generic name

Generic Name(Brand Name)

Drug Classification & Indication

Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Methergine(methylergonovine maleate)

PC: Ergot Alkaloid and Derivative

TC: oxytocic, lactation stimulant

Indication:Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution

IV:0.2 mg after delivery of anterior shoulder, after delivery of placenta, or during puerperium; may be repeated as required at intervals of 2-4 hours

Methergin↓

Stimulates uterine smooth

muscles↓

producing sustained

contractions↓

thereby shortens the third stage of

labor

Cardiovascular: hypertension, temporary chest pain, palpitation

CNSHallucinations, dizziness, seizure, headache

Gastrointestinal: Nausea, vomiting, diarrhea, foul taste

Local: Thrombophlebitis

Otic: Tinnitus

Renal: Hematuria

Respiratory: Dyspnea, nasal congestion

Miscellaneous: Diaphoresis

> contraindicated in patients hypersensitive to methylergonovine or any component of the formulation.

>ergot alkaloids are contraindicated with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics); hypertension; toxemia; pregnancy

>Be alert for adverse reactions and drug interactions.

>This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely.




Mechanism of Action


Magnesium Sulfate

PC: Magnesium Salt

TC: Anti-convulsant, Mineral

Indication: 1. Control seizures in preeclampsia and eclampsia

2. To manage preterm labor

I.M.: 1-4 g every 4 hours I.V.: Initial: 4 g, then switch to I.M. or 1-4 g/hour by continuous infusion

Magnesium Sulfate ↓

may decrease acetylcholine

released by nerve impulses

↓but anticonvulsant

mechanism is unknown.

↓Control seizures

CNS: drowsiness, depressed reflexes, flaccid paralysis and hypothermia.

CV: hypotension, flushing, circulatory collapsed, decreased cardiac function and heat block.

Metabolic: hypoglycemia

Respiratory:Respiratory paralysis

Skin: diaphoresis

Parenteral administration contraindicated in patients with heart block or myocardial damage.

Use cautiously in patients with impaired kidney function.

> Assess pt.’s condition before therapy and regularly thereafter to monitor the drug’s effectiveness.

> BP monitoring, and hold if BP is <80/60

>withhold if urine output is <30 cc/hour

>withhold if respiration <12 cpm

> Keep I.V. calcium gluconate at all times to reverse magnesium intoxication.

(↓ RR, ↓ BP, ↓ UO)




Mechanism of Action


Hyoscine Butylbromide

PC: anticholinergic

TC: antimuscarinic, antiemetic, antivertigo drug, antiparkinsonism

Indication:To reduce secretions perioperatively.

IV:1 mg/ml

HBB↓

Inhibits muscarinic actions of

acetylcholine in the ANS

↓Affecting neural

pathway↓

Relieves spasticity, nausea

and vomittin; reduces secretions; and blocks cardiac

vagal reflexes.

↓

Promotes cervical effacement

CNS: dizziness, headache, restlessness, disorientation, irritability, fever

GI: constipation, dry mouth, nausea, vomiting

CV: palpitations, tachycardia, flushing

EENT: dilated pupils, blurred vision, photophobia, dysphagia

GU: urinary hesitancy, urinary retention

Skin: rash, dryness

Contraindicated in patients with angle-closure glaucoma, obstructive uropathy, asthma, COPD, myasthenia gravis, paralytic ileus, intestinal atony, & unstable CV.

>Be alert for adverse reactions and drug interactions.

>Encourage pt. to void

>Monitor BP for possible hypotension.

>Monitor cervical effacement and dilatation.

Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

EPINEPHRINE (ep-i-ne'frin)

Bronkaid Mist, Epi-E-Zpen, Epinephrine Pediatric, EpiPen Auto-Injector, Primatene Mist Suspension

Classifications: AUTONOMIC NERVOUS SYSTEM AGENT; ALPHA- AND BETA-ADRENERGIC AGONIST; BRONCHODILATOR

AnaphylaxisAdult: SC 0.1–0.5 mL of 1:1000 q10–15min prn IV 0.1–0.25 mL of 1:1000 q10–15minChild: SC 0.01 mL/kg of, 1:1000 q10–15min prn IV 0.01 mL/kg of 1:1000 q10–15minNeonate: IV Intratracheal 0.01–0.03 mg/kg (0.1–0.3 mL/kg of 1:10,000) q3–5min prn

Cardiac ArrestAdult: IV 0.1–1 mg (1–10 mL of 1:10,000) q5min as needed Intracardiac 0.1–1 mgChild: IV 0.01 mg/kg (0.1 mL/kg of 1:10,000) q5min as needed Intracardiac 0.05–0.1 mg/kg

AsthmaAdult: SC 0.1–0.5 mL of 1:1000 q20min–4h Inhalation 1 inhalation q4h prnChild: SC 0.01 mL/kg of 1:1000 q20min–4h Inhalation 1 inhalation q4h prn

Naturally occurring catecholamine obtained from animal adrenal glands; also prepared synthetically. Acts directly on both alpha and beta receptors; the most potent activator of alpha receptors. Strengthens myocardial contraction; increases systolic but may decrease diastolic blood pressure; increases cardiac rate and cardiac output.

Temporary relief of bronchospasm, acute asthmatic attack, mucosal congestion, hypersensitivity and anaphylactic reactions, syncope due to heart block or carotid sinus hypersensitivity, and to restore cardiac rhythm in cardiac arrest. Ophthalmic preparation is used in management of simple (open-angle) glaucoma, generally as an adjunct to topical miotics and oral carbonic anhydrase inhibitors; also used as ophthalmic decongestant. Relaxes myometrium and inhibits uterine contractions.

Special Senses: Nasal burning or stinging, dryness of nasal mucosa, sneezing, rebound congestion. Transient stinging or burning of eyes, lacrimation, browache, headache, rebound conjunctival hyperemia, allergy, iritis; with prolonged use: melanin-like deposits on lids, conjunctiva, and cornea; corneal edema; loss of lashes (reversible); maculopathy with central scotoma in aphakic patients (reversible). Body as a Whole: Nervousness, restlessness, sleeplessness, fear, anxiety, tremors, severe headache, cerebrovascular accident, weakness, dizziness, syncope, pallor, sweating, dyspnea.

Hypersensitivity to sympathomimetic amines; narrow-angle glaucoma; hemorrhagic, traumatic, or cardiogenic shock; cardiac dilatation, cerebral arteriosclerosis, coronary insufficiency, arrhythmias, organic heart or brain disease; during second stage of labor; for local anesthesia of fingers, toes, ears, nose, genitalia. Safety during pregnancy (category C) or lactation is not established.

Assessment & Drug Effects

Monitor BP, pulse, respirations, and urinary output and observe patient closely following IV administration. Epinephrine may widen pulse pressure. If disturbances in cardiac rhythm occur, withhold epinephrine and notify physician immediately. Keep physician informed of any changes in intake-output ratio. Use cardiac monitor with patients receiving epinephrine IV. Have full crash cart immediately available.

NAME OF DRUG MECHANISMS OF ACTION

INDICATIONS DOSAGES CONTRAINDICATIONS ADVERSE REACTIONS

Brand name: Valium

Generic name: Diazepam

Depresses all levels of the CNS, including the Limbic andreticular formation, probably through the increase action of gammaaminobutyricacid (GABA), which is a major inhibitory neurotransmitter in thebrain

Anxiety

Adjunct treatment for seizure disorders

Preoperative sedation

Muscle spasm

Àdults: Depending on the severity, 2-10 mg PO bid – tid. Or, 2-10 mg IM or Iv q 3-4 hours PRN`Children age 6 months & older: 1-2.5 mg PO tid or qid, increase gradually as needed & toleratedÈlderly patients: Initially, 2-2.5 mg once daily or bid, increase gradually

Àdult: 2-10 mg PO bid – qid

Àdults: 10 mg IM (preferred) or IV before surgeryÀdults: 2-10 mg PO bid – qid. Or, 5-10 mg IV or IM initially; then 5-10 mg IV or IM q 3-4 hours PRN

hypersensitivity, cross-sensitivty with other benzodiazepines mayoccur, comatose patients, pre-existing CNS depression, uncontrolled severe pain,narrow angle glaucoma, pregnancy or lactation

CNS: dizziness, drowsiness, lethargy, depression, hangover,headache, paradoxical excitation

Resp: respiratory deoression

CV: hypotension(IV only)

GI: constipation, diarrhea, nausea, vomiting Derm: rash

Others:blured vision, pain (IM), phlebitis (IV), venous thrombosis, physical andpsychological dependence, tolerance

Name of Drug Dosage/Frequency / Route:

Mechanism of Action

Indication Contraindication Side Effects Nursing Consideration

Brand Name:Valium

Generic Name:Diazepam

Classification:Central Nervous System Drug

5-20 mg daily

PO

Facilitates/potentiates the inhibitory activity of GABA at limbic system and reticular formation to reduce anxiety, promote calmness and sleep.

Tablet: Symptomatic relief of anxiety, agitation, tension due to psychoneurotic states and transient situational disturbances, adjunct in major mental and organic disorders; relief of reflex muscle, spasm due to spinal and supraspinal interneurons.

Pregnancy (category D),Hypersensitivity,Dependence in other substance including alcohol, except in management of acute withdrawal reactions,Severe hypercapnia

Blurred vision,Paradoxical reactions,Dependence, Withdrawal symptoms

Obtain history of patients underlying condition before therapy and reassess regularly thereafter.

Monitor signs of anxiety.

Monitor vital signs: BP, CR, and RR. Hold drug if BP drops 20mmHg and monitor respirations every 5-15 minutes if drug is given IV.

Name of Drug Dosage/Frequency/Route:

Mechanism of Action

Indication Contraindication Side Effects Nursing Considerations

Brand Name:Furosemide

Generic Name:Furosemide

Classification:Dueretic/Antihypertensive Drug

40mg BID

PO

Inhibits sodium and chloride reabsortion at the proximal tubules, distal tubules and ascending loop of Henley leading to excertion of water together with sodium, chloride and potassium. Diuretic/ antihypertensive

Treatment of edema associated with congestive heart failure (CHF) hepatic cirrhocis, and , renal disease, hypertension

Hypersensitivity to sulfony lureas; anuria

Orthostatic hypotension, thromboplebitis, chronic aortitis, vertigo, fever, headache, dizziness, parethesia, sensitivity, restlessness, photo- uticaria, pruritis, necrotizing anginitis, exfolative dermatitis, erythema multiforme, rash, occasionally, local irritation and pain with parenteral use.

Assess patient’s underlying condition before starting therapy.

Monitor for renal, cardiac, neurologic, GI, pulmonary manifestation of hypokalemia.

Monitor for CV, GI, neurologic manifestations for hyponatremia.

Monitor for neurologic, respiratory manifestations for hyperchloremia.

Assess fluid volume status.

Assess patient for tinnitus hearing loss, ear pain.

Assess the pt’s and

family’s knowledge of drug therapy.

MEDICATION Dosage/ MECHANISM OF INDICATION CONTRAINDICATI0N SIDE EFFECTS NURSNG

Name of Drug Dosage/Frequency/Route: Mechanism of Action

Indication Contraindication Side Effects Nursing Consideration

Brand Name:Solu-cortef

Generic Name: Hydrrocortisone

Classification: Hormones and Related Drug

30 mg 2x a day 1 tab

PO

Suppresses inflammatory and immune responses, mainly by inhibiting migration of leukocytes and phagocytes and decreasing inflammatory mediators.

Replacement Therapy in adrenocortical insufficiencyHyperglycemia due to cancerArthritisCollagen diseases Dermatologic diseasesAutoimmune and Hematologic disorderTrichinosisUlcerative colitisMultiple sclerosisProtitisNephritic syndromeAspiration pneumonia

Hypersensitivity to drug, alcohol,bisulfites or tartrazineSystemic fungal infectionsConcurrent use of other immunosuppressant CorticosteroidsConcurrent administration of live-virus vaccines

CNS: headache, nervousness, depression, euphoriaEENT: cataracts, glaucoma, increased intraocular pressure, epistaxisGI: nausea, vomiting, esophageal candidiasis or ulcer, abdominal distentionRespiratory: cough, wheezing, rebound congestionSkin: rash, pruritus, urticaria, acne, bruising, straie, petechiae, acneiform lesions, skin fragility and thinnesOther: altered taste, weight gain

Do not confuse hydrocortisone with hydrocodone.

Check label of parenteral hydrocortisone because IM and IV preparations are not necessarily interchangeable.

Assess blood glucose levels in diabetic patients. Expect to increase insulin or oral hypoglycemic dosage

Urge patient to immediately report unusual weight gain, face or leg swelling, vomiting of blood, irregular menstrual cycle, prolonged sore throat, epigastric burning

Frequency:

Route:

ACTION CONSIDERATIONS

Brand Name:Dolotral

Generic Name: Tramadol

Classification: Analgesics, muscle relaxants & uricosurics

50-100mg/tab with 4-6 hours interval (NOTE: should not exceed 400mg)

PO

Centrally acting analgesic not chemically related to opioids but binds to mu-opioids receptors & inhibits reuptake of norepinephrine & serotonin

Moderate to severe pain.

Hypersensitivity, acute intoxication with alcohol, hypnotics, centrally acting analgesics, opioids, or psychotropic agents.

Vasodilation; dizziness, vertigo, headache, somnolence, stimulation, anxiety, confusions, coordination disturbances, euphoria, nervousness, sleep disorders, seizures. Pruritus, sweating, rash. Visual disturbances, dry mouth. Nausea, diarrhea, constipation, vomiting, dyspepsia, abdominal pain, anorexia, flatulence, urinary retention/frequency, menopausal symptoms, increased creatinine, proteinuria. Decreased hemoglobin, elevated liver enzymes, asthenia, hypertonia

Assess patient’s pain(location, type, character) before therapy & regularly thereafter to monitor effectiveness of the drug(give before pain becomes extreme)

Assess hypersensitivity reactions; monitor CNS, I&O, bowel pattern

Name of Drug Dosage / Frequency / Route:

Mechanism of Action Indication Contraindication Side Effects Nursing Consideraion

Brand Name: Novaluzid Atropine

Generic Name: Atropine

Classification: Antidotes

Adult:0.4-0.6mg/46hrPedia:0.1-0.6mg/46hr depending on weight

IV

Inhibits acetylcholine at parasympathetic neuro-effector junction, blocking vagal effect on the heart (SA node), exocrine glands, smooth muscles & urinary bladder. Drug increases heart rate, dries secretions, decreases sweating & salivation in low doses. Mydriallis (dilatation of the pupil) & cycloplegia (failure to accommodate for close vision) occur at moderate doses. Mobility of GI and GU systems are affected at high doses

Administration prior to anesthesia to prevent secretions of respiratory tract; to control rhinorrhea; treatment to parkinsonism; restoration of cardiac rate & arterial pressurein some situations; treatment of peptic ulcers; management of hypersecretion, irritation or inflammation of the stomach, intestines or pancrease; treatment of diarrhea; relief of infant colic

Hypersensitivity to anticholinergics; narrow-angle glaucoma; adhesions between iris and lens; prostatic hypertrophy; obstructive uropathy; myocardial ischemia; unstable cardiac status caused by hemorrhage; tachycardia, myasthenia, gravis; pyloric or intestinal obstruction asthma; hyperthyroidism; renal disease; hepatic disease; toxic megacolon; intestinal atony or paralytic ileus

Palpitations, bradycardia, tachycardia, orthostatic hypotension, headache, nervousness, drowsiness, weakness, dizziness, confusion, insomnia, fever, excitability, restlessness, tremor, allergic reactions, urticaria, rash, flushing, nasal congestion, altered taste, xerostomia, nausea, vomiting, dysphagia, heartburn, constipation, bloated feeling, paralytic ileus, urinary hesitancy, and retention, impotence, bronchospasm, suppression of lactation, decreased sweating

Obtain patient’s history of underlying condition & reassess regularly

Monitor cardiac rate, rhythm & character

Monitor respiratory status: rate, rhythm, cyanosis, wheezing, dyspnea, engorged neck veins

Monitor allergic reactions or hypersensitivity reactions: rash, urticaria

Decreased cardiac output

Name of drug Dosage / Mechanism of Indication Contraindication Side Nursing

Frequency/ Route

Action Effects Considerations

Brand Name:Aeknil

Generic Name: Paracetamol

Classification: Analgesics and Antipyretics

Adult & childn ≥10

yr 2-3 mL, ≤10

yr 1-2 mL

IV

Through the produce analgesia byblocking pain impulse by inhibitingsynthesis of prostaglandin in cns thatsynthesize pain receptor to stimulation

Pyrexia of unknown origin

Fever and pain associated with common childhood disorders

Tonsillitis

Upper respiratory tract infectios post-immunization reactions

After tonsillectomy and other conditions

Nephropathy Hematological, skin and other allergic reactions

instruct patient to takewith meals

have a plenty of waterwhen taking this drug

Name of Drug Dosage / Frequency/ Indication Adverse Effect Contraindication Nursing

Route Consideration

Sodium Bicarbonate

Brand name: Soda mint

Classification:Acidifiers and alkalinezers

Adult: PO Urine alkalinisation Up to 10 g/day in divided doses w/ sufficient fluid intake. Chronicmetabolic acidosis ≥4.8 g/day as needed. Dyspepsia 1-5 g when needed

IV Severe metabolic acidosis By slow inj of a hypertonic soln ≤8.4% or by continuous infusion of a weaker soln, usually 1.26%

Cardiac arrest, metabolic acidosis, systemic or urinary alkalinization, antacid

Tetany, edema, hypokalemia, metabolic alkalosis, hypernatremia,pain and irritation at injection site

Contraindicated in patients with metabolic or respiratory alkalosis and in those with hypocalcemia in which alkalosis may produce tetany, hypertension, seizures, or heart failure

To avoid alkalosis, obtain blood pH, partial pressure of arterial oxygen, partial pressure of arterial CO2 and electrolyte levels.

Keep prescriber informed of laboratory results.

Generic Name Dosage / Indication Adverse Effect Contraindication Nursing Consideration

http://mims.com/Philippines/diagnoses/info/713

http://mims.com/Philippines/diagnoses/info/1201

Frequency/ Route

Calcium gluconate

Brand name: Calcium gluconate

Classification:Electrolytes and replacement solutions

Hypocalcemic emergency, hypoclacemic tetany, adjunctive treatment of cardiac arrest, adjunctive treatment of magnesium intoxication, hyperphosphatemia,

Tingling sensation, syncope, mild drop in bp, bradycardia, arrhythmias, cardiac arrest, irritation, constipation, hemorrhage, abdominal pain, polyuria, renal calculi, hypercalcemia, pain

Contraindicated in cancer patients with bone metastases and in patients with ventricular fibrillation, hypercalcemia, hypophosphatemia, or renal calculi

Use all calcium products with extreme caution.

Monitor calcium levels frequently.

To avoid constipation and bloating and to improve absorption, give calcium gluconate in divided doses.

generic name

Documents

drug interactions

antivertigo drug

cervical effacement

antiparkinsonism indication

adverse reactions

monitor bp

mineral indication

cervical effacement