Drug Action Indication/Contraindication Nursing Responsibilities

Generic Name: Mechanism of action: Indication:  Observe 12 rights of medication

norgestimate and Oral Contraception Oral Contraceptive
ethinyl estradiol COCs lower the risk of ORTHO-CYCLEN and ORTHO  Monitor for the development of breast or
Brand Name: becoming pregnant TRI-CYCLEN Tablets are other estrogen-dependent tumors
Ortho Tri-Cyclen primarily by suppressing indicated for use by females
Classification: ovulation. Other possible of reproductive potential to  Monitor for thrombophlebitis or other
mechanisms may
Estrogens/Progestins prevent pregnancy. thromboembolic disease.
include cervical mucus
; Contraceptives, changes that inhibit
Dosage: sperm penetration and
Acne  Encourage client not to smoke.
1 tab daily ORTHO TRI-CYCLEN is
endometrial changes
Route: that reduce the indicated for the treatment  Monitor client’s knowledge level of proper
Oral likelihood of of moderate acne vulgaris in administration
implantation. females at least 15 years of
age, who have no known
Acne contraindications to oral
Acne is a skin condition contraceptive therapy and
with a multifactorial have achieved menarche.
etiology, including ORTHO TRI-CYCLEN should
androgen stimulation of be used for the treatment of
sebum production. While acne only if the patient
the combination of desires an oral contraceptive
ethinyl estradiol and for birth control.
norgestimate increases
sex hormone-binding Contraindication
globulin (SHBG) and
 Smoke, if over age
decreases free
testosterone, the 35
relationship between  Have deep vein
these changes and a thrombosis or
decrease in the severity pulmonary
of facial acne in embolism
otherwise healthy  Have inherited or
women with this skin acquired
condition has not been hypercoagulopathies
established.  Have
cerebrovascular
disease
 Have coronary artery
disease
 Have uncontrolled
hypertension
Side effects
 Irregular uterine
bleeding
 Nausea
 Breast tenderness
 Headache
Drug Action Indication/Contraindication Nursing Responsibilities

Generic Name: Mechanism of action: Indication:  Observe 12 rights of medication

Ibuprofen Relief of signs and
Brand Name: Antiinflammatory, symptoms of rheumatoid  Administer drug with food or after meals if
Advil analgesic, and arthritis and osteoarthritis GI upset occurs.
Classification: antipyretic · Relief of mild to moderate
Nonsteroidalanti- activities pain  Discontinue drug if eye changes, symptoms
inflammatorydrug largely related · Treatment of primary of liver dysfunction, renal impairment
(NSAID) to inhibition of dysmenorrhea occur.
Analgesic prostaglandin · Fever reduction
synthesis; exact  Teach patient to watch for and report to
Dosage: mechanisms of prescriber immediately signs and
Pain/Fever/Dysmenorrhe action are not Contraindication symptoms of GI bleeding, including blood
a known Contraindicated with allergy invomit, urine, or stool
OTC: 200-400 mg PO to ibuprofen, salicylates, or or coffee ground vomit.
q4-6hr; not to exceed other NSAIDs (more
1200 mg unless directed common in patients with  Tell patient to take with meals or milk to
by physician rhinitis, asthma, chronic reduce adverse GI reactions.
urticaria, nasal polyps); CV
dysfunction, hypertension;
Prescription: 400-800 mg
peptic ulceration, GI
PO q6hr; not to exceed
bleeding; pregnancy;
3200 mg/day
lactation.
Inflammatory Disease
Side effects:
400-800 mg PO q6-8hr;
 Headache
not to exceed 3200
 Dizziness
mg/day
 Somnolence
 Insomnia
Rheumatoid Arthritis
 Fatigue
300 mg, 400 mg, 600 mg,
 Tiredness
or 800 mg PO q6-8hr; not
 Dizziness
to exceed 3200 mg/day
 Tinnitus
  ophthalmologic
 effects
Route:  Rash
Oral  Pruritus
 Sweating
 dry mucous
 membranes
 stomatitis
  Nausea

Drug Action Indication/Contraindication Nursing Responsibilities

Generic Name: Mechanism of action: Indication:
Pantroprazole Duodenal and gastric ulcer, moderate  Observe 12 rights of
Brand Name: Inhibits both basal and stimulated and severe reflux esophagitis. medication
Protonix gastric acid secretion by suppressing Eradication of H. pylori inpatient with
Classification: the final step in acids production, peptic ulcers, pathological hyper  Monitor for possible
proton pump inhibitors through the inhabitation of the secretory conditions. Symptomatic drug induced
Dosage: proton pump by binding to and improvement and healing of mild reflux adverse reaction.
Erosive Esophagitis inhibiting hydrogenpotassium esophagitis. Prevention of  Assess GI symptoms:
Associated With GERD adenosine triphosphatase, the gastroduodenal ulcers induced by NSAID epigastric/abdominal
Treatment: 40 mg PO enzyme system located at the in patients at risk with a need for pain, bleeding and
qDay for 8-16 weeks secretory surface of the gastric continuous NSAID treatment. anorexia.
parietal cell.  Inspect the skin for
Contraindication lesions, rash,
Short-term Treatment of
Known hypersensitivity to any of the pruritus, and dryness
GERD
constituents of Pantoloc or of the to identify possible
Oral therapy
combination partners. Mild adverse effects.
inappropriate or not
gastrointestinal complaints eg, nervous  Assess for possible
possible: 40 mg IV
dyspepsia. Pantoloc must not be used in contraindications
infusion over 15 minutes
combination treatment for eradication and cautions: history
qDay for 7-10 days;
of H. pylori in patients with moderate to of allergy to a proton
switch to PO once patient pump inhibitor to
severe hepatic or renal dysfunction
able to swallow reduce the risk of
Side effects:
 Headache hypersensitivity
Zollinger-Ellison
 Dizziness reaction and current
Syndrome
 Somnolence status of pregnancy
40 mg PO qDay; up to
 Insomnia
240 mg/day administered
 Fatigue
in some patients
 Tiredness
80 mg IV infusion q8-
 Thrombophlebitis
12hr up to 7 days; switch
 diarrhea
to PO once patient able to
swallow

Peptic Ulcer Disease

(Off-label)
Duodenal ulcer: 40 mg
PO qDay for 2 weeks
Gastric ulcer: 40 mg PO
qDay for 4 weeks

Route:
Oral

Drug Action Indication/Contraindication Nursing Responsibilities

Generic Name: Mechanism of action: Indication:
Omeprazole Prochlorperazine is used to treat  Observe 12 rights of
Brand Name: An antisecretory compound that nervous, emotional, and mental medication
Prisolec is a gastric acid pump inhibitor. conditions (eg, schizophrenia) and
Classification: Suppresses gastric acid secretion non-psychotic anxiety. It is also used  Positioned
proton pump inhibitors by inhibiting the H+, K+-ATPase to control severe nausea and nauseated patients
Dosage: enzyme system [the acid (proton vomiting. This medicine should not who have received
10 mg, 20 mg, 40 mg H+) pump] in the parietal cells. be used to treat behavioral problems prochlorperazine
capsules; 20 mg powder carefully to prevent
in older adult patients who have
for oral suspension aspiration of
dementia.
vomitus; may have
depressed cough
Route: Contraindication
reflex.
Oral It is important to note that geriatric
patients with dementia have a higher  Most older adult and
emaciated patients
risk of death when treated with an
antipsychotic, including and children,
especially those with
prochlorperazine.
 History of allergy to
dehydration or acute
illness, appear to be
prochlorperazine or the
phenothiazine drug class particularly
susceptible to
 Concomitant use of CNS
depressants (opioids, extrapyramidal
effects. Be alert to
benzodiazepines, and
barbiturates) leading to sedation onset of symptoms:
Early in therapy
 Concomitant use of
anticholinergic medications watch for
pseudoparkinson's
(scopolamine, atropine, etc.)
 Pre-existing cardiac conduction
and acute dyskinesia.
After 1–2 mo, be
abnormalities
 History of seizure/epilepsy
alert to akathisia.
(prochlorperazine lowers seizure  Keep in mind that
threshold) the antiemetic effect
 Narrow-angle glaucoma
may mask toxicity of
 Prostatic hypertrophy
other drugs or make
  Past or current history of tardive it difficult to
dyskinesia diagnose conditions
 Patients under two years of age with a primary
symptom of nausea,
Side Effects: such as intestinal
 Headache obstruction and
 dizziness increased
 fatigue intracranial pressure.
 Lab tests: Periodic
Adverse Reactions: CBC with differential
 Anorexia in long-term therapy.
 Dyspepsia  Be alert to signs of
 Constipation high core
 Diarrhea temperature: Red,
 Ileus dry, hot skin; full
 Blood dyscrasia bounding pulse;
 Galactorrhea dilated pupils;
 Gynecomastia dyspnea; confusion;
temperature over
40.6° C (105° F);
elevated BP.
Exposure to high
environmental
temperature, to
sun's rays, or to a
high fever associated
with serious illness
places this patient at
risk for heat stroke.
Inform physician and
institute measures to
reduce body
temperature rapidly.
Drug Action Indication/Contraindication Nursing Responsibilities

Generic Name: Mechanism of action: Indication:

prochlorperazine  Duodenal and gastric ulcer.
Brand Name: As a first-generation  Gastroesophageal reflux
Compazine antipsychotic, prochlorperazine mainl
disease including severe
Classification: y blocks D2 dopamine receptors in the
antipsychotics brain. It can also block histaminergic, erosive esophagitis (4 to 8
Dosage: cholinergic, and noradrenergic wk treatment).
Severe Nausea & receptors.  Long-term treatment of
Vomiting pathologic hypersecretory
PO: Immediate-release, conditions such as
5-10 mg q6-8hr; Zollinger-Ellison syndrome,
extended-release, 10 mg
multiple endocrine
q12hr or 15 mg every
morning adenomas, and systemic
Suppository: 25 mg mastocytosis.
q12hr  In combination with
IM: 5-10 mg q3-4hr; not clarithromycin to treat
to exceed 40 mg/day duodenal ulcers associated
IV: 2.5-10 mg q3-4hr;
with Helicobacter pylori.
not to exceed 10
mg/dose or 40 mg/day Contraindication
 Long-term use for
Route:
Oral, IV, IM gastroesophageal reflux
disease (GERD)
 duodenal ulcers; proton
pump inhibitors (PPIs),
hypersensitivity; children <2
y; use of OTC formulation
in children <18 y or GI
bleeding; pregnancy
 use of Zegerid in metabolic
alkalosis, hypocalcemia,
vomiting, GI bleeding.

Side Effects:
 Headache
 dizziness
 fatigue
 abdominal pain
 nausea

Adverse Reactions:
 Mild Transient Increases In
Liver Function Tests
 Hematuria
 Proteinuria
Rash