DRUG STUDY

Lipa City Colleges

College of Nursing

In Partial Fulfillment

Of The Requirements for the Subject

Pharmacology

AY 2020 – 2021

Submitted by:

Vincent M. Material
BSN 2

Submitted to:

Ms. Maria Teresa Ira Bandelaria, MAN, RN, MHoA

NCM 107 Clinical Instructor

November 30, 2020

 Bronchodilators are a type of medication that make breathing
easier by relaxing the muscles in the lungs and widening the
airways (bronchi). They're often used to treat long-term
conditions where the airways may become narrow and inflamed,
such as: asthma, a common lung condition caused by
inflammation of the airways.
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Relaxes smooth ➣To prevent and ● Hypersensitivity to  CNS: dizziness, Availability Patient monitoring
Name:  muscles by relieve drug excitement, Aerosol: 90  Stay alert for
stimulating bronchospasm headache, mcg/actuation, hypersensitivity
beta2- in patients with Use cautiously in: hyperactivity, 108 mcg/inhalation reactions and
albuterol
receptors, reversible ● cardiac disease, insomnia Oral solution: 2 mg/5 ml paradoxical
(salbutamol)
thereby causing obstructive hypertension,  CV: Solution for inhalation: bronchospasm. Stop
bronchodilation airway disease diabetes mellitus, hypertension, 0.083% (3 ml), 0.5% (0.5 drug immediately if
Brand Name:  and vasodilation ➣To prevent glaucoma, seizure palpitations, and 20 ml), 0.63 mg/3 these occur.
exercise-induced disorder, tachycardia, ml, 1.25 mg/3 ml ● Monitor serum
bronchospasm hyperthyroidism, chest pain Syrup: 2 mg/5 ml electrolyte
Proventil exercise-induced  EENT: Tablets: 2 mg, 4 mg levels.
bronchospasm, conjunctivitis, Tablets (extended-
CLASSIFICA- prostatic hypertrophy dry and irritated release): 4 mg, 8 mg Patient teaching
TION: ● elderly patients throat, ● Tell patient to swallow
● pregnant or pharyngitis Dosages extended release tablets
breastfeeding  GI: nausea, ➣To prevent and relieve whole and not to mix
Pharmacologic patients vomiting, bronchospasm in patients them with food.
class: ● children. anorexia, with reversible obstructive ● Follow manufacturer’s
Sympathomimet heartburn, airway disease directions supplied with
ic (beta2- GI distress, dry Adults and children inhalation drugs.
adrenergic mouth ages 12 and older:  Teach patient signs
agonist)  Metabolic: Tablets—2 to 4 mg P.O. and symptoms of
hypokalemia three or four times daily, hypersensitivity reaction
Therapeutic  Musculoskelet not to exceed 32 mg and paradoxical
class: al: muscle daily. bronchospasm. Tell him
Bronchodilator, cramps Extended-release tablets to stop taking drug
antiasthmatic  Respiratory: —4 to 8 mg P.O. q 12 immediately and contact
cough, dyspnea, hours, not to exceed 32 prescriber if these
wheezing, mg daily in divided doses. occur.
Pregnancy risk paradoxical Syrup—2 to 4 mg (1 to 2  Instruct patient to
category C bronchospasm tsp or 5 to 10 ml) three or notify prescriber
 Skin: pallor, four times daily, not to immediately if
urticaria, rash, exceed 8 mg q.i.d. prescribed dosage fails
angioedema, Aerosol—one to two to provide usual relief,
flushing, inhalations q 4 to 6 hours because this may
sweating to relieve bronchospasm; indicate seriously
 Other: tooth two inhalations q.i.d. to worsening asthma.
discoloration, prevent bronchospasm. ● Advise patient to limit
increased Solution for inhalation— intake of caffeine-
appetite, 2.5 mg three to four times containing foods and
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Stimulates ➣Maintenance ● Hypersensitivity to  CNS: headache, Availability Patient monitoring

Name:  intracellular treatment of drug or its nervousness, Powder for inhalation ● Assess pulmonary status
adenylate asthma; components dizziness, using Diskus delivery and vital signs.
cyclase, an prevention of ● Acute asthma tremor system: 50  Stay alert for signs and
salmeterol
enzyme that bronchospasm in attack  CV: palpitations, mcg/blister (60 symptoms of hypersensitivity
xinafoate
catalyzes patients with hypertension, blisters) reaction, particularly rash,
conversion reversible Use cautiously in: tachycardia, urticaria, angioedema, and
Brand Name:  of adenosine obstructive ● cardiovascular arrhythmias Dosages paradoxical bronchospasm.
triphosphate to airway disease; disease, diabetes  GI: nausea, ➣Maintenance
cyclic-3’, 5’- maintenance mellitus, diarrhea, treatment of asthma; Patient teaching
Serevent Diskus adenosine treatment of hyperthyroidism prevention of ● Remind patient that drug
abdominal pain
monophosphate bronchospasm ● concurrent use of  Metabolic: bronchospasm in isn’t a rescue bronchodilator
CLASSIFICA- (cAMP). in patients with MAO inhibitors or hyperglycemia, patients with and won’t give immediate
TION: Increased cAMP chronic tricyclic hypokalemia reversible obstructive relief in emergency.
levels relax obstructive antidepressants  Musculoskelet airway disease; ● Teach patient proper
bronchial pulmonary (extreme caution al: muscle maintenance technique for using inhaler or
Pharmacologic smooth muscle disease (COPD) required) cramps and treatment of Diskus. Instruct him not to
class: Beta2- and inhibit ➣Prevention of ● pregnant or soreness bronchospasm exhale into device or use a
adrenergic release of exercise-induced breastfeeding  Respiratory: in patients with spacer with Diskus.
receptor agonist mediators of bronchospasm patients paradoxical chronic obstructive ● Advise patient to keep
(long-acting) immediate ● children younger bronchospasm pulmonary disease Diskus dry. Tell him not to
hypersensitivity than age 4.  Skin: urticaria, (COPD) rinse, wash, or take it apart.
Therapeutic (especially from angioedema, Adults and children ● Instruct patient to take
class: mast cells). rash older than age 4: regular doses 12 hours
Bronchodilator  Other: 50 mcg (one apart. Tell him to take doses
hypersensitivity inhalation) b.i.d. for exercise-induced
reaction approximately bronchospasm 30 to 60
Pregnancy risk 12 hours apart minutes before exercising.
category C ➣Prevention of ● Advise patient to take drug
exercise-induced exactly as prescribed and not
bronchospasm to exceed one inhalation
Adults and children twice daily.
older than age 4: ● Tell patient to consult
50 mcg (one prescriber if he needs more
inhalation) 30 to 60 inhalations than usual.
minutes Before ● Caution patient not to stop
exercise. Withhold taking drug without
additional doses for consulting prescriber.
at least 12 hours. ● As appropriate, review all
other significant and life-
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Inhibits smooth- ➣Long-term, ● Hypersensitivity to  CNS: Availability Patient monitoring

Name:  muscle once-daily atropine or its depression, Capsules for  Closely monitor patient for
muscarinic maintenance derivatives (including paresthesia inhalation: 18 mcg allergic reaction and
M3-receptors, treatment of ipratropium) or  CV: angina, paradoxical bronchospasm; if
tiotropium
leading to bronchospasm drug components increased heart Dosages these occur, discontinue drug
bronchodilation associated with rate ➣Long-term, once- and consider alternative
Brand Name:  chronic Use cautiously in:  EENT: eye pain daily maintenance therapy.
obstructive ● angle-closure or discomfort, treatment of ● Closely monitor patients
pulmonary glaucoma, prostatic blurred vision, bronchospasm with moderate to severe renal
Spiriva disease hyperplasia, bladder associated with impairment.
visual halos,
HandiHaler neck obstruction, chronic obstructive
cataract, colored
moderate to severe images in pulmonary disease Patient teaching
CLASSIFICA- renal impairment, association with Adults: Contents of ● Give patient information
TION: severe red eyes (with one capsule portion of package insert on
hypersensitivity to inadvertent eye inhaled orally once HandiHaler use.
milk proteins exposure), daily using supplied ● Inform patient that drug is
Pharmacologic ● concurrent use of epistaxis, HandiHaler once daily maintenance
class: other anticholinergics rhinitis, medicine that opens narrowed
Antimuscarinic, ● pregnant or sinusitis, airways and helps keep them
anticholinergic breastfeeding laryngitis, open for 24 hours. Stress that
patients pharyngitis, it’s not for immediate (rescue)
Therapeutic ● children (safety dysphonia relief of breathing problems.
class: and efficacy not  GI: vomiting, ● Tell patient that capsules are
Bronchodilator established). constipation, intended for oral inhalation
dyspepsia, only and should be used only
abdominal pain, with HandiHaler device.
Pregnancy risk gastroesophage Emphasize that HandiHaler
category C al reflux, must not be used to take any
stomatitis, dry other drug.
mouth  Caution patient not to let
 GU: urinary powder get into eyes.
tract infection, ● Teach patient to take
urinary prescribed dose in these
retention, steps: Immediately before
urinary difficulty use, open one sealed blister
 Musculoskelet foil and HandiHaler device,
al: myalgia, insert capsule, press
skeletal pain, HandiHaler button once to
arthritis, leg pierce capsule, and exhale
pain completely before placing
Corticosteroids (cortisone-like medicines) are used to provide
relief for inflamed areas of the body. They lessen swelling,
redness, itching, and allergic reactions. They are often used as
part of the treatment for a number of different diseases, such as
severe allergies or skin problems, asthma, or arthritis.
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE REACTIONS DOSAGE NURSING ACTIONS &
ACTION CONSIDERATIONS

Generic Decreases ➣Severe ● Hypersensitivity to  CNS: headache, Availability Patient monitoring

Name:  inflammation by inflammation; drug, other nervousness, Oral solution: 5 ● Monitor weight, blood
reversing immunosuppressi corticosteroids, depression, euphoria, mg/ml, 5 mg/5 pressure, and electrolyte
increased cell on alcohol, bisulfite, or personality changes, ml levels.
Prednisone
capillary ➣Acute tartrazine psychosis, vertigo, Syrup: 5 mg/5 ● Watch for cushingoid
permeability exacerbation of (with some products) paresthesia, insomnia, ml effects (moon face, central
Brand Name:  and inhibiting multiple sclerosis ● Systemic fungal restless-ness, Tablets: 1 mg, obesity, buffalo hump,
migration of ➣Adjunctive infections seizures, meningitis, 2.5 mg, 5 mg, hair thinning, high blood
polymorpho- therapy for ● Live-virus vaccines increased 10 mg, pressure, frequent
Winpred nuclear Pneumocystis (with intracranial pressure 20 mg, 50 mg infections).
leukocytes. jiroveci immunosuppressant  CV: hypotension,  Check for signs and
CLASSIFICA- Suppresses pneumonia in doses) hypertension, Dosages symptoms of depression
TION: immune system AIDS patients ● Active untreated vasculitis, ➣Severe and psychosis.
by reducing infections (except heart failure, inflammation; ● Assess blood glucose
lymphatic in selected thrombophlebitis, immunosuppres level carefully in diabetic
Pharmacologic activity. meningitis patients) thromboembolism, sion patient.
class: fat embolism, Adults: Dosage ● Monitor patient for signs
Corticosteroid Use cautiously in: arrhythmias, shock individualized and symptoms of infection,
(intermediate ● diabetes mellitus,  EENT: posterior based on which drug may mask or
acting) glaucoma, renal or subcapsular cataracts diagnosis, exacerbate.
hepatic disease, (especially in children), severity of  Assess for early
Therapeutic hypothyroidism, glaucoma, nasal condition, and indications of adrenal
class: Anti- cirrhosis, irritation and response. Usual insufficiency (fatigue,
inflammatory, diverticulitis, congestion, rebound dosage is 5 to weakness, joint pain, fever,
nonspecific ulcerative congestion, sneezing, 60 mg appetite loss,
immunosuppres
colitis, recent epistaxis, P.O. daily as a shortness of breath,
sant
intestinal nasopharyngeal and single dose or in dizziness, syncope).
anastomoses, oropharyngeal divided doses. ● Monitor musculoskeletal
Pregnancy risk inflammatory bowel fungal infections, status for joint, tendon,
category C disease, perforated nasal ➣Acute and muscle pain.
thromboembolic septum, anosmia, exacerbation of
disorders, seizures, dysphonia,hoarseness, multiple Patient teaching
myasthenia gravis, throat irritation (all sclerosis ● Tell patient to take with
heart failure, with longterm use) Adults: 200 mg food or milk to reduce GI
hypertension,  GI: nausea, vomiting, P.O. daily for 1 upset.
osteoporosis, abdominal distention, week, then 80  Teach patient to
hypothyroidism, rectal bleeding, mg every other recognize and immediately
ocular herpes esophageal day for 1 month report signs and symptoms
simplex, candidiasis, dry mouth, of early adrenal
immunosuppression, esophageal ulcer, ➣Adjunctive insufficiency and
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE REACTIONS DOSAGE NURSING ACTIONS &
ACTION CONSIDERATIONS

Generic Unclear. ➣Macular ● Hypersensitivity to  CNS: headache, Availability Patient monitoring

Name:  Reduces edema drug, benzyl malaise, vertigo, Elixir: 0.5 mg/5 ml ● Monitor blood glucose
inflammation following alcohol, bisulfites, psychiatric Intravitreal implant: level closely in diabetic
by suppressing branch EDTA, creatinine, disturbances, 0.7 mg patients receiving drug
dexamethasone
polymorphonuc retinal vein polysorbate 80, or increased Oral solution: 0.5 orally.
lear leukocyte occlusion or methylparaben intracranial pressure, mg/5 ml, 1 mg/ml ● Monitor hemoglobin
Brand Name:  migration, central retinal ● Systemic fungal seizures Solution for injection and potassium levels.
reversing vein occlusion; infections  CV: hypotension, (sodium phosphate): ● Assess for occult
increased noninfectious ● Active or suspected thrombophlebitis, 4 mg/ml, 10 mg/ml, blood loss.
Dexasone capillary uveitis ocular or periocular myocardial rupture 20 mg/ml, 24 mg/ml  In long-term therapy,
permeability, affecting infections, advanced after recent Tablets: 0.25 mg, 0.5 never discontinue drug
CLASSIFICA- and stabilizing posterior glaucoma myocardial mg, 0.75 mg, abruptly. Dosage must
TION: leukocyte segment of (intravitreal implant) infarction, 1 mg, 1.5 mg, 2 mg, be tapered gradually.
lysosomal eye thromboembolism 4 mg, 6 mg ● Monitor patient for
membranes. ➣Allergic and Use cautiously in:  EENT: cataracts; increased IOP after
Pharmacologic Also inflammatory ● renal insufficiency, elevated intraocular Dosages intravitreal injection.
class: suppresses conditions cirrhosis, diabetes pressure (IOP), ➣Macular edema
Glucocorticoid immune ➣Cerebral mellitus, conjunctival following branch Patient teaching
response (by edema diverticulitis, GI hemorrhage (with retinal vein occlusion  Instruct patient to
Therapeutic reducing ➣Suppression disease, intravitreal implant) or central retinal immediately report
class: Anti- lymphatic test for cardiovascular  GI: nausea, vomiting, vein occlusion; sudden weight gain,
inflammatory activity), Cushing’s disease, hypopro- abdominal distention, noninfectious uveitis swelling of face or
stimulates syndrome thrombinemia, dry mouth, anorexia, affecting posterior limbs, excessive
bone marrow, hypothyroidism, peptic ulcer, bowel segment of eye nervousness or sleep
Pregnancy risk and promotes myasthenia gravis, perforation, Adults: 0.7 mg by disturbances, excessive
category C protein, fat, glaucoma, pancreatitis, intravitreal implant body hair growth, vision
and osteoporosis, ulcerative changes, difficulty
carbohydrate infections, esophagitis ➣Allergic and breathing, muscle
metabolism. underlying  Metabolic: decreased inflammatory weakness, persistent
immunosuppression, carbohydrate tolerance, conditions abdominal pain, or
psychotic tendencies hyperglycemia, Adults: 0.75 to 9 change in stool color.
● pregnant or cushingoid appearance mg/day ● Tell patient to take
breastfeeding (moon face, buffalo (dexamethasone) oral drug with or after
patients hump), decreased P.O. as a single dose meals.
● children growth (in children), or in divided doses; in ● Advise patient to
latent diabetes mellitus, severe cases, much report vision changes
sodium and fluid higher dosages may and if eye becomes red,
retention, negative be needed. Dosage sensitive to light, or
nitrogen balance, requirements vary painful after intravitreal
adrenal suppression, and must be implant, to promptly
 Antihistamines are medicines often used to relieve symptoms
of allergies, such as hay fever, hives, conjunctivitis and reactions
to insect bites or stings. They're also sometimes used to prevent
motion sickness and as a short-term treatment for insomnia.
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Antagonizes ➣Allergic ● Hypersensitivity to  CNS: dizziness, Availability Patient monitoring

Name:  histamine’s symptoms drug or hydroxyzine drowsiness, Syrup: 5 mg/5 ml ● Monitor creatinine
effects at caused by ● Acute asthma fatigue Tablets: 5 mg, 10 mg levels in patients with
histamine1- histamine attacks  CV: palpitations, renal dysfunction.
cetirizine
receptor sites, release ● Angle-closure edema Dosages ● Assess hepatic
hydrochloride
preventing glaucoma  EENT: ➣Allergic symptoms enzyme levels in
allergic ● Pyloroduodenal pharyngitis caused by histamine patients with hepatic
Brand Name:  response. Also obstruction  GI: nausea, release disease.
has mild ● Breastfeeding vomiting, Adults and children
bronchodilatory abdominal older than age 6: Patient teaching
Zyrtec effects and Use cautiously in: 5 to 10 mg P.O. daily ● Tell patient to take
distress,
blocks ● renal impairment, dry mouth Children ages 2 to 5: with full glass of water.
CLASSIFICA- histamine- significant hepatic  Musculoskelet 2.5 to 5 mg ● Inform patient that
TION: induced dysfunction al: myalgia, P.O. daily drug may impair
broncho– ● elderly patients joint pain alertness and that
constriction in ● pregnant patients  Respiratory: Dosage adjustment alcohol may exaggerate
Pharmacologic asthma. ● children younger bronchospasm ● Renal impairment this effect.
class: than age 2 (safety  Skin: ● Hepatic impairment ● Caution patient to
Histamine1- not established). photosensitivity, avoid driving and other
receptor rash, hazardous activities
antagonist angioedema until he knows how drug
(peripherally  Other: fever affects concentration
selective) and alertness.
● As appropriate, review
Therapeutic all other significant
class: Allergy, and life-threatening
cold, and cough adverse reactions and
agent; interactions, especially
antihistamine those related to the
drugs, tests, and
behaviors mentioned
Pregnancy risk above.
category B
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Interferes with ➣Allergy ● Hypersensitivity to  CNS: Availability Patient monitoring

Name:  histamine symptoms drug drowsiness, Capsules: 25 mg, 50 mg ● Monitor
effects at caused by ● Alcohol intolerance dizziness, Elixir: 12.5 mg/5 ml cardiovascular
histamine1- histamine ● Acute asthma headache, Injection: 10 mg/ml, 50 status, especially in
diphenhydramin
receptor sites; release (including attacks paradoxical mg/ml patients with
e hydrochloride
prevents but anaphylaxis, ● MAO inhibitor use stimulation Strips (orally disintegrating): cardiovascular
doesn’t reverse seasonal and within past 14 days (especially in 12.5 mg, disease.
Brand Name:  histamine- perennial allergic ● Breastfeeding children) 25 mg ● Supervise patient
mediated rhinitis, ● Neonates,  CV: Syrup: 12.5 mg/5 ml during ambulation.
response. Also and allergic premature infants hypotension, Tablets: 25 mg, 50 mg Use side rails as
Benadryl possesses CNS dermatoses); palpitations, Tablets (chewable): 12.5 mg, necessary.
depressant nausea; vertigo Use cautiously in: tachycardia 25 mg
CLASSIFICA- and ➣Cough ● severe hepatic  EENT: blurred Tablets (orally Patient teaching
TION: anticholinergic ➣Dyskinesia; disease, angle- vision, tinnitus disintegrating): 12.5 mg ● Advise patient to
properties. Parkinson’s closure  GI: diarrhea, avoid alcohol and
disease glaucoma, seizure constipation, dry Dosages other depressants
Pharmacologic ➣Mild nighttime disorders, prostatic mouth ➣Allergy symptoms caused such as sedatives
class: sedation hypertrophy,  GU: dysuria, by histamine release while taking drug.
Ethanolamine cardiovascular urinary (including anaphylaxis, ● Caution patient to
derivative, disease, frequency or seasonal and perennial avoid driving and
nonselective hyperthyroidism retention allergic rhinitis, and allergic other hazardous
histamine1- ● elderly patients  Skin: dermatoses); nausea; vertigo activities until he
receptor ● pregnant patients photosensitivity Adults and children over knows how drug
antagonist (safety not  Other: age 12: 25 to 50 mg P.O. q affects concentration
established) decreased 4 to 6 hours, or 10 to 50 mg and alertness.
Therapeutic ● children younger appetite, pain at I.V. or I.M. q 2 to 3 hours ● As appropriate,
class: than age 2 (safety I.M. injection p.r.n. (Some patients may review all other
Antihistamine, not established). site need up to 100 mg.) Don’t significant
antitussive, exceed 400 mg/day. adverse reactions
Children ages 6 to 12: 12.5 and interactions,
antiemetic,
to 25 mg P.O. q 4 to 6 hours, especially those
antivertigo or 1.25 mg/kg (37.5 mg/m2) related to the
agent, I.M. or I.V. q.i.d. Don’t drugs, tests, herbs,
antidyskinetic exceed 150 mg/day. and behaviors
Children ages 2 to 5: 6.25 mentioned above.
Pregnancy risk mg P.O. q 4 to 6 hours.
category B Don’t exceed 37.5 mg/day.

➣Cough
Adults: 25 mg P.O. q 4
Cough medicines aim either to suppress a dry cough, or to help
you to cough up the extra phlegm (mucus) of a chesty cough
when you have a URTI. There are 2 types of OTC cough
medicines: antitussives and expectorants. If you have a dry cough,
a preparation containing an antitussive is the most suitable to try.
If you have a chesty cough, a preparation containing an
expectorant is the most suitable to try
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Depresses ➣Cough caused ● Hypersensitivity to  CNS: dizziness Availability Patient monitoring
Name:  cough reflex by minor viral drug and sedation Gelcaps: 15 mg, 30 mg ● Monitor cough
through direct upper respiratory ● Chronic productive  GI: nausea, Liquid: 3.5 mg/5 ml, 5 frequency and type, and
effect on cough tract infections or cough vomiting, mg/5 ml, assess sputum
dextromethorph
center in inhaled irritants ● MAO inhibitor use stomach pain 7.5 mg/5 ml, 15 mg/5 ml characteristics.
an
medulla. Has no within past 14 days Lozenges: 5 mg, 7.5 mg ● Assess hydration
hydrobromide
expectorant Oral suspension status. Increase
action and does Use cautiously in: (extended-release): patient’s fluid input to
Brand Name:  not inhibit ● tartrazine 30 mg/5 ml help moisten secretions.
ciliary action. sensitivity Syrup: 7.5 mg/5 ml, 10
Although ● diabetes mellitus mg/15 ml Patient teaching
Vicks 44 Cough related (with ● Advise patient to
Relief to opioids sucrosecontaining Dosages avoid irritants, such as
structurally, drug products) ➣Cough caused by minor smoking, dust, and
CLASSIFICA- lacks analgesia ● pregnant or viral upper respiratory fumes. Suggest use of
TION: and addictive breastfeeding tract infections or humidifier to filter air
properties. patients inhaled irritants pollutants.
● children younger Adults and children ● Inform patient that
Pharmacologic than age 2 (safety over age 12: 10 to treatment aims to
class: not established). 20 mg P.O. q 4 hours, or decrease coughing
Levorphanol 30 mg P.O. q 6 to 8 frequency and intensity
derivative hours, or 60 mg of without completely
extendedrelease form eliminating protective
Therapeutic P.O. b.i.d. (not to exceed cough reflex.
class: 120 mg/day) ● Instruct patient to
Antitussive Children ages 6 to 12: 5 contact health care
(nonnarcotic) to 10 mg P.O. q 4 hours, provider if cough lasts
or 15 mg P.O. q 6 to 8 more than 7 days.
hours, or 30 mg of ● As appropriate, review
Pregnancy risk extended-release form all other significant
category C P.O. q 12 hours (not to adverse reactions and
exceed 60 mg/day) interactions, especially
Children ages 4 to 6: those related to the
2.5 to 7.5 mg (syrup) drugs and behaviors
P.O. q 4 to 8 hours or 15 mentioned above.
mg (extended-release
form) P.O. b.i.d. Not to
exceed 30 mg/day.

Dosage adjustment
 DRUG DATA MECHANISM INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
OF ACTION REACTIONS CONSIDERATIONS

Generic Exerts ➣Cough due to ● Hypersensitivity to  CNS: Availability Patient monitoring

Name:  vasoconstric- upper respiratory drug headache, Capsules: 200 mg ● Assess cough quality
tive action tract infection ● Alcohol intolerance dizziness Oral solution: 100 mg/5 ml, and productivity.
that leads to (with some  GI: nausea, 200 mg/5 ml Reevaluate treatment if
guaifenesin
decreased products) vomiting, Syrup: 100 mg/5 ml cough persists and is
(glyceryl
edema and diarrhea, Tablets: 100 mg, 200 mg, 400 accompanied by fever
guaiacolate)
congestion. Use cautiously in: stomach pain mg or headache.
Also increases ● diabetes mellitus,  Skin: rash, Tablets (extended-release):
Brand Name:  respiratory cough lasting more urticaria 600 mg Patient teaching
secretions and than 1 week or ● Tell patient to take
reduces accompanied by Dosages with 8 oz of water and
Robitussin mucus fever, rash, or ➣Cough due to upper to drink plenty of fluids.
viscosity. headache respiratory tract infection ● Instruct patient to
CLASSIFICA- ● patients receiving Adults: 200 to 400 mg P.O. q 4 contact prescriber if
TION: disulfiram hours (not to exceed 2,400 cough lasts more than 1
concurrently mg/day), or 600 to 1,200 mg week.
● pregnant patients. P.O. (extended-release tablets) ● Caution patient to
Pharmacologic q 12 hours (not to exceed avoid driving and other
class: 2,400 mg/day) hazardous activities
Propanediol Children ages 6 to 12: 100 to until he knows how drug
derivative 200 mg P.O. q 4 hours (not to affects concentration
exceed 1,200 mg/day), or 600 and alertness.
Therapeutic mg P.O.(extendedrelease) ● As appropriate, review
class: q 12 hours (not to exceed all other significant
Expectorant 1,200 mg/day) adverse reactions and
Children ages 2 to 6: 50 to interactions, especially
100 mg P.O. q 4 hours (not to those related to the
Pregnancy risk exceed 600 mg/day) tests mentioned above.
category C

DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Binds to opioid ➣Mild to ● Hypersensitivity to  CNS: confusion, Availability Patient monitoring
Name:  receptors in moderately drug, its sedation, Tablets: 15 mg, 30 mg, ● Monitor vital signs and
CNS, altering severe pain components, or other malaise, 60 mg CNS status.
perception of opioids agitation, ● Assess pain level and
codeine sulfate
 A decongestant, or nasal decongestant, is a type of
pharmaceutical drug that is used to relieve nasal congestion in
the upper respiratory tract.
 DRUG DATA MECHANISM INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
OF ACTION REACTIONS CONSIDERATIONS

Generic Stimulates ➣Mild to ● Hypersensitivity to  CNS: Availability Patient monitoring

Name:  alpha- moderate drug or its headache, Injection: 10 mg/ml ● Monitor ECG
adrenergic hypotension components weakness, Nasal solution: 0.125%, 0.25%, continuously during
receptors, ➣Severe ● Severe anxiety, 0.5%, 1% I.V. administration;
phenylephrine
increasing hypotension hypertension restlessness, Ophthalmic solution: 0.12%, 2.5%, monitor blood
hydrochloride
blood pressure and shock ● Ventricular tremor, light- 10% pressure every 5 to
and causing ➣Hypotensive tachycardia headedness, Tablets (chewable): 10 mg 15 minutes until it
Brand Name:  pronounced emergency ● Angle-closure dizziness, stabilizes, then every
vasoconstricti during glaucoma drowsiness, Dosages 30 to 60 minutes.
on in skin, spinal ● Aneurysm (10% insomnia, ➣Mild to moderate hypotension ● Monitor central
Rhinall mucous anesthesia ophthalmic solution) hallucinations, Adults: 1 to 10 mg subcutaneously venous pressure and
membranes, ➣To prolong ● During intraocular nervousness, or I.M.; don’t exceed an initial fluid intake and
CLASSIFICA- and mucosa. spinal surgery when restlessness, dosage of 5 mg. output. Keep in mind
TION: Produces anesthesia corneal epithelial giddiness, that drug doesn’t
mydriasis by ➣Vasoconstric barrier has been prolonged ➣Severe hypotension and shock eliminate need for
contracting tor for disturbed psychosis, Adults: 0.1 to 0.18 mg/minute I.V. fluid resuscitation.
Pharmacologic papillary regional (ophthalmic solution) orofacial infusion. For maintenance infusion, ● Assess CBC; watch
class: dilator muscle. anesthesia ● Elderly patients dystonia 40 to 60 mcg/minute. for evidence of blood
Sympathomimet ➣Paroxysmal with severe  CV: dyscrasias.
ic, alpha- supraventricul arteriosclerotic hypertension, ➣To prevent hypotension during ● Monitor I.V. site;
adrenergic ar tachycardia or cerebrovascular palpitations, spinal anesthesia extravasation can
agonist ➣Nasal disease tachycardia, Adults: 2 to 3 mg subcutaneously cause tissue
congestion ● Some low-birth- bradycardia, or I.M. 3 to 4 minutes before spinal damage.
Therapeutic ➣Vasoconstric weight infants arrhythmias anesthetic is injected ● Assess for
class: tion and pupil  EENT: with symptomatic
Vasopressor, dilation Use cautiously in: ophthalmic ➣Hypotensive emergency during improvement in
nasal ➣Uveitis ● sulfite sensitivity solution— spinal anesthesia patients using nasal
decongestant, ➣Open-angle (some products) transient Adults: 0.2 mg I.V., up to a form.
ophthalmic glaucoma ● hyperthyroidism, pigment maximum of 0.5 mg/dose  Monitor for
vasoconstrictor ➣For wide partial heart block, floaters in adverse reactions,
pupil dilation bradycardia, aqueous ➣To prolong spinal anesthesia particularly life-
before hypertension, cardiac humor; Adults: 2 to 5 mg added to threatening
Pregnancy risk intraocular disease, rebound anesthetic solution (prolongs spinal asthmatic episodes.
category C surgery arteriosclerosis, miosis; block by up to 50%)
➣Refraction unstable vasomotor rebound Patient teaching
➣Provocative syndrome hyperemia ➣Vasoconstrictor for regional ● Tell patient to take
test for angle- ● type 1 (insulin- (with anesthesia exactly as directed
closure dependent) diabetes prolonged Adults: 1 mg of phenylephrine and not to exceed
glaucoma mellitus, use); light added to every 20 ml of local recommended
➣Retinoscopy hypertension, sensitivity; anesthetic solution dosage.
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Stimulates ➣Cough caused ● Hypersensitivity to  CNS: anxiety, Availability Patient monitoring
Name:  alpha- by minor viral drug or other nervousness, Capsules: 60 mg ● Monitor vital signs.
adrenergic upper sympathomimetics dizziness, Capsules (extended- ● Assess neurologic and
receptors, respiratory tract ● Alcohol intolerance drowsiness, release): 120 mg, 240 mg cardiovascular status
pseudoephedrin
causing infections or (with some liquid excitability, fear, Capsules (soft gel): 30mg regularly.
e hydrochloride
vasoconstriction inhaled irritants products) hallucinations, Oral solution: 15 mg/5
of respiratory ● Hypertension headache, ml, 30 mg/ 5 ml Patient teaching
Brand Name:  tract; relaxes ● Severe coronary insomnia, Syrup: 30 mg/5 ml ● Advise patient to take
bronchial artery disease restlessness, Tablets: 30 mg, 60 mg at least 2 hours before
smooth ● MAO inhibitor use asthenia, Tablets (chewable): 15mg bedtime to reduce
Sudafed muscle through within past 14 days seizures Tablets (extended- insomnia.
beta2- ● Children younger  CV: palpitations, release): 120 mg, 240 mg ● Tell patient not to
CLASSIFICA- adrenergic than age 12 hypertension, crush or break
TION: stimulation (extended-release tachycardia, Dosages extended-release
forms) cardiovascular ➣Nasal, sinus, or tablets or capsules.
collapse eustachian tube ● Advise patient to
Pharmacologic Use cautiously in:  GI: anorexia, congestion discontinue use and
class: ● hyperthyroidism, dry mouth Adults and children consult prescriber if he
Sympathomimet diabetes mellitus,  GU: dysuria ages 12 and older: experiences
ic prostatic hypertrophy,  Respiratory: 60 mg P.O. q 4 to 6 hours nervousness, dizziness,
ischemic heart respiratory p.r.n. (not to exceed 240 or insomnia.
Therapeutic disease, glaucoma difficulty mg/day); or 120 mg ● Tell patient to consult
class: ● elderly patients (extended-release) q 12 prescriber before taking
Decongestant (more sensitive to hours or 240 mg other over-the-counter
(systemic) drug’s CNS effects) (extended-release) q 24 products.
● pregnant or hours ● Caution patient to
breastfeeding avoid driving and
Pregnancy risk patients. other hazardous
category C activities until he knows
how drug affects
concentration and
alertness.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs and foods
mentioned above.
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Oxymetazoline ➣ Nasal Contraindicated in:  CNS: headache; Availability Special Considerations

Name:  is a direct acting Congestion patients insomnia; Nasal drops or
sympathomimet ➣ Relief of minor hypersensitive to drowsiness, spray: 0.05% • Excessive dosing may
ic amine, which eye redness drug. Ophthalmic dizziness, and Nasal solution: 0.025% irritate nasal mucosa and
oxymetazoline
acts on alpha- form contraindicated possible (drops) for children cause rebound congestion
hydrochloride
adrenergic in patients with sedation from Ophthalmic (nasal) or rebound
receptors in the angle-closure nasal form; light solution:  0.025% hyperemia (ophthalmic).
Brand Name:  arterioles of the glaucoma. headedness and • Watch for adverse
conjunctiva and nervousness Dosages reactions in patients with
nasal mucosa. It Use cautiously in: from ophthalmic CV disease, diabetes
Afrin produces patients with form.  Nasal mellitus, or prostatic
vasoconstriction hyperthyroidism,  CV: palpitations; congestion. Adults and hypertrophy because
CLASSIFICA- , resulting in cardiac disease, or CVcollapse and children older than age systemic absorption can
TION: decreased hypertension and in hypertension 6: 2 to 3 drops or sprays occur.
conjunctival those receiving MAO with nasal form; of 0.05% solution in Pediatric patients
congestion in inhibitors. Use nasal tachycardia, bra each nostril q 10 to 12 • Children may exhibit
Pharmacologic ophthalmic. In solution cautiously in dycardia, and hours for no longer than increased adverse effects
class: nasal it patients with irregular 3 to 5 days. Dosage for from systemic absorption;
sympathomimeti produces diabetes mellitus. heartbeat with younger children hasn’t 0.05% nasal solution is
c constriction, Use ophthalmic form ophthalmic been established. contraindicated in
resulting in cautiously in those form.  Relief of minor eye children younger than age
Therapeutic decreased blood with eye disease,  EENT: rebound redness. Adults and 6; 0.025% nasal solution
class: flow and infection, or injury. nasal congestion children older than age should be used in children
decongestant, decreased nasal or irritation with 6: 1 to 2 drops in the younger than age 2 only
vasoconstrictor congestion. excessive or conjunctival sac up to under medical direction
long-term use, q.i.d. (spaced at least 6 and supervision.
dryness of nose hours apart) Geriatric patients
Pregnancy risk and throat, • Use drug cautiously in
category C increased nasal elderly patients with
discharge, cardiac disease, poorly
stinging, controlled hypertension,
sneezing (with or diabetes mellitus.
nasal
form); transient Patient teaching
stinging upon • Emphasize that only
instillation, blurr one person should use
ed vision, dropper bottle or nasal
reactive spray.
hyperemia, • Advise patient not to
keratitis, exceed recommended
The drugs, cromolyn sodium (or cromolyn) and nedocromil, are
commonly grouped together as chromones (also called
cromoglycates). The chromones are listed as alternate initial
controller therapies for mild asthma in national and international
guidelines, although inhaled glucocorticoids (also known as
inhaled corticosteroids) are the preferred agents
 DRUG DATA MECHANISM INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
OF ACTION REACTIONS CONSIDERATIONS

Generic Inhibits ➣Mastocytosis ● Hypersensitivity to  CNS: Availability Patient monitoring

Name:  release of ➣Vernal drug headache, Nasal solution: 40 mg/ml ● Monitor pulmonary
histamine and keratoconjunct ● Status asthmaticus drowsiness, (5.2 mg/ spray) in 13-ml function periodically.
reacting ivitis, vernal dizziness container (100 sprays) or ● Evaluate patient for
cromolyn
substances of conjunctivitis, Use cautiously in:  EENT: nasal 26-ml container (200 signs and symptoms
sodium
anaphylaxis and vernal ● renal or hepatic irritation, sprays) of overdose, including
from keratitis impairment, acute sneezing, Ophthalmic solution: 4% bronchospasm and difficult
Brand Name:  mast cells, ➣To prevent bronchospasm epistaxis, Oral solution: 100 mg/5ml or painful urination.
stabilizing the and relieve attacks postnasal drip Solution for nebulization: 10
cell nasal ● pregnant or (with nasal mg/ml Patient teaching
Gastrocrom membrane symptoms of breastfeeding solution); With nasal form—
and reducing hay fever and patients stinging of Dosages ● Teach patient how to
CLASSIFICA- the other nasal ● children younger eyes, ➣Mastocytosis instill nasal spray as
TION: allergic allergies than age 5. lacrimation Adults and children ages directed.
response and ➣Prevention of (with 13 and older: 200 mg P.O. ● Tell patient that drug
inflammatory acute ophthalmic q.i.d. may cause unpleasant
Pharmacologic reaction bronchospasm solution) Children ages 2 to 12: 100 taste, but that rinsing
class: ➣Management  GI: nausea, mg P.O. q.i.d. mouth and performing
Chromone of bronchial diarrhea, frequent oral care may
derivative asthma stomachache, ➣Vernal keratoconjunctivitis, help. Also inform him that
swollen parotid vernal conjunctivitis, and drug may cause headache.
Therapeutic glands vernal keratitis ● Advise patient to report
class: Mast cell  GU: difficult or Adults and children ages increased
stabilizer, painful 4 and older: sneezing; nasal burning,
antiasthmatic, urination, One to two drops of stinging, or
ophthalmic urinary ophthalmic solution in each irritation; sore throat;
decongestant frequency eye four to six times daily at hoarseness; or nosebleed.
 Musculoskelet regular intervals With oral form—
al: myopathy ● Tell patient to take oral
Pregnancy risk  Respiratory: ➣To prevent and relieve form 30 minutes before
category B wheezing, nasal symptoms of hay fever meals.
cough, and other nasal allergies With ophthalmic form—
bronchospas Adults and children ages ● Instruct patient to wash
m 2 and older: hands before using.
 Skin: Spray once into each nostril. ● Teach patient how to
erythema, rash, To prevent nasal allergy instill drops: Instruct him
urticaria, symptoms, use up to 1 week to tilt his head back and
angioedema before contact with cause of look up, place drops inside
 Other: altered allergy. To relieve nasal lower eyelid, close his eye,
taste, symptoms, repeat three to and roll eyeball in all
 Leukotriene receptor antagonists (LTRA) are a new class of
drugs for asthma treatment, available in tablet form. Their unique
mechanism of action results in a combination of both
bronchodilator and anti-inflammatory effects.
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Blocks action of ➣Long-term ● Hypersensitivity to  CNS: fatigue, Availability Patient monitoring
Name:  leukotrienes, asthma drug or its headache, Oral granules: 4-mg ● Assess eosinophil
decreasing management components dizziness, base/packet count.
smooth muscle ➣Prevention of asthenia, Tablets: 10 mg ● Monitor temperature.
montelukast
contractions exercise-induced Use cautiously in: agitation, Tablets (chewable): 4 mg, Watch for fever and
sodium
and edema in bronchoconstricti ● acute asthma aggressive 5 mg other signs and
bronchial on (EIB) attack, hepatic behavior symptoms of infection.
Brand Name:  airways and ➣Seasonal impairment, or hostility, Dosages  Monitor patient for
preventing allergic rhinitis phenylketonuria anxiousness, ➣Long-term asthma change in mood or
inflammation ➣Perennial ● pregnant or depression, management behavior, including
Singulair and allergic rhinitis breastfeeding disorientation, Adults and children suicidal ideation.
bronchospasm patients dream ages 15 and older:
CLASSIFICA- ● children younger abnormalities, 10-mg tablet P.O. daily in Patient teaching
TION: than age 6 when hallucinations, evening ● Advise patient (or
used for EIB insomnia, Children ages 6 to 14: caregiver) who has
prevention (safety irritability, 5-mg chewable tablet P.O. asthma or asthma and
Pharmacologic not established) restlessness, daily in evening rhinitis to take drug in
class: ● children younger somnambulism, Children ages 2 to 5: 4- evening.
Leukotriene than age 2 when tremor, suicidal mg chewable tablet or one ● Instruct patient (or
receptor used for seasonal thinking and 4-mg packet oral granules caregiver) who has EIB
antagonist allergy (safety not behavior P.O. daily in evening not to take another
established) (including Children ages 12 to 23 dose within 24 hours of
Therapeutic ● children younger suicide) months: 4-mg packet previous dose.
class: than age 1 when  EENT: nasal oral granules P.O. daily in ● Inform patient (or
Antiasthmatic used for asthma congestion, evening caregiver) that he may
(safety not otitis and sprinkle granules onto
established) sinusitis (in ➣Prevention of exercise- soft foods (applesauce,
Pregnancy risk ● children younger children) induced carrots, rice, or ice
category B than age 6 months  GI: abdominal bronchoconstriction (EIB) cream only) and take
when used for pain; nausea Adults and children immediately. Drug isn’t
perennial allergy and diarrhea ages 15 and older: intended to be dissolved
(safety not (in children); Single-dose, 10-mg tablet in any liquid other than
established). dyspepsia; P.O. at least 2 hours breast milk or baby
infectious before exercise; additional formula. Don’t store
gastroenteritis dose shouldn’t be taken drug that has been
 Respiratory: within 24 hours. Patients mixed with food or
cough already taking 1 tablet liquids for future use.
 Skin: rash daily for another ● Instruct patient or
 Other: dental indication shouldn’t take caregiver that after
pain, influenza, an additional dose. opening packet of oral
 DRUG DATA MECHANISM OF INDICATIONS CONTRAINDICATIONS ADVERSE DOSAGE NURSING ACTIONS &
ACTION REACTIONS CONSIDERATIONS

Generic Antagonizes ➣Prophylaxis and ● Hypersensitivity to  CNS: headache, Availability Patient monitoring
Name:  activity of three long-term drug or its dizziness, Tablets (coated): 10 ● Assess patient’s
leukotrienes treatment of components asthenia, mg, 20 mg respiratory status to help
at specific asthma ● Hepatic insomnia, evaluate drug efficacy.
zafirlukast
receptor sites in impairment, depression Dosages  Monitor liver function
airway smooth including hepatic (especially in ➣Prophylaxis and tests closely; watch for
Brand Name:  muscle, cirrhosis children and long-term treatment signs and symptoms of liver
inhibiting adolescents) of asthma dysfunction.
inflammation Use cautiously in:  GI: nausea, Adults and children
Accolate ● acute asthma vomiting, ages 12 and older: Patient teaching
attacks diarrhea, 20 mg P.O. b.i.d. ● Tell patient to take at
CLASSIFICA- ● concurrent use of abdominal pain, Children ages 5 to least 1 hour before or 2
TION: warfarin dyspepsia 11: 10 mg P.O. b.i.d. hours after a meal.
● patients older than  Hepatic: ● Advise patient to take
age 55 hepatic exactly as prescribed, even
Pharmacologic ● pregnant patients dysfunction if he is symptom-free.
class: ● breastfeeding including  Tell patient to
Leukotriene patients (use not liver failure immediately report asthma
receptor recommended) and death attack. Advise him not to
antagonist ● children younger (rare) use drug for rapid relief of
than age 5 (safety  Musculoskelet bronchospasm.
Therapeutic not established). al: joint or back ● Instruct patient to
class: pain, myalgia continue taking other
Antiasthmatic,  Other: fever, asthma drugs unless
bronchodilator infection, pain prescriber directs otherwise.
 Instruct patient to
immediately report signs
Pregnancy risk and symptoms of liver
category B dysfunction (nausea,
anorexia, fatigue, lethargy,
pruritus, jaundice, flulike
symptoms, or right upper
quadrant abdominal pain).
● Instruct patient or
caregiver to report insomnia
or depression.
● Instruct female patient to
consult prescriber if she
plans to breastfeed.
● As appropriate, review all