Patient Name: So, Gladys T.
Diagnosis: Carcinoma with papillary features and psammoma bodies,favour ovarian serous carcinoma
Age: 65
DRUG NAME CLASSIFICA MECHANISM INDICATION CONTRAINDICATI SIDE EFFECT NURSING RESPONSIBILITY
TION OF ACTION ON
GENERIC Pharmacolo Piperacillin ➣Community- ● Hypersensitivity to Patient monitoring
NAME gic class: inhibits acquired penicillins, Diarrhea, Bladder Piroxicam 1007 FDA BOXED WARNING
Piperacillin Penicillin bacterial cell pneumonia; cephalosporins, ● Assess neurologic status, especially for seizures.
pain, bloating or
Tazobactan (extended- wall synthesis, ruptured appendix; imipenems, or beta ● Monitor vital signs and fluid intake and output.
swelling of the face,
spectrum), resulting in cell peritonitis; pelvic lactamase inhibitors ● Evaluate electrolyte levels, CBC with white cell
arms, hands, lower
BRAND NAME: beta- death. inflammatory differential, and culture and sensitivity tests.
● Neonates legs, or feet, blurred
Tazocin , Zosyn lactamase Tazobactam disease; skin and Watch for evidence of hypokalemia and blood
vision, burning
inhibitor increases skin structure upper abdominal or dyscrasias.
DOSAGE: 4.5 g
piperacillin infections stomach pain, ● In patients receiving high doses or prolonged
Therapeutic efficacy. ➣Nosocomial therapy, monitor for signs and symptoms of
ROUTE: IV changes in
class: Anti- pneumonia bacterial or fungal superinfection and
urination, chest
infective pseudomembranous colitis.
FREQUENCY: q pain, confusion,
6 hrs dizziness, faintness, ● Monitor patient’s dietary sodium intake (drug
or lightheadedness has high sodium content). Immediately report
AVAILABILITY: rash,hives, severe diarrhea, black tongue, sore
when getting up
Powder for throat, fever, or unusual bleeding or bruising.
suddenly from a
injection Patient teaching
lying or sitting
● Tell patient to monitor urinary output and report
position, fever or
significant changes.
sweating,
● Instruct patient to report unusual pain, redness,
headache, lower
swelling, or other changes at infusion site.
back or side pain, ● As appropriate, review all other significant and
nausea or vomiting, life-threatening adverse reactions and
pain, tenderness, or interactions, especially those related to the drugs
swelling of the foot and tests mentioned above.
or leg, pain, warmth, ● Drug may increase risk of serious cardiovascular
or burning in the thrombotic events, myocardial infarction, and
fingers, toes, and stroke (which can be fatal). Risk may increase with
legs, problems with duration of use. Patients with cardiovascular
vision or hearing, disease or risk factors for it may be at greater risk.
skin rash, slow or ● Drug increases risk of serious GI adverse events,
fast heartbeat, including bleeding, ulcers, and stomach or
intestinal perforation (which can be fatal). These
trouble breathing events can occur at any time during use and
without warning. Elderly patients are at greater
risk.
● Drug is contraindicated for treatment of
perioperative pain in setting of coronary artery
bypass graft surgery.
ADVERSE EFFECT
CNS: headache,
insomnia, agitation,
dizziness, anxiety,
lethargy, hallucinations,
depression, twitching,
coma, seizures
CV: hypertension, chest
pain, tachycardia
EENT: rhinitis, glossitis
GI: nausea, vomiting,
diarrhea, constipation,
dyspepsia, abdominal
pain,
pseudomembranous
colitis
GU: proteinuria,
hematuria, vaginal
candidiasis, vaginitis,
oliguria, interstitial
nephritis,
glomerulonephritis
Hematologic: anemia,
increased bleeding,
bone marrow
depression, leukopenia,
thrombocytopenia
Metabolic:
hypokalemia,
hypernatremia
Respiratory: dyspnea
Skin: rash, pruritus
Other: fever; pain,
edema, inflamma tion,
or phlebitis at I.V. site;
superinfec tion;
hypersensitivity
reactions includ ing
serum sickness and
anaphylaxis
DRUG NAME CLASSIFICA MECHANISM INDICATION CONTRAINDICATI SIDE EFFECT NURSING RESPONSIBILITY
TION OF ACTION ON
GENERIC Pharmacolo Unclear. ➣Acute migraine ● Hypersensitivity to Ringer n the ears, Patient monitoring
NAME: gic class: Thought to attacks drug or its com Itching, Drowsiness, ● Monitor hepatic and renal function.
Diclofenac Cyclooxygenas block activity of ➣Osteoarthritis ponents, other Diarrhea, rash, ● Observe for and report signs and symptoms
e inhibitor, cyclooxygenase, pain of joints NSAIDs, or aspirin headache, heartburn, of bleeding.
BRAND NAME: nonsteroidal thereby amenable to dizziness, red skin
● Active GI bleeding ● Assess for hypertension.
Voltaren XR anti-inflamma inhibiting topical treatment lesions
or ulcer disease ● Monitor sodium and potassium levels in
tory drug inflammatory ➣Osteoarthritis of patients receiving potassium sparing diuretics.
(NSAID) responses of knee ● Aspirin-sensitive 2Discontinue drug if rash or other signs of
vasodila tion ➣Acute pain due asthma, urticaria local skin reaction occur. 2Discontinue drug
DOSAGE: 50
and swelling to minor strains, immediately if abnormal liver test values
mg Therapeutic ● Use as
and blocking sprains, and persist or worsen.
class: perioperative
trans mission of contusions (topical ● Weigh patient to detect fluid retention.
Nonopioid analgesia in coronary
ROUTE: IV painful stimuli. treat ment) ADVERSE EFFECT Report gain of more than 2 lb in 24 hours.
analgesic, artery bypass graft
➣Analgesia; CNS: dizziness, Patient teaching
antiarthritic surgery
FREQUENCY: q dysmenorrhea drowsiness, headache, ● Instruct patient to take drug on empty
8 ➣Rheumatoid ● Use on nonintact paresthesia stomach 1 hour before or after a meal.
arthritis or damaged skin CV: hypertension, ● Advise patient not to lie down for 15 to 30
AVAILABILITY: ➣Osteoarthritis (patch) thrombosis minutes after taking oral drug, to minimize
Flector patch ➣Ankylosing EENT:tinnitus
Capsules, liquid-
esophageal irritation.
spondylitis GI: dyspepsia, diarrhea, ● Instruct patient to mix oral powder in 1 to 2
filled Precautions abdominal pain,
Powder for oral ounces of water only before taking.
dyspepsia, heartburn,
solution Use cautiously in: ● Tell patient to measure proper amount of gel
peptic ulcer, GI
Tablets using measuring dosing card supplied and to
● severe bleeding, GI perforation
Topical gel gently massage gel into skin of entire affected
cardiovascular GU: dysuria, frequent
Topical solution foot, knee, or ankle.
(including patients urination, hematuria,
● Instruct patient to apply 10 drops of topical
taking diuretics or proteinuria, nephritis,
solution to clean, dry skin and to spread evenly
ACE inhibitors, acute renal failure
Hepatic: liver failure
around front, back, and sides of knee; then
patients with fluid
reten tion, Hematologic: prolonged repeat this procedure until 40 drops have been
bleeding time applied and knee is completely covered with
hypertension, or
congestive heart Hepatic: hepatotoxicity solution.
Skin: eczema, ● Instruct patient not to apply gel, patch, or
failure), renal, or photosensitivity, rash, topical solution to open wounds and to avoid
hepatic disease; contact dermatitis, dry contact with eyes and mucous membranes.
bleeding tendency; skin, exfoliation; ● Advise patient to avoid exposing treated sites
dehydration application-site to bath water and sunlight, external heat,
● advanced renal reactions, including occlusive dressings or clothing, sunscreens,
disease (not recom pruritus, dermatitis, cosmetics, lotions, moisturizers, insect
mended) burning (with patch); repellants, or other topical drugs.
exfoliative dermatitis, ● Instruct patient to wash hands thor oughly
● history of Stevens-Johnson after applying topical solution, patch, or gel
porphyria or syndrome,toxic epi except when gel is applied to the hand. If gel is
preexisting asthma dermal necrolysis applied to a hand, advise patient to avoid
Other: dysgeusia, pain washing treated hands for at least 1 hour after
● concurrent
and redness allergic application.
methotrexate or
reactions (including ● Tell patient to discard used patches out of the
antico agulant use;
edema), anaphylaxis
concurrent use of reach of children and pets. 2Instruct patient to
drugs known to be stop drug and immediately report wheezing
potentially and signs or symptoms of hypersensitivity reac
hepatotoxic (such as tions (rash, swelling of face or throat, shortness
acetaminophen, of breath) or liver impair ment (unusual
anti-infec tives, or tiredness, weakness, nausea, yellowing of skin
antiepileptics) or eyes, ten derness on right upper side of
abdomen,flulike symptoms). 2Instruct patient
● concurrent use of
to stop taking drug and contact prescriber
aspirin (not rec
ommended)
promptly if he experiences ringing or buzzing
in ears, dizziness, GI discomfort, or bleeding.
● concurrent use 2Inform patient that drug may cause serious
with oral NSAIDs CV side effects and to immediately report such
(avoid use) signs and symptoms as unexplained weight
gain, chest pain, shortness of breath, weak
● elderly patients ●
ness, or slurred speech.
pregnant or
● Caution patient not to take over-the counter
breastfeeding
analgesics during diclofenac therapy.
patients
● Advise female patient to avoid pregnancy
● children (safety while taking this drug.
and efficacy ● Advise breastfeeding patient that she should
decide whether to discontinue breastfeeding or
nestablished).
discontinue drug, taking into account
importance of drug for her treatment.
● As appropriate, review all other significant
and life-threatening adverse reactions and
interactions, especially those related to the
drugs, tests, herbs, and behaviors mentioned
above.
DRUG NAME CLASSIFICA MECHANIS INDICATION CONTRAINDIC SIDE EFFECT NURSING RESPONSIBILITY
TION M OF ATION
ACTION
GENERIC NAME: Pharmacolo Blocks ➣To prevent nausea ● Hypersensitivity Diarrhea, headache, Patient monitoring
Ondansentron gic class: serotonin at and vomiting caused to drug hives, fast heartbeat , ● Monitor GI status.
Serotonin type 5-HT3 by moderately blurred vision, ● Assess for extrapyramidal reactions.
● Concurrent use
BRAND NAME: Zofran 3 (5-HT3) receptor emetogenic psychomotoragitation, ● Check vital signs. Watch for hypotension and
of apomorphine
antagonist sites in vagal chemotherapy fever, confusion, bronchospasm.
DOSAGE: nerve ➣To prevent nausea lightheadedness ● Monitor fluid intake and output. Stay alert for
8 mg Therapeutic terminals by and vomiting caused urinary retention. Be aware that cases of
class: Precautions ADVERSE EFFECT
disrupting by highly emetogenic torsades de pointes have been reported.
ROUTE: IV Antiemetic CNS chemo therapy Use cautiously in: Monitor ECG in patients with electrolyte
CNS: headache,
chemorecept ➣To prevent nausea abnormalities (such as hypokalemia or
● hepatic disease dizziness, malaise,
FREQUENCY: q 12 or trigger and vomiting caused hypomagnesemia), congestive heart failure, or
● congenital long drowsiness, fatigue,
zone by radiation bradyarrhythmias, and in patients taking other
QT syndrome weakness, extra
➣Prevention and drugs that lead to prolonged QT interval.
(avoid use) pyramidal reactions
treatment of post Be aware that using ondansetron after
CV: chest pain,
operative nausea ● hypersensitivity abdominal surgery or with chemotherapy-
hypotension, ECG
and vomiting to other selective induced nausea and vomiting may mask a
changes including QT-
5-HT3 receptor progressive ileus or gastric distention.
interval pro longation
antagonists Patient teaching
(rare and mostly with
● Tell patient to remove orally disintegrating
I.V. use), torsades de
● tablet by peeling back foil with dry hands—not
pointes (postmar keting
phenylketonuria by pushing tablet through foil backing. Instruct
reports) GI:
(with orally him to place tablet on tongue, where it will
constipation, diarrhea,
disinte grating dissolve within seconds, and then to swallow
abdominal pain, dry
tablets) saliva. Instruct patient to immediately report
mouth
extrapyramidal symptoms, irregular heartbeats,
● pregnant or GU: urinary retention
abdominal distention after abdominal surgery,
breastfeeding Respiratory:
or allergic reaction.
patients bronchospasm
● Inform patient with phenylketonuria (or
Skin: rash
● children caregiver) that powder contains phenylalanine.
Other: pain at injection
younger than age ● Caution patient to avoid driving and other
site, shivering,
12. hazardous activities until he knows how drug
anaphylaxis
affects concentration and alertness.
● As appropriate, review all other significant
and life-threatening adverse reactions and
interactions, especially those related to the
drugs and tests mentioned above.
