Republic of the Philippines

ISABELA STATE UNIVERSITY

Echague Campus

COLLEGE OF NURSING

NUR 221
Care of Mother, Child at Risk or with Problems (Acute and Chronic)
Individual Drug Study

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Inhibits cell-wall ●​ Uncomplicate Common:

Generic Name: synthesis during bac- d gonorrhea Before Administration:
Amoxicillin terial multiplication, ●​ Bacterial ●​ Nausea
leading to cell endocarditis ●​ Vomiting ●​ Check for allergies to
Brand Names: death. Shows enhanced prophylaxis ●​ Diarrhea penicillin or
Amoxil, Trimox, activity toward for dental, GI, ●​ Rash cephalosporins
Moxatag gram-negative bacteria and GU ●​ Assess infection
compared to procedures Serious: symptoms and obtain
Classification: natural and ●​ Lower culture & sensitivity
Antibiotic (Penicillin penicillinase-resistant respiratory ●​ Allergic tests before starting
class) penicillins. tract infections reactions therapy
caused by (hives, ●​ Monitor renal function
Dosage and streptococci, swelling, (especially in elderly
Administration: pneumococci, difficulty and renal-impaired
Adults: non-penicillina breathing) patients)
se-producing ●​ Severe
●​ Mild to diarrhea During Administration:
staphylococci,
moderate and (Clostridium
infections: difficile-associ ●​ Oral: Ensure the
Haemophilus
500–875 mg ated diarrhea) patient takes
influenzae
every 8–12 ●​ Liver medication as
●​ Ear, nose, and
hours (oral) dysfunction prescribed and
throat
●​ Severe (rare) completes the full
infections
infections: 1 g course
caused by
every 8 hours Rare: ●​ IV: Administer slowly
streptococci,
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

(oral) pneumococci, over 30 minutes and

non-penicillina ●​ Seizures (in monitor for allergic
Pediatric: se-producing high doses) reactions
staphylococci, ●​ Blood ●​ Monitor for side effects
●​ 20–40 and H. disorders (diarrhea, rash,
mg/kg/day in influenzae; (anemia, nausea)
divided doses GU infections thrombocytop
(depending on caused by enia) After Administration:
severity) Escherichia
coli, Proteus ●​ Observe for allergic
mirabilis, and reactions (rash,
Streptococcus difficulty breathing)
faecalis ●​ Assess for diarrhea or
●​ Eradication of gastrointestinal upset
Helicobacter ●​ Monitor for therapeutic
pylori to response (reduction in
reduce risk of fever, improvement in
duodenal infection symptoms.
ulcer
recurrence
●​ Post
Exposure
anthrax
prophylaxis
●​ Skin and
skin-structure
infections
caused by
streptococci
(alpha- and
beta-hemolyti
c strains),
staphylococci,
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

and E. coli

Patient Education:

●​ Take exactly as prescribed and do not stop early, even if symptoms improve
●​ If using oral suspension, shake well before measuring
●​ Report severe diarrhea or signs of an allergic reaction (rash, swelling, breathing difficulty)
●​ Store liquid form in the refrigerator and discard after 14 days
●​ Avoid taking with high-acidic drinks (e.g., soda, fruit juices) as they may affect absorption

Special Considerations:

●​ Elderly patients: Monitor renal function, as clearance may be reduced

●​ Pediatric patients: Dose adjusted based on weight
●​ Pregnancy: Category B (generally safe, but use only if needed)
●​ Renal impairment: Dose adjustment may be needed
●​ Liver disease: Use with caution, monitor liver function tests
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Inhibits HMG-CoA ●​ Adjunct to diet

Generic Name: reductase, which for controlling Common: Before Administration:
Atorvastatin catalyzes first step in LDL, total
cholesterol synthe- cholesterol, ●​ Headache ●​ Check baseline
Brand Names: sis; this action apo-lipoprotein ●​ Muscle pain cholesterol levels (LDL,
Lipitor reduces B, and ●​ Diarrhea HDL, triglycerides)
concentrations of triglyceride ●​ Nausea ●​ Assess liver function
Classification: serum cholesterol and levels and to tests (ALT, AST) before
low-density increase HDL Serious: starting therapy
Antilipidemic (Statin)
lipoproteins (LDLs), levels in patients ●​ Ask about muscle pain
linked to increased with primary ●​ Liver damage or history of liver
Dosage and
risk of coronary artery hypercholesterol (elevated disease
Administration:
disease (CAD). emia and mixed liver
enzymes) During Administration:
Oral (Tablets): Also moderately dyslipidemia;
increases primary ●​ Rhabdomyoly
sis (muscle ●​ Monitor for muscle
Adults: concentration dysbetalipoprote
breakdown pain, weakness, or dark
of high-density inemia in
leading to urine (signs of
●​ Initial dose: lipoproteins (HDLs), patients
kidney rhabdomyolysis)
10–20 mg once associated with unresponsive to
damage) ●​ Check liver function
daily decreased risk of diet alone;
●​ Memory loss tests regularly
●​ Severe cases: CAD. adjunct to diet to
or confusion ●​ Educate the patient to
40–80 mg once reduce elevated
(rare) report unexplained
daily triglyceride
fatigue or yellowing of
levels
the skin (signs of liver
Pediatric (10–17 ●​ Adjunct to other Rare:
years): damage)
lipid-lowering
treatments in ●​ Hypersensitiv
ity reactions After Administration:
●​ 10 mg once patients with
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

daily, max 20 homozygous (rash,

mg/day familial swelling) ●​ Evaluate cholesterol
hypercholesterol ●​ Severe levels after 4 weeks to
emia kidney assess effectiveness
●​ Adjunct to diet damage ●​ Continue monitoring for
to decrease total side effects (muscle
cholesterol, pain, liver issues)
LDL, and ●​ Reinforce lifestyle
apo-lipoprotein changes (healthy diet,
B levels in boys exercise) alongside
and medication
postmenarchal
girls ages 10 to
17 with familial
and nonfamilial
heterozygous
hypercholesterol
emia
●​ Prevention of
cardiovascular
disease in
patients without
clinically evident
coronary heart
disease (CHD)
but with multiple
CHD risk factors
●​ Prevention of
stroke and
myocardial
infarction in
patients with
type 2 diabetes
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

who have
multiple risk
factors for CHD
but without
clinically evident
CHD

Patient Education:

●​ Take at the same time every day for best results

●​ Avoid grapefruit juice and alcohol, as they can worsen liver damage
●​ Report any muscle pain, dark urine, or weakness immediately
●​ Continue healthy eating and exercise to support cholesterol control

Special Considerations:

●​ Elderly patients: Increased risk of muscle weakness and kidney damage

●​ Pediatric patients: Used with caution in children over 10 years old
●​ Pregnancy: Category X (not safe for pregnancy; can harm the fetus)
●​ Renal impairment: Increased risk of rhabdomyolysis; monitor kidney function
●​ Liver disease: Contraindicated in active liver disease; requires close monitoring
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING

ACTION INTERVENTIONS

Unclear. Thought to ●​ Acute pulmonary

Generic Name: inhibit sodium edema Common: Before Administration:
Furosemide and chloride reabsorption ●​ Edema caused by
from heart failure, ●​ Frequent ●​ Check blood
Brand Names: ascending loop of Henle hepatic cirrhosis, urination pressure and
Lasix and distal or renal disease ●​ Dizziness, heart rate (hold
renal tubules. Increases ●​ Hypertension headache if BP is too
Classification: potassium ●​ Low potassium low)
excretion and plasma (hypokalemia) ●​ Monitor
Loop Diuretic
volume, promot- ●​ Low blood potassium
ing renal excretion of pressure levels (normal:
Dosage and
water, sodium, (hypotension) 3.5–5.0
Administration:
chloride, magnesium, mEq/L)
Oral (Tablets or hydrogen, and Serious: ●​ Assess for
Solution): calcium. signs of
●​ Dehydration dehydration
Adults: and electrolyte (dry mouth,
imbalances dizziness, low
●​ Initial dose: ●​ Ototoxicity urine output)
20–80 mg once (hearing loss or
daily ringing in ears) During Administration:
●​ Maintenance ●​ Kidney damage
dose: up to 600 ●​ Give slow IV
mg/day (divided Rare: push (if IV) to
doses) prevent
●​ Allergic hearing loss
reactions (rash, ●​ Monitor urine
swelling) output and
electrolytes
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Pediatric: ●​ Muscle cramps ●​ Watch for

due to signs of
●​ 1–2 mg/kg per potassium loss hypokalemia
dose, max 6 (muscle
mg/kg/day weakness,
irregular
Intravenous (IV) / heartbeat)
Intramuscular (IM):
After Administration:
Adults:
●​ Recheck blood
●​ 20–40 mg pressure and
IV/IM, repeat potassium
every 2 hours levels
as needed ●​ Ensure patient
is hydrated but
Pediatric: not
overloaded.
●​ 1 mg/kg IV/IM, ●​ Monitor for
max 6 dizziness or
mg/kg/day falls, especially
in elderly
patients.

Patient Education:

●​ Take in the morning to avoid waking up at night to urinate

●​ Change positions slowly to prevent dizziness
●​ Eat potassium-rich foods (bananas, oranges) or take supplements if needed
●​ Report hearing changes (ringing, hearing loss) immediately
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Monitor daily weight (report weight gain of 2+ lbs in 24 hours)

Special Considerations:

●​ Elderly patients: Increased risk of dehydration and falls

●​ Pediatric patients: Use carefully, as they are prone to fluid imbalances
●​ Pregnancy: Category C (use only if necessary)
●​ Renal impairment: May need dose adjustment to prevent kidney damage
●​ Liver disease: Increased risk of electrolyte imbalance
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING

ACTION INTERVENTIONS

Inhibits conversion of ●​ Hypertension

Generic Name: angiotensin I to ●​ Heart failure Common: Before Administration:
Linosopril angiotensin II (a potent ●​ Adjunctive
vasoconstrictor), therapy after ●​ Cough (ACE ●​ Check blood
Brand Names: decreasing systemic acute myocardial inhibitor-induce pressure (hold if
Prinizil, Zestril vascular resistance, infarction. d dry cough) systolic BP <90
blood pressure, ●​ Dizziness, mmHg)
Classification: preload, and afterload. headache ●​ Assess potassium
Also inactivates ●​ Low blood levels (normal:
Angiotensin-Conve
bradykinin and other pressure 3.5–5.0 mEq/L)
rting Enzyme ●​ Evaluate kidney
vasodilatory (hypotension)
(ACE) Inhibitor, function (BUN,
prostaglandins, ●​ Fatigue
Antihypertensive creatinine levels)
increases
plasma renin levels, Serious: ●​ Ask about history of
Dosage and angioedema
and reduces aldos-
Administration: ●​ Angioedema (contraindicated if
terone levels.
(swelling of previous reaction)
Oral (Tablets or
Solution): face, lips,
tongue – During Administration:
Hypertension: life-threatening)
●​ Hyperkalemia ●​ Monitor blood
(high potassium pressure and heart
●​ Adults: 10–40
levels) rate
mg once daily
●​ Kidney ●​ Watch for signs of
●​ Pediatrics (≥6
dysfunction angioedema
years): 0.07
●​ Severe (swelling, difficulty
mg/kg once
breathing)
daily, max 5
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

mg/day hypotension ●​ Monitor potassium

levels (risk of
Heart Failure: Rare: hyperkalemia)

●​ Initial: 2.5–5 ●​ Liver toxicity After Administration:

mg once daily ●​ Blood disorders
●​ Maintenance: (leukopenia, ●​ Check for low blood
up to 40 anemia) pressure symptoms
mg/day (dizziness, fainting)
●​ Continue to monitor
Acute Myocardial renal function and
Infarction: electrolytes
●​ Watch for persistent
●​ Initial: 5 mg cough (may need
once daily, alternative
then increase medication)
gradually

Patient Education:

●​ Take at the same time daily for best results

●​ Avoid potassium-rich foods (bananas, oranges) and salt substitutes
●​ Change positions slowly to prevent dizziness
●​ Report any swelling of lips, face, or tongue immediately (angioedema risk)
●​ Do not stop abruptly (can cause rebound hypertension)
●​ If experiencing a persistent dry cough, talk to a doctor about alternatives
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Special Considerations:

●​ Elderly patients: Higher risk of hypotension and kidney dysfunction

●​ Pediatric patients: Use only in children ≥6 years
●​ Pregnancy: Category D (can cause fetal harm, discontinue immediately)
●​ Renal impairment: Dose adjustment required; avoid in severe kidney disease
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Blocks stimulation of ●​ Hypertension

Generic Name: beta1 (myocar- ●​ Angina pectoris Common: Before Administration:
Metoprolol dial) adrenergic receptors, ●​ MI
usually ●​ Symptomatic ●​ Fatigue, ●​ Check blood pressure
Brand Names: without affecting beta2 heart failure. dizziness and heart rate (hold if
Lopressor, (pulmonary, ●​ Low heart rate HR <60 bpm or BP
Toprol XL vascular, uterine) (bradycardia) <90/60 mmHg)
adrenergic receptor ●​ Hypotension ●​ Assess for history of
Classification: sites. ●​ Depression, asthma or COPD
confusion (beta-blockers can
Beta-blocker cause bronchospasm)
(Beta-1 Serious: ●​ Monitor kidney and
Adrenergic liver function
Antagonist), ●​ Heart block (metabolized by liver)
Antihypertensive ●​ Worsening ●​ Check for signs of
heart failure heart failure (edema,
Dosage and ●​ Bronchospasm weight gain, shortness
Administration: (especially in of breath)
asthma
Oral (Tablets, patients) During Administration:
Extended-Release
Tablets): ●​ Monitor blood pressure
Rare:
and heart rate
Hypertension: ●​ Hypoglycemia continuously if given IV
(especially in ●​ Watch for signs of
●​ Immediate bradycardia or
diabetics)
-release: hypotension
●​ Sexual
50–100 ●​ Assess for dizziness or
dysfunction
mg twice
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

daily ●​ Severe allergic fatigue

●​ Extended-r reactions
elease After Administration:
(Toprol
XL): ●​ Continue monitoring
25–100 BP and HR
mg once ●​ Educate patient about
daily symptoms of low blood
●​ Maximum pressure
dose: 400 ●​ Evaluate for worsening
mg/day heart failure (increased
shortness of breath,
Angina: edema)

●​ Initial: 50
mg twice
daily
●​ Maintenan
ce:
100–400
mg/day

Heart Failure
(HFrEF):

●​ Initial:
12.5–25
mg once
daily
●​ Target
dose: 200
mg once
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

daily

Myocardial
Infarction:

●​ Initial:
25–50 mg
every 6
hours,
then
switch to
maintenan
ce dose

Intravenous (IV)
Route:

Acute
Myocardial
Infarction:

●​ Initial: 5
mg IV
every 5
minutes
(up to
three
doses)
●​ Follow-up:
Switch to
oral dose
after
stabilizatio
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Patient Education:

●​ Do not stop taking suddenly (can cause rebound hypertension and tachycardia)
●​ Take with food to reduce stomach upset
●​ Monitor blood pressure and pulse at home
●​ Avoid activities requiring alertness until effects are known (dizziness possible)
●​ Diabetic patients: Monitor blood sugar carefully, as symptoms of hypoglycemia (tachycardia) may be masked
●​ Report severe dizziness, slow heartbeat, or difficulty breathing

Special Considerations:

●​ Elderly patients: Start at a lower dose due to increased risk of bradycardia and hypotension
●​ Pediatrics: Limited data on safety; only used in specific cases
●​ Pregnancy: Category C (use only if benefits outweigh risks)
●​ Renal impairment: No major adjustments needed, but monitor closely
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Promotes glucose ●​ Type 1

Regular Insulin transport, which (insulin-depend Common: Before Administration:
stimulates ent) diabetes
Generic Name: carbohydrate mellitus; type 2 ●​ Hypoglycemia ●​ Check blood glucose
Regular insulin metabolism in (non-insulin- (shakiness, levels (hold if <70
skeletal and cardiac dependent) sweating, mg/dL and notify
Brand Names: muscle and adi- diabetes confusion, provider)
Humulin R, Novolin pose tissue. Also mellitus tachycardia) ●​ Assess for
R promotes phosphory- unresponsive to ●​ Injection site hypoglycemia
lation of glucose in diet and oral reactions symptoms
NPH Insulin liver, where it is hypoglycemics (redness, ●​ Ensure patient has
converted to glycogen. ●​ Diabetic swelling) food available before
Generic Name: Directly affects ketoacidosis administering Regular
NPH insulin fat and protein insulin
metabolism, stimulates
Serious:
●​ Monitor potassium
Brand Names: protein synthesis, levels if given IV
●​ Severe
Humulin N, Novolin inhibits release of
hypoglycemia
free fatty acids, and
N
indirectly decreases
(seizures, During Administration:
unconsciousn
phosphate and
Classification: ess) ●​ Rotate injection sites
potassium.
Antidiabetic agent, ●​ Hypokalemia to prevent
Short-acting insulin (especially lipodystrophy
(Regular insulin), with IV insulin) ●​ Use correct syringe
Intermediate-acting ●​ Lipodystrophy (U-100 insulin syringe)
insulin (NPH insulin) (fat atrophy or ●​ If IV, monitor blood
hypertrophy at glucose every 30–60
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Dosage and injection site) minutes

Administration:
Regular Insulin Rare: After Administration:
(Short-Acting)
Subcutaneous (SC): ●​ Allergic ●​ Reassess blood
●​ Typical reactions glucose within peak
starting dose: (rash, difficulty action time
0.5–1 breathing) ●​ Observe for signs of
unit/kg/day ●​ Insulin hypoglycemia or
(divided resistance hypokalemia
doses) ●​ Educate patient about
●​ Given 30 self-administration
minutes techniques
before meals

Intravenous (IV):

●​ For
DKA/HHS: 0.1
units/kg IV
bolus,
followed by
continuous IV
infusion at 0.1
units/kg/hr
●​ For
hyperkalemia:
10 units IV
with glucose
to prevent
hypoglycemia
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

NPH Insulin
(Intermediate-Act
ing)
Subcutaneous (SC)
Only:

●​ Typical
starting dose:
0.1–0.2
units/kg once
or twice daily
●​ Often used in
combination
with Regular
insulin
●​ Administered
1–2 times
daily, usually
before
breakfast
and/or dinner

Patient Education:

●​ Recognize signs of hypoglycemia and treat with 15g of carbohydrates (juice, glucose tablets)
●​ Administer Regular insulin 30 minutes before meals
●​ NPH insulin should be taken at the same time each day
●​ Store unopened insulin in the refrigerator; opened vials can be kept at room temperature for 28 days
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Check blood glucose regularly and keep a log

Special Considerations:

●​ Elderly: Higher risk of hypoglycemia due to decreased renal function

●​ Pediatrics: Insulin doses may need frequent adjustments due to growth spurts
●​ Pregnancy: Insulin is the preferred treatment for gestational diabetes (safe in pregnancy)
●​ Renal Impairment: Lower doses may be required to prevent hypoglycemia
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Relaxes smooth ●​ To prevent

Generic Name: muscles by and relieve Common: Before Administration:
Albuterol stimulating bronchospas
beta2-receptors, m in patients ●​ Tremors ●​ Assess respiratory
Brand Names: thereby causing bron- with reversible ●​ Nervousness status (lung sounds,
Ventolin, ProAir, chodilation and obstructive ●​ Tachycardia oxygen saturation,
Proventil vasodilation. airway (rapid respiratory rate)
disease. heartbeat) ●​ Check heart rate and
Classification: ●​ To prevent ●​ Palpitations blood pressure (high
exercise-induc ●​ Dry mouth or doses may cause
Bronchodilator, Beta-2
ed throat irritation tachycardia)
adrenergic agonist
bronchospas ●​ Ensure proper inhaler
m technique for
Dosage and Serious:
Administration: metered-dose inhalers
●​ Paradoxical ●​ Monitor potassium
Inhalation (Preferred bronchospasm levels if using high
Route for Acute (worsening doses or IV
Symptoms) wheezing) – administration
discontinue
Metered-dose inhaler immediately During Administration:
(MDI): ●​ Hypertension
or hypotension ●​ Observe for immediate
●​ Adults & ●​ Cardiac relief of symptoms
children ≥4 arrhythmias (should improve within
years: 90 mcg ●​ Hypokalemia minutes)
per inhalation (low potassium ●​ Monitor for excessive
●​ Typical dose: 2 levels), nervousness or
inhalations especially with tremors
every 4–6 hours ●​ Ensure correct inhaler
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

as needed high doses use (deep inhalation

●​ Exercise-induce and holding breath for
d Rare: 10 seconds)
bronchospasm:
2 inhalations ●​ Allergic After Administration:
15–30 minutes reactions (rash,
before exercise swelling, ●​ Reassess respiratory
anaphylaxis) function (wheezing,
Nebulization (solution ●​ Hyperglycemia breathing effort)
for inhalation): ●​ Monitor heart rate
(watch for tachycardia
●​ Adults & or palpitations)
children ≥12 ●​ Educate patient on the
years: 2.5 mg importance of avoiding
every 6–8 hours overuse (can lead to
as needed tolerance or adverse
●​ Children 2–12 effects)
years: 1.25–2.5
mg every 4–6
hours as
needed

Oral (Less
Commonly Used)
Tablets:

●​ Adults: 2–4 mg
every 6–8 hours
●​ Extended-relea
se tablets: 4–8
mg every 12
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

hours
●​ Syrup (for
children):
Dosage based
on weight

Patient Education:

●​ Use only as prescribed – overuse can lead to severe side effects

●​ Wait at least 1 minute between puffs if more than one dose is needed
●​ For exercise-induced asthma, use inhaler 15–30 minutes before activity
●​ Report worsening symptoms (increased wheezing, difficulty breathing)
●​ Rinse mouth after use to prevent throat irritation
●​ Keep inhaler clean and check for medication levels regularly

Special Considerations:

●​ Elderly: Increased risk of cardiac effects (monitor for arrhythmias)

●​ Pediatrics: Safe for children but requires proper inhaler/spacer use
●​ Pregnancy: Generally considered safe (Category C), but use only if benefits outweigh risks
●​ Renal Impairment: No major adjustments, but monitor potassium levels carefully
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Prevents protein and ●​ Insulin-depen

Generic Name: nitrogen loss; dent Common: Before Administration:
Dextrose promotes glycogen hypoglycemia
deposition and ●​ Calorie ●​ Hyperglycemia ●​ Assess blood glucose
Brand Names: ketone accumulation replacement ●​ Irritation at the levels to confirm need
Dextrose Injection, (through IV site for dextrose
Dextrose 5% in osmotic diuretic action) ●​ Fluid overload ●​ Monitor electrolytes
Water (D5W), (especially in (especially potassium
Dextrose 10% in cardiac or renal levels) if using in
Water (D10W), patients) hyperkalemia
treatment
Dextrose 50% (D50)
Serious: ●​ Check IV site patency
Classification:Carbo (high concentrations
hydrate, Parenteral ●​ Rebound can cause tissue
nutritional agent, hypoglycemia damage if
Hypertonic, and (especially if extravasation occurs)
isotonic IV solution given rapidly)
(depending on ●​ Electrolyte During Administration:
concentration) imbalances
(hypokalemia ●​ Give slowly if using
Dosage and due to insulin high concentrations
Administration: secretion) (D50) to prevent
●​ Thrombophlebit complications
Dextrose 5% in is (vein irritation ●​ Monitor for signs of
Water (D5W): from high hyperglycemia
concentrations) (increased thirst, dry
●​ Used for fluid ●​ Pulmonary mouth, confusion)
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

replacement edema (if fluid ●​ Observe IV site for

and as a overload signs of irritation or
vehicle for occurs) extravasation
medications
●​ Rate: Based Rare: After Administration:
on fluid and
electrolyte ●​ Allergic ●​ Reassess blood
needs reactions (very glucose levels within
uncommon) 15–30 minutes
Dextrose 10% in ●​ Hyperosmolar ●​ Monitor for rebound
Water (D10W): syndrome (from hypoglycemia,
prolonged use especially in diabetics
●​ Used when of high ●​ Watch for signs of fluid
higher glucose concentrations) overload, particularly in
concentrations cardiac or renal
are needed patients
(e.g., total
parenteral
nutrition)

Dextrose 25% (D25):

●​ Used for
moderate
hypoglycemia
in pediatric
patients

Dextrose 50% (D50):

●​ Used for
severe
hypoglycemia
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Adults: 25–50
mL IV push
(each mL
contains 0.5 g
dextrose)
●​ Pediatrics:
0.5–1 g/kg IV
(often D10 or
D25 used)

Patient Education:
●​ If treating hypoglycemia, consume a balanced meal afterward to maintain glucose levels
●​ Monitor for symptoms of hyperglycemia (increased urination, thirst, confusion)
●​ Report any IV site pain, swelling, or redness
●​ For diabetic patients, adjust insulin doses if needed after receiving IV dextrose

Special Considerations:
●​ Elderly: Increased risk of fluid overload and hyperglycemia
●​ Pediatrics: Use diluted concentrations (D10 or D25) to prevent rapid shifts in glucose levels
●​ Pregnancy: Safe when used appropriately, but monitor for gestational diabetes risk
●​ Renal Impairment: Risk of fluid overload and electrolyte imbalances; use cautiously
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF ACTION INDICATION SIDE EFFECTS NURSING INTERVENTIONS

Interacts with opioid ●​ Severe to

Generic Name: receptor sites, moderate Common: Before Administration:
Morphine primarily in limbic system, pain
thalamus, ●​ Drowsiness, ●​ Assess pain level (use
Brand Names: and spinal cord. This dizziness a pain scale)
MS Contin, interaction alters ●​ Nausea, ●​ Monitor respiratory
Duramorph, neurotransmitter release, vomiting, rate, blood pressure,
Kadian, Roxanol altering per- constipation and heart rate
ception of and tolerance ●​ Itching ●​ Check for opioid
Classification: for pain. (pruritus) allergies or
Opioid analgesic, ●​ Dry mouth contraindications
Controlled ●​ Evaluate renal and
substance Serious: hepatic function
(Schedule II) (morphine is
●​ Respiratory metabolized in the liver
Dosage and depression and excreted by the
Administration: (major risk kidneys)
with high
Standard Adult doses) During Administration:
Dosages: ●​ Hypotension
(due to ●​ Monitor for respiratory
●​ Oral vasodilation) depression (hold dose
(Immediate ●​ Bradycardia if RR <10 bpm)
Release): ●​ Urinary ●​ Observe for excessive
10-30 mg retention sedation (risk of
every 4 ●​ Severe overdose)
hours as sedation/coma ●​ Assess for side effects
needed (in overdose (nausea, hypotension,
itching)
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Oral situations) ●​ Have naloxone

(Extended (Narcan) available in
Release): Rare: case of overdose
15-30 mg
every 8-12 ●​ Hallucinations After Administration:
hours ●​ Seizures
●​ IV/IM/Subc ●​ Anaphylaxis ●​ Monitor for pain relief
utaneous: (allergic effectiveness
2.5-10 mg reaction) ●​ Encourage fluids and
every 2-6 fiber intake to prevent
hours as constipation
needed ●​ Reassess vital signs
●​ Epidural: 5 regularly
mg initial ●​ Educate on fall
dose, can prevention due to
be repeated dizziness
as needed
●​ PCA
(Patient-Co
ntrolled
Analgesia):
Based on
patient
needs and
tolerance

Patient Education:
●​ Do not drive or operate heavy machinery while taking morphine
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Avoid alcohol and other CNS depressants (increases sedation risk)

●​ Take only as prescribed to prevent dependence or overdose
●​ Increase fluid, fiber, and exercise to prevent constipation
●​ Report any difficulty breathing, confusion, or severe drowsiness immediately

Special Considerations:
●​ Elderly: Higher risk of sedation, respiratory depression, and falls
●​ Pediatrics: Use weight-based dosing; monitor closely for respiratory effects
●​ Pregnancy: Category C (use only if benefits outweigh risks; may cause neonatal withdrawal if used
long-term)
●​ Renal Impairment: Increased risk of toxicity due to reduced clearance
●​ Liver Disease: Adjust dose as metabolism is affected
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Increases sodium and ●​ Edema

Generic Name: water excretion caused by Common: Before Administration:
Hydrochlorothiazide by inhibiting sodium heart failure,
(HCTZ) reabsorption in renal ●​ Hypokalemia ●​ Assess blood pressure
distal tubules; dysfunction, (low (hold if too low)
Brand Names: promotes excretion of cirrhosis, potassium) ●​ Check potassium,
Microzide, chloride, potassium, corticosteroid ●​ Dizziness, sodium, and renal
HydroDIURIL, magnesium, and therapy, or headache function (BUN,
bicarbonate. Also may estrogen ●​ Increased creatinine)
Oretic, Esidrix
produce arterio- therapy urination ●​ Assess for dehydration
lar dilation, reducing ●​ Mild to (polyuria) signs (dry mouth,
Classification:
blood pressure. moderate ●​ Fatigue dizziness, low urine
Thiazide diuretic,
hypertension output)
Antihypertensive
Serious:
Dosage and During Administration:
Administration: ●​ Severe
hypokalemia or ●​ Monitor blood pressure
Standard Adult hyponatremia and heart rate
Dosages: (can cause ●​ Observe for dizziness,
arrhythmias or weakness, or irregular
Hypertension: muscle heartbeats (signs of
weakness) electrolyte imbalance)
●​ 12.5-25 mg ●​ Orthostatic ●​ Encourage
orally once hypotension potassium-rich foods (if
daily, may (risk of falls in not contraindicated)
increase to 50 elderly) ●​ Monitor for signs of gout
●​ Hyperglycemia
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

mg daily in (caution in (joint pain, swelling)

divided doses diabetics)
●​ Gout After Administration:
Edema: (hyperuricemia)
●​ Monitor urine output
●​ 25-100 mg Rare: and weight (assess for
orally once dehydration)
daily or in ●​ Allergic ●​ Reassess blood
divided doses reactions (rash, pressure to ensure
anaphylaxis) effectiveness
Nephrogenic ●​ Pancreatitis ●​ Check for symptoms of
Diabetes Insipidus: ●​ Severe electrolyte imbalances
electrolyte
●​ 50-100 mg/day
imbalances
in divided
leading to
doses
arrhythmias

Patient Education:
●​ Take in the morning to avoid nighttime urination
●​ Rise slowly from sitting/lying positions to prevent dizziness (orthostatic hypotension)
●​ Increase potassium intake if needed (unless on potassium-sparing diuretics)
●​ Monitor blood pressure regularly at home
●​ Report any muscle weakness, irregular heartbeat, or severe dizziness
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Avoid excessive sun exposure (can cause photosensitivity)

Special Considerations:
●​ Elderly: Higher risk of dehydration and falls due to orthostatic hypotension
●​ Pediatrics: Use weight-based dosing; monitor electrolytes closely
●​ Pregnancy: Category B (generally safe, but only use if necessary)
●​ Renal Impairment: May cause worsening kidney function; monitor creatinine levels
●​ Diabetics: May increase blood glucose levels, requiring adjustments in diabetes medications
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING

ACTION INTERVENTIONS

Interferes with ●​ Venous

Generic Name: synthesis of vitamin thrombosis; Common: Before Administration:
Warfarin K–dependent clotting pulmonary
factors (II, VII, embolism; atrial ●​ Easy bruising ●​ Check baseline INR,
Brand Names: IX, and X) and fibrillation; and prolonged PT (prothrombin
Coumadin, Jantoven anticoagulant myocardial bleeding time), and liver
proteins infarction (MI); ●​ Nausea, function tests
Classification: C and S in liver thromboembolic vomiting ●​ Assess for history of
Anticoagulant (Vitamin K complications of ●​ Hair loss bleeding disorders or
antagonist), Blood cardiac valve (alopecia) recent surgery
thinner placement ●​ Ensure patient is not
Serious: pregnant
Dosage and (contraindicated in
Administration: ●​ Severe pregnancy)
bleeding (GI, ●​ Review medications
Standard Adult intracranial, and dietary intake for
Dosages: hematuria, possible interactions
epistaxis)
Initial dose: ●​ Warfarin-induc During Administration:
ed skin
●​ 2-5 mg orally necrosis (rare ●​ Monitor INR levels
once daily but serious, closely (adjust dose
usually in first as needed)
Maintenance dose: week of ●​ Watch for signs of
therapy) bleeding (gums,
●​ 2-10 mg orally ●​ Purple toe urine, stool, bruising,
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

once daily (based syndrome nosebleeds)

on INR (caused by ●​ Assess for symptoms
monitoring) cholesterol of thrombosis (chest
microemboliza pain, leg pain,
Target INR: tion) shortness of breath)

●​ 2.0-3.0 for most Rare: After Administration:

conditions (DVT,
PE, atrial ●​ Hepatitis (liver ●​ Monitor for adverse
fibrillation) dysfunction) effects like severe
●​ 2.5-3.5 for ●​ Hypersensitivit bleeding or necrosis
mechanical heart y reactions ●​ Educate patients on
valves (rash, fever, the importance of
anaphylaxis) INR monitoring
●​ Ensure follow-up for
dose adjustments

Patient Education:
●​ Take warfarin at the same time every day
●​ Keep a consistent diet in vitamin K intake (avoid sudden changes in green leafy vegetables)
●​ Monitor for signs of bleeding (black/tarry stools, prolonged nosebleeds, heavy menstruation)
●​ Avoid NSAIDs and aspirin unless prescribed (increase bleeding risk)
●​ Use soft toothbrush and electric razor to reduce bleeding risk
●​ Inform all healthcare providers before procedures (e.g., surgery, dental work)
●​ Carry a medical alert ID indicating warfarin use
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Report any unusual bruising, bleeding, or signs of stroke immediately

Special Considerations:
●​ Elderly: Increased bleeding risk; may require lower doses
●​ Pediatrics: Rarely used; requires careful monitoring
●​ Pregnancy: Contraindicated (Category X) – causes fetal abnormalities; use heparin instead
●​ Renal Impairment: Adjust dose based on INR monitoring
●​ Liver Disease: Use cautiously; liver function affects drug metabolism
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Inhibits thrombus by ●​ Therapeutic

Generic Name: preventing con- anticoagulation Common: Before Administration:
Heparin version of prothrombin ●​ To prevent
to thrombin thromboembolis ●​ Bleeding ●​ Check baseline aPTT,
Brand Names: and fibrinogen to m (bruising, platelet count, and
Hep-Lock, Hep-Pak fibrin, preventing ●​ To prevent blood gum hematocrit levels
clot formation. Doesn’t clotting during bleeding, ●​ Assess for signs of
Classification: lyse existing cardiovascular hematuria, active bleeding or
Anticoagulant clot, but prevents clot surgery epistaxis) bleeding disorders
(Unfractionated enlargement and ●​ I.V. flush ●​ Injection ●​ Verify correct dosage
Heparin), Blood thinner extension. site and infusion pump
reactions settings
Dosage and (redness,
Administration: pain, During Administration:
swelling)
Standard Adult ●​ Monitor aPTT levels
Dosages: Serious: every 6 hours (adjust
dosage accordingly)
Therapeutic IV dose: ●​ Heparin-ind ●​ Observe for signs of
uced bleeding (black/tarry
●​ Initial bolus: thrombocyto stools, hematuria,
5,000–10,000 penia (HIT) excessive bruising)
units IV (low platelet ●​ Monitor platelet count
●​ Continuous count for signs of HIT
infusion: 12–15 leading to ●​ Rotate injection sites
units/kg/hr, clot
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

adjusted based formation) if given SQ

on activated ●​ Severe
partial hemorrhage After Administration:
thromboplastin (GI
time (aPTT) bleeding, ●​ Continue monitoring
intracranial coagulation
Prophylactic hemorrhage parameters (aPTT,
Subcutaneous (SQ) ) platelets, hemoglobin)
dose: ●​ Osteoporosi ●​ Educate the patient
s (long-term about bleeding
●​ 5,000 units SQ use) precautions
every 8–12 ●​ Hypersensiti ●​ Ensure availability of
hours (for DVT vity protamine sulfate in
prevention) reactions case of overdose
(rash, fever,
Heparin flush (for IV anaphylaxis
patency): )

●​ 10–100
Rare:
units/mL
solution injected
●​ Alopecia
into IV catheters
(hair loss)
●​ Elevated
liver
enzymes
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Patient Education:
●​ Report any unusual bleeding or bruising immediately
●​ Avoid aspirin, NSAIDs, and other anticoagulants unless prescribed
●​ Use a soft toothbrush and electric razor to prevent bleeding
●​ Avoid activities that may cause injury (e.g., contact sports)
●​ Inform healthcare providers before surgeries or dental work

Special Considerations:
●​ Elderly: Increased risk of bleeding; require close monitoring
●​ Pediatrics: Adjust dose based on weight; close monitoring needed
●​ Pregnancy: Safe to use (does not cross placenta, unlike warfarin)
●​ Renal Impairment: Dose adjustments may be needed in severe renal dysfunction
●​ Liver Disease: Use cautiously as liver dysfunction can affect clotting factors
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Blocks serotonin at ●​ To prevent

Generic Name: 5-HT3 receptor sites nausea and Common: Before Administration:
Ondansetron in vagal nerve vomiting caused
terminals by by moderately ●​ Headache ●​ Assess baseline ECG
Brand Names: disrupting emetogenic ●​ Dizziness if the patient is at risk
Zofran, Zofran ODT, CNS chemoreceptor chemotherapy ●​ Fatigue for QT prolongation
Zuplenz trigger zone. ●​ To prevent ●​ Constipation ●​ Check for history of
nausea and or diarrhea hepatic impairment
Classification: vomiting caused (dose adjustment
Antiemetic, Selective by highly needed)
emetogenic
Serious:
5-HT3 receptor ●​ Assess for other
antagonist chemotherapy medications that may
●​ QT
prolongation increase serotonin
Dosage and (risk of levels (e.g., SSRIs,
Administration: Torsades de SNRIs, MAOIs)
Pointes)
Standard Adult ●​ Serotonin During Administration:
Dosages: syndrome (if
combined with ●​ Monitor for signs of
Chemotherapy-Induc other allergic reactions
ed Nausea and serotonergic (rash, swelling,
Vomiting (CINV): drugs) difficulty breathing)
●​ Severe ●​ Monitor ECG for QT
●​ Oral: 8 mg 30 hypotension prolongation in
minutes before ●​ Bronchospas high-risk patients
chemotherapy, m (rare ●​ Assess for symptom
allergic relief of nausea and
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

then 8 mg reaction) vomiting

every 8 hours
●​ IV: 0.15 mg/kg Rare: After Administration:
(max 16
mg/dose) 30 ●​ Extrapyramida ●​ Monitor for side effects
minutes before l symptoms such as headache and
chemotherapy (EPS), such dizziness
as involuntary ●​ Evaluate for bowel
Radiation-Induced muscle function (constipation
Nausea and movements risk)
Vomiting: ●​ Hepatic ●​ Continue to assess for
enzyme any drug interactions
●​ Oral: 8 mg 1–2 elevations or adverse effects
hours before
radiation, then
every 8 hours

Postoperative
Nausea and Vomiting
(PONV):

●​ IV: 4 mg slow
IV push before
anesthesia
induction or
postoperatively
●​ Oral: 16 mg 1
hour before
anesthesia

Pediatric Dosage:

●​ CINV: 0.15
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

mg/kg IV (max
16 mg)
●​ PONV: 0.1
mg/kg IV (max
4 mg)

Patient Education:
●​ Take as prescribed before chemotherapy, radiation, or surgery
●​ Avoid driving if dizziness occurs
●​ Report any heart palpitations or fainting episodes (QT prolongation risk)
●​ Increase fluid and fiber intake to prevent constipation
●​ Inform healthcare provider about all medications to avoid serotonin syndrome

Special Considerations:
●​ Elderly: Increased risk of QT prolongation; monitor ECG closely
●​ Pediatrics: Approved for nausea and vomiting but requires weight-based dosing
●​ Pregnancy: Generally considered safe (category B), commonly used for hyperemesis gravidarum
●​ Hepatic Impairment: Maximum daily dose should not exceed 8 mg in severe liver disease
●​ Renal Impairment: No significant dosage adjustments needed
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Reduces gastric acid ●​ Erosive

Generic Name: secretion and esophagitis Common: Before Administration:
Pantoprazole increases gastric caused by
mucus and bicarbon- gastroesophag ●​ Headache ●​ Assess for history of
Brand Names: ate production, eal reflux ●​ Diarrhea GERD, ulcers, or
Protonix creating protective disease ●​ Nausea Zollinger-Ellison
coating on gastric (GERD) ●​ Abdominal syndrome
Classification: mucosa ●​ Pathologic pain ●​ Check for allergies to
Proton pump inhibitor hypersecretory PPIs (e.g., omeprazole,
(PPI), conditions lansoprazole)
Serious:
Gastroesophageal ●​ Review patient’s
reflux disease (GERD) ●​ Clostridium medication list for
treatment agent difficile-assoc interactions (e.g.,
iated diarrhea warfarin, clopidogrel)
Dosage and (CDAD)
Administration: ●​ Hypomagnes During Administration:
emia (low
Standard Adult magnesium ●​ Monitor for relief of
Dosages: levels), GERD symptoms
leading to (heartburn, regurgitation,
GERD & Erosive muscle pain relief)
Esophagitis: cramps or ●​ Assess bowel function
arrhythmias for signs of Clostridium
●​ Oral: 40 mg ●​ Vitamin B12 difficile infection
once daily for deficiency (persistent diarrhea)
up to 8 weeks with ●​ Monitor magnesium
●​ IV: 40 mg once long-term use levels in patients on
daily for up to 7 ●​ Osteoporosis
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

days and fractures long-term therapy

(long-term
Zollinger-Ellison use risk) After Administration:
Syndrome ●​ Kidney
(Hypersecretory damage (rare ●​ Monitor for headache,
Conditions): but possible) dizziness, or
gastrointestinal upset
●​ Oral/IV: 40 mg Rare: ●​ Evaluate long-term users
twice daily for potential B12
(may increase ●​ Severe deficiency or bone health
as needed) allergic issues
reactions ●​ Educate patients on
Peptic Ulcer Disease (anaphylaxis, dietary calcium and
(PUD) (H. pylori angioedema) magnesium intake
eradication with ●​ Liver enzyme
antibiotics): abnormalities
●​ Oral: 40 mg
once daily for
10-14 days (in
combination
with amoxicillin
and
clarithromycin)

Patient Education:
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Take the medication before meals for best effect

●​ Do not crush, split, or chew tablets
●​ Report persistent diarrhea, as this may indicate an infection
●​ Avoid long-term use unless directed by a provider (risk of osteoporosis and B12 deficiency)
●​ Inform the provider of all medications being taken (may interact with blood thinners and antifungals)
●​ Increase dietary intake of calcium and magnesium if using long-term

Special Considerations:
●​ Elderly: Higher risk of osteoporosis and fractures; monitor bone density
●​ Pediatrics: Not commonly used in children under 5 years old unless prescribed for severe conditions
●​ Pregnancy: Generally considered safe (Category B), but use only if necessary
●​ Renal Impairment: No major dosage adjustments needed, but monitor for hypomagnesemia
●​ Hepatic Impairment: Dose adjustment may be needed in severe liver disease
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Inhibits platelet ●​ Recent

Generic Name: aggregation by myocardial Common: Before Administration:
Clopidogrel block- infarction (MI)
ing binding of or stroke or ●​ Easy bruising ●​ Assess for history of
Brand Names: adenosine established ●​ Minor bleeding bleeding disorders or
Plavix diphosphate peripheral (e.g., nosebleeds, recent surgery
to platelets, thereby arterial gum bleeding) ●​ Check baseline platelet
Classification: preventing throm- disease ●​ Diarrhea count and liver function
Antiplatelet agent, bus formation. ●​ Acute coronary tests
P2Y12 platelet syndrome ●​ Evaluate for medication
(ACS)
Serious:
inhibitor interactions (e.g.,
●​ Severe bleeding NSAIDs, warfarin,
Dosage and (e.g., omeprazole,
Administration: gastrointestinal or pantoprazole – can
intracranial affect metabolism)
Standard Adult hemorrhage)
Dosages: ●​ Thrombotic During Administration:
thrombocytopenic
Acute Coronary purpura (TTP) – ●​ Monitor for signs of
Syndrome (ACS): rare but excessive bleeding
life-threatening (e.g., prolonged
●​ Loading dose: ●​ Hepatic bleeding, black/tarry
300–600 mg dysfunction (rare stools, blood in urine)
orally once liver toxicity) ●​ Ensure the patient is
●​ Maintenance not taking another
dose: 75 mg antiplatelet or
orally once anticoagulant unless
daily prescribed
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Stroke, TIA, or PAD: After Administration:

●​ 75 mg orally ●​ Educate patient on
once daily bleeding precautions
(e.g., use a soft
toothbrush, avoid
contact sports)
●​ Monitor hemoglobin
and hematocrit levels
for occult bleeding
●​ Check for signs of TTP
(fever, confusion,
purpura, low platelet
count)

Patient Education:
●​ Take medication exactly as prescribed; do not stop abruptly without consulting a provider
●​ Report any unusual bleeding or bruising immediately
●​ Avoid NSAIDs or aspirin unless directed by a doctor (increases bleeding risk)
●​ Inform healthcare providers before any surgery or dental procedure
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Special Considerations:
●​ Elderly: Increased bleeding risk; monitor closely
●​ Pediatrics: Not typically used in children
●​ Pregnancy: Category B, use only if benefits outweigh risks
●​ Renal Impairment: Use with caution; may increase bleeding risk
●​ Hepatic Impairment: Reduced drug activation in severe liver disease
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Interferes with ●​ Infections of

Generic Name: bacterial cell-wall syn- respiratory Common: Before Administration:
Ceftriaxone thesis and division by system,bones,
binding to cell joints, and skin; ●​ Injection site ●​ Assess for penicillin or
Brand Names: wall, causing cell to septicemia. reactions cephalosporin allergies
Rocephin die. Active against ●​ Uncomplicated (pain, (risk of cross-reactivity)
gram-negative and gonorrhea swelling, ●​ Check renal and liver
Classification: gram-positive ●​ Surgical redness) function tests (monitor
Third-generation bacteria, with prophylaxis ●​ Diarrhea for toxicity in high doses
cephalosporin expanded activity ●​ Meningitis ●​ Nausea/vomiti or prolonged use)
antibiotic, Beta-lactam against gram-negative ●​ Otitis media ng ●​ Verify the correct
antibiotic bacteria. ●​ Skin and ●​ Headache dilution and
Exhibits minimal skin-structure compatibility for IV
Dosage and immunosuppres- infections administration
sant activity. ●​ Other serious
Serious:
Administration:
infections
●​ Clostridium During Administration:
Standard Adult difficile (C.
Dosages: diff) infection ●​ Monitor for signs of an
(risk of severe allergic reaction (rash,
General Infections: diarrhea and itching, swelling,
colitis) difficulty breathing)
●​ 1–2 g IV/IM ●​ Anaphylaxis ●​ Assess for diarrhea
once daily or severe (possible C. diff
allergic infection)
Severe Infections reactions ●​ Observe IV site for
(e.g., Meningitis, (rash, phlebitis or irritation
Sepsis): swelling,
difficulty
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ 2 g IV every breathing) After Administration:

12 hours ●​ Kidney toxicity
(especially in ●​ Monitor renal function
Gonorrhea: patients with (especially in elderly
pre-existing and patients with kidney
●​ 500 mg IM as renal disease) disease)
a single dose ●​ Gallbladder ●​ Assess for new or
sludge and worsening infections
Surgical pseudolithiasi (signs of superinfection
Prophylaxis: s (may cause such as oral thrush or
gallbladder vaginal yeast infections)
●​ 1 g IV 30–120 pain, ●​ Encourage hydration to
minutes before particularly in help prevent kidney and
surgery children) gallbladder
●​ Hemolytic complications
anemia (rare
but serious
destruction of
red blood
cells)

Rare:
●​ Stevens-John
son
Syndrome
(SJS) / Toxic
Epidermal
Necrolysis
(TEN)
●​ Severe
Hemolytic
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Anemia
●​ Agranulocytos
is
●​ Interstitial
●​ Nephritis
●​ Pancreatitis
●​ Neurotoxicity
(Seizures,
Encephalopat
hy)
●​ Gallbladder
●​ Pseudolithiasi
s (Sludge
Formation)

Patient Education:
●​ Complete the full course of antibiotics, even if symptoms improve
●​ Report any severe diarrhea, as it may indicate a C. difficile infection
●​ Notify the provider of any new rash, swelling, or breathing difficulties
●​ If receiving an IM injection, expect some discomfort at the injection site
●​ Avoid alcohol during treatment to prevent nausea, vomiting, and liver toxicity
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Special Considerations:
●​ Elderly: Increased risk of kidney toxicity; monitor renal function
●​ Pediatrics: Avoid in neonates (<28 days) if receiving calcium-containing IV solutions (risk of precipitation in
the lungs and kidneys)
●​ Pregnancy: Generally considered safe (Category B), but use with caution
●​ Renal Impairment: Adjust dosage if severe renal dysfunction is present
●​ Hepatic Impairment: Use with caution in patients with severe liver disease
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Bactericidal and ●​ Bacterial

Generic Name: bacteriostatic; conjunctivitis Common: Before Administration:
Azithromycin inhibits caused by CDC
protein synthesis coryneform ●​ Nausea, ●​ Assess for history of
Brand Names: after binding with group G, H. vomiting, hypersensitivity to
Zithromax, Z-Pak, 50S influenzae, S. diarrhea macrolides
ribosomal subunit of aureus, ●​ Abdominal ●​ Check liver function
AzaSite (ophthalmic),
susceptible Streptococcus pain tests (ALT, AST) in
Zmax ●​ Headache long-term use
organisms. mitis group, and
Demonstrates cross- S. pneumoniae ●​ Review ECG if patient
Classification:
resistance to ●​ Mild Serious: is at risk for QT
Macrolide antibiotic prolongation
erythromycin-resista community-acqui
nt red pneumonia ●​ QT
Dosage and prolongation During Administration:
Administration: gram-positive strains ●​ Community-acqu
and resistance to ired pneumonia (risk of
most strains of caused by arrhythmias ●​ Monitor for signs of
Oral: like torsades an allergic reaction
Enterococcus Chlamydia
faecalis and pneumoniae, de pointes) (rash, swelling,
●​ Standard dose:
methicillin-resistant Haemophilus ●​ Hepatotoxicity anaphylaxis)
500 mg on day
Staphylococcus influenzae, (elevated liver ●​ Observe for GI
1, followed by
aureus. Mycoplasma enzymes, liver distress and
250 mg once
pneumoniae, failure) encourage hydration
daily for 4 days
Streptococcus ●​ Clostridioides ●​ If IV, administer slowly
(Z-Pak)
pneumoniae, difficile-associa over 1 hour to reduce
●​ For chlamydia:
Legionella ted diarrhea phlebitis risk
Single 1 g
pneumophila, (C. diff
(1000 mg) oral After Administration:
Moraxella infection)
dose
●​ For catarrhalis, and
S. aureus Rare: ●​ Monitor liver function
Mycobacterium in prolonged therapy
●​ Pharyngitis and
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

avium complex tonsillitis ●​ Stevens-Johns ●​ Assess for signs of

(MAC) ●​ Acute bacterial on Syndrome superinfection (e.g.,
prophylaxis: sinusitis (SJS) / Toxic oral thrush, vaginal
1200 mg once ●​ Mild to moderate Epidermal yeast infection)
weekly acute Necrolysis ●​ Educate the patient
exacerbation of (TEN) about completing the
Intravenous (IV): chronic ●​ Cholestatic full antibiotic course
obstructive jaundice
●​ Pneumonia: pulmonary ●​ Hearing loss
500 mg IV daily disease (reversible)
for at least 2 ●​ Pelvic
days, then inflammatory
switch to oral disease caused
therapy by Chlamydia
●​ Pelvic trachomatis,
inflammatory Neisseria
disease: 500 gonorrhoeae, or
mg IV daily for Mycoplasma
1-2 days, hominis
followed by oral ●​ Nongonococcal
therapy urethritis or
cervicitis caused
Ophthalmic (AzaSite): by C.
trachomatis;
●​ One drop in the genital ulcers
affected eye(s) caused by
twice daily for 2 Haemophilus
days, then once ducreyi
daily for 5 days (chancroid)
●​ Urethritis and
cervicitis caused
by
N. gonorrhoeae
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ To prevent
disseminated
Mycobacterium
avium complex
disease in
patients with
advanced human
immunodeficienc
y virus
●​ Acute otitis
media

Patient Education
●​ Take medication as prescribed; do not skip doses
●​ Report any severe diarrhea (possible C. diff infection)
●​ Avoid excessive sun exposure (risk of photosensitivity)
●​ If taking antacids, separate administration by at least 2 hours

Special Considerations
●​ Elderly: Increased risk of QT prolongation
●​ Pediatric: Can be used in children; dosing based on weight
●​ Pregnancy: Generally safe (Category B) but should be used only if necessary
●​ Renal Impairment: No dosage adjustment needed unless severe renal failure
●​ Hepatic Impairment: Use cautiously in patients with liver disease
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Synthetic form of ●​ Hypothyroidis

Generic Name: thyroxine that m; treatment Common: Before Administration:
Levothyroxine replaces or prevention
endogenous of euthyroid ●​ Insomnia ●​ Assess baseline TSH, T3,
Brand Names: thyroxine, goiter ●​ Weight loss and T4 levels
Synthroid, Levoxyl, increasing thyroid Congenital ●​ Nervousness ●​ Check heart rate and blood
Tirosint, Euthyrox, hormone levels. hypothyroidis ●​ Palpitations pressure (hold if HR >100
Unithroid Thyroid hormones m ●​ Increased bpm)
help regulate cell ●​ Myxedema appetite ●​ Verify patient history of
Classification: growth and coma or cardiovascular disease
differentiation and stupor
Thyroid hormone
increase ●​ Thyroid-stimul
Serious:
replacement, metabolism of lipids, ating hormone
During Administration:
Synthetic thyroxine ●​ Cardiovascul
protein, suppression in
(T4) ar: ●​ Administer in the morning
and carbohydrates. well-differentia
Tachycardia, before meals
ted thyroid
Dosage and arrhythmias, ●​ Ensure patient does not
cancers and
Administration: angina, take with calcium, iron, or
thyroid
hypertension antacids
nodules
●​ Endocrine: ●​ Monitor for early signs of
Standard Dosage
Symptoms of overdose (nervousness,
Ranges: hyperthyroidis tachycardia)
m if
Adults overdosed
(Hypothyroidism): After Administration:
●​ Neurologic:
Seizures ●​ Recheck TSH levels in 4-6
●​ Initial: 25–50 (rare)
mcg/day weeks to adjust dosage
●​ Maintenance: ●​ Monitor for adverse effects
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

100–125 Rare: (arrhythmias,

mcg/day hyperthyroidism
●​ Maximum: ●​ Allergic symptoms)
Adjust based reactions ●​ Educate on the importance
on TSH levels (rash, of lifelong therapy
(target: swelling) adherence
0.5–2.5 mU/L) ●​ Osteoporosis
(long-term
Pediatric high doses)
(Congenital
Hypothyroidism):

●​ 10–15
mcg/kg/day

Myxedema Coma (IV

Route):

●​ Initial:
200–500 mcg
IV, followed by
50–100 mcg
IV daily

Patient Education:
●​ Take the medication at the same time daily, preferably before breakfast
●​ Do not stop abruptly; therapy is usually lifelong
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Report symptoms of overdose (rapid heartbeat, tremors) or underdose (fatigue, weight gain)
●​ Avoid grapefruit juice, calcium, iron, and high-fiber meals close to administration
●​ Pregnancy safe, but dose adjustments may be needed

Special Considerations:
●​ Elderly: Start with lower doses to avoid cardiovascular strain
●​ Pregnancy: Category A (safe); dose may need increase due to higher metabolic demands
●​ Pediatrics: Required for normal growth and brain development
●​ Renal Impairment: Adjust doses cautiously to prevent toxicity
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Decreases ●​ Severe
Generic Name: inflammation by inflammation; Common: Before Administration:
Prednisone reversing immunosuppr
increased cell ession ●​ Increased ●​ Assess baseline weight,
Brand Names: capillary permeability ●​ Acute appetite, weight blood pressure, and
Deltasone, Rayos, and inhibiting exacerbation gain glucose levels
Sterapred migration of of multiple ●​ Insomnia ●​ Check for history of
polymorphonuclear sclerosis ●​ Hyperglycemia diabetes, hypertension, or
Classification: leukocytes. ●​ Adjunctive ●​ Fluid retention peptic ulcers
Corticosteroid, Suppresses therapy for (swelling) ●​ Evaluate for active
anti-inflammatory, immune system by Pneumocystis ●​ Mood changes infections (prednisone
Glucocorticoid reducing lymphatic jiroveci (anxiety, suppresses immunity)
activity. pneumonia in irritability)
Dosage and AIDS patients
During Administration:
Administration: Serious:
●​ Administer with food to
Standard ●​ Cardiovascular: prevent GI distress
Dosage Hypertension, ●​ Monitor blood sugar
Ranges: arrhythmias levels (especially in
●​ Endocrine: diabetic patients)
Adults (General Adrenal ●​ Watch for signs of
Inflammatory suppression, Cushing’s syndrome
Conditions): Cushing’s (moon face, truncal
syndrome obesity)
●​ Mild-modera (long-term use)
te: 5–60 ●​ Gastrointestinal: After Administration:
mg/day PO Peptic ulcers,
GI bleeding
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

(individualize ●​ Musculoskeletal
d dosing) : Osteoporosis, ●​ Gradually taper dose if
●​ Severe muscle wasting therapy exceeds 2 weeks
cases (e.g., ●​ Immune: ●​ Monitor for adrenal
asthma Increased risk insufficiency (fatigue,
exacerbation of infections hypotension)
): 40–60 ●​ Educate on infection
mg/day for prevention (avoid crowds,
Rare: proper hygiene)
3–10 days
●​ Pediatric ●​ Vision changes
(Asthma, (cataracts,
Autoimmune glaucoma)
Conditions): ●​ Avascular
0.5–2 necrosis of
mg/kg/day bone (long-term
PO, divided high-dose use)
into 1–2
doses

Patient Education:
●​ Take with food to prevent stomach irritation
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Do not stop abruptly; follow the tapering schedule

●​ Report signs of infection (fever, sore throat)
●​ Monitor for weight gain, mood changes, or vision problems
●​ Long-term use may lead to osteoporosis—increase calcium and vitamin D intake

Special Considerations:
●​ Elderly: Increased risk of osteoporosis and fractures
●​ Pediatrics: May cause growth suppression with long-term use
●​ Pregnancy: Category C; use only if benefits outweigh risks
●​ Renal Impairment: No major adjustments needed, but monitor for fluid retention
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Increases force and ●​ Heart failure;

Generic Name: velocity of myocar- tachyarrhyth Common: Before Administration:
Digoxin dial contraction and mias; atrial
prolongs refrac- fibrillation ●​ Fatigue ●​ Check apical pulse for 1
Brand Names: tory period of and flutter; ●​ Nausea, vomiting, full minute (hold if HR < 60
Lanoxin, Digitek atrioventricular (AV) paroxysmal diarrhea bpm)
node by increasing atrial ●​ Headache ●​ Assess potassium levels
Classification: calcium entry into tachycardia ●​ Dizziness (hypokalemia increases
Antiarrhythmic, myocardial cells. toxicity risk)
Inotropic Agent, Slows conduction ●​ Monitor renal function
through sinoatrial
Serious:
Cardiac Glycoside (digoxin is excreted
and AV nodes and renally)
●​ Cardiovascular:
Dosage and produces
Bradycardia,
Administration: antiarrhythmic
effect.
arrhythmias During Administration:
●​ Neurologic:
Standard Confusion, visual ●​ Monitor for signs of toxicity
Dosage disturbances (anorexia, vision changes,
Ranges: (yellow-green bradycardia)
halos) ●​ If given IV, administer
Heart Failure ●​ Toxicity: Digoxin slowly over 5 minutes
(Adults): toxicity (nausea, ●​ Ensure continuous ECG
bradycardia, monitoring if IV route is
●​ Loading vision changes) used
dose: 0.5–1
mg PO or IV, Rare: After Administration:
divided into
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

doses over
24 hours ●​ Allergic reactions ●​ Monitor digoxin levels
●​ Maintenance ●​ Severe (therapeutic range: 0.5–2
dose: thrombocytopenia ng/mL)
0.125–0.25 ●​ Educate patient on toxicity
mg PO daily symptoms
●​ Monitor potassium levels
Atrial Fibrillation (hypokalemia worsens
(Adults): toxicity)

●​ 0.125–0.5
mg PO daily

Patient Education:
●​ Take at the same time each day
●​ Do not double doses if a dose is missed
●​ Report nausea, dizziness, or vision changes
●​ Avoid antacids and high-fiber foods (affect absorption)
●​ Regularly check heart rate before taking

Special Considerations:
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Elderly: Higher risk of toxicity due to decreased renal function

●​ Pediatrics: Dose based on weight (mcg/kg/day)
●​ Pregnancy: Category C; used only if benefits outweigh risks
●​ Renal Impairment: Adjust dose to prevent toxicity
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Inhibits influx of ●​ Essential

Generic Name: extracellular calcium hypertensio Common: Before Administration:
Amlodipine ions, thereby n, chronic
decreasing stable ●​ Dizziness, ●​ Check blood pressure and
Brand Names: myocardial angina headache heart rate (hold if SBP <
Norvasc contractility, relaxing pectoris, ●​ Peripheral 90 mmHg)
coronary and and edema ●​ Assess for peripheral
Classification: vascular muscles, vasospastic (swelling in edema
Antihypertensive, and decreasing L angina ankles/feet) ●​ Review liver function tests
Calcium Channel peripheral resistance (Prinzmetal’ ●​ Flushing (LFTs)
Blocker (CCB) s angina) ●​ Fatigue
During Administration:
Dosage and Serious:
Administration: ●​ Monitor blood pressure
●​ Cardiovascula response to treatment
Standard Dosage r: ●​ Assess for signs of
Ranges: Hypotension, hypotension (dizziness,
palpitations lightheadedness)
Hypertension & ●​ Neurologic: ●​ Watch for worsening
Angina (Adults): Severe edema
dizziness,
●​ Initial: 2.5–5 mg syncope After Administration:
PO once daily ●​ Rare but
●​ Maximum: 10 severe: ●​ Reassess BP & HR
mg PO once Hepatic regularly
daily dysfunction, ●​ Monitor for flushing and
jaundice headache, which may
Pediatric indicate excessive
Hypertension (Ages vasodilation
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

6–17 years): ●​ Educate on lifestyle

modifications for
●​ 2.5–5 mg PO hypertension (diet,
once daily exercise)

Patient Education:
●​ Take medication at the same time daily
●​ Rise slowly to prevent dizziness
●​ Avoid grapefruit juice (may increase drug levels)
●​ Monitor swelling in feet or ankles
●​ Report severe dizziness or palpitations

Special Considerations:
●​ Elderly: Increased risk of hypotension and falls
●​ Pediatrics: Limited data, but used in children ≥6 years
●​ Pregnancy: Category C; use only if benefits outweigh risks
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Renal Impairment: No dose adjustment needed

 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Reduces gastric acid ●​ Active

Generic Name: secretion and duodenal Common: Before Administration:
Ranitidine increases gastric ulcer
mucus and ●​ To ●​ Headache ●​ Assess history of ulcers or
Brand Names: bicarbonate maintain ●​ Nausea, GERD symptoms
Zantac production, creating a healing of vomiting ●​ Monitor liver function tests
protective coat- duodenal ●​ Diarrhea or (LFTs)
Classification: ing on gastric mucosa ulcers constipation ●​ Check renal function in
Antiulcer agent, ●​ Benign elderly patients
Histamine-2 Receptor gastric
ulcer
Serious:
Antagonist (H2 During Administration:
Blocker) ●​ Active
●​ Hepatotoxicity
duodenal
(liver ●​ Monitor for GI symptoms
Dosage and and
dysfunction, (persistent pain, bleeding)
Administration: gastric
jaundice) ●​ Watch for mental status
ulcers
●​ Blood changes in elderly patients
Standard Dosage ●​ To
disorders ●​ If given IV, monitor for
maintain
Ranges (Before healing of
(thrombocytop hypotension and arrhythmias
Market enia,
duodenal
agranulocytosi After Administration:
Withdrawal): and gastric ulcers
s)
●​ Erosive
●​ Confusion, ●​ Evaluate symptom relief
GERD & Ulcers esophagiti
especially in (heartburn, ulcer healing)
(Adults): s
elderly ●​ Monitor for adverse effects
●​ Gastroeso
●​ 150 mg PO patients (jaundice, confusion,
phageal
BID or 300 mg reflux bleeding)
PO once daily disease Rare: ●​ Educate on the recall and
(at bedtime) ●​ alternative medications
Pathologic ●​ Cardiac
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

IV Administration hypersecr arrhythmias

(Hospital Setting): etory (especially
conditions, with IV use)
●​ 50 mg IV every including ●​ Acute
6–8 hours Zollinger-E interstitial
(infused over 5 llison nephritis
minutes) syndrome (kidney
inflammation)

Patient Education:
●​ Take as prescribed, preferably at bedtime
●​ Avoid NSAIDs and alcohol, which can worsen ulcers
●​ Report black/tarry stools or vomiting blood
●​ Long-term use may increase the risk of infections and B12 deficiency
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Special Considerations:
●​ Elderly: Higher risk of confusion and renal impairment
●​ Pediatrics: Used cautiously in children for GERD
●​ Pregnancy: Category B (was considered safe before withdrawal)
●​ Renal Impairment: Dose adjustments required
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Causes ●​ Shock;
Generic Name: norepinephrine hemodynamic Common: Before Administration:
Dopamine release (mainly imbalance;
on dopaminergic hypotension; ●​ Tachycardia, ●​ Assess baseline blood
Brand Names: receptors), leading to heart failure palpitations pressure and heart rate
Intropin vasodilation of renal ●​ Hypertension ●​ Ensure patent IV access
and mesenteric ●​ Nausea, (preferably central line)
Classification: arteries. Also exerts vomiting ●​ Monitor for signs of
Vasopressor, inotropic effects on hypovolemia (administer
Inotropic Agent, heart, which fluids first)
increases the heart
Serious:
Adrenergic Agonist
(Sympathomimetic) rate,
blood flow,
●​ Arrhythmias During Administration:
(ventricular
Dosage and myocardial
tachycardia, ●​ Monitor BP, HR, and ECG
Administration: contractility,
fibrillation) continuously
and stroke volume.
●​ Severe ●​ Titrate dose based on BP
Standard Dosage hypertension and urine output
Ranges (IV → risk of ●​ Watch for extravasation (if
Infusion Only): stroke it occurs, administer
●​ Peripheral phentolamine to prevent
Shock & ischemia (at necrosis)
Hypotension: high doses
due to After Administration:
●​ Initial: 2–5 vasoconstricti
mcg/kg/min IV on) ●​ Reassess vital signs and
●​ Titrate up to ●​ Extravasation perfusion
20 → tissue ●​ Monitor renal function
necrosis (use
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

mcg/kg/min phentolamine (urine output should

based on for treatment) increase at low doses)
response ●​ Watch for signs of
●​ Max dose: 50 arrhythmias or
mcg/kg/min in hypertension
severe cases

Patient Education:
●​ Used in critical care settings only
●​ Explain the need for continuous monitoring
●​ Inform about possible side effects (palpitations, headache, nausea)

Special Considerations:
●​ Elderly: Higher risk of hypertension & arrhythmias
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

●​ Pediatrics: Used cautiously, with weight-based dosing

●​ Pregnancy: Category C; used if benefits outweigh risks
●​ Renal Impairment: Low doses may improve renal perfusion
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Competitively binds to ●​ Reversal of

Generic Name: opioid receptors (mu, opioid overdose Common: Before Administration:
Naloxone kappa, and delta) in (e.g., heroin,
the central nervous fentanyl, ●​ Increased ●​ Assess level of
Brand Names: system, Blocks opioid morphine heart rate consciousness (LOC)
Narcan, Evzio effects (e.g., overdose) ●​ Nausea, and respiratory rate
respiratory depression, ●​ Respiratory vomiting ●​ Check history of opioid
Classification: sedation, euphoria), depression due ●​ Sweating, use (risk of severe
Opioid Antidote, Rapidly reverses to opioid toxicity shivering withdrawal)
Opioid Antagonist opioid-induced central ●​ Postoperative ●​ Hypertension ●​ Have resuscitation
nervous system and opioid-induced equipment available
Dosage and respiratory depression respiratory
depression
Serious:
Administration: During Administration:
●​ Neonatal opioid
●​ Severe opioid
Standard withdrawal
withdrawal ●​ Monitor respiratory
syndrome
Dosage Ranges: (off-label use in
symptoms rate, oxygen
(agitation, saturation, and heart
emergencies)
Opioid Overdose tremors, rate
(Adults & tachycardia) ●​ Prepare for repeat
Pediatrics): ●​ Seizures (rare, doses (opioid effects
usually in may last longer than
●​ IV, IM, or opioid-depend naloxone)
Subcutaneou ent patients) ●​ Assess for pain levels
s: 0.4–2 mg ●​ Pulmonary (naloxone reverses
every 2–3 edema (rare
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

minutes as but serious) analgesia)

needed (max:
10 mg) After Administration:
●​ Intranasal
(Narcan): 4 ●​ Observe for return of
mg in one respiratory depression
nostril; repeat (opioid effects can
every 2–3 return)
minutes as ●​ Monitor for withdrawal
needed symptoms
(restlessness,
Postoperative sweating, tachycardia)
Opioid Reversal: ●​ Educate about opioid
safety and overdose
●​ IV: 0.1–0.2 prevention
mg every 2–3
minutes until
adequate
response

Neonatal Opioid
Reversal (off-label):

●​ IV, IM, SubQ:

0.01 mg/kg
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Patient Education:
●​ If using at home, call 911 immediately after administration
●​ Naloxone only lasts 30–90 minutes, so multiple doses may be needed
●​ Store in an easily accessible place
●​ Teach family or caregivers how to use Narcan

Special Considerations:
●​ Elderly: Higher risk of cardiovascular effects
●​ Pediatrics: Used in opioid overdose, but monitor closely
●​ Pregnancy: Category B; used only if benefits outweigh risks
●​ Renal & Hepatic Impairment: No dose adjustment needed
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

MEDICATION MECHANISM OF INDICATION SIDE EFFECTS NURSING INTERVENTIONS

ACTION

Inhibits bacterial DNA ●​ Acute sinusitis

Generic Name: synthesis by ●​ Prostatitis Common: Before Administration:
Ciprofloxacin inhibiting DNA gyrase ●​ Intra-abdominal
in susceptible infections ●​ Nausea, ●​ Assess for allergies to
Brand Names: Cipro, gram-negative and ●​ Febrile vomiting, fluoroquinolones
Cipro XR, Ciloxan, gram-positive neutropenic diarrhea ●​ Check renal function
Cetraxal organisms patients ●​ Dizziness, (BUN, creatinine
●​ Gonorrhea headache levels)
Classification: ●​ Infectious ●​ Photosensitiv ●​ Obtain culture &
Antibiotic, diarrhea ity sensitivity test before
Fluoroquinolone ●​ Inhalation first dose
anthrax
(postexposure)
Serious:
Dosage and During Administration:
Administration: ●​ Infections of
●​ Tendon
lower respiratory
rupture ●​ Monitor for tendon
tract, skin and skin
Standard Dosage structures, bones,
(Black Box pain/swelling (stop
Ranges: Warning) drug immediately if
and joints
(especially in occurs)
●​ Nosocomial
Urinary Tract elderly, ●​ Assess for GI
pneumonia
Infections (UTIs): transplant symptoms (diarrhea,
●​ Typhoid fever
recipients, abdominal pain) →
●​ Urinary tract
●​ Oral: 250–500 and risk of C. difficile
infections
mg every 12 corticosteroid infection
●​ Complicated
hours for 3–7 users) ●​ Monitor ECG in
urinary tract
days ●​ QT high-risk patients
infec-
prolongation (elderly, heart
tions or pyelonephritis
Respiratory Tract → risk of disease)
●​ Acute otitis
arrhythmias
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Infections: externa ●​ Peripheral After Administration:

➣ Bacterial neuropathy
●​ Oral: 500–750 conjunctivitis caused by ●​ Clostridioides ●​ Evaluate infection
mg every 12 susceptible organisms difficile-assoc response (WBC
hours for 7–14 ➣ Corneal ulcers iated diarrhea count, fever
days caused by suscepti- (C. diff resolution)
ble organisms infection) ●​ Monitor for signs of
Anthrax superinfection (oral
Post-Exposure: thrush, vaginal yeast
infection)
●​ Oral: 500 mg
●​ Ensure patient
every 12 hours
completes full course
for 60 days
of antibiotics
●​ IV
Administration:
●​ 200–400 mg IV
every 8–12
hours
depending on
infection
severity

Patient Education:
●​ Take with plenty of water to prevent kidney crystals
 Republic of the Philippines
ISABELA STATE UNIVERSITY
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COLLEGE OF NURSING

●​ Avoid sun exposure (risk of severe sunburn)

●​ Do not take with dairy, antacids, or multivitamins
●​ Stop immediately if experiencing tendon pain or swelling
●​ Report any severe diarrhea (could indicate C. diff infection)

Special Considerations:
●​ Elderly: Higher risk of tendon rupture & QT prolongation
●​ Pediatrics: Not recommended in children under 18 unless necessary (risk of joint damage)
●​ Pregnancy: Category C; avoid unless benefits outweigh risks
●​ Renal Impairment: Adjust dosage based on creatinine clearance
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

DRUG STUDY FLECTION:

After completing this drug study, I have gained a deeper appreciation for the critical role of pharmacology in nursing

practice. This exercise has reinforced my understanding of how medications work, their indications, contraindications,

dosages, side effects, and interactions. More importantly, it has highlighted the responsibility nurses have in ensuring the

safe and effective administration of drugs to patients.

One key takeaway from this study is the importance of medication safety. Understanding the pharmacokinetics and

pharmacodynamics of different drugs allows me to anticipate potential adverse effects and take preventive measures. For

instance, recognizing early signs of drug toxicity or allergic reactions can be lifesaving. This knowledge also reinforces the

importance of the "Five Rights of Medication Administration": the right patient, right drug, right dose, right route, and right

time. Adhering to these principles minimizes the risk of medication errors, which can have serious consequences for

patient health. Additionally, understanding medication reconciliation helps prevent polypharmacy issues and ensures that

patients receive the most appropriate and effective treatment.

Furthermore, this exercise has emphasized the significance of patient education. As a future nurse, I will be

responsible for ensuring that patients understand their medications, including how to take them properly and what side
 Republic of the Philippines
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COLLEGE OF NURSING

effects to watch for. This is especially crucial for patients with chronic illnesses who require long-term medication

management. Educating patients empowers them to adhere to their treatment plans and make informed decisions about

their health. Beyond verbal instructions, providing written materials and demonstrating proper medication administration

techniques can enhance patient comprehension and adherence.

Another vital lesson from this study is the importance of interprofessional collaboration in pharmacologic care.

Nurses work closely with physicians, pharmacists, and other healthcare professionals to optimize medication regimens.

Effective communication within the healthcare team ensures that any concerns about drug interactions, contraindications,

or dosage adjustments are promptly addressed, ultimately leading to better patient outcomes. Through this study, I have

learned how to critically evaluate medication orders, identify potential errors, and advocate for patient safety. This

collaborative approach fosters a more comprehensive and patient-centered healthcare environment.

Moreover, this experience has deepened my understanding of evidence-based practice in pharmacology. Keeping

up with the latest research and guidelines is crucial for providing high-quality care. Medication protocols and treatment

guidelines evolve over time as new research emerges, and it is the responsibility of nurses to stay informed about these

advancements. Participating in continuing education programs and reviewing updated literature will be essential in

ensuring that my pharmacologic knowledge remains current and relevant.

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COLLEGE OF NURSING

Additionally, this drug study has heightened my awareness of the ethical and legal aspects of medication

administration. Nurses must uphold ethical principles such as beneficence, non-maleficence, and patient autonomy while

administering drugs. Ensuring informed consent and respecting patients' decisions regarding their treatment are

fundamental ethical responsibilities. Moreover, maintaining accurate documentation and adhering to institutional policies

and national regulations are critical in preventing legal issues related to medication errors.

This drug study has strengthened my confidence in handling medications and has underscored the ethical

responsibility that comes with this role. As I continue my journey to becoming a nurse, I will apply this knowledge to

provide safe, effective, and compassionate care. Mastering pharmacology is not just about memorizing drug names and

dosages—it is about understanding the broader impact of medications on patient health and well-being. This realization

will guide my practice and inspire me to continuously expand my knowledge to become a competent and reliable nurse. I

now recognize that pharmacology is an ever-evolving field, and my commitment to lifelong learning will be crucial in

providing the best possible care to my future patients. By integrating pharmacologic knowledge with clinical judgment and

compassionate care, I will strive to make a meaningful difference in the lives of those I serve.
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ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING
 Republic of the Philippines
ISABELA STATE UNIVERSITY
Echague Campus

COLLEGE OF NURSING

Citations:

●​ MedlinePlus. (2024). Amoxicillin Drug Information. Retrieved from MedlinePlus.gov

●​ UpToDate. (2024). Amoxicillin: Uses, Side Effects, and Dosing.
●​ Nursing Drug Handbook (2024 Edition).
●​ MedlinePlus. (2024). Atorvastatin Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Atorvastatin: Uses, Side Effects, and Dosing.
●​ MedlinePlus. (2024). Furosemide Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Furosemide: Uses, Side Effects, and Dosing.
●​ MedlinePlus. (2024). Lisinopril Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Lisinopril: Uses, Side Effects, and Dosing.
●​ MedlinePlus. (2024). Metoprolol Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Metoprolol: Uses, Side Effects, and Dosing.
●​ MedlinePlus. (2024). Insulin Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Insulin Therapy in Diabetes Mellitus.
●​ MedlinePlus. (2024). Albuterol Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Beta-2 Agonists in Asthma and COPD.
●​ MedlinePlus. (2024). Dextrose Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Management of Hypoglycemia and IV Fluid Therapy.
●​ MedlinePlus. (2024). Morphine Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Opioid Analgesia and Pain Management.
●​ MedlinePlus. (2024). Hydrochlorothiazide Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Thiazide Diuretics in Hypertension and Edema Management.
●​ MedlinePlus. (2024). Warfarin Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Anticoagulant Therapy and INR Monitoring.
 Republic of the Philippines
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Echague Campus

COLLEGE OF NURSING

●​ MedlinePlus. (2024). Heparin Drug Information. Retrieved from MedlinePlus.gov

●​ UpToDate. (2024). Anticoagulant Therapy and aPTT Monitoring.
●​ MedlinePlus. (2024). Ondansetron Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Ondansetron Use in Nausea and Vomiting.
●​ MedlinePlus. (2024). Pantoprazole Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Pantoprazole Use in GERD and Peptic Ulcer Disease.
●​ MedlinePlus. (2024). Clopidogrel Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Clopidogrel Use in Cardiovascular.
●​ MedlinePlus. (2024). Ceftriaxone Drug Information. Retrieved from MedlinePlus.gov
●​ UpToDate. (2024). Ceftriaxone Use in Bacterial Infections.
●​ Lexicomp. (2024). Levothyroxine: Drug Information. UpToDate.
●​ American Thyroid Association. (2024). Guidelines for the Treatment of Hypothyroidism.
●​ National Institutes of Health (NIH). (2024). Levothyroxine Monograph.
●​ Lexicomp. (2024). Prednisone: Drug Information. UpToDate.
●​ National Institutes of Health (NIH). (2024). Prednisone Monograph.
●​ American College of Rheumatology. (2024). Guidelines for Corticosteroid Use in Autoimmune Diseases.
●​ Lexicomp. (2024). Digoxin: Drug Information. UpToDate.
●​ American Heart Association. (2024). Guidelines for Heart Failure Management.
●​ National Institutes of Health (NIH). (2024). Digoxin Monograph.
●​ Lexicomp. (2024). Amlodipine: Drug Information. UpToDate.
●​ American Heart Association. (2024). Guidelines for Hypertension Management.
●​ National Institutes of Health (NIH). (2024). Amlodipine Monograph.
●​ U.S. Food and Drug Administration (FDA). (2024). Ranitidine (Zantac) Recall Information.
●​ Lexicomp. (2024). Ranitidine: Drug Information. UpToDate.
●​ American Gastroenterological Association. (2024). Guidelines on GERD and Ulcer Management.
●​ Lexicomp. (2024). Dopamine: Drug Information. UpToDate.
●​ American Heart Association (AHA). (2024). Guidelines for Vasopressor Use in Shock.
●​ National Institutes of Health (NIH). (2024). Dopamine Monograph.
●​ Lexicomp. (2024). Naloxone: Drug Information. UpToDate.
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ISABELA STATE UNIVERSITY
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COLLEGE OF NURSING

●​ Centers for Disease Control and Prevention (CDC). (2024). Guidelines for Opioid Overdose Reversal.
●​ National Institutes of Health (NIH). (2024). Naloxone Monograph.
●​ Lexicomp. (2024). Ciprofloxacin: Drug Information. UpToDate.
●​ Centers for Disease Control and Prevention (CDC). (2024). Antibiotic Guidelines for Fluoroquinolones.
●​ National Institutes of Health (NIH). (2024). Ciprofloxacin Monograph.
●​ Nurses Drug Handbook 7E UnitedVRG. (Pages 69-71 , 113-115, 547-548, 723-725, 795-797, 636-638, 35-37, 359-360,
827-830, 589-591, 1311-1314, 586-588, 916-918, 949-950, 290-291, 237-239, 129-131, 707-709, 1033-1035, 369-372,
68-69, 1048-1086, 389-390, and 270-273)