Pharmacology Scrapbook

AN
PORTFOLIO IN PHARMACOLOGY
SUBMITTED BY: JESELL FRANCE K. PLANA
SUBMITTED TO: SIR AARON CARLO DECENDARIO
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ACKNOWLEDGEMENT
This part is dedicated to the people who give never ending support to Jesell France K.
Plana. This has been a great journey which all nursing students have been facing, a combination
of joyful, exciting and stressful events. Being thankful should not be forgotten.
It is an honor to be one of the students of Sir Aaron Carlo Decendario, RN, MAN, MIC,
PhD. He has imparted values, stories and guidance that will make aspiring nurses to strive more.
The course may be difficult but Sir Decendario made it easier. He has shown greatness, passion
and commitment as he delivers his presentations to the class. He is a great teacher!
To her block mates and co-SNs, the current situation may have posed a lot of challenges,
but this pandemic made us to strive and stronger to become Nurses soon. Thank you for the
funny moments, learning experience and unity. Indeed, we help one each to excel.
To her parents, a million thanks for the unconditional love, kindness, support, time,
effort, and for providing all the financial needs and resources. Thank you, Mr. and Mrs. Plana.
Most of all to our Almighty God, I am thankful because this requirement will never be
possible without you. The challenges may occur, but with your guidance grace, and help it
become easier. Thanks be to God! To God be the Glory!
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ABSTRACT
It is a basic responsibility of a nurse to be knowledgeable about drugs and its effects on

the body. This is a key to wellness and nursing back to good health of patients. Administering
the correct drug, its timing and exact dosage will be a vital component of cure to patients or
medical intervention.
There are instances when medication errors can be committed. A lot of factors may be
contributory to medication errors. When a nurse, however, is well-informed and practices her
knowledge about drugs, errors will be prevented.
This study will involve the relationship between pharmacology and nursing. This will
cover the drug’s pharmaceutics, pharmacokinetics, and its pharmacodynamics. Drug studies on
different system were also incorporated to investigate its action, indication, contraindication and
adverse effects. This is taking into account that administering drugs to patients is a dependent
intervention while monitoring the effects of the drug to the patient is an independent nursing
intervention. Nursing considerations and precautions while administering the drug is likewise be
emphasized.
TABLE OF CONTENTS
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Title Page………………………………………………………………………………………………….1
Acknowledgment……………………………………………………………………………………….2
Abstract………………………………………………………………………………………….………..3
Table of Contents……………………………………………………………………………….……….5
I. Introduction 7
What is pharmacology? 8
Application of pharmacology in nursing practice 8
II. Basic Principles of Pharmacology 9
Pharmacokinetics 9
Pharmacodynamics………………………………………………………….………………...…10
Drug interactions……………………………………………………………………………....…..11
Adverse drug reactions and medication errors……………………………….,……….….12
Individual variation in drug responses……………………………………………………..…12
Drug regulation, development, names, and information………………………………..12
III. Drug therapy across the life span…………………………………………………………...….12
Drug therapy during pregnancy and breast-feeding……………………………………..12
Drug therapy in pediatric patients…………………………………………………………….12
Drug therapy in geriatric patients……………………………………………………………..12
IV. Peripheral nervous system drugs…………………………………………………………...…..13

V. Central nervous system drugs……………………………………………………………………19
VI. Drugs that affect fluid and electrolyte balance…………………………………………….24
VII. Drugs that affect the heart, blood vessels, and blood………………………………...….29
VIII. Drugs for endocrine disorders……………………………………………………………….....34
IX. Women's health…………………………………………………………………………………….39
X. Men's health…………………………………………………………………………………………45
XI. Anti-inflammatory, anti-allergic, and immunologic drugs…………………………………49
XII. Drugs for bone and joint disorders……………………………………………………………..55
XIII. Respiratory tract drugs…………………………………………………………………………..60
XIV. Gastrointestinal drugs…………………………………………………………………………...65
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XV. Nutrition and Vitamins……………………………………………………………………….....70
XVI. Drugs for infectious diseases……………………………………………………………….…74
XVII. Drugs for parasitic diseases…………………………………………………………………..79
XVIII. Cancer chemotherapy………………………………………………………………………83
XIX. Additional important drugs…………………………………………………………………...88
XX. Alternative therapy………………………………………………………………………..……89
XXI. Toxicology…………………………………………………………………………………..……93
XXII. Appendixes…………………………………………………………………………………….
C. Commonly used abbreviations…………………………………………………………….….97
D. Philippine FDA Policy on Drug Approval and Regulation………………………..……….98
E. Drug Calculation Formula…………………………………………………………………...…..100
F. Drug Preparations…………………………………………………………………...…………….101
XXIII. References………………………………………………………………………………….….102
I. INTRODUCTION
Application of pharmacology in nursing
practice
Pharmacology is a branch of science that deals with the study of drugs and their actions on
living systems. It means it is a study that deals with drugs and their interaction on living systems.
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It ranges from how drugs work in the body and how the body reacts to a drug. It is essential in
nursing as it is the responsibility of nurses to understand in order to consider what a drug is, how
it affects our physical, emotional and psychological wellbeing, the type of drug being used, the
modes of administration, how the drug is absorbed and the characteristics of the person taking
the drug.
Assessment is important because this the basis for the drug therapy. Assessment has three
basic goals: (1) collecting baseline data needed to evaluate therapeutic and adverse responses, (2)
identifying high-risk patients, and (3) assessing the patient’s capacity for self-care. The first two
goals are intended for the administration of drugs. Baseline data are needed to evaluate drug
responses. For example, if we plan to give a drug to lower blood pressure, we must know the
patient’s blood pressure before administering the treatment. Without data, it is difficult to
determine the effectiveness of the drug. The same way in giving a drug that can damage the
liver, we need to assess baseline liver function in order to evaluate this potential toxicity.
Obviously, in order to collect appropriate baseline data, we must first know the effects of the
drugs.
In order to make an evaluation, the nurse must have a background knowledge about the
treatment and time course of the response of the body. If the nurse lacks knowledge, you will be
unable to evaluate the patient’s progress. However, when desired responses do not occur, it will
be identified quickly, so that alternative therapy will be addressed and then ordered.
All in all, nurses must acquire knowledge about Pharmacology as nurses should be skillful in
medicating and should not catch a medication error. However, Pharmacology’s focus is not only
on medications, but it also has an eye on patient education. As nurses, this to quicken the
awareness about the concepts of Drug Abuse and Drug Addiction. This is to educate patients on
prevention as well as management of Drug abuse and Drug Addiction.
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I.
BASIC PRINCIPLES OF
PHARMACOLOGY
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PHARMACOKINETICS
ADVERSE REACTIONS MEDICATION ERRORS
 An adverse drug reaction is a harmful reaction experienced  A medication error is a failure in the
after the administration of a drug or drugs under normal treatment process that leads to, or has the
condition of use. This will usually require the drug to be potential to lead to, harm to the patient.
discontinued or the dose reduced.  This can occur in deciding which medicine
 An adverse event is harmful when a patient is taking a drug, and dosage to utilize, inappropriate, and
irrespective of whether the drug is suspected to be the cause. ineffective prescribing, writing the
 A side-effect is any effect caused by a drug other than the prescription, dispensing the formulation,
intended therapeutic effect, it can be beneficial, neutral or
administering or taking the medicine
harmful.
(wrong dose, wrong route, wrong
frequency, wrong duration); monitoring
therapy (failing to alter therapy when
required, erroneous alteration).
FACTORS THAT CONTRIBUTE TO

INDIVIDUAL VARIATION IN DRUG MEDICATION ERRORS
RESPONSES  Fatigue or Exhaustion
 The effects of drugs vary from one person to another. Two  Miscommunication
people can take the same dosage and feel different results.  Lack of Knowledge
 Memory Lapses
Body Mass. Larger people also have larger vascular systems that
 Inadequate Memory
means that a substance must travel in more blood.
 Distractions
Genetics. Genes determine the activity of the enzymes that help  Equipment Failures
the body metabolize drugs.  Distractions
Sex. For women, menstrual cycle can change someone’s
NOTE: Nurses should be careful because they
sensitivity to certain drugs. For men, they bigger body sizes and
are the one’s who are accountable.
lower fat tissue proportions with that drugs affect them differently.
Age. As someone gets older, they develop more fats with that drug
lasts for a long time. The liver reduces in size with that it affected
its absorption of drugs.
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PHARMACOLOGY
III. BASIC PRINCIPLES OF
PHARMACOLOGY
DRUG INFORMATION
DRUG NAMES  Drug information covers the usage, discovery and
management of the medication. In addition,
CHEMICAL NAME identification, cost and pharmacokinetics to dosage
Name according to chemical structure and ad adverse effects are explained in this portion.
Example: (RS)-2-(4-(2-methylpropyl)phenyl)propanoic
acid
GENERIC NAME
A nonproprietary name that is universally accepted
Example: ibuprofen DRUG REGULATION

BRAND NAME
 The process of testing, developing and marketing of
A registered trademark chosen by a drug company
medicines has to regulated to protect the interests of
Example: Motrin the public. Major regulatory bodies include the
Food & Drug Administration (FDA) in the US and
Philippines and the European Medicines Agency
(EMA) in Europe. These bodies have various
functions.
DRUG DEVELOPMENT
DISCOVERY PRECLINICAL CLINICAL TRIAL FDA REVIEW FDA POST-
AND RESEARCH MARKET
DEVELOPMENT SAFETY
MONITORING
Research for a new Drugs undergo Drugs are tested on If a drug developer has FDA monitors all
drug begins in a laboratory and people to make sure evidence from its early drug and device
laboratory animal testing to they are safe and tests and preclinical and safety once products
answer basic effective. clinical research that a are available for use
drug is safe and
questions about by the public.
effective for its
safety. intended use, the
company can file an
application to market
the drug.
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I. DRUG THERAPY ACROSS THE
LIFE SPAN
DRUG THERAPY DURING PREGNANCY AND BREAST-FEEDING

 Drugs may be dangerous to the developing embryo and fetus. The first trimester of pregnancy
which is the embryonic development and organogenesis stage is of particular importance since
the teratogenic effects of certain drugs influence the normal development of the unborn child on
a structural or functional level. Precautions should be taken such as patient education to women
with childbearing age in order to have relative safety during pregnancy. This is also to be careful
when taking medications during breastfeeding as during lactation drugs may pass from the
bloodstream to the breast milk especially if the drugs is lipid soluble.
DRUG THERAPY IN PEDIATRIC PATIENTS

 The drug treatment in children differs from adults, most obviously because it is usually based on
weight or body surface area. Doses vary because of age-related variations in drug absorption,
distribution, metabolism, and elimination. A child cannot safely receive an adult drug dose. The
child must be educated in order to know that he or she have understood the reason of the drug,
the need of the drug despite unpleasant taste and the need to complete the drug regimen. For
pediatric patients, this is to closely monitor for the therapeutic effect and adverse reactions.
DRUG THERAPY IN GERIATRIC PATIENTS

 Administration of drugs to geriatric patients require special attention as age related factors has
already influenced drug absorption, distribution, metabolism and excretion Intense monitoring
should be done in order to prevent adverse reactions and toxicity. Non-adherence to drug therapy
is rampant in older adults with this nurses should plan strategies in order for patient to adhere
\ and educate the patient and family.
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I. PERIPHERAL NERVOUS
SYSTEM DRUGS
Name of Patient: ___________________
DRUG STUDY
DRUG ORDER MECHANISM OF INDICATION CONTRAINDICATIO ADVERSE NURSING

ACTION S NS EFFECTS RESPONSIBILI
TY AND
PRECAUTION
GENERIC NAME: May potentiate the To treat anxiety Acute angle-closure glaucoma, CNS: Amnesia, •Use extreme caution
effects of hypersensitivity to lorazepam, anxiety, ataxia, coma, when giving
Lorazepam gammaaminobutyric acid To treat insomnia its components, confusion, delusions, lorazepam to elderly
(GABA) and other or benzodiazepines; intra- depression, dizziness, patients, especially
caused by anxiety
BRAND NAME: inhibitory arterial delivery; drowsiness, euphoria, those with
neurotransmitters by psychosis extrapyramidal compromised
Apo-Lorazepam (can), binding to symptoms, fatigue, respiratory
Ativan, specific benzodiazepine headache, function, because
Lorazepam receptors in limbic hypokinesia, drug can cause
Intensol, Novo- and cortical areas of irritability, malaise, hypoventilation,
Lorazem (can), CNS. GABA inhibits nervousness, seizures, sedation,
Nu-Loraz (can) excitatory stimulation, slurred speech, unsteadiness,
which helps control suicidal ideation, and respiratory
CLASSIFICATION: emotional behavior. tremor, depression.
Limbic system unsteadiness, vertigo
Chemical class: contains a highly dense CV: Chest pain, •Use drug cautiously
Benzodiazepine area of palpitations, in patients with a
benzodiazepine tachycardia history of alcohol or
Therapeutic class: receptors, which may EENT: Blurred vision, drug abuse or a
Amnestic, antianxiety, explain drug’s anti- diplopia, dry mouth, personality disorder
anticonvulsant, anxiety effects. Also, increased salivation, because of an
sedative lorazepam hyperpolarizes photophobia increased risk of
696 lorazepam neuronal cells, ENDO: Syndrome of physical and
thereby interfering with inappropriate ADH psychological
Pregnancy category: D their ability to GI: Abdominal pain, dependence.
(parenteral), Not generate seizures. constipation, diarrhea, Also use cautiously
rated (oral) increased liver inpatients with severe
enzyme levels, hepatic insufficiency
Controlled substance jaundice, or encephalopathy
schedule: IV nausea, thirst, because drug may
vomiting worsen hepatic
ROUTE: GU: Libido changes encephalopathy.
HEME:
PO, PARENTERAL, Agranulocytosis, •For I.M. use, inject
INJECTION pancytopenia, lorazepam deep into
thrombocytopenia large muscle mass,
RESP: Apnea, such as gluteus
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respiratory depression, maximus.
worsening of sleep
DOSAGE: apnea or obstructive •For I.V. use, dilute
pulmonary disease lorazepam with equal
To treat anxiety SKIN: Diaphoresis amount of sterile
Other: Anaphylaxis, water for injection,
Adults and injection-site pain sodium chloride for
adolescents. 1 to 3 (I.M.) injection, or D5W.
mg twice or phlebitis (I.V.), Give diluted
daily or three times physical and lorazepam slowly, at
daily. Maximum: psychological no more
10 mg daily. dependence, than 2 mg/min.
•During I.V. use,
withdrawal symptoms
Dosage adjustment For monitor patient’s
elderly or respirations every 5
debilitated patients, to 15 minutes and
initial dosage may keep emergency
be resuscitation
reduced to 0.5 to 2 mg equipment
daily in divided readily available.
doses.
To treat insomnia
caused by anxiety
Adults and
adolescents. 2 to 4
mg at
bedtime.
Dosage adjustment:
Dosage possibly
reduced for elderly or
debilitated
patients.
To provide
preoperative sedation
i.v. injection
Adults and
adolescents.
0.044 mg/kg or
2 mg, whichever is
less, given 2 hr
before
procedure. Maximum:
0.05 mg/kg or total
of 4 mg.
i.m. injection
Adults and
adolescents. 0.05
mg/kg 2 hr
before procedure.
Maximum: 4 mg.
To treat status
epilepticus
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i.v. injection
Adults and
adolescents.
Initial: 4 mg at a
rate of 2 mg/min.
Repeated in 10 to
15 min
if seizures don’t
subside.
Maximum: 8
mg/24 hr.
FREQUENCY:
To treat anxiety
b.i.d or t.i.d
To treat insomnia
caused by anxiety
Bedtime
To treat status
epilepticus
Initial: 4 mg at a
rate of 2 mg/min.
Repeated in 10 to
15 min
if seizures don’t
subside.
Maximum: 8
mg/24 hr.
Note:
Route Onset Peak Duration
I.V. 5 min Unknown 12–24 hr
I.M. 15–30 min Unknown 12–24 hr
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Name of Patient: ___________________
DRUG STUDY
DRUG MECHANIS INDICATIO CONTRAINDICATIO ADVERSE NURSING
ORDER M OF NS NS EFFECTS RESPONSIBIL
ACTION ITY AND
PRECAUTION
GENERIC Blocks As adjunct, to Achalasia, bladder neck CNS: Agitation, • Expect to
NAME: acetylcholine’s treat all forms of obstruction, confusion, administer I.V. or
action at Parkinson’s glaucoma, hypersensitivity to delirium, I.M.
benztropine cholinergic disease benztropine delusions, benztropine when
mesylate receptor sites. mesylate or its components, depression, patient needs more
This restores the megacolon, disorientation, rapid response than
BRAND NAME: brain’s myasthenia gravis, prostatic dizziness, oral drug can
normal dopamine hypertrophy, drowsiness, provide.
Apo-Benztropine and acetylcholine pyloric or duodenal euphoria,
(can), Cogentin, balance, which obstruction, stenosing excitement, ●Be aware that I.M.
PMS Benztropine relaxes muscle peptic ulcer fever, route is commonly
(can) movement hallucinations, used because it
and decreases headache, provides effects in
CLASSIFICATI
drooling, rigidity, lightheadedness, about
ON: and tremor. listlessness, the same time as I.V.
Benztropine also memory loss, route.
Chemical class:
may inhibit nervousness,
Benzoquinolizine
dopamine paranoia, •Therapy typically
amide
reuptake and psychosis, begins with a low
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Therapeutic class: storage, which weakness dose
Antiemetic prolongs CV: Hypotension, followed by gradual
dopamine’s mild bradycardia, increases of 0.5 mg
Pregnancy action orthostatic every 5 or 6 days
category: Not rated hypotension, because benztropine
palpitations, has
ROUTE: tachycardia a cumulative action
EENT: Blurred
PO, I.M vision, diplopia, •Give drug before
dry mouth, or after meals based
DOSAGE: increased on
intraocular patient’s need and
Adults with
pressure, mydriasis, response. If patient
Parkinson’s
narrow-angle has
disease.
glaucoma, increased salivary
1 to 2 mg
suppurative secretions, expect to
daily (usual dose)
parotitis administer
with a range of 0.5
GI: Constipation, benztropine after
to
duodenal ulcer, meals.
6 mg daily.
epigastric
distress, ileus,
Adults with
nausea, vomiting
idiopathic
GU: Dysuria,
Parkinson’s
urinary hesitancy,
urine
retention
MS: Muscle
spasms, muscle
weakness
SKIN: Decreased
sweating,
dermatoses,
flushing, rash,
urticaria
NOTE:
P.O. 1–2 hr Unknown 24 hr
I.V., I.M 15 min Unknown 24 hr
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II. CENTRAL NERVOUS
SYSTEM DRUGS
Name of Patient: __________________
DRUG STUDY
DRUG ORDER MECHANISM OF INDICATION CONTRAINDICATIO ADVERSE NURSING
ACTION S NS EFFECTS RESPONSIBILIT
Y AND
PRECAUTION
GENERIC NAME: May potentiate the effects To provide short- Hypersensitivity to CNS: Ataxia, •Watch patients closely
of gammaaminobutyric acid term management chlordiazepoxide or its confusion, (especially children,
Chlordiazepoxide (GABA) and other of components depression, adolescents, and young
hydrochloride inhibitory neurotransmitters severe anxiety drowsiness, suicidal adults) for suicidal
by binding to ideation tendencies, particularly
BRAND NAME: specific benzodiazepine To provide CV: ECG changes, when chlordiazepoxide
receptors in limbic perioperative hypotension, therapy starts and
Apo-Chlordiazepoxide
and cortical areas of the relaxation and tachycardia dosage
(can),
CNS. By binding to reduce GI: Hepatic changes.
Librium, Novo-Poxide
these receptors, apprehension and dysfunction
(can) chlordiazepoxide increases anxiety HEME: •Be aware that
GABA’s inhibitory effects Agranulocytosis prolonged use of
CLASSIFICATION: chlordiazepoxide at
and blocks SKIN: Jaundice
cortical and limbic arousal, Other: Injection-site therapeutic doses can
Chemical class:
which helps pain, redness, and lead to dependence.
Benzodiazepine
control emotional behavior. swelling
It also helps •Monitor liver function
Therapeutic class: test results during
Antianxiety relieve symptoms of alcohol
withdrawal by therapy.
Pregnancy category: causing CNS depression.
•If patient is a
Not rated
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hyperactive, aggressive
Controlled substance child or has a history of
schedule: IV psychiatric
disorders, watch for
ROUTE: paradoxical
reactions, such as
PO, IV, IM excitement,
stimulation, and acute
DOSAGE: rage, during first
2 weeks of therapy.
To provide short-
term management of •Advise patient to avoid
severe anxiety other CNS
depressants during
capsules, tablets therapy.
Adults. 20 to 25 mg •Warn patient not to
three or four times take antacids with
daily. chlordiazepoxide.
i.v. or i.m. injection •Urge family or
Adults. Initial: 50 to caregiver to watch
100 mg. Then, 25 to 50 patient
mg three or four times closely for suicidal
daily, as needed. tendencies, especially
Maximum: 300 mg when therapy starts or
daily. dosage changes and
particularly if patient is
i.m. injection a child, teenager,
Children age 12 and or young adult.
over. 0.5 mg/kg daily
in equally divided
doses every 6 to 8 hr.
To provide
perioperative
relaxation and
reduce apprehension
and anxiety
capsules, tablets, i.m.

injection
Adults. 5 to 10 mg
P.O. three or four times
daily several days
before surgery; 50 to
100
mg I.M. 1 hr before
surgery.
FREQUENCY:
To provide short-
term management of
severe anxiety
capsules, tablets
Adults. 20 to 25 mg
three or four times
daily.
i.v. or i.m. injection
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Adults. Initial: 50 to
100 mg. Then, 25 to 50
mg three or four
times daily, as
needed.
Maximum: 300 mg
daily.
i.m. injection
Children age 12 and
over. 0.5 mg/kg daily
in equally divided
doses every 6 to 8 hr.
To provide
perioperative
relaxation and
reduce apprehension
and anxiety
capsules, tablets, i.m.

injection
Adults. 5 to 10 mg P.O.
three or four times
daily several days
before surgery; 50 to
100
mg I.M. 1 hr before
surgery.
Name of Patient: ___________________
DRUG STUDY
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DRUG ORDER MECHANISM INDICATION CONTRAINDICATIO ADVERSE NURSING
OF ACTION S NS EFFECTS RESPONSIBILITY
AND PRECAUTION
GENERIC NAME: Blocks serotonin To treat depression Congenital long QT syndrome, CNS: Agitation, •Be aware that effective
reuptake by adrenergic hypersensitivity to citalopram akathisia, amnesia, antidepressant
Citalopram nerves, which normally or its components, anxiety, apathy, therapy may convert
Hydrobromide release this pimozide therapy, use within asthenia, confusion, depression into
neurotransmitter from 14 days of CVA, mania in predisposed people.
BRAND NAME: their storage sites MAO inhibitor therapy delirium, depression, If patient
when activated by a dizziness, drowsiness, develops symptoms of
Celexa nerve impulse. This dyskinesia, fatigue, mania, notify
blocked reuptake fever, impaired prescriber immediately and
CLASSIFICATION increases serotonin concentration, expect to
: levels insomnia, migraine, discontinue citalopram.
at nerve synapses, myoclonus,
Chemical class: which may elevate neuroleptic malignant •If patient (especially a child
Racemic, bicyclic mood syndrome, paresthesia, or adolescent)
phthalate and reduce depression. seizures, takes citalopram for
Derivative serotonin syndrome, depression, monitor
suicidal ideation, him closely for suicidal
Therapeutic class: tremor tendencies,
Antidepressant CV: Angina, bundle especially when therapy
branch block, chest starts or dosage
Pregnancy category: pain, heart failure, MI, changes, because depression
C orthostatic may worsen
hypotension, at these times
ROUTE: prolonged QT
interval, •If patient (especially a child
PO tachycardia, or adolescent)
thrombosis, takes citalopram for
DOSAGE: ventricular depression, monitor
arrhythmias him closely for suicidal
tablets EENT: Abnormal tendencies,
Adults. Initial: 20 mg accommodation, especially when therapy
daily. Increased to blurred starts or dosage
40 mg daily, as vision, dry mouth, changes, because depression
needed. Maximum: rhinitis, sinusitis, taste may worsen
40 mg perversion at these times
daily. GI: Abdominal pain,
dosage adjustment anorexia, diarrhea,
Dosage should not flatulence, GI
exceed 20 mg daily bleeding, hepatic
necrosis,
FREQUENCY: indigestion, nausea,
Daily pancreatitis, vomiting
GU: Acute renal
failure, amenorrhea,
anorgasmia, decreased
libido, dysmenorrhea,
ejaculation disorders,
impotence, polyuria,
priapism
HEME: Abnormal
bleeding, decreased
PT,
hemolytic anemia,
thrombocytopenia
MS: Arthralgia,
myalgia,
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rhabdomyolysis
RESP: Cough, upper
respiratory tract
infection
SKIN: Diaphoresis,
ecchymosis, erythema
multiforme, pruritus,
rash
VI. DRUGS THAT AFFECT

FLUID AND ELECTROLYTE
BALANCE
Name of Patient: ___________________
DRUG STUDY

AND PRECAUTION
GENERIC NAME: Enhances chloride-rich To treat chronic Diarrhea, hypersensitivity to CNS: Asthenia, •Be aware that lubiprostone
intestinal fluid idiopathic lubiprostone dizziness, fatigue, shouldn’t be
Lubiprostone secretion by locally constipation, or components, mechanical GI headache, used in patients with severe
20
activating chloride to treat opioid- obstruction malaise diarrhea.
BRAND NAME: channels. By increasing induced CV: Chest
intestinal fluid constipation discomfort or pain, •Make sure woman has a
Amitiza secretion, lubiprostone edema, negative pregnancy test before
increases intestinal To treat irritable increased heart rate starting lubiprostone
CLASSIFICATION: motility, which aids bowel syndrome EENT: Dry mouth, because safety during
passage of stool, with throat tightness pregnancy is
Chemical class: alleviating constipation. constipation GI: Abdominal unknown.
Chloride channel distention or pain,
activator diarrhea, •Watch closely for adverse
dyspepsia, reactions,
Therapeutic class: flatulence, nausea, particularly dyspnea, and
Intestinal motility vomiting especially after
Enhancer MS: Muscle cramps first dose.
or spasms
Pregnancy category: RESP: Dyspnea
C SKIN: Rash
ROUTE:
PO
DOSAGE:
Adults. 24 mcg twice

daily with food and
Water
Adults. 8 mcg twice

daily with food and
water
FREQUENCY:
b.i.d
21
Name of Patient: ___________________
DRUG STUDY
AND PRECAUTION
GENERIC NAME: Acts as a surfactant that To treat Fecal impaction; CNS: Dizziness, •Assess for laxative abuse
softens stool by constipation hypersensitivity to syncope syndrome,
Docusate calcium decreasing surface docusate salts or their CV: Palpitations especially in women with
(dioctyl calcium tension between oil and components; depression,
sulfosuccinate) water in feces. This intestinal obstruction; nausea, personality disorders, or
action lets more fluid vomiting, or anorexia
BRAND NAME: penetrate stool, forming other symptoms of nervosa.
Albert Docusate a softer fecal appendicitis; undiagnosed
(can), DC Softgels, mass. abdominal pain •To help prevent constipation,
Docucal-P, Doxidan encourage
(can), Pro-CalSof, patient to increase fiber
Sulfolax, Surfak intake, exercise
regularly, and drink 6 to 8
CLASSIFICATION: glasses
Chemical class: (240 ml/glass) of water daily.
Anionic surfactant
•Instruct patient to notify
Therapeutic class: prescriber about
Laxative, stool rectal bleeding; symptoms of
softener electrolyte
imbalances, such as dizziness,
Pregnancy category: lightheadedness, muscle
C cramping, and
weakness; and unrelieved
ROUTE: constipation.
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PO •Expect long-term or
excessive use
DOSAGE: of docusate to cause
dependence on
Adults and laxatives for bowel
adolescents. 240 mg movements, electrolyte
at bedtime imbalances, osteomalacia,
until bowel steatorrhea, and
movements are vitamin and mineral
normal. deficiencies.
Children age 6 and
over. 50 to 150 mg at
bedtime.
capsules, liquid,
syrup, tablets
(docusate
sodium)
Adults and
adolescents. 50 to 500
mg at
bedtime.
Children ages 6 to 12.

40 to 120 mg at
bedtime.
20 to 60 mg at
bedtime.
Children under age 3.

10 to 40 mg at
bedtime.
capsules, tablets
(docusate potassium)
Adults and
adolescents. 100 mg
three
times daily until
bowel movements are
normal.
Children age 6 and

over. 100 mg at
bedtime.
FREQUENCY:
t.i.d and at bedtime
Adults and
adolescents. 240 mg
at bedtime
until bowel
movements are
normal.
Children age 6 and

over. 50 to 150 mg at
23
bedtime.
capsules, liquid,
syrup, tablets
(docusate
sodium)
Adults and
adolescents. 50 to 500
mg at
bedtime.
40 to 120 mg at
bedtime.
20 to 60 mg at
bedtime.
Children under age 3.
10 to 40 mg at
bedtime.
capsules, tablets
(docusate potassium)
Adults and
adolescents. 100 mg
three
times daily until
bowel movements are
normal.
Children age 6 and

over. 100 mg at
bedtime.
24
VII. DRUGS THAT AFFECT
THE HEART, BLOOD
VESSELS, AND BLOOD
Name of Patient: ___________________
DRUG STUDY
DRUG STUDY
AND PRECAUTION
GENERIC NAME: May reduce blood To control Aliskiren therapy in patients CNS: Anxiety, •Evaluate blood pressure
pressure by affecting hypertension alone with diabetes, asthenia, dizziness, with patient lying
Benazepril renin-angiotensin- or with a history of angioedema, drowsiness, fatigue, down, sitting, and standing
Hydrochloride aldosterone system. By thiazide diuretic hypersensitivity to headache, hypertonia, before starting
inhibiting angiotensin- benazepril or other ACE insomnia, benazepril and then every 4
BRAND NAME: converting enzyme, inhibitor nervousness, to 8 hours, as
benazepril: paresthesia, sleep appropriate, to monitor
Lotensin disturbance, effectiveness.
•prevents conversion somnolence, syncope,
CLASSIFICATION of angiotensin weakness •Check serum potassium and
: I to angiotensin II, a CV: Angina, ECG other
potent changes, hypotension, electrolyte levels to detect
Chemical class: vasoconstrictor that orthostatic electrolyte
Ethylester of also stimulates hypotension, imbalances.
benazeprilat aldosterone release. palpitations,
peripheral edema •To prevent injury caused by
Therapeutic class: •may inhibit renal and EENT: Sinusitis orthostatic
Antihypertensive vascular production ENDO: hypotension, take safety
of angiotensin II. Hyperglycemia precautions, such
Pregnancy category: GI: Abdominal pain, as having patient change
D •decreases serum acute liver failure, positions.
angiotensin II level cholestatic hepatitis,
ROUTE: and constipation, elevated •Teach patient how to
increases serum renin liver function test monitor blood
PO activity. This results, gastritis, pressure, and how to
decreases aldosterone hepatic recognize signs of
secretion, slightly necrosis, melena, hypertension and
DOSAGE: increasing serum nausea, pancreatitis, hypotension.
potassium level and small
Tablets: fluid loss. bowel angioedema, •Caution patient to avoid
Adults who don’t vomiting sudden position
receive a diuretic. •decreases vascular GU: Acute renal changes and to rise slowly
Initial: 10 mg daily. tone and blood failure, decreased from sitting.
25
Maintenance: 20 to pressure. libido,
40 mg daily as a elevated BUN and •Advise patient to stop
single dose or in two •inhibits aldosterone serum creatinine benazepril
divided doses. release, which levels, and notify prescriber as soon
reduces sodium and impotence, nephrotic as possible if
Adults who receive a water resorption, syndrome, oliguria, she experiences syncope
diuretic. 5 mg daily. increases their progressive azotemia,
dosage adjustment excretion, and reduces proteinuria, renal
Initial dosage of 5 blood pressure. insufficiency, UTI
mg/ HEME:
day for patients with Agranulocytosis,
impaired renal decreased
function and hemoglobin level,
creatinine clearance hemolytic anemia,
less than pemphigus,
30 ml/min/1.73 m2; leukopenia,
then increased neutropenia,
gradually until blood thrombocytopenia
pressure is controlled MS: Arthralgia,
or dosage reaches arthritis, myalgia
maximum of 40 mg RESP: ACE cough,
daily. asthma, bronchitis,
bronchospasm,
Tablets, suspension dyspnea
Children age 6 and SKIN: Dermatitis,
over with glomerular diaphoresis, flushing,
filtration rate of 30 photosensitivity,
ml/min/1.73 m2 or pruritus, rash,
higher. StevensJohnson
Initial: 0.2 mg/kg syndrome
daily. Maximum: Other: Anaphylaxis,
0.6 mg/kg daily or angioedema,
40 mg daily. hyperkalemia,
hyponatremia
FREQUENCY:
Tablets:
Adults who don’t
receive a diuretic.
Initial: 10 mg daily.
Maintenance: 20 to
40 mg daily as a
single dose or in two
divided doses.
Adults who receive a

diuretic. 5 mg daily.
dosage adjustment
Initial dosage of 5
mg/
day for patients with
impaired renal
function and
creatinine clearance
less than
30 ml/min/1.73 m2;
then increased
gradually until blood
pressure is controlled
or dosage reaches
maximum of 40 mg
daily.
26
Tablets, suspension
Children age 6 and
over with glomerular
filtration rate of 30
ml/min/1.73 m2 or
higher.
Initial: 0.2 mg/kg
daily. Maximum:
0.6 mg/kg daily or 40
mg daily.
NOTE:
Route P.O.
Onset 1 hr
Peak 2–4 hr
Duration 24 hr
-
Name of Patient: ___________________
DRUG STUDY
AND PRECAUTION
GENERIC NAME: Binds to To control Hypersensitivity to amlodipine CNS: Anxiety, •Use amlodipine cautiously in
dihydropyridine and hypertension or its dizziness, fatigue, patients with
Amlodipine Besylate nondihydropyridine cell components headache, heart block, heart failure,
membrane receptor To treat chronic lethargy, light- impaired renal
BRAND NAME: sites stable angina and headedness, function, hepatic disorder, or
on myocardial and Prinzmetal’s paresthesia, severe aortic
Norvasc vascular smoothmuscle (variant) angina somnolence, stenosis.
cells and inhibits influx syncope, tremor
CLASSIFICATION: of CV: Arrhythmias, •Monitor patient with
extracellular calcium chest pain, impaired hepatic
Chemical class: ions across slow hypotension, function closely because
Dihydropyridine calcium channels. This palpitations, amlodipine is
decreases peripheral edema extensively metabolized by
Therapeutic class: intracellular calcium EENT: Dry mouth, the liver, and
Antianginal, level, inhibiting gingival expect to titrate dosage slowly
Antihypertensive smooth-muscle cell hyperplasia, when
contractions and pharyngitis administering drug to patients
Pregnancy category: relaxing coronary and ENDO: Hot flashes with severe
C vascular smooth GI: Abdominal hepatic impairment.
muscles, decreasing cramps, abdominal
ROUTE: peripheral vascular pain, •Monitor blood pressure while
27
resistance, and reducing anorexia, adjusting
PO systolic and constipation, dosage, especially in patients
diastolic blood diarrhea, dysphagia, with heart
DOSAGE: pressure. Decreased elevated hepatic failure or severe aortic
peripheral vascular enzymes, stenosis.
To control resistance also esophagitis,
hypertension decreases myocardial flatulence, •Assess patient frequently for
workload, oxygen indigestion, chest pain
Adults. Initial: 5 mg demand, and possibly jaundice, nausea, when starting or increasing
daily, increased angina. Also, by pancreatitis, the dose of
gradually over 10 to inhibiting coronary vomiting amlodipine, because
14 days, as needed. artery muscle cell GU: Decreased worsening of angina
Maximum: 10 mg contractions and libido, impotence, or an acute myocardial
daily. restoring blood flow, urinary infarction can
Children age 6 to 17 drug may relieve frequency occur.
years. 2.5 mg to 5 mg Prinzmetal’s angina. MS: Myalgia
once daily. RESP: Dyspnea •Advise patient to have blood
Maximum: 5 mg once SKIN: Dermatitis, pressure
daily. flushing, rash checked routinely for possible
Other: Weight loss hypotension.
dosage adjustment
Initially 2.5 mg daily •Tell patient to immediately
for elderly patients or notify
patients with prescriber of dizziness, arm or
impaired hepatic leg swelling,
function. Increased difficulty breathing, hives, or
gradually over 7 to 14 rash.
days based on
response
To treat chronic stable

angina and
Prinzmetal’s (variant)
angina
Adults. 5 to 10 mg
daily.
dosage adjustment 2.5
to 5 mg daily for
elderly patients and
those with impaired
hepatic function.
FREQUENCY:
Daily
NOTE:
P.O. Unknown 6–12 hr 24 hr
28
VIII. DRUGS FOR ENDOCRINE
DISORDERS
Name of Patient: ___________________
DRUG STUDY
AND PRECAUTION
GENERIC NAME: Directly interferes with To treat mild Breastfeeding; hypersensitivity CNS: Drowsiness, •Closely monitor thyroid
thyroid hormone hyperthyroidism to headache, paresthesia, function test
Methimazole synthesis in the thyroid methimazole, other antithyroid vertigo results during methimazole
gland by To treat moderate drugs, or CV: Edema therapy
BRAND NAME: inhibiting iodide hyperthyroidism their components EENT: Loss of taste
incorporation into ENDO: •Watch for signs and
Tapazole thyroglobulin. To treat severe Hypothyroidism symptoms of
Iodination of hyperthyroidism GI: Diarrhea, hypothyroidism, such as cold
CLASSIFICATION thyroglobulin indigestion, nausea, intolerance,
: is an important step in vomiting depression, and edema.
synthesizing the HEME:
Chemical class: thyroid hormones Agranulocytosis, •Be aware that
Thioimidazole thyroxine and aplastic anemia, hyperthyroidism may
derivative triiodothyronine. leukopenia, increase metabolic clearance
Eventually, thrombocytopenia of beta
Therapeutic class: thyroglobulin MS: Arthralgia, blockers and theophylline
Antithyroid is depleted and the myalgia and that
circulating thyroid SKIN: Alopecia, dosages of these drugs may
Pregnancy category: hormone level drops. jaundice, pruritus, need to be
D rash, reduced as the patient’s
skin discoloration, thyroid condition
ROUTE: urticaria becomes corrected.
Other: Lupus-like
PO symptoms, •Instruct patient to take drug
lymphadenopathy with meals to
DOSAGE: avoid adverse GI reactions.
29
To treat mild •Explain about possible hair
hyperthyroidism loss or
tablets thinning during and for
Adults and months after
adolescents. Initial: therapy.
15 mg daily
as a single dose or in
divided doses twice
daily for 6 to 8 wk or
until euthyroid level
is
reached.
Maintenance: 5 to 30
mg daily as a
single dose or in
divided doses twice
daily.
Children. Initial: 0.4

mg/kg daily as a
single
dose or in divided
doses twice daily.
Maintenance: 0.2
mg/kg daily as a
single
dose or in divided
doses twice daily.
To treat moderate
hyperthyroidism
tablets
Adults and
adolescents. Initial:
30 to
40 mg/day as a single
dose or in divided
doses twice daily. for
6 to 8 wk or until
euthyroid level is
reached.
Maintenance: 5 to
30 mg daily as a
single dose or in
divided
doses twice daily.
mg/kg daily as a
single
dose or in divided
doses twice daily.
Maintenance: 0.2
mg/kg daily as a
single
dose or in divided
doses twice daily.
To treat severe
hyperthyroidism
tablets
Adults and
30
adolescents. Initial:
60 mg daily
as a single dose or in
divided doses twice
daily. for 6 to 8 wk or
until euthyroid level
is reached.
Maintenance: 5 to 30
mg daily as
a single dose or in
divided doses twice
daily.

mg/kg daily as a
single
dose or in divided
doses twice daily.
Maintenance: 0.2
mg/kg daily as a
single dose or in
divided doses twice
daily
FREQUENCY:
single dose (1x a day)

or in divided doses
twice (b.i.d)
daily
Name of Patient: ___________________
DRUG STUDY
31
AND PRECAUTION
GENERIC NAME: Inhibits action of To control blood Chronic intestinal disease, CV: Edema •If patient is receiving
alpha-amylase and glucose level in cirrhosis, colonic GI: Abdominal acarbose and a
Acarbose alphaglucoside patients ulceration, conditions that may distention and pain, sulfonylurea or insulin to
enzymes. Normally, with type 2 (non– deteriorate diarrhea, enhance glucose
BRAND NAME: alphaamylase insulin-dependent) because of increased gas flatulence, fulminant control, check blood glucose
hydrolyzes complex diabetes mellitus formation in hepatitis, level often, as
Precose starches to when the level intestines, diabetic hepatotoxicity, appropriate.
oligosaccharides in the can’t be ketoacidosis, digestive or ileus, intestinal wall
CLASSIFICATION small intestine and controlled by diet absorption disorders, history of gas-filled cysts, •Store drug in sealed
: alpha-glucoside alone bowel jaundice container in cool
hydrolyzes obstruction, hypersensitivity to HEME: environment.
Chemical class: oligosaccharides, acarbose, Thrombocytopenia •Expect to decrease dosage
Alpha-glucosidase trisaccharides, and inflammatory bowel disease SKIN: Erythema, to control GI
inhibitor, disaccharides to exanthema, rash, upset.
oligosaccharide glucose urticaria
and other •Monitor glycosylated
Therapeutic class: monosaccharides in the hemoglobin level as
Antidiabetic drug brush ordered every 3 months for
border of the small first year to evaluate glucose
Pregnancy category: intestine. In diabetic control and patient
B patients, acarbose compliance.
inhibits these actions
ROUTE: and •Monitor hematocrit and
delays glucose serum AST level
PO absorption, reducing every 3 months during first
blood year of
DOSAGE: glucose level after therapy and periodically
meals. thereafter, as
tablets ordered, because acarbose
Adults. Initial: 25 may decrease
mg three times daily hematocrit and increase
with serum AST level.
first bite of each
meal. Maintenance: •Explain importance of self-
Increased to monitoring
maximum at 4- to 8- glucose level during
wk acarbose therapy.
intervals p.r.n.
Maximum: 50 mg •Teach patient to recognize
three hypoglycemia
times daily for and hyperglycemia.
patients weighing 65
kg (143 •Advise patient who also
lb) or less; 100 mg takes another
three times daily for antidiabetic to carry glucose
patients weighing with him at
more than 65 kg. all times in case
hypoglycemia occurs.
FREQUENCY:
t.i.d
32
IX. WOMEN'S HEALTH
Name of Patient: ___________________
DRUG STUDY
33
AND PRECAUTION
GENERIC NAME: Increases the rate of To treat Active deep vein thrombosis, CNS: Affect liability, •Use estradiol cautiously in
DNA and RNA menopausal pulmonary chorea, dementia, patients with
Estradiol synthesis symptoms embolism, or history of these depression, dizziness, asthma, chorea, diabetes
in cells of female conditions; headache, irritability, mellitus, epilepsy,
BRAND NAME: reproductive organs, active or recent (within past migraine headache, migraine headaches,
pituitary gland, year) arterial nervousness, stoke porphyria, systemic
Estrace, Estrasorb, hypothalamus, and thromboembolic disease, such CV: Deep venous lupus erythematosus, or
Estring, Estrogel, other as stroke or thrombosis, hepatic
Evamist, Vagifem target organs. In the MI; hepatic dysfunction or hypertension, hemangiomas because
hypothalamus, disease; history MI, peripheral edema, estradiol may
CLASSIFICATION estrogens of anaphylactic reaction or pulmonary worsen these disorders.
: reduce release of angioedema to embolism,
gonadotropin-releasing estradiol; hypersensitivity to thromboembolism, •Administer oral preparations
Chemical class: hormone, which estradiol, thrombophlebitis with or
Estrogen derivative, decreases pituitary ethinyl estradiol, or their EENT: Intolerance of immediately after food to
steroid release of components; contact lenses, retinal decrease nausea
Hormone follicle-stimulating hypersensitivity to tartrazine vascular thrombosis,
hormone and dye (contained vision changes •Watch for elevated liver
Therapeutic class: luteinizing in 0.02-mg estradiol and ENDO: Breast function test
Antineoplastic, hormone. In women, ethinyl estradiol enlargement, pain, results because estrogens
antiosteoporotic these hormones are tablets); known or suspected tenderness, or tumors; may worsen such
agent, ovarian required for normal breast cancer breast cancer; conditions as acute
hormone genitourinary and other or history of breast cancer fibrocystic breast intermittent or
Replacement essential body except in changes; variegate hepatic porphyria
functions. appropriately selected patients gynecomastia;
Pregnancy category: At the cellular level, being treated hyperglycemia; nipple •Watch for peripheral edema
X estrogens increase for metastatic disease; known discharge or mild
cervical secretions, or suspected GI: Abdominal weight gain because
ROUTE: cause endometrial cell estrogen-dependent cancer; cramps or pain, estrogens can cause
proliferation, and known protein anorexia, sodium and fluid retention.
PO improve uterine tone. C, protein S, or antithrombin bloating, bowel
Estrogen replacement deficiency, or obstruction (vaginal •Frequently monitor serum
DOSAGE: helps maintain other known thrombophilic ring), glucose level in
genitourinary function disorders; cholelithiasis, patients who have diabetes
To treat menopausal and reduces pregnancy; liver impairment or constipation, diarrhea, mellitus
symptoms vasomotor symptoms disease; elevated liver function because estrogens may
when estrogen undiagnosed abnormal genital test results, decrease insulin
tablets (estradiol) production declines as bleeding enlargement of sensitivity and alter glucose
Adult menopausal a result of menoÂ hepatic hemangiomas, tolerance.
and postmenopausal pause, surgical gallbladder disease or
women. Starting on removal of ovaries, or obstruction, hepatitis, •Before therapy starts,
day 5 of a cycle, 0.5 other increased appetite, inform patient of
to estrogen deficiency nausea, pancreatitis, risks involved in estrogen
2 mg daily in cycles states. Estrogen vomiting therapy, such as
of 3 wk on, 1 wk off. replacement also helps GU: Amenorrhea, increased risk of breast,
Adult prevent osteoporosis breakthrough endometrial, or
postmenopausal by inhibiting bone bleeding, ovarian cancer;
women with intact resorption. cervical erosion, clear cardiovascular disease;
uterus receiving vaginal discharge, dementia (if age 65 or over);
progestin. 0.5 to 2 mg decreased libido gallbladder
daily with daily (males), disease; and vision
progestin. Or, 0.5 to 2 dysmenorrhea, abnormalities.
mg endometrial cancer,
daily on days 1 impotence, increased
through 25 of a 28- libido (females),
day ovarian cancer, pelvic
34
cycle, with progestin pain,
starting day 12 or 16 prolonged or heavy
and continuing menstrual bleeding,
through day 25 of the ring adherence,
cycle; testicular atrophy,
then no drugs on days uterine
26 through 28, as leiomyomata,
prescribed. vaginitis, vaginal
vaginal ring candidiasis,
worsening of
FREQUENCY: endometriosis
Daily MS: Arthralgia, leg
cramps
RESP: Pulmonary
embolism
SKIN: Acne,
alopecia, erythema
multiforme
or nodosum,
hirsutism, jaundice,
melasma,
oily skin, prutitis,
purpura, rash,
seborrhea,
urticaria
Other: Angioedema,
folic acid deficiency,
hypercalcemia (in
metastatic bone
disease),
hypersensitivity, toxic
shock syndrome
(vaginal ring), weight
gain or loss
35
Name of Patient:___________________
DRUG STUDY
DRUG MECHANISM INDICATIONS CONTRAINDIC ADVERSE NURSING
ORDER OF ACTION ATIONS EFFECTS RESPONSIBILIT
Y
AND
PRECAUTION
GENERIC NAME: Increase the rate of DNA To treat moderate to severe Gastritis; CNS: Asthenia, • Monitor
and RNA vasomotor hypersensitivity or dementia, depression, patient
Estrogens synthesis in the cells of menopausal symptoms idiosyncrasy to dizziness, growth benign closely, especially
(conjugated) and female reproductive chloral hydrate or its meningioma,
within minutes
medroxyprogestero organs, hypothalamus, To prevent components; severe headache, insomnia,
ne pituitary glands, and postmenopausal cardiac, hepatic, or renal migraine headache, to hours of taking
other target organs. In the osteoporosis disease mood disturbance, first
BRAND NAME: hypothalamus, nervousness, dose, as
estrogens reduce the paresthesia, stroke anaphylaxis
Premphase, Prempro release of CV: Hypertension, MI, may occur,
gonadotropin-releasing peripheral edema, requiring
CLASSIFICATIO hormone, which thromboembolism, emergency
N: decreases pituitary release thrombophlebitis,
intervention.
of follicle vasodilation
Chemical class: stimulating hormone and EENT: Intolerance of Be aware that
Estrogen luteinizing contact lenses, estrogen therapy
derivative, steroid hormone. In women, these pharyngitis, retinal may exacerbate
Hormone hormones are vascular thrombosis, symptoms of
required for normal rhinitis, sinusitis angioedema in
Therapeutic class: genitourinary and ENDO: Breast women with
Antiosteoporotic other essential body enlargement, pain, hereditary
agent, functions. At the tenderness, or tumors;
angioedema.
ovarian cellular level, estrogens gynecomastia (men); hot
hormone increase cervical flashes; hyperglycemia Monitor for signs
replacement secretions, cause GI: Abdominal cramps of swelling of the
endometrial cell or pain, anorexia, lips, tongue, face or
Pregnancy category: proliferation, and increase cholestatic jaundice, throat, and
X uterine tone. constipation, diarrhea, provide
Estrogen replacement flatulence, gallbladder emergency care, as
ROUTE: helps maintain disease or needed
genitourinary function and obstruction, hepatic
PO reduce hemangioma
vasomotor symptoms when enlargement, hepatitis, •Instruct patient to
DOSAGE: estrogen increased appetite, perform
production declines from ischemic colitis, nausea, monthly breast
To menopause, pancreatitis, self-examination
treat moderate to surgical removal of vomiting and to comply
severe vasomotor ovaries, or other GU: Amenorrhea, with all
menopausal estrogen deficiency. breakthrough bleeding, prescribed
symptoms Estrogen also helps cervical erosion, clear
follow-up
prevent osteoporosis by vaginal discharge,
tablets (prempro) keeping bone decreased libido (men), examinations
Adults. resorption from exceeding dysmenorrhea,
36
0.3 mg bone formation. endometrial cancer or •Instruct patient to
conjugated hyperplasia, notify prescriber if
estrogens and impotence, increased she
1.5 mg libido (women),
sees something
medroxyprogesteron leukorrhea, ovarian
e cancer, prolonged or that resembles a
daily. Increased heavy menstrual tablet in
up bleeding, testicular her stool.
to 0.625 mg atrophy, uterine
conjugated leiomyomata
estrogens and enlargement,
5 mg vaginal candidiasis,
Medroxyprogesteron vaginitis, vaginal-site
e reactions (vaginal
daily as needed. administration only)
such as burning,
tablets irritation, and genital
(premphase) pruritus
Adults. 0.625 mg MS: Arthralgias, back
conjugated pain
estrogens RESP: Bronchitis,
daily on days 1 increased cough,
through 14 and pulmonary embolism
combination product SKIN: Acne, alopecia,
(0.625 mg chloasma, erythema
conjugated multiforme, erythema
estrogens and 5 mg nodosum,
medroxyprogesteron hemorrhagic eruption,
e) hirsutism, melasma,
on days 15 through oily skin, pruritus,
28 purpura, rash, seborrhea,
urticaria
To
prevent
postmenopausal
osteoporosis
tablets (prempro)
Adults.
0.3 mg
conjugated
estrogens and
1.5 mg
medroxyprogesteron
e
daily.
Increased to 0.625
mg conjugated
estrogens
and 5 mg
medroxyprogesteron
e daily as
needed.
tablets
(premphase)
Adults.
0.625 mg
conjugated
estrogens
daily
on
days 1 through 14
and
combination
product (0.625 mg
conjugated
estrogens and 5 mg
medroxyprogesteron
e)
37
on days 15 through
28.
FREQUENCY:
Daily
X. MEN'S HEALTH
Name of Patient:___________________
38
DRUG STUDY
AND PRECAUTION
GENERIC NAME: Enhances the effect of To treat erectile Continuous or intermittent CNS: Depression, •Monitor the patient’s vision,
nitric oxide released in dysfunction nitrate therapy, dizziness, fatigue, especially in
Avanafil the penis through hypersensitivity to avanafil or headache, insomnia, patients over age 50; who
stimulation. Nitric its somnolence, vertigo have diabetes,
BRAND NAME: oxide components CV: Abnormal ECG, hypertension, coronary artery
increases cGMP level, angina, deep vein disease, or
Stendra relaxes smooth muscle, thrombosis, hyperlipidemia; or who
and increases blood hypertension, smoke, because
CLASSIFICATION: flow to the corpus palpitations, avanafil rarely may cause
cavernosum, thus peripheral edema nonarteritic
Chemical class: producing an erection. EENT: Epistaxis, anterior ischemic optic
Phosphodiesterase 5 eyelid swelling, neuropathy that
Inhibitor hearing or may lead to decreased vision
vision loss, nasal or or
Therapeutic class: sinus congestion, permanent vision loss.
Anti-impotence nasopharyngitis,
oropharyngeal pain, •Explain to patient that
Pregnancy category: C sinusitis, tinnitus avanafil should be
ENDO: Alterations taken about 30 minutes
ROUTE: in blood glucose before sexual
GI: Constipation, activity and that sexual
PO diarrhea, dyspepsia, stimulation is
elevated liver required for drug to be
DOSAGE: enzymes, gastric pain, effective.
tablets gastritis,
Adults. 100 mg 30 gastroesophageal •Remind patient that avanafil
min before sexual reflux disease, should not be
activity, as needed. nausea, vomiting taken more than once a day
Maximum: Once GU: Hematuria,
daily. nephrolithiasis, •Advise patient taking
dosage adjustment pollakiuria, prolonged avanafil to seek
Dosage may be erection, urinary sexual counseling to enhance
decreased to 50 mg or tract infection the drug’s
increased to 200 mg MS: Arthralgia, back effects.
30 min before sexual or musculoskeletal
activity, as needed. pain, muscle spasms, •Instruct patient to notify
For patient who is myalgia prescriber
stable on alpha- RESP: Bronchitis, immediately if erection is
blocker cough, exertional painful or lasts
therapy or who is dyspnea, upper longer than 4 hours.
taking a moderate respiratory infection,
CYP3A4 inhibitor wheezing
such as amprenavir, SKIN: Flushing,
aprepitant, diltiazem, pruritis, rash
erythromycin, Other: Influenza
fluconazole,
fosamprenavir, or
verapamil,
dosage is limited to 50
mg.
FREQUENCY:
Once daily
39
Name of Patient: ___________________
DRUG STUDY
AND PRECAUTION
GENERIC NAME: Enhances the effect of To treat erectile Continuous or intermittent CNS: •Monitor patient’s blood
nitric oxide released dysfunction nitrate therapy, Cerebrovascular, pressure and heart
Sildenafil Citrate in the penis by hypersensitivity to sildenafil or intracerebral, or rate and rhythm before and
stimulation. Nitric components subarachnoid often during
BRAND NAME: oxide hemorrhage; therapy.
increases cGMP level, dizziness;
Revatio, Viagra relaxes smooth headache; migraine; •Monitor vision, especially
muscle, and increases seizures; syncope; in patients over
CLASSIFICATION: blood flow to the transient global age 50; who have diabetes,
corpus cavernosum, amnesia, transient hypertension,
Chemical class: thus producing an ischemic coronary artery disease, or
Pyrazolopyrimidinone erection. attack hyperlipidemia; or who
Derivative CV: Heart failure, smoke, because
hypertension, sildenafil rarely may cause
Therapeutic class: hypotension, nonarteritic
Antihypertensive myocardial anterior ischemic optic
(pulmonary arterial), infarction or neuropathy that
anti-impotence ischemia, orthostatic may lead to decreased
hypotension, vision or
40
Pregnancy category: B palpitations, sudden permanent vision loss.
cardiac death,
ROUTE: tachycardia, vaso- •Explain that sildenafil used
occlusive crisis to treat erectile
PO (presence dysfunction may be taken
of sickle cell up to 4 hours
DOSAGE: disease), ventricular before sexual activity, but
arrhythmias that taking it
tablets EENT: Blurred 1080 silodosin
Adults. 50 mg daily, vision; change in 1 hour beforehand provides
taken 1 hr before color the most
sexual activity; increased perception; diplopia; effective results.
as prescribed, epistaxis; hearing
based on clinical loss; increased •Instruct diabetic patient to
response. Maximum: intraocular pressure; monitor his
100 mg daily nasal blood glucose level
congestion; frequently because
FREQUENCY: nonarteritic anterior drug may affect glucose
1 hr before ischemic control.
sexual activity optic neuropathy;
ocular burning,
pressure, redness or
swelling;
paramacular
edema;
photophobia; retinal
vascular
bleeding or disease;
tinnitus, visual
decrease or
temporary vision
loss; vitreous
detachment
ENDO:
Uncontrolled
diabetes mellitus
GI: Diarrhea,
indigestion
GU: Cystitis,
dysuria, painful
erection,
priapism, UTI
MS: Arthralgia,
back pain
RESP: Pulmonary
hemorrhage, upper
respiratory tract
infection
SKIN: Flushing,
photosensitivity
41
XI. ANTI-INFLAMMATORY, ANTI-
ALLERGIC, AND IMMUNOLOGIC
DRUGS
Name of Patient: ___________________
DRUG STUDY
AND PRECAUTION
GENERIC NAME: Blocks the activity of To relieve mild Allergy to tartrazine dye, CNS: Confusion, •Don’t crush timed-release
cyclooxygenase, the pain or fever asthma, bleeding CNS depression or controlled release aspirin
Aspirin enzyme needed for problems (such as hemophilia), EENT: Hearing loss, tablets unless directed.
(acetylsalicylic acid, prostaglandin To relieve mild to hypersensitivity to aspirin or its tinnitus
ASA) synthesis. moderate pain components, peptic ulcer GI: Diarrhea, GI •Ask about tinnitus. This
Prostaglandins, from disease bleeding, heartburn, reaction usually
BRAND NAME: important mediators in inflammation, as hepatotoxicity, occurs when blood aspirin
the in rheumatoid nausea, stomach pain, level reaches
Ancasal (can), Apo- inflammatory response, arthritis and vomiting or exceeds maximum for
As (can), ApoASEN cause local osteoarthritis HEME: Decreased therapeutic
(can), Arthrinol (can), vasodilation with blood iron level, effect.
Arthrisin (can), swelling and pain. To treat juvenile leukopenia, prolonged
Aspergum, Aspirin, With rheumatoid bleeding time, •Advise adult patient taking
Atria S.R. (can), blocking of arthritis shortened life span of low-dose
Bayer, Easprin, cyclooxygenase and RBCs, aspirin not to also take
Ecotrin, Ecotrin inhibition thrombocytopenia ibuprofen because
Maximum Strength, of prostaglandins, SKIN: Ecchymosis, it may reduce the
Extra Strength Bayer inflammatory rash, urticaria cardioprotective and
Advanced symptoms Other: Angioedema, stroke preventive effects of
Aspirin, 8-Hour subside. Pain is also Reye’s syndrome, aspirin.
Bayer Time Release, relieved because salicylism (dizziness,
Empirin, Genprin, prostaglandins play a tinnitus, difficulty •Instruct patient to take
Maximum Bayer, role in pain hearing, vomiting, aspirin with food
Norwich Extra- transmission from the diarrhea, confusion, or after meals because it may
42
Strength, Novasen periphery to the CNS depression, cause GI
(can), Sal-Adult spinal cord. Aspirin diaphoresis, headache, upset if taken on an empty
(can), Sal-Infant inhibits platelet hyperventilation, and stomach.
(can), St. Joseph aggregation by lassitude) with
Children’s, Supasa interfering with regular use of large •Instruct patient to stop
(can), Therapy Bayer, production doses taking aspirin and
ZORprin of thromboxane A2, a notify prescriber if any
substance that symptoms of
CLASSIFICATION stimulates platelet stomach or intestinal
: aggregation. Aspirin bleeding occur such
acts as passage of black, bloody,
Chemical class: on the heat-regulating or tarry stools
Salicylate center in the or if patient is coughing up
hypothalamus and blood or vomit
Therapeutic class: causes peripheral that looks like coffee
Anti-inflammatory, vasodilation, grounds.
antiplatelet, diaphoresis, and heat
antipyretic, nonopioid loss. •Tell patient to consult
analgesic prescriber before
taking aspirin with any
Pregnancy category: prescription drug
D for blood disorder, diabetes,
ROUTE: gout, or
arthritis.
PO
•Tell patient not to use
DOSAGE: aspirin if it has a
strong vinegar-like odor.
To relieve mild pain
or fever
Adults and
adolescents. 325 to
650 mg
every 4 hr, as
needed.; or 500 mg
every 3 hr,
as needed; or 1,000
mg every 6 hr, as
needed

10 to 15 mg/kg/dose
every 4 hr, as needed,
up to 80 mg/kg daily
To relieve mild to
moderate pain from
inflammation, as in
rheumatoid
arthritis and
osteoarthritis
Adults and
adolescents. 3.2 to 6
g daily in
divided doses.
Maximum: 6 g daily.
10 to 15 mg/kg, in
divided doses every 4
43
to 6 hr. Maximum:
80 mg/kg daily
To treat juvenile
rheumatoid arthritis
Children ages 2 to
14. 60 to 110 mg/kg
daily in divided doses
every 6 to 8 hr.
FREQUENCY:
To relieve mild pain

or fever
Adults and
adolescents. 325 to
650 mg
every 4 hr, as
needed.; or 500 mg
every 3 hr,
as needed; or 1,000
mg every 6 hr

10 to 15 mg/kg/dose
every 4 hr, as
needed, up to 80
mg/kg daily.
To relieve mild to
moderate pain from
inflammation, as in
rheumatoid
arthritis and
osteoarthritis
Adults and
adolescents.
Daily

10 to 15 mg/kg, in
divided doses every 4
to 6 hr. Maximum:
80 mg/kg daily
To treat juvenile
rheumatoid arthritis

60 to 110 mg/kg
daily in divided doses
every 6 to 8 hr.
NOTE:
44
P.O. Rapid Unknown 1–4 hr
(chewable tablets)
P.O. 5–30 mins 15–40 mins 1–4 hr
(solution)
P.O. 15–30 mins 1–2 hr 4–6 hr

(tablets)
Name of Patient: ___________________
DRUG STUDY
AND
PRECAUTION
GENERIC NAME: Binds to central and To treat chronic Children ages 6 to 11 with CNS: Aggression, •Use levocetirizine
peripheral H1 idiopathic impaired renal agitation, asthenia, cautiously in patients with
Levocetirizine receptors, competing urticaria; function; creatinine clearance depression, dizziness, predisposing risk factors
with histamine for to treat allergic less than fatigue, fever, for urinary
BRAND NAME: these sites and rhinitis 10 ml/min/1.73 m2; end-stage hallucinations, insomnia, retention, such as spinal
preventing it from renal disease movement cord lesion or
Xyzal reaching in adults and children age 12 disorders, myoclonus prostatic hyperplasia.
its site of action. By and over; and extrapyramidal Monitor patient’s
CLASSIFICATION: blocking histamine, hypersensitivity to symptoms, paraesthesia, intake and output closely.
Chemical class: levocetirizine produces levocetirizine, cetirizine seizures, somnolence, If urinary
H1-receptor antihistamine or their components; renal suicidal ideation, retention is suspected,
antagonist effects, inhibiting failure syncope, tic, notify prescriber and
45
respiratory, vascular, tremor, vertigo expect drug to be
Therapeutic class: and CV: Edema, discontinued if
Antihistamine GI smooth-muscle palpitations, tachycardia confirmed.
contraction; decreasing EENT: Blurred vision,
Pregnancy category: capillary permeability, dry mouth, epistaxis, •Expect to stop drug at
B which reduces nasopharyngitis, least 72 hours
wheals, flares, and pharyngitis, visual before skin tests for
ROUTE: itching; and decreasing disturbances allergies because drug
salivary and lacrimal GI: Hepatitis, increased may inhibit cutaneous
PO gland secretions to appetite, nausea, histamine
relieve chronic vomiting response, thus producing
DOSAGE: urticaria and signs and GU: Dysuria, urinary false-negative
symptoms of allergic retention results.
To treat chronic rhinitis. MS: myalgia
idiopathic RESP: Cough, dyspnea •Instruct patient to take
urticaria; SKIN: Fixed drug drug exactly as
to treat allergic eruption, pruritus, rash, prescribed. For oral
rhinitis urticaria solution, patient
Other: Anaphylaxis, should use appropriate
tablets, oral angioedema, weight measuring device.
solution gain
Adults and children •Urge patient to avoid
age 12 and over. alcohol while taking
2.5 Levocetirizine
to 5 mg once daily in
evening. •Advise patient to avoid
Maximum: hazardous
5 mg daily. activities until drug’s
CNS effects are
FREQUENCY: known.
Once a day in evening •Tell patient to notify

prescriber if he is
feeling bladder fullness or
notices that his
urine output is
significantly less than his
intake.
46
XII. DRUGS FOR BONE AND JOINT
DISORDERS
Name of Patient: ___________________
DRUG STUDY
DRUG ORDER MECHANISM INDICATIONS CONTRA- ADVERSE NURSING
OF ACTION INDICATIONS EFFECTS RESPONSIBILITY AND
PRECAUTION
GENERIC NAME: Reduces activity of cells To prevent Esophageal CNS: Asthenia, •Monitor patient’s
that cause bone loss, postmenopausal abnormalities that dizziness, serum calcium level
Alendronate Sodium slows rate of bone loss osteoporosis delay headache, vertigo before, during, and
BRAND NAME: after menopause, and esophageal emptying, CV: Peripheral after treatment. Expect
increases amount of To treat such as stricture or edema hypocalcemia to be
Binosto, Fosamax bone mass. May act by postmenopausal achalasia; GI: Abdominal treated before
inhibiting osteoclast osteoporosis hypersensitivity to distention and alendronate therapy. If
CLASSIFICATION: activity on newly alendronate or pain, hypocalcemia
formed bone resorption its components; constipation, occurs during therapy,
Chemical class: surfaces, which hypocalcemia; diarrhea, expect prescriber
Aminobisphos- reduces the number of inability to dysphagia, to order a
phonate sites where bone is stand or sit upright esophageal calcium supplement.
remodeled. Bone for at least 30 perforation or
Therapeutic class: formation then exceeds minutes ulceration, •Ensure adequate
Bone resorption inhibitor bone resorption at these esophagitis, dietary intake of calcium
remodeling sites, flatulence, and vitamin D before,
Pregnancy category: which gradually gastritis, during, and after
C increases bone mass. gastroesophageal treatment.
47
May reflux disease,
ROUTE: also inhibit bone heartburn, •Be aware
dissolution by binding to indigestion, that oral osteoporosis
PO hydroxyapatite crystals, melena, nausea, drugs such
which are composed vomiting as alendronate may have the
DOSAGE: of calcium, phosphate, MS: Arthralgia; potential to
and hydroxide and femoral shaft or increase the
To prevent give bone its rigid subtrochanteric risk of esophageal cancer.
postmenopausal structure. fractures; focal
osteoporosis osteomalacia; jaw •Advise patient to
osteonecrosis; take alendronate in the
Tablets joint morning with a
Adults. 5 mg daily or 35 swelling; muscle full glass of water. Explain
mg once/wk in the spasms; myalgia that beverages such
morning with a full glass severe as orange juice, coffee,
of water at least bone, joint, and/or and mineral water
30 min before first food, muscle pain reduce alendronate’s
drink, or other RESP: Asthma effects.
drugs. exacerbation
SKIN: •To help reduce
To treat Photosensitivity, esophageal irritation, tell
postmenopausal pruritus, rash, patient not to chew
osteoporosis Stevens-Johnson or suck on tablet.
syndrome, toxic
oral solution, tablets epidermal •Instruct patient to
Adults. 10 mg daily or 70 necrolysis wait at least 30 minutes
mg once/wk in Other: after taking
the Anaphylaxis, alendronate before eating,
morning with a full glass hypocalcemia drinking, or taking other
of water drugs. Teach
at patient to remain
least 30 min before first upright for 30 minutes
food, drink, or after taking
other drugs. alendronate and until
she has
effervescent tablets eaten the first food of
Adults. the day.
70 mg
once/wk in the morning •Encourage patient
dissolved in 4 oz of room to consume adequate
temperature water daily amounts of
at least 30 min before first calcium and vitamin D.
food, drink, or
other drugs. •Instruct patient
to report to prescriber any
FREQUENCY: new or unusual pain in
hip or thigh.
Once/week
•Instruct patient
to report any difficulty
swallowing or
pain when swallowing,
chest pain, or
new or worsening heartburn
to prescriber.
•Inform patient
receiving the effervescent
tablet form to be
aware that each tablet
contains 650
mg sodium, which is
48
equivalent to
approximately 1650 mg of
sodium chloride per tablet.
Name of Patient: ___________________
DRUG STUDY
DRUG ORDER MECHANISM INDICATIONS CONTRAINDICATIO ADVERSE NURSING
OF ACTION NS EFFECTS RESPONSIBILI
TY AND
PRECAUTION
GENERIC NAME: Based on its affinity To prevent Esophageal abnormalities that CNS: Asthenia, • Do not mix with
for hydroxyapatite, osteoporosis in post delay depression, dizziness, calcium-containing
Ibandronate Sodium which is part of the menopausal women esophageal emptying, such as fatigue, headache, solutions or other
mineral matrix of stricture or insomnia, nerve root intravenously
BRAND NAME: bone, To treat osteoporosis achalsia (oral form); lesion, vertigo administered drugs.
osteoclast activity is in postmenopausal hypersensitivity to CV:
Boniva inhibited and bone women ibandronate or its components; Hypercholesterolemia •Be aware that
resorption and uncorrected , hypertension hypocalcemia, hypo
CLASSIFICATION: turnover is reduced. In hypocalcemia EENT: vitaminosis D, and
Chemical class: postmenopausal Nasopharyngitis, other disturbances of
Bisphosphonate women, the elevated pharyngitis, tooth bone and mineral
rate disorder metabolism must be
Therapeutic class: Bone of bone turnover is ENDO: Transient effectively treated
resorption inhibitor reduced leading to, on decrease in serum before starting
average, a net gain in calcium values ibandronate therapy.
Pregnancy category: C bone mass. GI: Abdominal pain,
constipation, diarrhea, •Know that
ROUTE: dyspepsia, gastritis, ibandronate should
gastroenteritis, not be
PO, INJECTION, IV nausea, administered to
vomiting patients with severe
DOSAGE: GU: Cystitis, UTI renal
MS: Arthralgia; impairment.
To prevent osteoporosis arthritis; atypical
in post subtrochanteric and •Use cautiously in
menopausal women diaphyseal femoral patients with active
fractures; back, bone upper gastrointestinal
tablets or extremity pain; problems (such as
Adults. 2.5 mg daily. joint disorder; known Barrett’s
Alternatively, 150 mg localized esophagus, dysphagia,
once monthly taken same osteoarthritis; other esophageal
day of each myalgia diseases, gastritis,
month. duodenitis, or ulcers
RESP: Bronchitis, because drug may
To treat osteoporosis in pneumonia, upper cause local irritation
postmenopausal respiratory infection of the upper
Women SKIN: Rash gastrointestinal
49
Other: Allergic mucosa.
tablets reaction, infection,
Adults. 2.5 mg daily. influenza, injection- •Administer parenteral
Alternatively, 150 mg site reactions such as ibandronate
once monthly taken same redness or swelling intravenously over 15
day of each to 30 seconds using
month. the needle provided.
Prefilled syringes are
i.v. injection for single use only. Be
Adults. 3 mg every 3 careful not to inject
months drug intra-arterally or
paravenously, as
FREQUENCY: this could lead to
tissue damage.
Tablet: daily, once
monthly taken same •If appointment is
day of each missed for parenteral
Month ibandronate therapy,
administer drug as
IV/Injection: every 3 soon as possible.
months Schedule next
injection
from the date of the
last injection, as drug
must not be
administered more
frequently
than once every 3
months.
•Instruct patient
prescribed oral
ibandronate to take
the tablet at least
586 ibuprofen
1 hour before first
food or drink of day
(except water) while
in an upright position
and with 6 to 8 oz of
water. Caution
against lying down for
at least 30 minutes
after taking drug to
keep it from lodging
in esophagus and
causing irritation.
Also
instruct patient not to
chew or suck on
tablet because doing
so may irritate mouth
or throat.
•Inform patient of
need and importance
of
taking supplemental
calcium and vitamin
D on daily basis.
•Instruct patient to
50
take calcium suppleÂ
ments at least 2 hours
before or after oral
ibandronate.
•Advise patient to stop

taking drug and to
notify prescriber if GI
symptoms appear
or become worse.
•Tell patient to stop

taking drug and notify
prescriber if he
develops dysphagia,
pain
while swallowing,
retrosternal pain, or
new or worsening
heartburn.
XIII. RESPIRATORY TRACT DRUGS
Name of Patient: ___________________
DRUG STUDY
OF ACTION S NS EFFECTS RESPONSIBILIT
Y AND
PRECAUTION
GENERIC NAME: Attaches to beta2 To treat Angina, cerebral arteriosclerosis, CNS: Dizziness, fatigue, •Anticipate that a single
receptors on bronchial bronchospasm dilated headache, dose of nebulized
Metaproterenol cell heart failure, heart block from insomnia, malaise, metaproterenol may not
membranes, which digitalis nervousness, tremor completely stop
Sulfate
stimulates intracellular toxicity, hypersensitivity to CV: ECG changes, an acute asthma attack.
BRAND NAME: enzyme adenyl cyclase metaproterenol or its components, hypertension,
to convert adenosine labor, palpitations, tachycardia •Monitor for adverse
Arm-a-Med triphosphate to cyclic local anesthesia, organic brain EENT: Dry mouth, reactions and signs of
Metaproterenol, Dey- adenosine damage, pharyngitis, taste toxicity, especially if patient
Lute monophosphate (cAMP). tachyarrhythmias perversion uses tablets
Metaproterenol Increased GI: Diarrhea, nausea, and aerosol. Notify
intracellular cAMP level vomiting prescriber if they
relaxes bronchial RESP: Asthma develop.
CLASSIFICATION: smooth-muscle cells and exacerbation, cough
inhibits histamine •Be aware that tolerance
Chemical class: release. may occur with
Sympathomimetic continued use.
amine
•Caution patient not to use
51
Therapeutic class: metaproterenol
Antiasthmatic, inhaler or nebulizer more
bronchodilator often than
prescribed.
Pregnancy category: C •Teach patient to use
metaproterenol
ROUTE: inhaler correctly, to hold
breath during
PO, INHALATION second half of inhalation,
and to wait 2
DOSAGE: minutes between
inhalations.
syrup, tablets •Instruct parents to use
Adults and children age 9 spacer with their
or over child’s metered-dose
weighing more than 27 kg inhaler.
(59 lb). 20 mg
every 6 to 8 hr. •Advise patient to use
metaproterenol 5
minutes before using
Children ages 6 to 9
corticosteroid
weighing 27 kg or inhaler, if prescribed, to
less. 10 mg every 6 to 8 maximize airway
hr. opening and drug effects.
inhalation aerosol •Instruct patient to report

Adults and adolescents. 2 immediately
to 3 inhalations diarrhea, increased shortness
of breath,
(1.3 to 1.95 mg) every 3
insomnia, or irregular
to 4 hr. Maximum: heartbeat.
12 inhalations daily.
Children ages 6 to 12. 1 •Instruct patient to notify
to 3 inhalations prescriber if drug
(0.65 to 1.95 mg) every 3 becomes less effective.
to 4 hr.
Maximum: 12 inhalations
daily.
inhalation nebulizer
Adults and adolescents.

0.2 to 0.3 ml of 5%
solution diluted in 2.5 ml
normal saline
solution three times daily
or four times daily,
as needed,, but no more
than every 4 hr.
Children ages 6 to 12. 0.1
to 0.2 ml of 5%
solution diluted in normal
saline solution to
a total volume of 3 ml
three times daily or
four times daily, as
needed, but no more
than every 4 hr.
FREQUENCY:
syrup, tablets Adults and

children age 9 or over
weighing more than
27 kg (59 lb). 20 mg
52
every 6 to 8 hr.
Children ages 6 to 9
weighing 27 kg or
less. 10 mg every 6
to 8 hr.
inhalation aerosol Adults

and adolescents. 2 to
3 inhalations (1.3 to
1.95 mg) every 3 to 4
hr. Maximum: 12
inhalations daily.
inhalation nebulizer
Adults and
adolescents. 0.2 to
0.3 ml of 5% solution
diluted in 2.5 ml
normal saline
solution three times
daily or four times
daily, as needed,, but
no more than every
4 hr.
Children ages 6 to 12. 0.1

to 0.2 ml of 5%
solution diluted in
normal saline
solution to a total
volume of 3 ml three
times daily or four
times daily, as
needed, but no more
than every 4 hr.
Name of Patient: ___________________
53
DRUG STUDY
AND PRECAUTION
GENERIC NAME: Interferes with the As adjunct to Hypersensitivity to bedaquiline CNS: Headache, •Know that bedaquiline
function of an enzyme combination or its syncope should only be
Bedaquiline required by the therapy to components CV: Chest pain, given in combination with at
tuberculosis bacterium treat pulmonary prolonged QT interval least 3 other
BRAND NAME: to multidrug-resistant GI: Anorexia, drugs that the patient’s
produce energy and to tuberculosis elevated liver multidrug-resistant
Sirturo replicate. enzymes, TB (MDR-TB) isolate has
hepatic dysfunction, shown to be
CLASSIFICATION: nausea susceptible in vitro. If in
MS: Arthralgia vitro testing
Chemical class: RESP: Blood-tinged results are not known,
Diarylquinoline sputum expect patient to
SKIN: Rash receive at least 4 other drugs
Therapeutic class: to which the
Antimyobacterial patient’s MDR-TB is likely
antibiotic, to be
antitubercular susceptible.
Pregnancy category: B •Be aware that bedaquiline

therapy is used
ROUTE: only when an effective
treatment regimen
PO cannot otherwise be
provided due to
DOSAGE: potential increased mortality
with
Adults. 400 mg once bedaquiline therapy.
daily with food for
wks 1 and 2, then 200 •Assess patient frequently
mg 3 times per week for signs and
with food (with at symptoms of new or
least 48 hrs between worsening liver
doses) for wks 3–24. dysfunction. Report
significant elevations
FREQUENCY: of aminotransferases and/or
bilirubin and/
400 mg: Once daily or symptoms such as
with food for fatigue, anorexia,
wks 1 and 2 nausea, jaundice, dark urine,
liver
200 mg: 3 times per tenderness, or
week hepatomegaly.
with food (with at
least 48 hrs between •Give bedaquiline by using
doses) for wks 3–24. directly
observed therapy (DOT).
•Emphasize importance of
taking
bedaquiline and the
companion drugs
exactly as directed.
54
•Tell patient that bedaquiline
requires the
drug to be administered by
directly
observed therapy.
•Advise patient that if he

misses a dose
during the first 2 weeks of
therapy, he
should not make up the
missed dose.
However, if he misses a
dose from week
3 onwards, he should take
the missed dose
as soon as he remembers
and then resume
the 3 times a week regimen,
making sure
48 hours has elapsed
between doses,
including the missed dose.
•Instruct patient to avoid

alcohol
throughout bedaquiline
therapy, especially
if he has a diminished liver
reserve.
•Emphasize importance of
seeking
immediate emergency
assistance if
fainting occurs.
•Inform patient that an ECG

and blood
work will be required
regularly
throughout bedaquiline
therapy.
XIV. GASTROINTESTINAL DRUGS
Name of Patient: ___________________
DRUG STUDY
55
AND PRECAUTION
GENERIC NAME: Inhibits basal and To prevent Acute porphyria, CNS: Dizziness, •Be aware that ranitidine must
nocturnal secretion of duodenal and hypersensitivity to drowsiness, fever, be diluted
Ranitidine gastric acid and pepsin gastric ulcers ranitidine or its components head for I.V. use if not using
Hydrochloride by competitively ache, insomnia premixed solution.
inhibiting the action of To prevent CV: Vasculitis For I.V. injection, dilute to
BRAND NAME: histamine at H2 duodenal and GI: Abdominal total of 20 ml
receptors on gastric gastric ulcers distress, with normal saline solution,
Apo-Ranitidine parietal cells. This capsules, constipation, D5W, D10W,
(CAN), 1032 ranolazine effervescent diarrhea, nausea, lactated Ringer’s solution, or
GenRanitidine action reduces total granules, vomiting 5% sodium
(CAN), Novo- volume of gastric juices effervescent GU: Acute bicarbonate. For I.V. infusion,
Ranitidine and, thus, irritation of interstitial nephritis, dilute to
(CAN), Nu-Ranit GI mucosa. To treat acid impotence total volume of 100 ml of
(CAN), Zantac, indigestion, MS: Arthralgia, same solutions.
Zantac EFFERdose heartburn, myalgia
Tablets, Zantac and sour stomach RESP: •Give I.V. injection at no
150 GELdose, Zantac Bronchospasm more than 4 ml/
300 GELdose SKIN: Alopecia, min, intermittent I.V. infusion
erythema at 5 to 7 ml/
CLASSIFICATION: multiforme, rash min, and continuous I.V.
Other: infusion at
Chemical class: Anaphylaxis, 6.25 mg/hr (except with
Aminoalkyl- angioedema hypersecretory
substituted conditions, when initial
furan derivative infusion rate is 1 mg/
kg/hr, gradually increased
Therapeutic class: after 4 hours, as
Antiulcer agent, needed, in increments of 0.5
gastric mg/kg/hr).
acid secretion
inhibitor •Tell patient to dissolve 150-
mg efferÂ
Pregnancy category: vescent tablets or granules in
B 6 to 8 oz
water or 25-mg effervescent
ROUTE: tablets in at
least 5 ml water.
PO, IV
•Advise patient (or parent) to
wait until
DOSAGE: effervescent tablet is
completely dissolved
To prevent duodenal before taking (or giving to
and gastric ulcers child or infant).
capsules, effervescent
granules, effervescent •Caution patient not to chew
tablets, syrup, tablets effervescent
Adults and tablets, swallow them whole,
adolescents. 150 mg or let them
at bedtime. dissolve on the tongue.
To prevent acid •Alert patients with

indigestion, phenylketonuria that
heartburn, effervescent tablets and
and sour stomach granules contain
caused by eating phenylalanine.
56
certain
foods or drinking •Tell patient that she may take
certain beverages drug with
food.
tablets
Adults and •Tell patient to stop taking
adolescents. 75 mg 30 ranitidine and
to contact prescriber if she has
60 min before food or trouble
beverages expected swallowing, vomits blood, or
to cause symptoms. passes black
Maximum: 150 mg or bloody stools.
daily over no more
than 2 continuous wk. •If needed, advise patient to
take antacids,
To treat acid 2 hours before or after
indigestion, ranitidine; advise
heartburn, against taking other acid
and sour stomach reducers with
tablets drug.
Adults and
adolescents. 75 mg •If patient takes drug to
when prevent heartburn,
symptoms start; tell her to contact prescriber
repeated once within about frequent
24 hr, chest pain or wheezing with
if needed. heartburn;
stomach pain; unexplained
FREQUENCY: weight loss;
nausea; vomiting; heartburn
To prevent duodenal lasting more
and gastric ulcers than 3 months; heartburn with
capsules, lightheadedness, dizziness, or
effervescent sweating; chest or
granules, shoulder pain with shortness
effervescent tablets, of breath,
syrup, tablets sweating, light-headedness, or
Adults and pain
adolescents. 150 mg spreading to arms, neck, or
at bedtime. shoulders.
These problems may be
To prevent acid serious.
indigestion,
heartburn, •Inform patient that healing of
and sour stomach an ulcer
caused by eating may require 4 to 8 weeks of
certain therapy.
foods or drinking
certain beverages
tablets
Adults and
adolescents. 75 mg 30
to
60 min before food
or beverages
expected
to cause symptoms.
Maximum: 150 mg
daily over no more
than 2 continuous
wk.
57
To treat acid
indigestion,
heartburn,
and sour stomach
tablets
Adults and
adolescents. 75 mg
when
symptoms start;
repeated once within
24 hr,
if needed.
NOTE:
P.O., I.V., Unknown 1–3 hr 13 hr I.M.
Name of Patient: ___________________
DRUG STUDY
AND PRECAUTION
GENERIC NAME: Enhances chloride-rich To treat chronic Diarrhea, hypersensitivity to CNS: Asthenia, •Be aware that lubiprostone
intestinal fluid idiopathic lubiprostone dizziness, fatigue, shouldn’t be
Lubiprostone secretion by locally constipation, or components, mechanical GI headache, used in patients with severe
activating chloride to treat opioid- obstruction malaise diarrhea.
BRAND NAME: channels. By increasing induced CV: Chest
intestinal fluid constipation discomfort or pain, •Make sure woman has a
Amitiza secretion, lubiprostone edema, negative pregnancy test before
increases intestinal To treat irritable increased heart rate starting lubiprostone
CLASSIFICATION: motility, which aids bowel syndrome EENT: Dry mouth, because safety during
passage of stool, with throat tightness pregnancy is
Chemical class: alleviating constipation constipation GI: Abdominal unknown.
Chloride channel distention or pain,
activator diarrhea, •Watch closely for adverse
dyspepsia, reactions,
Therapeutic class: flatulence, nausea, particularly dyspnea, and
Intestinal motility vomiting especially after
Enhancer MS: Muscle cramps first dose.
or spasms
Pregnancy category: RESP: Dyspnea •Advise patient to take drug
C SKIN: Rash with food to
Other: Angioedema minimize risk of nausea.
ROUTE:
•Tell women to use effective
PO contraception
while taking lubiprostone and
DOSAGE: to notify
58
prescriber if pregnancy is
To treat chronic suspected. Drug
idiopathic may need to be discontinued.
constipation,
to treat opioid- •Instruct patient to notify
induced constipation prescriber if
capsules severe diarrhea occurs.
Adults. 24 mcg twice
daily with food and
water.
To treat irritable
bowel syndrome
with
constipation
capsules
Adults. 8 mcg twice

daily with food and
Water
FREQUENCY:
b.i.d
59
XIV. NUTRITION AND VITAMINS
Name of Patient: ___________________
DRUG STUDY
DRUG ORDER MECHANISM INDICATION CONTRAINDICATION ADVERSE NURSING
OF ACTION S S EFFECTS RESPONSIBILITY
AND PRECAUTION
GENERIC NAME: Acts as a catalyst for To prevent Folic Hypersensitivity to folic acid or Other: Allergic • To prevent decreased
normal production of Acid deficiency its reaction absorption, give folic
Folic Acid red blood cells, helping components (bronchospasm, acid supplements at least 1
(Vitamin B9) to prevent erythema, fever, hour before or
megaloblastic anemia, malaise, rash, 4 hours after cholestyramine
BRAND NAME: and helps maintain pruritus) or sulfasalazine
normal and don’t give antacids
Apo-Folic (can), homocysteine levels. within 1 hour before
Folvite, Novo-Folacid After being or 2 hours after giving folic
(can) converted to acid.
tetrahydrofolic acid in
CLASSIFICATION: the • Know that folic acid will
intestines, folic acid correct hematoÂ
Chemical class: promotes synthesis of logic disorders in pernicious
Water-soluble B- several enzymes, anemia, but
complex including purine and neurologic problems will
Vitamin thymidylates; progressively
metabolism of amino worsen.
Therapeutic class: acids,
Nutritional including glycine and •Advise against taking folic
supplement methionine; and acid supplements as a
metabolism of substitute for proper dietary
Pregnancy category: histidine, all of which intake. Explain that good
A are sources of folic
essential for normal acid include green
ROUTE: cell structure and vegetables, potatoes,
growth. cereals, and organ meats.
60
PO Recommend
eating raw green vegetables
DOSAGE: because heat
used during cooking destroys
Adult women and up to 90%
girls age 11 and of folic acid found in food.
over.
150 to 400 mcg •Explain to patients with
daily. pernicious anemia
that folic acid won’t affect
Pregnant women. 400 the neurologic
to 800 mcg symptoms associated with
daily. the disease.
Breastfeeding
women. 260 to 800
mcg
daily.
FREQUENCY:
Daily
61
Name of Patient: ___________________
DRUG STUDY
DRUG ORDER MECHANISM INDICATION CONTRAINDICATION ADVERSE NURSING
OF ACTION S S EFFECTS RESPONSIBILITY
AND
PRECAUTION
GENERIC NAME: Vitamin E is a potent Treatment & Hypersensitivity. Pregnancy Large doses may cause • Assess PT for signs of
chain-breaking prevention of vit E (especially 1st trimester) & diarrhea, abdominal vit E deficiency (neonates
dl-alpha tocopheryl antioxidant that deficiency; lactation. pain, other GI —irritability, edema,
acetate (vit E) inhibits the production neurological disturbances; blurred haemolytic anemia,
of reactive oxygen disorder. vision, dizziness, creatinuria;
BRAND NAME: species molecules Correction of vit E fatigue and weakness) adults/children [rare]—
when fat undergoes deficiency muscle weakness, ceroid
Evirose-400 oxidation and during occurring in deposits, anemia,
the propagation of free malabsorption creatinuria) prior to &
CLASSIFICATION radical reactions. disorder ie, cystic periodically throughout
: fibrosis, chronic therapy.
cholectasis &
Vitamins abetalipo- • Assess nutritional status
proteinemia. through 24-hr diet recall.
ROUTE: Determine frequency of
consumption of vit E–
PO rich foods.
DOSAGE: • Instruct PT to take

medication as directed. If
200-400 IU a dose is missed, it should
be omitted, because fat-
FREQUENCY: soluble vitamins are
stored in the body for long
Daily periods.
• Encourage PT to comply
w/ diet recommendations
of health care
professional. Explain that
the best source of
vitamins is well-balanced
diet w/foods from the four
basic food groups.
• Foods high in vitamin E

include vegetable oils,
wheat germ, whole-grain
cereals, egg yolk, & liver.
Vitamin E content is not
markedly affected by
cooking.
62
• PTs self-medicating w/
vit supplements should be
cautioned not to exceed
RDA. The effectiveness
of megadoses for
treatment of various
medical conditions is
unproved, & this may
cause side effects and
toxicity.
XIV. DRUGS FOR INFECTIOUS

DISEASES
63
Name of Patient: ___________________
DRUG STUDY
OF ACTION NS EFFECTS RESPONSIBILIT
Y AND
PRECAUTION
GENERIC NAME: Inhibits protein To treat serious History of regional enteritis, CNS: Fatigue, headache • To prevent physical
synthesis in respiratory tract ulcerative CV: Hypotension, incompatibility, don’t
Clindamycin susceptible infections caused by colitis, or antibiotic-associated thrombophlebitis (after administer with
Hydrochloride bacteria by binding to anaerobes such as colitis; I.V. injection) aminophylline,
the 50S subunits of occur with anaerobic hypersensitivity to clindamycin EENT: Glossitis, ampicillin,
BRAND NAME: bacterial ribosomes pneumonitis, or metallic or unpleasant barbiturates, calcium
and preventing empyema, and lung lincomycin taste (with high I.V. gluconate, magnesium
Cleocin, Dalacin C peptide abscess and those doses), stomatitis sulfate, or phenytoin.
bond formation, caused by GI: Abdominal pain,
CLASSIFICATION which causes bacterial pneumococci, diarrhea, esophagitis, • Expect to obtain a
: cells to die. staphylococci, nausea, specimen for culture and
and streptococci; pseudomembranous sensitivity testing before
Chemical class: serious skin and colitis, vomiting giving first dose.
Lincosamide softtissue infections GU: Cervicitis,
caused by anaerobes, vaginitis, and vulvar • Store oral solution for
Therapeutic class: staphylococci, and irritation (with vaginal up to 2 weeks at
Antibacterial and streptococci; form) room temperature or
antiprotozoal septicemia HEME: reconstituted
antibiotic caused by anaerobes; Agranulocytosis, parenteral solution for
intra-abdominal eosinophilia, up to 24 hours at
Pregnancy category: infections caused by leukopenia, neutropenia, room temperature.
B anaerobes such as thrombocytopenic
occur with intra- purpura • Monitor results of liver
ROUTE: abdominal abscess and SKIN: Irritation, function tests,
peritonitis; infections pruritus, rash, urticaria CBC, and platelet counts
PO, IV, IM of the female pelvis Other: Anaphylaxis; during
and genital tract induration, pain, or prolonged therapy.
DOSAGE: caused by anaerobes sterile abscess after • Observe patient for
such as occur with injection; superinfection signs and symptoms of
Adults and endometritis, superinfection, such as
adolescents. For nongonococcal tubo- vaginal itching and
serious ovarian abscess, sore mouth, which may
infections, 150 to pelvic cellulitis, and occur 2 to 9 days
300 mg every 6 hr; postsurgical vaginal after therapy begins.
for cuff infection; bone
severe infections, and joint infections • Tell patient to
300 to 450 mg every caused by complete the prescribed
6 hr. Staphylococcus course of therapy, even
Children. For aureus; as if he feels better
serious infections, 8 adjunct therapy in before it’s finished.
to chronic bone and joint
16 mg/kg daily in infections • Instruct patient to take
equally divided doses oral clindamycin
three times daily or with at least 8 oz of
four times daily; for water to prevent
severe infections, 16 esophageal irritation.
to 20 mg/kg/day in
64
equally divided doses • Advise patient to take
three times daily or oral drug with food,
four times daily if needed, to reduce GI
distress.
FREQUENCY:
• Tell patient not to
Adults and refrigerate reconstituted
adolescents. oral solution because it
may become thick
For serious and difficult to pour and
Infections: every 6 to discard
hr unused drug after 14
days.
For severe
infections: every 6 • Inform patient that
hr. I.M. injection may be
painful.
Children.
• Tell patient to
For serious immediately report an
infections: inflamed mouth or
daily in equally vagina, and rash or
divided doses lesions.
three times daily or
four times daily • Urge patient to report
watery, bloody
For severe stools to prescriber
infections: immediately, even up
equally divided doses to 2 months after drug
three times daily or therapy has ended.
four times daily
65
Name of Patient: ___________________
DRUG STUDY
OF ACTION NS EFFECTS RESPONSIBILITY
AND PRECAUTION
GENERIC NAME: Kills bacteria by To treat ear, nose, History of severe CNS: Agitation, anxiety, • Patients with
binding to and throat, GU tract, hypersensitivity behavior changes, mononucleosis shouldn’t
Amoxicillin inactivating skin, reactions (anaphylaxis or confusion, dizziness, receive amoxicillin because
Trihydrate penicillin-binding and soft-tissue Stevens-Johnson insomnia, reversible this class of
(amoxycillin) proteins on the infections caused by syndrome) to other beta-lactam hyperactivity, seizures drugs may cause an
inner susceptible gram- antibiotics, CV: Hypersensitivity erythematous rash.
BRAND NAME: bacterial cell wall, positive and gram- hypersensitivity to amoxicillin vasculitis
weakening the negative organisms or its EENT: Black, hairy • Monitor patient closely for
Amoxil, Apo-Amoxi bacterial components, tongue; mucocutaneous diarrhea, which
(can), Disper cell wall and To treat lower candidiasis; tooth may indicate
Mox, Moxatag, causing lysis. respiratory tract discoloration pseudomembranous colitis
Novamoxin (can), infections caused by GI: Diarrhea, diarrhea caused by Clostridium
Nu-Amoxi (can), susceptible related to difficile. If diarrhea
Polymox, Trimox, grampositive and Clostridium difficile, occurs, notify prescriber,
Wymox gram-negative elevated liver enzymes, expect to
organisms hemorrhagic or withhold amoxicillin, and
CLASSIFICATION pseudomembranous treat with fluids,
: To treat gonorrhea colitis, electrolytes, protein, and an
and acute jaundice, hepatic antibiotic
Chemical class: uncomplicated dysfunction, nausea, effective against C. difficile.
Aminopenicillin anogenital and vomiting
urethral GU: Crystalluria, • Expect treatment that lasts
Therapeutic infections caused by vaginal mycosis at least 10 days
class: Antibiotic susceptible strains HEME: for hemolytic streptococci
of gram-positive and Agranulocytosis, anemia infections
Pregnancy gram-negative (including
category: B organisms hemolytic anemia), • Monitor patient for
66
capsules, chewab eosinophilia, superinfection. If it
ROUTE: granulocytosis, occurs, expect to
leukopenia, discontinue drug and
PO thrombocytopenia, provide treatment as
thrombocytopenic ordered.
DOSAGE: purpura
SKIN: Erythema • Tell patient to refrigerate
Adults and children multiforme, reconstituted
weighing 20 kg (44 erythematous suspension and to shake
lb) or more. maculopapular rash, well before
generalized each use.
250 mg every 8 hr; exanthematous
for severe pustulosis, Stevens- • To prevent infection from
infections, 500 mg Johnson recurring, urge
every 8 hr or 875 mg syndrome, toxic patient to take amoxicillin
every 12 hr. epidermal necrolysis, for full length
urticaria of time prescribed, even if
Children age 12 wk Other: Allergic he feels better.
and over weighing reaction, anaphylaxis,
less than 20 kg. 20 serum sickness-like • Teach patient to report
mg/kg daily in reaction (such as adverse reactions
divided arthralgia, arthritis, and notify prescriber if
doses every 8 hr; for fever, myalgia, rash, infection worsens
severe infections, and urticaria) or doesn’t improve after 72
40 to 45 mg/kg/day hours
in divided doses
every • Urge patient to tell
8 hr. prescriber about
diarrhea that’s severe or
Children under age lasts longer than
12 wk. 30 mg/kg/day 3 days. Remind patient that
in divided doses watery or
every 12 hr. bloody stools can occur 2 or
more months
FREQUENCY: after antibiotic therapy and
may be
Adults and children serious, requiring prompt
weighing 20 kg (44 treatment.
lb) or more.
• When amoxicillin
Every 8 hr suspension is prescribed
for a child, instruct parents
For severe to place it
Infections: directly on child’s tongue to
every 12 hr. swallow. If
this doesn’t work, tell
Children age 12 wk parents to mix dose
and over weighing of suspension with formula
less than 20 kg. or cold drink
(milk, fruit juice, ginger ale,
Daily in divided water) and
doses every 8 hr have child drink it
immediately.
For severe
infections:
every
8 hr.
Children under age

12 wk.
every 12 hr.
NOTE:
67
P.O. Unknown Unknown 6–8 hr
XIV. DRUGS FOR PARASITIC

DISEASES
Name of Patient: ___________________
DRUG STUDY
DRUG ORDER MECHANIS INDICATIONS CONTRAINDICATIO ADVERSE NURSING
M OF NS EFFECTS RESPONSIBILITY
ACTION AND PRECAUTION
GENERIC NAME: May disrupt As adjunct to treat G6PD deficiency, history of CNS: Dizziness, • Be aware that quinine
function in chloroquine-resistant quinineinduced headache shouldn’t be used in
Quinine Sulfate malarial parasite malaria caused by blackwater fever or thrombo- CV: Prolonged PTs w/ blackwater fever, which
by elevating Plasmodium cytopenic purpura, PR, QRS or QT can follow chronic malaria,
BRAND NAME: intracellular pH in falciparum. hypersensitivity to quinine or intervals; because they’re at increased
parasitic acid its components, optic neuritis, torsades de risk for anemia & hemolysis w/
Qualaquin vesicles. pregnancy, tinnitus pointes; renal failure. Quinine also isn’t
ventricular recommended for treating or
CLASSIFICATION: arrhythmias preventing nocturnal leg
EENT: Blurred cramps because lives
Antimalarial vision, hearing threatening hematologic
loss, tinnitus, reactions have occurred w/
ROUTE: vision changes potential for chronic renal
including impairment. Quinine therapy
PO blindness should not be used if PT has
ENDO: severe hepatic dysfunction.
DOSAGE: Hypoglycemia
GI: Abdominal • Be aware that quinine
Adults: 648mg (2 or epigastric shouldn’t be given I.M. Doing
capsules) pain, diarrhea, so may cause bleeding,
nausea, vomiting bruising, or hematomas
FREQUENCY: HEME: because of quinine’s effect on
Thrombo- platelets.
Every 8 hr for 7 cytopenia
days SKIN: • Monitor PT w/ type 2 DM for
Diaphoresis, alterations in blood glucose lvl
flushing. because quinine stimulates
release of insulin & may
promote hypoglycemia.
• Be aware that quinine can

exacerbate optic neuritis or
tinnitus. It may also exacerbate
muscle weakness & cause
dysphagia & respiratory
distress in myasthenic PTs.
68
• Assess for early signs &
symptoms of cinchonism,
including blurred vision,
confusion, diplopia, fever, and
headache, loss of hearing, &
tinnitus, w/c may indicate
quinine toxicity.
• Be aware that PTs who

develop quinine-dependent
antibodies could develop
thrombo-cytopenia more
rapidly & more severely upon
reexposure to quinine from any
source.
Name of Patient: ___________________
DRUG STUDY
69
ACTION AND
PRECAUTION
GENERIC NAME: Cryptos-poridium To treat diarrhea caused Hypersensitivity to CNS: Headache • Use nitazoxanide
parvum and by Giardia lamblia and nitazoxanide or its GI: Abdominal pain, cautiously in children with
Nitazoxanide Giardia lamblia by diarrhea caused by Components. anorexia, diarrhea, impaired hepatic function,
interfering w/ Cryptosporidium nausea, vomiting biliary disease, or renal
BRAND NAME: enzyme-dependent parvum. insufficiency.
electron transfer
Alinia required for their • Prepare suspension by
anaerobic energy first tapping bottle until
CLASSIFICATION: metabolism. Other powder flows freely. Add
unidentified 24 ml of tap water to
Antiprotozoal mechanisms may powder & shake
also be involved. vigorously to suspend
ROUTE: With loss of powder. Add another 24
protozoal activity ml water and shake
PO in the intestines, vigorously again. Keep
diarrhea ceases. bottle of reconstituted
DOSAGE: suspension tightly capped.
Adults & Children • Use oral suspension for

age 12 and over: children age 11
Tab, 500 mg & under because tablets
contain more nitazoxanide
Children age 4-11: than is recommended for
Oral suspension, 200 children under age 12.
mg (10mL)
Children age 12
months to 47
months: Oral
suspension, 100mg
(5mL)
FREQUENCY:
Adults & Children

age 12 and over:
Every 12 hr with
meals for 3 days.
Children ages 4 to
11: Every 12 hr with
meals for 3 days.
Children ages 12
months to 47
months: Every 12 hr
with meals for 3
days.
70
XVIII. CANCER CHEMOTHERAPY
Name of Patient: ___________________
DRUG STUDY
71
DRUG ORDER MECHANISM INDICATION CONTRA- ADVERSE NURSING
OF ACTION S INDICATIONS EFFECTS RESPONSIBILITY AND
PRECAUTION
GENERIC NAME: Inhibits 5-alpha To treat Age (childhood), CNS: Asthenia, • Be aware that
reductase, an symptomatic benign hypersensitivity to depression, dizziness, patient should have a
Finasteride intracellular prostatic finasteride, sex headache, progressive urologic evaluation
enzyme that converts hyperplasia; to (female) multifocal prior to starting
BRAND NAME: testosterone to its reduce the risk of leukoencephalopathy finasteride therapy
metabolite (5-alpha symptomatic (extremely rare) and periodically
Propecia, Proscar dihydrotestosterone) progression of CV: Hypotension, throughout
in liver, prostate, and benign peripheral edema therapy because
CLASSIFICATION: skin. prostatic EENT: Lip swelling, drug can
hyperplasia when rhinitis increase the
Chemical class: 4-Azasteroid The metabolite given with ENDO: risk of prostate cancer,
compound is a potent androgen doxazocin Gynecomastia, male especially
partially responsible breast cancer high-grade
Therapeutic class: for benign prostatic GI: Abdominal pain, prostate cancer.
Benign prostatic hyperplasia and hair diarrhea
hyperplasia agent, loss. GU: Altered prostate- • Expect patient to
hair growth stimulant specific antigen level, have a digital rectal
decreased ejaculatory examination of
Pregnancy category: X volume, decreased the prostate before
libido, erectile and
ROUTE: dysfunction, high- periodically
grade during finasteride
PO prostate cancer, therapy.
impotence, male
DOSAGE: infertility, • Be aware
testicular pain that
Adults. 5 mg. MS: Back pain finasteride
RESP: Dyspnea therapy affects
FREQUENCY: SKIN: Pruritus, rash, prostate-specific
urticaria antigen (PSA) levels. For
Daily Other: Angioedema example, drug
may decrease
levels even in
the presence
of prostate cancer. Any
increases, no
matter how slight
or even if
increase is still
within normal limits,
warrant
further
evaluation
because of
finasteride’s risk
of high-grade prostate
cancer.
•Explain how to
take drug, and urge
patient to
follow instructions
that
accompany it.
•Inform patient
72
that drug may
cause a
variety of
sexual
dysfunction problems
including
erectile dysfunction,
decreased libido,
and male infertility,
which may
continue after drug is
discontinued.
•Urge patient to
have periodic
follow-up to
determine
drug effectiveness.
•Caution patient
that noncompliance with
therapy may
affect PSA test results.
Name of Patient: ___________________
DRUG STUDY
OF ACTION INDICATIONS EFFECTS RESPONSIBILITY
AND
PRECAUTION
GENERIC NAME: The mechanism of For the treatment of Hypersensitivity. Renal: Increase of • Studies have
action is not known, but metastatic malignant Pregnancy. BUN, proteinuria may demonstrated that this
Dacarbazine appears to exert melanoma. In occur. agent is teratogenic when
cytotoxic effects via its addition, dacarbazine Hypersensitivity: administered to animals.
BRAND NAME: action as an alkylating is also indicated for Anaphylaxis, Dacarbazine therefore
agent. Other theories Hodgkin's disease as a photosensitivity may should not be
Duticin include DNA synthesis secondary-line occur. administered to pregnant
inhibition by its action therapy when used in GASTRO: Nausea, women or women who are
CLASSIFICATION: as a purine analog, and combination with vomiting, anorexia, suspected of being
73
interaction with SH other antineoplastic diarrhea, and pregnant.
Cytotoxic Chemotherapy groups. Dacarbazine is agents. gastralgia may occur.
not cell cycle-phase Nervous System: • Since the safe use in
ROUTE: specific. Giddiness, mouth nursing mothers has not
numbness, facial been established, breast
IV paresthesia may feeding should be avoided
The antineoplastic occur. during dacarbazine
DOSAGE: effect is due to an DERMA: therapy.
inhibition of cell growth Erythematous
2-4.5 mg/kg/day IV for 10 which is independent of eruption, urticaria, • In long-term therapy,
days repeated at intervals of 4 the cell cycle and due to alopecia may occur. side-effects may be
wk or 250 mg/m2 daily for 5 an inhibition of DNA Site of Injection: chronic or more severe.
days, repeated at intervals of synthesis. An alkylating Vascular pain may Therefore, careful
3 wk. effect has also been occur. treatment is needed.
shown and other OTHER: Malaise, Bleeding tendency should
Malignant melanoma: 850 cytostatic mechanisms myalgia, headache, be cautioned.
mg/m2 IV infusion at 3 wk may also be influenced ruber, flush,
interval. by dacarbazine. influenza-like • Severe side-effects such
Dacarbazine is syndrome may occur. as bone marrow
Hodgkin's disease: 150 considered not to show depression, hepatic
mg/m2/day for 5 days in an antineoplastic effect impairment, renal
combination w/ other by itself. impairment may occur;
effective drugs. May be therefore, careful
repeated every 4 wk or 375 However by monitoring (blood-
mg/m2/day in combination microsomal N- hepatic-renal function) is
w/ other antineoplastic demethylation it is needed. If any symptom
agents, to be repeated every quickly converted to 5- occurs, the administration
15 days. amino-imidazole-4- should be discontinued or
carboxamide and a appropriate therapy
methyl cation, which is instituted.
FREQUENCY: responsible for the
alkylating effect of the • Monitor result of
2 to 4.5 mg/kg/day IV for 10 drug. laboratory tests such as
days repeated at intervals of
CBC with differential to
4 wk or 250 mg/m2 daily for
identify possible bone
5 days, repeated at intervals
marrow suppression and
of 3 wk.
toxic drug effects and
establish appropriate
Malignant melanoma: 850
dosing for the drug; and
mg/m2 IV infusion at 3 wk
liver and renal function
interval.
tests to determine need for
possible dose adjustment
Hodgkin's disease: 150
and identify toxic drug
mg/m2/day for 5 days in
effects.
combination w/ other
effective drugs. May be
repeated every 4 wk or 375
mg/m2/day in combination w/
other antineoplastic agents, to
be repeated every 15 days.
74
XIX. ADDITIONAL IMPORTANT
DRUGS
Name of Patient: ___________________
DRUG STUDY
Name of Patient:___________________
DRUG STUDY
ACTION AND
PRECAUTION
GENERIC NAME: Inhibits To treat tuberculosis as Hypersensitivity to CNS: Encephalopathy, • Administer

incorporation of adjunct to aminosalicylate sodium, fever aminosalicylate with food
Aminosalicylate para-aminobenzoic isoniazid, streptomycin, severe renal disease CV: Vasculitis to
Sodium acid into folic acid or both and in ENDO: Goiter with or reduce GI upset.
(para-aminosalicylate, and prevents patients with multidrug- without myxedema
PAS) synthesis of resistant GI: Abdominal pain, • Protect drug from water,
75
folic acid, a tuberculosis or when diarrhea, hepatitis, heat,
BRAND NAME: compound needed therapy with nausea, vomiting and sunlight to prevent
for bacterial rifampin and isoniazid HEME: rapid
Nemasol Sodium growth. isn’t possible Agranulocytosis, deterioration. Don’t give
(can), PAS Aminosalicylate because of resistance or hemolytic anemia, tablets with
sodium is intolerance leukopenia, brown or purple
CLASSIFICATION: bacteriostatic thrombocytopenia discoloration—a sign of
against SKIN: Jaundice, deterioration.
Chemical class: Para- Mycobacterium various types of
aminobenzoic acid tuberculosis, and it eruptions • Teach patient to discard
Analogue delays bacterial Other: Infectious aminosalicylate
resistance mononucleosis-like that appears brown or
Therapeutic class: to streptomycin syndrome, Loeffler’s purple.
Antitubercular and isoniazid. syndrome
(anorexia, • Instruct patient to take
Pregnancy category: breathlessness, fever, drug with food.
C and
weight loss)
ROUTE:
PO
DOSAGE:
Adults. 14 to 16 g
daily in 2 or 3 divided
doses.
Children. 275 to 420

mg/kg daily in 3 or
4 divided doses.
FREQUENCY:
Daily
76
XIX. ALTERNATIVE THERAPY
Name of Patient: ___________________
DRUG STUDY
OF ACTION INDICATIONS EFFECTS RESPONSIBILITY
AND PRECAUTION
GENERIC NAME: The compounds found Appears to be Hypersensitivity Allergic skin reactions • Do not take Eun-haeng,
in ginkgo may have a effective in: fossil tree, ginko biloba,
ginkgo biloba protective role in alleviating age- Avoid prior to surgery: Bleeding disorders ginkyo, icho, ityo, Japanese
different stages of the related memory may cause bleeding. silver apricot, kew tree,
BRAND NAME: decline of intellectual impairment in some Constipation maidenhair tree, salisburia,
function via several elderly people with Attempting conception orsilver apricot if you are
Eun-haeng, Fossil mechanisms of action: mild to moderate age- Contact dermatitis allergic to ginkgo biloba or
Tree, Ginko Biloba, vasoregulating activity related memory or (topical use) any ingredients contained in
Ginkyo, Icho, Ityo, of arteries, capillaries, cognitive impairment; this drug.
Japanese Silver and veins (increased improving cognitive Diarrhea
Apricot, Kew Tree, blood flow); platelet function in healthy • Do not take Zyprexa,
Maidenhair Tree, activating factor (PAF) young to middle-aged Dizziness Zyprexa Relprevv, or
Salisburia, Silver antagonism; people; improving Zyprexa Zydis if you are
Apricot homeostasis of symptoms of Impaired fertility allergic to Ginkgo biloba or
inflammation and Alzheimer's, vascular any ingredients contained in
CLASSIFICATION: oxidative stress; and or mixed dementia; Headache this drug.
prevention of cell improving damage to
Neurology & membrane damage the visual field in Nausea/vomiting • WARNING: seeds and
Psychiatry, Herbals causedby free radicals; patients with normal fruit pulp are toxic.
and neurotransmission tension glaucoma; Palpitations
ROUTE: modulation. The most decreasing the Restlessness • May modulate some CYP
important substances number of painful 450 enzymes but clinical
PO are flavonoids (ginkgo attacks in patients Seizures significance unknown,
flavone glycosides) with Raynaud's monitor when using
DOSAGE: and terpenoids syndrome; and may Stomach upset concomitant substrates (e.g.,
(ginkgolides and improve symptoms of CYP3A4).
Altitude Sickness, bilobalide).The vertigo and dizziness Subdural hematoma
Prevention compounds inginkgo in some patients.
Leaf extract: act to varying degrees Weakness
77
as scavengers for free
80 mg taken orally radicals. Vertigo (rare)
two times daily
Cognitive Function
Leaf extract:
120-600 mg taken
orally two times daily
Dementia
Leaf extract:
120-240 mg taken
orally in divided
doses two to three
times daily
Vertigo/Tinnitus
Leaf extract:
120-160 mg/d taken

orally in divided
doses two to three
times daily
FREQUENCY:
Altitude Sickness &

Cognitive Function
Two times a day
Dementia &
Vertigo/Tinnitus
Two to Three Times a

day
78
Name of Patient: ___________________
DRUG STUDY
DRUG ORDER MECHANISM INDICATIONS CONTRAINDICATION ADVERSE NURSING
OF ACTION S EFFECTS RESPONSIBILITY
AND
PRECAUTION
GENERIC NAME: There have been more As anti-urolithiasis There are no known epigastric pain, • Patients must also
than 100 volatile or in patients with contraindications. constipation and drink an additional 3
Sambong non-volatile urinary tract stones flatulence liters of water per 24
constituents isolated with normal kidney hours to prevent
BRAND NAME: from Sambong, function. dehydration related to
including As diuretic in diuretic intake. Normal
Re-Leaf/Re-Leaf monoterpenes, patients with mild to daily intake of water is 6-
Forte sesquiterpenes, moderate congestive 8 glasses/day.
diterpenes, flavonoids, heart failure and
CLASSIFICATION: organic acids, esters, edema. • For patients with
alcohols, excretory urogram
G04BX - Other dihydroflavone, and showing signs of renal
urologicals ; Used in sterols. L-borneol was obstruction, consultation
the treatment of the most abundant and with a physician is
urological problems. active constituent in necessary.
this plant.
ROUTE: • Store at temperatures
In the Philippines, not exceeding 30°C.
PO Sambong (Re-leaf) has Shelf-Life: 48 months
been shown to have (250 mg tablet) & 60
DOSAGE: diuretic properties at months (500 mg tablet).
32-50 mg/kg BW in 3
Diuretic: RE-LEAF divided doses
250 mg: 2 tablets 3 comparable to that of
times a day. thiazide producing
significant chloriuresis
RE-LEAF FORTE and some potassium
500 mg: 1 tablet 3 and sodium sparing
times a day. effect. This showed that
Sambong (Re-leaf) may
Anti-urolithiasis: 40 act along more than one
to 50 mg/kg body segment of the
weight per day in 3 nephron.
equal doses.
This property may
Usual Adult Dose: explain the ability of
RE-LEAF 250 mg: 4 Sambong (Re-leaf) to
tablets 3 times a day. cause spontaneous
stone passage despite
RE-LEAF FORTE the stone size affording
500 mg: 2 tablets 3 dramatic pain relief in
times a day. most patients.
Or as prescribed by Comparing the in-vitro
the physician. dissolution of calcium
and uric acid stones,
Sambong (Re-leaf)
FREQUENCY: used at 20 mg/kg and
40 mg/kg was able to
Diuretic: RE-LEAF significantly reduce the
79
250 mg: 2 tablets 3 weight of stones with a
times a day. higher calcium oxalate
content.
RE-LEAF FORTE
500 mg: 1 tablet 3 A maximal dose of 40
times a day. mg/kg/day for 6 weeks
showed statistically
Anti-urolithiasis: 40 significant radiographic
to 50 mg/kg body evidences of decrease
weight per day in 3 in size of stones and
equal doses. spontaneous stone
passage, resulting to
Usual Adult Dose: complete cure in the
RE-LEAF 250 mg: 4 majority of patients.
tablets 3 times a day.
RE-LEAF FORTE
500 mg: 2 tablets 3
times a day.
Or as prescribed by
the physician.
XXI. TOXICOLOGY
Name of Patient: ___________________
DRUG STUDY
80
OF ACTION NS EFFECTS RESPONSIBILITY
AND PRECAUTION
GENERIC NAME: Fomepizole is For treatment The only The most • If the Antizol
an alcohol of methanol contraindication is frequent (fomepizole) solution
Fomepizole dehydrogenas and Ethylene hypersensitivity to adverse has become solid in the
e inhibitor glycol (EG) fomepizole or effects are vial, the solution should
BRAND NAME: that works as poisoning. other headache, be liquefied by running
an antidote pyrazoles. nausea, the vial under warm
Antizol by preventing ≥ 0.2 mL/kg of dizziness, water or by holding in
formation of 100% EG or ≥ increased the hand.
CLASSIFICATION: the toxic 0.1 mL/kg of drowsiness
metabolites 100% methanol and bad taste.
Alcohol of EG and was ingested. Rare allergic • Using sterile technique,
dehydrogenase/ methanol. It reactions the appropriate dose of
Antidote can be used Unknown include skin Antizol (fomepizole)
alone or in amount was rash and should be drawn from
ROUTE: combination ingested and eosinophilia. the vial with a syringe
with one of the and injected into at
IV infusion hemodialysis. following: least 100 mL of sterile
• Serum EG or 0.9% sodium chloride
DOSAGE: methanol injection or dextrose 5%
concentration > injection.
Loading 20 mg/dL (200
dose: 15 mcg/mL) • Mix well. The entire
mg/kg I.V. contents of the
over 30 • Presence of resulting solution
minutes, CNS depression should be infused over
followed by 30 minutes
10 mg/kg I.V. • Metabolic
over 30 acidosis with
minutes q 12 anion gap > 15
hours for
four doses.
FREQUENCY:
Loading
dose: 15
mg/kg I.V.
over 30
minutes,
followed by
10 mg/kg I.V.
over 30
minutes q 12
hours for
four doses.
81
Types of Immunizations Function Used to protect against
or Vaccinations the following diseases:
 Used a weakened form  Measles, mumps,

Live-attenuated vaccines of the germ that causes rubella (MMR
a disease combined vaccine)
 Because these vaccines  Rotavirus
are similar to the  Smallpox
natural infection, they  Chickenpox
create a strong and
long-lasting immune
response.
 Just 1 or 2 doses of most
live vaccines can give
you a lifetime of
protection against a
82
germ and the disease.
 Use the killed version  Hepatitis A

Inactivated vaccines of the germ that causes  Flu (shot only)
a disease.
 Polio (shot only)
 Don’t provide immunity  Rabies
(protection) that’s as
strong as live vaccines.
So you may need
several doses over time
(booster shots) in order
to get ongoing
immunity against
diseases.
 use specific pieces of  Hib (Haemophilus
Subunit, recombinant, the germ — like its influenzae type b)
polysaccharide, and conjugate protein, sugar, or capsid disease
vaccines (a casing around the  Hepatitis B
germ).  HPV (Human
papillomavirus)
 They give a very strong  Whooping cough (part
immune response of the DTaP combined
that’s targeted to kill vaccine)
parts of the germ.  Pneumococcal disease
 Meningococcal disease
 They can also be used  Shingles
on almost everyone who
needs them, including
people with weakened
immune systems and
long-term health
problems.
 use a toxin (harmful  Diphtheria

Toxoid vaccines product) made by the  Tetanus
germ that causes a
disease.
 They create immunity to
the parts of the germ
that cause a disease
instead of the germ
itself. That means the
immune response is
targeted to the toxin
instead of the whole
germ.
83
COMMONLY USED ABBREVIATIONS
a.c Before meals. As in taking a medicine before
meals.
Ad lib At liberty. For example, a patient may be
permitted to move out of bed freely and
orders would, therefore, be for activities to be
ad lib.
ADR Adverse drug reaction
ANED Alive no evidence of disease
ADH Antidiuretic hormone
b.i.d. Twice daily
bld Blood
BKA Below the Knee Amputation
BP Blood Pressure
C&S Culture and sensitivity
cap Capsule
Ca Cancer
CBC Complete blood count
CT Chemotherapy
84
CVA Cerebrovascular accident (Stroke)
D/C or DC Discontinue or discharge
DX Diagnosis
DDX Differential diagnosis
DNR Do not resuscitate
FX Fracture
gtt Drop
H&H Hemoglobin and hematocrit
H&P History and physical examination
h.s At bedtime
HA Headache
HTN Hypertension
I&D Incision and drainage
ICU Intensive care unit
ID Intradermal
IV Intravenous
IM Intramuscular
JT Joint
LBP Low back pain
MCL Medial collateral ligament
N/V Nausea or vomiting
npo Nothing by mouth
O.D Right eye
O.S Left eye
O.U. Both eyes
p¯ After Meals
p.o. By mouth
p.r.n. As needed
PERRLA Pupils equal, round, and reactive to light and
accommodation.
q.d. Each day
q.i.d. Four times daily
q2h Every 2 hours
q3h Every 3 hours
qAM Each morning
qhs At each bedtime
qod Every other day
qPM Each evening
SOB Shortness of breath
SQ Subcutaneous
T Temperature
t.i.d. Three times daily
tab Tablet
UA or u/a Urinalysis
VS Vital Signs
85
VSS Vital Signs are stable
Wt Weight
XRT Radiotherapy (external)
APPENDIXES
PHILIPPINE FDA POLICY ON DRUG APPROVAL AND
REGULATION
Drug Approval System

Clinical Trial Application
 The FDA is mandated to conduct, supervise, monitor and audit research studies on health and
safety issues of health products undertaken by duly authorized by the FDA. All clinical trials to
be conducted in the Philippines need to secure approval of their protocol prior to the conduct,
which is required per phase of the trial.
 In the conduct of clinical trial, strict adherence to GCP, good laboratory practice, and other best
practices is required, including full disclosure of all pertinent documentation during application
and inspection.
 Establishments authorized by the FDA include Sponsors and Clinical Research Organizations
(CROs). The FDA issues a License to Operate (LTO) as proof of authorization for these
establishments.
1) Oversight (e.g. ensuring quality assurance and/or quality control systems are in place to ensure
clinical trials are conducted, data is gathered, and subsequently reported)
2) Management of clinical trials 86

 development of protocols and/or trial design;
 selection of investigator(s) and/or site(s);
 screening and/or recruitment of subjects;
APPENDIXES
DRUG CALCULATION FORMULA
Basic Formula for Drugs

D
1. ×V=A
H
D
2. =A
H
D= Desired Dose
H= Dose on hand (Preparation)
V= Vehicle (Drug form)
A= Amount
87
APPENDIXES
DRUG PREPARATIONS
Bemfola
Common Name: follitropin alfa
Pharmacotherapeutic Group: Sex hormones and modulators of the genital system
Indication: Follitropin alfa in association with a luteinizing hormone (LH) preparation is recommended for the stimulation
of follicular development in women with severe LH and FSH deficiency. In clinical trials these patients were defined by an
endogenous serum LH level < 1.2 IU/l.
Usage: Women who do not produce eggs and who do not respond to treatment with clomiphene citrate (another
medicine that stimulates the ovaries to produce eggs); women who are undergoing assisted reproductive techniques
(fertility treatment) such as in vitro fertilization. Bemfola is given to stimulate the ovaries to produce more than one egg
at a time
88
REFERENCES
 Clinical Pub. (2016). Nurse Key. Retrieved from Application of pharmacology in nursing practice:
https://nursekey.com/application-of-pharmacology-in-nursing-practice/.
 Drug Bank. (2020). Retrieved from Drug Bank: https://go.drugbank.com/drugs/DB00851
 Learning, J. (2015). 2015 Nurse's Drug Handbook. Retrieved from http://index-of.es/Varios-2/Nurse's
%20Drug%20Handbook.pdf.
 McCuiston, L.D. (2019). Pharmacology: A Patient Centered Nursing Process Approach (p. 918).
Singapore: Elsevier.
 MIMS Drug Reference Philippines. (2019 ). MIMS.
 Pharmacology, T. I. (2020). Adverse Drug Reactions. Retrieved from Pharmacology Education Project:
https://www.pharmacologyeducation.org/clinical-pharmacology/adverse-drug-reactions.
 Australian Government. (2004). 2.1 What is pharmacology? Retrieved from The Department of Health:
https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front6-wk-
toc~drugtreat-pubs-front6-wk-secb~drugtreat-pubs-front6-wk-secb-2~drugtreat-pubs-front6-wk-secb-2-1
 REASONS FOR STUDYING PHARMACOLOGY IN NURSING. (2017). Retrieved from
HEALTHNGCARE: http://healthngcare.blogspot.com/2017/04/reasons-for-studying-pharmacology-in.html
 https://www.drugs.com/drug-classes.html
 https://nursece4less.com/Tests/Materials/N071BMaterials.pdf
 https://explorehealthcareers.org/field/pharmacology/#:~:text=Pharmacology%20is%20the%20study
%20of,toxic%2C%20depending%20on%20many%20factors.
89

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AN

SUBMITTED BY: JESELL FRANCE K. PLANA

SUBMITTED TO: SIR AARON CARLO DECENDARIO

It is a basic responsibility of a nurse to be knowledgeable about drugs and its effects on

IV. Peripheral nervous system drugs…………………………………………………………...…..13

FACTORS THAT CONTRIBUTE TO

Example: ibuprofen DRUG REGULATION

DRUG THERAPY DURING PREGNANCY AND BREAST-FEEDING

DRUG THERAPY IN PEDIATRIC PATIENTS

DRUG THERAPY IN GERIATRIC PATIENTS

DRUG ORDER MECHANISM OF INDICATION CONTRAINDICATIO ADVERSE NURSING

Route Onset Peak Duration

I.V. 5 min Unknown 12–24 hr

I.M. 15–30 min Unknown 12–24 hr

Route Onset Peak Duration

P.O. 1–2 hr Unknown 24 hr

I.V., I.M 15 min Unknown 24 hr

Name of Patient: __________________

capsules, tablets, i.m.

i.v. or i.m. injection

capsules, tablets, i.m.

Name of Patient: ___________________

VI. DRUGS THAT AFFECT

Name of Patient: ___________________

DRUG ORDER MECHANISM INDICATION CONTRAINDICATIO ADVERSE NURSING

Adults. 24 mcg twice

Adults. 8 mcg twice

Children ages 6 to 12.

Children under age 3.

Children age 6 and

t.i.d and at bedtime

Children age 6 and

Children age 6 and

Name of Patient: ___________________

Adults who receive a

To treat chronic stable

Children. Initial: 0.4

Children. Initial: 0.4

single dose (1x a day)

Name of Patient: ___________________

Name of Patient: ___________________

Name of Patient: ___________________

Children ages 2 to 14.

To relieve mild pain

Children ages 2 to 14.

Children ages 2 to 14.

Children ages 2 to 14.

P.O. 5–30 mins 15–40 mins 1–4 hr

P.O. 15–30 mins 1–2 hr 4–6 hr

Name of Patient: ___________________

Once a day in evening •Tell patient to notify

Name of Patient: ___________________

•Advise patient to stop

•Tell patient to stop

XIII. RESPIRATORY TRACT DRUGS

Name of Patient: ___________________

inhalation aerosol •Instruct patient to report

Adults and adolescents.

syrup, tablets Adults and