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Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations

Dosage

Clopidogrel 75 mg Tab Anticoagulant, Prophylaxis of Clopidogrel selectively inhibits Haematoma, epistaxis, diarrhoea, - May be taken with or
antiplatelet thromboembolic adenosine diphosphate (ADP) dyspepsia, abdominal pain, without food.
disorders, Acute from binding to its platelet P2Y12 bruising, bleeding at puncture site. - Monitor for signs of
coronary receptor and subsequent Rarely, Stevens-Johnson bleeding; Hb and
syndrome, activation of glycoprotein syndrome, erythema multiforme, haematocrit periodically
GPIIb/IIIa complex thus reducing serum sickness, interstitial - May substantially reduce
platelet aggregation. pneumonitis, lichen planus, antiplatelet effect w/
myalgia. grapefruit juice.

Aspirin 80 mg tab Nonsteroidal Anti- Mild to moderate Aspirin is an analgesic, anti- GI disturbances; prolonged bleeding - Should be taken with
Inflammatory Drugs pain and fever, inflammatory and antipyretic. It time, rhinitis, urticaria and epigastric food.
discomfort; angioedema, salicylism,
(NSAIDs) / Prophylaxis of inhibits cyclooxygenase, which is - Alcohol, corticosteroids,
tinnitus; bronchospasm. Potentially
Anticoagulants, myocardial responsible for the synthesis of analgin, phenylbutazone
Fatal: Gastric erosion, ulceration and
Antiplatelets & infarction, Juvenile prostaglandin and thromboxane. and oxyphenbutazone
bleeding; severe, occasionally fatal
Fibrinolytics rheumatoid It also inhibits platelet exacerbation of airway obstruction in may increase risk of GI
(Thrombolytics) arthritis, Pain and aggregation. asthma; Reye's syndrome (children <12 ulceration. Aspirin
inflammation yr). Hepatotoxicity; CNS depression increases phenytoin
associated with which may lead to coma; CV collapse levels. May antagonize
musculoskeletal and resp failure; paroxysmal actions of uricosurics and
bronchospasm and dyspnoea.
and joint disorders, spironolactone.
- May potentiate effects of
anticoagulants,
methotrexate and oral
hypoglycaemics.

Rodriguez, Roxas 1 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Captopril 75-100 mg tab ACE Diabetic Captopril competitively inhibits Nonproductive cough, dyspnoea, - Should be taken on an
Inhibitors/Direct nephropathy the conversion of angiotensin I headache, abdominal pain, dry empty stomach. Take 1
Renin Inhibitors Post-myocardial (ATI) to angiotensin II (ATII), thus mouth, dizziness, GI and taste hr before or 2 hr after
infarction resulting in reduced ATII levels disturbances, sleep disorders. meals.
Hypertension and aldosterone secretion. It also Hypotension, tachycardia, chest - May impair ability to drive
Heart failure increases plasma renin activity pain, palpitations, hyperkalaemia, and operate machinery.
and bradykinin levels. Reduction hyponatremia, gynaecomastia - Concurrent treatment w/
of ATII leads to decreased Na (reversible). Pruritus, skin rashes, NSAIDs reduces
and water retention. This alopecia. hypotensive action and
promotes vasodilation and BP increases the risk of
reduction. nephrotoxicity.
- Food may reduce serum
levels of Captopril. Avoid
ginseng (may worsen
HTN) and garlic (may
increase antihypertensive
effect).

Rodriguez, Roxas 2 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Morphine Cough & Cold - Moderate to Morphine is a phenanthrene Nausea, vomiting, constipation, - May be taken with or
Preparations / severe pain derivative which acts mainly on abdominal pain, dry mouth, without food. May be
Analgesics (Opioid) - Acute the CNS and smooth muscles. It anorexia, taste disturbance, taken w/ meals to reduce
pulmonary binds to opiate receptors in the dyspepsia, resp depression, GI discomfort.
edema CNS altering pain perception and sedation, dizziness, confusion, - May impair ability to drive
- Pain associated response. Analgesia, euphoria insomnia, headache, somnolence, or operate machinery.
with myocardial and dependence are thought to involuntary muscle contractions, - Monitor efficacy of pain
infarction be due to its action at the mu-1 hyperhidrosis, rash, pruritus, control, vital signs, and
receptors while resp depression asthenic conditions, HTN, mental status; signs of
and inhibition of intestinal bronchospasm, seizures, drug abuse, addiction, or
movements are due to action at amenorrhoea, rhabdomyolysis, diversion; signs or
the mu-2 receptors. Spinal nystagmus. symptoms of
analgesia is mediated by hypogonadism or
morphine agonist action at the K hypoadrenalism.
receptor. - MAOIs intensify the effect
of morphine resulting to
severe and even fatal
events (e.g. anxiety,
confusion, resp
depression, sometimes
leading to coma).
- Alcohol enhances the
CNS depressant effect of
morphine.

Rodriguez, Roxas 3 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Nitroglycerin 1 patch Anti-Anginal Drugs Management of Glyceryl trinitrate acts on the Facial flushing, dizziness, - May interfere with Zlatkis-
stable angina enzyme nitric oxide stimulating tachycardia, throbbing headache Zak colour reaction,
guanylate cyclase in the vascular and tolerance. Large doses can resulting in false report of
smooth muscle cells resulting in cause vomiting, restlessness, decreased serum
the relaxation of smooth muscles. hypotension, syncope, rarely cholestero
It reduces venous return cyanosis and - rthostatic hypotension
(preload) and facilitates methaemoglobinaemia, impaired may be produced by
subendocardial blood flow with respiration, bradycardia. IV admin: combined use of calcium
redistribution into ischaemic IV preparation contains substantial channel blockers,
areas. It relieves coronary quantities of alcohol and alcohol antihypertensives,
vasospasm and dilates arterioles intoxication can occur. Sublingual phenothiazines and
reducing afterload. It is useful for Tabs/Spray: Dry mouth, localised TCAs. Alcohol may cause
relief and prevention of anginal burning sensation. Topical: Contact severe hypotension and
attacks. dermatitis, erythema, local irritation. collapse.
Transdermal patches: Contact - Aspirin and other NSAIDs
dermatitis, metal-containing may reduce the
patches should be removed before therapeutic response to
cardioversion, defibrillation, glyceryl trinitrate.
diathermy. Buccal tablets: Delayed - Make sure to clean area
dissolution, may be swallowed by thoroughly, especially if
mistake. an old patch was there.
Hypotension Make sure area is
completely dry before
administering patch.
Wear gloves

Rodriguez, Roxas 4 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Insulin Insulin Preparations - Diabetic Insulin lowers blood glucose Hypoglycemia, insulin resistance, - Possible absence of
ketoacidosis levels. It regulates carbohydrate, lipoatrophy, hypokalaemia, blurred hypoglycaemic warning
symptoms with -blockers.
- Diabetes protein and fat metabolism by vision.
- Note: Frequency of blood
mellitus inhibiting hepatic glucose
glucose monitoring is
production and lipolysis, and determined by the type of
enhancing peripheral glucose insulin regimen and health
disposal. The various insulin status of the patient.
formulations are classified - Check BP, I&O ratio, and
according to their durations of blood glucose and ketones
action after SC Inj. They are every hour during treatment
for ketoacidosis with IV
divided into short-, intermediate-,
insulin.
or long-acting insulin. Soluble
- Respond promptly to
insulin (also known as 'neutral beginning symptoms of
insulin' or 'regular insulin') is a hypoglycemia. Severe
short-acting preparation. To hypoglycemia is an
extend the duration of action of emergency situation. Take 4
insulin, preparations are oz (120 mL) of any fruit juice
formulated as suspensions in 2 or regular carbonated
beverage [1.53 oz (4590
methods. The 1st method
mL) for child] followed by a
involves complexing insulin with a
meal of longer-acting
protein so that it is slowly carbohydrate or protein food.
released, e.g. protamine zinc Failure to show signs of
insulin (contains an excess of recovery within 30 min
protamine) and isophane insulin indicates need for
(or NPH insulin which contains emergency treatment.
equal amounts of protamine and
insulin). An alternative method is
particle size modification e.g.
insulin zinc suspensions. While
all the formulations can be admin
by SC inj, most by IM inj, only
soluble insulin can be admin by
IV. Compared to SC inj, IM admin

Rodriguez, Roxas 5 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

usually has a faster onset of


action, with a shorter duration of
action.

Rodriguez, Roxas 6 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Levophed 4 mL ampule Vasoconstrictor Emergency Noradrenaline, a Body as a Whole: Ischemic injury - Prolonged administration
measure in blood sympathomimetic amine, acts due to potent vasoconstrictor action of any potent
pressure predominantly on - and - and tissue hypoxia. vasopressor may result in
restoration in receptors in the heart. It therefore Cardiovascular System: plasma volume depletion
cases of acute causes peripheral Bradycardia, probably as a reflex which should be
hypotension. vasoconstriction (-adrenergic result of a rise in blood pressure, continuously corrected by
action), and a positive inotropic arrhythmias. appropriate fluid and
effect on the heart and dilation of Nervous System: Anxiety, transient electrolyte replacement
coronary arteries (-adrenergic headache. therapy. If plasma
action). These actions result in Respiratory System: Respiratory volumes are not
an increase in systemic blood difficulty. corrected, hypotension
pressure and coronary artery Skin and Appendages: may recur when
blood flow. In myocardial Extravasation necrosis at injection Levophed SF is
infarction accompanied by site. discontinued, or blood
hypotension, noradrenaline pressure may be
usually increases aortic blood maintained at the risk of
pressure, coronary artery blood severe peripheral and
flow, and myocardial visceral vasoconstriction
oxygenation, thereby helping to (eg, decreased renal
limit the area of myocardial perfusion) with diminution
ischemia and infarction. Venous in blood flow and tissue
return is increased and the heart perfusion with
tends to resume a more normal subsequent tissue
rate and rhythm than in the hypoxia and lactic
hypotensive state. In hypotension acidosis and possible
that persists after correction of ischemic injury.
blood volume deficits, - Levophed SF should not
noradrenaline helps raise the be given to patients who
blood pressure to an optimal level are hypotensive from
and establish a more adequate hypovolemia, except as
circulation an emergency measure
to maintain coronary and
cerebral artery perfusion

Rodriguez, Roxas 7 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

until blood volume


replacement therapy can
be completed.
- watch out for
extravasation

Rodriguez, Roxas 8 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Salbutamol 2.5 mL Nebule Antiasthmatic & - Severe Salbutamol activates adenyl Tremor, nervousness, nausea and - Should be taken on an
COPD Preparations bronchospasm cyclase, the enzyme that vomiting, tachycardia, palpitations, empty stomach. Take 1
- Acute stimulates the production of cyclic chest pain, shakiness, dizziness, hr before or 2 hr after
adrenergic bronchospasm adenosine-3', 5'-monophosphate headache, insomnia, inhalation site meals
inhalants, selective - Acute severe (cAMP). Increased cAMP leads sensation, hyperactivity, HTN, - Increased risk of
beta-2- asthma to activation of protein kinase A, hypotension, increased sweating, hypokalaemia w/ K
adrenoreceptor which inhibits phosphorylation of allergic reactions, DM, muscle depleting agents (e.g.
agonists myosin and lowers intracellular cramps, flu-like syndrome, corticosteroid, diuretics,
ionic Ca concentrations, resulting conjunctivitis, UTI, hypokalaemia,. xanthines, digoxin).
in smooth muscle relaxation. Rarely, erythema multiforme, Increased uterine inertia
Stevens-Johnson syndrome. w/ halogenated anaesth
Potentially Fatal: Paradoxical (IV). Increased risk of
bronchospasm. pulmonary oedema w/
corticosteroids.
- May antagonise the
effect of anti-diabetics.

Rodriguez, Roxas 9 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Duavent 2.5mL Nebule salbutamol and - Management of Ipratropium bromide is a potent Respiratory: Bronchitis, dyspnea, - Ipratropium bromide-
ipratropium bromide reversible bronchodilator, particularly in coughing, pneumonia, salbutamol combination
; Belongs to the bronchospasm large bronchial airways; however, bronchospasm, pharyngitis, can produce paradoxical
class of adrenergics associated with some evidence suggests that it sinusitis, rhinitis. bronchospasm that can
in combination with obstructive also has bronchodilator activity in be life-threatening. If it
anticholinergics airway diseases small airways. Bronchodilation edema, fatigue, hypertension, occurs, discontinue the
- For patients with results from relaxation of smooth dizziness, nervousness, preparation immediately
chronic muscles of the bronchial tree. paresthesia, tremor, dysphonia, and institute alternative
obstructive The extent of bronchodilation insomnia, diarrhea, dry mouth, therapy. It should be
pulmonary produced by ipratropium appears dyspepsia, vomiting, arrhythmia, recognized that
disease (COPD) to be determined by the level of palpitation, tachycardia, arthralgia, paradoxical
on a regular cholinergic parasympathetic angina, increased sputum, taste bronchospasm, when
inhaled bronchomotor tone and by perversion and urinary tract associated with inhaled
bronchodilator inhibition of bronchoconstriction infection/dysuria. formulations, frequently
who continue to resulting from neural reflex occurs with the first use
have evidence activation of cholinergic of a new pulmoneb.
of pathways. - Salbutamol sulfate
bronchospasm contained in the
and who require Salbutamol: see above formulation, like other -
a second adrenergic agonists, can
bronchodilator. produce a clinically
significant cardiovascular
effect in some patients as
measured by pulse rate,
blood pressure and/or
other symptoms

Rodriguez, Roxas 10 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Tranexamic 100 mg/ml Haemostatics - Short-term Tranexamic acid is an Diarrhea, nausea, vomiting, - May be taken with or
Acid management of antifibrinolytic agent that disturbances in colour vision, without food.
hemorrhage competitively inhibits breakdown giddiness, hypotension (after rapid - Unusual change in
of fibrin clots. It blocks binding of IV inj), thromboembolic events. bleeding pattern should
plasminogen and plasmin to be immediately reported
fibrin, thereby preventing to the physician.
haemostatic plug dissolution. - Tranexamic acid is
distributed into breast
milk; concentrations
reach approximately 1%
of the maternal plasma
concentration
- Contraindicated in:
Presence of blood clots
(eg, in the leg, lung, eye,
brain), have a history of
blood clots, or are at risk
for blood clots

Potassium 20 ml Electrolytes - Severe acute Potassium chloride is a major GI ulceration (sometimes with - Should be taken with
Chloride 40 mEq/L hypokalemia cation of the intracellular fluid. It haemorrhage and perforation or food.
- Hypokalemia, plays an active role in the with late formation of strictures) - Ensure adequate urine
Prophylaxis of conduction of nerve impulses in following the use of enteric-coated output; monitor plasma-
hypokalemia the heart, brain and skeletal K chloride preparation; potassium and other
and mild K muscle; contraction of cardiac hyperkalaemia. Oral: Nausea, electrolyte concentrations
deficiency skeletal and smooth muscles; vomiting, diarrhoea and abdominal - Discontinue treatment if
maintenance of normal renal cramps. IV: Pain or phloebitis; severe nausea, vomiting
function, acid-base balance, cardiac toxicity. or abdominal distress
carbohydrate metabolism and develops. Accumulation
gastric secretion. of potassium may occur
in renal impairment.

Rodriguez, Roxas 11 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Isordil 5 mg tab Anti-Anginal Drugs, - Angina Pectoris The exact mechanism of action of Cutaneous vasodilation with - Nitrates may cause
(Isosorbide organic nitrate - Congestive the nitrates in the relief of angina flushing may occur. hypotension as a result of
denitrate) vasodilators Heart Failure pectoris is not fully understood. Vascular headache is common and peripheral vasodilatation.
- Acute They appear to relieve classic may be severe and persistent. Alcohol may enhance this
Congestive angina pectoris by reducing Headache is usually relieved by the effect.
Heart Failure myocardial oxygen demand ie, by use of suitable analgesics or by a - Sildenafil may amplify the
- Chronic decreasing the heart's "afterload" temporary reduction in dosage and vasodilatory effects of
Congestive and "preload" through dilatation tends to disappear after the 1st nitrates eg, Isordil and
Heart Failure of peripheral venous capacitance week or 2 of use. can result in severe
and to a lesser extent, arteriolar Transient episodes of dizziness and hypotension
resistance vessels. Nitrates may weakness - Paradoxical bradycardia
cause a redistribution of coronary and increased angina
blood flow to ischemic areas by pectoris may accompany
selectively dilating large coronary nitrate-induced
vessels or collateral vessels hypotension.
which may develop secondary to - Systolic pressure should
myocardial ischemia. be preserved in patients
with preexisting
hypotension in the range
of 90-100 mmHg.

Rodriguez, Roxas 12 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Amiodarone 5 mg amp Cardiac Drugs, - Ventricular Amiodarone is a class III Blue-grey discolouration of skin, - May be taken with or
class III arrhythmias antiarrhythmic agent which photosensitivity, peripheral without food. Take
antiarrhythmic agent - Life-threatening inhibits stimulation, prolongs neuropathy, paraesthesia, consistently w/ or w/o
ventricular action potential and refractory myopathy, ataxia, tremor, nausea, meals. Take w/ meals if
arrhythmias period in myocardial tissues. It vomiting, metallic taste, high dose or to reduce GI
- Pulseless also decreases AV conduction hypothyroidism, hyperthyroidism, discomfort.
ventricular and sinus node function. Sinus alopoecia, sleep disturbances, - Close monitoring is
fibrillation or rate is reduced by 15-20%, PR corneal microdeposits, hot flushes, recommended as
ventricular and QT intervals are increased. sweating. Heart block, bradycardia, amiodarone may worsen
tachycardia Amiodarone can cause marked sinus arrest, hepatotoxicity, heart arrhythmia especially
sinus bradycardia or sinus arrest failure. when used concurrently
and heart block. In acute IV with other anti-arrhythmic
doses, amiodarone may exert a drugs or drugs that
mild negative inotropic effect. prolong QT interval.
- . May cause hypotension
and bradycardia. May
increase risk of liver
toxicity.

Hydrocortisone 100 mg amp Corticosteroid Soft tissue Hydrocortisone is a corticosteroid Sodium and fluid retention. - Should be taken with
Hormones / Eye inflammation used for its anti-inflammatory and Potassium and calcium depletion. food.
Corticosteroids / Supplement in immunosuppressive effects. Its Muscle wasting, weakness, - Establish baseline and
Topical adrenal anti-inflammatory action is due to osteoporosis. GI disturbances and continuing data on BP,
Corticosteroids insufficiency during the suppression of migration of bleeding. Increased appetite and weight, fluid and
minor surgery polymorphonuclear leukocytes delayed wound healing. Bruising, electrolyte balance, and
under general and reversal of increased striae, hirsutism, acne, flushing. blood glucose.
anesthesia capillary permeability. It may also Raised intracranial pressure, - Do NOT use aspirin or
Supplement in be used as replacement therapy headache, depression, psychosis, other OTC drugs unless
adrenal in adrenocortical insufficiency. menstrual irregularities. prescribed specifically by
insufficiency during Hyperglycaemia, glycosuria, DM, the physician.
moderate or major obesity, moon-face, buffalo hump. - Interferes with calcium
surgery absorption.
Acute

Rodriguez, Roxas 13 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

adrenocortical
insufficiency

Aminophylline 25 mg/ml amp Antiasthmatic & Acute severe Aminophylline is a combination Nausea, vomiting, abdominal pain, - Should be taken on an
COPD Preparations bronchospasm of theophylline and diarrhoea, headache, insomnia, empty stomach. Take at
Chronic ethylenediamine. dizziness, anxiety, restlessness; least 1 hr before or 2 hr
bronchospasm Ethylenediamine is inactive; it tremor, palpitations. after meals.
increases the solubility of - Contraindicated with
theophylline in water. hypersensitivity to any
Theophylline relaxes bronchial xanthine or to
smooth muscle. Suggested ethylenediamine, peptic
mechanisms are an increase in ulcer, active gastritis;
intracellular cAMP through rectal or colonic irritation
inhibition of phosphodiesterase; or infection (use rectal
adenosine receptor antagonism, preparations).
prostaglandin antagonism and - Monitor results of serum
effects on intracellular calcium. theophylline levels
carefully, and arrange for
reduced dosage if serum
levels exceed therapeutic
range of 1020 mcg/mL.

Rodriguez, Roxas 14 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Calcium 10 ml ampule Electrolytes Antidote in severe Calcium gluconate is used to GI irritation; soft-tissue calcification, - Assess for cutaneous
Gluconate hypermagnesaemi prevent or treat negative calcium skin sloughing or necrosis after burning sensations and
a, Severe balance. It also helps facilitate IM/SC inj. Hypercalcaemia peripheral vasodilation,
hyperkalaemia nerve and muscle performance characterised by anorexia, nausea, with moderate fall in BP,
Hypocalcaemic as well as normal cardiac vomiting, constipation, abdominal during direct IV injection.
tetany, Severe function. pain, muscle weakness, mental - Monitor ECG during IV
acute disturbances, polydipsia, polyuria, administration to detect
hypocalcemia nephrocalcinosis, renal calculi; evidence of
chalky taste, hot flushes and hypercalcemia:
Hypocalcaemia peripheral vasodilation. decreased QT interval
and calcium associated with inverted
deficiency states T wave.
- Calcium absorption can
be inhibited by zinc-rich
foods: nuts, seeds,
sprouts, legumes, soy
products (tofu).

Nicardipine 10 ml ampule Anti-Anginal Drugs - Short-term Nicardipine is a dihydropyridine Pedal oedema, tachycardia, - May be taken with or
/ Calcium treatment of Ca channel blocker. It inhibits Ca hypotension, abnormal ECG, without food. Avoid
Antagonists hypertension ion from entering the slow palpitations, flushing, headache, grapefruit juice 1 hr
- Hypertension channels or select voltage- asthenia, dizziness, paraesthesia, before or 2 hr after a
- Angina pectoris sensitive areas of vascular somnolence, myalgia, nausea, dose.
smooth muscle and myocardium vomiting, constipation, dyspepsia, - Extended-Release:
during depolarisation, producing dry mouth, rash, polyuria, Should be taken with
a relaxation of coronary vascular dyspnoea, hypokalaemia, food. Avoid grapefruit
smooth muscle and coronary increased urinary frequency, juice 1 hr before or 2 hr
vasodilatation. It also increases haematuria, nocturia. after a dose. Avoid taking
myocardial oxygen delivery in w/ high fat meals.
patients w/ vasospastic angina. Swallow whole, do not
crush/chew.
- BP and heart rate should
be monitored carefully

Rodriguez, Roxas 15 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

esp during initiation of


therapy and titration or
upward adjustment of
dosage.

Omeprazole 40 mg vial Antacids, Antireflux - Zollinger-Ellison Omeprazole is a substituted Increased risk of Clostridium - Powd For Oral Susp:
Agents & syndrome benzimidazole gastric difficile-associated diarrhoea Should be taken on an
Antiulcerants - Gastric and antisecretory agent and is also (CDAD) and osteoporosis-related empty stomach. Take at
duodenal ulcers, known as PPI. It blocks the final fractures. Headache, rash, pruritus, least 1 hr before a meal.
Gastro- step in gastric acid secretion by dizziness, fatigue, cough, back or - Monitor Mg
oesophageal specific inhibition of H+/K+ abdominal pain, arthralgia and concentrations prior to
reflux disease, ATPase enzyme system present myalgia, urticaria, dry mouth, initiation and periodically
NSAID- on the secretory surface of the photosensitivity, bullous eruption, thereafter.
associated gastric parietal cell. Both basal fever, angioedema, bronchospasm, - Overdosage: Confusion,
ulceration and stimulated acid are inhibited. anaphylaxis, somnolence, depression, apathy,
- Gastro- aggression and vertigo, insomnia, vomiting, nausea,
oesophageal reversible confusional states, headache, dizziness,
reflux disease depression, agitation, hallucination. abdominal pain,
- H.pylori infection diarrhoea. Management:
- Peptic ulcer Symptomatic and
supportive treatment.
- Avoid concomitant St

Rodriguez, Roxas 16 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

John's wort as it may


decrease omeprazole
levels.

Fucidin 2% ointment in Topical Antibiotics Skin infections caused Fusidic acid/sodium fusidate, an Fucidin is remarkably well tolerated - Caution should be
by Staphylococci,
gauze antibiotic derived from Fusidium and there is an extremely low observed when applying
Streptococci,
Propionibacterium coccineum exerts powerful frequency of hypersensitivity Fucidin ointment in the
acnes, Corynebacterium antibacterial activity against a reactions. eye region as this
minutissimum and other
number of gram-positive preparation may cause
fusidic acid- and/or
fusidate-sensitive
organisms. Staphylococci, irritation upon contact
organisms eg, impetigo, including the strains resistant to with the eye.
infected wounds, penicillin or to other antibiotics
folliculitis, boils, sycosis
are particularly susceptible to
barbae, carbuncles,
hidradenitis, paronychia fusidic acid and/or sodium
and erythrasma. fusidate. Besides pronounced
Fucidin Cream is an antibacterial activity against the
invisible, nonstaining
preparation used in the
majority of organisms responsible
treatment of face and for skin infections, it also
scalp infections. possesses unique ability to
penetrate to the focus of

Rodriguez, Roxas 17 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

infection, even when applied to


intact skin.

Metoclopramid 10mg/2ml Antiemetics / GIT - Intubation of the Metoclopramide blocks dopamine Extrapyramidal symptoms (usually - Should be taken on an
e Regulators, small intestine, receptors and in higher doses, it acute dystonic reactions); empty stomach. Take
Antiflatulents & Anti- Premedication also blocks serotonin receptors in parkinsonism; tardive dyskinesia; hr before meals.
Inflammatories for radiologic chemoreceptor trigger zone of restlessness, drowsiness, - May impair ability to drive
examination of the CNS. It enhances the dizziness, anxiety, confusion, or operate machinery.
the upper response to acetylcholine of tremor; hallucinations (rare); - Monitor signs of tardive
gastrointestinal tissue in upper GI tract causing depression w/ suicidal ideation; dyskinesias,
tract enhanced motility and hypotension, HTN, GI disturbances, extrapyramidal
- Prophylaxis of accelerated gastric emptying w/o dyspnoea, visual disturbances, symptoms;
chemotherapy- stimulating gastric, biliary, or urinary frequency and incontinence, signs/symptoms of
induced nausea pancreatic secretions. It also headache, Cardiac conduction neuroleptic malignant
and vomiting increases lower esophageal disorders, transient flushing of face syndrome.
- Nausea and sphincter tone. and upper body (high dose). - May potentiate sedative
vomiting Potentially Fatal: Neuroleptic effect w/ alcohol.
associated with malignant syndrome.
cancer
chemotherapy or

Rodriguez, Roxas 18 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

radiotherapy

Tramadol 1mL amp Analgesics (Opioid) - Moderate to Tramadol inhibits reuptake of Resp depression, seizure, - May be taken with or
50mg/mL severe pain norepinephrine, serotonin and dizziness, headache, somnolence, without food.
- Postoperative enhances serotonin release. It weakness, CNS stimulation (e.g. - May impair ability to drive
pain alters perception and response to anxiety, euphoria, hallucinations), or operate machinery.
pain by binding to mu-opiate asthenia, sweating, confusion, - Monitor pain relief, resp
receptors in the CNS. coordination disturbance, rate, BP, pulse rate; signs
paraesthesia, hypoaesthesia, of tolerance, abuse, or
amnesia, cognitive dysfunction, suicidal ideation.
depression, dysphoria,
constipation, nausea, vomiting,
dyspepsia, diarrhoea, abdominal
pain

Rodriguez, Roxas 19 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Buscopan ampule Antispasmodics Acute The active ingredient in Anticholinergic adverse effects of - Inform physician if taking
gastrointestinal, Buscopan is hyoscine-N- Buscopan are generally mild and any other medicine while
belladonna biliary and butylbromide, a known self-limited. taking Buscopan. The
alkaloids, genitourinary antispasmodic substance. It Immune System Disorders: anticholinergic effect of
semisynthetic, spasm, including relieves the pain by acting on the Anaphylactic shock/reactions, drugs eg, tri- and
quaternary biliary and renal muscle spasm which causes the dyspnea, skin reactions (eg, tetracylic
ammonium colic. pain. Buscopan exerts a urticaria, rash, erythema and antidepressants,
compounds As an aid in spasmolytic action on the smooth pruritus) and other hypersensitivity antihistamines,
diagnostic and muscle of the gastrointestinal, reactions. antipsychotics, quinidine,
therapeutic biliary and genitourinary tracts. Eye Disorders: Accommodation amantadine,
procedures, where As a quaternary ammonium disorders, mydriasis, increased disopyramide and other
spasm may be a derivative, hyoscine-N- intraocular pressure. anticholinergics (eg,
problem eg, butylbromide does not enter the Cardiac Disorders: Tachycardia. tiotropium, ipratropium,
gastroduodenal central nervous system. Vascular Disorders: Decreased atropine-like compounds)
endoscopy, and in Therefore, anticholinergic side blood pressure, dizziness, flushing. may be intensified by
radiology. effects at the central nervous Gastrointestinal Disorders: Dry Buscopan.
system do not occur. Peripheral mouth.
anticholinergic action results from Skin and Subcutaneous Tissue
a ganglion-blocking action within Disorders: Dyshidrosis.
the visceral wall as well as from Renal and Urinary Disorders:
an anti-muscarinic activity. Urinary retention.

Rodriguez, Roxas 20 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Furosemide 2mL amp Diuretics Acute pulmonary Furosemide inhibits reabsorption Hyponatraemia, hypochloraemic - May be taken with or
10mg/ml oedema of Na and Cl mainly in the alkalosis, hypokalaemia, headache, without food. May be
medullary portion of the drowsiness, muscle cramps, taken w/ meals to reduce
Oedema ascending loop of Henle. hypotension, dry mouth, thirst, GI discomfort.
associated with Excretion of K and ammonia is weakness, lethargy, restlessness, - Monitor BP, serum
heart failure also increased while uric acid oliguria, GI disturbances, electrolytes, renal
excretion is reduced. It increases hypovolaemia, dehydration, function, orthostasis,
Hypertension plasma-renin activity, plasma- hyperuricaemia hearing (on high doses or
norepinephrine and plasma- rapid IV admin)
arginine-vasopressin - Give early in the day so
concentrations. that increased urination
will not disturb sleep.
- Measure and record
weight to monitor fluid
change
- Arrange for potassium-
rich diet or supplemental
potassium as needed.

Rodriguez, Roxas 21 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Dobutamine 5ml amp adrenergic and Acute heart failure Dobutamine exerts positive Increased heart rate, ectopic - Monitor BP, ECG, cardiac
250mg/5mL dopaminergic inotropic effect on the heartbeats, angina, chest pain, output and pulmonary
cardiac stimulants Cardiac stress test myocardium by stimulating 1- palpitation, elevations in BP, skin wedge pressure.
adrenergic receptors, thereby rash, fever, eosinophilia, - Monitor potassium
increasing myocardial bronchospasm, paraesthesia, concentrations during
contractility, stroke vol and nausea, vomiting, tingling therapy; may cause
cardiac output. sensation, dyspnoea, fever, hypokalemia.
headache, mild leg cramps; pruritus - Palpate peripheral pulses
of the scalp; phlebitis at the inj site. and assess appearance
Rarely, ventricular tachycardia, of extremities routinely
hypokalaemia. throughout dobutamine
administration. Notify
physician if quality of
pulse deteriorates or if
extremities become cold
or mottled.

Verapamil 2ml amp phenylalkylamine Supraventricular Verapamil inhibits entry of Ca AV block, bradycardia, worsening - Should be taken with
2.5mg/ml derivative selective arrhythmias ions into the slow channels or heart failure, transient asystole, food.
calcium-channel select voltage-sensitive areas of hypotension, dizziness, flushing, - Monitor BP, heart rate,
blockers with direct Angina pectoris vascular smooth muscle and fatigue, headache, dyspnoea, ECG, LFTs (periodically).
cardiac effects myocardium during peripheral oedema, constipation,
Secondary depolarisation. It relaxes nausea, abnormal liver function,
prophylaxis of coronary vascular smooth muscle skin reactions, gingival hyperplasia,
myocardial and coronary vasodilation, extrapyramidal symptoms. Rarely,
infarction increases myocardial oxygen gynaecomastia.
delivery, and slows automaticity
and AV node conduction.

Rodriguez, Roxas 22 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Dexamethason 2 ml amp Corticosteroid Prophylaxis of Dexamethasone is a synthetic Growth retardation, osteoporosis, - Monitor intake and output
e 4mg/ml Hormones / Topical nausea and glucocorticoid which decreases peptic ulcer, glaucoma and of patient.
Corticosteroids vomiting inflammation by inhibiting the subcapsular cataracts, vertebral - Observe the patient for
associated with migration of leukocytes and compression fractures. Cushing-like peripheral edema, steady
cytotoxic therapy reversal of increased capillary features, pancreatic dysfunction weight gain, rales or
permeability. It suppresses and pancreatitis, GI upsets, crackles or dyspnea.
Unresponsive normal immune response. increased appetite, increased Notify the physician
shock fragility of the skin. Increased immediately if these
susceptibility to infection clinical manifestations
Bacterial are noted.
meningitis

Diphenhydrami 1 ml amp aminoalkyl ethers Allergic conditions, Diphenhydramine is an Chest tightness, extrasystoles, - This drug may cause
ne 50mg/ml used as systemic Treatment and antihistamine w/ anticholinergic hypotension, palpitations, blurred vision, dizziness,
antihistamines prophylaxis of and sedative effects. It competes tachycardia; ataxia, chills, cognitive and
motion sickness w/ histamine for H1-receptor sites confusion, dizziness, drowsiness, psychomotor impairment
on effector cells in the GI tract, euphoria, excitement, fatigue, which may impair ability
Parkinson's blood vessels and resp tract. headache, insomnia, irritability, to drive or operate
disease nervousness, neuritis, machinery.
paraesthesia, paradoxical - Monitor mental alertness,
excitation, restlessness, sedation, relief of symptoms.
seizure, vertigo; diaphoresis; - Additive effect w/ other
menstrual disease; GI disturbances CNS depressants
- May potentiate the effect
of anticholinergic drugs
(e.g. atropine).
- Additive CNS depressant
effect w/ alcohol.

Rodriguez, Roxas 23 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Ranitidine 2 ml amp Antacids, Antireflux Stress ulceration of Ranitidine competitively blocks Headache, malaise, dizziness, - Monitor serum ALT
25mg/ml Agents & upper histamine at H2-receptors of the somnolence, insomnia, vertigo, concentrations daily from
Antiulcerants gastrointestinal gastric parietal cells which reversible mental confusion, the 5th day to the
tract inhibits gastric acid secretion. It agitation, mental depression, remainder of IV therapy;
does not affect pepsin secretion, hallucinations, constipation, gastric pH and renal
Hypersecretory pentagastrin-stimulated intrinsic nausea, vomiting, abdominal function.
conditions factor secretion or serum gastrin. discomfort or pain, rash (urticaria, - Ranitidine minimally
maculopapular, and/or pruritic), loss inhibits hepatic
Prophylaxis of acid of libido. Small increases in serum metabolism of coumarin
aspiration during creatinine, increases in serum anticoagulants,
general aminotransferase (AST and ALT), theophylline, diazepam
anaesthesia alkaline phosphatase, LDH, total and propanolol. May alter
bilirubin, and -glutamyl absorption of pH-
transferase. Rarely, mild erythema dependent drugs
multiforme-like rash, reversible
involuntary motor disturbances,
pancreatitis, alopecia,
bronchospasm, fever, cardiac
arrhythmias, eosinophilia,
leukopenia, granulocytopenia,
agranulocytosis, thrombocytopenia,
aplastic anaemia, acquired immune
haemolytic anaemia, and
pancytopenia.

Rodriguez, Roxas 24 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Paracetamol 2ml amp, Analgesics (Non- Mild to moderate Paracetamol exhibits analgesic Thrombocytopenia, leucopenia, - Alcohol may increase risk
150mg/ml Opioid) & pain and fever action by peripheral blockage of pancytopenia, neutropenia, of hepatotoxicity.
Antipyretics pain impulse generation. It agranulocytosis, pain and burning - Do not give more than
500 mg tab produces antipyresis by inhibiting sensation at inj site. Rarely, four doses in 24 hours
the hypothalamic heat-regulating hypotension and tachycardia. - Alcohol increases the risk
centre. Its weak anti- Potentially Fatal: Stevens-Johnson of liver damage that can
inflammatory activity is related to syndrome, toxic epidermal occur if an overdose of
inhibition of prostaglandin necrolysis, acute generalised paracetamol is taken.
synthesis in the CNS. exanthematous pustulosis, acute The hazards of
renal tubular necrosis and paracetamol overdose
hepatotoxicity. are greater in persistent
heavy drinkers and in
people with alcoholic liver
disease.

Epinephrine 1 ml amp Cardiac Drugs / Anaphylactic shock Epinephrine, an active principle CNS effects; GI disturbances; - Overdosage intravascular
1mg/ml Antiasthmatic & of the adrenal medulla, is a epigastric pain; CV disorders; inj of epinephrine may
COPD Preparations Advanced cardiac direct-acting sympathomimetic. It difficulty in micturition with urinary cause cerebral
life support stimulates - and -adrenergic retention; dyspnoea; haemorrhage due to a
receptors resulting in relaxation hyperglycaemia; sweating; sharp rise in BP.
Acute asthma of smooth muscle of the hypersalivation; weakness, tremors; Fatalities may also result
bronchial tree, cardiac stimulation coldness of extremities; from pulmonary oedema
and dilation of skeletal muscle hypokalaemia. Gangrene, tissue because of peripheral
vasculature. It is frequently added necrosis and sloughing vascular constriction
to local anaesthetics to retard (extravasation) when used in together with cardiac
diffusion and limit absorption, to addition to local anaesthetics stimulation.
prolong the duration of effect and - may cause Increase in
to lessen the danger of toxicity bilirubin, catecholamines,
glucose, uric acid.

Rodriguez, Roxas 25 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Atropine 1 ml amp Mydriatic Drugs / Bradycardia Atropine is an anticholinergic Dry mouth, dysphagia, - May cause hyperthermia,
1mg/ml Antispasmodics / agent which competitively blocks constipation, flushing and dryness hypertension, increased
Other Poisoning or the muscarinic receptors in of skin, tachycardia, palpitations, respiratory rate, nausea
Cardiovascular overdosage with peripheral tissues such as the arrhythmias, mydriasis, and vomiting. May also
Drugs / Antidotes & compounds having heart, intestines, bronchial photophobia, cycloplegia, raised lead to CNS stimulation.
Detoxifying Agents muscarinic actions muscles, iris and secretory intraocular pressure. Toxic doses Severe intoxication may
glands. Some central stimulation cause tachycardia, hyperpyrexia, lead to CNS depression,
Organophosphorus may occur. Atropine abolishes restlessness, confusion, coma, respiratory failure
poisoning bradycardia and reduces heart excitement, hallucinations, delirium and death.
block due to vagal activity. and may progress to circulatory - Additive anticholinergic
Smooth muscles in the bronchi failure and resp depression. effects with quinidine,
and gut are relaxed while antidepressants and
glandular secretions are reduced. some antihistamines.
It also has mydriatic and - 2 mg IV/IM, every 10-30
cycloplegic effect. minutes until muscarinic
effects disappear or
atropine toxicity appears.
In severe cases, dose
can be given as often as
every 5 minutes. In
moderate to severe
poisoning, a state of
atropinisation is
maintained for at least 2
days and continued for
as long as symptoms are
present.

Rodriguez, Roxas 26 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Dopamine 5ml amp, adrenergic and Acute heart failure Dopamine stimulates Ectopic heartbeats, angina, - Monitor BP, ECG, urine
40mg/ml dopaminergic dopaminergic receptors at lower tachycardia, palpitation, flow, cardiac output,
cardiac stimulants doses producing renal and hypotension, vasoconstriction, pulmonary wedge
mesenteric vasodilation; at higher dyspnoea, nausea, vomiting, pressure
doses stimulates both headache, cardiac conduction - May suppress pituitary
dopaminergic and 1-adrenergic abnormalities, HTN, azotemia, secretion of thyrotropin
receptors producing cardiac anxiety, widened QRS complex, (TSH), growth hormone
stimulation and renal bradycardia, piloerection, peripheral and prolactin
vasodilation; large doses cyanosis.
stimulates -adrenergic
receptors.

Rodriguez, Roxas 27 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Lipitor 80 mg tab Dyslipidaemic Prevention of Atorvastatin is a selective, Metabolism and Nutrition - Atorvastatin should be
Agents Cardiovascular competitive inhibitor of HMG-CoA Disorders: Hyperglycemia. used with caution in
Complications reductase, the rate-limiting Respiratory, Thoracic and patients who consume
HMG CoA enzyme that converts HMG-Co-A Mediastinal Disorders: substantial quantities of
reductase inhibitors Chronic Kidney to mevalonate, a precursor of Pharyngolaryngeal pain, epistaxis. alcohol and/or have a
Disease sterols, including cholesterol. In Gastrointestinal Disorders: history of liver disease.
patients with homozygous and Diarrhea, dyspepsia, nausea, Active liver disease or
heterozygous familial flatulence. unexplained persistent
hypercholesterolemia, non- Musculoskeletal and Connective transaminase elevations
familial forms of Tissue Disorders: Arthralgia, pain in are contraindications to
hypercholesterolemia, and mixed extremity, musculoskeletal pain, the use of atorvastatin
dyslipidemia, atorvastatin muscle spasms, myalgia, joint
reduces total-C, LDL-C, and apo swelling.
B. Atorvastatin also reduces very Investigations: Abnormal liver
low-density lipoprotein function test, increased blood
cholesterol (VLDL-C) and TG and creatine phosphokinase.
produces variable increases in
HDL-C.
Atorvastatin lowers plasma
cholesterol and lipoprotein levels
by inhibiting HMG-CoA reductase
and cholesterol synthesis in the
liver and by increasing the
number of hepatic LDL receptors
on the cell surface for enhanced
uptake and catabolism of LDL.

Rodriguez, Roxas 28 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Amlodipine 5 mg tab Anti-Anginal Drugs / Prinzmetal's Amlodipine relaxes peripheral Somnolence, dizziness, headache, - May impair ability to drive
Calcium angina, Stable and coronary vascular smooth ankle swelling, oedema, flushing, and operate machinery.
Antagonists angina muscle. It produces coronary fatigue, palpitations, abdominal - Monitor BP and heart
vasodilation by inhibiting the pain, nausea. Rarely, confusion, rate.
Hypertension entry of Ca ions into the slow rash, gingival hyperplasia, muscle - Concomitant therapy w/
channels or select voltage- cramps, dyspnoea. simvastatin may increase
sensitive channels of the vascular risk of myopathy
smooth muscle and myocardium including rhabdomyolysis
during depolarisation. It also
increases myocardial oxygen
delivery in patients w/
vasospastic angina

Pregabalin 75 mg cap Drugs for Adjunct in partial Pregabalin is an analog of the Somnolence, dizziness, headache, - May impair ability to
Neuropathic Pain / seizures neurotransmitter GABA. It binds diplopia, blurred vision, vertigo, drive, operate machinery
Anxiolytics / potently to the 2- subunit fatigue, irritability, arthralgia, or engage in hazardous
Anticonvulsants Anxiety resulting in modulation of Ca muscle cramp, back and limb pain, activities.
channels and reduction in the cervical spasm, disorientation, - Monitor visual
Neuropathic pain release of several insomnia, nasopharyngitis, ataxia, disturbances. Closely
neurotransmitters, including tremor, dysarthria, amnesia, observe for clinical
Fibromyalgia glutamate, norepinephrine, paraesthesia, hypoaesthesia, worsening, suicidality
serotonin, dopamine, calcitonin lethargy, sedation, oedema, and unusual changes in
gene-related peptide and peripheral oedema, dry mouth, behaviour.
substance P. constipation, diarrhoea, vomiting, - May potentiate the effects
nausea, flatulence, abdominal of lorazepam. Additive
distension, increased appetite, wt CNS depressant effects
gain, euphoria, confusion, reduced w/ opiates and
libido, erectile dysfunction; benzodiazepines. May
attention, memory, coordination increase risk of
and gait disturbances; fall, feeling angioedema w/ ACE
drunk, abnormal feeling inhibitors. May increase
risk of wt gain and
peripheral oedema w/

Rodriguez, Roxas 29 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

thiazolidinediones.

Rodriguez, Roxas 30 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Clonidine 75 mcg tab centrally-acting Hypertension Clonidine stimulates 2- Headache, dizziness, drowsiness, - May impair ability to drive
antiadrenergic adrenoceptors in the brain stem dry mouth, constipation, or operate machinery.
agents which results in reduced depression, anxiety, nausea, - May cause dryness of
sympathetic outflow from the fatigue, anorexia, parotid pain, eyes in patients who
Antihypertensives CNS, and a decrease in paraesthesia, delusional wear contact lenses.
peripheral resistance, heart rate, perception, sleep disturbances, - Monitor BP (standing and
BP and renal vascular resistance. vivid dreams, impotence and loss of sitting/supine), mental
libido, urinary retention or status, heart rate.
incontinence, orthostatic - May potentiate CNS
hypotension, itching or burning depressant effect of
sensations in the eye, alcohol
accommodation disorder,
decreased lacrimation, fluid
retention, pruritus and rashes
(transdermal), bradycardia
(including sinus bradycardia w/ AV
block), other ECG disturbances,
heart failure, hallucinations, cramp,
Raynaud's syndrome,
gynaecomastia, transient
abnormalities in LFTs.

Rodriguez, Roxas 31 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Midazolam 5 ml amp Anxiolytics / Sedation in critical Midazolam is a short-acting Physical and psychological - Bioavailability of oral
5mg/1ml Anticonvulsants / care benzodiazepine. It exerts dependence with withdrawal midazolam increased by
1mg/1ml Hypnotics & sedative and hypnotic, muscle symptoms; decreased tidal volume grapefuit juice. Avoid
Sedatives Induction of relaxant, anxiolytic and and respiration rate; apnoea; concomittant use.
anaesthesia anticonvulsant actions. While the headache; hiccup; nausea, - May impair ability to drive
probable anxiolytic action might increased appetite, vomiting; or operate machinery
Sedation for dental be as a result of the drug's ability cough; oversedation; seizure-like - monitor for early signs of
and minor surgical to increase glycine inhibitory activity (paediatrics); paradoxical hypoventilation, airway
procedures neurotransmitter level, the reactions; obstruction, or apnea
hypnotic/anaesthetic action may
be due to the occupation of the
benzodiazepine and GABA
receptors leading to membrane
hyperpolarisation and neuronal
inhibition, and further interfering
with the re-uptake of GABA at the
synapses.

Morphine 10 mg in 1 mL Analgesics (Opioid) Acute pulmonary Morphine is a phenanthrene Nausea, vomiting, constipation, - May impair ability to drive
Sulfate edema derivative which acts mainly on abdominal pain, dry mouth, or operate machinery.
the CNS and smooth muscles. It anorexia, taste disturbance, - Monitor efficacy of pain
Pain associated binds to opiate receptors in the dyspepsia, resp depression, control, vital signs, and
with myocardial CNS altering pain perception and sedation, dizziness, confusion, mental status;
infarction response. Analgesia, euphoria insomnia, headache, somnolence, - monitor for signs of drug
and dependence are thought to involuntary muscle contractions, abuse, addiction, or
Pain associated be due to its action at the mu-1 hyperhidrosis, rash, pruritus, diversion;
with myocardial receptors while resp depression asthenic conditions, HTN, - monitor for signs or
infarction and inhibition of intestinal bronchospasm, seizures, symptoms of
movements are due to action at amenorrhoea, rhabdomyolysis, hypogonadism or
the mu-2 receptors. Spinal nystagmus. hypoadrenalism.
analgesia is mediated by
morphine agonist action at the K
receptor.

Rodriguez, Roxas 32 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Phenobarbital 1 ml amp, 130 Anticonvulsant Preoperative Phenobarbital is a long-acting Bradycardia, syncope, hypotension; - Avoid abrupt withdrawal
mg/ml sedation barbiturate. It depresses the anxiety, agitation, ataxia, CNS - May impair ability to drive
barbiturates and sensory cortex, reduces motor excitation or depression, confusion, or operate machinery.
derivatives anti Emergency activity, changes cerebellar dizziness, drowsiness, - Monitor CBC, LFTs,
epileptics management of function and produces hallucinations, hangover effect, mental status and seizure
acute seizures, drowsiness, sedation and headache, hyperkinesias; activity.
Status epileptics hypnosis. Its anticonvulsant constipation, nausea, vomiting; - May reduce plasma
property is exhibited at high agranulocytosis, thrombocytopenia, levels of oral
Hypnotic doses. megaloblastic anaemia; oliguria; anticoagulants (e.g.
pain at inj site, thrombophlebitis (w/ warfarin, dicoumarol,
IV use); laryngospasm, resp acenocoumarol,
depression, apnoea (esp w/ rapid phenprocoumon)
IV use), hypoventilation; gangrene - May increase CNS
(w/ unintentional intra-arterial inj). depressant effect w/
phenytoin,
antihistamines,
sedative/hypnotics,
tranquilizers
- May prolong the effect w/
MAOIs

Rodriguez, Roxas 33 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Diazepam 2 ml amp, Anxiolytics / Premedication Diazepam is a long-acting Sedation, drowsiness, ataxia, - Monitor CV, resp and
5mg/ml Anticonvulsants before benzodiazepine w/ muscle weakness, fatigue, mental status
anaesthesia, anticonvulsant, anxiolytic, confusion, depression, headache, - May impair ability to drive
Sedation in minor sedative, muscle relaxant and vertigo, amnesia, paradoxical or operate machinery.
surgical and amnestic properties. It increases reactions (e.g. anxiety, May increase metabolism
medical neuronal membrane permeability hallucinations, insomnia, by smoking.
procedures to Cl ions by binding to psychoses, sleep disturbances), - Avoid abrupt withdrawal
stereospecific benzodiazepine visual disturbances, tremor, slurred - Avoid Use in patient w/
Severe anxiety receptors on the postsynaptic speech or dysarthria, paradoxical depression or anxiety
GABA neuron w/in the CNS and excitation, resp depression, associated w/ depression
Muscle spasms enhancing the GABA inhibitory hypotension, changes in libido and esp those w/ suicidal or
effects resulting in salivation, GI disturbances, urinary aggressive behaviour
Alcohol withdrawal hyperpolarisation and retention or incontinence; pain and - Assess for History of
syndrome stabilisation thrombophlebitis (IV). Rarely, drug and alcohol
hypersensitivity, blood disorders, addiction
jaundice, increased liver enzyme
values.

Rodriguez, Roxas 34 of 35
Drug Name Route and Classification Indication Mechanism of action Side effects NSGConsiderations
Dosage

Enoxaparin 0.6 units SQ heparin Prophylaxis of Enoxaparin binds to antithrombin Hemorrhages: In clinical studies, - Do not administer by IM
venous thrombosis (a circulating anticoagulant) to hemorrhages were the most route.
anticoagulant in surgical patients form a complex that irreversibly commonly reported reaction. These - Enoxaparin sodium, as
inactivates clotting factor Xa. It included major hemorrhages, with any other
patient w/ has less activity against factor IIa reported at most in 4.2% of the anticoagulant therapy,
moderate risk of (thrombin) compared to patients (surgical patients). Some should be used with
thromboembolism unfractionated heparin (UFH) due of these cases have been fatal.As caution in conditions with
to its low molecular weight with other anticoagulants, increased potential for
treatment of DVT hemorrhage may occur in the bleeding eg, impaired
w/ or w/o presence of associated risk factors hemostasis, history of
pulmonary eg, organic lesions liable to bleed, peptic ulcer, recent
embolism invasive procedures or the ischemic stroke,
concomitant use of medications uncontrolled severe
Treatment of acute affecting hemostasis (see arterial hypertension,
STEMI Precautions and Interactions) diabetic retinopathy,
recent neuro- or
ophthalmologic surgery,
concomitant use of
medications affecting
hemostasis

Rodriguez, Roxas 35 of 35

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