D R U G S T U D Y

DRUG CLASSIFICATION

THERAPEUTIC ACTION

INDICATION CONTRAINDICATION

& CAUTION

ADVERSE EFFECTS NURSING RESPONSIBILITY

misoprostol(mye soe prost’ ole)

Brand Name: Cytotec

Pregnancy category x

Prostaglandin A synthetic prostaglandin E1 analogue; inhibitsgastric acid secretion and increases bicarbonateand mucus production, protecting the liningof the stomach.

● Prevention of NSAID (including aspirin)-induced gastric ulcers in patients at highrisk of complications from a gastric ulcer(the elderly; patients with concomitant debilitatingdisease, history of ulcers)● With mifepristone as an abortifacient (seemifepristone)● Unlabeled use: Appears effective in treatingbut not preventing duodenal ulcers in patientsunresponsive to histamine-2 antagonists;cervical ripening and labor induction;postpartum hemorrhage; chronic idiopathicconstipation

● Contraindicated with history of allergy toprostaglandins; pregnancy (abortifacient;advise women of childbearing age in writtenand oral form of use, have a negativeserum pregnancy test within 2 wk prior totherapy, provide contraceptives, and begintherapy on the second or third day ofthe next normal menstrual period); lactation.● Use cautiously in the elderly, and with renalimpairment, duodenal ulcers.

● GI: Nausea, diarrhea, abdominal pain,flatulence, vomiting, dyspepsia, constipation● GU: Miscarriage, excessive bleeding, spotting,cramping, hypermenorrhea, menstrualdisorders, dysmenorrhea● Other: Headache

● Give to patients at high risk for developingNSAID-induced gastric ulcers; give for thefull term of the NSAID use.

● Arrange for oral and written explanation ofthe risks to pregnancy; appropriate contraceptivemeasures must be taken; begin therapyon the second or third day of a normalmenstrual period.

D R U G S T U D Y

DRUG CLASSIFICATION

THERAPEUTIC ACTION

INDICATION CONTRAINDICATION

& CAUTION

ADVERSE EFFECTS NURSING RESPONSIBILITY

Oxytocin

(ox i toe’ sin)

Brand Name:

Pitocin

pregnancy category x

HormoneOxytocic

Synthetic form of an endogenous hormoneproduced in the hypothalamus and stored inthe posterior pituitary; stimulates the uterus,especially the gravid uterus just before parturition,and causes myoepithelium of the lactealglands to contract, which results in milk ejectionin lactating women.

● Antepartum: To initiate or improve uterinecontractions to achieve early vaginal delivery;stimulation or reinforcement of laborin selected cases of uterine inertia; managementof inevitable or incomplete abortion;second trimester abortion.● Postpartum: To produce uterine contractionsduring the third stage of labor and to controlpostpartum bleeding or hemorrhage● Lactation deficiency● Unlabeled uses: To evaluate fetal distress(oxytocin challenge test), treatment of breastengorgement

● Contraindicated with significant cephalopelvicdisproportion, unfavorable fetal positionsor presentations, obstetric emergenciesthat favor surgical intervention, prolongeduse in severe toxemia, uterine inertia, hypertonicuterine patterns, induction or augmentationof labor when vaginal delivery iscontraindicated, previous cesarean section,pregnancy.● Use cautiously with renal impairment.

● CV: Cardiac arrhythmias, PVCs, hypertension,subarachnoid hemorrhage● Fetal effects: Fetal bradycardia, neonataljaundice, low Apgar scores● GI: Nausea, vomiting● GU: Postpartum hemorrhage, uterine rupture,pelvic hematoma, uterine hypertonicity,spasm, tetanic contraction, ruptureof the uterus with excessive dosage or hypersensitivity● Hypersensitivity: Anaphylactic reaction● Other: Maternal and fetal deaths when usedto induce labor or in first or second stagesof labor; afibrinogenemia; severewater intoxication

● Ensure fetal position and size and absenceof complications that are contraindicatedwith oxytocin before therapy.●Ensure continuous observationof patient receiving IV oxytocin for inductionor stimulation of labor; fetal monitoringis preferred. A physician should beimmediately available to deal with complicationsif they arise.● Regulate rate of oxytocin delivery to establishuterine contractions that are similar tonormal labor; monitor rate and strength ofcontractions; discontinue drug and notifyphysician at any sign of uterine hyperactivityor spasm.

with seizures andcoma, maternal death (associated withslow oxytocin infusion over 24 hr; oxytocinhas antidiuretic effects)

D R U G S T U D Y

Nomenclature Mechanism of action Contraindication Indication Adverse Effect Nursing Responsibilities

Generic Name: Ceftriaxone

Brand Name:

Rocephin

Classification:

Third- generation Cephalosporin

Bacterial: inhibits synthesis of bacterial cell wall, causing cell death.

Allergy to cephalosporins or penicilins, renal failure, lactation and pregnancy

Lower respiratory tract infections cause S.pneumonia, S.ureas,Klebsiella,H.influenza, E. coli,P. mirabilis, E.aerogens ,Seratia marcessens, Haemophilus parainfluenza, streptococcus (excluding enterococci)

CNS: headache, dizziness, lethargy, paresthesias .

GI: nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomembranous colitis, liver toxicity

GU: nephrotoxicity

Hematologic: bone marrow depression; decrease WBC, decrase platelets, decrease HCT

Hypersensitivity: Ranging from rash to fever to anaphylaxis, serum,sickess,reaction

Assess for the pt. history: liver and kidney dysfunction, lactation, pregnancy

Physical: skin, status, liver and kidney function test, culture of affected area sensitivity teeest