Ivanne D'Laureil I.

Hisoler
BSN III-A

Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Type 1 antiarrhythmic: Decreases General Indications Concentrations Antiarrhythmic with systemic Before
Lidocaine HCl Class diastolic depolarization, decreasing - Management of - Allergy to lidocaine or administration - Check drug concentration carefully.
Amide-type Local automacity of ventricular cells; acute ventricular amide-type local CNS: Dizziness or lightheadedness, - Reduce dosage with hepatic or renal
Trade Name Anesthetic increases ventricular fibrillation arrhythmias during anesthetics fatigue. Drowsiness, unconsciousness, failure.
Xylocaine threshold cardiac surgery and - Heart failure tremors, twitching, vision changes, - Keep life-support equipment and
Therapeutic Class Local anesthetic: Blocks the MI. - Cardiogenic shock may progress to seizures vasopressors readily available in case
Minimum Dose Antiarrhythmic, generation and conduction of action - Infiltration - Second or third CV: Cardiac arrhythmias, cardiac severe adverse reaction occurs.
- Instruct about side effects of drug.
50 mg at a rate of Local Anesthetic potentials in sensory nerves by anesthesia, peripheral degree heart block arrest, vasodilation, hypotension
- Keep in mind that amount used
25 mg/min reducing sodium permeability, and sympathetic - Stokes-Adams Hypersensitivity: Rash,
should be as small as possible.
Pregnancy Risk reducing height and rate of rise of nerve blocks, central syndrome anaphylactoid reactions - Observe the 15 rights of drug
Maximum Dose Factor the action potential, increasing nerve blocks, spinal - Wolff-Parkinson- Respiratory: Respiratory depression, administration.
300 mg B excitation threshold, and slowing and caudal White syndrome respiratory arrest
conduction velocity anesthesia, Other: Malignant hyperthermia, fever, During
Precaution
Contents retrobulbar and local injection site reaction - Continuously monitor response
- Impaired renal and
Lidocaine HCl Pharmacokinetics transtracheal when used as antiarrhythmic or
hepatic function
injection, topical Injectable local anesthetic for epidural injected as local anesthetic.
- Inflammation or
Availability and A: Lidocaine is also well-absorbed anesthetic for skin or caudal anesthesia - Titrate dose to minimum needed for
sepsis in the region of
color from the GIT, although little intact disorders and CNS: Headache, backache, septic cardiac stability.
- Direct injection- 10, injection - Make sure that such solutions are
drug appears in the circulation accessible mucous meningitis, persistent sensory, motor
20 mg/mL - Labor and delivery used only to produce locale
because of biotransformation in the membranes or autonomic deficit of lower spinal
- IV injection- 40, 100, (may prolong second anesthesia.
liver. - As local analgesia segments, sometimes with incomplete
200 mg/mL stage of labor) - Apply lidocaine ointments or creams
D: Lidocaine crosses the blood- before venipuncture recovery
- IV infusion- 2, 4 ,8 - Lactation to a gauze or bandage before
mg/mL brain and placental barriers, or peripheral IV CV: Hypotension due to sympathetic
presumably by passive diffusion. cannulation when block applying to the skin.
- IM injection- 300 Drug interaction
M: Hepatic applied to intact skin Dermatologic: Urticaria, pruritus, - Establish safety precautions if CNS
mg/mL
Drug to drug changes occur.
- Topical liquid- 2.5% E: Urine in children 3-18 yr erythema, edema
- Topical ointment- 5% - Increased lidocaine
GU: Urinary retention, urinary or fecal
- Topical cream- 0.5% Route levels with beta After
incontinence - Educate client about side effects of
Topical gel- 0.5%, 2%, Onset blockers, cimetidine,
2.5%, 4%, 5% Peak ranitidine drug.
Duration Topical local anesthetic - Instruct to report to physician if
- Topical spray- 0.5%, - Prolonged apnea with
10%
IM Dermatologic: Contact dermatitis, adverse reactions occur.
5-10 min succinylcholine
- Topical solution- 2%, urticaria, cutaneous lesions - Monitor for malignant hyperthermia.
5-15 min
4% 2 hr Hypersensitivity: anaphylactoid - Monitor fluid load carefully.
Drug to food
- Injection- 0.5%, 1%, IV reactions - Have patients who have received
1.5%, 2%, 4%, 5% Immedi-ate - none reported
Local: Burning, stinging, tenderness, lidocaine as spinal anesthetic remain
- Transdermal system- Immedi-ate
10-20 min
swelling, tissue irritation, tissue lying flat for 6-12 hr afterward.
0.5mg sloughing, necrosis - Ensure adequate hydration to
Other: Methemoglobinemia, seizures minimize risk of headache.
Routes of Drug Half Life (children) - Do not give food or drink for 1 hr
administration 10 min, then 1.5-3 hr after use of oral anesthetic.
Intramuscular - Do proper documentation.
Intravenous

Source: Source: Source: Source: Source: Source: Source:

Karch, Amy: 2009 Karch, Amy: 2009 http://mims.com.ph/, Karch, Amy: 2009 Karch, Amy: 2009 Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug
Lippincott’s Nursing Drug Lippincott’s Nursing Drug Lippincott’s Nursing Drug Guide, pp. 693-696 Lippincott’s Nursing Drug Nursing Drug Guide, pp. 693- Guide, pp. 693-696 Guide, pp. 693-696
Guide, pp. 693-696 Guide, pp. 693-696 Guide, pp. 693-696 696
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Hypertonic solution has a greater General Indications Concentrations CV: Vein damage Before
D5LR (5% Dextrose Class concentration of solutes than - Replacement therapy - Renal failure - Obtain vital signs for baseline
in Lactated Ringer's Hypertonic solution plasma. H2O draws out of a cell particularly in - Liver dysfunction Respiratory: Coughing, sneezing, data.
Solution) causing the cell to shrink. extracellular fluid deficit - Diabetes Mellitus dyspnea - Check physician's order.
accompanied by acidosis - Lactic acidosis - Assess lab values.
Trade Name Pregnancy Risk - Used to treat losses for - Alkalosis - Check for minute leaks by
Braun D5LR, LVP Factor lower GI tract and burns Other: Allergic reaction squeezing inner bag firmly.
Precaution
D5LR C - Attach administration set. Refer to
- Pediatric patients
Skin: Generalized urticaria, complete directions accompanying
- Congestive Heart
Minimum Dose pruritus, facial edema set.
Failure
KVO IV - Check patency of IV line.
- Severe renal
insufficiency
Maximum Dose During
- Metabolic or
Fast drip IV - Do not administer unless solution
respiratory alkalosis
is clear and seal is intact.
Contents - Prepare medication site. Puncture
Per 100 mL medication part and inject using
dextrose Na syringe with 19 to 22 gauge needle.
lactated sol'n.: - Maintain sterility of needle or
manohydrate 50% catheter.
620 mg; NaCl 600 - Explain importance of IVF to
mg, Kcl 30 mg, patient.
CaCl2 200 mg - Regulate the flow properly.
- Monitor the patient closely for first
Availability and 15-20 minutes.
color
- Infusion solution
(clear): 500 mL and After
1000 mL - Watch for adverse reactions.
- Encourage patient to report signs
Routes of of adverse reactions.
administration - If an adverse reaction does occur,
Intravenous discontinue infusion.
- Check patency of IV line everyday.
- Monitor for fluid overload.
- Assess for signs of thrombosis or
phlebitis.
- Document that infusion has been
started.
Source: Source: Source: Source: Source: Source: Source:
http://www.rxlist.com/lacta http://www.rxlist.com/lacta http://www.rxlist.com/lactated-ringers-in-5- http://www.rxlist.com/lactated- http://www.rxlist.com/lactated- http://www.rxlist.com/lactated-ringers-in-5- http://www.rxlist.com/lactated-ringers-in-5-
ted-ringers-in-5-dextrose- ted-ringers-in-5-dextrose- dextrose-drug.htm ringers-in-5-dextrose-drug.htm ringers-in-5-dextrose-drug.htm dextrose-drug.htm dextrose-drug.htm
drug.htm drug.htm
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Class Inhibits folic acid reductase, General Indications Concentrations CNS: Headache, drowsiness, Before
Methotrexate Folic acid antagonist leading to inhibition of DNA - Burkitt's lymphoma - Pregnancy blurred vision, aphasia, - Observe 15 rights of drug
synthesis and inhibition of cellular - Acute lymphoblastic - Lactation hemiparesis, paresis, seizures, administration.
Trade Name Therapeutic Class replication; selectively affects the leukaemia - Alcoholism fatigue, malaise, dizziness - Assess for hypersensitivity to drug.
Folex Antimetabolite. most rapidly dividing cells - Choriocarcinoma - Chronic liver disease - Assess for contraindications of the
Antineoplastic, (neoplastic and psoriatic cells) - Mycosis fungoides - Immune deficiencies Dermatologic: Erythematous drug.
Minimum Dose Antipsoriatic, - Psoriasis - Blood dyscrasias rashes, pruritus, urticaria, - Arrange for tests to evaluate CBC,
7.5 mg 1 tab BID Antirheumatic Pharmacokinetics - Rheumatoid arthritis - Hypersensitivity photosensitivity, urinalysis, renal and liver function tests,
- Crohn's disease depigmentation, alopecia, and chest X-ray before therapy.
Precaution
Maximum Dose Pregnancy Risk A: Rapidly absorbed from the GI - Osteosarcoma ecchymosis, telangiectasia, - Ensure that patient is not pregnant
- Renal disease
15 mg 1 tab q6˚ Factor tract at low doses, higher doses - Breast cancer - Infection acne, furunculosis before administering.
X are less well absorbed. Rapidly - Advanced - Prepare a calendar of treatment days.
- Peptic ulcer
Contents and completely absorbed after IM lymphosarcoma - Ulcerative colitis GI: Ulcerative stomatitis,
Methotrexate doses. - Acute lymphoblastic During
- Debility gingivitis, pharyngitis, anorexia,
D: Tissues and extracellular leukaemia - Do not administer any other
fluids; crosses the blood-brain nausea, vomiting, diarrhea, medications containing alcohol.
Availability and - Choriocarcinoma Drug interaction
barrier and placenta; enters hematemesis, melena, GI - Arrange for adequate hydration during
color - Acute lymphoblastic Drug to drug
breast milk. Small amounts in ulceration, bleeding, enteritis, therapy to reduce risk of hyperuricemia.
- Tablets- 2.5, 5, leukaemia - Potentially serious to
saliva and breast milk. 50% hepatic toxicity - Arrange to have leucovrin readily
7.5 10, 15mg - Mycosis fungoides fatal reactions when
- Powder for bound to plasma proteins. Bound - Crohn's disease available as antidote for methotrexate
given with NSAID’s
injection- 20 mg, 1 as polyglutamate conjugates, - Psoriasis GU: Renal failure, effects on overdose.
- Risk for toxicity with
g per vial bound drug may remain in the - Meningeal leukaemia fertility - Instruct to use contraceptives during
alcohol
- Injection- 25 body for several mth, particularly - Hydatidiform mole therapy.
- Increased risk of
mg/mL in the liver. Hematologic: Severe bone - Avoid contact with needles for
toxicity with salicylates,
M: Partly by intestinal flora. Does marrow depression, increased parenteral administration.
probenecid,
Routes of not undergo significant susceptibility to infection
sulfonamides
administration metabolism at low dose therapy; After
- Decreased serum
Oral 7-hydroxy metabolite is detected - Arrange for tests to evaluate CBC,
levels and therapeutic Hypersensitivity:
Intramuscular at high-doses. urinalysis, renal and liver function tests,
effects of digoxin Anaphylaxis, sudden death
Intravenous E: Primarily via urine; small and chest X-ray several weeks after
- May decrease
amounts in bile, feces. therapy.
theophylline clearance
Respiratory: Interstitial - Instruct to report black tarry stools,
Route pneumonitis, chronic interstitial fever, chills, sore throat, unusual
Onset Drug to food
Peak
obstructive pulmonary disease bleeding or bruising, cough or shortness
- none reported
Duration of breath, darkened or bloody urine,
Oral
Other: Chills and fever, abdominal, flank or joint pain, jaundice
Varies symptoms, mouth sores.
1-2 hr metabolic changes, cancer
Unknown - Reduce dosage or discontinue if renal
IM failure occurs.
Rapid - Arrange for frequent, regular medical
0.5-1 hr
Unknown
check-ups.
IV - Document that drug has been given.
Rapid
0.5-1 hr
Unknown

Drug Half Life

3-15 hr
Source: Source: Source: Source: Source: Source: Source:
Karch, Amy: 2009 http://www.keele.ac.uk/ http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Karch, Amy: 2009 Lippincott’s Nursing Drug Guide,
Lippincott’s Nursing Karch, Amy: 2009 Lippincott’s Lippincott’s Nursing Drug Guide, p. 768 Nursing Drug Guide, p. 769 Drug Guide, p. 769 p. 769
Drug Guide, p. 767-768 Nursing Drug Guide, p. 767
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Acts directly on vascular smooth General Indications Concentrations CNS: Headache, peripheral Before
Hydralazine Class muscle to cause vasodilation, - Hypertension - Hypersensitivity neuritis, dizziness, tremors, - Check blood pressure.
Vasodilator primarily arteriolar, decreasing - Eclampsia - CAD psychotic reactions, characterized - Arrange for CBC, LE cell
Trade Name peripheral resistance; maintains or - mitral valvular by depression, disorientation, preparations, and ANA titers before
Apresoline, Novo- Therapeutic Class increases renal and cerebral flow. rheumatic heart anxiety therapy.
Hylazin Antihypertensive disease - Assess for contraindicated
Pharmacokinetics CV: Palpitations, tachycardia, conditions.
Precaution
Minimum Dose Pregnancy Risk angina pectoris, hypotension, - Observe the 15 rights of drug
- with CAV’s
5 mg/hr by IV Factor A: Rapidly absorbed from the GI paradoxical pressor response, administration.
- increased intracranial
infusion C tract after oral administration. orthostatic hypotension - Assess bowel sounds.
pressure
D: About 90% bound to plasma - Assess voiding pattern.
- severe hypertension
Maximum Dose proteins.
with uremia GI: Anorexia, nausea, vomiting,
10 mg by IV M: Undergoes considerable first- During
- advanced renal diarrhea, constipation, paralytic
infusion pass metabolism by acetylation in - Give oral drug with food.
damage ileus
the GI mucosa and liver. - Use parenteral drug immediately
- slow acetylators
Contents E: Mainly excreted in urine as after opening ampule.
- lactation
Hydralazine HCl metabolites. GU: Difficult micturition, impotence - Discard discolored solutions.
- pregnancy
- Arrange for CBC, LE cell
- pulmonary
Availability and Route Hematologic: Blood dyscrasias preparations, and ANA titers during
hypertension
color Onset prolonged therapy.
- Tablets- 10, 25, Peak - Instruct to take drug exactly as
Duration Drug interaction Hypersensitivity: Rash, urticaria,
50, 100 mg Oral prescribed.
Drug to drug pruritus, fever, chills, arthralgia,
- Injection- 20 Rapid
- Increased eosinophilia; rarely, hepatits,
mg/mL 1-2 hr After
6-12 hr pharmacologic effects obstructive jaundice - Withdraw drug gradually.
Routes of IM of beta-adrenergic
Rapid - Discontinue if blood dyscrasias
administration blockers and
10-20 min Other: Nasal congestion, flushing, occur.
Oral 2-4 hr hydralazine when given
edema, muscle cramps, - Arrange for pyridoxine therapy if
Intramuscular IV concomitantly
Rapid
lymphadenopathy, splenomegaly, patient develops symptoms of
Intravenous 10-20 min dyspnea, lupus-like syndrome, peripheral neuritis.
Drug to food
2-4 hr possible carcinogenesis, - Monitor for orthostatic
- Increased
lacrimation, conjunctivitis hypotension.
bioavailability of oral
Drug Half Life - Report persistent or severe
hydralazine given with
3-7 hr constipation, unexplained fever or
food.
malaise, muscle or joint aching,
chest pain, rash, numbness,
tingling.
- Do proper documentation.
Source: Source: Source: Source: Source: Source: Source:
Karch, Amy: 2009 http://mims.com.ph/, http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug
Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 588 Nursing Drug Guide, p. 589 Guide, p. 589 Guide, pp. 589-590
Guide, p. 588 Lippincott’s Nursing Drug
Guide, p. 588
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Cofactor of many enzyme systems General Indications Concentrations CNS: Weakness, Before
Magnesium Class involved in neurochemical transmission - Constipation - Allergy to magnesium drowsiness, dizziness, - Assess for contraindicated conditions.
Sulfate Mineral, Electrolyte and muscular excitability; prevents or - Torsades de pointes products fainting, sweating - Monitor knee-jerk reflex before
controls seizures by locking the - Muscle stimulating - Abdominal pain repeated parenteral administration.
Trade Name Therapeutic Class neuromuscular transmission; attracts effects of barium - Nausea Respiratory: Decreased - Give as laxative as temporary
Martham Antiepileptic, and retains the water in the intestinal poisoning - Vomiting respiratory rate measure.
Laxative; Mineral, lumen and distends the bowel to - Reduction of - Acute surgical abdomen - Reserve IV use in eclampsia for life-
Minimum Dose electrolyte promote mass movement and relieve cerebral oedema. - Fecal impaction threatening situations.
1-2 g qH by IV replacement constipation. - Hypomagnesaemia - Intestinal and biliary tract CV: Palpitations - Observe the 15 rights of drug
infusion - Seizures associated obstruction administration.
Pregnancy Risk Pharmacokinetics with epilepsy, - Hepatitis GI: Excessive bowel activity,
Maximum Dose Factor glomerulonephritis or - Myocardial damage perianal irritation During
4-6 g qH by IV A A: Following administration, 30-50% of hypothyroidism. - Heart blocks - Give IM route by deep IM injection.
infusion B (Laxative) the dose is absorbed from the small - Toxemias of - 2 hr preceding delivery Metabolic: Magnesium - Monitor serum magnesium levels.
intestine. pregnancy intoxication, hypocalcemia - Do not give oral MgSO4 with
Precaution
Contents D: Crosses the placenta and small - Boils and carbuncles with tetany abdominal pain, nausea, or vomiting.
- Renal insufficiency
Magnesium amounts enter the breast milk. - Do not administer if knee-jerk reflexes
sulfate M: Unknown are suppressed
Drug interaction
E: Via urine and feces. - Monitor bowel function.
Drug to drug
Availability and
Route - Potentiation of
color After
Onset neuromuscular blockade
- Granules- 40 Peak
- Arrange to discontinue administration
produced by
mEq/5 g Duration as soon as levels are within normal
nondepolarizing
- Injection- 0.325, Oral limits and desired clinical response is
1-2 hr neuromuscular relaxants
0.65, 1, 4 mEq/mL obtained.
Unknown
3-4 hr - Discontinue if diarrhea or cramping
Drug to food
Routes of IM occurs.
- none reported
administration 60 min - Arrange for dietary measures, exercise
Unknown
Oral 3-4 hr
and environmental control to return to
Intramuscular IV normal bowel activity.
Intravenous Immediate - Report sweating, flushing, muscle
Unknown tremors or twitching, inability to move
30 min
extremities.
- Maintain urine output at a level of 100
Drug Half Life
mL every 4 hr during parenteral
Unknown
administration.
- Do proper documentation.

Source: Source: Source: Source: Source: Source: Source:

Karch, Amy: 2009 http://mims.com.ph/, http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug
Lippincott’s Nursing Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 724- Nursing Drug Guide, pp. 724- Nursing Drug Guide, p. 725 Guide, pp. 725-726
Drug Guide, p. 724 Lippincott’s Nursing 725 725
Drug Guide, pp. 724
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic It increases neuronal membrane General Indications Concentrations CNS: Transient, mild Before
Diazepam Class permeability to chloride ions by - Short-term - Hypersensitivity drowsiness initially; sedation, - Discuss risk of fetal abnormalities with
Benzodiazepine binding to stereospecific management of anxiety - Preexisting CNS depression, lethargy, apathy, patients desiring to become pregnant.
Trade Name benzodiazepine receptors on the - Insomnia associated depression or coma fatigue, disorientation, - Instruct about side effects of drug:
Valium Therapeutic Class postsynaptic GABA neuron within the with anxiety - Respiratory depression restlessness, confusion, Drowsiness, dizziness, GI upset,
Antiepileptic, CNS and enhancing the GABA - Sleepwalking - Acute pulmonary delirium, headache, slurred dreams, difficulty concentrating, fatigue,
Minimum Dose Anxiolytic, Skeletal inhibitory effects resulting in - Night terrors insufficiency or sleep speech, dysarthria, stupor, nervousness, crying.
2mg/day muscle relaxant hyperpolarisation and stabilization. - Premedication before apnea rigidity, tremor, mild - Assess for hypersensitivity.
anaesthesia - Severe hepatic paradoxical excitatory - Reduce dose of opioid analgesics with
Maximum Dose Pregnancy Risk Pharmacokinetics - Adjunct in the impairment reactions, extrapyramidal IV diazepam; dose should be reduced
60mg/day Factor management of - Acute narrow angle symptoms, visual and by at least one-third or eliminated.
D A: Readily and completely absorbed seizures glaucoma auditory disturbances - Instruct not to stop taking the drug
Contents from the GI tract, peak plasma - Muscle spasms - Children < 6 mth CV: Bradycardia, without consulting the health care
Diazepam concentrations after 30-90 min (oral). - Acute symptoms of - Pregnancy and lactation. tachycardia, CV collapse, provider.
Rapidly absorbed, peak plasma alcohol withdrawal hypertension and - Observe the 15 rights of drug
Precaution
Availability and concentrations after 10-30 min - Premedication before hypotension, edema administration.
- Impaired renal and
color (rectal). anaesthesia Dependence: Drug
hepatic function
- Tablets-2, 5, 10 D: Readily crosses the blood-brain dependence with withdrawal During
- Chronic pulmonary
mg barrier; redistributed into fat depots syndrome - Do not administer intrarterially; may
insufficiency
- Oral solution- and tissues. Protein-binding: 98-99%. Dermatologic: Urticaria, produce arteriospasm, gangrene.
- Organic cerebral
1mg/mL, 5mg/mL M: Extensively hepatic; converted to pruritus, skin rash, dermatitis - Carefully monitor P. BP, respiration
changes; elderly
- Rectal pediatric desmethyldiazepam, oxazepam and GI: Constipation, diarrhea, during IV administration.
- History of alcohol or drug
gel- 2.5, 5, 10mg temazepam. dry mouth, salivation, - Change from IV therapy to oral therapy
addiction.
- Injection- E: Urine (as free or conjugated nausea, anorexia, vomiting, as soon as possible.
5mg/mL metabolites) difficulty in swallowing, - Do not use small veins for IV injection.
Drug interaction
elevation in blood enzymes, - Instruct to take drug exactly as
Drug to drug
Routes of Route hepatic impairment prescribed.
- Increased CNS
administration Onset GU: Incontinence, urinary
Peak depression with alcohol,
Oral retention, changes in libido, After
Duration omeperazole
Intramuscular Oral menstrual irregularities - Maintain patients receiving parenteral
- Increased pharmacologic
Intravenous 30-60 min Hematologic: Decreased benzodiazepines in bed for 3 hours.
effects of diazepam if
Rectal 1-2 hr Hct, blood dyscrasias - Do not permit ambulatory patients to
3 hr combined with cimetidine,
IM
Other: Phlebitis, thrombosis, operate a vehicle following an injection.
disulfiram, hormonal
15-30 min hiccups, fever, diaphoresis, - Instruct patient to report adverse
contraceptives
30-45 min paresthesias, muscular reactions.
3 hr - Decreased effects of
disturbances, gynecomastia, - Monitor EEG in patients treated for
IV diazepam with
1-5 min pain, burning, redness after status epilepticus, seizures may recur
theophyllines, ranitidine
30 min IM injection after initial control.
15-60 min - Monitor liver and renal function, CBC
Rectal Drug to food
Rapid
during long term therapy.
- none reported
1.5 hr - Taper dosage gradually after long-term
3 hr therapy.
- Document that drug has been given.
Drug Half Life
20-80 hr

Source: Source: Source: Source: Source: Source: Source:

Karch, Amy: 2009 Karch, Amy: 2009 http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug Guide,
Lippincott’s Nursing Lippincott’s Nursing Drug Lippincott’s Nursing Drug Guide, pp. 374-376 Nursing Drug Guide, pp. 374-376 pp. 374-376
Drug Guide, pp. 374 Guide, pp. 374-376
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Insulin is a hormone secreted by General Indications Concentrations Hypersensitivity: Rash, Before
Insulin Class beta cells of the pancreas that, by - Diabetes mellitus - Allergy to pork anaphylaxis, angioedema - Observe the 15 rights of drug
Hormone receptor-mediated effects, - Diabetic ketoacidosis products administration.
Trade Name promotes the storage of the body’s - Diabetic coma - History of smoking or Respiratory: Decline in pulmonary - Ensure uniform dispersion of
Humulin R Therapeutic Class fuels, facilitating the transport of - Basal insulin control lung disease function insulin suspensions.
Antidiabetic metabolites and ions through cell - Use caution when mixing two
Precaution
Minimum Dose membranes and stimulating the types of insulin.
- Lactation Local: Allergy, lipodystrophy,
0.05 unit/kg/hr Pregnancy Risk synthesis of glycogen from glucose - Double check, or have a colleague
- Pregnancy pruritus
Factor of fats from lipids, and proteins check dosage for pediatric patients.
Maximum Dose B from amino acids. - Keep life support equipment and
Drug interaction
1.2 units/kg/hr Metabolic: Hypoglycemia, glucose readily available.
Drug to drug
Pharmacokinetics ketoacidosis - Use the same type and brand of
- Increased
Contents insulin to avoid dosage errors.
hypoglycaemic effects
70% Human Insulin A: Inactivated (oral); fairly rapid
of insulin with MAOI’s,
Isophane (SC); rapid (IM); increased by During
beta blockers,
Suspension and exercise. - Give maintenance doses
salicylates, alcohol
30% Human Insulin D: Crosses placenta, does not subcutaneously.
- Delayed recovery
Injection (rDNA enter breast milk - Monitor patients receiving insulin
from hypoglycaemic
origin) M: Mainly in liver, also in kidneys IV carefully.
episodes and masked
and muscle tissue. - Do not give insulin injection
signs and symptoms of
Availability and E: Small amount excreted as concentrated IV.
hypoglycaemia if taken
color unchanged drug in urine. - Do not change the order of mixing
with beta adrenergic
- Injection- 100 insulins.
Route blockers.
units/mL, 500 - Avoid alcohol upon administration.
Onset - Decreased
units/mL Peak effectiveness of insulin
- Prefilled cartridges Duration After
with corticosteroids,
and pens- 100 Parenteral - Store insulin in a cool place away
30-60 min diuretics, atypical
units/mL from direct sunlight, do not freeze.
2-3 hr antipsychotics
6-12 hr - Monitor urine or serum glucose
Routes of levels frequently to determine
administration Drug to food
effectiveness of drug and dosage.
Intramuscular Drug Half Life - none reported
- Monitor insulin needs during times
Subcutaneous Varies with preparation of trauma or severe stress.
Intravenous - Arrange for proper disposal of
syringes.
- Rotate injection sites regularly.
- Document that drug has been
given.
Source: Source: Source: Source: Source: Source: Source:
Karch, Amy: 2009 http://mims.com.ph/, http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug
Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 626-627 Nursing Drug Guide, pp. 626- Guide, p. 627 Guide, pp. 627-628
Guide, p. 626 Lippincott’s Nursing Drug 627
Guide, p. 626
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Accelerates the breakdown of General Indications Concentrations CV: Hypotension, Before
Glucagon Class glycogen to glucose in the liver, - Severe hypoglycaemia - Hypersensitivity hypertension, tachycardia - Observe 15 rights of drug
Hormone causing an increase in blood - As a diagnostic aid in - Pheochromocytoma administration.
Trade Name glucose level; relaxes the smooth the radiologic exam of GI - Insulinoma Hypersensitivity: - Teach administration of drug
GlucaGen Therapeutic Class muscle of the GI tract and tract Anaphylaxis, urticaria, subcutaneously.
Precaution
Diagnostic agent, increases the force of contraction - Treatment of beta respiratory distress, - Assess for contraindicated conditions.
- Pregnancy
Minimum Dose Glucose-elevating of the heart. blocker and calcium hypotension - Assess nutritional status.
- Lactation
5 mg/hr drug channel blocker overdose - Assess bowel sounds; blood and urine
- Insulinoma
Pharmacokinetics glucose.
Maximum Dose Pregnancy Risk GI: Nausea, vomiting
Drug interaction
0.02 mg/kg Factor A: Glucagon binds to the glucagon During
Drug to drug
B receptor, a G protein-coupled Hematologic: Hypokalemia in - For parenteral administration, avoid
- Increased
Contents receptor located in the plasma overdose contact with needles.
anticoagulant effect
Glucagon membrane - Teach patient signs and symptoms of
and risk of bleeding
D: Enters breast milk and crosses hypoglycemia.
with oral
Availability and placenta. - Position client on side until fully alert.
anticoagulants.
color M: Mainly hepatic; some - Assess for nausea and vomiting.
- Powder for inactivation in kidneys and plasma. - Adjust insulin dosage as needed.
Drug to food
injection- 1 mg E: Urine, bile - Instruct patient to take oral glucose as
- none reported
soon as symptoms of hypoglycaemia
Routes of Route occur.
administration Onset
Peak
Intramuscular Duration After
Intravenous IM - Arouse hypoglycemic patient as soon
Subcutaneous 8-10 min as possible after drug injection.
20-30 min
19-32 min - Provide supplemental carbohydrates.
IV - Arrange for evaluation of insulin
1 min dosage.
15 min - Monitor for signs of nausea and
9-20 min
vomiting.
- Instruct to notify health care provider in
Drug Half Life case of hypoglycemia.
3-10 - Document that drug has been given.

Source: Source: Source: Source: Source: Source: Source:

Karch, Amy: 2009 http://mims.com.ph/, http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Karch, Amy: 2009 Lippincott’s Nursing Drug Guide,
Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 568-569 Nursing Drug Guide, p. 569 Drug Guide, p. 569 p. 569
Guide, pp. 568 Lippincott’s Nursing Drug
Guide, p. 568
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Heparin inactivates factor XA, General Indications Concentrations Dermatologic: Loss of hair Before
Heparin Class therefore inhibiting thrombus and clot - Prevention and - Hypersensitivity to - Observe 15 rights in drug
Anticoagulant formation by blocking the conversion treatment of venous heparin Hematologic: Hemorrhage, administration.
Trade Name of prothrombin to thrombin and thrombosis, pulmonary - Severe bruising, thrombocytopenia, - Assess for contraindicated
Hepalean Therapeutic Class fibrinogen to fibrin, the final steps of embolism, and peripheral thrombocytopenia elevated AST, ALT levels, conditions.
Antithrombotic the clotting process. Heparin also arterial embolism - Uncontrolled bleeding hyperkalemia - Adjust dose according to
Minimum Dose inhibits the activation of factor XIII, - Atrial fibrillation with - Patients who cannot coagulation test results performed
150 mg 1 tab q24˚ Pregnancy Risk thrombin-induced activation of embolization be monitored regularly just before injection.
Factor factors V and VIII. - Diagnosis and with blood coagulation Hypersensitivity: Chills, fever, - Always check compatibilities with
C treatment of DIC tests urticaria, asthma other IV solutions.
Maximum Dose
150 mg 1 tab q6˚ Pharmacokinetics - Prevention of clotting in - Labor and immediate - Have protamine sulfate readily
blood samples and postpartum period Other: Osteoporosis, suppression available in case of overdose.
A: Absorbed from systemic heparin lock sets and of renal function, white clot
Contents Precaution
circulation. during dialysis syndrome During
Ranitidine HCl - Women older than 60
D: Reticuloendothelial system. procedures - Use heparin lock needle to avoid
yr
Protein-binding: Extensive. repeated injections.
Availability and - Pregnancy
M: Does not cross placenta, does - Give deep subcutaneous
color - Recent surgery or
not enter breast milk, broken down in injections, not IM.
- Injection- 1,000, injury
liver. - Apply pressure to all injection
2,000, 2,500, 5,000,
E: Urine sites after needle is withdrawn.
7,500, 10,000, Drug interaction
- Mix well when adding heparin to
12,500, 20,000, Drug to drug
Route IV infusion.
40,000 units/mL - Increased bleeding
Onset - Do not add heparin to infusion
- Single-dose and Peak tendencies with oral
lines of other drugs; do not
unit dose forms Duration anticoagulants,
piggyback other drugs into heparin
- Lock flush SubQ salicylates, penicillins,
20-60 min line.
solution- 10, 100 2-4 hr cephalosporins, low-
units/mL 8-12 hr molecular weight
After
IV heparins, platelet
Routes of Immediate - Inspect injection sites for signs of
inhibitors
administration Minutes hematoma, do not massage
2-6 hr - Decreased
Subcutaneous injection sites.
anticoagulation effects
Intravenous - Provide safety measures.
of taken concurrently
Drug Half Life - Check for signs of bleeding,
with nitroglycerin
30-180 min monitor blood tests.
- Alert all health care providers of
Drug to food
heparin use.
- none reported
- Instruct to be careful to avoid
injury.
- Do proper documentation.
Source: Source: Source: Source: Source: Source: Source:
Karch, Amy: 2009 http://mims.com.ph/, http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug
Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 574 Nursing Drug Guide, pp. 574- Guide, p. 575 Guide, pp. 575-576
Guide, p. 574 Lippincott’s Nursing Drug 575
Guide, p. 574
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic Interferes with bacterial cell wall General Indications Concentrations CNS: Lethargy, hallucinations, Before
Penicillin G Classification synthesis during active - Severe infections - Allergies to penicillins, seizures - Observe 15 rights of drug
Benzathine Penicillin multiplication, causing cell wall caused by sensitive cephalosporins, or administration.
death and resultant bactericidal organisms (streptococci) other allergens GI: Glossitis, stomatitis, gastritis, - Reduce dosage with hepatic or
Trade Name Therapeutic Class activity against susceptible - URTI caused by sore mouth, furry tongue, black renal failure.
Precaution
Penadur Anti-infective, bacteria. sensitive streptococci “hairy” tongue, nausea, vomiting, - Assess for hypersensitivity to drug.
- Renal disorders
Antibiotic - Treatment of syphilis, diarrhea, abdominal pain, bloody - Assess for any contraindications to
Pharmacokinetics - Pregnancy
Minimum Dose bejel, congenital syphilis, diarrhea, enterocolitis, the drug.
- Lactation
300,000 units IM Pregnancy Risk pinta, yaws pseudomembranous colitis, - Educate about side effects of
Factor D: Crosses placenta; enters breast - Prophylaxis of nonspecific hepatitis drug.
milk Drug interaction
Maximum Dose B rheumatic fever and
M: Hepatic Drug to drug
2.4 million units IM chorea GU: Nephritis During
E: Urine - Decreased
weekly for 3 weeks - Drug is not for IV use. Do not
effectiveness with
inject or mix with other IV solutions.
Route tetracyclines Hematologic: Anemia,
Contents - Give IM injection in upper outer
Onset - Inactivation of thrombocytopenia, leukopenia,
Benzathine Peak quadrant of the buttock.
parenteral neutropenia, prolonged bleeding
benzylpenicillin Duration - Avoid contact with the needle.
aminoglycosides itme
IM - Withdraw needle as quickly as
Slow (amikacin, gentamicin,
Availability and possible to avoid discomfort.
12-24 hr kanamycin, neomycin, Hypersensitivity: Rash, fever,
color Days - Stay with patient throughout whole
tobramycin) wheezing, anaphylaxis
- Injection: duration of administration.
600,000, 1.2 Drug Half Life Drug to food Local: Pain, phlebitis, thrombosis
million, 2.4 million After
30-60 min - none reported at injection site, Jarisch-Herxheimer
units/dose - Monitor client for at least 30
reaction when used to treat syphilis minutes.
Routes of - Arrange for regular follow-up,
Other: Superinfections, sodium including blood tests, to evaluate
administration
overload leading to heart failure effects.
Intramuscular
- Instruct to report difficulty
breathing, rashes, severe pain at
injection site, mouth sores, unusual
bleeding or bruising.
- Instruct to take medication as
directed for the full course of
therapy, even if feeling better.
- Do proper documentation.

Source: Source: Source: Source: Source: Source: Source:

Karch, Amy: 2009 Karch, Amy: 2009 Karch, Amy: 2009 Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug
Lippincott’s Nursing Drug Lippincott’s Nursing Drug Guide, pp. 929, Nursing Drug Guide, pp. 929 Nursing Drug Guide, pp. 929 Guide, pp. 930 Guide, pp. 930
Guide, pp. 929 Guide, pp. 929 http://www.merck.com/mmpe/print/lexicomp/
penicillin%20g%20benzathine.html
 Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Pharmacologic In low doses, acts relatively General Indications Concentrations CNS: Restlessness, apprehension, Before
Terbutaline sulfate Class selectively at beta2-adrenergic - Prophylaxis and - Hypersensitivity to anxiety, fear, CNS stimulation, - Observe 15 rights of drug
Beta2-selective receptors to cause bronchodilation treatment of bronchial terbutaline hyperkinesia, insomnia, tremor, administration.
Trade Name adrenergic and relax the pregnant uterus; asthma and reversible - Tachyarrhythmias, drowsiness, irritability, weakness, - Reduce dosage with hepatic or
Brethine antagonist At higher doses, beta2 selectively bronchospasm that may tachycardia caused by vertigo, headache, seizures renal failure.
is lost and the drug acts at beta1 occur with bronchitis and digitalis intoxication - Assess for hypersensitivity to drug.
Minimum Dose Therapeutic Class receptors to cause typical emphysema, in patients - General anesthesia CV: Cardiac arrhythmias, - Assess for any contraindications to
5 mg at 6-hr Antasthmatic, sympathomimetic cardiac effects. 12 yr and older with halogenated palpitations, angina pain, changes the drug.
intervals tid Bronchodilator, - Unlabeled use: Tocolytic hydrocarbons or in BP and ECG - Educate about side effects of
Sympathomimetic, Pharmacokinetics to prevent preterm labor cyclopropane drug.
Maximum Dose Tocolytic drug - Unstable vasomotor GI: Nausea, vomiting, heartburn,
15 mg/day D: May cross placenta; enters system disorders unusual or bad taste in mouth During
Pregnancy Risk breast milk - Labor and delivery - Use minimal doses for minimal
Contents Factor M: Tissue - Lactation Respiratory: Respiratory periods of time, drug tolerance can
Terbutaline sulfate B E: Urine difficulties, pulmonary edema, occur with prolonged use.
Precaution
coughing, bronchospasm - Keep a beta-blocker, such as
- Diabetes, Coronary
Availability and Route atenolol, readily available in case
insufficiency, CAD,
color Onset Other: Sweating, pallor, flushing, cardiac dysrhythmias occur.
Peak History of CVA, COPD
- Tablets: 2.5, 5 Duration patient,
muscle cramps, elevated LFTs - For oral forms, administer with
mg Oral water to facilitate swallowing.
Hyperthyroidism,
- Injection: 1 30 min - For parenteral forms, avoid
2-3 hr History of seizure
mg/mL contact with the needle.
4-8 hr disorder,
SubQ
- Stay with patient throughout
Psychoneurotic
Routes of 5-15 min whole duration of administration.
30-60 min
individuals,
administration Hypertension
1.5-4 hr After
Oral
Subcutaneous - Monitor client for at least 30
Drug interaction
Drug Half Life minutes.
Drug to drug
2-4 hr - Arrange for regular follow-up,
- Increased likelihood
including blood tests, to evaluate
of cardiac arrhythmias
effects.
with halogenated
- Instruct to report chest pain,
hydrocarbon
dizziness, insomnia, weakness,
anesthetics
tremor or irregular heartbeat, failure
- Risk of
to respond to usual dosage.
bronchospasms if
- Instruct to take medication as
combined with diuretics
directed for the full course of
- Increased risk of
therapy, even if feeling better.
hypokalemia and ECG
- Do not double dose.
changes with MAOIs
- Do proper documentation.
and TCAs

Drug to food
- none reported
Source: Source: Source: Source: Source: Source: Source:
Karch, Amy: 2009 Karch, Amy: 2009 Karch, Amy: 2009 Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug Karch, Amy: 2009 Lippincott’s Nursing Drug
Lippincott’s Nursing Drug Lippincott’s Nursing Drug Guide, pp. 1125-1126 Nursing Drug Guide, pp. 1126 Nursing Drug Guide, pp. 1126 Guide, pp. 1126 Guide, pp. 1127
Guide, pp. 1125-1126 Guide, pp. 1125