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DRUG

MECHANISM OF
ACTION

INDICATION

CONTRAINDICATIONS

ADVERSE EFFECTS
AND SIDE EFFECTS

NURSING
RESPONSIBILITIES

Generic Name
Potassium
Chloride
Brand Name
Kalium Durule
Classification
Electrolyte

Sub
Classification

Dosage
1 tab

Principal
intracellular cation
of most body
tissues participates
in a number of
physiologic
processes
maintaining
intracellular
tonicity;
transmission of
nerve impulses,
contraction of
cardiac, skeletal,
and smooth muscle;
maintenance of
normal renal functi
on; also plays a role
in carbohydrate
metabolism and
various enzymatic
reactions.

Prevention
and
correction of
potassium
deficiency;
when
associated
with
alkalosis,
use potassium
chloride;
when
associated
acidosis,
use potassium
acetate bicarb
onate, citrate,
or gluconate.

Route
oral

Frequency
Every 8 hours

Form
Tablet

Adverse Effects:
Contraindicated
Dermatologic:
with allergy to
tartrazine, aspirin (t
Rash
artrazine is found in
GI: Nausea,
some preparations
vomiting,
marketed as Kaondiarrhea, abdomina
Cl, Klor-Con);
l discomfort, GI
therapy with
obstruction, GI
potassium-sparing
bleeding,
diuretics or
GI ulceration or
aldosteroneperforation.
inhibiting agents;
Hematologic:
severerenal impair
Hyperkalemiament with oliguria,
increased serum
anuria, azotemia;
potassium, ECG
untreated Addisons
changes (peaking
disease;
of T waves, loss of
hyperkalemia;
P waves,
adynamiaepisodica
depression of ST
hereditaria; acute
segment,
dehydration; heat
prolongation of
cramps; GI
OTC interval).
disorders that delay
Local: Tissue
passage in the GI
sloughing, local
tract.
necrosis,
Use cautiously
local phlebitis, and
with cardiac
venospasm with
disorders,
injection.
especially if treated Side Effects:
with cardiac
Confusion,
glycosides,
anxiety, feeling
pregnancy and
like you might
lactation.
pass out
Uneven heartbeat
Extreme thirst,
increased urination
Leg discomfort

Consider the 10
Golden Rights of
administering
medication
Arrange for serial
serum potassium
levels before and
during therapy
Administer oral
drugs after meals
or with food and a
full glass of water
to decrease GI
upset.
Caution patient
not to chew or
crush tablet; have
patient swallow
tablet whole.
Caution patient
that expanded wax
matrix capsules
will be found in
stool.
Caution patient
not to use salt
substitutes.
Ask the patient to
have periodic
blood tests and
medical
evaluation.
Tell the patient to
report tingling of
hands or feet,
unusual tiredness
or weakness,


Color
White

DRUG

MECHANISM OF
ACTION

INDICATION

CONTRAINDICATIONS

Muscle weakness
or limp feeling
Numbness or
tingly feeling in
your hands or feet,
or around your
mouth
Severe stomach
pain, ongoing
diarrhea or
vomiting
Black, bloody, or
tarry stools; or
Coughing up blood
or vomit that looks
like coffee grounds

ADVERSE
EFFECTS AND
SIDE EFFECTS

feeling of
heaviness in the
legs, severe
nausea, vomiting,
abdominal pain,
black or tarry
stool.

NURSING
RESPONSIBILITIE
S

Generic
Name
Metronidazol
e
Brand Name
Flagyl
Classificatio
n
Amebicide,
Antibacterial,
Antibiotic,
Antiprotozoal
Sub
Classificatio
n
Dosage
500mg/tablet
Route
Oral
Frequency
Thrice a day
(TID)
Form
Tablet
Color
White

Bactericidal:
inhibits DNA
synthesis in
specific
(obligate)
anaerobes,
causing cell
death;
antiprotozoaltrichomonacidal
, amebicidal:
Biochemical
mechanism of
action is not
known.

Acute infection
with susceptible
anaerobic bacteria
Acute intestinal
amebiasis
Amebic liver
abscess
Trichomoniasis
(acute and partners
of patients
undergoing
colorectal surgery
Unlabeled uses:
Prophylaxis for
patients
undergoing
gynecologic,
abdominal
surgery, hepatic
encephalopathy,
Crohns disease;
antibioticassociated pseudo
membranous
colitis, treatment
of Gardnerella
vaginalis,
giardiasis (use
recommended by
the CDC); infected
decubitus ulcers;
perioral dermatitis

Contraindicated
with
hypersensitivity to
metronidazole;
pregnancy ( do not
use for
trichomoniasis in
first trimester)
Use continuously
with CNS diseases,
hepatic diseases,
candidiasis
(moniliasis), blood
dyscrasias,
lactation.

Adverse Effect:
CNS:
Headache,
dizziness,
ataxia,
vertigo,
incoordiantio
n, insomnia,
seizures,
peripheral
neurophaty,
fatigue
GI:
Unpleasant
metallic taste,
anorexia,
nausea,
vomiting,
diarrhea, GI
upset, cramps
GU: Dysuria,
incontinence,
darkening of
the urine
Local:
Thrombophle
bitis (IV);
redness,
burning,
dryness, and
skin irritation
(topical)
Others:
Severe,
disulfiramlike
interaction
with alcohol,

Consider the
10 Golden
Rights of
administering
medication
Tell the
patient to
take full
course drug
therapy; take
the drug with
food if GI
upset occur.
Tell the
patient not to
take alcohol
(beverages or
preparations
containing
alcohol,
cough
syrups) for
24-72 hr of
drug use;
severe
reactions
may occur.
Caution the
patient that
their urine
may be
darker in
color than
usual; this is
expected
Tell the
patient that
they may

candidiasis
(superinfectio
n)
Side Effects:
Numbness or
tingling in
your hands or
feet;
White
patches or
sores inside
your mouth
or on your
lips;
Pain or
burning when
you urinate;
Diarrhea that
is watery or
bloody;
Vision
problems,
pain behind
your eyes;
Trouble
concentrating
, slurred
speech, mood
or behavior
changes,
tremors,
muscle
twitching,
seizure
(convulsions)
;
Fever, chills,
muscle pain,

experience
this side
effects like:
Dry mouth
with strange
metallic taste
(frequent
mouth care,
sucking
sugarless
candies may
help);
nausea,
vomiting,
diarrhea (eat
frequent
small meals)
Tell the
patient to
report severe
GI upset,
dizziness,
unusual
fatigue or
weakness,
fever, chills.

DRUG

MECHANISM
OF ACTION

INDICATION

CONTRAINDICATIONS

confusion,
headache,
sore throat,
neck
stiffness,
increased
sensitivity to
light,
drowsiness,
nausea and
vomiting; or
Severe skin
reaction -fever, sore
throat,
swelling in
your face or
tongue,
burning in
your eyes,
skin pain,
followed by a
red or purple
skin rash that
spreads
(especially in
the face or
upper body)
and causes
blistering and
peeling.

ADVERSE EFFECTS
AND SIDE EFFECTS

NURSING
RESPONSIBILITIES

Generic Name
Metoclopramid
e
Brand Name
Reglan
Classification
Antiemetic,
Dopaminergic
blocker, GI
stimulant
Sub
Classification
Dosage
1 ampule
Route
Parenteral
Frequency
TID/ q6
Form
Liquid ampule
Color
Clear

Stimulates
motility of
upper GI
tract
without
stimulating
gastric,
biliary, or
pancreatic
secretions,
appears to
sensitize
tissues to
action of
acetylcholin
e, relaxes
pyloric
sphincter
which when
combined
with effects
on motility,
accelerates
gastric
emptying
and
intestinal
transit; little
effect on
gallbladder
or colon
motility;
increases
lower
esophageal
sphincter
pressure;
has sedative

Relief
symptoms of
acute and
recurrent
diabetic
gastroparesis.
Short term
therapy (412weeks) for
adults with
symptomatic
gastro
esophageal
reflux who fail
to respond to
conventional
therapy
Prophylaxis of
postoperative
nausea and
vomiting when
nasogastric
suction is
undesirable

Contraindicated
with allergy to
metaclopramide,
GI hemorrhage,
mechanical
obstruction or
perforation;
pheochromocytom
a (may cause
hypertensive
crisis); epilepsy.
Use continuously
with previously
detected breast
cancer (one third
of such tumors are
prolactin
dependent);
lactation,
pregnancy; fluid
overload; renal
impairment.

Adverse Effects:
CNS: Restlessness,
drowsiness,
fatigue, lasitudes,
insomnia,
extrapyramidalreac
tion,
parkinsonism- like
reactions,
akathisia, dystonia,
myoclonus,
dizziness, anxiety
CV: Transient
hypertension
GI: Nausea,
diarrhea
Side Effects:
tremors, or restless
muscle movements
in your eyes,
tongue, jaw, neck,
arms, or legs
mask-like
appearance of the
face
very stiff (rigid)
muscles, high
fever, sweating,
confusion, fast or
uneven heartbeats,
tremors, feeling
like you might
pass out
depressed mood,
thoughts of suicide
or hurting yourself
hallucinations,

Consider the 10
Golden Rights
of administering
medication
Asses if the
patient has
historyof
allergies
tometocloprami
de.
Monitor BP
carefully during
IVadministratio
n.
Monitor
extrapyramidal
reactions and
consultphysicia
n if they occur.
Monitor
patients with
diabetes,
arrange for
alteration in
insulin dose or
timing
ifdiabetic
control is
comprisedby
alterations in
timing of food
absorption.
Keep
diphenhydramin
e injection
readily
available in
case

properties,
induces
release of
prolactin.

anxiety, agitation,
jittery feeling,
trouble staying still
swelling, fluid
retention
jaundice
(yellowing of your
skin or eyes)
seizure
(convulsions)
Less serious side effects
may include:
feeling restless,
drowsy, tired, or
dizzy
headache, sleep
problems
(insomnia)
nausea, vomiting,
diarrhea
breast tenderness
or swelling
changes in your
menstrual periods
urinating more
than usual

extrapyramidal
reaction occur
(50mg IM)
Have
phentolamine
readily
available in
case of
hypertensive
crisis (most
likely to occur
with
undiagnosed
pheochromocyt
oma)
Do not use
alcohol, sleep
remedies, or
sedatives;
serious sedation
could occur.
Tell the patient
that they may
experience
these side
effects:
drowsiness,
dizziness (do
not drive or
perform other
task that
requires
alertness);
restlessness,
anxiety,
depression,
headache,
insomnia

(reversible);
nausea,
diarrhea.
Tell the patient
to report
involuntary
movement of
the face, eyes,
or limbs, severe
depression, and
severe diarrhea.

DRUG

MECHANISM
OF ACTION

Generic
Name
Furosemide
Brand Name
Lasix
Classification
Loop
Diuretics
Sub
Classification
Dosage
10mg
Route
Parenteral
Frequency
STAT
Form
Liquid ampule
Color
Clear

Inhibits
reabsorption of
sodium
chloride from
the proximal
and distal
tubules and
ascending limb
of the loop of
Henle, leading
to a sodiumrich diuresis.

INDICATION

Oral, IV:
Edema
associatedwit
h heart
failure,
cirrhosis,rena
l disease.
IV: acute
Pulmonary
Edema
Oral:
hypertension

CONTRAINDICATIONS

Contraindicated
with allergy to
furosemide,
sulfonamides,
allergy to tartrazine
(in oral solution);
anuria, severe renal
failure; hepatic
coma; pregnancy;
lactation.
Use cautiously with
SLE, gout, diabetes
mellitus.

ADVERSE EFFECTS AND

SIDE EFFECTS

Adverse Effects:
CNS: dizziness,
vertigo, paresthesias,
xanthopsia, weakness,
headache, drowsiness,
fatigue, blurred vision,
tinnitus, irreversible
hearing loss
CV: orthostatic
hypotension, volume
depletion, cardiac
arrhythmias,
thrombophlebitis
Dermatologic:
photosensitivity, rash,
pruritus, urticaria,
purpura, exfoliative,
dermatitis, erythema
multiforme
GI: nausea, anorexia,
vomiting, oral and
gastric irritation,
constipation, diarrhea,
acute pacreatitis,
jaundice
GU: polyuria, nocturia,
glycosuria, urinary
bladder spasm.
Hematologic:
leukopenia, anemia,
thrombocytopenia, fluid
and electrolytes
imbalance,
hyperglycemia,
hyperuricemia

NURSING
RESPONSIBILITIES

Consider the
10 Golden
Rights of
administering
medication
Profound
dieresis with
water and
electrolyte
depletion can
occur, careful
medical
supervision is
required.
Administer
with food or
milk to prevent
GI upset.
Reduce dosage
if given with
other anti
hypertensive;
readjust
dosage
gradually as
BP responds.
Give early in
the day so that
increase
urination will
not disturb
sleep.
Do not mix
parenteral
solution with
highly acidic

Others: Muscle cramps

and muscle spasm
Side Effects:
Common side effects of
furosemide:
low blood pressure
dehydration
electrolyte depletion
(for example, sodium,
potassium)
Less common side effects
include :
jaundice,
ringing in the ears
(tinnitus)
sensitivity to light
(photophobia)
rash
pancreatitis
nausea
diarrhea
abdominal pain
dizziness
Increased blood sugar
increase uric acid level

salutions with
pH below 3.5
Do not expose
to light, which
may discolor
tablets or
solution; do
not use
discolored
drug or
solution.
Discard
diluted
solutions after
24 hr.
Measure and
record weight
to monitor
fluid change
Arrange to
monitor serum
electrolytes,
hydration,
liver and renal
function.
Arrange with
potassium rich
diet or
supplemental
potassium as
needed.
Tell the patient
that they may
experience this
side effects:
increased
volume and
frequency of

urination;
dizziness,
feeling faint on
arising,
drowsiness
(avoid rapid
position
changes;
hazardous
activities, like
driving and
consumption
of alcohol);
sensitivity to
sun light( use
sun glasses,
wear
protective
clothing, or
use sunscreen;
increased thirst
(suck on
sugarless
lozenges; use
frequent
mouth care);
loss of body
potassium(a
potassium rich
diet or
potassium
supplement
will be
needed).
Tell the patient
to report loss
or gain of
more than

1.5kg in 1 day,
swelling in the
ankle or
fingers,
unusual
bleeding or
bruising,
dizziness,
trembling,
numbness,
fatigue, muscle
weakness or
cramps.

DRUG

Generic Name
Omeprazole
Brand Name
Zefxon
Classification:
Antisecretory
drug
Proton pump
inhibitor
Sub
Classification
Dosage
40mg
Route
Parenteral
Frequency
twice a day
(BID)
Form
Powder in vial,
diluted with
sterile water
Color
Cloudy

MECHANISM
OF ACTION

INDICATION

Gastric acid
pump inhibitor
suppresses
gastric acid
secretion by
specific
inhibition of
the hydrogen
potassium
ATPase
enzymes
system at the
secretory
surface of the
gastric parietal
cells; blocks
the finalstep
acid
production.

Short term
treatment of
active
duodenal ulcer.
Treatment of
heartburn or
symptoms of
GERD
Short term
treatment of
active benign
gastric ulcer
GERD, severe
erosive
esophagitis,
poorly
responsive
symptomatic
GERD
Long term
therapy:
treatment of
pathologic
hypersecretory
conditions
(Zollinger
Ellisons
syndrome,
multiple
adenomas,
systemic
mastocytosis)
Eradication of
H. pylori with
amoxicillin or
metronidazole

CONTRAINDICATIONS

ADVERSE EFFECTS
AND SIDE EFFECTS

Adverse Effects:
Contraindicated
CNS: headache,
with
hypersensitivity to
dizziness,
Omeprazole or its
asthenia, vertigo,
components
insomnia, apathy,
anxiety,
Use cautiously with
paresthesias,
pregnancy, lactation
dream
abnormalities
Dermatologic:
rash,
inflammation,
urticaria, pruritus,
alopecia, dry skin.
GI: diarrhea,
abdominal pain,
nausea, vomiting,
constipation, dry
mouth, tongue
atrophy
Respiratory: URI
symptoms, cough,
epistaxis
Others: cancer in
preclinical studies,
back pain, fever
Side Effects:
Dizziness (avoid
driving or
performing
hazardous tasks)
headache (request
medications)
nausea
vomiting

NURSING
RESPONSIBILITIES

Consider the 10
Golden Rights
of administering
medication
Assess other
medications
patient may be
taking for
effectiveness
and interactions
(especially
those dependent
on cytochrome
P450
metabolism or
those dependent
on acid
environment for
absorption).
Monitor
therapeutic
effectiveness
and adverse
reactions at
beginning of
therapy and
periodically
throughout
therapy.
Assess GI
system: bowel
sounds every
8hours,
abdomen for
pain and
swelling,

and
clarithromycin

diarrhea (maintain
proper nutrition)
symptoms of URI
cough (do not selfmedicate; consult
with your health
care provider if
uncomfortable).

appetite loss.
Monitor hepatic
enzymes: AST,
ALT, increased
alkaline
phosphatase
during
treatment.
Tell the patient
to report if
experiencing
this side effects:
dizziness,
headache,
nausea,
vomiting,
diarrhea.

DRUG

MECHANISM
OF ACTION

INDICATION

Generic Name
Ambroxol HCL
Brand Name
Ambrolex
Classification
Mucolytic
Sub
Classification
Dosage
75mg
Route
Oral
Frequency
Once a day
Form
Capsule
Color
Half white and
half green

It makes phlegm
in the airways
thinner and less
sticky. It does this
by increasing the
body's natural
production of
surfactant. This
contributes to a
secretomotoric
effect: it helps the
cilia - tiny hairs
that line the
respiratory tract to transport the
phlegm out of the
lungs.

Adjuvant therapy in
patients with
abnormal, viscid, or in
spissated mucous
secretions in acute and
chronic broncho
pulmonary diseases,
and in pulmonary
complications of cystic
fibrosis and surgery,
tracheostomy, and
atelectasis.

CONTRAINDICATIONS

ADVERSE EFFECT
AND SIDE EFFECT

There is no absolute
Adverse Effect:
contraindication but in
Occasional
patient with gastric
gastrointestinal
ulceration relative caution
side effects may
should be observed.
occur but these
are almost
invariably mild
Rashes
Fatigue
Dry mouth
Rhinorrhea
Constipation
Dysuria
Contact
dermatitis

NURSING
RESPONSIBILITIES

DRUG

MECHANISM
OF ACTION

INDICATION

CONTRAINDICATIO
NS

ADVERSE EFFECT
AND SIDE EFFECTS

Consider the 10
Golden Rights of
administering
medication
Monitor S/Sx of
aspiration of
excess secretions
and for
bronchospasm.
Have suction
apparatus
immediately
available.
Tell the client to
report difficulty
with clearing the
airway or any
other respiratory
distress.
Tell the client to
report if
experiencing this
side effects: GI
upset, rashes,
fatigue, dry mout.

NURSING
RESPONSIBILITIES

Generic Name
Cefuroxime Sodium
Brand Name
Zinacef
Classification
Antibiotic,
Cephalosporin
Sub Classification
Second generation
Dosage
750mg
Route
Parenteral
Frequency
q8
Form
powder in vial,
diluted with sterile
water
Color
Light yellow

Bactericidal:
inhibits synthesis
of bacterial cell
wall, causing cell
death.

Lower
respiratory
infections
caused by S.
pneumonia, S.
aureus, E. coli,
Klebsiella
pneumonia, H.
influenza, S.
pyogenes
Dermatologic
infections
caused by S.
aureus, S.
pyogenes, E.
coli, K.
pneumonia,
Enterobacter
UTIs caused
by E. coli, K.
pneumonia
Uncomplicated
and
disseminated
gonorrhea
caused by N.
gonorrhoeae
Septicimia
caused by S.
pneumonia, S.
aureus, E. coli,
K pneumonia,
H. influenza
Meningitis
caused by S.
pneumoniae,
H. influenza,
S. aureus, N.

Contraindicate
d with allergy
to
cephalosporins
or penicillins
Use
continuously
with renal
failure,
lactation,
pregnancy

Side Effects
Diarrhea, stomach
upset
Difficulty of
breathing
Anusual tiredness
or fatigue
Pain at injection
site
Adverse Effect:
CNS: headache,
dizziness,
lethargy,
paresthesias
GI: nausea,
vomiting,
diarrhea,
anorexia,
abdominal pain,
flatulence,
pseudomenbranou
se colitis,
hepatotoxicity
GU:
Nephrotoxicity
Hematologic:
Bone marrow
depression
Hypersensitivity:
ranging from rash
to fever to
anaphylaxis;
serum sickness
reaction
Local: pain,
abcess at injection
site, phlebitis,

Consider the 10
Golden Rights of
administering
medication
Determine history
of hypersensitivity
reactions
to cephalosporins,
penicillins, and
history of allergies,
particularly to
drugs, before
therapy is initiated.
Lab tests: Perform
culture and
sensitivity tests
before initiation of
therapy and
periodically during
therapy if
indicated. Therapy
may be instituted
pending test
results. Monitor
periodically BUN
and creatinine
clearance.
Do skin test before
administering the
drug
Inspect IV
injection sites
frequently for
signs of phlebitis.
Monitor for
manifestations of
hypersensitivity.
Discontinue drug

meningitides
Bone and joint
infections due
to S. aureus
Perioperative
prophylaxis
Treatment of
acute bacterial
maxillary
sinusitis in
patients 3-mo
12yr

inflammation of
IV site
Others:
superinfection,
disulfram- like
reaction with
alcohol

DRUG

MECHANISM OF
ACTION

INDICATION

CONTRAINDICATIO
NS

ADVERSE
EFFECTS AND
SIDE EFFECTS

and report their

appearance
promptly.
Monitor I&O rates
and pattern:
Especially
important in
severely ill
patients receiving
high doses. Report
any significant
changes.
Tell the client to
report loose stools
or diarrhea
promptly.
Tell the client to
avoid alcohol
while taking this
drug and for 3days
after because
severe reaction
often occurs.

NURSING
RESPONSIBILITIES

Generic Name
Paracetamol
Brand Name
Biogesic
Classification
Non- narcotic
analgesic,
Antipyretic
Sub
Classification
Dosage
300mg
Route
P.O
Frequency
PRN
Form
Ttablet
Color
Orange

Decreases
fever by a
hypothalamic
effect leading
to sweating
and
vasodilation
Inhibits
pyrogen effect
on the
hypothalamicheat-regulating
centers
Inhibits
CNS prostagla
ndin synthesis
with minimal
effects on
peripheral pros
taglandin synth
esis
Does not cause
ulceration of
the GI tract
and causes no
anticoagulant
action

Control of pain
due to headache,
earache,
dysmenorrhea,
arthralgia,
myalgia,
musculoskeletal
pain,
arthritis, immuni
zations, teething,
tonsillectomy
Reduce fever in
viral
and bacterial infe
ctions
As a substitute
for aspirin in
upper GI
disease, bleeding
disorders clients
in anticoagulant
therapy and
gouty arthritis

Anemia, cardiac Side Effects:

Minimal GI
& pulmonary
disease. Hepatic
upset,
or severe renal
methemoglo
disease.
binemia,
hemolytic
Liver toxicity
anemia,
(hepatocyte
neutropenia,
necrosis) may
thrombocyto
occur with
penia,
doses not far
pancytopenia
beyond labeled
,
dosing.
leucopenia,ur
ticaria, CNS
stimulation,
hypoglycemi
c coma,
jaundice,
glissitis,
drowsiness,
liver damage
Adverse Effect
Allergic skin
reactions &
GI
disturbances.

Consider the 10
Golden Rights of
administering
medication
Monitor CBC,
liver and renal
functions.
Assess for fecal
occult blood and
nephritis.
Tell the patient to
avoid using OTC
drugs
with Acetaminoph
en
Tell the patient to
take the drug with
food or milk to
minimize GI upset.
Tell the client to
report N&V.
cyanosis, shortness
of breath and
abdominal pain as
these are signs of
toxicity.
Tell the client to
report paleness,
weakness and heart
beat skips
Tell the client to
report abdominal
pain, jaundice,
dark urine,
itchiness or claycolored stools.
Tell the client that

DRUG

MECHANISM
OF ACTION

INDICATION

CONTRAINDICATIO
NS

ADVERSE EFFECT
AND SIDE EFFECT

Phenmacetin may
cause urine to
become dark
brown or winecolored.
Tell the client to
report pain that
persists for more
than 3-5 days
Tell the client that
this drug is not for
regular use with
any form of liver
disease because it
might cause further
damage.

NURSING
RESPONSIBILITIES

Generic Name
Aminoleban
Brand Name
Classification
V06DD - Amino
acids, incl.
combinations with
polypeptides ; Used
as general nutrients.
Sub Classification
Dosage
500mg
Route
Parenteral
Frequency
q8
Form
Liquid
Color
Clear

Given to
normalize
the amino
acid,
carbohydr
ates, fats,
vitamins
and
minerals
in the
plasma

Hepatic
encephalopathy
due to acute or
chronic liver
diseases & of
-ve nitrogen
balance when
adequate
nutrition PO or
gastro duodenal
tube is
impossible or
undesirable.

Adverse Effect:
Patient with
Cardiovascular:
abnormal amino
acid
Chest discomfort,
metabolism
& palpitation.
(since the infuse
amino acids are
Hypersensitivity
not adequately
: rare skin
metabolized,
eruptions
the patient
clinical
Gastrointestinal:
condition may
occasional nausea
be worsened.)
and vomiting
Severe renal
disorders
Others:
occasional chills,
fever, headache
Side Effects:
Hypoglycemia
may occur and
hyperammonemia
has been reported.
Hypersensitivity
reactions such as
skin rash may
occur rarely.
Nausea, vomiting,
chest discomfort
and palpitations
may occur
infrequently.
Large doses and
rapid
administration
may lead to
acidosis.
Chills, fever and

Consider the 10
Golden Rights of
administering
medication
Asses patients
condition before
starting the
therapy.

Be alert to
adverse reaction.

Monitor patient
temperature.

If GI reaction
occur monitor
patient
hydration.

Tell the patient to

report if felt this
side effects:
nausea,
vomiting, chest
discomfort,
palpitation occur.

headache may
infrequently
occur.

DRUG

Generic Name
Sinutab extrastrength
Brand Name
Sinutab Forte
Classification
phenylpropanola
mine,
combinations ;
Belongs to the
class of systemic
sympathomimeti
c preparations
used as nasal
decongestant
Sub
Classification
Dosage
1 cap
Route
oral
Frequency
TID
Form
Capsule
Color
Red and yellow

MECHANISM OF
ACTION

Sinutab ExtraStrength is a
fixed-dose
combination
capsule
containing the
following 3 active
ingredients:
Phenylpropanola
mine HCl (PPA)
or Phenylephrine:
A systemic
decongestant to
relieve clogged
nose and sinuses.
Chlorphenamine
Maleate or
Phenyltoloxamine
Citrate: An
antihistamine/anti
allergy.
Paracetamol: A
pain killer, as well
as an antipyretic
(for fever).

INDICATION

Temporary
relief of sinus
headache;
promote nasal
and sinus
drainage; help
relieve runny
nose, facial
pain, malaise
and fever often
associated with
colds,
influenza,
acute and
chronic
sinusitis,
allergic rhinitis
(hay fever) and
vasomotor
rhinitis.

CONTRAINDICATI
ONS

ADVERSE EFFECT
AND SIDE EFFECTS

Patients who Adverse Effect:

chest pain, rapid
are
hypersensiti
pulse, fast or
ve or allergic
uneven heart
to any of the
rate;
components
confusion,
of Sinutab
hallucinations,
Extrasevere
Strength.
nervousness;
Unless
tremor, seizure
otherwise
(convulsions);
advised by a
easy bruising or
physician,
bleeding,
during
unusual
pregnancy
weakness;
and
little or no
lactation,
urinating;
patients with
nausea, pain in
severe
your upper
kidney
stomach,
disease or
itching, loss of
who are
appetite, dark
taking other
urine, claymedications
colored stools,
containing
jaundice
PPA.
(yellowing of
your skin or
eyes); or
Dangerously
high blood
pressure (severe
headache,
blurred vision,
buzzing in your
ears, anxiety,

NURSING
RESPONSIBILITIES

Consider the 10
Golden Rights of
administering
medication
Tell the patient not
take more of this
medication than is
recommended. An
overdose of
acetaminophen can
damage your liver
or cause death.
Instruct the patient
that this
medication could
not use if she/he
are allergic to
acetaminophen,
chlorpheniramine,
or
pseudoephedrine.
Inform patient that
she need to avoid
drinking alcohol. It
may increase your
risk of liver
damage while
taking
acetaminophen,
and can increase
certain side effects
of
chlorpheniramine.
Explain to the
patient that theres
a side effects that

chest pain,
shortness of
breath, uneven
heartbeats,
seizure).
Side Effect:
dizziness,
drowsiness;
mild headache,
blurred vision;
dry mouth,
nose, or throat;
constipation;
feeling nervous;
sleep problems
(insomnia);

DRUG

MECHANISM OF
ACTION

INDICATION

CONTRAINDICATION
S

ADVERSE EFFECTS
AND SIDE EFFECTS

she may
experience upon
taking the
medication such as
blurred vision or
impair your
thinking or
reactions.
If other unwanted
effects not
previously listed
occur, consult a
physician.

NURSING
RESPONSIBILITIES

Generic Name
Ketorolac
Tromethamine
Brand Name
Toradol
Classification
nonsteroidal antiinflammatory
agents, nonopioid
analgesics
Sub Classification
pyrroziline
carboxylic acid
Dosage
30 mg
Route
Parenteral
Frequency
q8
Form
Liquid ampule
Color
Clear

Inhibits
prostaglandin
synthesis,
producing
peripherally
mediated
analgesia.
Also has
antipyretic and
antiinflammatory
properties.
Therapeutic
Effects:
Decreased pain.

Short-term
manageme
nt of pain
(not to
exceed 5
days total
for all
routes
combined).

Contraindicated
in:

Hypersensitivity

Cross-sensitivity
with other
NSAIDs may exist

Adverse Effects:
CNS:
drowsiness,
abnormal
thinking,
dizziness,
euphoria,
headache.

Pre- or
perioperative use

Known alcohol
intolerance
(injection only)

Perioperative pain
from coronary
artery bypass graft
(CABG) surgery .

Use Cautiously
in:

Cardiovascular
disease or risk
factors for
cardiovascular
disease (may risk
of serious
cardiovascular
thrombotic events,
myocardial
infarction, and
stroke, especially
with prolonged
use)

Consider the 10
Golden Rights of
administering
medication

Assessment
Patients who have
asthma, aspirin-induced
allergy, and nasal polyps
are at increased risk for
Respiratory:
developing
asthma,
hypersensitivity reactions.
dyspnea.
Assess for rhinitis,
asthma, and urticaria.
CV: edema,
Pain: Assess pain (note
pallor,
type, location, and
vasodilation.
intensity) prior to and 1-2
hr following
GI: GI
administration.
bleeding,
Lab Test
abnormal taste, Considerations: Evaluate
diarrhea, dry
liver function tests,
mouth,
especially AST and ALT,
dyspepsia, GI
periodically in patients
pain, nausea.
receiving prolonged
therapy. May cause
GU: oliguria,
levels.
renal toxicity,
tell the patient that it
urinary
may cause prolonged
frequency.
bleeding time that may
persist for 24-48 hr
Dermatologic: following discontinuation
exfoliative
of therapy.
dermatitis,
Inform the patient that it
Stevens
may cause BUN, serum
Johnson
creatinine, or potassium
Syndrome, toxic concentrations. .
necrolysis
Implementation
pruritus,
Do not confuse Toradol

History of GI
bleeding

Renal impairment
(dosage reduction
may be required)

purpura,
sweating,
urticaria.

Hematology:
prolonged
bleeding time.

Local: injection
site pain.
Neurology:
paresthesia.

Misc: allergic
reactions
including,
anaphylaxis
Side Effects:
chest pain,
weakness,
shortness of
breath, slurred
speech,
problems with
vision or
balance;
black, bloody,
or tarry stools;
coughing up
blood or vomit
that looks like
coffee grounds;
swelling or
rapid weight
gain;
urinating less
than usual or

(ketorolac) with Torecan

(thiethylperazine) or
tramadol (Ultram).
Administration in
higher-than-recommended
doses does not provide
increased effectiveness but
may cause increased side
effects. Duration of
ketorolac therapy, by all
routes combined, should
not exceed 5 days Use
lowest effective dose for
shortest period of time.
Coadministration with
opioid analgesics may
have additive analgesic
effects and may permit
lower opioid doses. .
PO: Ketorolac therapy
should always be given
initially by the IM or IV
route. Use oral therapy
only as a continuation of
parenteral therapy.
injection, 0.9%
NaCl.
Patient/Family
Teaching
Instruct patient
on how and when
to ask for pain
medication.
Instruct patient
to take medication
exactly as directed.
Take missed doses

not at all;
nausea, stomach
pain, low fever,
loss of appetite,
dark urine, claycolored stools,
jaundice
(yellowing of
the skin or
eyes);
fever, sore
throat, and
headache with a
severe
blistering,
peeling, and red
skin rash;
the first sign of
any mouth sores
or skin rash, no
matter how
mild;
pale skin, easy
bruising, severe
tingling,
numbness, pain,
muscle
weakness; or
fever, headache,
neck stiffness,
chills, increased
sensitivity to
light, purple
spots on the
skin, and/or
seizure
(convulsions).
Less serious side

as soon as
remembered if not
almost time for
next dose. Do not
double doses. Do
not take more than
prescribed or for
longer than 5 days.
May cause
drowsiness or
dizziness. Advise
patient to avoid
driving or other
activities requiring
alertness until
response to the
medication is
known.
Caution patient
to avoid the
concurrent use of
alcohol, aspirin,
NSAIDs,
acetaminophen, or
other OTC
medications
without consulting
health care
professional.
Advise patient to
inform health care
professional of
medication
regimen prior to
treatment or
surgery.
Advise patient to
consult health care

effects may include:

upset stomach,
mild nausea or
vomiting,
diarrhea,
constipation;
mild heartburn,
stomach pain,
bloating, gas;
dizziness,
headache,
drowsiness;
sweating; or
ringing in your
ears.

professional if
rash, itching,
visual
disturbances,
tinnitus, weight
gain, edema, black
stools, persistent
headache, or
influenza-like
syndrome (chills,
fever, muscle
aches, pain)
occurs. .
Evaluation/Desire
d Outcomes
Decrease in
severity of pain.
Patients who do
not respond to one
NSAID may
respond to another.

DRUG

Generic Name
Perindopril
Brand Name
Coversyl plus
Classification
Antihypertensive
Sub
Classification
ACE Inhibitor
Dosage
1 cap
Route
oral
Frequency
BID
Form
Tablet
Color
White

MECHANISM OF
ACTION

Antihypertensive
.
Pharmacology:
Perindopril is an
ACE-inhibitor
that works by
widening the
blood vessels,
which makes it
easier for the
heart to pump
blood through
them.
Indapamide is a
diuretic that
causes an
increase in the
amount of urine
produced.
Each of the
active
ingredients of
Coversyl Plus
reduces blood
pressure and
work together to
control blood
pressure.

INDICATION

Treatment
of essential
hypertensio
n

CONTRAINDICATIO
NS

Allergy to
perindopril or
other ACEinhibitors, or to
indapamide or
any other
sulfonamides.
History or
presence of
wheezing,
swelling of the
face or tongue,
intense itching
or severe skin
rashes with
previous ACEinhibitor
treatment, or
other
circumstances
(eg,
angioedema).
Severe liver
diseases or if
suffering from
hepatic
encephalopathy
; severe kidney
disease, or on
dialysis; low or
high blood
potassium;
untreated
decompensated
heart failure
(severe water

ADVERSE EFFECTS
AND SIDE EFFECTS

Adverse Effect:
CNS: dizziness,
asthenia, sleep
disorder,
paresthesia,
depression,
somnolence,ner
vousness,
headache.
CV: palpitatio
ns, edema,
chest pain, ab
normal ECG.
EENT:rhinitis,
sinusitis, ear
infection,
pharyngitis,
tinnitus.
GI: dyspepsia,
diarrhea,
abdominalpain,
nausea, vomit
ing, flatulence
.
GU: proteinur
ia, urinarytrac
t infection, m
alesexual
dysfunction,
menstrual
disorder.
Musculoskele
tal: back
pain,
hyperonia,
neck pain,

NURSING
RESPONSIBILITIES

Consider the 10
Golden Rights of
administering
medication
Assess patients
condition.
Dont let the
patient to take this
if she has an
allergy to
penidopril. And if
she has a history of
wheezing, swelling
of the face or
tongue, intense
itching or severe
skin rashes.
Explain to patient
what was the
medication for, and
what are the side
effects that she
may encounter.
Instruct the patient
to consult her
doctor if she
experiencing
unwanted effect.

retention,
difficulty in
breathing);
children.

joint pain,
myalgia,
arthritis, arm or
leg pain
Respiratory:
Use in
cough, upper
pregnancy &
respiratory
lactation: Cove
infection
rsyl Plus should
Skin: Rash
not be used
Other: viral
during the first
infection,
3 months of
injury, seasonal
pregnancy and
allergy
must not be
Side Effect:
taken from the
Cough, often
4th month of
described as dry
pregnancy.
and irritating,
When
shortness of
pregnancy is
breath,
planned or
discomfort on
confirmed, the
exertion.
switch to an
Headache,
alternative
dizziness,
treatment
vertigo, pins
should be
and needles.
initiated as soon

Changes in the
as possible.
rhythm or rate
Do not take
of the heart
Coversyl Plus if
beat, fast or
breastfeeding.
irregular heart
beat
Stroke,
myocardial
infarction,
angina pectoris
(a feeling of
tightness,
pressure or

heaviness in the
chest).
Feeling tired or
lethargic.
Tinnitus
(persistent noise
in the ears),
vision
disturbances.
Hypotension,
flushing,
impaired
peripheral
circulation, nose
bleeds.
Nausea,
vomiting, taste
disturbances,
indigestion,
diarrhoea,
constipation or
stomach pain.
Muscle cramps.
Rash, pruritus
(itching).
Eosinophilic
pneumonia.
Hepatitis.
Renal failure.
Bleeding or
bruising more
easily than
normal caused
by a low blood
platelet count ,
frequent
infections such

as fever, severe
chills, sore
throat or mouth
ulcers caused by
a lack of white
blood cells,
pancytopenia (a
rare type of
anaemia).
Decreased
blood sugar
levels.
Fainting.