~ DRUG STUDY ~

DRUG ORDER

Date Ordered
/Started:
1/21/2015
Generic Name:
Aluminum
Magnesium
Hydroxide
Brand Name:
Maalox
Classification:
Antacid

ACTION OF DRUG

Pharmacologic:
Binds with phosphate
ions in intestine
Form insoluble
aluminum-phosphate
compounds

INDICATIONS
AND
CONTRAINDICATI
ONS
Indication:
Hyperphosphatemi
a
Contraindication
:
* Hypersensitivity
to aluminum

Lower blood phosphate

level

ADVERSE EFFECTS
OF THE DRUG
CNS: Encephalopathy
MS: Osteomalacia
GI: Intestinal obstruction,
Constipation, Anorexia,
META:
Hypophosphatemia

Desired:
Relieves GI discomfort

NURSING RESPONSIBILITIES

Monitor serum phosphate and calcium

levels periodically during chronic use of
aluminum hydroxide.
Shake suspension well before giving the
medication. Follow administration with
water to ensure passage into stomach.
. Separate administration of aluminum
hydroxide and oral medications by at least
12 hours because it may interfere with
absorption of other oral medications
Be alert for any adverse reaction or drug
interactions.
.

Dosage:
1ml
Route:
PO
Frequency:
TID
Date Ordered
/Started:
1/25/2015
Generic Name:

Pharmacologic:
Inhibits the synthesis of
prostaglandins
Acts directly on

Indication:
Fever
Contraindication
:

GI: Abdominal pain,

hepatotoxicity, nausea,
vomiting
GU: renal failure

Monitor the patients temperature, before

and during the therapy
Monitor liver function and renal function
test before and during the therapy

Paracetamol
Brand Name:
Biogesic
Classification:
Antipyretic

temperature-regulating
center in the
hypothalamus

* Hypersensitivity
to the drug and its
components
.

Desired:
For reducing fever

HEMA:
Hemolytic anemia

Assess fever; for the presence of

associated signs (diaphoresis, tachycardia,
and malaise)

META: hypoglycemia
SKIN: Jaundice, rash,
urticaria

Assess amount, frequency and type of

drugs taken by the patient
Give paracetamol on the exact dose
prescribed

Dosage:
100mg/ml
0.75ml
(7:00pm)
0.6ml
(11:25pm)
Route:
PO
Frequency:
PRN
Q4 for
temperature
37.8C and above
Date Ordered
/Started:
2/3/2015
Generic Name:
Salbutamol
Sulfate
Brand Name:
Ventolin
Classification:
Bronchodilator

Pharmacologic:
Albuterol attaches to
beta2 receptors on
membrane bronchial cell
membranes,
Stimulates the
intracellular enzyme
adenylate cyclase
convert adenosine
triphosphate
(ATP) to cyclic adenosine

Indication:
To control and
prevent
reversible airway
obstruction
Contraindication
:
* Hypersensitivity
to the drug and its
components
.

CNS: Anxiety,
dizziness, , headache,
insomnia, irritability,
tremor
CV: Tachycardia,
hypertension palpitations
EENT: Dry and irritation
of nose, mouth and
throat,
GI: Heartburn, nausea,

Obtain baseline assessment of

patients respiratory status by
auscultating the lung sound, and
monitoring the RR and CR before,
during and after the therapy.
If on a scheduled dosing
regimen, Give as directed and do
not to exceed recommended
dose.
Advise the mother to rinse the
patients mouth with water after

Dosage:
2.5mg/2.5ml
Route:
Inhalation
(Aerosol)
Frequency:
1 nebule Q15mins.
for 3 doses

Date Ordered
/Started:
2/5/2015

monophosphate
(cAMP).

vomiting

inhalation dose to minimize dry

mouth.

MS: Muscle cramps

This reaction decreases
intracellular calcium
levels. It also
increases intracellular
levels of cAMP

RESP: Bronchospasm,
cough,
pulmonary edema
META: hypokalemia,
metabolic acidosis

Relax bronchial smoothmuscle cells and inhibit

histamine release.
Desired:
Improves ventilation
Pharmacologic:
Essential for the activity
of many enzymes

Instruct the mother to wash the

mouthpiece after use with water
and let it air-dry.

Indication:
Prevention of
hypomagnesemia

CNS: Drowsiness,
hypothermia,

Monitor the patients fluid intake and

output, make sure output is 100ml or more
before administration

RESP: Dyspnea.
Generic Name:
Magnesium Sulfate
Brand Name:
Magnesium Sulfate
20% Injectable
Classification:
Mineral and
electrolyte
supplement
Dosage:
Prehydration
1.2 meq / 0.6 ml
(Incorporated to

Replaces and Maintains

magnesium levels
Plays an important role in
eurotransmission and
muscular
excitability
Desired:
Raises magnesium levels

Contraindication
:
* Patients with
renal impairment
and myocardial
disease.
.

Monitor renal function before therapy

CV: Arrhythmias,
bradycardia, hypotension.
GI: Diarrhea.
MS: Muscle weakness,
weak deep tendon reflex,
SKIN: flushing,
sweating.
META:
Hypermagnesemia

Monitor the patients magnesium level

Dilute the solution as ordered by the
physician.
Keep I.V. calcium available to reverse
magnesium intoxication.

D5, 0.45% NaCl

150ml)
Posthydration
6 meq / 3ml
(Incorporated to
D5, 0.45% NaCl
760ml
Route:
TIV
Frequency:
Prehydration
To run for 4 hours
@ 37cc/hr
Posthydration
To run for 2 hours
@ 38cc/hr
Date Ordered
/Started:
2/5/2015
Generic Name:
Cisplatin
Brand Name:
Planitol

Pharmacologic:
Cross links strands of
cellular DNA
Interferes with RNA
transcription
Imbalance of growth
Cell Death

Classification:
Antineoplastic
(akalating agent)
Dosage:

Desired:
Kills selected cancer cells

Indication:
Chemotherapy for
liver tumor
Contraindication
:
* Hypersensitivity
to the drug and or
other platinum
containing
compound

CNS: peripheral neuritis,

seizures

Monitor renal function and CBC

before and after the therapy

EENT: tinnitus, hearing

loss

Keep corticosteroid or
antihistamines available in case
of anaphylactic reaction

GI: Nausea and vomiting

beginning 1-4 hours after
dose, loss of taste,
metallic taste

Monitor the patients vital signs

frequently during administration.

HEMA: Mild
myeolosupression,
anemia,
thrombocytopenia,

Solution should be prepared in

a biologic cabinet. Wear gloves,
gown, and mask while handling
medication. If powder or solution
comes in contact with skin or

19 mg
(Incorporated with
PNSS 150 ml and
Mannitol 2.4 g)

leukopenia
GU: nephrotoxicity
META:
Hypomagnesemia,
hypokalemia,
hypocalcemia

Route:
TIV
Frequency:
To run for 4 hours
@ 38cc/hr
1st Cycle, Day 1

Date Ordered
/Started:
2/5/2015
Generic Name:
Mannitol
Brand Name:
Osmitrol
Classification:
Osmotic diuretic
Dosage:
2.4 g
(Incorporated with
PNSS 150 ml and

OTHER: Anaphylactic
reaction, alopecia

Pharmacologic:
Increase osmotic
pressure of glomerular
filtrate
Inhibits tubular
reabsorption of water
and electrolytes
Elevates blood
osmolality, enhancing
sodium and water flow
into extracellular fluid.
Desired:
Promotes excretion of
drug overdosage.

mucosa, wash thoroughly with

soap and water. Discard materials
in specially designated containers
Hydrate the patient before and
after the therapy
Do not use aluminum needles or
equipment during preparation or
administration. Aluminum reacts
with this drug, forms a black or
brown precipitate, and renders
the drug ineffective.

Indication:
Diuresis

CNS: headache,
confusion, seizure

Assess patency of IV site

frequently, Cisplatin may cause
severe irritation and
necrosis of tissue if extravasation
occurs
Monitor the patients vital signs,
input and output hourly.

Contraindication
:
* Hypersensitivity
to the drug and its
components

EENT: tinnitus, hearing

loss

monitor the patients weight and

kidney function.

GI: Nausea, vomiting,

diarrhea, thirst

Administer through IV , do not

administer if the crystals remain
undissolved.

CV: circulatory overload

EENT: blurred vision,
rhinitis
GU: urine retention
META: water
intoxication, cellular

Administer as ordered by the

physician, if mixed with an
antineoplastic drug prepare the
solution prepared in a biologic
cabinet. Discard materials
in specially designated containers

19mg cisplatin)

dehydration, electrolyte
imbalances

Route:
TIV
Frequency:
To run for 4 hours
@ 38cc/hr
1st Cycle, Day 1
Date Ordered
/Started:
2/6/2015
Generic Name:
Ondansetron
Brand Name:
Zofran

Pharmacologic:
Takes place in the CNS at
chemoreceptor trigger
zone and in the
peripheral nervous
system on terminals of
the vagus nerve
Blocks effect of the
serotonin

Classification:
Antiemetic
Dosage:
1.5mg

Indication:
To prevent nausea
and vomiting
emetogenic
chemotherapy
Contraindication
:
* Hypersensitivity
to the drug and its
components

CNS: Headache,
dizziness, fatigue,
weakness, extrapyramidal
syndrome
CV: Arrhythmias,
hypotension.
GI: Diarrhea,
constipation
SKIN: Rash, pruritus

Assess patient for nausea, vomiting,

abdominal distention, and bowel sounds
prior to and following administration.
Assess patient for extrapyramidal effects
(involuntary movements, facial grimacing,
rigidity, shuffling walk, trembling of
hands) periodically during therapy.
First dose is administered prior to
emetogenic Event, as ordered by the
physician

Desired:
Prevents nausea and
vomiting

Route:
TIV
Frequency:
Prior to
chemotherapy,
then q8
Date Ordered
/Started:
2/6/2015

Pharmacologic:
A glycoprotein, filgrastim
binds to and stimulates
immature neutrophils to

Indication:
To decrease risk of
infection in
patients with non-

CNS: fever, fatigue,

headache, weakness
CV: Arrhythmia, chest
pain

Dont give within 24 hours of

chemotherapy, may cause
sensitivity in rapidly dividing
cells.

Generic Name:
Filgrastim (G-CSF
Granulocyte
colony stimulating
factor)
Brand Name:
Neupogen

divide and differentiate..

Also activates mature
neutrophils
Desired:
Raises WBC kevels

Classification:
Biologic response
modifier

myeloid cancers
receiving myeloid
suppressive
antineoplastics
Contraindication
:
* Patients
hypersensitive to
proteins derived
from E-coli or to
the drugs or any of
its components.

Dosage:
30 meq/dose x 3
doses

Generic Name:
Vincristine
Brand Name:
Oncovin
Classification:

Obtain baseline CBC and

platelet count before and during
therapy.

HEMA:
thrombocytopenia,
leukocytosis

Refrigerate; do not freeze. Do

not shake. May warm to room
temperature for up to 6 hrs.
before injection.

MS: skeletal pain

GU: hematuria,
proteinuria
SKIN: rash

Route:
SQ Injection
Frequency:
OD, 1st dose given
24 hours after last
dose of
chemotherapy
Date Ordered
/Started:
2/8/2015

GI: Nausea, vomiting

diarrhea, mucositis,
stomatitis, constipation

Pharmacologic:
Binds to proteins of
mitotic spindle
Arrest mitosis in
metaphase
Blocking cell division.
Desired:
Inhibits replication of

Indication:
Liver tumor
Contraindication
:
* Hypersensitivity
to the drug and its
components
*Use cautiously in
patients with
hepatic

Once the dose is withdrawn

from the vial, discard the unused
portion. Vials are for single-dose
use and contain no preservatives.

OTHER: Anaphylactic
reaction, alopecia

Administered drug as ordered

by the physician. Give
subcutaneous may be divided
into 2 injection sites.

CNS: fever, sensory loss,

headache, atraxia,
seizure, coma

Monitor patients vital signs and assess

her neurological status before and during
therapy.

CV: hypotension,
hypertension, phlebitis

Give antiemetic before the drug.

RESP: acute
bronchospasm
GI: Diarrhea,
constipation, cramps,

1 vial of the drug can be used for

multiple doses.
Maintain good hydration and Monitor
intake and output ratios and daily
Weight.

Antineoplastic
(vinca alkaloid)

certain cancers.

dysfunction

nausea, vomiting,
dysphagia, stomatitis
HEMA: Anemia,
leukopenia,
thrombocytopenia

Dosage:
0.3 mg
Route:
TIV

MS: muscle weakness,

footdrop, wristdrop, loss
of deep tendon reflex

Frequency:
1st Cycle, Day 3

GU: urine retension,

dysuria, polyuria, SIADH

Check patency before administration and

Assess infusion site frequently for
redness, irritation, or inflammation. To
avoid extravasation
Solution should be prepared in a
biologic cabinet. Wear gloves, gown, and
mask while handling medication. If
powder or solution comes in contact with
skin or mucosa, wash thoroughly with
soap and water. Discard materials
in specially designated containers

SKIN: rash, cellulitis in

injection site

Date Ordered
/Started:
2/8/2015
Generic Name:
Fluorouracil

Pharmacologic:
Preventing thymidine
production (cell-cycle Sphasespecific)
Inhibits DNA and RNA
synthesis

Indication:
Liver tumor
Contraindication
:
* Hypersensitivity
to the drug and its
components

OTHER: Anaphylactic
reaction, alopecia
CNS: Ataxia, confusion,
disorientation, euphoria,
weakness, malaise
CV: angina, myocardial
ischemia

Monitor patients vital signs and Monitor

intake and output and during therapy.
Monitor renal function, hepatic
function and CBC before and after the
therapy

GI: Diarrhea,
constipation, anorexia,
nausea, vomiting, GI
bleeding, stomatitis

WOF for diarrhea and stomatitis which

can be a sign of toxicity

Dosage:
115 mg

HEMA: Anemia,
leukopenia,
thrombocytopenia

Check patency before administration and

Assess infusion site frequently for
redness, irritation, or inflammation. To
avoid extravasation

Route:
TIV

SKIN: dermatitis,
erythema, scaling,

Brand Name:
Adrucil
Classification:
Antineoplastic
(antimetabolite)

Desired:
. Inhibits cell growth of
certain cancers.

Dont refrigerate

Apply pressure to venipuncture sites for

Frequency:
1st Cycle, Day 3

pruritus

10 min.

OTHER: Anaphylactic
reaction, alopecia

Solution should be prepared in a

biologic cabinet. Wear gloves, gown, and
mask while handling medication. If
powder or solution comes in contact with
skin or mucosa, wash thoroughly with
soap and water. Discard materials
in specially designated containers

REFERENCES:
2011 Nurses Drug Handbook Tenth Edition by Jones & Bartlett Learning
Springhouse Nurses Drug Guide 2006 by Lippincott, Williams & Wilkins