DRUG STUDY

Name of the Patient: Melissa Age: 26 y.o Sex: Female Name of Student: Sanguyo, Camille B.
Civil Status: N/A Religion: N/A Rm/Bed No.: N/A Area: MEDICAL – ICU Level/ Block: BSN III-B

Address: N/A Date Submitted: January 27, 2022

Date of Admission: N/A Diagnosis: Irritable Bowel Syndrome Rating:

MEDICATION Classification/ Action Indications Contraindications Side Effects Adverse Effects Nursing Responsibilities

 Bloating Before:
Generic name: Pharmacologic Class: Only for the treatment This drug is  Abdominal distension
 Gas
of symptoms of severe contraindicated to  Hemorrhoids  Verify the doctor’s order
Alosetron 5-HT3 receptor  Burping with
diarrhea-predominant patients with:  Regurgitation regarding the medication.
antagonists heartburn
irritable bowel  Reflux  Observe the ten rights of
 Hypersensitivity to  Stomach discomfort
Action: syndrome (IBS) in  Ileus perforation medication administration.
Brand name: the drug, or any of  Nausea
women with chronic  Ischemic colitis  Assess patients
Selectively inhibits 5- its components,  Headache
Lotronex symptoms appropriate for treatment
HT3 receptors in the GI and in those with a  Constipation  Small bowel mesenteric
history of or current should be women who
tract, which blocks  Skin rash  Ischemia
chronic or severe experience symptoms for
neuronal depolarization,  Impaction at least 6 months, have no
Usual dosage/ resulting in less visceral constipation,  Obstruction
sequelae from anatomic or biochemical GI
frequency: pain, colonic transit, and
constipation, tract abnormalities, and
1 mg P.O once daily GI secretions. have not responded to
intestinal
with or without food. obstruction other therapies.
May increase the  If a patient taking the drug
dosage to 1 mg b.i.d., Pharmacokinetics: stricture, toxic develops constipation, stop
if necessary, after 4 Absorption: megacolon, GI the drug until symptoms
weeks. perforation. subside.
50-60%  Advise patient that drug
Usual route Use cautiously in may be taken with or
Distribution:
Oral patients with: without food.
Unknown
 The predominant During:
Protein Binding: symptom is
Drug order: constipation  Maintain patient comfort
82%
Alosetron (0.5 mg BID  Pregnant and safety.
Metabolism:  Breast-feeding  Administer the drug as
for 4 weeks)
 Younger than age ordered.
Drug Interactions: 18
Hepatic, via microsomal
After:
 Hydralazine, cytochrome P450 (CYP)
isoniazid, and  Monitor patient for allergic
procainamide; Excretion:
reactions throughout drug
May cause slower Renal excretion therapy and after the drug
metabolism of is discontinued.
these drugs Half-life:  Monitor the side and
because of N- adverse effects that the
1.5 hours
acetyltransferase patient can feel and
inhibition. immediately inform the
Pharmacodynamics: physician.
 Advise patients to take
Onset: Unknown medication as they are
prescribed.
Peak: 1 hr  Document the data.
Duration: Variable
Patient/Family Teaching:

 Have patient sign a

 Patient-Physician
Agreement before starting
therapy
 Urge patient to read the
medication guide before
starting drug and each time
she refills the prescription
 Tell patient that this drug
wont cure but may alleviate
some IBS symptoms.
 Inform patient that most
women notice their
symptoms improving after
about 1 week of therapy,
but some may take up to 4
weeks to get relief from
abdominal pain, discomfort,
and diarrhea.
 Let the patient know that
symptoms usually return
within 1 week after
stopping the drug.
 Inform the patient not to
share drug with other
people having similar
symptoms
 Tell patient to notify the
prescriber immediately if
she becomes pregnant.
References:
Amy M. Karch. (1995). Lippincott's nursing drug guide. Philadelphia, PA: Lippincott. (725-726)
 MEDICATION Classification/ Action Indications Contraindications Side Effects Adverse Effects Nursing Responsibilities
Before:
Occasional (11%–5%):  Hypersensitivity
Generic name: Pharmacologic Class: Indicated for irritable This drug is  Verify the doctor’s order
reaction
bowel syndrome with contraindicated to  Flatulence regarding the medication.
Rifaximin Anti-infective  superinfection occur
diarrhea (IBS-D) in patients with:  Headache  Observe the ten rights of
Clinical: adult men and women rarely
 Hypersensitivity to  abdominal discomfort medication administration.
rifaximin, other  rectal tenesmus  Check baseline hydration
Brand name: Site-specific antibiotic
rifamycin antibiotics  defecation urgency status: skin turgor, mucous
Xifaxan Action:  nausea membranes for dryness,
Use cautiously in urinary status.
Inhibits bacterial RNA  Assess stool frequency,
patients with: Rare (4%–2%):
synthesis by binding to consistency.
Usual dosage/
bacterial DNA-  Question for the history of
frequency:
dependent RNA
 Severe Hepatic  Constipation
allergies and full
impairment  Fever
PO: ADULTS, polymerase. medication history; screen
 vomiting for interactions
ELDERLY: 550 mg 3
Therapeutic Effect:  Educate the patient that
times/ day for 14 days.
May repeat up to 2 Bactericidal drug may be taken with or
times if symptoms without food.
Pharmacokinetics:  Educate and verify patient
recur
Absorption: and SO’s understanding
Usual route about the medication.
Less than 0.4%
 Check the medication three
Oral absorbed after PO times.
administration  Obtain baseline vital signs.
Distribution:
Drug order: Well distributed During:
Rifaximin (Xifaxan) Protein Binding:  Maintain patient’s comfort
550 mg PO q8hr for and safety.
80%
14 days  Administer the drug as
Metabolism: ordered.
Drug Interactions:
Liver  Stay with patient
 None significant
Excretion: throughout whole duration
Feces of administration.

Half-life:
After:
5 hours
 Monitor patient for allergic
reactions throughout drug
Pharmacodynamics: therapy and after the drug
is discontinued.
Onset: Unknown  Monitor the side and
Peak: Unknown adverse effects that the
patient can feel and
Duration: Unknown immediately inform the
physician.
Route: P.O  Encourage adequate fluid
intake.
 Assess bowel sounds for
peristalsis.
 Monitor daily pattern of
bowel activity, stool
consistency.
 Assess for GI disturbances,
blood in stool
 Advise patients to take
medication as they are
 prescribed.
 Document the data.

 Patient/Family Teaching:
 Report if diarrhea worsens
or if blood occurs in stool,
fever develops within 48
hrs.
 Tell patient to take all
prescribed drug even he
feels better before the drug
is finished.
 Advise the patient to notify
the prescriber if diarrhea
worsens or lasts longer
than 1 or 2 days after
starting treatment.
 Tell patient to call
prescriber if he/she
develops a fever or has
blood in his stool.
 Caution not to share this
drug with others.
 Explain that this drug is
only for treating diarrhea
caused by contaminated
foods or beverages while
traveling and not for any
other type of infection.
References:
Amy M. Karch. (1995). Lippincott's nursing drug guide. Philadelphia, PA: Lippincott. (684-685)
 MEDICATION Classification/ Action Indications Contraindications Side Effects Adverse Effects Nursing Responsibilities
 Abrupt withdrawal Before:
Frequent (32-12%): increases risk of seizure
Generic name: Pharmacologic Class: Indicated as a This drug is  Dizziness frequency in pts with  Verify the doctor’s order
management of contraindicated to  Drowsiness seizure disorders; regarding the medication.
Pregabalin Analgesics,
postherpetic neuralgia patients with:  Ataxia withdraw gradually over  Observe the ten rights of
Anticonvulsants
 Hypersensitivity to  Peripheral edema a minimum of 1 wk. May medication administration.
Therapeutic Class: pregabalin increase risk of suicidal  Review history of seizure
Brand name:
Occasional (12-5%) thoughts and behavior. disorder (type, onset,
Gamma-aminobutyric
Lyrica Use cautiously in  Weight gain intensity, frequency,
acid (GABA) analogs,  Blurred vision duration, LOC).
nonopioid analgesics patients with:
 Diplopia  Assess location,
Usual dosage/ Action:  Hepatic failure  Difficulty with characteristics, and
 Renal impairment concentration, intensity of pain periodically
frequency:
Binds to calcium attention, cognition during therapy.
 Cardiovascular
PO (Adults): 75 mg channels in CNS tissues disease  Tremor  Question for history of
twice daily which regulate  Diabetes  Dry mouth allergies and full
neurotransmitter  History of  Headache medication history; screen
release. Does not bind angioedema  Constipation for interactions.
to opioid receptors.  Patients at risk for  Asthenia  Educate and verify patient
Usual route suicide and SO’s understanding
Therapeutic Effects:
 Concurrent use of Rare (4-2%) about the medication.
Oral Decreased neuropathic  Abnormal gait  Check the medication three
thiazolidine
or post-herpetic pain.  Confusion times.
antidiabetics
Decreased partial-onset  Incoordination  Obtain baseline vital signs.
Drug order: seizures  Twitching
 Flatulence During:
75mg BID for 7 days Pharmacokinetics:  Vomiting
 for abdominal pain Absorption:  Edema  Maintain patient’s comfort
 Myopathy and safety.
Interactions: Well absorbed (90%)  Administer the drug as
following oral ordered.
 Concurrent use administration.
with  PO: May be administered
thiazolidinediones Distribution: without regard to meals.
(pioglitazone,  Do not confuse Lyrica
rosiglitazone) may Probably crosses the (pregabalin) with Lopressor
increase the risk blood-brain barrier (metoprolol).
of fluid retention.  Do not confuse Lyrica with
Metabolism and Hydrea (hydroxyurea).
 Increase risk of Excretion:
CNS depression
with other CNS Minimally metabolized, After:
depressants 90% excreted  Monitor for changes in
including opioids, unchanged in the urine. behavior, depression,
alcohol, suicidal ideation.
benzodiazepines, Half-life:  Monitor CBC, neurologic
or other sedatives/ status (frequency, duration,
6hrs the severity of seizures.
hypnotics
Pharmacodynamics:  Monitor for therapeutic
serum level: 4–12 mcg/
Onset: Unknown mL; toxic serum level: more
than 12 mcg/mL.
Peak: 2-4 weeks  Monitor B/P (standing,
Duration: Unknown sitting, supine).
 Monitor patient for allergic
reactions throughout drug
therapy and after the drug
is discontinued.

Patient/Family Teaching:
 Instruct patient to take
medication as directed. If a
 dose is missed take it as
soon as remembered
unless almost time for the
next dose. Do not double
doses.
 Do not discontinue
abruptly; may cause
insomnia, nausea,
headache, or diarrhea or
increase in frequency of
seizures
 May cause dizziness,
drowsiness, and blurred
vision. Caution patient to
avoid driving or activities
requiring alertness until
response to medication is
known.
 Instruct patient to promptly
report unexplained muscle
pain, tenderness, or
weakness, especially if
accompanied by malaise or
fever.
 Inform patient that
pregabalin may cause
edema and weight gain.
 Strict maintenance of drug
therapy is essential for
seizure control.
 Slowly go from lying to
standing.
 Avoid Alcohol.
  Report depression,
thoughts of suicide,
unusual changes in
behavior.
References:
Vallerand, A. H., & Sanoski, C. A. (2019) Davis’s Drug Guide for Nurses (16th Edition). F.A Davis Company. (pp. 1048-1049)
Kizior, R. J., & Hodgson, K. J. (2020). Saunders Nursing Drug Handbook 2021 (1st ed.). Elsevier. (pp.966-968)

MEDICATION Classification/ Action Indications Contraindications Side Effects Adverse Effects Nursing Responsibilities
This drug is Rare:  Toxicity results in Before:
contraindicated to  Dry mouth constipation, GI irritation
Generic name: Pharmacologic Class: Controls, provides  Drowsiness  Verify the doctor’s order
patients with: (nausea, vomiting)
symptomatic relief of  Abdominal regarding the medication.
Loperamide Antidiarrheal agents  CNS depression
chronic diarrhea  Hypersensitivity to discomfort  Observe the ten rights of
 Activated charcoal is
Therapeutic Class: associated with loperamide  Rash medication administration.
used to treat loperamide
inflammatory bowel  Abdominal pain  Pruritus  Assess frequency and
Brand name: Antidiarrheal. toxicity
disease. without diarrhea consistency of stools and
Lomotil Action:  Acute dysentery bowel sounds prior to and
 Acute ulcerative during therapy.
Directly affects intestinal colitis  Assess fluid and
wall muscles through  Bacterial electrolyte balance and
Usual dosage/ enterocolitis caused
the opioid receptors. skin turgor for
frequency: by invasive dehydration.
Therapeutic Effect: organisms including
PO (ADULTS):  Do not administer if GI
Slows intestinal motility, Salmonella,
Initially, 4 mg, then 2 bleeding, mechanical
prolongs transit time of Shigella, obstruction is suspected.
mg after each
intestinal contents by Campylobacter  Investigate cause of
unformed stool until
reducing fecal volume,  Pseudomembranou diarrhea.
diarrhea is controlled.
diminishing loss of fluid, s colitis associated  Question for history of
electrolytes, increasing with broad allergies and full
viscosity, the bulk of spectrum antibiotic medication history; screen
stool. Increases tone of use.
Usual route the anal sphincter. for interactions.
Use cautiously in  Educate and verify patient
Oral Pharmacokinetics: patients with: and SO’s understanding
Absorption: about the medication.
 Hepatic impairment  Check the medication
Drug order: Poorly absorbed from  Avoid use when three times.
GI tract. inhibition of  Obtain baseline vital
2mg, initially 2-tab w/
peristalsis is signs.
subsequent dose of 1 Protein Binding: undesirable
tab after each loose (potential for ileus During:
97%
stool)  or megacolon)
Distribution:  Avoid use in pts  Maintain patient comfort
Interactions:
with risk factors for and safety.
Unknown. Does not
 May increase QT prolongation.  Administer the drug as
cross the blood-brain
concentration/ ordered.
barrier
effects of QT-  PO: Administer with clear
prolonging agents Metabolism: fluids to help prevent
(e.g., amiodarone, dehydration, which may
haloperidol, Metabolized in liver accompany diarrhea.
sotalol).
Excretion:
 Ranolazine may After:
increase Excreted in feces  Encourage adequate fluid
levels/effects. (30%), urine (less than intake.
2%). Not removed by  Assess bowel sounds for
hemodialysis. peristalsis.
 Monitor daily pattern of
Half-life: bowel activity, stool
9-14hrs. consistency.
 Withhold drug, notify
physician promptly in
Pharmacodynamics:
event of abdominal pain,
Onset: Unknown distention, fever.
 Monitor patient for allergic
Peak: 2-4 weeks reactions throughout drug
therapy and after the drug
Duration: Unknown is discontinued.

Patient/Family Teaching:
 Instruct patient to take
medication as directed.
Do not take missed doses,
and do not double doses.
In acute diarrhea,
medication may be
ordered after each
unformed stool.
 Advise the patient not to
exceed the maximum
number of doses. May
cause drowsiness.
 Advise patient to avoid
driving or other activities
requiring alertness until
response to drug is
known.
 Advise patient that
frequent mouth rinses,
good oral hygiene, and
sugarless gum or candy
may relieve dry mouth.
 Caution patient to avoid
using alcohol and other
CNS depressants
concurrently with this
medication.
 Instruct patient to notify
 health care professional if
diarrhea persists or if
fever, abdominal pain, or
distention occurs.

References:
Vallerand, A. H., & Sanoski, C. A. (2019) Davis’s Drug Guide for Nurses (16th Edition). F.A Davis Company. (pp. 786-787)
Kizior, R. J., & Hodgson, K. J. (2020). Saunders Nursing Drug Handbook 2021 (1st ed.). Elsevier. (pp.713-715)

MEDICATION Classification/ Action Indications Contraindications Side Effects Adverse Effects Nursing Responsibilities
 Drowsiness  Easy bruising or
 Dizziness bleeding Before:
Generic name: Pharmacologic Class: For the relief of This drug is  Dry mouth  Persistent heartburn
symptoms of contraindicated to  Blurred vision  Verify the doctor’s order
Amitriptyline Psychotherapeutic  Shaking
depression patients with:  Constipation regarding the medication.
Combos  Mask-like facial
 Hypersensitivity to  Weight gain expressions,  Observe the ten rights of
Clinal: Amitriptyline  Difficulty urinating  Muscle spasms medication administration.
Brand name:
 It should not be  Severe stomach pain  Assess patients
Tricyclic Antidepressant
Elavil given concomitantly  Decreased sexual appropriate for treatment
Action: with monoamine desire should be women who
oxidase inhibitors experience symptoms for
Amitriptyline inhibits the  Enlarged or painful
Usual dosage/  Amitriptyline at least 6 months, have no
membrane pump breasts
hydrochloride anatomic or biochemical GI
frequency:  Black stool
mechanism responsible tract abnormalities, and
should not be given  Severe dizziness
-Initial dose: 100 mg for uptake of with Cisapride have not responded to
norepinephrine and  Fainting other therapies.
orally per day  This drug is not
serotonin in adrenergic  Seizures  If patient taking drug
-Maintenance dose: recommended for  Eye pain, redness or
and serotonergic use during the develops constipation, stop
40 to 100 mg orally as neurons. swelling the drug until symptoms
acute recovery
a single dose at  Vision changes subside.
Pharmacokinetics: phase following
bedtime  Muscle stiffness During:
myocardial
Usual route Absorption: infarction.  Severe confusion
 Advice the patient not to
Oral Well absorbed in GI drink alcohol
Distribution:  Advice to avoid driving or
hazardous activity until you
Drug order: Unkown know how Elavil will affect
you.
Elavil 25 mg OD HS Protein Binding:
 Avoid exposure to sunlight
Drug Interactions: 90% or tanning beds.
After:
 Concomitant use Metabolism:
of tricyclic  Monitor patient for allergic
antidepressants reactions throughout drug
with drugs that Metabolized in liver
therapy and after the drug
can inhibit Excretion: is discontinued.
cytochrome P450  Monitor the side and
2D6 may require Excreted in Urine adverse effects that the
lower doses than patient can feel and
Half-life:
usually prescribed immediately inform the
for either the 10-50 hours physician.
tricyclic  Advise patients to take
antidepressant or medication as they are
the other drug. Pharmacodynamics: prescribed.
 Document the data.
Onset: Unknown
Peak: Unknown
Duration: Unknown
References:

Amy M. Karch. (1995). Lippincott's nursing drug guide. Philadelphia, PA: Lippincott. (725-726)