Name of Classific Dose Mechanism of Specific Side effects Nursing Implication

the drug ation Freque action Indication

Generic ncy s
name Route
(Brand
name)
GENERIC antip 1.2 Inhibits the Mild Haema: BEFORE:
NAME: yretic mL synthesis of pain hemolytic
s, q4 prostaglandin anemia,neutr ~ Advise parents or caregiver to check
Acetami hr s that may Fever openia,leuko concentrations of liquid preparations. Errors have
nophen nono od serve as penia, resulted in serious liver damage.
pioid mediators of pancytopenia
BRAND PRN ~ Assess fever; note presence of associated signs
NAME: analg pain and . (diaphoresis,tachycardia, and malaise).
esics i.v. fever, primarily
(Paracet in the CNS Hepa:jaundic DURING:
amol) Metabolic: ~ Adults should not take acetaminophen longer
hypoglycemia than 10 days and children not longer than 5 days
unless directed
GI:HEPATIC by health care professional.
FAILURE, ~ Advise mother or caregiver to take medication
HEPATOT exactly as directed and not to take more than
OXICITY the recommended amount.
(overdose)
AFTER:
GU:renal
failure ~ Advise patient to consult health care professional
(high if discomfort or fever is not relieved by routine
doses/chro doses of this drug or if fever is greater than
nic use). 39.5°C (103°F) or lasts longer than 3 days.

Derm:rash,
urticaria.
 Name of the drug Classification Dose Mechanism of Specific Side effects Nursing Implication
Generic name Freque action Indications
(Brand name) ncy
Route
Vitamin B Vitamins 150 mg A coenzyme that Pernicious CV:
complex and Bd stimulate anemia peripheral BEFORE:
Minerals orally metabolic CONTRA: ~ Determine reticulocyte
function and is vascular
~ hypersen- count, hct, Vit.B12, iron, folate
needed for cell thrombosis,
replication, sitive to levels before
heart failure.
hematopoiesis, vitamin B12 GI:transient beginning therapy.
and nucleoprotein or cobalt. diarrhea.
and myelin ~ Obtain a sensitivity test
~ early Respi:
synthesi pulmonary history before administration
Leber’s edema. ~ Avoid I.V. administration
disease Skin:it ching, bec. faster systemic
transitory elimination will reduce
exanthema, effectiveness of vitamin.
urticaria. DURING:
Other: ~ Don’t give large doses of
anaphylaxis, vitaminB12 routinely; drug is
anaphylactoid lost through excretion.
reactions with ~Don’t mix parenteral
parenteral preparation in same syringe
with other drugs.
administration AFTER:
, pain or ~ Protect Vit.B12 from light.
burning at Don’t refrigerate orfreeze.
 injection site. ~ Monitor patient for
hypokalemia for first 48
hours, as anemia correct
itself. Give potassium
supplements, as needed.

Name of the drug Classification Dose Mechanism of Specific Side effects Nursing Implication
Generic name Freque action Indications
(Brand name) ncy
Route

CNS: Monitor BP, PR,RR prior to

GENERIC NAME: Antianxiety 10 mg Depress the CNS, Adjunct in the 1) dizziness periodically throughout
Diazepam agents, tab probably by management of: 2) drowsiness therapy and frequently during
anticonvulsants potentiating 1) Anxiety 3) lethargy IV therapy.
BRAND NAME: , Od GABA, an 2) Preoperative 4) hangover - Assess IV site frequently
Valium sedative/hypto inhibitory sedation 5) headache during administration,
nics, skeletal neurotransmitter. 3) Conscious 6) depression diazepam may cause phlebitis
muscle IM - EENT: and venous thrombosis.
- Produces sedation
relaxants skeletal muscle - Provides light 1) blurred - Prolonged high-dose therapy
(centrally relaxation by anesthesia and vision may lead to psychological or
acting inhibiting spinal anterograde - RESP: physical dependence. Restrict
polysynaptic amnesia 1) respiratory amount of drug available to
afferent - Treatment of depression patient. Observe depressed
pathways. status epilepticus/ - CV: patients closely for suicidal
- Has anticonvul- uncontrolled 1) hypotension tendencies.
sant properties seizures - GI: - Observe and record intensity,
due to enhanced - Skeletal muscle 1) constipation duration and location of
presynaptic relaxant 2) diarrhea seizure activity. The initial
inhibi- - Management of 3) nausea dose of diazepam offers
tion.Therapeutic the symptoms of 4) vomiting seizure control for 15-20 min
effects: alcohol - DERM: after administration.
(1) Relief of withdrawal 1) rashes - IM injections are painful and
Anxiety - LOCAL: erratically absorbed. If IM
(2) Sedation CONTRAINDICAT 1) pain (IM) route is used, inject deeply
(3) Amnesia IONS:Hypersensit 2) phlebitis (IV) into deltoid muscle for
3) venous maximum absorption.
 thrombosis - Caution patient to avoid
(4) Skeletal ivity - MISC: taking alcohol or other CNS
muscle relaxant - Cross-sensitivity 1) physical & depressants concurrently with
(5) Decreased with other psychological this medication.
seizure activity benzodiazepines depen-dence - Effectiveness of therapy can
may occurs 2)tolerance be demonstrated by decrease
- Comatose anxiety level; control of
patients seizures; decreased
- Pre-existing CNS tremulousness
depression
-Uncontrolled
severe painUse
cautiously in:
1) Hepatic
dysfunction
2) Severe renal
impairment
3) History of
suicide attempt or
drug dependence

Name of the drug Classification Dose Mechanism of Specific Side effects Nursing Implication
Generic name Frequency action Indications
(Brand name) Route
GENERIC NAME: central nervous Phenytoin Aside from Neurologic Assessment & Drug Effects
system agent; sodium is a seizures, it
phenytoin anticonvulsant; 125 mg commonly used is an option At therapeutic • Continuously monitor
hydantoin antiepileptic. in the doses, phenytoin vital signs and
BRAND NAME: bd Phenytoin treatment of produces symptoms during IV
(fœnit'oin, IPA) trigeminal horizontal gaze infusion and for an hour
acts to suppress neuralgia in nystagmus, which afterward. Watch for
 the abnormal the event
Dilantin i.v. brain activity that is harmless but respiratory depression.
seen in seizure carbamazep occasionally Constant observation
by reducing ine or other tested for by and a cardiac monitor
electrical 1st line police as a marker are necessary with
conductance treatment is for alcohol older adults or patients
among brain deemed intoxication with cardiac disease.
cells by inappropriat (which can also Margin between toxic
stabilizing the e. It is produce and therapeutic IV
inactive state of sometimes nystagmus). At doses is relatively
voltage-gated considered toxic doses, small.
sodium a class 1b patients • Be aware of
channels. antiarrhyth experience therapeutic serum
mic sedation, concentration: 10–20
cerebellar ataxia, mcg/mL; toxic level:
and 30–50 mcg/mL; lethal
ophthalmoparesis level: 100 mcg/mL.
, as well as Steady-state
seizures. therapeutic levels are
Idiosyncratic side- not achieved for at
effects of least 7–10 d.
phenytoin, as with • Lab tests: Periodic
other serum phenytoin
anticonvulsants, concentration; CBC
include rash and with differential,
severe allergic platelet count, and Hct
reactions. and Hgb; serum
glucose, serum
Phenytoin may calcium, and serum
accumulate in the magnesium; and liver
cerebral cortex funtion tests.
over long periods • Observe patient closely
of time, as well as for neurologic adverse
causing atrophy effects following IV
of the cerebellum administration. Have
when on hand oxygen,
administered at atropine, vasopressor,
chronically high assisted ventilation,
 seizure precaution
levels equipment (mouth gag,
nonmetal airway,
Hematologic a suction apparatus).
reduction in folic • Be aware that gingival
acid levels, hyperplasia appears
predisposing most commonly in
patients to children and
megaloblastic adolescents and never
anemia. Folic acid occurs in patients
is presented in without teeth.
foods as • Make sure patients on
polyglutamate, prolonged therapy
which is then have adequate intake
converted into of vitamin D-containing
monoglutamates foods and sufficient
by intestinal exposure to sunlight.
conjugase. • Monitor diabetics for
Phenytoin acts by loss of glycemic
inhibiting this control.
enzyme, thereby • Check periodically for
causing folate decrease in serum
deficiency. Other calcium levels.
side effects may Particularly susceptible:
include: patients receiving other
agranulocytosis, anticonvulsants
aplastic anemia, concurrently, as well as
leukopenia, those who are inactive,
thrombocytopenia have limited exposure
. to sun, or whose
dietary intake is
Terat craniofacial inadequate.
anomalies • Observe for symptoms
(broad of folic acid deficiency:
nasal neuropathy, mental
bridge, dysfunction.
cleft lip • Be alert to symptoms
and palate, of hypomagnesemia
 (see Appendix F);
microceph neuromuscular
aly) and a symptoms: tetany,
mild form positive Chvostek’s and
of mental Trousseau’s signs,
retardation seizures, tremors,
(average ataxia, vertigo,
IQ=71). nystagmus, muscular
fasciculations.
There is no good
evidence that Patient & Family Education
phenytoin is a
human • Be aware that drug
carcinogen may make urine pink or
red to red-brown.
Gingival drug • Report symptoms of
induced gingival fatigue, dry skin,
enlargement deepening voice when
(hyperplasia) in receiving long-term
the oral cavity therapy because
probably due to phenytoin can unmask
above mentioned a low thyroid reserve.
folate defiency. • Do not alter prescribed
Effects consist of drug regimen. Stopping
the following: drug abruptly may
bleeding upon precipitate seizures
probing, and status epilepticus.
increased gingival • Do not to
exudate, request/accept change
pronounced in drug brand when
gingival refilling prescription
inflammatory without consulting
response to physician.
plaque levels, • Understand the effects
associated in of alcohol: Alcohol
some instances intake may increase
with bone loss but phenytoin serum
without tooth
 levels, leading to
detachment phenytoin toxicity.
• Discontinue drug
Suicide risk immediately if a
measles-like skin rash
or jaundice appears
Dermatologic
and notify physician.
• Be aware that influenza
Hypertrichosis, vaccine during
rash, exfoliative phenytoin treatment
dermatitis, may increase seizure
pruritis. activity. Understand
that a change in dose
In autoimmune may be necessary.
disease • Do not breast feed
while taking this drug.
drug-induced
lupus.

life-threatening
skin reactions
Stevens-Johnson
syndrome (SJS)
and toxic
epidermal
necrolysis (TEN).

induction of
reversible IgA
deficiency
 Name of the drug Classification Dose Mechanism of Specific Side effects Nursing Implication
Generic name Frequency action Indications
(Brand name) Route
• central •Adult/Child: • Long- • Long Body as a Assessment & Drug Effects
nervous IV 15–18 acting -term Whole: Myalgia,
GENERIC NAME: system mg/kg in barbiturate. manageme neuralgia, CNS • Observe patients receiving
agent; single or Sedative and nt of tonic- depression, coma, large doses closely for at
PHENOBARBITAL anticonv divided hypnotic effects clonic and death. CNS: least 30 min to ensure that
SODIUM ulsant; doses (max: of barbiturates (grand mal) Somnolence, sedation is not excessive.
sedative 20 mg/kg) appear to be seizures nightmares, • Keep patient under
- Neonate: IV due primarily to and partial insomnia, constant observation when
hypnoti 15–20 interference seizures; "hangover," drug is administered IV, and
BRAND NAME headache,
c; mg/kg in with impulse status record vital signs at least
barbitur single or transmission of epilepticus, anxiety, thinking every hour or more
ate divided cerebral cortex eclampsia, abnormalities,
doses by inhibition of febrile dizziness,
Luminal Sodium • convulsions nystagmus,
in irritability,
• paradoxic often if indicated.
• reticular
activating • youn
g children. excitement and Lab tests: Obtain liver
system. CNS
Also used exacerbation of function and hematology
depression may
as a hyperkinetic tests and determinations of
range from mild
sedative in behavior (in serum folate and vitamin D
sedation to
anxiety or children); levels during prolonged
coma,
tension confusion or therapy.
depending on
states; in depression or
dosage, route of
pediatrics marked • Monitor serum drug levels.
administration,
as excitement (older Serum concentrations >50
degree of
preoperativ adult or mcg/mL may cause coma.
nervous system
e and debilitated Therapeutic serum
excitability, and
postoperati patients); ataxia. concentrations of 15–40
drug tolerance.
ve sedation CV: Bradycardia, mcg/mL produce
Initially,
and to treat syncope, anticonvulsant activity in
barbiturates
pylorospas hypotension. GI: most patients. These values
suppress REM
m in infants Nausea, vomiting, are usually attained after 2
sleep, but with
• constipation, or 3 wk of therapy with a
chronic therapy
 • Cont diarrhea,
REM sleep raindicatio epigastric pain, dose of 100–200 mg/d.
returns to ns liver damage. • Expect barbiturates to
normal. Hematologic: produce restlessness when
• Sensi Megaloblastic given to patients in pain
tivity to anemia, because these drugs do not
barbiturates agranulocytosis, have analgesic action.
; manifest thrombocytopenia • Be prepared for
hepatic or . Metabolic: paradoxical responses and
familial Hypocalcemia, report promptly in older
history of osteomalacia, adult or debilitated patient
porphyria; rickets. and children (i.e., irritability,
severe Musculoskeletal marked excitement
respiratory : Folic acid [inappropriate tearfulness
or kidney deficiency, and aggression in children],
disease; vitamin D depression, and confusion).
history of deficiency.
previous Respiratory:
addiction to Respiratory
sedative depression. Skin:
hypnotics; Mild
uncontrolle maculopapular,
d pain; morbilliform rash;
pregnancy erythema
multiforme,
Stevens-Johnson
syndrome,
exfoliative
dermatitis (rare). .

Name of the drug Classification Dose Mechanism of Specific Side effects Nursing Implication
Generic name Frequency action Indications
 (Brand name) Route
GENERIC NAME •Anticonvulsta 1.2 g • Decrease • INDI • • • Administer
nt s synaptic CATION / •CNS: headache, medication with food to
carbamazepine od transmission in USES: tremors, minimize gastric irritation.
the CNS by • Reduces confusion, Tablets may be crushed if
BRAND NAME i.v. affecting anxiety, restlessness, patient has difficulty
sodium irritability, memory loss, swallowing. Do not crush or
channels in elation seizures, slurred chew extended-release
Tegretol, Tegretol
neurons • Impulse speech, muscle tablets.
XR , Equetro,
control weakness, lack of • Instruct patient to take
Carbatrol
Prevention of behavior coordination, carbamazepine around the
seizure lethargy, stupor clock, exactly as directed. If
• CON •CV: a dose is missed, take as
TRA- bradycardia, ECG soon as possible but not just
INDICATIO changes, before next dose; do not
NS: arrhythmias, double doses. Medication
• hypotension, should be gradually
Hypersensi peripheral discontinued to prevent
tivity circulatory seizures.
• Kidney collapse • May cause dizziness or
disease •EENT: blurred drowsiness.
• vision, tinnitus • Instruct patients that fever,
Cardiovasc • GI: anorexia, sore throat, mouth ulcers,
ular nausea, easy bruising, petechiae,
disease vomiting, unusual bleeding, abdominal
• Seizure abdominal pain, chills, rash, pale stools,
disorder, cramps or pain, dark urine or jaundice should
myastheni diarrhea, dry be reported.
a gravis mouth, extreme • Advise patient not to take
• thirst, metallic alcohol or other CNS
Dehydratio taste, weight depressant concurrently with
n gain this medication.
• • GU: polyuria, • Caution patients to use
Hypothyroi glycosuria, sunscreen and protecting
dism proteinuria, clothing to prevent
incontinence, photosensitivity reactions.
edema, •Inform patient that frequent
hyponatremia mouth rinses, good oral
• Hematologic: hygiene, and sugarless gum
leukocytosis or candy may help reduce
• Skin: rash, dry mouth. Saliva substitute
pruritus, may be use
alopecia,
sweating,
dryness or
thinning of hair