DRUG: Risperidone

DOSE: 2mg/1tab
ROUTE: Oral Route
FREQUENCY: Hours of
Sleep
CLASSIFICATION
THERAPEUTIC CLASS
Antipsychotic

PHARMACOLOGIC CLASS
Benzisozole dermative
MECHANISM OF ACTION
Blocks dopamine and 5h2 receptors in the
brain.
Selectively blocks serotonin and dopamine
receptors in the mesocortical tract of the
CNS to suppress psychotic symptoms.
INDICATIONS
Schizophrenia
Irritability including aggression,
self injury and temper tantrums
associated with an autistic
disorder.
CONTRAINDICATIONS
Hypersensitive to drug and in
breastfeeding women
Caution in patients with
increase QT interval
SIDE EFFECTS
CNS: parkinsonism, suicide attempt,

agitation, anxiety, dizziness, fever,

impaired concentration, fatigue,
depression
CV: tachycardia, orthostatic hypotension,

peripheral edema, HPN, syncope

EENT: sinusitis, pharyngitis, double vision

GI: constipation, nausea, vomiting, abdominal

pain, anorexia, dry mouth, increased salivation,
diarrhea
GU: urinary incontinence, increased urination,
abnormal orgasm, vaginal dryness
Metabolic: weight gain, hyperglycemia , weight
loss
Respiratory: dyspnea, coughing, upper
respiratory tract infection
ADVERSE EFFECTS:
CNS: abnormal coordination, anxiety,
confusion, dizziness, drowsiness, fatigue,
headache, parkinsonism, restlessness
CV: Bradycardia, orthostatic hypotension
EENT: Decreased or increased salivation,
dry mouth, nasal congestion, vision changes
G.I: abdominal pain, constipation,
anorexia, nausea and vomiting
RESP: Cough, dyspnea, URTI
SKIN: Dry skin, diaphoresis, pruritus,
rash
Other: weight gain or loss, pain,
redness or swelling
NURSING RESPONSIBILITIES:
BEFORE:
Obtained vital signs for baseline data.
Assessed for hypersensitivity
Health teaching done regarding
adverse effects
DURING
To relieve thirst and dry mouth, give
frequent mouth care or fluids.
Advised to avoid alcohol while taking this
drug.
Warned patient to avoid hazardous
activities.
Provided safety to patient.
AFTER
Monitored for S/S of overdose (Drowsiness,
sedation, tachycardia, hpn, EPS, seizures
Instructed to do DBE
Warned patient to notify prescriber if
adverse reactions occur.
Advised patient high fiber diet
Instructed patient to elevate feet if not
contraindicated
DRUG: DIAZEPAM
DOSE: 5mg, 1 tablet/
day
ROUTE: Oral
CLASSIFICATION
THERAPEUTIC CLASS
Anxiolytic

PHARMACOLOGIC CLASS
Benzodiazepine
MECHANISM OF ACTION
Probably potential the
effects of GABA, depress
the CNS and supress the
spread of seizure activity
INDICATIONS:
Anxiety
Muscle Spasm
Tetanus
CONTRAINDICATIONS:
Hypersensitive to drug or soya
protein
Experiencing shock and coma
Acute angle closure glaucoma
liver or renal impairment,
depression, history of substance
abuse
SIDE EFFECTS
CNS: drowsiness, dysarthria, slurred
speech, tremor, transient amnesia, fatigue,
ataxia, headache, insomnia, paradoxical
anxiety, hallucination, minor changes in
EEG pattern
CV: CV collapse, bradycardia, hypotension
EENT: diplopia, blurred vision
GI: constipation, diarrhea
with rectal pain
GU: urinary incontinence &
retention
RESPI: depression, apnea
NURSING
RESPONSIBILITIES
BEFORE
Monitored V/S and BP
Assessed for
hypersensitivityand allergic
history
Monitored I&O
DURING
Warned patient to avoid activities that
require alertness
Provided safety to patient
Advised to increased fiber diet &
avoid alcohol
Advised patient to take drug with
food.
AFTER
Monitored for dizziness,
ataxia, mental state changes
Instructed patient not to
abruptly withdraw drug.
DRUG: CEFTRIAXONE
DOSE: 500mg
ROUTE: IVTT
FREQUENCY: Every 24
hours (8am-8pm)
CLASSIFICATION
THERAPEUTIC CLASS
Antibiotic
PHARMACOLOGIC CLASS
Third Generation Cephalosporin,
Pregnancy risk category B
MECHANISM OF ACTION
Inhibits cell wall
synthesis, promoting
osmotic instability, usually
bactericidal
INDICATION
Perioperative
prevention
UTI, septicaemia, skin
structure infection
CONTRAINDICATION
Hypersensitive to dry or other
cephalosporin
Cautiously in patient
hypersensitive to penicillin
Cautiously in breast feeding
women
SIDE EFFECTS
CNS: dizziness, headache, lethargy
GI: pseudomembranous colitis, diarrhea
HEMA: Eosinophilia, thrombocytosis,
leukopenia
SKIN: pain, induration, rash
OTHER: hypersensitivity reactions,
anaphylaxis
NURSING RESPONSIBILITIES
Before
Monitored Vital signs and I&O
for baseline data.
Obtained culture and
sensitivity results.
Assessed patients allergic
During
Administered pain medication as prescribed
by the physician
Health teaching done regarding adverse
effects.
Advised patient to avoid alcohol during
therapy
Warned patient to avoid activities that require
alertness
After
Instructed patient to report discomfort at IV
site
Advised patient to report adverse reactions
promptly
Advised patient to notify prescriber if having
loose stools.
Assessed bowel pattern daily
Provided safety to patient.
DRUG: Mannitol
DOSE: 100ml
ROUTE: IVTT
FREQUENCY: Every 12
hours (8 am- 8pm)
CLASSIFICATION
THERAPEUTIC CLASS
Diuretic
PHARMACOLOGIC CLASS
Osmotic diuretic
MECHANISM OF ACTION
Increases osmotic pressure
glomerular filtrate, thus
inhibiting tubular reabsorption
of H2O and electrolytes. It
elevates plasma osmolarity
and increased H2O flow into
INDICATION
To reduce intraocular or
intracranial pressure or cerebral
edema
To prevent oliguria or acute
renal failure
Oliguria
CONTRAINDICATION
Hypersensitive to drug
active intracranial
bleeding, severe
dehydration, metabolic
edema
SIDE EFFECTS
CNS: seizures, dizziness, headache, fever
CV: edema, thrombophlebitis,
hypotension, hypertension, heart failure,
tachycardia, vascular overload
EENT: blurred vision, rhinitis
GI: thirst, dry mouth, nausea, vomiting,
diarrhea
GU: urine retention
META: dehydration
SKIN: local pain,
urticaria
OTHERS: thirst, chill
NURSING RESPONSIBILITIES

BEFORE
Monitored Vital signs and
I&O for baseline data.
Assessed for allergic
history.
DURING
To relieve thirst and dry mouth, give frequent
mouth care or fluids
Emphasized importance of drinking only the
amount of fluids ordered.
Warned patient to avoid activities that require
alertness.
advised patient to avoid alcohol during therapy
AFTER
Monitored vital sign and intake
and output
Instructed patient to promptly
report adverse reactions and
discomfort at I.V. site.
DRUG: Ketorolac
Tromethamine
DOSE: 10 ml
ROUTE: IVTT
FREQUENCY: Every 8 hours
(8 am- 4pm- 12 am)
CLASSIFICATION
THERAPEUTIC CLASS:
NSAID

PHARMACOLOGIC CLASS:
NSAID

THERAPEUTIC ACTIONS:
Anti inflammatory and analgesics activity; inhibits
INDICATION
Short term management of ain (up to 5days)
Ophthalmic: Relief of ocular itching due to seasonal
conjunctivitis and relief of postoperative inflammation and
pain after cataract surgery.

CONTRAINDICATIONS:
Contraindicated with significant renal impairment,
during labor and delivery , lactation; patients wearing
soft contact lenses (ophthalmic); aspirin allergy;
concurrent use of NSAIDs
SIDE EFFECTS:
CNS: Headache, dizziness, insomnia, fatigue, tinnitus,
ophthalmologic effects.
DERMATOLOGIC: Rash, pruritus, sweating, dry mucous
membranes,
GI: Nausea, dyspepsia, GI pain, diarrhea, vomiting,
constipation, flatulence, hepatic impairment.
GU: Dysuria, renal impairment
HEMATOLOGIC: Bleeding, decreased Hgb and Hct
RESPIRATORY: Dyspnea, bronchospasm, rhinitis.
OTHER: Peripheral edema
NURSING RESPONSIBILITIES
Renal impairment, Impaired hearing, allergies, hepatic,
Skin color and lesions, orientation, reflexes, peripheral
sensation, clotting times, CBC, adventitious sounds
Be aware that patient may be at risk for CV events, GI
bleeding, renal toxicity, monitor accordingly.
Keep emergency equipment readily available at time
of initial dose, in case of severe hypersensitivity
reaction.
DRUG: Ranitidine
Hydrochloride
DOSE: 25 mg
ROUTE: IVTT
FREQUENCY: Every 8
hours (8am- 4pm- 12am)
CLASSIFICATION
THERAPEUTIC CLASS
Antiulcer
PHARMACOLOGIC CLASS
Histamine 2 antagonist
THERAPEUTIC ACTIONS
Competitively inhibits the action of
histamine at the H2 receptors of the
parietal cells of the stomach, inhibiting
basal gastric acid secretion and gastric
acid secretion that is stimulated by
food, insulin, histamine, cholinergic
agonists, gastrin, and pentagastrin.
INDICATION
Short term treatment of
active duodenal ulcer.
Maintenance therapy for
duodenal ulcer at reduced
dosage.
Short term treatment and
maintenance therapy of active,
benign gastric ulcer.
Treatment and maintenance of
healing of erosive esophagitis.
Treatment of heartburn, acid
indigestion, sour stomach.
SIDE EFFECTS
CNS: Headcahe, malaise, dizziness,
insomnia, vertigo.
CV: Tachycardia, bradycardia
DERMATOLOGIC: Rash, alopecia
GI: Constipation, diarrhea, nausea,
vomiting, abdominal pain,hepatitis.
GU: Impotence or decreased libido
HEMATOLOGIC: Leukopenis,
granulocytopenia,
thrombocytopenia
LOCAL: Pain at IM site local
burning or itching at IV site
OTHER: Arthralgias
NURSING RESPONSIBILITIES
Before
Monitored vital signs, intake and
output for baseline data.
Instrucedt patient not to take new
medication w/o consulting physician.
Allow 1 hour between any other
antacid and ranitidine.
 During:
Instructed patient to take as directed and do not
increase dose
Advised patient to avoid excessive alcohol
Warned patient to avoid activities that require alertness.
Informed patient that increased fluid and fiberintake
may minimize constipation
Informed patient that medication may temporarily
cause stools and tongue to appear gray black.
After:
Assess patient for epigastric or abdominal pain and
frank or occult blood in the stool, emesis, or gastric
aspirate
Advise patient to report adverse effects or discomforts
to health care professional promptly
 DRUG
Dexamethasone Sodium Sulphate IVTT 10mg every 8
hours (8am- 4pm- 12am)
 CLASSIFICATION
THERAPEUTIC CLASS:
Anti inflammatory

PHARMACOLOGIC CLASS:
Corticosteroid

MECHANISM OF ACTION:
Suppresses edema, fibrin deposition, capillary dilation, leukocyte
migration, capillary proliferation, and collagen deposition.
 INDICATION
Hypercalcemia associated with cancer
Cancer chemotheraphy induced nausea and vomiting.
Cerebral edema associated with brain tumor,
craniotomy, or head injury.
Ulcerative colitis, acute exacerbations of MS, and
palliation in some leukemia and lymphomas.
CONTRAINDICATION:
Contraindicated with allergy to ranitidine, lactation
 SIDE EFFECTS
CNS: Seizures, vertigo, headaches, insomnia, mood swings,
depression, psychosis, intracerebral haemorrhage, cataracts,
glaucoma.
CV: Hypertension, heart failure, necrotizing angiitis.
ENDOCRINE: Growth retardation, decreased carbohydrate
tolerance, diabetes mellitus
GI: Peptic or esophageal ulcer, pancreatitis, abdominal
distention,G.I distress
GU: Amenorrhea. Irregular menstruation.
NURSING RESPONSIBILITIES
Before:
Monitored vital signs, intake and output for baseline data.
Instrucedt patient not to take new medication w/o
consulting physician.
Allow 1 hour between any other antacid and ranitidine
During:
Instructed patient to take as directed and do not increase dose
Advised patient to avoid excessive alcohol
Warned patient to avoid activities that require alertness.
Informed patient that increased fluid and fiberintake may minimize constipation
Informed patient that medication may temporarily cause stools and tongue to
appear gray black.

After:
Assess patient for epigastric or abdominal pain and frank or occult blood in the
stool, emesis, or gastric aspirate
Advise patient to report adverse effects or discomforts
to health care professional promptly