Bernardo, Christine Jamie C.

August 23, 2018

BSN 301`/ NCM103D Lec. Prof. Dhonna C. Cambe

ASSIGNMENT #2 : DRUG STUDY

 TRANQUILIZERS & SEDATIVES

Name of Drug Mechanism of Indications / Adverse Drug Nursing Health

Action Contraindications Reactions Interactions Considerations Teachings
Generic Name May potentiate INDICATION: CNS: Cimetidine: May Monitor patient Because drug
MIDAZOLAM the effects of Preoperative sedation oversedation, increase and throughout diminishes
GABA, (to induce sleepiness or drowsiness, prolong procedure. patient’s recall
Brand Name depress the drowsiness and relieve amnesia, sedation. of events
Versed CNS, and apprehension) headache, Have oxygen around the
suppress the seizures, Avoid use and time of
Route of spread of Moderate sedation involuntary together CNS resuscitation surgery,
administration seizure before short diagnostic movements, depressants. equipment provide written
IV activity. or endoscopic nystagmus, May cause available in case information,
procedures hiccups, apnea. Adjust of severe family member
paradoxical dose of respiratory iinstructions,
To induce sleepiness behavior or midazolam if depression. and follow-up
and amnesia and to excitement used with contact
relieve apprehension opiates or other Monitor BP,
before anesthesia or CV: variations CNS heart rate and Warn patient to
before and during in BP and depressants rhythm, avoid
procedures pulse rate respirations, hazardous
Ditiazem: May airway integrity, activities that
To induce general EENT: increase CNS and pulse require
anesthesia nystagmus depression and oximetry during alertness or
prolong effects procedure. good
As continuous infusion GI: nausea, of midazolam coordination
to sedate intubated vomiting until effects of
patients in critical care Erythromycin: drug are
unit Respiratory: May alter known.
apnea, metabolism of
CONTRAINDICATIONS decreased midazolam
 Contraindicated in respiratory
patients hypersensitive rate, oxygen Fluconazole,
to drug and in those desaturation, itraconazole,
with acute angle- coughing ketoconazole,
closure glaucoma, miconazole:
shock, coma, or acute Other: pain at May increase
alcohol intoxication injection site, and prolong
redness midazolam level
Use cautiously in and causes
patients with psychomotor
uncompensated acute impairment.
illness and in elderly or
debilitated patients Hormonal
contraceptives:
May prolong
half-life of
midazolam

Name of Drug Mechanism of Indications / Adverse Drug Nursing Health

Action Contraindications Reactions Interactions Considerations Teachings
Generic Name A INDICATIONS CNS: Cimetidine. Monitor periodic Warn patient
DIAZEPAM benzodiazepine For elderly or drowsiness, Disulfiram, hepatic, renal, to avoid
that probably debilitated patients, dysarthria, fluoxetine, and activities that
Brand Name potentiates the give 2 to 2.5 mg PO. slurred speech, fluvoxamine, hematopoietic require
Diastat, effects of Daily or bid tremor, hormonal function studies alertness and
Diazemuls, GABA, depress transient contraceptives, in patients good
Novo-Dipam, the CNS, and For Acute alcohol amnesia, isoniazid, receiving coordination
Valium suppresses the withdrawal fatigue, ataxia, metoprolol, repeated or until effects of
spread of Adults: 10mg P.O tid or headache, propoxyphene, prolonged drug are
Route of seizure activity qid during first 24 hours insomnia, propranolol, therapy known
administration paradoxical valproic acid:
IV Before endoscopic anxiety, May decrease Monitor elderly Tell patient to
procedures hallucinations, clearance of patients for avoid alcohol
Adults: Adjust I.V dose minor changes diazepam and dizziness, while taking
to desired sedative in EEG increase risk of ataxia, and drug
response (up to 20mg) patterns, pain, adverse effects. mental status
or 5 to 10mg I.M. 30 vertigo, Monitor patient changes. Notify patient
minutes before confusion, for excessive Patients are at that smoking
procedure depression sedation and an increase risk may decrease
impaired for falls. drug’s
Preoperation sedation CV: CV psychomotor effectiveness
Adults: 10mg I.M or collapse, function.
I.V.before surgery bradycardia, Warn patient
hypotension CNS not to abruptly
CONTRAINDICATIONS depressants: stop drug
Contraindicated in EENT: diplopia, May increase because
patients hypersensitive blurred vision, CNS withdrawal
to drug or soy protein; nystagmus depression. symptoms
in patients experiencing Use together may occur.
shock, coma, or acute GI: nausea, cautiously.
alcohol intoxication constipation, Advise female-
diarrhea with Digoxin: May patient to
Contraindicated In rectal form, dry increase avoid use
patients with acute mouth digoxin level during
angle-closure glaucoma and risk of pregnancy and
GU: toxicity. Monitor of the potential
Use cautiously in incontinence, patient and hazard to the
patients with liver or urine retention digoxin level fetus if drug is
renal impairment, closely. used during
depression, history of Hematologic: pregnancy of if
substance abuse, or neutropenia Diltiazem: May patient
chronic open-angle increase CNS becomes
glaucoma. Hepatic: depression and pregnant while
jaundice prolong effects taking drug.
of diazepam.
Respiratory: Reduce dose of
respiratory diazepam.
depression,
apnea, hiccups Fluconazole,
itraconazole,
Skin: rash, ketoconazole,
 phlebitis at miconazole:
injection site May increase
and prolong
Other: altered diazepam level,
libido, physical CNS
or depression,
psychological and
dependence psychomotor
impairment.
Avoid using
together.

Name of Drug Mechanism Indications / Adverse Drug Nursing Health

of Action Contraindications Reactions Interactions Considerations Teachings
Generic Name May INDICATIONS CNS: Clozapine: May Monitor hepatic, When used
LORAZEPAM potentiate the Insomnia from anxiety drowsiness, cause delirium, renal, and before surgery,
effects of or transient situational sedation, sedation, hematopoietic drug causes
Brand Name GABA, stress amnesia, sialorrhea, and function substantial
Ativan, depress the Adults: 2 to 4mg P.O. at insomnia, ataxia. Don’t periodically in preoperative
Lorazepam CNS, and bedtime agitation, start patients amnesia.
Intensol, suppress the weakness, simultaneously. receiving Patient
Lorazepam spread of Anxiety unsteadiness, repeated or teaching
Preservative seizure Adults: 2 to 6mg P.O. disorientation, CNS prolonged requires extra
Free activity. daily in divided doses, depression, depressants: therapy. care to ensure
with the largest dose headache May increase adequate recall
Route of taken before bedtime CNS depression
Administration CV: Warn patient to
IV Status epilepticus hypotension Oral hormonal avoid
Adults: 4mg I.V. at a contraceptives: hazardous
rate of 2 mg/minute. If EENT: visual May decrease activities that
seizures continue or disturbances, lorazepam level. require
recur after 10 to 15 nasal alertness or
mins., an additional 4- congestion Probenecid: May good
mg dose may be given. result in coordination
Drug may be given I.M GI: abdominal prolonged until effects of
if I.V access isn’t discomfort, lorazepam half- drug are
available. nausea, life and a known.
change in decrease in total
CONTRAINDICATIONS appetite clearance Tell patient to
Contraindicated in avoid use of
patients hypersensitive Sodium oxybate: alcohol while
to drug, other May result in taking drug
benzodiazepines, or the additive effects,
vehicle used in including Notify patient
parenteral dosage form, increased sleep that smoking
and in patients with duration and may decrease
acute angle-closure CNS drug’s
glaucoma. depression. effectiveness.
Coadministration
Contraindicated for is Warn patient
intra-arterial contraindicated. not to stop
administration drug abruptly
Valproate: May because
Use cautiously in increase withdrawal
patients with lorazepam symptoms may
pulmonary, renal, or plasma occur.
hepatic impairment, or concentration
history of substance Advise women
abuse to avoid
becoming
Use cautiously in pregnant while
elderly and debilitated taking drug.
patients

PREGNANCY-
LACTATION-
REPRODUCTION
May cause fetal harm
  ANALGESICS

Name of Drug Mechanism of Indications / Adverse Drug Nursing Health

Action Contraindications Reactions Interactions Considerations Teachings
Generic Name Binds with INDICATIONS CNS: CNS Reassess Explain
NALBUPHINE opioid In patients with renal or dizziness, depressants, patient’s level of assessment
Brand Name receptors in hepatic impairment, headache, general pain at least 15 and monitoring
Nubain the CNS, decrease dosage sedation, anesthetics, and 30 minutes process to
altering vertigo hypnotics, after parenteral patient and
Route of perception of Moderate to severe MAO inhibitors, administration. family. Instruct
Administration and emotional pain (non-opioid- CV: sedatives, them to
I.V response to tolerant patients) bradycardia tranquilizers, Carefully immediately
pain Adults: For patient TCAs: May monitor vital report difficulty
weighing about 70 kg EENT: dry cause signs, pain level, breathing or
(154lb), 10 to 20 mg mouth respiratory respiratory other signs ad
subcutaneously, I.M., or depression, status, and symptoms of a
I.V. every 3 to 6 hours GI: nausea, hypertension, sedation level in potential
p.r.n vomiting profound all patients adverse opioid
sedation, or receiving –related
Adjunct to balanced Respiratory: coma. Use opioids, reaction.
anesthesia respiratory together with especially those
Adults: 0.3 to 3 mg/kg depression caution, and receiving I.V. Caution
I.V. over 10 to 15 monitor patient drugs, even ambulatory
minutes; then Skin: response. those given patient about
maintenance dose of clamminess, postoperatively. getting out of
0.25 to 0.5 mg/kg in diaphoresis Opioid bed or walking.
single I.V. dose p.r.n analgesics: Drugs acts as Warn
May decrease an opioid outpatient to
CONTRAINDICATIONS analgesic antagonist and avoid driving
Contraindicated in effect. Avoid may cause and other
patients hypersensitive using together. withdrawal hazardous
to drug syndrome. activities that
require mental
alertness until
drug’s CNS
 effects are
known.
 ANTICHOLINERGICS

Name of Drug Mechanism of Indications / Adverse Drug Nursing Health

Action Contraindications Reactions Interactions Considerations Teachings
Generic Name Inhibits INDICATIONS CNS: Anticholinergics, In adults, avoid Instruct
ATROPINE acetylcholine at Bradyarrhythmias headache, drugs with doses less than patient to
SULFATE parasympathetic Adults: Usually 0.4 to restlessness, anticholinergic 0.5 mg because report
neuroeffector 1mg I.V push, repeated insomnia, effects of risk of serious or
Brand Name junction, every 1 to 2 hours to dizziness, (amantadine, paradoxical persistent
AtroPen blocking vagal maximum of 2mg ataxia, antiarrhythmics, bradycardia. adverse
effects on SA Children and disorientation, antiparkinsonians reactions
Route of and AV nodes, adolescents: 0.01 to hallucinations, , glutethimide, Watch for promptly.
Administration enhancing 0.03mg/kg I.V. delirium, meperidine, tachycardia in
IV conduction excitement, phenothiazines, cardiac patients Tell patient
through AV node Preoperatively to agitation, TCAs): May because it may about
and increasing diminish secretions and confusion increase lead to potential fpr
heart rate. block cardiac vagal anticholinergic ventricular sensitivity of
reflexes CV: effects. fibrillation. the eyes to
Adults and children bradycardia, the sun and
weighing 20kg (44 lb) palpitations, Potassium May adverse suggest use
or more: 0.4 to 0.6 ng tachycardia chloride wax- reactions (such of
I.V., I.M., or matrix tablets: as dry mouth sunglasses.
subcutaneously 30 to EENT: blurred May increase risk and
60 minutes before vision, of mucosal constipation) Tell patient to
anesthesia. mydriasis, lesions. Avoid vary with dose. protect the
photophobia, combination. AtroPen from
Hypotonic radiography cycloplegia, Monitor fluid light and not
Adults: 1 mg I.M. increase IOP. intake and urine to freeze it.
output. Drug
CONTRAINDICATIONS GI: dry mouth, causes urine
Contraindicated in constipation, retention and
patients hypersensitive thirst, nausea, urine hesitancy.
to drug. vomiting
 Use cautiously in GU: urine
patienrs with Down retention,
syndrome because they erectile
may be more sensitive dysfunction
to drug. Other:
anaphylaxis
 PROTON PUMP INHIBITORS

Name of Drug Mechanism of Indications / Adverse Drug Nursing Health

Action Contraindicatios Reactions Interactions Considerations Teaching
Generic Name Inhibits proton INDICATIONS CNS: asthenia, Ampicillin May increase Tell patient to
OMEPRAZOLE pump activity Symptomatic GERD dizziness, esters, azole risk of CDAD. swallow
by binding to without esophageal headache anti-fungals Evaluate for tablets whole
Brand Name hydrogen- lesions (such as CDAD in and not to
Losec, Prilosec potassium Adults: 20 mg P.O., as GI: abdominal ketoconazole), patients who open, crush,
adenosine delayed release form or pain, iron develop or chew them
Route of triphosphatase, oral suspension, daily constipation, derivatives: diarrhea that
Administration located at for 4 weeks for patients diarrhea, May cause doesn’t improve. Caution
IV secretory who respond poorly to flatulence, poor patient to
surface of customary medical nausea, bioavailability avoid
gastric parietal treatment, usually vomiting of these drugs hazardous
cells, to including an adequate because they activity if he
suppress course of H2-receptor Musculoskeletal: need a low gets dizzy
gastric acid antagonists. back pain gastric pH for
secretion. optimal Teach patient
Duodenal ulcer (short- Respiratory: absorption. to recognize
term treatment) cough, upper and report
Adults: 20 mg P.O., as respiratory tract signs and
delayed-release form or infection symptoms of
oral suspension, daily low
for 4 to 8 weeks. Skin: rash magnesium
CONTRAINDICATIONS levels.
Contraindicated in
patients hypersensitive
to drug or its
components.
Name of Drug Mechanism of Indications / Adverse Drug Nursing Health
Action Contraindications Reactions Interactions Considerations Teachings
Generic Name Competitively INDICATIONS CNS: None Assess patient Instruct patient
FAMOTIDINE inhibits action For patients with CrCl headache, significant for abdominal in proper use of
of histamine on below 50mL/minute, dizziness pain OTC product, if
Brand Name the H2- give half the dose, or appropriate
Pepcid, Pepcid receptor sites increase dosing interval GI: Look for blood in
AC of parietal to every 36 to 48 hours constipation, emesis, stool, or Warn patient
cells, diarrhea gastric aspirate with
Route of decreasing CONTRAINDICATIONS phenylketonuria
Administration gastric acid Contraindicated in Monitor patients that Pepcid AC
IV secretion. patients hypersensitive with renal chewable
to drug. dysfunction for tablets contain
QT-interval phenylalanine
Drug may cause prolongation.
reversible confusional Tell patient to
states that clear within take prescription
3 to 4 days after drug with a
discontinuation. snack, if
Patients older than age desired.
50 and those with renal
or hepatic impairment Advise patient
may be more at risk. to report
abdominal pain,
blood in stools
or vomit, black
tarry stools, or
coffee-ground
emesis

Urge patient to
avoid cigarette
smoking
because it may
 increase gastric
acid secretion
and worsen
disease.

Reference:

Nursing 2017 Drug Handbook. Wolters Kluwer