LYCEUM OF THE PHILIPPINES UNIVERSITY

College of Nursing

DRUG STUDY

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Laxatives • Indicated in the short- Indicate to patients with: • Gas • Examine the patient for • serum electrolytes
Cephulac, movelax, lilac term treatment of • Bloating abdominal distention, • stool color, consistency,
Lactulose is broken down serious bacterial • Chronic constipation: • Burping bowel noises, and a and amount
Generic Name: into low molecular organic infections due to The colon's • stomach normal bowel function
Lactulose acids in the colon by susceptible strains of physiological rhythm is • rumbling/pain pattern.
colonic bacteria. These gram-negative bacteria regulated. Treatment • nausea • Patients should be
Dosage: acids reduce the pH in the • Effective in bacterial and prevention of • cramps informed that this
30cc intestinal lumen and septicemia (including hepatic coma or pre- medicine can induce
increase the volume of neonatal sepsis); in coma with portal belching, gas, and
Route: the colonic contents serious infections of the systemic stomach discomfort. If
OD through an osmotic respiratory tract, bones encephalopathy (PSE). this gets unpleasant or if
impact. These effects help and joints, central diarrhea happens,
Frequency: to regulate bowel nervous system • When a soft stool is contact a health care
HS (Hour of Sleep) consistency by stimulating (including meningitis) thought to be beneficial practitioner.
colon peristalsis. and skin and soft tissue; to one's health
Constipation is relieved, intra-abdominal (haemorrhoids, post-
and the colon's natural infections (including colon/anal surgery).
rhythm is restored. peritonitis); and in burns
and postoperative
infections (including
post-vascular surgery)
 Classification and Side Effects/Adverse Nursing
Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Analgesic, antipyretic Acetaminophen is Acetaminophen is Some common side • Assess the patient’s For patients who are at
Acetaminophen indicated for the relief of generally considered safe effects of acetaminophen pain level before risk for hepatotoxicity or
Acetaminophen is an mild to moderate pain when taken as directed, include: administering the renal toxicity, the nurse
Generic Name: over-the-counter pain and fever. but there are some medication. should closely monitor
Paracetamol reliever and fever reducer. precautions and CNS: agitation, anxiety, • Assess overall health AST and ALT levels and
Its mechanism of action is Some of the common contraindications to be headache, fatigue, status before BUN and creatinine.
Dosage: not fully understood, but it conditions for which it is aware of. insomnia Resp: administering
300 mg is thought to work by used include: atelectasis, dyspnea acetaminophen. Monitor liver function tests
inhibiting the production of Some of the precautions CV: hypertension, • Assess fever; note (LFTs), including
Route: prostaglandins, which are Headaches and include: hypotension the presence of International Normalised
IV substances in the body migraines GI: hepatotoxicity, associated signs Ratio (INR).
that contribute to pain and Overdosage Hepatic or constipation, increased (diaphoresis,
Frequency: inflammation. Additionally, Toothaches Renal disease. liver enzymes, nausea, tachycardia, and
Every 4 hours it also affects the activity Alcoholism vomiting malaise).
of certain Menstrual cramps Allergy F & E: hypokalemia GU: • Monitor vital signs
neurotransmitters in the renal failure Hemat: every 15 minutes.
brain that are involved in Back pain Sore throat Acetaminophen is neutropenia, • Monitor the patient’s
the perception of pain. It contraindicated in certain pancytopenia response to the
does not have any anti - Cold and Flu Symptoms situations, such as: MS: muscle spasms, medication.
inflammatory properties. trismus • Monitor the patient for
Hypersensitivity Warfarin Derm: acute generalized hypersensitivity and
Malnutrition Lactation exanthematous allergic reactions
pustulosis, stevenjohnson during the infusion
syndrome, toxic epidermal and for at least 30
necrolysis minutes afterward.
• Advice the patient to
Less common side effects report signs of
include: overdose, such as
Rash nausea, vomiting,
Urticaria loss of appetite,
Itching sweating, confusion,
Hives or yellowing of the
Swelling of the face, lips, skin or eyes.
tongue, or throat Difficulty
breathing Unusual
bleeding or bruising In
rare cases,
acetaminophen can cause
 serious side effects such
as yellowing of the skin or
eyes, dark urine, and
severe stomach pain.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Generic Name: Tramadol Pharmacologic • Moderate to • Hypersensitivity to CNS: dizziness, vertigo, - Inform patient (and - Assess patient’s
Classification: Opioid moderately severe drug, its components, headache, drowsiness, significant other as response to drug 30
Brand Name: Ultram agonist pain in patients who or opioids anxiety, stimulation, appropriate) that drug minutes after
require around-the- • Acute intoxication confusion, incoordination, may cause respiratory administration.
Dosage: 50 mg Therapeutic Classification: clock treatment of with alcohol, sedative- euphoria, nervousness, depression if used with
Analgesic pain for an extended hypnotics, centrally sleep disorder, asthenia, alcohol. Recommend - Monitor respiratory
Route: IV period. acting analgesics, hypertonia, seizures, abstinence. status. Withhold drug and
Mechanism of Actions: opioid analgesics, or suicide contact prescriber if
Frequency: Q8 Inhibits reuptake of psychotropic agents CV: vasodilation - Instruct patient to respirations become
serotonin and • Physical opioid EENT: visual immediately report shallow or slower than 12
norepinephrine in CNS. dependence disturbances seizure, suicidal behavior, breaths/minute.
Significant respiratory GI: nausea, vomiting, or suicidal ideation.
depression, acute or severe diarrhea, constipation, - Monitor for physical and
bronchial asthma or abdominal pain, - Instruct patient to watch psychological drug
hypercapnia in unmonitored dyspepsia, flatulence, dry for and immediately report dependence. Report signs
settings or absence of mouth, anorexia signs and symptoms of to prescriber.
resuscitative equipment GU: urinary retention and serotonin syndrome
frequency, proteinuria, (shivering and diarrhea, - Monitor patient for signs
menopausal symptoms muscle rigidity, fever, and and symptoms of
Respiratory: respiratory seizures). potentially life-threatening
depression (with large serotonin syndrome,
doses, concomitant - Tell patient to which may range from
anesthetic use, or alcohol immediately report sign shivering and diarrhea to
ingestion), bronchospasm and symptoms of allergic muscle rigidity, fever,
Skin: pruritus, sweating, reaction (such as itching, mental-status changes,
hives, angioedema, toxic hives, difficulty breathing, and seizures.
epidermal necrolysis, or swelling of face,
Stevens-Johnson tongue, or throat).
syndrome
 Other: physical or - Tell patient drug
psychological drug interacts with many
dependence, drug common over-the-counter
tolerance, serotonin drugs and herbal
syndrome, serious and remedies. Instruct him to
rarely fatal anaphylactoid consult prescriber before
reactions taking these products.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Losartan belongs to the Losartan is used to treat Losartan is • dizziness Educate patient on • Blood pressure
Cozaar class of drugs known as hypertension (high blood contraindicated in patients • fatigue importance of healthy • serum potassium
angiotensin receptor pressure) and reduce with a history of • Headache lifestyle choices which levels
Generic Name: Losartan blockers (ARBs). stroke risk in patients with hypersensitivit y to • Hyperkalemia include regular exercise, • liver function tests
hypertension and left losartan or any other • hypotension weight loss, smoking • renal function
Dosage: Losartan blocks the action ventricular hypertrophy. component of the cessation, and low- • electrolyte balance
100mg of angiotensin II, a formulation. Rare but severe sodium diet to maximize
hormone that causes adverse effects: the effect of
Route: blood vessels to constrict, • angioedema antihypertensive therapy.
PO thus lowering blood • liver toxicity
pressure. Administer drug on empty
• renal impairment.
Frequency: OD stomach one hour before
or two hours after meal to
ensure optimum drug
absorption.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Antiineffective; Prescribed for bacterial • Hypersensitivity to Allergic reaction (difficulty • Monitor periodically • Perform culture and
Merrem carbapenem antibiotic infections like skin and drug, its components, breathing; closing of the liver and kidney sensitivity testing prior
skin structure infections, or other beta-lactams throat; swelling of the lips, function to initiation of therapy.
Generic Name: The bacterial activity of bacterial meningitis, tongue, or face; or hives); • Determine history of
Meropenem meropenem results from serious nosocomial Precautions seizures; severe or watery hypersensitivity • Monitor renal
the inhibition of cell wall infections like Use cautiously in: diarrhea; a skin rash; reactions to other function, LFT, CBC
Dosage: synthesis. Meropenem septicaemia, febrile unusual tiredness or beta-lactams, (prolonged use).
500mg readily penetrates the cell neutropenia, weakness; or unusual
 wall of most Gram- intraabdominal and pelvic • Sulfite sensitivity, bleeding or bruising; cephalosporins,
Route: positive and Gram- infections. renal disease, seizure nausea or vomiting; penicillins, or other
IV negative bacteria to reach The medication inhibits disorder diarrhea or constipation; drugs. • Monitor for signs of
penicillin-binding-protein cell wall synthesis in • Pregnant or headache; or soreness, • Discontinue drug and anaphylaxis during
Frequency: (PBP) targets. Its bacteria, and thereby breastfeeding patients redness, or mild swelling immediately report 1st dose.
Q24 strongest affirmities are leading to cell death. at the injection site. S&S of
toward PBPs 2,3 and 4 of hypersensitivity
Escherichia coli and • Report S&S of
pseudomonas superinfection or
aeruginosa; and PBPs 1,2 pseudomembranous
and 4 of Staphylococcus colitis
aureus. • Monitor for seizures
especially in older
adults and those with
renal insufficiency.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Erythropoiesis stimulating Anemia caused by Hypersensitivity to • CNS: Seizures, • Monitor renal studies, • Renal Function
Eprex agent (ESA) reduction endogenous albumin, hypertension, coldness, sweating urinalysis, blood, • urinalysis
erythropoietin production erythropoietin levels of BUN, creatinine, I & • blood pressure
Generic Name: Stimulates division, primarily end stage renal >200 mU/ml • CV: Hypertension, O; report drop in • BUN
Epoetin differentiation of erythroid disease; to correct hypertensive output < 50 ml/hr • WBC
progenitor cells in bone hemostatic defect in encephalopathy • Monitor blood studies; • Creatinine
Dosage: marrow. It induces uremia. reticulocyte count • I&O
4000 units erythropoiesis, releases • MS: bone pain weekly; check for • reticulocyte count
reticulocytes from bone symptoms of anemia. • Monitor serum iron
Route: marrow into blood, where Fatigue, pallor, levels
Subcutaneous (SC) they mature into dyspnea
erythrocytes. • Assess CV status: BP
Frequency: before and during Tx;
2x/week Htn may occur rapidly
leading to Htn
encephalopathy
• Assess patient during
hemodialysis for
 bruits, thrills of
shunts; drug prevents
severe anemia in
chronic renal failure;
clotting may need to
be treated with
increased
anticoagulant.
• Monitor serum iron
levels, ferritin,
transferring levels;
iron therapy may be
needed to prevent
recurring anemia.
• Monitor blood studies;
BUN, WBC,
phosphorus,
potassium, bleeding
time. Hct should be
checked in chronic
renal failure.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Antigout Prevention, treatment of • Hypersensitivity to • Nausea • Obtain baseline
Goutsaph acute gouty arthritis. Used colchicine. • Vomiting laboratory studies. • Baseline and repeated
Decreases leukocyte to reduce frequency of • Concomitant use of a • Abdominal discomfort Gout: Assess involved at 1-month
Generic Name: motility, phagocytosis, recurrence of familial Pglycoprotein • Anorexia joints for pain, mobility, • Complete Blood Count
Colchicine lactic acid production. Mediterranean fever (cyclosporine) or • Hypersensitivity edema. • Liver transaminases
(FMF). OFF-LABEL: strong CYP3A4 reaction, including • Mediterraneum fever: (AST, ALT)
Dosage: Therapeutic effect: Treatment of biliary inhibitor angioedema Assess abdominal pain, • Creatine
0.5mcg Reduces inflammatory cirrhosis, recurrent (clarithromycin) in fever, chills, erythema, Phosphokinase (CPK)
process. pericarditis. presence of renal or • Bone marrow swollen skin lesions. • Serum Creatinine
Route: hepatic impairment. depression (aplastic • Discontinue medication
PO anemia, immediately if GI
agranulocytosis, symptoms occur.
Frequency:
Q48 • Mitigate: patients with thrombocytopenia) may • Encourage high fluid
both renal/hepatic occur with long-term intake
impairement. therapy. Overdose • Monitor I & O, CBC,
initially causes burning hepatic/renal function
feeling in skin/throat; tests.
severe diarrhea, • Monitor serum uric acid
abdominal pain. Second • Assessed therapeutic
stage manifests as response: relief of pain,
fever, seizures, delirium, stiffness, swelling,
renal impairment increased joint mobility;
(hematuria, oliguria). reduced joint
Third stage causes hair tenderness; improved
loss, leukocytosis, grip strength.
stomatitis.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Glycopeptide antibiotics It is indicated for It is contraindicated in • Bitter taste • ensuring a patient IV Perform culture and
Vancocin treatment of serious or patients with known • Reddish rash on face line susceptibility tests;
Vancomycin inhibits severe infectious caused hypersensitivity to this and upper body • Assess for infection consult local institutional
Generic Name: transpeptidation by by susceptible strains of antibiotic • Low blood pressure • Obtain culture prior to recommendations before
Vancomycin binding to D-alanyl-D- methicillin-resistant (beta- accompanied by initiating therapy treatment initiation due to
alanine residues of the lactam-resistant) flushing • Monitor blood pressure antibiotic resistance risks.
Dosage: bacterial cell wall staphylococci. • Nausea • Dose dependent draw
500mg • Vomiting serum through levels Monitor CBC, LFT, urine,
• High levels of white frequently and serum trough
Route: blood cells • Administer over at least vancomycin concentration
IV (eosinophilia) 6o minutes to avoid skin periodically. Serial
• Rash irritation monitoring of renal
Frequency: function and auditory
• Fatigue
Q48 function should be
• Swelling of hands and
performed. Monitor for
feet
signs and symptoms of
• Back pain skin reactions.
• Headache
• Inflammation of the
blood vessels
 • Low blood pressure
• Shortness of breath
• itching

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Beta1-selsctive • Hypertension, alone Uncompensated HF; • Allergic: Pharyngitis, • Do not stop taking this • Monitor Blood pressure
Metoprolol adrenergic blocker or with other drugs, Pulmonary edema; erythematous rash, drug unless instructed • Heart rate
Antihypertensive especially diuretics Cardiogenic shock; fever, sore throat, to do so by a healthcare • Electrocardiogram
Generic Name: • Immediate-release bradycardia, heart block, laryngospasm provider
Betaloc Competitively blocks beta- tablets and injection: or sick sinus syndrome (in
adrenergic receptors in Prevention of absence of a pace maker) • CNS: Dizziness, vertigo, • Swallow the ER tablets
Dosage: the heart and reinfarction in MI tinnitus, fatigue, whole; do not cut, crush,
50mg juxtaglomerular patients who are emotional depression, or chew them.
apparatus, decreasing the hemodynamically paresthesias, sleep
Route: influence of the stable or within 3-10 disturbances,
PO sympathetic nervous days of the acute MI hallucinations,
system on these tissues • Treatment of angina disorientation, memory
Frequency: and the excitability of the pectoris loss, slurred speech
BID heart, decreasing cardiac
output and the release of • CHF, cardiac
renin and lowering B; acts arrhythmias, peripheral
in the CNS to reduce vascular insufficiency,
sympathetic outflow and claudication, pulmonary
vasoconstrictor tone. edema, hypotension

• Dermatologic: Rash,
pruritis, sweating, dry
skin

• EENT: Eye irritation, dry

eyes, conjunctivitis,
blurred vision
Drug Name Classification and Indication Contraindication Side Nursing Monitoring Parameters
Mechanism of Effects/Adverse Responsibilities
Actions Reaction
Calcium Carbonate is Calcium Carbonate constipation Gas bloating Assess patients regularly calcium level
Brand Name: Antacid primarily used as a should not be used in when used as an antacid. for response to calcium
dietary supplement to patients with a known stomach cramps carbonate therapy, phosphate levels.
Tums neutralizing the acid in provide calcium to the allergy to calcium diarrhea anorexia. monitor calcium levels,
the body. It is commonly used carbonate or any of its and evaluate for adverse VS
Generic Name: stomach and by to treat or prevent components. Use with effects.
inhibiting pepsin, which conditions associated with caution in patients with I and O
Calcium carbonate is a calcium deficiency, conditions such as
Dosage: proteolytic enzyme including osteoporosis kidney stones,
and calcium deficiency in hypercalcemia (elevated Screen patients for
500 mg contraindications and
pregnancy and blood calcium levels), or
breastfeeding. It can also certain gastrointestinal potential drug
Route:
be used as an antacid to disorders. interactions before
relieve symptoms of initiating calcium
Oral
heartburn, acid carbonate therapy.
Frequency: indigestion, and upset
stomach caused by
BID excess stomach acid.
Drug Name Classification and Indication Contraindication Side Nursing Monitoring Parameters
Mechanism of Effects/Adverse Responsibilities
Actions Reaction
This medication is used This medication is • Headache • Report for any • Urinalysis for Hematuria
Brand Name: Proton pump inhibitor in patients with: contraindicated to patients changes in and proteinuria
with: • Dizziness urinary
Prilosec • Duodenal cancer elimination
Suppresses gastric • Dysphagia • Fatigue
acid secretions which • Gastric cancer • Report severe
Generic Name: relieves gastrointestinal • Metabolic or • Diarrhea diarrhea
Omeprazole distress; Promotes • Severe erosive respiratory alkalosis
ulcer healing esophagitis • Abdominal pain
• Lactation
Dosage: • ZollingerEllison’s • Nausea
Syndrome
40mg • Hematuria

Proteinuria Rash
Route:
Oral

Frequency:
OD

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Xanthine oxidase Indicated for the chronic Concomitant use with • Significant: Gout flares, • Regularly assess the Monitor LFTs at baseline
Adenuric, Uloric inhibitors management of azathioprine, xanthine deposition, patient's vital signs and periodically
hyperuricemia in adult mercaptopurine. LFT abnormalities, and overall health thereafter; serum uric
Generic Name: Febuxostat is a potent, patients with gout who increased TSH. status. acid levels 2 weeks after
Febuxostat non-purine, selective have an inadequate Patient with history of • Eye disorders: Blurred • Monitor for any signs initiation of treatment,
inhibitor of xanthine response to a maximally hypersensitivity reaction vision. of allergic reactions or after each dosage
Dosage: oxidase, the enzyme that titrated dose to allopurinol; major CV • Gastrointestinal adverse effects and titration, then every 6
40mg tab catalyses the conversion of allopurinol, who are disease (e.g. MI, stroke, disorders: Diarrhoea, report them to the months (symptomatic
of hypoxanthine to intolerant to allopurinol, or unstable angina), thyroid nausea. healthcare team. patients or tophi) or every
Route: xanthine to uric acid. The for whom treatment with disorders; increased risk • General disorders and • Advise the patient to 12 months (patients on
PO inhibition of xanthine allopurinol is not for urate formation (e.g. administration site maintain adequate urate-lowering therapy,
oxidase decreases the advisable. It is not Lesch-Nyhan syndrome, conditions: Oedema, hydration to help regardless of symptoms);
Frequency: serum concentrations of recommended for the malignant disease and its fatigue. prevent gout attacks. renal function. Assess for
OD uric acid. treatment of treatment). Organ • Musculoskeletal and • Monitor for signs of gout flares and signs or
asymptomatic transplant recipients. Not connective tissue gout attacks, such as symptoms of CV events
hyperuricemia or recommended to be disorders: Arthralgia, joint pain, redness, and hypersensitivity or
secondary hyperuricemia. started during an acute myalgia, pain in and swelling. severe skin reactions.
attack of gout. Use of extremity. • Monitor the patient's
febuxostat is restricted to • Nervous system adherence to dietary
patients who are disorders: Headache, and lifestyle
intolerant to allopurinol or dizziness, recommendations.
for whom allopurinol is paraesthesia.
contraindicated or • Psychiatric
ineffective. Not disorders: Somnolence.
recommended for the
• Respiratory, thoracic
treatment of
and mediastinal
asymptomatic or
disorders: Dyspnoea.
secondary
• Skin and subcutaneous
hyperuricaemia. Hepatic
tissue disorders: Rash,
and renal impairment.
pruritus.
Pregnancy and lactation.
• Potentially Fatal: CV
death, hepatic failure.
Rarely,
hypersensitivity,
including Stevens-
Johnson syndrome,
 toxic epidermal
necrolysis, drug
reaction with
eosinophilia and
systemic symptoms,
and acute anaphylactic
reaction/shock.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Antihistamine • Seasonal Allergic Severe renal impairment • Eye Administer cetirizine as Monitor relief of
Zyrtec Rhinitis disorders: Decreased prescribed by the symptoms, sedation,
Cetirizine, a piperazine • Perennial allergic Patients with epilepsy visual acuity, ocular healthcare provider. mental alertness, and
Generic Name: derivative and metabolite rhinitis and patients at risk of hyperaemia (ophth anticholinergic effects.
Cetirizine of hydroxyzine, is an • Chronic urticaria convulsions; risk factors soln). Verify the patient's
antihistamine which for urinary retention (e.g. • Gastrointestinal allergies and potential
Dosage: competitively and spinal cord lesion, disorders: Abdominal drug interactions before
10mg tab selectively inhibits prostatic hyperplasia). pain, dry mouth, administration.
H1 receptors in the Hepatic and mild to nausea, diarrhoea,
Route: gastrointestinal tract, moderate renal vomiting. Explain the purpose of
PO blood vessels, and impairment. Children, • General disorders and cetirizine to the patient,
respiratory tract. elderly. Pregnancy and administration site emphasizing its use for
Frequency: lactation. conditions: Fatigue, allergy symptom relief.
BID local pain at
instillation site Emphasize that cetirizine
(ophth). may cause drowsiness in
• Nervous system some individuals, and
disorders: Dizziness, advise patients to
headache, exercise caution when
somnolence. operating heavy
• Respiratory, thoracic machinery or driving if
and mediastinal they experience
disorders: Pharyngitis, drowsiness.
rhinitis, epistaxis,
bronchospasm. Encourage the patient to
avoid consuming alcohol
while taking cetirizine, as
 it can increase
drowsiness.

Regularly assess the

patient's vital signs and
overall health status.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Angiotensin II • Chronic heart failure Hypersensitivity or history • Significant: Hypotension, • Administer Monitor K levels at
Entresto Antagonists • Renal Impairment of angioedema, biliary hyperkalaemia, sacubitril/valsartan as baseline and periodically
• Hepatic Impairment cirrhosis, cholestasis. decreased renal function. prescribed by the thereafter, blood
Generic Name: Sacubitril is a prodrug of Concomitant use or use • Blood and lymphatic healthcare provider, pressure, LFT, renal
Sacubitril sacubitrilat (LBQ-657) within 36 hours of ACE system following the function (e.g. serum
which inhibits neprilysin, inhibitors or Angiotensin disorders: Anaemia. recommended dosing creatinine, BUN). Correct
Dosage: a neutral endopeptidase II Receptor Blockers • Gastrointestinal schedule. hyperkalaemia, volume
50mg 1 tab (NEP), leading to (ARBs). Concomitant use disorders: Diarrhoea, • Ensure that the and Na depletion prior to
increased levels of with aliskiren-containing nausea, gastritis. patient understands initiation of treatment.
Route: endogenous vasoactive products in patients with • General disorders and the importance of
PO peptides including diabetes mellitus. Severe administration site taking the medication
natriuretic peptides, hepatic impairment conditions: Fatigue, regularly and as
Frequency: bradykinin and (Child-Pugh class C). asthenia. directed.
BID adrenomedullin. Pregnancy. • Investigations: Increased • Monitor the patient for
serum creatinine. any signs of
Valsartan is an • Metabolism and nutrition medication
angiotensin II type 1 disorders: Hypokalaemia, intolerance or
(AT1) receptor blocker. It hypoglycaemia. adverse reactions.
antagonizes AT1-induced • Nervous system • Ensure that the
vasoconstriction, disorders: Dizziness, patient understands
aldosterone, headache, vertigo. the importance of
catecholamine and
• Renal and urinary taking the medication
arginine vasopressin regularly and as
disorders: Renal failure.
release, water intake, directed.
• Respiratory, thoracic and
and hypertrophic • Monitor the patient for
mediastinal
response. any signs of
disorders: Cough.
medication
 • Vascular intolerance or
disorders: Orthostatic adverse reactions.
hypotension, syncope. • Regularly assess the
• Potentially patient's vital signs,
Fatal: Angioedema. including blood
pressure and heart
rate.
• Monitor for signs and
symptoms of heart
failure exacerbation,
such as fluid
retention, dyspnea,
and edema.
• Check potassium
levels periodically, as
hyperkalemia can
occur with
sacubitril/valsartan
use.

Classification and Side Effects/Adverse Nursing

Drug Name Indication Contraindication Monitoring Parameters
Mechanism of Actions Reaction Responsibilities
Brand Name: Corticosteroids, Topical Indicated for the relief of Hypersensitivity. • Significant: Hypothalamic- Assess the patient's skin Monitor for HPA axis
Clobex the inflammatory and Treatment of rosacea, pituitary-adrenal (HPA) condition thoroughly, suppression with
Clobetasol is a very pruritic manifestations of perioral dermatitis, acne axis suppression or including the location, prolonged use through
Generic Name: potent topical corticosteroid-responsive vulgaris, perianal or hypercortisolism; Kaposi severity, and extent of the ACTH stimulation test,
Clobetasol Propionate corticosteroid with anti- dermatoses genital pruritus; viral sarcoma (prolonged use); affected areas. morning plasma cortisol
inflammatory, antipruritic, lesions of the skin (e.g. allergic contact dermatitis, test, and urinary free
Dosage: and vasoconstrictive herpes simplex or zoster, local effects (e.g. folliculitis, Document baseline data, cortisol test; ocular
effects. It promotes varicella); bacterial or skin atrophy, perioral such as skin appearance, changes.
induction of fungal infection of the dermatitis, telangiectasia, temperature, and any
Route: phospholipase skin, parasitic infections, acneiform eruptions), skin signs of infection or skin
Topical route A2 inhibitory proteins skin symptoms relating to infections; osteonecrosis changes.
(lipocortins) and tuberculosis or syphilis, (prolonged use); ocular
Frequency: subsequently inhibits the eruptions following effects (e.g. posterior Educate the patient about
BID to affected area release of arachidonic vaccinations, burns, subcapsular cataracts, the proper use of
acid, thereby depressing ulcerous wounds. Atrophy glaucoma, central serous clobetasol propionate,
the formation, release, at treatment site. Primary chorioretinopathy); including the prescribed
and activity of infections of the scalp systemic effects (e.g. dosage, frequency, and
endogenous chemical (scalp solution). manifestations of duration of treatment.
mediators of inflammation Cushing’s syndrome,
(e.g. kinins, histamine, hyperglycaemia, Instruct the patient on
leukotrienes, glycosuria). Rarely, how to apply the
prostaglandins). generalised pustular medication to clean and
psoriasis (prolonged use in dry skin, gently
psoriasis). massaging it in until
• General disorders and absorbed.
administration site
conditions: Application site Apply a thin layer of
reactions. clobetasol propionate to
• Nervous system the affected area(s) as
disorders: Headache. directed by the healthcare
• Respiratory, thoracic and provider.
mediastinal
disorders: Nasopharyngitis, Monitor the patient's skin
upper respiratory tract condition regularly to
infection. assess treatment
• Skin and subcutaneous progress and check for
tissue disorders: Pruritus, any adverse reactions or
skin dryness, striae, local complications.
skin burning sensation,
skin pain.