DRUG STUDY

DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES

CONTRAINDICATION

GENERIC: In pharmacologic doses, suppresses INDICATIONs: CNS: depression, euphoria, headache, BEFORE:
PREDNISONE inflammation and the normal Used systemically and locally in a personality changes, psychoses, Dx:
BRAND: immune response. Has numerous wide variety of chronic diseases restlessness. a. Assess for contraindications.
DELTASONE intense metabolic effects. including: Inflammatory, Allergic, CV: hypertension, b. Assess Vital signs, Check for
CLASS: Suppresses adrenal function at Hematologic, Neoplastic, Autoimmune EENT: cataracts, increase intraocular allergies.
THERAPEUTIC chronic doses of 5 mg/day. Replaces disorders. Suitable for alternate- day pressure. c. Assess involved systems before
CORTICOSTEROID anti- endogenous cortisol in deficiency dosing in the management of chronic GI: PEPTIC ULCERATION, and periodically during therapy.
inflammatories (steroidal) states. Has minimal illness. Unlabeled Use: Adjunctive anorexia, nausea, vomiting. d. Assess baseline mental status
(intermediate acting), immune mineralocorticoid activity. therapy of hypercalcemia. Adjunctive Metabolic: weight gain, weight loss. e. Assess patient for signs of
modifiers SOURCE: Karch, Amy: 2009 management of nausea and vomiting Musculoskeletal: muscle wasting, adrenal insufficiency
PHARMACOLOGIC: Lippincott’s Nursing Drug from chemotherapy. osteoporosis, avascular necrosis of (hypotension, weight loss,
ADRENOCORTICOIDS Guide, p. 592, F.A. Davis CONTRAINDICATION: joints, muscle pain. weakness, nausea, vomiting,
DOSAGE: Company. (2015). Prednisone. Active untreated infections (may be Derm: acne, slow wound healing, anorexia, lethargy, confusion,
5 mg/ml used in patients being treated for ecchymoses, fragility, hirsutism, restlessness)
FREQUENCY: tuberculous meningitis); Some products petechiae. Tx:
Twice a day contain alcohol and should be avoided Endo: adrenal suppression, a. Supervise patient closely during
ROUTE: in patients with known intolerance; hyperglycemia. therapy.
IV Lactation: Avoid chronic use. F and E: fluid retention (long-term b. Perform a thorough physical
Use Cautiously in: Chronic treatment high doses), hypokalemia, assessment to establish baseline
(leads to adrenal suppression; use hypokalemic alkalosis. data before drug therapy begins,
lowest possible dose for shortest period Hemat: THROMBOEMBOLISM, to determine the effectiveness of
of time); Pedi: Chronic use will result thrombophlebitis. therapy, and to evaluate for the
in decreased growth; use lowest Misc: cushingoid appearance (moon occurrence of any adverse effects
possible dose for shortest period of face, buffalo hump), Increased associated with drug therapy.
time; Stress (surgery, infections); susceptibility to infection. c. Administer in the morning to
supplemental doses may be needed; coincide with the body’s normal
Potential infections may mask signs secretion of cortisol.
(fever, inflammation); OB: Safety not
established. EDx:
DRUG TO DRUG INTERACTION: a. Caution pt. that drowsiness or
Additive hypokalemia with thiazide dizziness may occur.
and loop diuretics, amphotericin B, b. Educate client on drug therapy to
piperacillin, or ticarcillin. Hypokalemia promote compliance.
may increase risk of digoxin toxicity. c. Advise patient to report any
May requirement for insulins or oral untoward signs and symptoms
hypoglycemic agents. Phenytoin, DURING:
phenobarbital, and rifampin stimulate Dx:
metabolism; may decrease a. Monitor mood changes.
effectiveness. Oral contraceptives may b. Monitor for consistency, color,
decrease metabolism. Increase risk of and amount of stool.
adverse GI effects with NSAIDs a. Monitor intake and output ratios
(including aspirin). At chronic doses and daily weights. Observe
that suppress adrenal function, may patient for peripheral edema,
decrease antibody response to and steady weight gain,
increase the risk of adverse reactions rales/crackles, or dyspnea.
from live virus vaccines. May increase Notify health care professional
risk of tendon rupture from if these occur.
fluoroquinolones. Tx:
DRUG TO FOOD INTERACTION: a. Assist pt. in taking the
Drug-food: no data medication.
b. Provided safety, when vertigo or
dizziness is present
c. Assist patient on rising slowly
from supine to sitting position to
avoid orthostatic hypotension
EDx:
a. Instruct the client take the drug
with meals
b. Instruct pt. to report diarrhea,
nausea, dyspepsia, insomnia,
drowsiness, dizziness, or
persistent headache to physician.
c. Instruct patient to inform health
care professional promptly if
severe abdominal pain or tarry
stools occur. Patient should also
report unusual swelling, weight
gain, tiredness, bone pain,
bruising, non-healing sores,
visual disturbances, or behavior
changes.
a. Inform of drugs that can interact
to the therapy
b. Instruct patient to verbalize
feelings and concerns.
AFTER:
Dx:
a. Assess knowledge/teach patient
appropriate use ,interventions to
reduce side effects, and adverse
symptoms to report
b. Monitor for effectiveness as
exhibited by a decrease in
symptoms
c. Monitor for side effects.
d. Periodic adrenal function tests
may be ordered to assess degree
of hypothalamic pituitary-
adrenal axis suppression in
systemic and chronic topical
therapy.
Tx:
a. Remember that a lot of these
drugs can cause dizziness in the
first few weeks of taking so take
safety precautions.
b. Provide safety measures (e.g.
adequate lighting, raised side
rails, etc.) to prevent injuries.
c. Provide comfort measures (e.g.
voiding before dosing, taking
food with drug, etc.) to help
patient tolerate drug effects.
EDx:
a. Instruct the patient to comply
with the drug therapy.
b. Monitor patient for 2-4 weeks to
ascertain onset of full therapeutic
effect.
c. Encourage adequate food and
fluid intake
d. Caution patient to avoid
vaccinations without first
consulting health care
professional.
 DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES
CONTRAINDICATION
GENERIC: Results in the accumulation of cyclic INDICATIONs: CNS: nervousness, restlessness, BEFORE:
EPINEPHRINE adenosine monophosphate (cAMP) Management of reversible airway tremor, headache, insomnia Dx:
BRAND: at beta-adrenergic receptors. Affects disease due to asthma or COPD. CV: angina, arrhythmias, a) Assess lung sounds, respiratory
ADRENALIN, ALLERJECT both beta1(cardiac)-adrenergic Management of severe allergic hypertension, tachycardia. pattern, pulse, and BP before
CLASS: receptors and beta2(pulmonary)- reactions. Management of cardiac arrest RESPIRATORY: paradoxical administration and during peak of
THERAPEUTIC: adrenergic receptor sites. Produces (unlabeled). Management of upper bronchospasm. medication. Note amount, color,
ANTIASTHMATICS, bronchodilation. Also has alpha- airway obstruction and croup (racemic GI:nausea, vomiting. and character of sputum
BRONCHODILATORS, adrenergic agonist properties, which epinephrine). Adjunct in the Endo: hyperglycemia. produced, and notify health care
VASOPRESSORS result in vasoconstriction. Inhibits localization/prolongation of anesthesia. professional of abnormal
PHARMACOLOGIC: the release of mediators of CONTRAINDICATION: findings.
ADRENERGICS immediate hypersensitivity reactions Hypersensitivity to adrenergic amines; b) Assess for contraindications.
DOSAGE: from mast cells. Therapeutic Effects: Some products may contain bisulfites c) Check for allergies.
0.1–0.25 mg Bronchodilation. Maintenance of or fluorocarbons (in some inhalers) and d) Assess baseline status
FREQUENCY: heart rate and BP. Localization/ should be avoided in patients with Tx:
every 5–15 min prolongation of local/spinal known hypersensitivity or intolerance. a) Second practitioner
ROUTE: anesthetic. Use Cautiously in: Cardiac disease independently check original
IV (angina, tachycardia, MI); order, dose
SOURCE: Vallerand, A. H., Hypertension; Hyperthyroidism; b) Perform a thorough physical
Sanoski, C. A., & Deglin, J. H. Diabetes; Cerebral arteriosclerosis; assessment to establish baseline
(2017). In H. G. Mansell Glaucoma (except for ophthalmic use); data before drug therapy begins,
(Contributing Ed.), Davis’s Drug Excessive use may lead to tolerance to determine the effectiveness of
Guide (15th ed.). F.A. Davis and paradoxical bronchospasm therapy, and to evaluate for the
Company. (inhaler); occurrence of any adverse effects
OB: Use only if potential maternal associated with drug therapy.
benefit outweighs potential risks to c) Periodically assess dose.
fetus; Lactation: High intravenous EDx:
doses of epinephrine might decrease a) Instruct patient to contact health
milk production or letdown. Low-dose care professional immediately if
epidural, topical, inhaled or ophthalmic shortness of breath is not relieved
epinephrine are unlikely to interfere by medication or is accompanied
with breast feeding (NIH); Geri: More by diaphoresis, dizziness,
susceptible to adverse reactions; may palpitations, or chest pain.
require decrease dose. b) Educate client on drug therapy to
DRUG TO DRUG INTERACTION: promote compliance.
Concurrent use with other adrenergic c) Insure the patient takes the
agents will have additive adrenergic medication as prescribed.
side effects. Use with MAO inhibitors DURING:
may lead to hypertensive crisis. Beta Dx:
blockers may negate therapeutic effect. a) Monitor pulmonary function
Tricyclic antidepressants enhance tests before and periodically
pressor response to epinephrine. during therapy.
DRUG TO FOOD INTERACTION: b) Observe for paradoxical
Drug-food: Use with caffeine- bronchospasm (wheezing). If
containing herbs (cola nut, guarana, condition occurs, withhold
mate, tea, coffee) increase stimulant medication and notify health
effect. care professional immediately.
c) Check for drug interactions
Tx:
a) Medication can cause irritation of
tissue. Rotate injection sites to
prevent tissue necrosis. Massage
injection sites well after
administration to enhance
absorption and to decrease local
vasoconstriction
b) Assist patient on rising slowly
from supine to sitting position to
avoid orthostatic hypotension
EDx:
a) Instruct the client to increase
fluid intake
b) Instruct pt. to report diarrhea,
nausea, dyspepsia, insomnia,
drowsiness, dizziness, or
persistent headache to physician.
c) Inform of drugs that can interact
to the therapy
AFTER:
Dx:
a) Monitor blood and urine glucose
in diabetic patients.
b) Monitor for effectiveness as
exhibited by a decrease in
symptoms
c) Monitor for side effects.
d) Assess for hypersensitivity
reaction (rash; urticaria; swelling
of the face, lips, or eyelids). If
condition occurs, withhold
medication and notify health care
professional immediately.
Tx:
a) Remember that a lot of these
drugs can cause dizziness in the
first few weeks of taking so take
safety precautions.
b) Provide safety measures (e.g.
adequate lighting, raised side
rails, etc.) to prevent injuries.
c) Provide comfort measures (e.g.
voiding before dosing, taking
food with drug, etc.) to help
patient tolerate drug effects.
EDx:
a) Monitor patient for 2-4 weeks to
ascertain onset of full therapeutic
effect.
b) Encourage adequate food and
fluid intake
 DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES
CONTRAINDICATION

GENERIC: Inhibits tubulin polymerization, INDICATIONs: CNS: headache, dizziness/vertigo, BEFORE:

ALBENDAZOLE resulting in the loss of cytoplasmic Treatment of: Neurocysticercosis, increased intracranial pressure Dx:
BRAND: microtubules. Hydatid disease. HEMAT: granulocytopenia, a) Assess for contraindications.
ALBENZA Therapeutic Effects: Death of CONTRAINDICATION: agranulocytosis, pancytopenia. b) Assess Ophthalmic examinations
CLASS: affected larval form of susceptible Hypersensitivity; Hepatic dysfunction; GI: abnormal liver function tests before therapy to determine
THERAPEUTIC parasites. Spectrum: Echinococcus Patients with neurocysticercosis abdominal pain, nausea/ vomiting presence of retinal lesions. Check
ANTHELMINTICS granulosus (dog tapeworm). Taenia involving the retina; OB: Due to the Derm: reversible alopecia. for allergies.
PHARMACOLOGIC: solium (pork tapeworm). potential for birth defects, women of Neuro: meningeal signs c) Assess baseline mental status
BROAD-SPECTRUM SOURCE: Vallerand, A. H., childbearing age should be cautioned Misc: fever Tx:
ANTHELMINTIC. Sanoski, C. A., & Deglin, J. H. against becoming pregnant while on a) Supervise patients at risk for
DOSAGE: (2017). In H. G. Mansell albendazole or within 1mo of toxicity closely during initial
15 mg/kg/day given in 2 divided (Contributing Ed.), Davis’s Drug completing treatment. therapy.
doses with meals (maximum daily Guide (15th ed.). F.A. Davis DRUG TO DRUG INTERACTION: b) Perform a thorough physical
dose 800 mg) Company. Blood levels of albendazole sulfoxide assessment to establish baseline
FREQUENCY: are increased by concurrent data before drug therapy begins,
Once a day for 8–30 days. dexamethasone and praziquantel. to determine the effectiveness of
ROUTE: Albendazole may decrease blood levels therapy, and to evaluate for the
ORAL of theophylline. occurrence of any adverse effects
DRUG TO FOOD INTERACTION: associated with drug therapy.
Blood levels of albendazole sulfoxide c) Periodically assess dose.
are increased by concurrent ingestion of
a high-fatmeal.
EDx:
a. Emphasize the importance of
regular blood tests to check
WBCs and hepatic function.
b. Caution pt. on the adverse
reactions
c. Educate client on drug therapy to
promote compliance.
d. Insure the patient takes the
medication as prescribed.
DURING:
Dx:
a. Monitor liver function tests
 before start of each treatment and
at least every 2 weeks during
treatment. Monitor mood
changes.
b. Check for drug interactions
c. Monitor WBC count before each
28-day cycle and every 2 weeks
during
each 28–day cycle.
Tx:
a) Assist pt. in taking the
medication.
Administer with food (preferably
high in fat content).
b) Provided safety, when vertigo or
dizziness is present
c) Assist patient on rising slowly
from supine to sitting position to
avoid orthostatic hypotension
d) Adjust diet as tolerated to support
nutritional status.
EDx:
a) Instruct the client take the drug
with meals
b) Caution patients to notify health
care professional if signs of
hepatotoxicity (e.g. jaundice,
dark urine, light-colored bowel
movement, anorexia, nausea,
abdominal pain) occur.
c) Instruct patient to take
medication with a fatty food
exactly as directed.
AFTER:
Dx:
a. Assess decrease in WBC count is
usually reversible upon
discontinuation of therapy.
Therapy may be continued if
decrease is moderate and does
not progress.
b. Monitor for side effects.
Tx:
a) Restrict amount of drug available
 to patient.
b) Assist patient in ADL because
these drugs can cause dizziness
in the first few weeks of taking
so take safety precautions.
c) Provide safety measures (e.g.
adequate lighting, raised side
rails, etc.) to prevent injuries.
EDx:
a) Instruct the patient to comply
with the drug therapy.
b) Advise to Inform health care
professional if demonstrates
significant increase in anxiety,
nervousness, or insomnia
c) Advise pt. to avoid alcohol
intake.