DRUG ORDER MECHANISM INDICATIONS CONTRAINDICATI ADVERSE NURSING

OF ACTION ONS REACTIONS IMPLICATIONS

Generic name: Enhances reflex To combat dry, Hypersensitivity to GI: Low Monitor for
Guaifenesin outflow of nonproductive guaifenesin; incidence of therapeutic
(gwye-fene-sin) respiratory tract cough associated pregnancy (category nausea. effectiveness.
Brand fluids by irritation with colds and C), lactation. CNS: Persistent cough
name:Robitussin of gastric mucosa. bronchitis. A Drowsiness. may indicate a
Classifications: common serious condition
antitussive; ingredient in requiring further
expectorant Therapeutic cough mixtures. diagnostic work.
Route & Dosage: effects: Notify physician if
adult: PO 200400 Aids in high fever, rash, or
mg q4h up to 2.4 expectoration by headaches develop.
g/d reducing
adhesiveness and HEALTH EDUCATION
surface tension of Increase fluid intake
secretions to help loosen
mucus; drink at least
8 glasses of fluid
daily
Contact physician if
cough persists
beyond 1 wk.
Contact physician if
high fever, rash, or
headache develops.
DRUG ORDER MECHANISM INDICATIONS CONTRAINDICATIONS ADVERSE NURSING
OF ACTION REACTIONS IMPLICATIONS
Generic Name: Diphenhydramin Treatment of Use with other products Drowsiness Give full prophylactic
Diphenhydramin e is a common hypersensiti containing Constipatio dose 30min. prior to
e hydrochloride antihistamine vity diphenhydramine n travel if used as a
Brand Name: used by the reactions. Hypersensitivity to Diarrhea prophylaxis for motion
Benadryl general public to Antitussive. antihistamines Dizziness sickness
Classification: treat allergies. Special Concerns: Dry mouth/ Take similar doses
Antihistamine, Has high Increases the risk of nose/throa with meals and at
second sedative, cognitive decline in the t bedtime
generation, anticholinergic elderly Headache Do not use more than
ethanolamine and antiemetic Use with caution in Anorexia 2 weeks to treat
Dosage: effects. clients suffering from insomnia
N&V
PO 25-50 mg Blocks the action the following: For IV, may give
Anxiety
TID- QID of acetylcholine -Increased Pressure in undiluted
GI upset
Blocks H-1 the Eye Do not exceed IV rate
Asthenia
IV: 10-50mg up receptors on -Closed Angle of 25mg/minute.
to 100mg/IV effector cells of Glaucoma, Chronic Drug causes
the respiratory Difficulty having a drowsiness.
tract Bowel Movement Avoid activities
-High Blood Pressure, requiring mental
-Stenosing Peptic Ulcer alertness
-Blockage of Urinary
Use sun protection as
Bladder
it may cause
-Enlarged Prostate
photosensitivity
-Cannot Empty Bladder
-Overactive Thyroid Use sugarless
Gland candy/gum to
diminish dry mouth
effects
Avoid alcohol and
other CNS
depressants
Stop therapy 72-96 hr.
prior to skin testing.
Report adverse effect
and lack of response
 DRUG MECHANISM INDICATION CONTRAINDICA ADVERSE NURSING IMPLICATIONS
ORDER OF ACTION S TIONS REACTIONS
Brand Name: Dexamethasone Relieves Hypersensitivity Acne Monitor intake and output of
Dexamethas suppresses inflammati Active Decreased patient.
one inflammation on untreated wound healing Observe the patient for
Classification and the normal Allergic infection Depression peripheral edema, steady
: Long- immune Disorders Lactation Vomiting weight gain, rales or crackles
acting response. It Asthma Systemic fungal Easy bruising or dyspnea. Notify the
corticosteroi prevents the Arthritis infection Headache physician immediately if
d release of Use Cautiously Increased hair these clinical manifestations
Route and substances in in: are noted.
growth
Dosage the body that -Children Periodic growth evaluation for
Insomnia
PO (Adults): causes (chronic use children should be done time
Restlessness
2 mg q 8-12 inflammation. may result in to time.
Stomach
hours decreased Guaiac-test stools should be
irritation
IM, IV growth) carried out. Guaiac-positive
Irregular or
(adults): 10 -Stress (surgery stools should be reported to
mg initially absent
or infections) the physician immediately.
IV, 4 mg q 6 menstruation
-Potential Administer with meals to
hr, may be Dizziness
infections as minimize GI irritation.
decreased to Skin rash
dexamethasone For patients with difficulty
2 mg q 8-12 may mask the Swollen face,
swallowing, tablets can be
hr, then signs of legs or ankles
crushed and administered
change PO. infection such (fluid retention)
with fluids or food. However,
as fever and Vision problems
capsules should be swallowed
inflammation. (Dexamethason
whole.
-Pregnancy e may cause
Educate the patient to take
(safety is not cataracts and
missed doses as soon as
established with increased
remembered, unless almost
the sue of the intraocular
time for the next dose skip
drug during pressure)
the missed dose and continue
pregnancy) Cold or infection
your regular dosing schedule.
that last for a
Do not take a double dose to
long time
make up for a missed one.
Muscle
Instruct patient to avoid
weakness
people with known infection
Black or tarry
and contagious illnesses as
stool
corticosteroids causes
(suggestive of
 peptic immunosuppression and may
ulceration mask symptoms of infection.
caused by
Dexamethasone
use)

DRUG MECHANISM INDICATIONS CONTRAINDICA ADVERSE NURSING IMPLICATIONS

ORDER OF ACTION TIONS REACTIONS
Generic Name: Hinders growth of Bacterial Contraindicated Headache Before
Metronidazole selected infection caused with Dizziness Assess pt. Infection
Brand Name: organisms, by anaerobic hypersensitivity to Ataxia Watch carefully for edema
Flagyl including most microorganisms metronidazole; Vertigo because it may cause
Classification: anaerobic Incoordinatio sodium retention
Antibiotic, bacteria and Lactation. n Assess skin for severity
Antibacterial protozoa Insomnia areas of local adverse
Dose: Seizures reactions
Metronidazole Record number and
Peripheral
500mg1 tab character of stools
neuropathy
TID PO Assess pt.s and familys
Fatigue
Minimum Dose: knowledge of drug therapy
Unpleasant
PO : 250mg TID During
metallic
IV : 100mg /mL Give drug with meals to
taste
Maximum
Anorexia minimize GI
Dose:
Nausea Tablets may be crushed for
PO : 750 mg
Vomiting pts. with difficult
TID 6-10days IV
Diarrhea swallowing
:100mg/mL
GI upset Do not use aluminium
Cramps needles or hubs, color will
Dysuria turn orange/rust
After
Incontinence
Darkening of Tell pt. that metallic taste
the urine and dark or red brown
urine may occur
Instruct pt. to take oral
form with meals to
minimize reactions
Instruct to complete full
course of therapy
 Tell pt. not to use alcohol or
drugs that contain alcohol
May cause dizziness/ light
headedness
 DRUG ORDER
MECHANISM OF ACTION
INDICATIONS
CONTRAINDICATIONS
ADVERSE REACTIONS
NURSING IMPLICATIONS
Generic Name:
Diazepam(dye-aze-pam)
Brand Name: Valium
Classifications: central nervous system agent; benzodiazepine anticonvulsant; anxiolytic
Pregnancy Category:D

Psychotherapeutic agent related to chlordiazepoxide; reportedly superior in antianxiety and anticonvulsant activity, with
somewhat shorter duration of action. Like chlordiazepoxide, it appears to act at both limbic and subcortical levels of CNS.
Used adjunctively for relief of skeletal muscle spasm associated with tetanus.
Injectable form:
Shock, coma, acute alcohol intoxication, depressed vital signs, obstetrical patients, infants <30 d of age. Tablet form: Infants <6
mo of age, acute narrow-angle glaucoma, untreated open-angle glaucoma; during or within 14 d of MAO inhibitor therapy. Safe
use during pregnancy (category D) and lactation is not established.
Body
Whole: Throat and chest pain.
CNS: Drowsiness, fatigue, ataxia, confusion, paradoxic rage, dizziness, vertigo, amnesia, vivid dreams, headache, slurred speech,
tremor; EEG changes, tardive dyskinesia.
CV: Hypotension, tachycardia, edema, cardiovascular collapse
Spec Senses: Blurred vision, diplopia, nystagmus.
GI: Xerostomia, nausea, constipation, hepatic dysfunction.
Urogenital: Incontinence, urinary retention, gynecomastia (prolonged use), menstrual irregularities, ovulation failure.
Respiratory: Hiccups, coughing, laryngospasm.
Other: Pain, venous thrombosis, phlebitis at injection site.
Monitor for adverse reactions. Most are dose related. Physician will rely on accurate observation and reports of patient response
to the drug to determine lowest effective maintenance dose.
Monitor for therapeutic effectiveness. Maximum effect may require 12 wk; patient tolerance to therapeutic effects may develop
after 4 wk of treatment.
Observe necessary preventive precautions for suicidal tendencies that may be present in anxiety states accompanied by
depression.
Observe patient closely and monitor vital signs when diazepam is given parenterally; hypotension, muscular weakness,
tachycardia, and respiratory depression may occur.
Lab tests: Periodic CBC and liver function tests during prolonged therapy.
Supervise ambulation. Adverse reactions such as drowsiness and ataxia are more likely to occur in older adults and debilitated or
those receiving larger doses. Dosage adjustment may be necessary.
Monitor I&O ratio, including urinary and bowel elimination
 DRUG ORDER
MECHANISM OF ACTION
INDICATIONS
CONTRAINDICATIONS
ADVERSE REACTIONS
NURSING IMPLICATIONS
Generic Name & Brand Names
: Baclofen
(bak loe fen)
Lioresal
Pregnancy Category C
Drug class
Centrally acting skeletal muscle relaxant
Dosage & Route
PO 5 mg 3 times/day for 3 days, increased to 10 mg 3 times/day for 3 days
Baclofen is a centrally-acting skeletal muscle relaxant. Baclofen is an antispastic. It inhibits both monosynaptic and polysynaptic
reflexes at spinal level.
Alleviation of signs and symptoms of spasticity resulting from MS, particularly for the relief of flexor spasms and concomitant
pain, clonus, muscular rigidity (for patients with reversible spasticity to aid in restoring residual function
Hypersensitivity. Active peptic ulcer disease.
Sedation, drowsiness, ataxia, dizziness, headache, confusion, hallucinations, skin reactions, GI symptoms, enuresis.
Potentially Fatal: Respiratory or CV depression, seizures.

Give with caution to patients whose spasticity contributes to upright posture or balance in locomotion or whenever spasticity is
used to increase function.
BLACK BOX WARNING: Taper dosage gradually to prevent hallucinations, possible psychosis, or other serious effects; abrupt
discontinuation can cause serious reactions.
Teaching points

Take this drug exactly as prescribed. Do not stop taking this drug without consulting your healthcare provider; abrupt
discontinuation may cause hallucinations or other serious effects.
Avoid alcohol, sleep-inducing, or over-the-counter drugs because these could cause dangerous effects.
.
ASSESSMENT DIAGNOS ANALYSIS PLANNING INTERVENTIO RATIONALE EVALUATION
IS NS
SUBJECTIVE: Pat Acute pain Leptospirosis After 8 hours Explore Cognitive After 8 hours of
ient verbalized related to is a bacterial of nursing alternative behavioural nursing interventions,
of headache bacterial disease that interventions, pain relief interventions the patient was able to
and body pain infections affects the patient measure like may reduce demonstrate use of
OBJECTIVE: in the body humans and will relaxation reliance on relaxation skills, other
Facial animals. It is demonstrate technique, pharmacologic methods to promote
grimacing caused by use of breathing al therapy and comfort and to relieve
Irritability bacteria of the relaxation techniques enhance pain
Guarding genus skills, other and guided patients sense
of the Leptospira. In methods to imagery of control
affectedareas. humans it promote
causes a wide comfort and Carefully Reduces
range of to relieve position discomfort,
symptoms, pain. affected part. and risk for
and some injury.
infected Apply local
persons may massage Help reduce
have no gently to muscle
symptoms at affected tension.
all. Symptoms areas.
of
leptospirosis Encourage
include high range of Prevents joint
fever, severe motion stiffness and
headache, exercises. possible
chills, muscle contracture
aches, and formation.
vomiting, and
may include Maintain Dehydration
jaundice adequate increases
(yellow skin fluid intake. sickling and
and eyes), red
corresponding
eyes,
pain.
abdominal Administer
pain, medication Analgesics
diarrhoea, or as indicated
reduces pain
a rash. like
analgesics and promotes
and rest and
antibiotics comfort, while
antibiotics
inhibits further
bacterial
infection.