Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar
Web: http://uep.edu.ph Email: [email protected]

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

BS NURSING

Submitted by:
CUI, MARK CHRISTIAN T.

Submitted to:
JEANETTE J. ROJO, RN, MAN, DNS
Clinical Instructor

NAME SPECIF INDICATI CONTRAINDI DRUG ADVERSE SPECIFI NURSING

 OF C ON CATION INTERAC REACTION C RESPONSIBI
DRUG ACTION TION PRECAU LITIES
TION
Generic Suppress Ventricular ● Wolff- Drug- CNS: Use
Monitor vital signs and
name: es arrhythmia Parkinson- drug: anxiety; cautiousl
ECG continuously.
Lidocai automati s caused White or atenolol, confusion; yWatch
in: for cardiac
ne city of by MI, AdamsStokes metoprol difficulty ●depression.
renal or
ventricul cardiac syndrome ol, speaking; hepatic
Evaluate level of
Brand ar cells, manipulati ●Hypersensitiv nadolol, dizziness; disorders,
consciousness closely.
name: decreasi on, or ity to drug, its pindolol, hallucination inflamma
Watch for adverse
Xylocai ng cardiac components, or propranol s; lethargy; tion or
reactions, particularly
ne diastolic glycosides other amide ol: may paresthesia; sepsis in
anaphylaxis.
depolari ADULT: local reduce light- injection
Stay alert for seizures.
zation 50 to 100 anesthetics hepatic headedness; area
Monitor neurologic
Route: and mg (1 to ● Heart failure, metabolis fatigue; ●status
labor
for lower spinal
I.V. increasin 1.5 mg/kg) cardiogenic m of drowsiness; orsegment deficits.
onset: g by I.V. shock, second- lidocaine, headache; delivery ● Give
(immedi ventricul bolus at 25 or third-degree increasing persistent ● supportive
ate; ar to 50 heart block, the risk of sensory, breastfee oxygen
peak: fibrillati mg/minute intraventricular toxicity. motor, or ding therapy, as
immedia on . Bolus block in Give autonomic patients. indicated and
te; threshol dose is absence of a bolus deficit of prescribed.
duration d. repeated pacemaker doses of lower spinal ● Monitor
: 10-20 Produces every 3 to ● Severe lidocaine segment; electrolyte,
minutes) local 5 minutes hemorrhage, at a septic blood urea
I.M. anesthesi until shock, or heart slower meningitis; nitrogen, and
(onset: a by arrythmias block rate, and seizures creatinine
5-15 reducing subside or (lidocaine with monitor CV: levels.
mins; sodium adverse dextrose) lidocaine bradycardia, ● Assess
peak: 10 permeab reactions ● Local level and hypotension, topical site
mins; ility of develop. infection at patient new or for adverse
duration sensory Don’t puncture site closely. worsening reactions.
: 2 nerves, exceed (lidocaine with Cimetidin arrhythmias,
hours) which 300-mg dextrose) e: may cardiac
blocks total bolus ● Septicemia decrease arrest
Classific impulse ring a 1 hr (lidocaine with clearance EENT:
ation: generati period. dextrose) of diplopia,
local on and Simultaneo lidocaine, abnormal
anesthet conducti usly, increasing vision
ics on. constant the risk of GI: nausea,
infusion of toxicity. vomiting, dry
20 to Consider mouth
Referen It also 50mcg/kg/ using a GU: urinary
ce: has roles minute (1 different retention
Nursing as an to 4 H2 Metabolic:
2009 adjuvant mg/minute receptor methemoglo
Drug analgesi ) is begun. antagonist binemia
Handbo c in If single if Respiratory:
ok & managin bolus has possible. suppressed
Nurses g acute been Monitor cough reflex,
Drug and given, lidocaine respiratory
Handbo chronic smaller level depression,
ok 7E pain bolus may closely. respiratory
United be arrest
VRG repeated Drug- Skin: rash;
15 to 20 herb: urticaria;
minutes Parreira: pruritus;
after start may erythema;
infusion to increase contact
maintain the effect dermatitis;
therapeutic of cutaneous
level. Or, neuromus lesions; tissue
200 to 300 cular irritation,
mg I.M.; blockade. sloughing,
then Discourag and necrosis
second e use Other: fever;
I.M. dose together edema;
60 to 90 infection,
minutes Drug- burning,
later, if lifestyle: stinging,
needed. smoking: tenderness,
CHILDRE may and swelling
N: 1 mg/kg increase at injection
by I.V. or of site;
intraosseou metabolis anaphylaxis
s bolus. If m of
no lidocaine.
response, Monitor
start patient
infusion of closely.
20 to 50
mcg/kg/mi
nute. Give
an
additional
bolus dose
of 0.5 to 1
mg/kg if
delay of
greater
than 15
minutes
between
initial
bolus and
starting the
infusion.
Bolus
doses
shouldn’t
exceed 3 to
5 mg/kg.
 ELDERLY
PATIENT
S: reduce
dosage and
rate of
infusion by
50%.

ADJUST-
A-DOSE:
for patients
with heart
failure,
with renal
or liver
disease, or
who weigh
less than
50 kg (110
lb.), reduce
dosage.

NAME SPECIF INDICATI CONTRAIN DRUG ADVERSE SPECIFIC NURSING

OF C ON DICATION INTERACTI REACTION PRECAU RESPONSIBILI
DRUG ACTIO ON TION TIES
N
Generi Directly  Preven ● Drug-drug. CNS: Use Monitor and
c stimulat tion Hypersensitiv Dopamine, dizziness, cautiously record blood
name: es and ity to drug ergot headache, in: pressure, pulse
methy vascular treatm ● alkaloids, hallucination, ● severe rate, and uterine
lergon smooth ent of Hypertension oxytocin, seizures, hepatic or response; report
ovine muscle postpa ● Toxemia regional CVA (with renal sudden change
malea contracti rtum ● Pregnancy anesthetics, I.V. use) disease, in vital signs,
te ons in hemorr (except vasoconstrict CV: vascular frequent periods
uterus hage during third ors: may hypertension, disease, of uterine
Brand and Adults: 0.2 stage of cause hypotension, jaundice, relaxation, and
name: cervix mg I.M.; labor) excessive transient sepsis character and
Methe and repeat q 2 vaso chest pain, ● patients amount of
rgine decrease to 4 hours constriction. palpitations, in second vaginal
s as needed Use Use together thrombophl stage of bleeding.
bleeding to a total of cautiously cautiously. ebitis labor.
Route after five doses. during last Clarithromyc EENT: Monitor
: P.O. delivery In labor in, tinnitus, contraction
(ONS emergencie delavirdine, nasal which may
ET: 5- s, 0.2 mg Use erythromycin congestion begin
10 I.V. over 1 cautiously in , indinavir, GI: nausea, immediately.
mins minute. patients with itraconazole, vomiting, Contractions
PEAK After initial sepsis, ketoconazole, diarrhea may continue up
: 30 I.M. or I.V. obliterative nelfinavir, GU: to 45 minutes
mins dose, 0.2 vascular ritonavir, hematuria after I.V. use or
DUR mg P.O. q 6 disease, or telithromycin Musculoskel for 3 hours or
ATIO to 8 hours hepatic or , etal: leg more after P.O.
N: 3 for 2 to 7 renal disease troleandomyc cramps or I.M. use.
hr) days; in, Respiratory:
decrease voriconazole: dyspnea
I.V. dosage if may cause Skin:
(ONS cramping vasospasm, diaphoresis,
ET: occurs. leading rash, allergic
immed ischemia. reactions
iate Avoid using Other: foul
DUR together taste
ATIO
N: 45
mins)

I.M.
(ONS
ET: 2-
5 mins
DUR
ATIO
N: 3
hr)

Classif
ication
: ergot
alkalo
ids

Refer
ence:
Nursi
ng
2009
Drug
Hand
book
&
Nurse
s Drug
Handb
ook 7E
Unite
d VRG

NAME SPECIFC INDICATIO CONTRAIN DRUG ADVERS SPECIF NURSING

OF ACTION N DICATION INTERA E IC RESPONSI
DRUG CTION REACTIO PRECA BILITIES
N UTION
Generic Promotes ➣ Mephyton is Anticoag Hyperbilir  Docu
name: hepatic Hypoprothr contraindicat ulants ubinemia ment
Phyton synthesis of ombinemia ed in Mephyto (in the
adione active caused by patients with n may infants); giving
(vitami prothrombi anticoagula a history of induce with of the
n K) n, nt therapy a temporar parenteral medic
proconverti Adults: hypersensiti y administra ation
n, Initially, 2.5 vity reaction resistance tion— to
Brand plasmathro to 10 mg to to pain, newbo
name: mboplastin P.O., I.M., phytonadion prothrom swelling, rn to
Mephy component, subcutaneou e or inactive bin- tenderness preven
ton and Stuart sly, or I.V. ingredients depressin at t an
factor (at doses g injection accide
not anticoagu site; itchy ntal
exceeding 1 lants, rash after doubli
Route: mg/minute); especiall repeated ng of
I.V., repeat if y when injections; dose.
I.M. needed larger transient  Obser
within 12 to doses of flushing ve for
48 hours the drug sensations bleedi
Classifi after P.O. are used; ; peculiar ng
cation: dose or should taste; (usuall
Hemost within 6 to this anaphyla y
atic: 8 hours of occur. ctoid occurs
Vitami I.M., higher reactions on
ns, Fat subcutaneou doses of secon
Soluble s, or I.V. anticoagu d or
dose. lant third
Subsequent therapy day).
dosages may be Bleedi
Refere determined needed ng
nce: by when may
Nursin prothrombin resuming be
g 2009 time or anticoagu seen
Drug clinical lant as
Handb condition. therapy, genera
ook & ➣ or a lized
Nurses Hypoprothr change in ecchy
Drug ombinemia therapy moses
Handb secondary to a or
ook 7E to other different bleedi
United causes class of ng
VRG Adults: 2.5 anticoagu from
to 25 mg lant may umbili
(rarely, up be cal
to 50 mg); necessary cord.
dosage and (ie., circu
administrati heparin mcisio
on route sodium) n site,
depend on  The nose,
severity and drug or
response. does gastroi
Children: 5 not ntestin
to 10 mg; affec al
dosage and t tract.
administrati antic  Obser
on route oagu ve for
depend on lant jaundi
severity and actio ce and
response. ns of kernic
➣ hepa terus,
Prevention rin especi
and ally in
treatment of preter
hemorrhagi m
c disease of infants
newborn .
Neonates:  Obser
For ve for
prevention, signs
0.5 to 1 mg for
I.M. as a local
single dose inflam
within 1 matio
hour of n.
birth. For  Apply
treatment, 1 pressu
mg I.M. or re to
subcutaneou the
sly if injecti
mother on site
received to
oral preven
anticoagula t
nts. further
bleedi
ng.
 Protec
 t drug
from
light.
 Give
vitami
n K
before
circu
mcisio
n
proced
ure.

NAME SPEC INDICA CONTRAINDIC DRUG ADVERSE SPECIFI NURSING

OF IFC TION ATION INTERA REACTIO C RESPONSIB
DRUG ACTI CTION N PRECAU ILITIES
ON TION
Generic Provi To  Contrai Drug- CNS Use Obtain
name: des prevent ndicated drug (I.V.): cautiousl history of
hepatitis passi hepatitis in Live- chills, y in allergies and
B. ve B patients virus fever, patients reactions to
immune immu recurrenc with vaccines: headache with immunizatio
globulin, nity e history may GI(I.V.): specific n. Keep
human followin of interfere nausea, IgA epinephrine
(HBIG) g liver anaphyl with vomiting deficienc 1:1,000
transplan actic response Musculos y available
tation in reaction to live- keletal:
Brand HBsAg- to virus arthralgia, For
name: positive immune vaccines. low back postexposure
Hepaga liver serum Postpone pain, prophylaxis
m B. transplan  Give to routine myalgia (such as after
HyperH t patients patients for 3 Skin: pain needlestick
EP (HepaGa with months and or direct
BS/D. m B coagulat tenderness contact),
Nabi- only) ion at give drug
HB disorder injection with hepatitis
s or site, B vaccine
thrombo urticaria
cytopeni Other: A vial of
Route: a only if anaphylax HBIG
I.V., I.M. benefits is (human) that
outweig angioede ahs been
Classific h risk ma or flu, entered
ation:  malaise should be
Therapeu used within 6
tic class hours. Don’t
Prophyla reuse or save
ctic for future use
agent
The maltose
Pharmac contained in
ologic HepaGam B
class: can interfere
Immune with some
scrum blood
glucose
monitoring
systems,
causing
falsely
Referen elevated
ce: readings.
Nursing
2009
Drug
Handbo
ok &
Nurses
Drug
Handboo
k 7E
United
VRG

NAME SPECI INDICATI CONTRAIND DRUG ADVERS SPECIFI NURSING

OF FC ON ICATION INTERAC E C RESPONSIB
DRUG ACTI TION REACTIO PRECA ILITIES
ON N UTION
Generic Thoug To induce ● Drug- CNS: Use Continuousl
name: ht to or Hypersensitiv drug. seizures, cautiousl y monitor
Oxytoci directl stimulate ity to drug Sympathom coma, y in: contractions,
n y labor ● imetics: neonatal ● fetal and
stimula Adults: Cephalopelvic postpartal brain previous maternal
Brand te initially 10 disproportion hypertensio damage, cervical heart rate,
name: smooth units in ● Fetal n subarach or and
Pitocin muscle 1000 ml of distress when Thiopental noid uterine maternal
contrac D5W delivery is not anesthetics hemorrh surgery, blood
tions injection, imminent : delayed age history pressure and
Route: in lactated ● Prolonged anesthesia CV: of ECG.
I.V. uterus ringer’s or use in uterine induction premature uterine Discontinue
(ONSE and normal inertia or Vasoconstr ventricula sepsis infusion if
T: cervix. saline severe ictors: r ● uterine
immedia solution toxemia severe contractio breastfee hyperactivit
te I.V. ● Hypertonic hypertensio ns, ding y occurs.
PEAK: Cause infused at or hyperactive n (when arrhythm patients.
40 mins potent 0.5 to 2 uterine pattern given ias, Monitor
DURA and milliunits/ ● within 3 to neonatal patient
TION: selecti minute. Unfavorable 4 hours of bradycar extremely
1 hr) ve Increase fetal position oxytocin) dia closely
stimula rate by 1 or Drug- GI: during first
I.M. tion of to 2 presentation herbs. nausea, and second
(ONSE uterine milliunits/ that’s Ephedra vomiting stages of
T: 3-5 and minutes at undeliverable (ma GU: labor
mins mamm 30 to 60 without huang): postparta because of
PEAK: ary minutes conversion increased l risk of
4O mins gland interval ● Labor hypertensio hemorrh cervical
DURA smooth unit induction or n age; laceration,
TION: muscle normal augmentation pelvic uterine
2-3 hr) contractio when vaginal hematom rupture, and
n pattern delivery is a; uterine maternal
Classific is contraindicate hypertoni and fetal
ation: establishe d (as in city, death.
Oxytoci d. invasive spasm, or ● When
c Maximum cervical tetanic giving drug
hormon dose is 20 cancer, active contracti to control
es milliunits/ genital on; postpartal
minute. herpes, or abruptio bleeding,
total placenta placentae monitor and
To control previa) ; uterine record
postpartu rupture vaginal
m (with bleeding.
Referen bleeding excessive ● Assess
ce: after doses) fluid intake
Nursing expulsion Hematolo and output.
2009 on gic: Watch for
Drug placenta afibrinog signs and
Handbo Adults: 10 enemia symptoms
ok & to 40 units Hepatic: of water
Nurses in 1000 ml neonatal intoxication.
Drug of D5W jaundice
Handbo injection, Other:
ok 7E lactated hypersens
United ringer’s or itivity
VRG normal reactions
saline including
solution anaphyla
I.V. xis, low
infused at 5-minute
rate Apgar
needed to score
control (neonate)
bleeding,
which is
usually 20
to 40
milliunits/
minute.
also 10
units may
be given
I.M. after
delivery of
placenta.

Incomplet
e abortion
Adults: 10
units I.V.
in 500 ml
of normal
saline
solution,
lactated
ringer’s or
dextrose
5% in
normal
saline
solution.
Infused at
10 to 20
milliunits
(20 to 40
drops)/min
ute. Don’t
exceed 30
units in 12
hours.
NAME SPECI INDICAT CONTRAIND DRUG ADVERS SPECIFI NURSING
OF FC ION ICATION INTERACT E C RESPONSIB
DRUG ACTI ION REACTI PRECA ILITIES
ON ON UTION
Generic Inhibit ➣ Pelvic ●Hypersensiti Drug-drug. CNS: Use ● Check
name: s inflamma vity to drug or Alfentanil, fever cautiousl temperature,
erythro bacteri tory tartrazine alprazolam, CV: vein y in: and watch
mycin al disease ● Hepatic bromocripti irritation ● for signs and
protein Adults: impairment ne, or myasthe symptoms of
Brand synthe 500 mg (with estolate) buspirone, thrombop nia superinfectio
name: sis by (base) ● Pregnancy carbamazep hlebitis gravis n.
erythro bindin I.V. q 6 (with estolate) ine, after I.V. ● hepatic ● Monitor
cin g to hours for clozapine, injection, disease. liver
the 3 days, cyclosporin ventricul function
50S then 250 e, ar tests. Watch
Route: subuni mg (base, diazepam, arrythmi for signs and
P.O. t of estolate, disopyrami as. symptoms of
suscep or de, ergot EENT: hepatotoxicit
tible stearate) alkaloids, hearing y.
bacteri or 400 felodipine, loss (with ● Assess
al mg methylpred high I.V. patient’s
riboso (ethylsuc nisolone, doses). hearing for
mes, cinate) q midazolam, GI: signs of
suppre 6 hours tacrolimus, abdomina ototoxicity
ssing for 7 days theophyllin l pain and ●monitor
protein ➣ e, cramping, patient for
synthe Syphilis triazolam, diarrhea, superinfectio
sis in Adults: vinblastine, nausea, n. Drug may
bacteri 500 mg warfarin: vomiting cause
al cells (base, increased Hepatic: overgrowth
and estolate, blood levels cholestati of non-
causin or and risk of c jaundice susceptible
g cell stearate) toxicity (erythrom bacteria or
death P.O. q.i.d. from these ycin fungi.
for 14 drugs estolate). ●monitor
days Clindamyci Skin: hepatic
n, anaphyla function.
➣ Most
lincomycin: xis, Erythromyci
upper and
antagonism overgrowt n estolate
lower
of h of non- may cause
respirator
erythromyci susceptibl serious
y tract
n’s effects e bacteria hepatotoxicit
infections
CYP3A of fungi. y in adults.
; otitis
inhibitors: Other salts
media;
increased cause less
skin
erythromyci serious
infections
n blood hepatotoxicit
;
level, with y
Legionnai
risk of
res’
ventricular
disease
arrhythmias
Adults: and sudden
250 mg death
P.O. q 6 Digoxin:
hours, or increased
333 mg digoxin
P.O. q 8 blood level
hours, or HMG-CoA
500 mg reductase
P.O. q 12 inhibitors:
hours increased
(base, risk of
estolate, myopathy
or and
stearate); rhabdomyol
or 400 ysis
mg P.O. q Hormonal
6 hours or contracepti
800 mg ves:
P.O. q 12 decreased
hours contraceptiv
(ethylsuc e efficacy
cinate); or Astemizole,
250 to cisapride,
500 mg pimozide,
I.V. (up sparfloxaci
to 1 g) q n,
6 hours terfenadine:
(gluceptat increased
e or risk of
lactobion serious
ate) arrhythmias
Children Rifabutin,
: 30 to 50 rifampin:
mg/kg/da decreased
y (base, erythromyci
estolate, n effects,
ethylsucci increased
nate, or risk of
lactobion adverse GI
ate) I.V. reactions
or P.O., Theophyllin
in divided e: increased
doses q 6 theophyllin
hours e blood
when level,
giving decreased
I.V. and q erythromyci
6 to 8 n blood
hours level
when Drug-
giving diagnostic
P.O. tests.
Maximu Alanine
m dosage aminotransf
is 2 g/day erase,
for base alkaline
or phosphatas
estolate, e, aspartate
3.2 g/day aminotransf
for erase,
ethylsucci bilirubin:
nate, and increased
4 g/day levels
for Urine
lactobion catecholami
ate. nes: false
➣ elevations
Intestinal Drug-
amebiasis food.Grape
Adults: fruit juice:
250 mg increased
(base, erythromyci
estolate, n blood
or level
stearate)
or 400
mg
(ethylsuc
cinate)
P.O. q 6
hours for
10 to 14
days
Children
: 30 to 50
mg/kg/da
y (base,
estolate,
ethylsucci
nate, or
stearate)
P.O. in
divided
doses
over 10 to
14 days
➣
Prophyla
xis of
ophthalmi
a
neonatoru
m caused
by
Neisseria
gonorrho
eae or
Chlamydi
a
trachoma
tis
Neonates
: 0.5- to
1-cm
ribbon of
ointment
into each
lower
conjuncti
val sac
once
➣
Treatmen
t of
conjuncti
vitis of
the
newborn
caused by
susceptibl
e
organism
s
Neonates
: 50
mg/kg/da
y
(ethylsuc
cinate)
P.O. in
four
divided
doses for
at least 14
days
➣
Pertussis
Children
: 40 to 50
mg/kg/da
y
(estolate
preferred)
P.O. in
four
divided
doses for
14 days
➣
Pneumoni
a of
infancy
Infants:
50
mg/kg/da
y
(estolate
or
ethylsucci
nate) P.O.
in four
divided
doses for
at least 3
weeks
➣ Acne
Adults
and
children
older
than age
12: 2%
ointment,
gel, or
solution
applied
topically
b.i.d.