DRUG MECHANISM

OF ACTION
INDICATIONS/
CONTRAINDICATI
ONS
SIDE
EFFECTS/ADVE
RSE
REACTIONS
NURSING
RESPONIBILIT
IES
Generic name:
epinephrine
(adrenaline),
epinephrine
bitartrate,
epinephrine
borate,
epinephrine
hydrochloride
Trade name:
Aerosol:
Primatene Mist
Ophthalmic
solution: Epinal
Injection, OTC
nasal solution:
Adrenalin
Chloride
Insect-sting
emergencies:
EpiPen Auto-
Injector
(delivers 0.3 mg
IM adult dose),
EpiPen Jr. Auto-
Injector
(delivers 0.15
mg IM for
children)
OTC solutions
for nebulization:
AsthmaNefrin,
microNefrin,
Nephron, S2

Classification:
Sympathomimeti
c, Alpha-
adrenergic
agonist, Beta1-
and beta2-
adrenergic
agonist, Cardiac
stimulant,
Vasopressor,
Bronchodilator,
Antasthmatic,
Nasal
decongestant,
Mydriatic
Dosage:
Epinephrine
Epinephrine,
an active
principle of the
adrenal
medulla, is a
direct-acting
sympathomime
tic. It
stimulates -
and -
adrenergic
receptors
resulting in
relaxation of
smooth muscle
of the
bronchial tree,
cardiac
stimulation and
dilation of
skeletal muscle
vasculature. It
is frequently
added to local
anaesthetics to
retard diffusion
and limit
absorption, to
prolong the
duration of
effect and to
lessen the
danger of
toxicity.
Indications
IV: In ventricular
standstill after all
other measures
have failed to
restore
circulation, given
by trained
personnel by
intracardiac
puncture and
intramyocardial
injection;
treatment and
prophylaxis of
cardiac arrest
and attacks of
transitory AV
heart block with
syncopal seizures
(Stokes-Adams
syndrome);
syncope due to
carotid sinus
syndrome; acute
hypersensitivity
(anaphylactoid)
reactions, serum
sickness,
urticaria,
angioneurotic
edema; in acute
asthmatic attacks
to relieve
bronchospasm
not controlled by
inhalation or
subcutaneous
injection;
relaxation of
uterine
musculature;
additive to local
anesthetic
solutions for
injection to
prolong their
duration of action
and limit systemic
absorption
Injection: Relief
from respiratory
distress of
bronchial asthma,
chronic
bronchitis,
CNS effects;
GI
disturbances;
epigastric
pain; CV
disorders;
difficulty in
micturition
with urinary
retention;
dyspnoea;
hyperglycaemi
a; sweating;
hypersalivatio
n; weakness,
tremors;
coldness of
extremities;
hypokalaemia.
Gangrene,
tissue necrosis
and sloughing
(extravasation
) when used
in addition to
local
anaesthetics.
Eye drops:
Severe
smarting,
blurred vision,
photophobia;
naso-
lachrymal
ducts
obstruction.
Oedema,
hyperaemia
and
inflammation
of the eyes
with repeated
administration
.
WARNING:
Use extreme
caution when
calculating
and
preparing
doses;
epinephrine
is a very
potent drug;
small errors
in dosage can
cause serious
adverse
effects.
Double-check
pediatric
dosage.
Use minimal
doses for
minimal
periods of
time;
"epinephrine-
fastness" (a
form of drug
tolerance)
can occur
with
prolonged
use.
Protect drug
solutions
from light,
extreme
heat, and
freezing; do
not use pink
or brown
solutions.
Drug
solutions
should be
clear and
colorless
(does not
apply to
suspension
for injection).
Shake the
suspension
for injection
well before
withdrawing
the dose.
Rotate
subcutaneous
injection sites
injection
Cardiac
arrest: 0.51
mg (510
mL of
1:10,000
solution) IV
or by
intracardiac
injection into
left
ventricular
chamber;
during
resuscitation
, 0.5 mg q 5
min.
Intraspinal

0.20.4 mL of a
1:1,000 solution
added to anesthetic
spinal fluid mixture.
Other use
with local
anesthetic:
Concentratio
ns of
1:100,000
1:20,000 are
usually used.
1:1,000 solution
Respiratory
distress:
0.30.5 mL
of 1:1,000
solution
(0.30.5
mg),
subcutaneou
sly or IM, q
20 min for 4
hr.
1:200 suspension
(for subcutaneous
administration only)
Respiratory
distress:
0.10.3 mL
(0.51.5
mg)
subcutaneou
sly.
Inhalation
emphysema,
other COPDs
Aerosols and
solutions for
nebulization:
Temporary relief
from acute
attacks of
bronchial asthma,
COPD
Topical nasal
solution:
Temporary relief
from nasal and
nasopharyngeal
mucosal
congestion due to
a cold, sinusitis,
hay fever, or
other upper
respiratory
allergies;
adjunctive
therapy in middle
ear infections by
decreasing
congestion
around
eustachian ostia
0.1% ophthalmic
solution:
Conjunctivitis,
during eye
surgery to control
bleeding, to
produce
mydriasis

Contraindications
:
Pre-existing
hypertension;
occlusive vascular
disease; angle-
closure glaucoma
(eye drops);
hypersensitivity;
cardiac
arrhythmias or
tachycardia.
When used in
addition to local
anaesthetics:
Procedures
involving digits,
ears, nose, penis
or scrotum.
to prevent
necrosis;
monitor
injection sites
frequently.
WARNING:
Keep a
rapidly acting
alpha-
adrenergic
blocker
(phentolamin
e) or a
vasodilator (a
nitrate)
readily
available in
case of
excessive
hypertensive
reaction.
WARNING:
Have an
alpha-
adrenergic
blocker or
facilities for
intermittent
positive
pressure
breathing
readily
available in
case
pulmonary
edema
occurs.
WARNING:
Keep a beta-
adrenergic
blocker
(propranolol;
a
cardioselectiv
e beta-
adrenergic
blocker, such
as atenolol,
should be
used in
patients with
respiratory
distress)
readily
available in
case cardiac
arrhythmias
occur.
Do not
exceed
recommende
d dosage of
(aerosol)
Begin
treatment at
first
symptoms of
bronchospas
m.
Individualize
dosage. Wait
15 min
between
inhalations
to avoid
overdose.
Inhalation
(nebulization)
Place 815
drops into
the nebulizer
reservoir.
Place
nebulizer
nozzle into
partially
opened
mouth.
Patient
inhales
deeply while
bulb is
squeezed
one to three
times. If no
relief in 5
min, give 2
3 additional
inhalations.
Use four to
six times per
day usually
maintains
comfort.
Topical nasal
solution
Apply locally
as drops or
spray or
with a sterile
swab, as
required.
Ophthalmic
solution
Vasoconstric
tion,
mydriasis:
inhalation
products;
administer
pressurized
inhalation
drug forms
during
second half
of inspiration,
because the
airways are
open wider
and the
aerosol
distribution is
more
extensive. If
a second
inhalation is
needed,
administer at
peak effect of
previous
dose, 35
min.
Use topical
nasal
solutions only
for acute
states; do not
use for
longer than
35 days,
and do not
exceed
recommende
d dosage.
Rebound
nasal
congestion
can occur
after
vasoconstricti
on
Instill 12
drops into
the eye or
eyes; repeat
once if
necessary.






























DRUG MECHANISM
OF ACTION
INDICATIONS/
CONTRAINDICATIO
NS
SIDE
EFFECTS/ADVER
SE REACTIONS
NURSING
RESPONIBILITI
ES
Generic
name:
Prednisone

Trade name:
Apo-
Prednisone
(CAN),
Deltasone,
Liquid Pred,
Meticorten,
Novo-
Prednisone
(CAN),
Orasone,
Panasol-S,
Prednicen-
M,
Prednisone-
Intensol,
Sterapred
DS, Winpred
(CAN)

Classification
:

Corticosteroi
d
(intermediat
e acting),
Glucocorticoi
d, Hormone

Dosage,
frequency
and route:
40-60 mg
daily for 3-
10 days;
give as
single or in
2 divided
doses PO

Prednisone is a
glucocorticoid
receptor
agonist. It is
first
metabolized in
the liver to its
active form,
prednisolone.
Prednisolone
crosses cell
membranes
and binds with
high affinity to
specific
cytoplasmic
receptors. The
result includes
inhibition of
leukocyte
infiltration at
the site of
inflammation,
interference in
the function of
mediators of
inflammatory
response,
suppression of
humoral
immune
responses, and
reduction in
edema or scar
tissue. The
antiinflammato
ry actions of
corticosteroids
are thought to
involve
phospholipase
A2 inhibitory
proteins,
lipocortins,
which control
the
biosynthesis of
potent
mediators of
inflammation
such as
prostaglandins
and
leukotrienes.
Indications
- Replacement therapy
in adrenal cortical
insufficiency
Hypercalcemia
associated with cancer
Short-term
management of
various inflammatory
and allergic disorders,
such as rheumatoid
arthritis, collagen
diseases (eg, SLE),
dermatologic diseases
(eg, pemphigus),
status asthmaticus,
and autoimmune
disorders
Hematologic
disorders:
thrombocytopenia
purpura,
erythroblastopenia
Ulcerative colitis,
acute exacerbations of
multiple sclerosis and
palliation in some
leukemias and
lymphomas
Trichinosis with
neurologic or
myocardial
involvement

Contraindications:
Contraindicated
with infections,
especially
tuberculosis, fungal
infections,
amebiasis, vaccinia
and varicella, and
antibiotic-resistant
infections;
lactation
Vertigo, headache,
paresthesias,
insomnia,
convulsions,
psychosis,
cataracts,
increased
intraocular
pressure, glaucoma
(long-term
therapy)
Hypotension,
shock,
hypertension and
CHF secondary to
fluid retention,
thromboembolism,
thrombophlebitis,
fat embolism,
cardiac
arrhythmias

Administer once-
a-day doses
before 9 AM to
mimic normal
peak
corticosteroid
blood levels.
Increase dosage
when patient is
subject to stress.
Taper doses
when
discontinuing
high-dose or long-
term therapy.
Do not give live
virus vaccines with
immunosuppressiv
e doses of
corticosteroids.




DRUG MECHANISM
OF ACTION
INDICATIONS/
CONTRAINDICATIO
NS
SIDE
EFFECTS/ADVER
SE REACTIONS
NURSING
RESPONIBILITI
ES
Generic
name:
Methimazol
e

Trade
name:

Tapozole

Classificatio
n:

Antithyroid
agent

Dosage:

20mg

Frequency:

BID

Route:

PO
Inhibits the
synthesis of
thyroid
hormones.
Indicated for
palliative
treatment of
hyperthyroidis
m.
Indications
Methimazole is
indicated in the
medical treatment of
hyperthyroidism. Long-
term therapy may lead
to remission of the
disease. Methimazole
may be used to
ameliorate
hyperthyroidism in
preparation for
subtotal thyroidectomy
or radioactive iodine
therapy. Methimazole
is also used when
thyroidectomy is
contraindicated or not
advisable.

Contraindications:
Hepatitis caused by
Drugs, Abnormal
Liver Function
Tests, Pregnancy,
Underactive
Thyroid, Acquired
Decrease of All
Cells in the Blood,
Decreased Function
of Bone Marrow,
Decrease in the
Blood-Clotting
Protein
Prothrombin,
Decreased Blood
Platelets,
Deficiency of
Granulocytes a
Type of White
Blood Cell,
Decreased White
Blood Cells

fever, chills,
sore throat,
body aches, flu
symptoms;
easy bruising
or bleeding,
unusual
weakness;
blood in your
urine or stools;
severe
blistering,
peeling, and
red skin rash;
or
nausea,
stomach pain,
low fever, loss
of appetite,
dark urine,
clay-colored
stools,
jaundice
(yellowing of
the skin or
eyes).
Less serious side
effects of
methimazole may
include:
headache,
drowsiness,
dizziness;
mild nausea,
vomiting, or
stomach
upset;
itching, minor
skin rash;
muscle, joint,
or nerve pain;
swelling; or
hair loss.

Assess patient for
hypersensitivity.

Use cautiously in
patients 40 years
old and above.
Drug may cause
agranulocytosis

Monitor patients
vital signs

If the patient
misses to take the
drug, ask the
patient to take it
as soon as
remembered










DRUG MECHANIS
M OF
ACTION
INDICATIONS/
CONTRAINDICATION
S
SIDE
EFFECTS/ADVER
SE REACTIONS
NURSING
RESPONIBILITI
ES
Generic
name:

Amikacin

Trade name:

Amikacide

Classification
:

Antibiotic
aminoglycosi
de

Dosage:

200mg


Route:

Intravenous
Inhibits
protein
synthesis by
binding
directly to
the 30S
ribosomal
sub unit;
bactericidal.
Indication:

Serious infection
cause by
sensitive
restrains of
Pseudomonas
aeruginusa,
E.coli, Proteus,
Klebsiella,
staphylococcus
Uncomplicated
UTI caused by
organism
susceptible to
less toxic drugs.
Active
tuberculosis, with
other
antituberculotics
Mycobacterium
avium complex
(MAC) infection.

Contraindication:
Renal insufficiency,
anemia.

Clients with
cardiac and
pulmonary
diseases are
more susceptible
to
acetaminophen
toxicity
Tinnitus,
hearing
impairment,
renal
impairment,
headache,
tremor,
lethargy,
rashes, fever,
joint pain.
Obtain
specimen
for culture
and
sensitivity
test before
giving first
dose.
Therapy
may begin
while
awaiting
the results.
Evaluate
patients
hearing
before and
during
therapy if
he will be
receiving
drug for
longer
than 2
weeks.
Notify
prescriber
if patient
has
tinnitus,
vertigo, or
hearing
loss.
Weigh
patient
and review
renal
function
studies
before
therapy
begins.
Correct
dehydratio
n before
therapy
because of
increase
risk of
toxicity.





DRUG MECHANIS
M OF
ACTION
INDICATIONS/
CONTRAINDICATION
S
SIDE
EFFECTS/ADVER
SE REACTIONS
NURSING
RESPONIBILITI
ES
Generic
name:

Doxycycline

Trade
name:

Periostat

Classificatio
n:

Tertacycline

Dosage:

250mg


Route:

PO
To inhibit
bacterial
protein
synthesis at
level or 30S
and 50S
bacterial
ribosomes
and to alter
cytoplasmic
membrane of
susceptible
organisms
Indication:

To reduce the
development of
drug-resistant
bacteria and
maintain the
effectiveness of
Sumycin 250 and
Sumycin 500
Tablets (Tetracycline
Hydrochloride
Tablets) and other
antibacterial drugs,
Sum- ycin 250 and
Sumycin 500
Tablets (Tetracycline
Hydrochloride
Tablets) should be
used only to treat or
prevent infections
that are proven or
strongly suspected
to be caused by
susceptible bacteria.
When culture and
susceptibility
information are
available, they
should be
considered in
selecting or
modifying
antibacterial
therapy. In the
absence of such
data, local
epidemiology and
susceptibility
patterns may
contribute to the
empiric selection of
therapy.

Contraindication:

Contraindicated
in patients
hypersensitive to
drug or
Use cautiously in
patients with
impaired renal
function or
neuromuscular
disorders, in
neonates and
infants and in
elderly patients
anorexia,
epigastric
distress,
nausea,
vomiting,
diarrhea, bulky
loose stools,
stomatitis, sore
throat,
glossitis, black
hairy tongue,
dysphagia,
hoarseness,
enterocolitis,
and
inflammatory
lesions (with
candidal
overgrowth) in
the anogenital
region,
including
proctitis and
pruritus ani.
Rare instances
of esophagitis
and
esophageal
ulceration have
been reported
in patients
receiving
particularly the
capsule and
also the tablet
forms of
tetracyclines
Monitor for
s/s of super
infection
and
hypersensit
ivity
reaction.
With long-
term use,
monitor
CBC, liver
function
tests, and
bone
growth
Assess
neurologic
status, stay
alert fir
benign
intra cranial
hypertensio
n



DRUG MECHANIS
M OF
ACTION
INDICATIONS/
CONTRAINDICATIO
NS
SIDE
EFFECTS/ADVER
SE REACTIONS
NURSING
RESPONIBILITI
ES
Generic name:

Azithromycin

Trade name:

Zithromax

Classification:

Macrolide

Dosage:

300mg

Frequency:

OD


Route:

PO
Azithromycin
blocks
transpeptidati
on by binding
to 50s
ribosomal
subunit of
susceptible
organisms
and
disrupting
RNA-
dependent
protein
synthesis at
the chain
elongation
step.
Indication:
Treatment of
lower respiratory
infections: Acute
bacterial
exacerbations of
COPD due to
Haemophilus
influenzae,
Moraxella
catarrhalis,
Streptococcus
pneumoniae;
community-
acquired
pneumonia due to
S. pneumoniae, H.
influenzae
Treatment of
lower
respiratory
infections:
Streptococcal
pharyngitis
and tonsillitis
due to
Streptococcus
pyogenes in
those who
cannot take
penicillins
Treatment of
uncomplicated
skin infections
due to
Staphylococcu
s aureus, S.
pyogenes,
Streptococcus
agalactiae
Treatment of
nongonococcal
urethritis and
cervicitis due
to Chlamydia
trachomatis;
treatment of
PID
Treatment of
acute sinusitis
Contraindication
Contraindicated
with
hypersensitivity to
azithromycin,
Mild to
moderate
nausea,
vomiting,
abdominal
pain,
dyspepsia,
flatulence,
diarrhoea,
cramping;
angioedema,
cholestatic
jaundice;
dizziness,
headache,
vertigo,
somnolence;
transient
elevations of
liver enzyme
values.
Culture site
of infection
before
therapy.
Administer
on an
empty
stomach 1
hr before
or 23 hr
after
meals.
Food
affects the
absorption
of this
drug.
Prepare
Zmax by
adding 60
mL water
to bottle,
shake well.
Counsel
patients
being
treated for
STDs about
appropriate
precautions
and
additional
therapy.
Teaching points
Take the
full course
prescribed.
Do not
take with
antacids.
Tablets and
oral
suspension
can be
taken with
or without
food.
Prepare
Zmax by
adding 60
milliliters
(1/4 cup)
water to
bottle

DRUG

MECHANIS
M OF
ACTION

INDICATIONS/
CONTRAINDICATIO
NS

SIDE
EFFECTS/ADVER
SE REACTIONS

NURSING
RESPONIBILITI
ES
Generic name:

Dexamethorp
han

Trade name:

Mucubron

Classification:

Antitussives

Dosage:

Adult: 15ml
Pedia: 5-10 ml

Frequency:
BID



Route:
PO

Supresses
cough reflex
by direct
action on the
cough center
in the medulla
Indication:
Relief of
cough due to
minor throat &
bronchial
irritation as
may occur
with the
common cold,
bronchitis or
inhaled
irritants
Contraindication:
Should not be taken
for persistent/chronic
cough
-When
coughing
accompanied
by excessive
secretions
Nausea,
drowsiness,
dizziness
-Obtain patient
history of cough
before therapy
and reassess after
giving the drug
-Assess cough:
type, frequency,
character including
sputum

Instruct patient to
follow exactly the
direction on
medication
-Advice medical
consultation for
persistent cough
more than 7 days
-Suggest sugarless
lozenges to
decrease throat
irritation and
cough.















DRUG MECHANIS
M OF
ACTION
INDICATIONS/
CONTRAINDICATION
S
SIDE
EFFECTS/ADVER
SE REACTIONS
NURSING
RESPONIBILITI
ES
Generic
name:

Calcium
Carbonate

Trade
name:

Calci-aid

Classificatio
n:

Calcium
preparation
drugs

Dosage:

Adult: 1-2
capsules

Pedia: 1-2
tablets


Route:

PO
Decreases
total acid
load of GI
tract.
Increase
esophageal
sphincter
tone
Indication:

Antacid, calcium
supplement,
osteoporosis

Contraindication:

Hypercalcemia,
bone tremors,
severe renal
failure,hypersen
sitivity
PRECAUTION:
History of stone
formation,
pregnancy

ADVERSE RXN
Constipation,
flatulence,
diarrhea, renal
dysfunction,
acid rebound
administer as
antacid 1 hr fter
meal and at bed
time
>administer as
supplement 1
hrs after meal and
at bed time
>advice pt to
increase fluids to
2L unless
contraindicated


















DRUG MECHANIS
M OF
ACTION
INDICATIONS/
CONTRAINDICATIO
NS
SIDE
EFFECTS/ADVERS
E REACTIONS
NURSING
RESPONIBILITI
ES
Generic
name:

Digoxin

Trade
name:

Lanoxin

Classificatio
n:

Cardiotonic-
inotropic
agents

Dosage:

80 mg

Route:

PO
Makes the
heart beat
slower but
stronger;
improves the
pumping
ability of the
heart;
increases the
force of
hearts
contraction
Indication:

Congestve Heart
Failure

Atrial flutter

Atrial fibrillation

Contraindication:

bsence of Urine
Formation,
Pancreatitis,
Hearing
Problem, Heart
Attack, Blood
Pressure Drop
Upon Standing,
Abnormally Low
Blood Pressure,
Blockage of
Urinary Bladder,
Enlarged
Prostate,
Systemic Lupus
Erythematosus,
Blood
Circulation
Failure due to
Serious Heart
Condition, High
Amount of Uric
Acid in the
Blood,
Azotemia,
Decreased
Blood Volume,
Acid Base
Imbalance of
the Blood
Toward the
Basic Side,
Diabetes, Gout,
Low Amount of
Magnesium in
the Blood, Low
Amount of
Calcium in the
Blood, Low
Amount of
Sodium in the
Blood, Low
Amount of
Potassium in
the Blood, Low
Amount of
Chloride in the
Blood
inging in
your ears,
hearing loss;
feeling very
thirsty or
hot, being
unable to
urinate,
heavy
sweating, or
hot and dry
skin;
painful or
difficult
urination;
pale skin,
unusual
bleeding
(nose,
mouth,
vagina, or
rectum),
purple or red
pinpoint
spots under
your skin;
Hyponatraemia,
hypokalaemia,
hypomagnesaemi
a.


- Hypochloraemic
alkalosis.


- Increased
calcium
excretion.


- Hypotension.


- Nausea.


- Dizziness.

Furosemide is
often given in
conjunction with
a potassium
supplement or a
potassium-
sparing diuretic
to counteract
potassium loss.


- The medication
has a rapid
onset of effect of
about one hour
when taken
orally and five
minutes by
injection.


- Duration of
action is about
six hours so it is
possible to use a
twice daily dose
if necessary.


PATIENT
TEACHING
- Explain to
patients that
furosemide
controls high
blood pressure
but does not
cure it and
therefore they
need to continue
with the
medication even
if they feel well.


- Advise patients
not to stop
taking
furosemide
without
consulting the
prescribing
health care
professional.


- Health
education should
be given
regarding diet
and exercise.




























DRUG MECHANI
SM OF
ACTION
INDICATIONS/
CONTRAINDICAT
IONS
SIDE
EFFECTS/ADV
ERSE
REACTIONS
NURSING
RESPONIBILITIES
Generic
name:

Isorbide
nitrate

Trade
name:

Imdur
Classifica
tion:

Nitrates

Dosage:

60mg



Route:

PO
Nitrates
are drugs
that
act directly
on the
smooth
muscleto
cause
relaxation
and
todepress
muscle
tone.

Indication:

Prevention and
treatment of Angina
Pectoris in Adults


Contraindication
:

The presence of
any allergiesto
nitrates. These
drugs arealso
contraindicated in
the following
conditions: Severea
nemia, head trauma
orhemorrhage, preg
nancy andlactation.


CNS)
Headache,
dizziness,an
d
myasthenia.
(GI) N &
Vand
incontinenc
e. (
CV) Hypote
nsion.
(SKIN)
Flushintg pal
lor sweating
and
increasedper
spiration
Instruct patient to
takemedication asdirected,
even if feeling better.
Takemissed doses as soonas
remembered; dosesof
isosorbide dinitrateshould be
taken at least 2 hr apart (6
hrwith extended-
releasepreparations);
dailydoses
of isosorbidemononitrate
should betaken 7 hr apart.
Donot double doses. Donot
discontinueabruptlyCaution patie
nt tomake positionchanges
slowly tominimize
orthostatichypotension





Norjetalexis M Cabrera
ADZU BSN III B