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TULAGAN ALLEN VINCENT C 03/03/20

BSNII-SIIIC

DRUG NAME MECHANISM OF ACTION INDICATIONS / ADVERSE EFFECTS NURSING


CONTRAINDICATIONS RESPONSIBILITIES
Generic Name:  Cephalosporins exert INDICATIONS: BODY AS A WHOLE:  Contraindicated in
Cefuroxime bactericidal activity by Pharyngitis, tonsillitis, Thomboplheblitis, pain, hypersensitivity to
interfering with bacterial infections of the urinary burning cellulitis, other cephalosporins
Brand Name:  cell wall synthesis and and lower respiratory superinfections, positive  Ask patient if he
Zoltax inhibiting cross-linking of tracts, and skin an skin Coomb’s test. have any had
the peptidoglycan. The structure infections reaction to previous
Classification:  cephalosporins are also caused by streptococcus GI: Diarrhea, nausea, cephalosporin or
Antibiotic thought to play a role in pneumonieae and S. antibiotic-associated colitis penicillin therapy
the activation of bacterical pyogenes, Haemophilus  Prolonged use may
Therapeutic cell autolysins which may influenzae, SKIN: Rash, pruritus, urticaria result in overgrowth
Anti-infectives contribute to bacterial cell Staphylococcus aureus, of nonsusceptible
lysis.. E. Coli UROGENITAL: Increased organism.
Pharmacologic: CONTRAINDICATIONS: serum cretonne and BUN,  Monitor patient for
Second – Generation Source: Hypersensitivity to decreased creatinine superinfections
Penicillin http://www.antimicrobe.org cephalosporins and clearance  Obtain cultures for
/drugpopup/Cefuroxime.ht related antibiotics; sensitivity test
Dosage: m pregnancy (category B) before therapy
125mg – 500mg lactation
.
Route:
Oral

DRUG NAME MECHANISM OF ACTION INDICATIONS / ADVERSE EFFECTS NURSING


CONTRAINDICATIONS RESPONSIBILITIES
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

Generic Name:  Lidocaine is a local INDICATIONS: CNS: seizures; anxiety,  Don’t administer


Lidocaine hydrochloride anesthetic of the amide Xylocaine (lidocaine HCl) nervousness, lethargy, lidocaine with
type. It is used to provide 2% Jelly is indicated for somnolence, paresthesia, epinephrine (for
Brand Name:  local anesthesia by nerve prevention and control of muscle twitching; confusion, local anesthesia) to
Lidocaine blockade at various sites in pain in procedures tremor, stupor, restlessness, treat arrhythmias.
the body. It does so by involving the male and light-headedness, hallucination Use solutions with
Classification:  stabilizing the neuronal female urethra, for s (with systemic form); epinephrine
Antidysrhythmics, Local membrane by inhibiting topical treatment of apprehension, cautiously in CV
anesthetics the ionic fluxes required for painful urethritis, and as unconsciousness, confusion, disorders and in
the initiation and an anesthetic lubricant tremors, stupor, restlessness, body areas with
Therapeutic conduction of impulses, for endotracheal slurred speech, euphoria, limited blood supply
ventricular antiarrhythmic, thereby effecting local intubation (oral and depression, light-headedness (ears, nose, fingers,
local anesthetic anesthetic action. In nasal). (with topical use). toes).
particular, the lidocaine CV: bradycardia,CARDIAC  Patient requires
Pharmacologic: agent acts on sodium ion CONTRAINDICATIONS: ARREST; hypotension,  new constant cardiac
amide derivative channels located on the Lidocaine is or worsened monitoring when
internal surface of nerve contraindicated in arrhythmias (with systemic receiving I.V.
Dosage: cell membranes. At these patients with a known form); hypotension, lidocaine. Use
Percutaneous: 1-60 mL of channels, neutral history of hypersensitivity myocardial infusion pump or
0.5-1% solution (5-300 mg uncharged lidocaine to local anesthetics of the depression, arrhythmias (wit microdrip system
total dose) molecules diffuse through amide type or to other h topical use); and timer to monitor
IV regional: 10-60 mL of neural sheaths into the components of Xylocaine edema, asystole. infusion precisely.
0.5% solution (50-300 mg axoplasm where they are 2% Jelly EENT: tinnitus, blurred or Never exceed 4
total dose) subsequently ionized by double vision (with systemic mg/minute. A faster
joining with hydrogen ions. form); tinnitus, blurred or infusion greatly
The resultant lidocaine double vision (with topical increases risk of
Route: cations are then capable of use). toxicity.
Intravenous reversibly binding the GI: nausea, vomiting (with  Monitor vital signs
Intramuscular sodium channels from the topical use). and serum
Peripheral injection inside, keeping them Respiratory: respiratory electrolyte, BUN,
Topical locked in an open state arrest, status asthmaticus. and creatinine
that prevents nerve Skin: dermatologic reactions, levels.
depolarization. As a result, sensitization; diaphoresis, rash  Advise patient to
with sufficient blockage, (with topical use). report slowed or
the membrane of the Other: anaphylaxis; sorenes abnormal heart
postsynaptic neuron will s at injection site, sensation of rhythms, ringing in
ultimately not depolarize the ears, vision
and will thus fail to
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

transmit an action cold (with systemic form). changes, difficulty


potential. This facilitates an breathing, and
anesthetic effect by not confusion.
merely preventing pain  Tell patient
signals from propagating to receiving lidocaine
the brain but by aborting I.M. that drug may
their generation in the first cause soreness at
place  injection site.
Source:
https://www.drugbank.ca/d
rugs/DB00281

DRUG NAME MECHANISM OF ACTION INDICATIONS / ADVERSE EFFECTS NURSING


CONTRAINDICATIONS RESPONSIBILITIES
Generic Name:  Amlodipine is considered a INDICATIONS: CNS: headache, dizziness,  Assess BP (sitting,
Amlodipine peripheral arterial • Hypertension fatigue
lying, standing) and
vasodilator that exerts its CV: peripheral edema, angina,
Brand Name:  action directly on vascular • Coronary artery disease bradycardia, hypotension, pulse periodically
Norvasc smooth muscle to lead to a palpitations during therapy.
reduction in peripheral • Chronic stable angina GI: gingival hyperplasia,  Monitor frequency of
Therapeutic vascular resistance, nausea
causing a decrease in Derm: flushing prescription refills to
Anti-hypertensives • Vasospastic angina
blood pressure. Amlodipine Hydrochlorothiazide determine
(Prinzmetal’s or Variant
Pharmacologic: is a dihydropyridine CNS: dizziness, drowsiness, adherence to
angina)
angiotensin II receptor calcium antagonist lethargy, weakness
therapy.
antagonists (calcium ion antagonist or CV: hypotension
• Angiographically  Assess patient for
calcium channel blockers slow-channel blocker) that GI: anorexia, cramping,
inhibits the influx of documented coronary hepatitis, nausea, vomiting
thiazide diuretics signs of angioedema
artery disease in patients
calcium ions into both Derm: photosensitivity, (dyspnea, facial
vascular smooth muscle without heart failure or rashes
Dosage:
an ejection fraction < swelling). May rarely
10mg-25mg and cardiac muscle. Endo: hyperglycemia
Experimental studies imply 40% F and E: hypokalemia, cause angioedema.
Route: that amlodipine binds to dehydration, hypercalcemia,  Instruct patient and
both dihydropyridine and n CONTRAINDICATIONS: hypochloremic alkalosis, family on proper
Oral
ondihydropyridine binding  Hypersensitivity hypomagnesemia, technique for
sites, located on cell (cross-sensitivity with hyponatremia, monitoring BP.
membranes. The hypophosphatemia, Advise them to
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

contraction of cardiac other thiazides or hypovolemia check BP at least


muscle and vascular Hemat: blood dyscrasias weekly and to report
sulfonamides may
smooth muscle are Metabolic: hyperuricemia, significant changes.
dependent on the exist) hypercholesterolemia  Caution patient to
movement of extracellular  Some products MS: muscle cramps avoid salt
calcium ions into these contain tartrazine and Misc: pancreatitis substitutes
cells by specific ion Olmesartan containing
channels. Amlodipine should be avoided in CNS: dizziness potassium or foods
blocks calcium ion influx patients with known CV: hypotension containing high
across cell membranes intolerance F and E: hyperkalemia levels of potassium
with selectivity. A stronger GU: impaired renal function or sodium unless
 Anuria
effect of amlodipine is Misc: ANGIOEDEMA directed by health
exerted on vascular  Lactation. care professional.
smooth muscle cells than See food sources for
on cardiac muscle cells Label. specific nutrients.
Direct actions of  May cause dizziness.
amlodipine on vascular Caution patient to
smooth muscle result in avoid driving and
reduced blood pressure  other activities
requiring alertness
Source: until response to
https://www.drugbank.ca/d medication is
rugs/DB00381 known.
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

DRUG NAME MECHANISM OF ACTION INDICATIONS / ADVERSE EFFECTS NURSING


CONTRAINDICATIONS RESPONSIBILITIES
Generic Name:  Epinephrine acts on both INDICATIONS: CNS: nervousness,  • After S.C. or I.M.
Epinephrine alpha and beta-adrenergic Bronchospasms, tremor, vertigo, headache,  dis injection, massaging
receptors. The mechanism anaphylactic reactions, orientation, the site may hasten
Brand Name:  of the rise in blood cardiac arrest, agitation, drowsiness, fear, absorption.
Adrenalin pressure is 3-fold: a direct pallor, dizziness,  Avoid I.M. injection
myocardial stimulation that CONTRAINDICATIONS: weakness, cerebral into buttocks.
Therapeutic increases the strength of Hypersensitivity to hemorrhage, CVA, pain. In Epinephrine-induced
bronchodilator, ventricular contraction epinephrine or any patients with Parkinson’s vasoconstriction
vasopressor, cardiac (positive inotropic action), componentCardiac disease, drug may increase favors growth of the
stimulant, local anesthetic an increased heart rate arrhythmias, angle- rigidity, tremor, brow ache, anaerobe Clostridiu
(adjunct), topical (positive chronotropic closure glaucoma headache, and light- m perfringens.
antihemorrhagic, action), and peripheral headedness with ophthalmic  When using
antiglaucoma drug vasoconstriction. form; nervousness and separate solutions of
excitation with nasal form. epinephrine and a
Source: CV: palpitations; widened topical miotic, instill
Pharmacologic: https://www.rxlist.com/adre pulse the miotic 2 to 10
Adrenergic nalin-drug.htm#clinpharm pressure; hypertension;  ventr minutes before
icular fibrillation; epinephrine.
Dosage: shock; angina; ECG changes,   Monitor blood
Children 1 month-2 yrs. including a decreased T-wave pressure, pulse,
0.3-0.5 mg/kg; children .2 amplitude; palpitations;  tachyc respirations, and
yrs. ± Adults 0.4-0.5 ardia; arrhythmias; hyperten urine output;
mg/kg sion with ophthalmic observe patient
preparation; tachycardia with
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

Route: nasal solution. closely. Epinephrine


Intramuscular EENT: corneal or conjunctival may widen pulse
Subcutaneous pigmentation or corneal pressure. If
edema in long-term use; arrhythmias occur,
follicular hypertrophy; discontinue
chemosis; conjunctivitis; iritis; epinephrine
hyperemic conjunctiva; immediately. Watch
maculopapular rash; eye pain; for changes in
allergic lid reaction; ocular intake and output
irritation; eye stinging, ratio.
burning, and tearing on  Make sure patients,
instillation of ophthalmic form; especially elderly
rebound nasal congestion; ones, receive
slight sting upon application of regular tonometry
nasal solution. readings during
GI: nausea, vomiting  . continuous therapy.
Metabolic: hyperglycemia.   Warn patient that
Respiratory: dyspnea. overuse or too-
Skin: urticaria, hemorrhage frequent use can
(at injection site). cause severe
adverse reactions.
 Advise patient to
call immediately if
he has no relief
within 20 minutes or
if condition worsens.
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

DRUG NAME MECHANISM OF ACTION INDICATIONS / ADVERSE EFFECTS NURSING


CONTRAINDICATIONS RESPONSIBILITIES
Generic Name:  tetanus toxoid vaccine is a INDICATIONS: Significant: Syncope.  Monitor patient for
Tetanus toxoid preparation of inactivated Prevention against Blood and lymphatic hypersensitivity
toxin produced by virulent tetanus in children and system disorders: reactions, seizures,
Brand Name:  tetanus bacilli (product adult Lymphadenopathy. and injection site
Tetanus Toxoid Adsorbed of Clostridium tetani). It Gastrointestinal disorders: reactions.
acts as antigen and CONTRAINDICATIONS: Nausea.   Don’t confuse drug
Classification:  produces active immunity Hypersensitivity, febrile General disorders and with tetanus
Vaccine against tetanus. illness and other acute administration site immune globulin.
Source: infections, patient with conditions: Inj site reactions  Refrigerate at 36° to
Therapeutic https://www.mims.com/phil low immune response (e.g. pain, redness, bruising, 46° F (2° to 8° C).
  tetanus prophylaxis ippines/drug/info/vaccine swelling, induration), fever, Don’t freeze.
%2C%20tetanus%20toxoid malaise, irritability.  Inform patient of
Pharmacologic: %2C%20tetanus%20toxoid Musculoskeletal and possible adverse
Toxoid %20adsorbed/ connective tissue reactions.
disorders: Arthralgia,  Encourage patient
Dosage: myalgia. to report distressing
0.5mL Nervous system disorders: adverse reactions.
Neuritis, headache, dizziness.  Tell patient that
Route: Skin and subcutaneous immunization
Intramuscular tissue disorders: Rash. requires a series of
Subcutaneous Vascular disorders: injections. Stress the
Hypotension. importance of
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

Potentially Fatal: keeping scheduled


Anaphylactoid or appointments for
hypersensitivity reactions. subsequent doses.

DRUG NAME MECHANISM OF ACTION INDICATIONS / ADVERSE EFFECTS NURSING


CONTRAINDICATIONS RESPONSIBILITIES
Generic Name:  The rabies vaccine is INDICATIONS: Blood and Lymphatic  Do not inject the
Rabies Vaccine manufactured from Imovax Rabies is a System Disorders: vaccine into
inactivated strains of the vaccine indicated for pre- Lymphadenopathy the gluteal area as
Brand Name:  rabies virus. Each dose (1 exposure and post- Immune System Disorders: administration in
Imovax Rabies, RabAvert ml) of the vaccines exposure Anaphylactic reaction, serum this area may result
marketed in the US, prophylaxis against sickness type in lower neutralizing
Classification:  ImoVax and RabAvert, rabies. Imovax Rabies reaction, dermatitis allergic, pr antibody titers
Rabies Vaccine contains at least 2.5 vaccine is approved for uritus (itching), edema  In both pre-exposure
international units of rabies use in all age groups. and post-
Nervous System Disorders:
Dosage: antigen. When CONTRAINDICATIONS: exposure immunizati
Paresthesia, neuropathy, conv
1mL administered Pre-exposure Prophylaxis on, the full 1.0 mL
ulsion, encephalitis
intramuscularly, the rabies Do not administer to dose should be
antigen induces production anyone with a known life- Gastrointestinal Disorders:
Route: given
of specific neutralizing threatening systemic Vomiting, diarrhea
Intramuscular intramuscularly.
antibodies against the hypersensitivity reaction Musculoskeletal and
 Anaphylactoid/hyper
rabies virus, thereby to any component of the Connective Tissue
sensitivity reactions:
providing active immunity. vaccine Disorders:
 Monitor patient for
The active antibody Arthralgia
hypersensitivity
response requires General Disorders and reactions, seizures,
approximately 7 to 10 days Administration Site and injection site
to develop, and detectable Conditions: reactions.
rabies virus neutralizing Asthenia, malaise, fever and

antibodies generally persist chills (shivering), injection
for several years. Due to site hematoma
the delay in development Respiratory, Thoracic, and
of antibodies, post- Mediastinal
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

exposure prophylaxis must Disorders:Wheezing, dyspnea


include administration of
Rabies Immune Globulin
(see separate monograph).
Source:
https://www.pdr.net/drug-
summary/RabAvert-rabies-
vaccine-454

DRUG NAME MECHANISM OF ACTION INDICATIONS / ADVERSE EFFECTS NURSING


CONTRAINDICATIONS RESPONSIBILITIES
Generic Name:  Dopamine is a precursor to INDICATIONS: CNS: headache.  Give drug into a
dopamine norepinephrine in For the correction of CV: ectopic beats, large vein to prevent
Brand Name:  noradrenergic nerves and hemodynamic tachycardia, anginal pain, the possibility of
Intropin is also a neurotransmitter imbalances present in the palpitations, hypotension,bra extravasation.
in certain areas of the shock syndrome due to dycardia, conduction  During infusion
Classification:  central nervous system. myocardial infarction, disturbances, hypertension, monitor ECG, blood
Vaccine Dopamine produces trauma, endotoxic vasoconstriction, widening of pressure, cardiac
positive chronotropic and septicemia, open-heart QRS complex (less frequently). output, central
Therapeutic inotropic effects on the surgery, renal failure, and GI: nausea, vomiting. venous pressure,
vasopressor, inotropic myocardium, resulting in chronic cardiac GU: azotemia. pulmonary artery
drug increased heart rate and decompensation as in Metabolic: hyperglycemia, wedge pressure,
cardiac contractility. This is congestive failure decreased thyroid-stimulating pulse rate, urine
Pharmacologic: accomplished directly by hormone, growth hormone, output, and color
Adrenergic exerting an agonist action CONTRAINDICATIONS: and prolactin levels. and temperature of
on beta-adrenoceptors and Contraindicated in Respiratory: dyspnea, asth limbs.
Dosage: indirectly by causing patients with uncorrected ma attacks.  Dopamine is
40 mg/ml, 80 mg/ml, and release of norepinephrine tachyarrhythmias, Skin: necrosis and tissue administered by I.V.
160 mg/ml parenteral from storage sites in pheochromocytoma, or sloughing with extravasation, infusion using an
concentrate for injection sympathetic nerve ventricular fibrillation. piloerection. infusion device to
for I.V. infusion; 0.8 mg/ml endings. In the brain, Other: anaphylactic control flow.
(200 or 400 mg) in D5W, dopamine actas as an reactions.  Advise patient to
1.6 mg/ml (400 or 800 agonist to the five report adverse
mg) in D5W, and 3.2 dopamine receptor reactions.
mg/ml (800 mg) in D5W subtypes (D!, D2, D3, D4,   Inform patient of
TULAGAN ALLEN VINCENT C 03/03/20
BSNII-SIIIC

parenteral injection for I.V. D5). need for frequent


infusion Source: monitoring of vital
https://www.drugbank.ca/d signs and condition.
Route: rugs/DB00988  Don’t mix other
Intravenous drugs in dopamine
solutions. Discard
solutions after 24
hours.