IX.

Pharmacologic Management (Drug Study)

Drugs Classification Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Inhibits cell-wall  diarrhea that is CNS:  Tell patient to report
synthesis, promoting watery or bloody; adverse reactions or
Ceftazidime Antibiotics osmotic instability; seizures signs and symptoms of
 swelling, pain, or
Brand Name: usually bactericidal irritation where the CV: superinfection promptly
injection was given;  Instruct patient to
Fortaz Pharmacologic: Phlebitis, thrombophlebitis report discomfort at I.V
 cold feeling,
Third-generation GI: insertion site
Dosage, Route, discoloration, or skin
Timing: changes in your
cephalosporins Pseudomembranes colitis,
fingers;
1 gm IVTT q 8h nausea, vomiting, diarrhea,
 seizure (black-out or abdominal cramps
convulsions);
Hematologic:
 white patches or
sores inside your Agranulocytosis, leukopenia,
mouth or on your lip; thrombocytopenia,
 eosinophilia, thrombocytosis,
haemolytic anemia
Skin: maculopapular and
erythematous rashes,
urticarial pain, induration,
sterile abscesses, tissue
sloughing at injection site
Other:
Anaphylaxis, hypersensitivity
reactions, serum sickness

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 Drugs Classification Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Inhibits protein  Ringing in the ears CNS:  Instruct patient to
synthesis by binding  Headache promptly report
Gentamycin Antibiotics Encephalopathy, seizures,
directly to the 30S  Dizziness adverse reactions,
fever, headache, lethargy,
Brand Name: ribosomal subunit;  nausea confusion, dizziness,
such as dizziness,
bactericidal  vomiting vertigo, unsteady gait,
Cidomycin Pharmacologic: numbness, peripheral ringing in the ears,
 stomach upset neuropathy, vertigo, ataxia,
 loss of appetite hearing loss,
Dosage, Route, Aminoglycosides tingling
 injection site numbness, tingling, or
Timing:
reactions(pain, CV: muscle twitching
80 mg IVTT q 8h irritation, and  Encourage patient to
Hypotension drink plenty of fluids
redness)
EENT:  Warn patient to avoid
hazardous activities if
Ototoxicity, blurred vision, adverse CNS reactions
tinnitus occur
GI:
Vomiting, nausea
GU:
Nephrotoxicity, possible
increase in urinary excretion
of casts
Hematologic:
Agranulocytosis, leukopenia,
thrombocytopenia, anemia,
eosinophilia
Musculoskeletal:

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 Muscle witching, myasthenia
gravis-like syndrome
Respiratory:
Apnea
Skin:
Rash, urticarial, pruritus,
injection-site pain
Other:
anaphylaxis
Drugs Classification Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Replaces calcium and  an irregular CNS:  Tell patient to take oral
maintains calcium level heartbeat; calcium with a full
Calcium Calcium Tingling sensations, sense of glass of water
supplements  nausea oppression or heat waves
Brand Name:  Tell patient to report
 constipation; with I.V use, syncope with
anorexia, nausea,
Calsan  weakness rapid I.V use
vomiting, constipation,
Pharmacologic:  drowsiness CV: abdominal pain, dry
Dosage, Route,
Calcium salts  headache; mouth, thirst, polyuria
Timing: Bradycardia, arrhythmia,  Warn patient that, in
1 tab OD P.O  dry mouth, or a cardiac arrest with rapid I.V the meal before he
metallic taste in your use, mild drop in BP, takes calcium, he
mouth; or. vasodilation shouldn’t have
 muscle or bone pain GI: rhubarb, spinach, bran
and whole-grain
Constipation, irritation, cereals, or dairy
chalky taste, haemorrhage, products; these foods
nausea, vomiting, thirst, may interfere with
calcium absorption

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 abdominal pain
GU:
Polyuria, renal calculi
Metabolic:
Hypercalcemia
Skin:
Local reactions, including
burning necrosis, tissue
sloughing, cellulitis, sof-
tissue

Drugs Classification Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Competes with  pounding heartbeats CNS:  Reassure patient that
histamine for H1- or fluttering in your GI side effects usually
Diphenyhydramine Antihistamines receptor sites. chest; Drowsiness, sedation, decrease after the first
Prevents, but doesn’t  painful or difficult sleepiness, incoordination, month of therapy
seizures, confusion,
reverse, histamine- urination;  Inform the patient that
Brand Name: Pharmacologic: mediated responses,  little or no urinating; insomnia, headache, vertigo,
flushing may occur
particularly those of the  confusion, feeling like fatigue, restlessness, tremor,
Ethanolamines after starting the
Benadryl bronchial tubes, GI you might pass out; nervousness
medication and that
Dosage, Route, tract, uterus, and blood or CV: taking it with food may
Timing: vessels  tightness in your neck help
or jaw, uncontrollable Palpitations, hypotension, 
50 mg IVTT for movements of your tachycardia
tongue.
Transfusion EENT:
Diplopia, blurred vision,

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 nasal congestion, tinnitus
GI:
Dry mouth, nausea.
epigastric distress, vomiting,
diarrhea, constipation,
anorexia
GU:
Dysuria, urine retention,
urinary frequency
Hematologic:
Thrombocytopenia,
agranulocytosis, haemolytic
anemia
Respiratory:
Thickening og bronchial
secretions
Skin:
Urticaria, photosensitivity,
rash
Other:
Anaphylactic shock
Drugs Classification Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: May inhibit  Hepatotoxic CNS:  Advise patient to

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Ketorolac NSAIDs prostaglandin  Nephrotoxic Headache, dizziness, maintain adequate fluid
synthesis, to produce  upset stomach drowsiness, sedation intake
Brand Name: anti-inflammatory,  mild nausea  Advise patient to be
CV:
Dyrolac
analgesic, and  vomiting alert for signs and
antipyretic effects  diarrhea Arrhythmias, edema, symptoms of CV
Pharmacologic: events(chest pain,
Dosage, Route,  constipation hypertension, palpitations
Timing:  mild heartburn shortness of breath,
NSAIDs EENT:
 stomach pain weakness, slurred
30 mg IVTT now speech) and to seek
then q 8h  bloating Throat irritation, nasal
medical attention
 dizziness discomfort
immediately if they
for 3 more doses  headache occur
GI:
 drowsiness  Tell patient to promptly
 sweating Dyspepsia, GI pain, nausea, report edema and
 ringing in ears constipation, diarrhea, weight gain
flatulence, peptic ulceration,  Teach patient the
stomatitis, vomiting. warning signs and
GU: symptoms for
hepatotoxicity (nausea,
Renal failure fatigue, lethargy,
pruritus, jaundice, right
Hematologic:
upper quadrant
Decreased platelet adhesion, abdominal tenderness,
prolonged bleeding time, flulike symptoms), and
purpura advise him to stop drug
and seek medical help
Skin: immediately if they
Diaphoresis, pruritus, rash occur
 Warn patient receiving
Other: drug I.M that pain may
occur at injection site
Pain at injection site

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 Drugs Classification Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Unknown. Thought to  headache CNS:  Explain assessment

bind to opioid receptors  dizziness and monitoring
Tramadol Analgesic Dizziness, headache,
and inhibit reuptake od  drowsiness process to patient and
somnolence, vertigo,
Brand Name: norepinephrine and  tired feeling seizures, anxiety, asthenia,
family. Instruct them to
serotonin  constipation immediately report
Conzip Pharmacologic: CNS stimulation, confusion, difficulty breathing or
 diarrhea coordination, disturbance,
Synthetic centrally other signs and
Dosage, Route,  nausea euphoria, malaise,
acting analgesic symptoms of a
Timing:  vomiting nervousness, sleep disorder potential adverse
 stomach pain
50 mg IVTT q 4h x CV: opioid-related reaction
 feeling nervous
6 doses  Warn patient to avoid
 anxious Vasodilation potentially hazardous
Then PRN for  itching activities that require
severe pain  sweating EENT:
mental alertness until
 flusing Visual disturbances drug’s CNS effects are
known
GI:  Warn patient to not
Constipation, nausea, stop the drug abruptly
vomiting, abdominal pain,
anorexia, diarrhea, dry
mouth, dyspepsia, flatulence,
GU:
Menopausal symptoms,
proteinuria, urinary
frequency, urine retention
Musculoskeletal:
Hypertonia

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 Respiratory depression
Skin:
Diaphoresis, pruritus, rash
Drugs Classification Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Thought to produce  blood or black tarry CNS:  Tell patient to take oral
analgesia by inhibiting stool form with food to
Paracetamol Analgesics Anxiety, fatigue, headache,
prostaglandin and other  bloody or cloudy urine minimize GI upset
insomnia, pyrexia
Brand Name: substances that  fever with or without  Tell patient not to
sensitize pain chills CV: crush, chew, or open
Biogesic Pharmacologic: receptors. Drug may  skin rash capsules
Para-aminophenol relieve fever through  hives Hypertension, hypotension,  Caution patient not to
Dosage, Route, derivatives central action in the peripheral edema, periorbital
Timing:  itching perform hazardous
hypothalamic heat- edema, tachycardia(I.V.)
 yellow eyes or skin activities if adverse
regulating center CNS reactions occur
500 mg I tab P.O  unusual tiredness GI:
 Instruct patient to avoid
Pre Blood Nausea, vomiting, abdominal prolonged exposure to
transfusion pain, diarrhea, constipation sunlight because drug
medication may cause
GU: phototoxicity
Oliguria  Instruct patient to notify
rescriber of unusual
Hematologic: bleeding, bruising,
Haemolytic anemia, tingling, tremors, rash,
leukopenia, neutropenia, fever, kidney stones, or
pancytopenia; anemia loss of appetite

Hepatic:
Jaundice

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 Metabolic:
Hypoglycaemia,
hypokalemia, hypervolemia,
hypomagnesemia,
hypophosphatemia(I.V.)
Musculoskeletal:
Muscle spasms, extremity
pain
Respiratory:
Abnormal breath sounds,
dyspnea,
hypoxia,atelectasis, pleural
effusion, pulmonary edema,
stridor, wheezing,
Skin:
Rash, urticaria; pruritus
Drugs Classification Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Replaces calcium and  Nausea CNS:  Tell patient to report
maintains calcium level  Vomiting anorexia, nausea,
Calcium Gluconate Calcium Tingling sensations, sense of
 Decreased appetite vomiting, constipation,
supplements oppression or heat waves
 Constipation with I.V. use, syncope with
abdominal pain, dry
 Dry mouth rapid I.V. use
mouth, thirst, or
Brand Name:  increased thirst polyuria
Calcinate  increased urination CV:
Pharmacologic:  tingling sensations Bradycardia, arrhythmias,
Dosage, Route,
Timing: Calcium salts cardiac arrest with rapid I.V.
use, mild drop in BP,

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1:1 dilution very vasodilation
slow IVTT
GI:
after 3 bags of
transfusion Constipation, irritation,
chalky taste, haemorrhage,
nausea, vomiting, thirst,
abdominal pain
GU:
Polyuria, renal calculi
Metabolic:
Hypercalcemia
Skin:
Local reactions, including
burning, necrosis, tissue
sloughing, cellulitis, soft
tissue calcification with I.M.
use
MAINTENANCE

Drugs Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Inhibits bacterial DNA  diarrhea CNS:  Tell patient to take
synthesis mainly by  dizziness drug as prescribed
Ciprofloxacin Antibiotics  Seizure, confusions,
blocking DNA gyrase; drowsiness  advise patient to drink
bactericidal  headache headache, restlessness
plenty of fluids to
 stomach upset GI: reduce risk of urine
Brand Name: Pharmacologic:  abdominal pain crystals
Fluoroquinolones  nausea/vomiting Crystalluria, interstitial  advise patient not to
Cipro  blurred vision crush, split, or chew

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Dosage, Route,  nervousness nephritis the extended-release
Timing:  anxiety tablets
 agitation Hematologic:  Warn patient to contact
500 mg P.O BID  sleep problems practitioner
Leukopenia, neutropenia,
(insomnia or thrombocytopenia, immediately if
nightmares), and eosinophilia symptoms of
 rash peripheral neuropathy
Musculoskeletal: occur
Tendon rupture  Warn patient to avoid
hazardous tasks that
Skin: require alertness until
effects of drug are
Rash known
Other:  Instruct patient to avoid
caffeine while taking
Hypersensitivity reactions drug because potential
for increased caffeine
effects
 Advise patient that
hypersensitivity
reactions may occur
even after first dose. if
a rash or other allergic
reaction occurs, tell
patient to stop drug
immediately and notify
prescriber
 tell patient to avoid
excessive sunlight or
artificial ultraviolet light
during therapy

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 Drugs Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Unknown. Thought to  headache CNS:  Explain assessment

bind to opioid receptors  dizziness and monitoring
Tramadol Analgesics Dizziness, headache,
and inhibit reuptake od  drowsiness process to patient and
somnolence, vertigo,
Brand Name: norepinephrine and  tired feeling seizures, anxiety, asthenia,
family. Instruct them to
serotonin  constipation immediately report
Conzip Pharmacologic: CNS stimulation, confusion, difficulty breathing or
 diarrhea coordination, disturbance,
Synthetics other signs and
Dosage, Route,  nausea euphoria, malaise,
centrally active symptoms of a
Timing: analgesics  vomiting nervousness, sleep disorder potential adverse
 stomach pain
500 mg P.O PRN CV: opioid-related reaction
 feeling nervous
for pain  Warn patient to avoid
 anxious Vasodilation potentially hazardous
 itching activities that require
 sweating EENT:
mental alertness until
flusing Visual disturbances drug’s CNS effects are
known
GI:  Warn patient to not
Constipation, nausea, stop the drug abruptly
vomiting, abdominal pain,
anorexia, diarrhea, dry
mouth, dyspepsia, flatulence,
GU:
Menopausal symptoms,
proteinuria, urinary
frequency, urine retention
Musculoskeletal:
Hypertonia

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 Respiratory depression
Skin:
Diaphoresis, pruritus, rash
Drugs Mechanism of Action Side Effects Adverse Effects Nursing Responsibilities

Generic Name: Therapeutic: Direct-acting  nausea, vomiting, CNS:  Instruct patient to take
trichomonocide and loss of appetite, extended-release
Metronidazole Antiprotozoals amebicide that works stomach pain; Headache, seizures, fever, tablets at least 1 hour
inside and outside the  diarrhea, vertigo, ataxia, dizziness, before or 2 hours after
Brand Name: syncope, incoordination,
intestines. It’s thought constipation; meals but to take all
Flagyl Pharmacologic: to enter the cells of  unpleasant metallic confusion, irritability, other oral forms with
Nitroimidazoles microorganism that taste; depression, weakness, food minimize GI upset
Dosage, Route,  insomnia, peripheral
contain nitroreductase, rash, itching;  Instruct patient in
Timing: forming unstable  vaginal itching or neuropath
proper hygiene
500 mg P.0 TID compounds that bind to discharge; CV:  Tell patient ot avoid
DNA and inhibit  mouth sores; or alcohol and alcohol-
synthesis, causing cell  swollen, red, or Flattened T wave, edema, containing drugs
death "hairy" tongue. flushing during and for at least
EENT: rhinitis, sinusitis, 3 days after treatment
pharyngitis, course
 Tell patient that he
GI: may experience a
metallic taste and have
Vomiting, nausea, epigastric a dark or red-brown
distress, constipation, urine
diarrhea
 tell patient to report to
GU: prescriber immediately
any neurologic
Darkened urine, polyuria, symptoms
dysuria, cystitis, UTI

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 Hematologic:
Transient leukopenia,
neutropenia
Musculoskeletal:
Transient joint pains
Respiratory:
Upper respiratory tract
Infection
Skin:
Rash, genital pruritus
Other:
Decreased libido

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