DRUG THERAPEUTIC RECORD

MECHANISM SIDE EFFECTS/

DRUG NAME DRUG CLASS INDICATIONS CONTRAINDICATIONS NURSING CONSIDERATION
OF ACTION ADVERSE EFFECTS
Generic: Therapeutic: Blocks dopamine Treatment or Hypersensitivity; Possible CNS: drowsiness, Before:
Metoclopramide antiemetics receptors in prevention of GI extrapyramidal - Assess for nausea, vomiting,
chemoreceptor trigger nausea and obstruction or reactions, restlessness, abdominal distention, and bowel
zone of the CNS. vomiting hemorrhage; History of neuroleptic malignant sounds before and after
Stimulates motility of seizure disorders; syndrome, anxiety, administration.
the upper GI tract and Pheochromocytoma; depression,
Brand: accelerates gastric Parkinson’s disease. irritability, tardive During:
emptying. dyskinesia. - Doses may be given slowly over
CV: arrhythmias 1–2 min. Rapid administration
(supraventricular causes a transient but intense
Therapeutic Effects: tachycardia, feeling of anxiety and
Complete Decreased nausea and bradycardia), restlessness followed by
Prescription: vomiting. Decreased hypertension, drowsiness.
Metoclopramide symptoms of gastric hypotension. - Assess for extrapyramidal side
10mg IVTT stasis. Easier passage of GI: constipation, effects (parkinsonian—
q8hrs nasogastric tube into diarrhea, dry mouth, difficulty speaking or
small bowel. nausea. swallowing, loss of balance
Endo: gynecomastia. control, pill rolling, mask-like
Hemat: neutropenia, face, shuffling gait, rigidity,
methemoglobinemia, tremors; and dystonic—muscle
leukopenia, spasms, twisting motions,
agranulocytosis. twitching, inability to move
eyes, weakness of arms or legs)
periodically throughout course
of therapy.

After:
- Advise patient to notify health
care professional immediately if
involuntary or repetitive
movements of eyes, face, or
limbs occur.
- May cause drowsiness. Caution
patient to avoid driving or other
activities requiring alertness
 until response to medication is
known
- Advise patient to avoid
concurrent use of alcohol and
other CNS depressants while
taking this medication.

DRUG THERAPEUTIC RECORD:

MECHANISM SIDE EFFECTS/
DRUG NAME DRUG CLASS INDICATIONS CONTRAINDICATIONS NURSING CONSIDERATION
OF ACTION ADVERSE EFFECTS
Generic: Therapeutic: Binds to an enzyme on Diminished Hypersensitivity to CNS: dizziness, Before:
Omeprazole antiulcer agents gastric parietal cells in accumulation of omeprazole or related drowsiness, fatigue, - Assess patient routinely for
the presence acid in the gastric drugs (benzimidazoles) headache, weakness. epigastric pain or abdominal
of acidic gastric pH, lumen CV: chest pain. pain
preventing the final GI: clostridium
transport of hydrogen difficile-associated During:
Brand: ions into the gastric diarrhea (cdad), - Monitor CBC with differential
Omepron Pharmacologic: lumen. abdominal pain, acid periodically during therapy.
proton-pump regurgitation, - May cause hypomagnesemia.
inhibitors constipation, diarrhea, Monitor serum magnesium prior
Therapeutic effects: flatulence, nausea, to and periodically during
Complete Diminished vomiting. therapy.
Prescription: accumulation of acid in F and E: - Monitor bowel function.
Omeprazole the gastric lumen with hypomagnesemia Diarrhea, abdominal cramping,
(Omepron) 40mg lessened GU: acute interstitial fever, and bloody stools should
IVTT now then gastroesophageal reflux. nephritis. be reported to health care
OD Healing of duodenal Derm: itching, rash. professional promptly as a sign
ulcers Hemat: vitamin B12 of Clostridium difficile-
deficiency. associated diarrhea (CDAD).
MS: bone fracture
Misc: allergic After:
reactions. - May cause dizziness. Caution
patient to avoid activities
requiring alertness until
response to medication is
known.
 - Instruct patient to notify health
care professional of all Rx or
OTC medications, vitamins, or
herbal products being taken and
consult health care professional
before taking any new
medications
- Advise patient to avoid alcohol,
products containing aspirin or
NSAIDs, and foods that may
cause an increase in GI
irritation.
- Advise patient to report onset of
black, tarry stools; diarrhea;
abdominal pain; or persistent
headache to health care
professional promptly.
DRUG THERAPEUTIC RECORD:
MECHANISM SIDE EFFECTS/
DRUG NAME DRUG CLASS INDICATIONS CONTRAINDICATIONS NURSING CONSIDERATION
OF ACTION ADVERSE EFFECTS
Generic Therapeutic: Inhibits synthesis of Fever Previous hypersensitivity; CNS: agitation, Before:
Acetaminophen prostaglandins that may Products containing anxiety - Assess overall health status and
antipyretics, serve as mediators of alcohol, aspartame, headache, fatigue, alcohol usage before
nonopioid pain and fever, primarily saccharin, insomnia administering acetaminophen.
analgesics in the CNS. Has no sugar, or tartrazine (FDC RESP: atelectasis, ,
Brand - Assess amount, frequency, and
significant anti- yellow dye #5) should be dyspnea type of drugs taken in patients
inflammatory properties avoided in patients who CV: hypertension, self-medicating, especially with
or GI toxicity. have hypersensitivity or hypotension. OTC drugs.
intolerance to these GI: hepatotoxicity, - Assess fever; note presence of
compounds; Severe vomiting associated signs (diaphoresis,
Complete Rx: Therapeutic Effects: hepatic impairment/active constipation, nausea, tachycardia, and malaise).
Paracetamol Analgesia. Antipyresis. liver disease. F and E: hypokalemia
500mg tab now GU: renal failure
then q4hrs for HEMAT: During:
fever neutropenia,, - PO: Administer with a full glass
pancytopenia. of water.
MS: muscle spasms - May be taken with food or on
trismus . an empty stomach.
 DERM: acute - Assess for rash periodically
generalized during therapy.
exanthematous
pustulosis, stevens-
johnson syndrome, After:
toxic epidermal - discontinue acetaminophen and
necrolysis, rash, notify health care professional if
urticaria. rash occurs.
- Advise patient to consult health
care professional if discomfort
or fever is not relieved by
routine doses of this drug or if
fever is greater than 39.5C (103F)
or lasts longer than 3 days.

DRUG THERAPEUTIC RECORD:

MECHANISM SIDE EFFECTS/
DRUG NAME DRUG CLASS INDICATIONS CONTRAINDICATIONS NURSING CONSIDERATION
OF ACTION ADVERSE EFFECTS
Generic Therapeutic: Bind to the bacterial cell Treatment of the Hypersensitivity to CNS: SEIZURES, Before:
Ceftriaxone anti-infectives wall membrane, causing following cephalosporins; headache. - Assess for infection (vital signs;
cell infections caused Serious hypersensitivity GI: Clostridium sputum, urine, and stool; WBC)
death. by susceptible to penicillins; difficile- at beginning of and throughout
organisms: Intra- ; Pedi: ASSOCIATED therapy.
Brand Pharmacologic: Therapeutic Effects: abdominal hyperbilirubinemic DIARRHEA, - Before initiating therapy, obtain
keptrix third-generation Bactericidal action infections neonates diarrhea, nausea, a history to determine previous
cephalosporins against susceptible (may lead to bilirubin vomiting, use of and reactions to
bacteria encephalopathy); cholelithiasis, cramps, penicillins or cephalosporins.
Carnitine deficiency or pancreatitis - Obtain specimens for culture
inborn errors of Derm: STEVENS- and sensitivity before initiating
Complete Rx: metabolism (cefditoren JOHNSON therapy. First dose may be
Ceftriaxone(keptr only); hypersensitivity to SYNDROME, rash, given before receiving results.
ix) 2 grams IVTT milk protein (ceftidoren urticaria. - Obtain skin test
OD anst ( ) to run only; contains sodium GU: acute renal
for 1 hour OD caseinate). failure During:
urolithiasis - Administer the medication after
Hemat: negative skin test
agranulocytosis, - Avoid IV push administration
bleeding, of ceftriaxone.
eosinophilia, - 2-g vial with 19.2 mL of sterile
hemolytic anemia, water for injection, 0.9% NaCl,
lymphocytosis, or D5W for a concentration of
neutropenia, 100 mg/mL. Diluent: Solution
thrombocytopenia, should be further diluted in 50–
thrombocytosis. 100 mL of 0.9% NaCl, D5W,
GU: hematuria, D10W, D5/0.45% NaCl, or D5/0.9%
vaginal moniliasis. NaCl. Solution may appear light
yellow to amber. Infuse over 1
hour.
- Observe for signs and
symptoms of anaphylaxis
(rash, pruritus, laryngeal edema,
wheezing). Discontinue drug
and notify health care
professional immediately if
these symptoms occur.

After:
- Advise patient to report signs of
superinfection
(furry overgrowth on the
tongue, vaginal itching or
discharge, lose or foul-smelling
stools) and allergy.
- Instruct patient to notify health
care professional if rash, fever
and diarrhea develop, especially
if stool contains blood, pus, or
mucus. Advise patient not to
treat diarrhea without consulting
health care professional.
DRUG THERAPEUTIC RECORD:
MECHANISM SIDE EFFECTS/
DRUG NAME DRUG CLASS INDICATIONS CONTRAINDICATIONS NURSING CONSIDERATION
OF ACTION ADVERSE EFFECTS
Generic Therapeutic: Inhibits prostaglandin Short-term Hypersensitivity; Cross- CNS: drowsiness, Before:
Ketorolac nonsteroidal anti- synthesis, producing management of sensitivity abnormal thinking, - Assess pain (note type, location,
inflammatory peripherally mediated pain with other NSAIDs may dizziness, euphoria, and intensity) prior to and 1–2 hr
agents, nonopioid analgesia. Also has exist; Preoperative use; headache. following administration.
analgesics antipyretic and anti- Active or history of peptic EENT: lacrimation - Patients who have asthma,
Brand inflammatory properties. ulcer disease or GI (spray), nasal aspirin-induced allergy, and
bleeding; Known alcohol discomfort (spray), nasal polyps are at increased
Toradol intolerance (injection throat irritation risk for developing
Pharmacologic: Therapeutic Effects: only); Perioperative pain (spray). hypersensitivity reactions.
 pyrroziline Decreased pain. from coronary artery Resp: asthma, Assess for rhinitis, asthma, and
carboxylic acid bypass graft (CABG) dyspnea. urticaria.
Complete Rx:
surgery; Cerebrovascular CV: HF,
Ketorolac 30mg bleeding; Advanced renal MYOCARDIAL During:
IVVT now dose impairment or at risk for INFARCTION, - Administer over at least 15 sec.
only renal failure due to STROKE, edema, - Assess for rash periodically
volume depletion; pallor, vasodilation. during therapy.
Concurrent use of GI: GI BLEEDING,
pentoxifylline or abnormal taste, After:
probenecid; diarrhea, dry mouth, - May cause drowsiness or
dyspepsia, GI pain, dizziness. Advise patient to
liver enzymes, avoid driving or other activities
nausea. requiring alertness until
GU: oliguria, renal response to the medication is
toxicity, known.
urinary frequency. - Advise patient to consult health
Derm: exfoliative care professional if rash,
dermatitis, itching, visual disturbances,
stevens-johnson tinnitus, weight gain, edema,
syndrome, toxic black stools, persistent
epidermal necrolysis, headache, or influenza-like
pruritus, purpura, syndrome (chills, fever, muscle
sweating, urticaria. aches, pain) occurs.
Hemat: prolonged
bleeding time. Local:
injection site pain.
Neuro: paresthesia.
Misc: allergic
reactions
including,
anaphylaxis.
DRUG THERAPEUTIC RECORD:
MECHANISM SIDE EFFECTS/
DRUG NAME DRUG CLASS INDICATIONS CONTRAINDICATIONS NURSING CONSIDERATION
OF ACTION ADVERSE EFFECTS
Generic Therapeutic: Chemical: acts by Reduce spasm and hypersensitive to the drug, CNS: dizziness, Before:
Hyoscine-N- interfering with the abdominal pain with myasthenia gravis, anaphylactic - Check doctor’s order
butylbromide anticholinergic transmission of nerve megacolon and narrow reactions, - Assess whether patient is
agent impulses by angle glaucoma, use anaphylactic shock, contraindicated to the drug
 acetylcholine in the cautiously in patients with increased ICP, - Prepare medication ahead of
parasympathetic nervous hepatic dysfunction disorientation, time
Brand Pharmacologic:
system; exerts a restlessness, - Dilute with 20cc compatible
Hyos antispasmodic,
spasmolytic action on irritability, dizziness, intravenous fluid
belladona
the smooth muscle of the drowsiness, headache, - Verify drug, dose, route, timing
alkaloid
gastrointestinal, biliary confusion, and pt.’s identity
and urinary tracts hallucination, - Explain procedure to pt.
delirium, impaired
Complete Rx:
memory During:
HNBB (Hyos) 1
CV: hypotension, - Administer on right route
amp IVTT now
tachycardia, - Observe aseptic techniques
palpitations, flushing - Ensure patency
GI: Dry mouth,
- Introduce medication slowly
constipation, nausea,
epigastric distress
After:
DERM: flushing,
- Educate pt. about possible
dyshidrosis
adverse reactions
GU: Urinary
retention, urinary - Instruct patient to report any
hesitancy unusual reaction
Resp: dyspnea, - Chart accordingly
bronchial plugging, - Institute safety precautions
depressed respiration - Ensure adequate ventilation
EENT: mydriasis,
dilated pupils, blurred
vision, photopobia,
increased intraocular
pressure, difficulty of
swallowing

DRUG THERAPEUTIC RECORD:

MECHANISM SIDE EFFECTS/
DRUG NAME DRUG CLASS INDICATIONS CONTRAINDICATIONS NURSING CONSIDERATION
OF ACTION ADVERSE EFFECTS
Generic Therapeutic: Maintain acid-base Treatment/preventi Hyperkalemia; Severe CNS: confusion, Before:
potassium mineral and balance, isotonicity, and on of potassium renal restlessness, - Assess for signs and symptoms
chloride electrolyte electrophysiologic depletion. impairment; Untreated weakness. of hypokalemia (weakness,
replacements/ balance of the cell. Addison’s disease; Severe CV: fatigue, U wave on ECG,
 supplements Activator in many tissue trauma; ARRHYTHMIAS, arrhythmias,
enzymatic reactions; Hyperkalemic familial ECG changes. polyuria, polydipsia)
Brand
essential to transmission periodic paralysis; Some GI: abdominal pain, - Explain to patient purpose of
Klor-Con of nerve impulses; products may contain diarrhea, the medication and the need to
contraction of cardiac, tartrazine (FDC yellow flatulence, nausea, take as directed,
skeletal, and smooth dye #5) or vomiting;
muscle; gastric alcohol; avoid using in GI ulceration, stenotic During:
secretion; renal function; patients with known lesions. Local: - Assess for extravasation; severe
Complete Rx:
tissue synthesis; and hypersensitivity or irritation at IV site. pain and tissue necrosis may
Incorporate carbohydrate intolerance; Potassium Neuro: paralysis, occur. Never administer
20mEq kcl to
metabolism. acetate injection contains paresthesia. potassium IV push or bolus.
present IVF aluminum, which may - Do not administer
become toxic with concentrations of _1.5 mEq/mL
Therapeutic Effects: prolonged use to high risk undiluted; fatalities have
Replacement or groups (renal impairment, occurred. Concentrated products
prevention of deficiency. premature neonates) have black caps on vials or
black stripes above constriction
on ampules and are labeled with
a warning about dilution
requirement. Each single dose
must be diluted and thoroughly
mixed in 100–1000 mL of IV
solution.
- Monitor pulse, BP, and ECG
periodically during IV therapy.

After:
- Instruct patient to avoid salt
substitutes or low-salt milk or
food unless approved by health
care professional.
- Patient should be advised to
read all labels to prevent excess
potassium intake.
- Instruct patient to avoid salt
substitutes or low-salt milk or
food unless approved by health
care professional.