Drug Study Summary

Baby oil/Mineral oil

Drug Classification:
Emollient Indications:
Dry skin
Diaper rash
Cold sores
Chapped lips
Acne
Indicated for the client for the dry and crustations on ears
Contraindicated in:
Hypersensitivity
Skin infection
Open wounds
Adverse Effects:
Anaphylactic reactions
Side effects
Rashes (in allergies)
Interactions: Non-significant
Nursing Considerations
Avoid contact with mouth, eyes or nose. Rinse with water immediately should this happen
Avoid exposure to sunlight
Chlorhexidine
Drug Classification: antimicrobial
Pharmacologic Action of the Drug:
Antimicrobial activity in oral rinsing
Indications:
gingivitis
Mouth infection
Prevention of tooth decay
Weakened immune systems to prevent mucositis
Prevention of pneumonia on mechanical ventilator
Indicated for: Mouth infection and hygiene
Contraindicated in:
Hypersensitivity
Side effects
Tooth/tongue staining
Increased tartar
Mouth/throat irritation
Change in taste of food or drinks
Skin sensitivity
Parotid gland swelling
Irritation of conjunctiva when in contact with eyes
Adverse effects:
Gastric distress when ingested in large amounts
Anaphylaxis
Nursing Considerations
Instruct client to brush teeth before chlorhexidine rinse to reduce teeth staining
Instruct client to consume meals prior to oral care with rinsing of chlorhexidine to decrease changes in taste
Store at room temperature away from light and moisture
Drug Name: Tramadol
Drug classification: Analgesic (centrally acting), Opiod analgesic

Desired Action:
Binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin
Indications for patient:
Relief of moderate to moderately severe pain
Relief of moderate to severe chronic pain in adults who need around-the-clock treatment for extended periods
Premature ejaculation
Restless leg syndrome
Indicated for: Pain management (throat)
Contraindications:
Hypersensitivity to tramadol or opioids
Acute intoxication with alcohol, opioids, or psychoactive drugs
Pregnancy, lactation (use cautiously)
Seizures
Concomitant use of CNS depressants
Renal impairment
Hepatic impairment
Adverse Effects:
CNS: sedation, dizziness or vertigo, headache, confusion, dreaming, sweating, anxiety, seizures
CV: hypotension, tachycardia, bradycardia
Dermatologic: sweating, pruritus, rash, pallor, urticaria
GI: nausea, vomiting, dry mouth, constipation, flatulence
Other: Potential for abusem anaphylactoid reactions

Nursing Considerations
History: Hypersensitivity to tramadol; pregnancy; acute intoxication with alcohol, opioids, psychotropic drugs or other centrally acting
analgesics; lactation; seizures; concomitant use of CNS depressants or MAOIs; renal or hepatic impairment; past or present history of opioid
addiction
Physical: skin color, texture, lesions; orientation, reflexes, bilateral grip strength, affect; renal function tests
Control environment (temperature, lighting) if sweating or CNS effect occur
Ensure that patient does not cut, crush, or chew ER tablets
Ask patient to report severe nausea, dizziness, severe constipation
Metoclopramide
Drug Classification: Antiemetic
Pharmacologic Action of the Drug:
o
Blocks dopamine receptors in chemoreceptor trigger zone of the CNS
o
Stimulates motility of the upper GI tract and accelerates gastric emptying.
Indications:
o Prevention of chemotherapy-induced emesis
o Treatment of postsurgical and diabetic gastric stasis
o Facilitation of small bowel intubation in radiographic procedures
o Management of esophageal reflux
o Treatment of postoperative nausea and vomiting when nasogastric suctioning is undesirable
o Treatment of hiccups
o Adjunct management of migraine headaches
Indicated for: Nausea and vomiting associated with chemotherapy and radiation therapy
Contraindicated in:
Hypersensitivity
Possible GI obstruction or hemorrhage
History of seizure disorders
Pheochromocytoma
Parkinsons disease
Side effects:
CNS: drowsiness, extrapyramidal reactions, restlessness, anxiety, depression, irritability
GI: constipation, dry mouth, diarrhea, nausea
Endo: gynecomastia
Adverse Effects:
CV: arrhythmias, supraventricular tachycardia, bradycardia, hypertension, hypotension
Nursing Considerations
Assess patient for nausea, vomiting, abdominal distention, and bowel sounds before and after administration.
Assess patient for extrapyramidal side effects (parkinsoniandifficulty speaking or swallowing, loss of balance control, pill rolling,
mask-like face, shuffling gait, rigidity, tremors; and dystonicmuscle spasms, twisting motions, twitching, inability to move eyes,
weakness of arms or legs) periodically throughout course of therapy. May occur weeks to months after initiation of therapy and are

reversible on discontinuation. Dystonic reactions may occur within minutes of IV infusion and stop within 24 hr of discontinuation of
metoclopramide. May be treated with 50 mg of IM diphenhydramine or diphenhydramine 1 mg/kg IV may be administered
prophylactically 15 min before metoclopramide IV infusion.
Monitor for tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities; lip smacking or puckering; puffing
of cheeks; uncontrolled chewing; rapid or worm-like movements of tongue). Usually occurs after a year or more of continued
therapy. Report immediately; may be irreversible.
Assess patient for signs of depression periodically throughout therapy.
Lab Test Considerations: May alter hepatic function test results.

Drug Name: Omeprazole (Losec, Prilosec, Zegerid)

Drug classification: Antisecretory Drug.Proton Pump Inhibitor
Drug action: Gastric acid-pump inhibitor: suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium ATPase enzyme system at the
secretory surface of the gastric parietal cells; blocks the final step of acid production
Indications for patient:
Short-term treatment of active duodenal ulcer
Treatment of heartburn or symptoms of GERD.
Short-term treatment of active benign gastric ulcer.
GERD, severe erosive esophagitis, poorly responsive symptomatic GERD
Treatment of pathologic hypersecretory conditions (Zollinger Ellisons syndrome, multiple adenomas, systemic mastocytosis)
Eradication of Helicobacter pylori with amoxicillin or metronidazole and clarithromycin
Posterior laryngitis

Indicated for: Prevention of nausea/vomiting

Contraindicated in:
Hypersensitivity
Pregnancy
Lactation
Concurrent oral iron therapy
Adverse Effects:
CNS: headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities.
GI: diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue, atrophy
Derm: rash, inflammation, urticaria, pruritus, alopecia, dry skin.
Respiratory: URI symptoms, cough, epistaxis.
Other: Cancer in preclinical studies, back pain, fever

Drug-drug interactions

Increase effects of antifungal agents, atazanavir, diazepam, digoxin, flurazepam, triazolam, cyclosporine, disulfiram, phenytoin, tacrolimus,
warfarin,

Interfere with absorption of ampicillin, iron salts, digoxin, cyanocobalamine,ketoconazole

Used safely with antacids

Increase risk of bleeding with warfarin

Nursing Considerations

History: Hypersensitivity to omeprazole

Physical:skin lesions, reflexes, affect; urinary output, abdominal examination; respiratory auscultation
Administer before meals
Caution patient to swallow capsules whole
Ask patient to report severe headache, worsening of symptoms, fever, chills, severe diarrhea

Drug Name: Acetaminophen, Paracetamol

Drug classification: Antipyretics, nonopioid analgesic
Drug action: Prostaglandin inhibitor, analgesia,
Indications for patient:

Mild pain

Fever
Indicated for: Fever
Contraindications:

Previous hypersensitivity

Products with alcohol, aspartame, saccharine, sugar or tartrazine

Adverse effects:

GI: Hepatic failure, hepatotoxicity

GU: Renal failure


Febrile neutropenia
Side effects

Derm: rash, urticaria

Neutropenia, leucopenia, pancytopenia

Drug-to-drug interactions

Inc risk of bleeding with warfarin

Additive with other hepatotoxic (inc alcohol)

Sulfinpyrazone, isoniazid, rifampin, rifabutin, phenytoin, barbiturates, carbamazepine (liver) and dec

NSAIDS inc risk of renal effects

Propanolol increase effects but decreas modification

Decreases effects of lamotrigine, zidovudine

Y-Site Incompatibility:

chlorpromazine
diazepam
Additive incompatibility: Do not mix with other medications
Intermittent Infusion:

For 1000 mg dose, insert vented IV set through septum of 100 mL vial; may be administered without further dilution.

For doses <1000 mg, withdraw appropriate dose from vial place in a separate empty, sterile container for IV infusion. Place small volume
pediatric doses up to 60 mL in a syringe and administer via syringe pump. Solution is clear and colorless; do not administer solutions that
are discolored of contain particulate matter. Administer within 6 hrs of breaking vial seal
Rate: Infuse over 15 min. Monitor end of infusion in order to prevent air embolism, especially if acetaminophen is primary infusion

Nursing responsibilities

Assess overall health status and alcohol usage before administering acetaminophen. Patients who are malnourished or chronically abuse
alcohol are at higher risk of developing hepatotoxicity with chronic use of usual doses of acetaminophen
Pain
Assess type, location, and intensity prior to and 30 min following administration
Fever
Assess fever; note presence of associated signs (diaphoresis, tachycardia, and malaise)
Lab Test Considerations
serum bilirubin, LDH, AST, ALT, and prothrombin time may indicate hepatotoxicity
Toxicity and Overdose
If overdose occurs, acetylcysteine (Acetadote) is the antidote