University of the Philippines

The Health Sciences Center

COLLEGE OF NURSING
Sotejo Hall, Pedro Gil Street, Manila

Drug Study

DRUG ORDER
(Generic
name, PHARMACOLOGI NURSING
INDICATIONS AND ADVERSE EFFECTS DESIRED ACTION
Dosage, C ACTION OF RESPONSIBILITIES
CONTRAINDICATIONS OF THE DRUG ON THE CLIENT
Route, DRUG /PRECAUTIONS
Frequency,
etc.)
1. Paracetamo Antipyretic: Indications CNS: Headache Fever reduction - Monitor liver
l Reduces fever by - Analgesic-antipyretic in CV: Chest pain, function studies;
(250mg/5ml acting directly on patients with aspirin dyspnea, may cause
) 3ml q4h the hypothalamic allergy, hemostatic myocardial hepatic toxicity
for fever heat-regulating disturbances, bleeding damage when at doses
2. Paracetamo center to cause diatheses, upper GI doses of 5–8 g/day >4g/day
l 145mg IV vasodilation and disease, gouty arthritis are ingested daily for - Monitor renal
q4h for T > sweating, which - Arthritis and rheumatic several weeks or function studies;
38oC helps dissipate disorders involving when doses of 4 albumin
heat. musculoskeletal pain (but g/day are ingested indicates
lacks clinically significant for 1 yr nephritis
Analgesic: Site antirheumatic and anti- GI: Hepatic - Monitor blood
and mechanism inflammatory effects) toxicity and studies,
of action unclear - Common cold, flu, other failure, jaundice especially CBC
viral and bacterial GU: Acute kidney and pro-time if
infections with pain and failure, renal tubular patient is on
fever necrosis long-term
- Unlabeled use: Hematologic: therapy.
Prophylactic for children Methemoglobinemia - Check I&O ratio;
receiving DPT vaccination —cyanosis; decreasing
to reduce incidence of hemolytic anemia— output may
fever and pain hematuria, anuria; indicate renal
neutropenia, failure.
Contraindications leucopenia, - Assess for fever
- Contraindicated with pancytopenia, and pain
allergy to acetaminophen. thrombocytopenia, - Assess
- Use cautiously with hypoglycemia hepatotoxicity:
impaired hepatic function, Hypersensitivity: dark urine, clay-
chronic alcoholism, Rash, fever colored stools
pregnancy, lactation. - Assess allergic
reactions: rash,
urticaria
Ibuprofen Inhibits Indications CNS: Headache, Fever reduction - Assess pain
(200mg/5ml) prostaglandin -Relief of signs and dizziness, - Assess
4ml q6h for synthesis by symptoms of rheumatoid somnolence, musculoskeletal
T>/= 39oC decreasing arthritis and insomnia, fatigue, status: ROM
enzyme needed osteoarthritis tiredness, dizziness, before dose and
for biosynthesis; -Relief of mild to tinnitus, 1 hr after.
analgesic, anti- moderate pain ophthalmologic - Monitor liver
inflammatory, -Treatment of primary effects function studies
antipyretic dysmenorrhea CV: Hypertension, - Monitor renal
-Fever reduction palpitations, function studies
-Unlabeled uses: arrhythmia - Monitor blood
Prophylactic for migraine; Dermatologic: studies: CBC,
abortive treatment for Rash, pruritus, Hgb, Hct,
migraine sweating, dry protime if patient
mucous membranes, is on long-term
Contraindications stomatitis therapy
-Contraindicated with GI: Nausea, - Check I&O ratio
allergy to ibuprofen, dyspepsia, GI pain, - Assess
salicylates, or other diarrhea, vomiting, hepatotoxicity
NSAIDs (more common in constipation, - Assess for
patients with rhinitis, flatulence, GI allergic
asthma, chronic urticaria, bleeding reactions, visual
nasal polyps). GU: Dysuria, renal changes and
impairment, ototoxicity
menorrhagia - Identify prior
Hematologic: drug history
Bleeding, platelet - Identify fever:
inhibition with higher length of time in
doses, neutropenia, evidence and
eosinophilia, related
leukopenia, symptoms
pancytopenia,
aplastic anemia, Precautions:
decreased Hgb or - Pregnancy B,
Hct, bone marrow lactation,
depression children,
Respiratory: bleeding
Dyspnea, disorders, GI
hemoptysis, disorders,
pharyngitis, cardiac
bronchospasm, disorders,
rhinitis hypersensitivity
Other: Peripheral to other anti-
edema, inflammatory
anaphylactoid agents, elderly,
reactions to CHF
 anaphylactic
shock

Cotrimoxazole Blocks synthesis Indications Dermatologic: Prevent infection - Assess allergic

(200mg/5ml) of tetrahydrofolic - Uncomplicated UTIs Rash, pruritus, reactions
5ml BID acid;combination caused by susceptible exfoliative dermatitis - Monitor I&O ratio
blocks two strains of E. coli, Proteus GI: Epigastric - Monitor kidney
consecutive steps mirabilis, Klebsiella distress, nausea, function
 in bacterial pneumoniae, vomiting, glossitis - Assess type of
synthesis of Enterobacter species, and Hematologic: infection; obtain
essential nucleic coagulase-negative Thrombocytopenia, C&S before
acids, protein Staphylococcus species, leukopenia, starting therapy
including Staphylococcus neutropenia, - Assess blood
saprophyticus megaloblastic dyscrasias
- Treatment of acute otitis anemia,
media due to susceptible methemoglobinemia, Precautions:
strains of S. pneumoniae elevated serum - Pregnancy C,
and H. influenza in transaminase and renal disease,
children bilirubin, increased eldery, G6PD
BUN and serum deficiency,
Contraindications creatinine levels impaired
- Allergy to trimethoprim, Other: Fever hepatic/renal
pregnancy (teratogenic in disease,
preclinical studies), possible folate
megaloblastic anemia deficiency,
due to folate deficiency. severe
allergy,
bronchial
asthma
Allopurinol Inhibits the Indications: CNS: Headache, Reduce uric acid - Assess for pain
100mg/tab 1 enzyme - Management of the drowsiness, synthesis - Monitor uric acid
tab BID responsible for signs and symptoms of peripheral levels q2 wk
the conversion of primary and secondary neuropathy, neuritis, - Monitor CBC,
purines to uric gout paresthesias AST, BUN,
acid, thus - Management of patients Dermatologic: creatinine before
reducing the with malignancies that Rashes— starting
production of uric result in elevations of maculopapular, treatment
acid with a serum and urinary uric scaly or exfoliative - Monitor
decrease in serum acid —sometimes fatal nutritional
and sometimes in - Management of patients GI: Nausea, status:
urinary uric acid with recurrent calcium vomiting, diarrhea, discourage organ
levels, relieving oxalate calculi whose abdominal pain, meat, sardines,
the signs and daily uric acid excretion gastritis, salmon, legumes
symptoms of gout exceeds 800 mg/day hepatomegaly, (high purine),
(males) or 750 mg/day hyperbilirubinemia, gravies,alcohol
(females) cholestatic jaundice
- Orphan drug use: GU: Exacerbation of Precautions:
Treatment of Chagas' gout and renal - Pregnancy C,
disease; cutaneous and calculi, renal failure lactation,
visceral leishmaniasis Hematologic: renal disease,
- Unlabeled uses: Anemia, leukopenia, hepatic
Amelioration of agranulocytosis, disease,
granulocyte suppression thrombocytopenia, children
with fluorouracil; as a aplastic anemia,
mouthwash to prevent bone marrow
fluorouracil-induced depression
stomatitis

Contraindications
- allergy to allopurinol,
blood dyscrasias,
hypersensitivity.