CEBU NORMAL UNIVERSITY

College of Nursing

DRUG STUDY FORM

Name of Patient: Age: Height:

Diagnosis: Sex: Weight:
Doctor: Date of Admission: Body Built:

DRUG DATA CLASSIFICATI MECHANISM OF INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES
ON ACTION
Generic Name: Pharmacologic Pharmacokinetics: General Contraindication: Before
biperiden Class: Blocks cholinergic activity Indication: Hypersensitivity. Narrow angle CNS: confusion, - check doctor’s order
anticholinergics in CNS< which is partially glaucoma. Bowel obstruction. depression, - Assess hypersensitivity to drug
Trade Name: responsible for the Adjunctive Megacolon. Tardive dyskinesia dizziness, - Assess mental status
Akineton symptoms of Parkinson’s treatment of all hallucinations, - Assess fluid and bowel Function
Therapeutic disease. Restores the fors of Precautions: headache, sedation, - Observe the 15 rights of drug
Patient’s Dose: Class: natural balance of Parkinson's USe cautiously in: weakness administration
Biperiden 2mg/tab Antiparkinson neurotransmitters in the disease, Geriatric patients;
1 tab BID agents body including drug- Prostatic enlargement EENT: blurred During:
induced Seizure disorders vision, dry eyes, - Administer with food or milk
Minimum Dose: Pregnancy A: Well absorbed after extrapyramidal Cardiac arrhythmias mydriasis - Give with a full glass of water
2mg, PO Risk Category: oral or IM administrations effects and acute Pregnancy and lactation - Inspect patient’s mouth to make sure
C D: Unknown dystonic CV: arrhythmias, the medication was consumed
Maximum Dose: M: in the liver reactions hypotension, - Constantly monitor vital signs
2mg, PO E: excreted in urine palpitations, - Do not dilute concentrate with
Control of tachycardia coffee/tea
Availability and Pharmacodynamics extrapyramidal Drug-drug interactions:
color: disorders Drug drug: Additive GI: constipation, dry After:
PO(Adults): 2m 3- Route:PO secondary to anticholinergic effects with mouth, ileus, nausea - Monitor for adverse reactions
4 times daily Onset: 10-30min neuroleptic drug drugs sharing anticholinergic - Advise patient to change position
initially (not to Peak: unknown therapy properties, such as GU: hesitancy, slowly
exceed 16mg/day) Duration: unknown antihistamines, phenothiazines, urinary retention - Promote good oral hygiene
Patient’s quinidines, disopyramide,, and - caution patient that this medication
Tablets: 2mg Route:IM Indication: TCA. decreases perspiration
Onset: 10-30min Counteracts the cholinergic - instruct to report about dysuria or
Color: white with Peak: unknown Control of effects of bethanechol. Antacids constipation
triangle Duration: unknown extrapyramidal or antidiarrheals may decrease
disorders absorption.
Contents: Route:IV secondary to
biperiden Onset: 10-30min neuroleptic drug Drug-Natural Products:
Peak: unknown therapy – Increased anticholinergic
Route of Duration: 1-8hours phenothiazine effects with angel's trumpet and
Administration: (Chlorpromazine jinson weed and scopolia.
PO, IM, IV Drug half life: 30 min to 1 HCl)
hour
Source: Deglin, Judith Hopfer and April Hazard Vallerand. Davis’s Drug Guide for Nurses 10th Edition. 2007. F.A. Davis Company, Philadelphia
 DRUG DATA CLASSIFICATI MECHANISM OF INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES
ON ACTION
Generic Name Pharmacologic Pharmacodynamics General Contraindication: CNS: severe Before
Haloperidol Class A butyrophenone that Indication: - hyypersensitivity extrapyramidal - check doctor’s order
probably exerts Psychotic - with parkinsonism, coma, or reactions, tardive - Assess hypersensitivity to drug
Trade Name: antipsychotic effects by disorders CNS depression. dyskinesia, sedation, - Assess mental status
Apo-Haloperidol, phenylbutylpipe blocking postsynaptic drowsiness, - Assess positive and negative
Haldol, Novo- radine dopamine receptors in Chronic Precautions: lethargy, headache, symptoms of depression
Peridol, Peridol, derivative the brain. psychosis - elderly and debilitated insomnia, confusion, - Monitor blood pressure and pulse
Serenace requiring patients; - patients with history vertigo, seizures, - Assess fluid and bowel Function
Therapeutic Pharmacokinetics: prolonged of seizures or EEG neuroleptic - Monitor for Tardive dyskinesia
Patients Dose Class: therapy abnormalities, severe CV malignant syndrome.
Haloperidol antipsychotic A: Readily absorbed after disorders, allergies, glaucoma, During
20mg/tab ¼ tab oral administration Nonpsychotic or urine retention; CV: tachycardia, - Avoid skin contact with oral solution
OD Pregnancy behavior - taking anticonvulsants, hypotension, - Administer with food or full glass of
Risk Category: D: Widely distributed disorders anticoagulants, hypertension, ECG water
Minimum Dose: C antiparkinsonians, or lithium. changes, torsades - Use calibrated measuring device for
0.5mg, tablet M: Metabolized by the Tourette de pointes, with I.V. accurate dosage.
Maximum Dose: liver syndrome Drug-drug interactions: use. - Do not dilute concentrate with
20mg, tablet - Anticholinergics: May increase coffee/tea
E: excreted via the urine Delirium anticholinergic effects and EENT: blurred - Inspect patient’s mouth to make sure
Contents glaucoma. vision. the medication was consumed
haloperidol - Azole antifungals, buspirone, - Observe the 15 rights of drug
Availability and macrolides: May increase GI: dry mouth, administration
color: haloperidol level anorexia,
haloperidol Route: PO - Carbamazepine: May constipation, After
Tablets: 0.5 mg, 1 Patient’s decrease haloperidol level. diarrhea, nausea, - Monitor for adverse reactions
mg, 2 mg, 5 mg, Indication: - CNS depressants: May vomiting, dyspepsia. - Inform patient of the possibility of
Onset: 2 houra
10 mg, 20 mg Treatment of increase CNS depression. extra-pyramidal symptoms and Tardive
haloperidol patient’s -Lithium: May cause lethargy GU: urine retention, Dyskinesia
decanoate Peak: 2-6 hours psychosis and confusion after high doses. menstrual - Advise patient to change position
Injection: 50 Methyldopa: May cause irregularities, slowly
mg/ml, 100 mg/ml Duration: 8-12 hours dementia. priapism. - Advise patient to use sunscreen and
haloperidol lactate - Rifampin: May decrease protective clothing
Injection: 5 mg/ml Half-life: 21-24 hours haloperidol level. - Promote good oral hygiene
Oral concentrate: 2 - Notify physician if fever, tremors,
mg/ml Drug-lifestyle weakness, and visual disturbances
Color: orange Alcohol use: May increase CNS occur.
Route of depression.
Administration:
PO
Source: Deglin, Judith Hopfer and April Hazard Vallerand. Davis’s Drug Guide for Nurses 10th Edition. 2007. F.A. Davis Company, Philadelphia
 DRUG DATA CLASSIFICATION MECHANISM OF INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES
ACTION
Generic Name: Pharmacologic Unknown; may block General Contraindication: CNS: drowsiness, Before :
Chlorpromazine HCl Class: post synaptic Indication: allergic to chlorpromazine, insomia, vertigo, - Check doctor’s orders.
Phenothiazine dopamine receptors in coma or severely depressed headache, - Assess for hypersensity or allergy to
Trade Name: brain and depress management of states ,bone marrow depression weakness, tremors, drug and any of its components.
Chlorpromanyl, areas in wakefulness manifestations circulatory collapse, subcortical ataxia, slurring, - Check blood count levels for possible
Largactil, Novo- Therapeutic and emesis. Also of psychotic brain damage, Parkinson’s cerebral edema, bone marrow depression.
Chlorprmazine, Class: possesses disorder; control disease, liver damage, cerebral/ seizures, - Ask patient if he/she was diagnosed
Thorazine, Thorazine antipsychotic, anticholinergic, manic- coronary arteriosclerosis, exacerbation of with peptic ulcer disease. Notify
Spansule, Thor-Prom anxiolytic, antihistaminic, and depressive severe hypotension psychotic features physician.
antiemetic adrenergic properties. illness; therapy Precautions: CV: hypotension, - Asses renal function before therapy.
Patient’s Dose: for respiratory disorder, glaucoma, orthostatic - Protect oral concentrates from
100mg/tab ½ tab at Pharmacokinetics: combativeness, history of epilepsy, PUD, hypotension, sunlight.
HS if unable to sleep Pregnancy Risk A: variable absorption hyperactivity; decreased renal function, tachycardia, CHF, - Observe 15 rights of drug
Category: fromtablets/suppositor control of prostate hypertrophy, cardiac arrest, administration.
Minimum Dose: C ies, better with oral nausea, thyrotoxicosis, myelography, pulmonary edema, During:
10 mg PO liquid formation well vomiting, and breast cancer, CNS infection cardiomegaly - Do not administer via subcutaneous.
absorbed in IM; D: intractable Drug-drug interactions: EENT: nasal - Dilute oral concentrates in 60ml or
Maximum Dose: widely distributed, hiccups; severe Activated charcoal: decreased congestion, more of tomatoes, juice, and milk.
200 mg PO high CNS behavioral chlorpromazine absorption; glaucoma, - Inspect patient’s mouth to make sure
concentrations, problems in antidiarrheals,antacids: photophobia, blurredthe medication was consumed
Availability and crosses placenta, children decreased chlorpromazine vision, mydriasis - Avoid skin contact with oral
color: enters breast milk; M absorption; antidepressants, Endocrine: lactation,
concentrates and parenteral drug
capsules (sustained- and E: highly antihistamines, MAOI: CNS breast engorgement, solutions due to possible contact
release): 30 mg, 75 metabolized by liver Patient’s depression; disopyramide, galactorrhea, dermatitis.
mg, 150 mg, 200 mg, and GI mucosa, some Indication: quinine: increased SIADH, menstrual - Do not administer if patient is taking
300 mg; injection: 250 metabolites are active To manage anticholinergic effect; irregularities, OTCs unless consultation to a health
mg/ml; oral manifestations antihypertensives: additive decreased care provider has been done
concentrate: 30 Pharmacodynamics of psychotic hypotension; barbiturates: gonadotropin levels After:
mg/ml, 40 mg/ml, 100 disorder and increased metabolism and GU: urinary - Monitor closely for s/sx of allergic
mg/ml; suppositories: PO: onset 30-60min, control decreased chlorpromazine retention, polyuria,reactions for about 15 minutes after
10 mg/5ml, 25 peak 2-4 hrs, duration hyperactivity efficacy; Lithium: priapism, ejaculation
drug administration.
mg/5ml, 100 mg/5ml; 4-6 hrs and inability to extrapyramidal effects; TCAs: inhibition - Monitor WBC. Discontinue if WBC
tablets: 10 mg, 25 mg, IM: 10-15min, peak sleep at increased TCA in blood levels GI: dry mouth, level is low.
50 mg, 100 mg, 200 15-20min, duration 4- bedtime. and effects diarrhea, - Patient/ SO must be warned of
mg 6 hrs Drug-herb interactions: constipation, ileus,possible tardive dykinesia.
Color: orange Rectal: onset less St John’s wort: may cause Rash - Monitor elderly patients for
Contents: than one hour, peak photosensitivity reactions Laryngeal edema dehydration, sedation, and increased,
Chlorpromazine unknown, duration 3-4 Drug-behaviors interactions decreased sensation/ taste.
hydrochloride hours. Alcohol use: increased CNS - Avoid alcohol intake, it may increase
Route of depression; sun exposure: chance of seizure attacks.
Administration: Drug half life: 30 increased risk for phosensitivty - Notify physician for adverse
PO, IM, rectal hours reactions.
Source: Deglin, Judith Hopfer and April Hazard Vallerand. Davis’s Drug Guide for Nurses 10th Edition. 2007. F.A. Davis Company, Philadelphia
 DRUG DATA CLASSIFICATION MECHANISM OF INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES
ACTION
Generic Name: Interferes with the General Contraindication: CNS: drowsiness, Before :
diphenhydramine Pharmacologic histamine effects at Indication: Allergy to any dizziness, - check doctor’s order
hydrochloride Class: histamine1- receptor antihistamines, thitd headache, - Assess allergy to drug
sites; prevents but Allergy symptoms trimester of pregnancy, paradoxical - Monitor blood pressure, drug may
Trade Name: Ethanolamide doesn’t reverse caused by lactation, glaucoma, stimulation cause orthostatic hypotension.
Benadryl, Banophen, derivative, non histamine-mediated histamine release alcohol intolerance, acute (especially in - Obtain baseline vital signs.
Allerdryl, AllerMax, selective response. Also exerts (including asthma attacks children) - Assess bowel function.
Compoz, Diphen AF, histamine1- significant CNS anaphylaxis,seaso Drug-drug interactions: CV: hypotension, - Note alcohol intake.
Hyrexin, receptor antagonist depressant and nal and perennial Antihistamines, opiods, palpitations - Monitor renal function before and after
Siladryl,Sominex, anticholinergic activity. allergic rhinitis, sedative-hypnotics: EENT: blurred therapy
Twilite Therapeutic allergic additive CNS depression; vision, tinnitus
Class: Pharmacokinetics: dermatoses);cough Disopyramide, quinidine, GI: diarrhea,
Patient’s Dose: D: crosses placenta, ; dyskinesia, tricyclic anti-depressants: constipation, dry During:
50mg/ml 1 amp IM Antihistamine, enters breastmilk Parkison’s increased anticholinergic mouth - observe asceptic technique in
OD antitussive, M: hepatic metabolism disease; mild effects; MAOI: intensified GU: dysuria, urinary preparing drug
(taken with antiemetic, E: excreted by nighttime sedation and prolonged frequency or - IM: administer deep in the muscle
haloperidol) antivertigo, agent, kidneysin form of anticholinergic effects retention - administer slowly to decrease pain. Do
antidyskinetic urine Patient’s Drug-diagnostics Skin: not massage site.
Minimum Dose: Indication: interactions photosensitivity - Avoid altering the form of medications.
25 mg every 4hrs Pregnancy Risk Pharmacodynamics For mild sedation, Skin allergy tests: false- Hematology: - Observe the 15 rights of administration
Maximum Dose: Category: in combination with negative results hemolytic anemia,
50 mg every 8hrs B PO: onset 15-60min, haloperidol, and for thrombocytopenia, After:
peak 1-4hrs, duration agitation. agranulocytis, - monitor for adverse reactions
Availability and 4-8hrs pancytopenia - monitor vital signs
color: IV: onset rapid, peak Respiratory: - Advise patient to change position
Capsules: 25mg, unknown, duration 4- thickening of slowly
50mg; elixir: 8hrs bronchial secretions, - Advise to suck on ice chips/ candies
12.5mg/5ml; IM: onset 20-30min, chest tightness, and practice oral hygiene to relive
injection:10mg/ml, peak 1-4hrs, duration wheezing, nasal mouth dryness.
50mg/ml; syrup: 4-8 hrs stiffness, dry mouth - Instruct to avoid/ limit activity requiring
12.5mg/5ml; tablets: Other: decreased alertness until drug response is known.
25mg, 50mg; appetite, pain at IM
tablets(chewable): site, rash,
25mg anaphylaxis,
urticaria
Contents:
diphenhydramine
hydrpchloride
Route of
Administration:
PO, IM, IV
Source: Deglin, Judith Hopfer and April Hazard Vallerand. Davis’s Drug Guide for Nurses 10th Edition. 2007. F.A. Davis Company, Philadelphia
 DRUG DATA CLASSIFICATION MECHANISM OF INDICATIONS CONTRAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES
ACTION
Generic Name: Pharmacodynamics General Contraindication: CNS: headache, Before:
Sertraline Pharmacologic Unknown. Thought to Indication: Hypersensitivity, taking tremor, dizziness, - assess hypersensitivity to drug
hydrochloride Class: be linked to drug’s Treatment of: pimozide or MAOI or within 14 insomnia, - obtain baseline vital signs
Selective serotonin inhibition of CNS Major depressive days of MAOI therapy somnolence, -obtain doctor’s order. Check/verify
Trade Name: reuptake inhibitor neuronal uptake of disorder paresthesia, - assess neurologic function
Zoloft serotonin Depression, Precautions: hyperthesia, fatigue, - Monitor mood changes
Therapeutic obsessive- At risk for seizure disorders, nervousness, - Observe 15 rights of drug
Patient’s Dose: Class: Pharmacokinetics: compulsive major affective disorder, or anxiety, agitation, administration
Sertraline 50 Anti depressant disorder diseases or conditions that hypertonia,
mg/tab 1 tab OD A: Readily absorbed Panic disorder affect metabolism or twitching, confusion - Give once daily in the morning
Pregnancy Risk after oral Post traumatic hemodynamic process CV: palpitations, - Make dose adjustments at interval of
Minimum Dose: Category: administration stress disorder chest pain, hot, no less than one week
50mg/day C Premenstrual Drug-drug interactions: flushes - Monitor mood changes
D: Widely distributed, dysphoric Benzodiazebpines, talbutamide: GI: - Don’t use oral concentrate dropper,
Maximum Dose: crosses placenta, disorder may decrease clearance of Dry mouth, N/V which is made of rubber in patient with
200mg/day enters breastmilk Social anxiety these drugs Constipation, thirst, latex allergy.
disorder Cimetidine: may decrease flatulence, anorexia, - Give with one full glass of water
Availability and M: Metabolized by the Premature clearance of sertraline abdominal pain,
color: liver ejaculation Disulfiram: oral concentrate increased appetite, - Monitor for adverse reactions
Capsules: 25mg, caontains alcohol which may loose stools, - Advise not to stop drug abruptly
50mg; 100mg, oral E: excreted via the Patient’s react to drug dyspepsia - Instruct to avoid alcohol
concentrate: urine Indication: MAOI: may cause serotonin GU: male sexual - Advise to use caution in performing
20mg/ml; tablets: Treatment of syndrome dysfunction hazardous activities
25mg, 50mg; major depressive Pimozide: may increase MS: myalgia - Instruct to perform frequent oral care
100mg tablets: Route: PO disorder pimozide level SKIN: rash, pruritus, for dry mouth
25mg, 50mg, Warfarin, other highly protein diaphoresis - Monitor vital signs
100mg bound drugs: may increase OTHERS
Onset: unknown
level of sertraline or highly Weight loss, anemia
Contents: protein bound drugs.
Sertraline Peak: 4-8 hours
hydrpchloride
Duration: unknown
Route of
Administration: Half-life: unknown
PO

Source: Deglin, Judith Hopfer and April Hazard Vallerand. Davis’s Drug Guide for Nurses 10th Edition. 2007. F.A. Davis Company, Philadelphia