to
moderate renal and
hepatic impairment.
Children. Pregnancy
and lactation.
 DRUG MECHANISM INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
OF ACTION RESPONSIBILITY

CEFTRIAXONE Bactericidal:  Susceptible  Allergy to  CNS: Headache, dizziness, Assessment

Generic Name Inhibits infections cephalosporin or lethargy, paresthesias  History: Hepatic
synthesis of  UTI penicillin  GI: Nausea, vomiting, diarrhea, and renal
Brand Name: bacterial cell  Use cautiously anorexia, abdominal pain, impairment,
Rocephin wall, causing with renal failure, flatulence, pseudomembranous lactation,
cell death. pregnancy colitis, hepatotoxicity pregnancy
Dose: 2 gms  GU: Nephrotoxicity  Physical: Skin
 Hematologic: Bone marrow sttus, LFTs,
Frequency: OD depression-decreased WBC, renal function
decreased platelets, decreased tests, culture of
Route: Hct affected area,
Parenteral  Hypersensitivity: Ranging from sensitivity tests
rash to fever to anaphylaxis; Interventions
Classification: serum sickness reaction  Protect drug
 Local: Pain, abscess at injection from light
Therapeutic site; phlebitis, inflammation at IV  Discontinue if
Class: site hypersensitivity
Antibiotic  Other: Superinfections, reaction occurs.
disulfram-like reaction with Teaching Points
Pharmacologic alcohol  You may
Class: experience
3rd Generation these side
Cephalosporin effects:
Stomach upset
or diarrhea
 Report severe
diarrhea,
difficulty
breathing,
unusual
tiredness or
fatigue, pain at
injection site.