MARCOS, Arian May S.

Ma’am Nasper Anod

BSN 2-Fa March 5, 2021

DRUG STUDY
DRUG NAME MECHANISM OF INDICATION/CONTRAINDICATIO ADVERSE EFFECT NURSING
ACTION N RESPONSIBILITIES:

GENERIC: Hyoscine Hyoscine is aquaternary INDICATION: relief of smooth muscle CNS: dizziness, anaphylactic  Be alert for adverse
ammonium antimuscarinic spasm of the gastrointestinal and reactions, anaphylactic reactions and drug
BRAND: Buscopan agent.Hyoscine genitourinary systems. shock, increased ICP, interactions.
butylbromide does not disorientation, restlessness,
CLASS: CONTRAINDICATION:  Assess for eye pain.
readily pass the blood-brain irritability, dizziness,
antispasmodic
barrier. It is a competitive drowsiness, headache,
 Hypersensitivity to hyoscine Assess for urinary hesitancy.
THERAPEUTIC: It antagonist of the actions of confusion, hallucination,
butylbromide.
acts by interfering acetylcholine and other delirium, impaired memory Assess for constipation.
with the transmission muscarinic agonists. The  Porphyria
receptors affected are those CV: hypotension, Monitor urine output.
of nerve impulses by
of peripheral structures that  Myasthenia gravis tachycardia, palpitations,
acetylcholine in the
flushing Encourage patient to void.
parasympathetic are either stimulated or
inhibited by muscarine,  Prostatic enlargement,paralytic ileus
nervous system. GI: Dry mouth, constipation, Monitor BP for possible
ie.exocrine glands, smooth or pyloricstenosis and fever .
Buscopan exerts a nausea, epigastric distress hypertension.
spasmolytic action on and cardiac muscle.  Closed angle glaucoma,or narrow
the smooth muscle of angle between the iris and cornea, DERM: flushing, dyshidrosis  For pregnant
SOURCE: women,monitor cervical
the gastrointestinal, ashyoscine increases intra-ocular
https://www.scribd.com/doc/ GU: Urinary retention, effacement and dilatation.
biliary and urinary pressure.
33211867/Drug-Study- urinary hesitancy
tracts. As a quaternary
Hyoscine-Butylbromide-IV  Pregnant and lactating mothers.
ammonium derivative,
Resp: dyspnea, bronchial
hyoscine-N-
plugging, depressed
butylbromide does not
respiration
enter the central
nervous system. EENT: mydriasis, dilated
Therefore, pupils, blurred vision,
anticholinergic side photopobia, increased
effects at the central intraocular pressure,
nervous system do not difficulty of swallowing.
occur. Peripheral
anticholinergic effects
result from a ganglion-
blocking action within
the visceral wall as
well as from anti-
muscarinic activity.

DOSAGE:

Preanesthetic

Adult: PO 0.5–1 mg
 DRUG NAME MECHANISM OF INDICATION/CONTRAINDICATIO ADVERSE EFFECT NURSING
ACTION N RESPONSIBILITIES:

GENERIC: Ergot alkaloid that induces INDICATION: Routine management GI: Nausea, vomiting  Monitor vital signs
Methergine rapid, sustained tetanic after delivery of placenta and for (especially with IV doses). (particularly BP) and
uterine contraction that postpartum atony, subinvolution, and uterine response during and
BRAND: shortens third stage of labor hemorrhage. With full obstetric CV: Severe hypertensive after parenteral
Methylergonovine and reduces blood loss. supervision, may be used during second episodes, bradycardia. administration of
stage of labor. methylergonovine until
CLASS: SOURCE: Body as a Whole: Allergic
partum period is stabilized
AUTONOMIC http://www.robholland.com/ CONTRAINDICATION: phenomena including shock,
(about 1–2 h).
NERVOUS SYSTEM Nursing/Drug_Guide/data/m Hypersensitivity to ergot preparations; to ergotism.
AGENT; onographframes/M053.html induce labor; use prior to delivery of  Notify physician if BP
ADRENERGIC placenta; threatened spontaneous suddenly increases or if
ANTAGONIST abortion; prolonged use; uterine sepsis; there are frequent periods
(SYMPATHOLYTIC) hypertension; toxemia; lactation. of uterine relaxation.
; ERGOT
ALKALOID; DRUG TO DRUG INTERACTION:  Advise patient that
OXYTOCIC PARENTERAL medication may cause
SYMPATHOMIMETICS, other ERGOT menstrual-like cramps
THERAPEUTIC: ALKALOIDS, TRIPTANS add to
Administered after pressor effects and carry risk of  Caution patient to avoid
delivery of the hypertension; amprenavir, delavirdine, smoking, because nicotine
placenta. It minimizes efavirenz, indinavir, nelfinavir, ritonavir, constricts blood vessels.
the risk of postpartal and saquinavir may decrease metabolism
hemorrhage.  Instruct patient to notify
of ergot derivatives.
health care professional if
DOSAGE: infection develops, as this
Postpartum may cause increased
Hemorrhage sensitivity to the
medication.
Adult: PO 0.2–0.4 mg
q6–12h until danger of
atony passes (2–7 d)
IM/IV 0.2 mg q2–4h
(max: 5 doses)

ROUTE: Oral, IV

DRUG NAME MECHANISM OF INDICATION/CONTRAINDICATIO ADVERSE EFFECT NURSING

GENERIC: Synthetic, water-soluble INDICATION: To initiate or improve Body as a Whole: Fetal  Start flow charts to record
OXYTOCIN polypeptide consisting of uterine contraction at term only in trauma from too rapid maternal BP and other vital
eight amino acids, identical carefully selected patients and only after propulsion through pelvis, signs, I&O ratio, weight,
BRAND: Pitocin pharmacologically to the cervix is dilated and presentation of fetus fetal death, anaphylactic strength, duration, and
oxytocic principle of has occurred; used to stimulate letdown reactions, postpartum frequency of contractions,
CLASS:
posterior pituitary. reflex in nursing mother and to relieve hemorrhage, precordial pain, as well as fetal heart tone
HORMONES AND
pain from breast engorgement. Uses edema, cyanosis or redness and rate, before instituting
SYNTHETIC SOURCE: include management of inevitable, of skin. treatment.
SUBSTITUTES; http://www.robholland.com/ incomplete, or missed abortion;  Monitor fetal heart rate and
OXYTOCIC Nursing/Drug_Guide/data/m CV: Fetal bradycardia and
stimulation of uterine contractions during maternal BP and pulse at
onographframes/O031.html third stage of labor; stimulation to arrhythmias, maternal least q15min during
THERAPEUTIC: By
overcome uterine inertia; control of cardiac arrhythmias, infusion period; evaluate
direct action on
postpartum hemorrhage and promotion hypertensive episodes, tonus of myometrium
myofibrils, produces
of postpartum uterine involution. Also subarachnoid hemorrhage, during and between
phasic contractions
used to induce labor in cases of maternal increased blood flow, fatal contractions and record on
characteristic of
diabetes, preeclampsia, eclampsia, and afibrinogenemia, ECG flow chart. Report change
normal delivery.
Promotes milk erythroblastosis fetalis. changes, PVCs, in rate and rhythm
ejection (letdown) cardiovascular spasm and immediately.
reflex in nursing CONTRAINDICATION: collapse.  Stop infusion to prevent
mother, thereby Hypersensitivity to oxytocin; significant fetal anoxia, turn patient on
increasing flow (not cephalopelvic disproportion, unfavorable GI: Neonatal jaundice, her side, and notify
volume) of milk; also fetal position or presentations that are maternal nausea, vomiting. physician if contractions
facilitates flow of milk undeliverable without conversion before Endocrine: ADH effects are prolonged (occurring at
during period of breast delivery, obstetric emergencies in which leading to severe water less than 2-min intervals)
engorgement. Uterine benefit-to-risk ratio for mother or fetus intoxication and and if monitor records
sensitivity to oxytocin favors surgical intervention, fetal distress hyponatremia, hypotension. contractions about 50 mm
increases during in which delivery is not imminent, Hg or if contractions last
prematurity, placenta previa, prolonged CNS: Fetal intracranial
gestation period and 90 seconds or longer.
use in severe toxemia or uterine inertia, hemorrhage, anxiety.
peaks sharply before Stimulation will wane
parturition. Not used hypertonic uterine patterns, previous rapidly within 2–3 min.
Respiratory: Fetal hypoxia,
for elective induction surgery of uterus or cervix including Oxygen administration
maternal dyspnea.
of labor. cesarean section, conditions predisposing may be necessary.
to thromboplastin or amniotic fluid Urogenital: Uterine  If local or regional (caudal,
DOSAGE: embolism (dead fetus, abruptio hypertonicity, tetanic spinal) anesthesia is being
placentae), grand multiparity, invasive contractions, uterine rupture, given to the patient
Antepartum cervical carcinoma, primipara >35 y of pelvic hematoma. receiving oxytocin, be alert
age, past history of uterine sepsis or of to the possibility of
Adult: IV Start at 1
traumatic delivery, intranasal route hypertensive crisis (sudden
mU/min, may increase
during labor, simultaneous intense occipital headache,
by 1 mU/min q15min
administration of drug by two routes. palpitation, marked
(max: 20 mU/min)
hypertension, stiff neck,
Postpartum nausea, vomiting, sweating,
fever, photophobia, dilated
Adult: IV Infuse a
pupils, bradycardia or
total of 10 U at a rate
tachycardia, constricting
of 20–40 mU/min
after delivery chest pain).
 Monitor I&O during labor.
To Promote Milk If patient is receiving drug
Ejection by prolonged IV infusion,
watch for symptoms of
Adult: Nasal 1 spray
water intoxication
or 1 drop in 1 or both
(drowsiness, listlessness,
nostrils 2–3 min
headache, confusion,
before nursing or
anuria, weight gain).
pumping
Report changes in alertness
ROUTE: IV and orientation and
changes in I&O ratio (i.e.,
marked decrease in output
with excessive intake).
 Check fundus frequently
during the first few
postpartum hours and
several times daily
thereafter.
 Incidence of
hypersensitivity or allergic
reactions is higher when
oxytocin is given by IM or
IV injection rather than by
IV infusion (diluted
solution).
 DRUG NAME MECHANISM OF INDICATION/CONTRAINDICATIO ADVERSE EFFECT NURSING
ACTION N RESPONSIBILITIES:

GENERIC: Synthetic narcotic analgesic INDICATION: Symptomatic relief of CV: Hypertension,  Assess respiratory rate
NALBUPHINE with agonist and weak moderate to severe pain. Also hypotension, bradycardia, before drug administration.
HYDROCHLORIDE antagonist properties. preoperative sedation analgesia and as a tachycardia, flushing. Withhold drug and notify
Analgesic potency is about 3 supplement to surgical anesthesia. physician if respiratory rate
BRAND: NUBAIN or 4 times greater than that of GI: Abdominal cramps, bitter falls below 12.
pentazocine and CONTRAINDICATION: History of taste, nausea, vomiting, dry
CLASS: CENTRAL hypersensitivity to drug. Safety during mouth.  Watch for allergic response
approximately equal to that
NERVOUS SYSTEM pregnancy (category C) or lactation is not in persons with sulfite
produced by equivalent
AGENT; established. Prolonged use during CNS: Sedation, dizziness, sensitivity.
doses of morphine. On a
ANALGESIC; pregnancy could result in neonatal nervousness, depression,
weight basis, produces
NARCOTIC withdrawal. restlessness, crying,  Administer with caution to
respiratory depression about
(OPIATE) AGONIST- euphoria, dysphoria, patients with hepatic or
equal to that of morphine;
ANTAGONIST DRUG TO DRUG INTERACTION: distortion of body image, renal impairment.
however, in contrast to
Alcohol and other CNS DEPRESSANTS unusual dreams, confusion,
THERAPEUTIC: morphine, doses >30 mg  Monitor ambulatory
add to CNS depression. hallucinations; numbness and
Analgesic action that produce no further patients; nalbuphine may
tingling sensations,
relieves moderate to respiratory depression. produce drowsiness.
headache, vertigo.
severe pain with Antagonistic potency is
apparently low approximately one fourth Respiratory: Dyspnea,  Watch for respiratory
potential for that of naloxone and about asthma, respiratory depression of newborn if
dependence. 10 times greater than that of depression. drug is used during labor
pentazocine. and delivery.
DOSAGE: Skin: Pruritus, urticaria,
SOURCE: burning sensation, sweaty,  Avoid abrupt termination
Moderate to Severe clammy skin. of nalbuphine following
Pain http://robholland.com/Nursin prolonged use, which may
g/Drug_Guide/data/monogra Special Senses: Miosis, result in symptoms similar
Adult: IV/IM/SC 10– phframes/N006.html blurred vision, speech to narcotic withdrawal:
20 mg q3–6h prn difficulty. nausea, vomiting,
(max: 160 mg/d) abdominal cramps,
Urogenital: Urinary urgency. lacrimation, nasal
Child: IV/IM/SC 0.1– congestion, piloerection,
0.15 mg/kg q3–6h prn fever, restlessness, anxiety.
ROUTE: IV, IM, SC

DRUG NAME MECHANISM OF INDICATION/CONTRAINDICATIO ADVERSE EFFECT NURSING

GENERIC: Short-acting parenteral INDICATION: Sedation before general CNS: Retrograde amnesia,  Inspect insertion site for
MIDAZOLAM benzodiazepine. Mechanism anesthesia, induction of general headache, euphoria, redness, pain, swelling, and
of action unclear. Intensifies anesthesia; to impair memory of drowsiness, excessive other signs of extravasation
BRAND: activity of gamma- perioperative events (anterograde sedation, confusion. during IV infusion.
MIDAZOLAM aminobenzoic acid (GABA), amnesia); for conscious sedation prior to
a major inhibitory short diagnostic and endoscopic CV: Hypotension.  Monitor for hypotension,
CLASS: CENTRAL especially if the patient is
neurotransmitter of the brain, procedures; and as the hypnotic
NERVOUS SYSTEM Special Senses: Blurred premedicated with a
by interfering with its supplement to nitrous oxide and oxygen
AGENT; vision, diplopia, nystagmus, narcotic agonist analgesic.
reuptake and promoting its (balanced anesthesia) for short surgical
BENZODIAZEPINE pinpoint pupils.
accumulation at neuronal procedures.
ANXIOLYTIC;  Monitor vital signs for
synapses. This calms the GI: Nausea, vomiting.
SEDATIVE- CONTRAINDICATION: Intolerance to entire recovery period. In
patient, relaxes skeletal
HYPNOTIC benzodiazepines; acute narrow-angle obese patient, half-life is
muscles, and in high doses Respiratory: Coughing,
glaucoma; shock, coma; acute alcohol prolonged during IV
THERAPEUTIC: produces sleep. laryngospasm (rare),
intoxication; intraarterial injection. infusion; therefore,
CNS depressant with respiratory arrest. Skin:
SOURCE: Safety in pregnancy (category D), labor duration of effects is
muscle relaxant, Hives, swelling, burning,
prolonged (i.e., amnesia,
sedative-hypnotic, http://www.robholland.com/ and delivery, or lactation is not pain, induration at injection postoperative recovery).
anticonvulsant, and Nursing/Drug_Guide/data/m established. site, tachypnea.
amnestic properties. onographframes/M067.html  Be aware that overdose
DRUG TO DRUG INTERACTION: Body as a Whole: Hiccups, symptoms include
DOSAGE: Alcohol, CNS DEPRESSANTS, chills, weakness. somnolence, confusion,
ANTICONVULSANTS potentiate CNS sedation, diminished
Conscious Sedation depression; cimetidine increases reflexes, coma, and
midazolam plasma levels, increasing its untoward effects on vital
Adult: IM 0.07–0.08
toxicity; may decrease antiparkinsonism signs.
mg/kg 30–60 min
effects of levodopa; may increase
before procedure IV
phenytoin levels; smoking decreases
1–1.5 mg, may repeat
sedative and antianxiety effects. Herbal:
in 2 min prn; Intubated
Kava-kava, valerian may potentiate
Patients, 0.05–0.2
sedation.
mg/kg/h by continuous
infusion

Child: IM 0.08 mg/kg

Neonate: IV 0.5–1
mcg/kg/min
IV Induction for
General Anesthesia

Adult: IV
Premedicated, 0.15–
0.25 mg/kg over 20–
30 s, allow 2 min for
effect IV
Nonpremedicated,
0.3–0.35 mg/kg over
20–30 s, allow 2 min
for effect

Child: IV 0.15 mg/kg

Status Epilepticus

Child: IV Loading
Dose >2 mo, 0.15
mg/kg IV
Maintenance Dose 1
mcg/kg/min infusion,
may titrate upward as
needed q5min

Preoperative Sedation

Child: PO <5 y, 0.5

ROUTE: IM, IV, PO