Name of

Drug

Classificat
ion

Mechanism
of Action

Indication

Side
Effects

Nursing
Consideration

Sodium
Bicarbonate

Electrolytes

Sodium
bicarbonate
raises blood
and urinary
pH by
dissociation
to provide
bicarbonate
ions, which
neutralizes
the hydrogen
ion
concentratio
n. It also
neutralizes
gastric acid
via
production
of carbon
dioxide.

Urine
alkalinisation.
To prevent
development of
uric-acid renal
calculi in the
initial stages
of uricosuric
therapy
forhyperuricaemi
a in chronic
gout.

Metabolic
alkalosis;
mood changes,
tiredness,
shortness of
breath,
muscle
weakness,
irregular
heartbeat;
muscle
hypertonicity
, twitching,
tetany;
hypernatraemi
a,
hyperosmolali
ty,
hypocalcaemia
,
hypokalaemia;
stomach
cramps,
flatulence.
Tissue
necrosis at
inj site.

- Assess the
clients fluid
balance throughout
the therapy.
This assessment incl
udes intake and
output, daily
weight, edema and
lung sounds.
- Symptoms of fluid
overload should be
reported such
as hypertension,
edema, difficulty
breathing or
dyspnea, rales or
crackles and frothy
sputum.
- IV sites should
be observed closely.
Extravasation should
be avoided as tissue
irritation or
cellulitis may occur
when taking sodium
bicarbonate.

Name of Drug

Classification

Mechanism of
Action

Indication

Side Effects

Nursing
Consideration

Gentamycin

Topical
Antibiotics/Anti
Infectives &
Antiseptics

Gentamicin is an
aminoglycoside
that binds to 30s
and 50s ribosomal
subunits of
susceptible
bacteria
disrupting
protein
synthesis, thus
rendering the
bacterial cell
membrane
defective.

Parenteral use
restricted to
treatment of
serious infections
of GI,
respiratory, and
urinary tracts,
CNS, bone, skin,
and soft tissue
(including burns)
when other less
toxic
antimicrobial
agents are
ineffective or are
contraindicated.
Has been used in
combination with
other antibiotics.
Also used
topically for
primary and
secondary skin
infections and for
superficial
infections of

Ototoxicity
(vestibular
disturbances,
impaired hearing),
optic neuritis.
Neuromuscular
blockade: skeletal
muscle weakness,
apnea, respiratory
paralysis (high
doses);
arachnoiditis
(intrathecal use).
Hypotension
or hypertension,
Nausea, vomiting,
transient increase
in AST, ALT, and
serum LDH and
bilirubin;
hepatomegaly,
splenomegaly

- Draw blood
specimens for
peak serum
gentamicin
concentration 30
min1h after IM
administration,
and 30 min after
completion of a
3060 min IV
infusion. Draw
blood specimens
for trough levels
just before the
next IM or IV
dose. Use no
heparinized tubes
to collect blood.

external eye and

its adnexa.

Name of Drug

Classification

Mechanism of
Action

Indication

Side Effects

Nursing
Consideration

Salbutamol

Name of Drug

Bronchodilator

Classification

It relieves nasal
congestion and
reversible
bronchospasm by
relaxing the
smooth muscles of
the bronchioles.
The relief from
nasal congestion
and bronchospasm
is made possible
by the following
mechanism that
takes place when
Salbutamol is
administered.

Mechanism of
Action

To control and
prevent reversible
airway obstruction
caused by asthma
or chronic
obstructive
pulmonary disorder

Indication

Nervousness
Restlessness
Tremor
Headache
Insomnia
Chest pain
Palpitations
Angina
Arrhythmias
Hypertension
Nausea and vomiting
Hyperglycemia
Hypokalemia

Side Effects

- Assess lung
sounds, PR and BP
before drug
administration and
during peak of
medication.
- Observe for
paradoxical spasm
and withhold
medication and
notify physician if
condition occurs.
- Advise the
patient to rinse
mouth with water
after each
inhalation to
minimize dry mouth.
Inform the patient
that Albuterol may
cause an unusual or
bad taste.

Nursing
Consideration

Diazepam

Central Nervous
Psychotherapeutic
System Agent, Anti - agent related to
Convulsant
chlordiazepoxide;
reportedly superior
in antianxiety and
anticonvulsant
activity, with
somewhat shorter
duration of action.
Like
chlordiazepoxide, it
appears to act at
both limbic and
subcortical levels of
CNS

Drug of choice for

status epilepticus.
Management of
anxiety disorders,
for short-term
relief ofanxiety
symptoms, to allay
anxiety and tension
prior to surgery,
cardioversion and
endoscopic
procedures, as an
amnesic, and
treatment for
restless legs.

Psychological and
physical
dependence with
withdrawal
syndrome,
fatigue,
drowsiness,
sedation, ataxia,
vertigo,
confusion,
depression, GI
disturbances,
changes in
salivation,
amnesia,
jaundice,
paradoxical
excitation,
elevated liver
enzyme values;
muscle weakness,
visual
disturbances,
headache,
slurring of
speech and
dysarthria,
mental changes,
incontinence,
constipation,
hypotension,
tachycardia,
changes in
libido, pain.

- Monitor
Frequently
to therapy
frequently
IV therapy

V/S
prior
and
during

- Assess IV site
frequently during
administration,
Diazepam may cause
phlebitis and
Venous Thrombosis

Name of Drug

Classification

Mechanism of
Action

Indication

Side Effects

Nursing
Consideration

Nalbuphine

Analgesics

Nalbuphine is a
phenanthrene
derivative opioid
analgesic with
mixed opioid
agonist and
antagonist
activity. It
inhibits the
ascending pain
pathways, altering
the perception of
and response to
pain by binding to
opiate receptors
in the CNS. It
also produces
generalized CNS
depression.

Relief of Moderate
to severe pain.

Sedation,
dizziness,
vertigo, miosis,
headache; nausea,
vomiting, dry
mouth; itching,
burning,
urticaria.
Respiratory
depression,
dyspnoea, asthma;
speech difficulty,
urinary urgency,
blurred vision,
flushing, warmth;
clamminess.

- Give diretct IV
undiluted 10mg or
less over 3-5 mins
or more

Preoperative
analgesia, as a
supplement to
surgical
anesthesia.

Name of Drug

Classification

Methergine

Drugs acting on the

Uterus

Mechanism of
Action
Stimulates smooth
muscles

Indication

Active management
of the 3rd stage
of labor.

Produces sustained
contractions

Side Effects

Headache, HTN,
skin eruptions,
abdominal pain,
Dizziness,
convulsions, chest
pain, hypotension,
nausea, vomiting,
hyperrhidosis,
Bradycardia,
tachycardia

Name of Drug

Classification

Mechanism of
Action

Indication

Side Effects

Phenobarbital

Anti- Convulsants

Phenobarbitone is
a short-acting
barbiturate. It
depresses the

Sedative
treatment of
generalized
tonic- clonic and

Bradycardia,
hypotension,
syncope; drowsiness,
lethargy, CNS

Nursing
Consideration
- Be alert for
drug interactions
and side effects
- Use drug
carefully due to
potent
vasoconstrictor
action

Nursing
Consideration
- Check the
doctors order
- Check V/S

sensory cortex,
reduces motor
activity, changes
cerebellar
function, and
produces
drowsiness,
sedation and
hypnosis. Its
anticonvulsant
property is
exhibited at high
doses.

Name of Drug

Classification

Epinephrene

Cardiac Drugs

Mechanism of
Action
Epinephrine, an
active principle
of the adrenal
medulla, is a
direct-acting
sympathomimetic.
It stimulates and -adrenergic
receptors
resulting in
relaxation of

cortical focal
seizures
Emergency control
of certain acute
seizures

excitation or
depression, impaired
judgment, hangover
effect, confusion,
somnolence,
agitation,
hyperkinesia,
ataxia, nervousness,
headache, insomnia,
nightmares,
hallucinations,
anxiety, dizziness;
rash, exfoliative
dermatitis; nausea,
vomiting,
constipation;
agranulocytosis,
thrombocytopenia.

- Check drug
history for
hypersensitivity
and condition of
patient if not
contraindicated
- Watch out for
Patients with acute
pain and depressive
disorders

Indication

Side Effects

Nursing
Consideration

Temporary relief of
bronchospasm, acute
asthmatic attack,
mucosal congestion,
hypersensitivity
and anaphylactic
reactions, syncope
due to heart block
or carotid sinus
hypersensitivity,
and to restore

epigastric pain;
dyspnoea;
hyperglycaemia;
sweating;
hypersalivation;
weakness, tremors;
coldness of
extremities;
hypokalaemia.
Gangrene, tissue
necrosis and

- Watch out for

palpitations, and
other Side
effects
- Instruct
patient for any
anaphylactic
reaction

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.

cardiac rhythm in
cardiac arrest.
Ophthalmic
preparation is used
in management of
simple (open-angle)
glaucoma, generally
as an adjunct to
topical miotics and
oral carbonic
anhydrase
inhibitors.

sloughing, when
used in addition
to local
anaesthetics. Eye
drops: Severe
smarting, blurred
vision,
photophobia; nasolachrymal ducts
obstruction.
Oedema, hyperaemia
and inflammation
of the eyes with
repeated
administration.

- Instruct
patient on proper
administration
technique,
depending on
formulation used

Drug

Mode of Action

Indications

Tetanus toxoid

Tetanus toxoid
adsorbed induces
active immunity to
tetanus antigen by
stimulating the immune
system to produce
specific antitoxin

Indications:
Prophylaxis and
treatment of tetanus.

GENERIC NAME: Antitetanus serum

BRAND NAME: Tetanus
Toxoid
GENERAL
CLASSIFICATION:
EPI vaccine,
Anti-tetanus

Contraindications:
Hypersensitivity
reaction to the serum
globulin or any of its
components, a
hypersensitivity
reaction to a test
dose, and any
condition that will
contraindicate
intramuscular
injection such as
thrombocytopenia.

Side effects

Redness
Edema
urticarial
Malaise
transient fever
pain
hypotension
nausea
arthralgia

Nursing Considerations

Observe 10 rights
in giving medications:
o
Right Patient
o
Right Drug
o
Right Dose
o
Right Time
o
Right Route
o
Right to refuse
o
Right Assessment
o
Right Education
o
Right
Documentation
o
Right Evaluation

Ask for any

history of allergy to
the drug

Assess site for

administration

Monitor for any

occurrence of side
effects
Perform skin testing
before administration

DRUG ORDER
Generic Name:
Purified Verocell
vaccine, rabies
(PVRV)
Brand Name:
verorab
Classification:
Anti-rabies, Vaccine,
antisera &
immunologicals

MECHANISM OF ACTION

INDICATIONS

Used in a postexposure
prophylaxis regimen that
includes active immunizatio
n with rabies vaccine
and passive immunization
with RIG. RIG provides
immediate, temporary rabies
virus-neutralizing
antibodies until the
patient has an immunologic
response to active
immunization with rabies
vaccine and produces virusneutralizing antibodies.

For the prevention of

rabies in subjects at a
high risk of exposure. All
subjects at a permanent
risk eg, diagnostic,
research and production
laboratory staff working
on rabies virus, should be
vaccinated. A serological
test is recommended every
6 months
Contraindications:
Severe febrile infection,
acute disease, progressive
chronic disease (it is
preferable to postpone
vaccination); known
hypersensitivity to any of
the ingredients of
Verorab.
Post-Exposure: Due to the
fatal progression of
declared rabies infection,
there are no
contraindications to
curative vaccination.
If there is any doubt, it
is essential to consult
the doctor or pharmacist.
Use in pregnancy &
lactation: Verorab has not
been the subject of animal
teratogenicity studies

ADVERSE EFFECTS OF THE DRUG

Minor local reactions

(pain, erythema, edema,
pruritus and induration
at the injection
point); systemic
reactions (moderate
fever, shivering,
faintness, asthenia,
headaches, dizziness,
arthralgia, myalgia,
gastrointestinal
disorders [nausea,
abdominal pains]);
exceptionally,
anaphylactoid
reactions, urticaria
and rash.

NURSING
RESPONSIBILITIES/
Favirab must only be
administered in a rabies
control center, under
medical supervision.
Do not administer
Favirab IV (due to the
risk of shock ie, sudden
collapse with drop in
blood pressure).
Consequently, make sure
that the needle has not
penetrated a blood
vessel.
Favirab should not be
administered in repeated
doses.