MARY CHILES COLLEGE

COLLEGE OF MIDWIFERY
Bachelor of Science in Midwifery
First Semester 2021-2022

Course Title Midwifery Pharmacology Course Code Mid C

Full Name of Students Ana Guia Labita, Agnes Billedo Modina, Violy Kindipan Cabigat

Date May 31, 2022 Rating

DRUG STUDY
MEDICATION SUMMARY OF PATIENT F.A
CASE: Epidural, Normal Vaginal Spontaneous Delivery Complicated with PPH Due to Uterine Atony
DATE OF ADMISSION: May 22, 2022
DATE OF DISCHARGE: May 24, 2022
Drug Name Action Indication Contraindication Interaction Adverse Effect Nursing Consideration
(Generic)
1) ACETAMINOPHEN - Categorized alongside - In general, - Contraindicated to patient  Drug: Common Drug  CNS: Headache Assessment:
OR PARACETAMOL NSAIDs (nonsteroidal acetaminophen is used with allergy or interactions
anti-inflammatory for the treatment of mild hypersensitivity of the include carbamazepine,  CV: Chest pain, dyspnea, - History of known allergy to
Dosage Form: Tablet drugs) due to its ability to moderate pain and drug. isoniazid, rifampin, alcohol, myocardial damage paracetamol, and
to inhibit the reduction of fever. cholestyramine and when used in long term contraindicated diseases.
cyclooxygenase (COX) - IV form is contraindicated warfarin. high dose form.
Route: Oral
pathways - It is available over the in patient with severe Interventions and Teaching
counter in various forms, hepatic impairment or  Disease: Liver disease,  GI: Hepatic failure, points:
Required Dosage and - It is thought to exert the most common being severe active liver disease. Phenylketonuria. toxicity and jaundice.
Timing: central actions which oral forms. - Do not exceed recommended
ultimately lead to the Cautious Use :  Food: None  GU: Acute kidney dose.
1000mg q8h PRN for 14 alleviation of pain failure, Renal tubular - Monitor and advise patient to
days symptoms and fever. - Patients with any type of necrosis. report any severe adverse
liver disease Alcohol may increase the effects.
- G6PD deficiency risk of hepatotoxicity.  Hematologic: - Avoid using multiple
- Severe hypovolemia, or Methemoglobinia preparations containing
severe renal impairment (cyanosis), hematologic paracetamol.
- Patients with long term anemia, hematuria, - Give drug with food if GI upset
use of alcohol. neutropenia, occurs.
leucopenia, - Discontinue drug if any
thrombocytopenia, hypersensivity occurs.
hypoglycemia.
- Ensure right name, right drug,
 Hypersensitivity: right dose, and right time, right
route and right documentation
Rash, fever during administration
2) ANTIHEMORRHOIDAL - An adrenocortical - For the relief of the - Contraindicated to patient  Drug: May interact with this  CNS: Mental/mood Assessment:
/CORTISONE (Anusol- steroid that inhibits inflammatory and pruritic with allergy or drug are: other changes (such
HC) accumulation of manifestations of hypersensitivity of the corticosteroids/immunosup as depression, mood - History of known allergy to the
inflammatory cells at corticosteroid-responsive drug or to other pressants (such swings, agitation, drug, and contraindicated
inflammation sites, dermatoses. corticosteroids (such as prednisone), other rectal dizziness. diseases.
phagocytosis, - Also used to treat as prednisone). products.
Dosage Form: Suppository lysosomal enzyme endocrine (hormonal)  CV: Chest pain, dyspnea, Interventions and Teaching
release and synthesis, disorders (adrenal - Pre-caution use with  Disease: Refer to the listed trouble breathing, points:
Route: Rectal and release of insufficiency, Addisons patient with medical contraindicated diseases or irregular heartbeat,
mediators of disease). history, includes: condition. muscle weakness. - Do not exceed recommended
Required Dosage and inflammation. - It is also used to treat other stomach/intestinal dose.
Timing: many immune and problems (such as ulcers,  Food: None  GI: Rectal bleeding, GI
allergic disorders, such as blockage, bleeding, bleeding, abdominal - Monitor and advise patient to
25mg TID for 7 days: PRN if arthritis, lupus, severe infection, recent surgery), pain, black tarry stool, report any severe adverse
constipation psoriasis, severe asthma, infections (such rectal redness or effects.
ulcerative colitis, and as tuberculosis, fungal irritation.
Crohn's disease. infections), - Instruct the patient how to
certain eye conditions  GU: Acute kidney insert the drug to her anus.
(cataracts, glaucoma, failure, renal tubular
herpes infection of necrosis. - Advised the patient to
the eye), heart problems discontinue drug if any
(such as congestive heart  Hypersensitivity: hypersensivity occurs.
failure, recent heart
attack), high blood Rash, fever, sorethroat,
pressure, liver painful urination,
disease, kidney swelling of the anal part.
disease, thyroid
problems (overactive or
underactive thyroid
disease), diabetes, bone
loss (osteoporosis),
bleeding or blood clotting
problems, mental/mood
conditions (such
as psychosis, depression),
low potassium blood level.

3) Bupivacaine - A local anesthetics - Used as a local anesthetic - Contraindicated to patient - Drug: No known severe  Common adverse Assessment:
Hydrcloride block generation and during or after surgery or with allergy or interaction with other drugs effects:
the conduction of other procedures, hypersensitivity of the but can moderately interact Burning, crawling, - History of known allergy to the
Dosage Form: Injection nerve impulses by childbirth, or dental drug or sensitivity to with the following drugs itching, numbness, drug, and contraindicated
increasing the work. parabens. which includes: benazepril, prickling, "pins and diseases.
threshold for electrical - Obstetrical paracervical bupivacaine liposome, needles", or tingling
Route: Epidural
excitation in the nerve, block anesthesia. captopril, dofetilide, nadolol, feelings Interventions and Teaching
by slowing the - Intravenous regional nevirapine, pindolol, Change or loss of taste points:
Required Dosage and propagation of the anesthesia use. proprandolol, timolol Chest pain or
Timing: nerve impulse, and by discomfort - Monitor and advise patient to
reducing the rate of CAUTION USE: - Disease: (G6PD) deficiency, Continuing ringing or report any severe adverse
0.1% Epidural injection rise of the action methemoglobinemia, second buzzing or other effects.
continuous @ 10ml/hr potential. - History of malignant degree atrioventricular heart unexplained noise in the
infusion rate of the bundle hyperthermia. block slow heartbeat, ears - Ensure right name, right drug,
5-15ml/hr for 4 days. - Patients with hepatic significantly low blood Decrease in the right dose, and right time, right
impairment. pressure, severe liver route and right documentation
 disease, kidney disease frequency and amount during administration.
of urine - Monitor Vital signs
 Food: None Diarrhea
Difficult or painful - Evaluate therapeutic response
urination
Dizziness
Dry mouth
Fever
Headache
Hearing loss
Increased thirst
Loss of appetite
Mood changes
Muscle pain or cramps
Nausea or vomiting
Seizures
Sleepiness or unusual
drowsiness
Slow or irregular
heartbeat
Trouble breathing
Unusual bleeding or
bruising
Unusual tiredness or
weakness

4) CARBOPROST - A synthetic - To induce abortion - Contraindicated to patient  Drug: Moderate interactions  Common side effects: Assessment / Drug
TROMETHAMINE prostaglandin. It binds between 13th and 20th with allergy or with the following drugs: Burning, crawling, Effects/Health
the prostaglandin E2 week of pregnancy, as hypersensitivity of the eluxadoline and oxytocin itching, numbness, Teachings/Intervention
receptor, causing calculated from first day drug. prickling, "pins and
myometrial of last menstrual period.  Disease: Asthma, anemia; needles", or tingling - History of known allergy to the
Dosage Form: Injection
contractions, causing - Acute pelvic inflammatory hypotension; hypertension; feelings drug, and contraindicated
the induction of labor - Also for refractory disease; active cardiac, diabetes mellitus; epilepsy; Change or loss of taste diseases.
Route: Intraveneous or the expulsion of the postpartum bleeding. pulmonary, renal, or Chest pain or - Monitor uterine contractions
history of uterine surgery;
placenta. hepatic disease; cervical stenosis; fibroids. discomfort and observe and report
Required Dosage and - Prostaglandins occur pregnancy (category D); Acute pelvic inflammatory Continuing ringing or excessive vaginal bleeding and
Timing: naturally in the body lactation. disease; active cardiac, buzzing or other cramping pain. Save all clots
and act at several sites pulmonary, renal, or hepatic unexplained noise in the and tissue for physician
250 mcg QID for 1 day in the body including Cautious Use : disease; ears inspection and laboratory
the womb (uterus). Decrease in the analysis.
- They act on the - History of asthma; adrenal  Food: None frequency and amount - Monitor uterine activity and
muscles of the womb, disease; anemia; of urine fetal condition when used for
causing them to hypotension; Diarrhea labor induction.
contract. hypertension; diabetes Difficult or painful - Monitor vital signs at regular
mellitus; epilepsy; history urination intervals. Carboprost-induced
of uterine surgery; Dizziness febrile reaction occurs in more
cervical stenosis; fibroids. Dry mouth than 10% of patients and must
Fever be differentiated from
Headache endometritis, which occurs
Hearing loss around third day after
Increased thirst abortion.
Loss of appetite - Report promptly onset of
 Mood changes bleeding, foul-smelling
Muscle pain or cramps discharge, abdominal pain, or
Nausea or vomiting fever.
Seizures - Since ovulation may reoccur as
Sleepiness or unusual early as 2 wk post-abortion,
drowsiness you may wish to consider
Slow or irregular appropriate contraception.
heartbeat - Ensure right name, right drug,
Trouble breathing right dose, and right time, right
Unusual bleeding or route and right documentation
bruising during administration
Unusual tiredness or
weakness

5) CEFAZOLIN - Is a semi-synthetic first - Mainly used to treat - Contraindicated to patient  Drug: May interact with this  CNS: Headache, Assessment / Drug
generation bacterial infections of the with allergy or drug include: Amino hyperactivity, Effects/Health
Dosage Form: Injection cephalosporin for skin. hypersensitivity to the glycoside antibiotics (such as hypertonia, seizures, Teachings/Intervention
parenteral drug. tobramycin, gentamicin), confusion.
administration. Has - It can also be used to "blood thinners" (such as - History of known allergy to the
Route: Intravenous syringe
broad-spectrum treat moderately severe Cautious Use : warfarin), chloramphenicol.  GI: Anorexia, nausea, drug and contraindicated
injection
antibiotic action due to bacterial infections vomiting, diarrhea, conditions.
inhibition of bacterial involving the lung, bone, - History of cardiovascular  Disease: Liver and Kidney abdominal pain, - Advise patient to immediately
Required Dosage and cell wall synthesis. It joint, stomach, blood, disease, renal hepatic disease, stomach/intestinal dyspepsia, pseudo report rash or bleeding
Timing: attains high serum heart valve, and urinary disease and acute pelvic diseases (such as colitis). membranous colitis tendency.
levels and is excreted tract. It is clinically inflammatory disease. - Instruct patient to take drug
1000mg IV syringe q24hrs quickly via the urine. effective against  Food: None  GU: hematuria, renal, with food every 12 hours as
over 3-5 minutes mix with infections caused by oral candidiasis prescribed.
10ml sterile water for 1 day. staphylococci and dysfunction, acute renal - Teach patient how to recognize
streptococci species of failure signs and symptoms of super
Gram positive bacteria. infection. Instruct him to
 Hematologic: report these right away.
- May be used for surgical Thrombocytopenia, - Advise patient to report CNS
prophylaxis; if required thrombocytosis, changes.
metronidazole may be leukopenia, hemolytic - As appropriate, review all
added to cover B. fragilis. anemia, transient other significant and life
elevation of hepatic threatening adverse reactions
enzyme. and interactions, especially
those related to the drugs,
 Metabolic: tests, and foods mentioned
Hyperglycemia above.
- Ensure right name, right drug,
 Skin: Toxic epidermal right dose, and right time, right
necrolysis, erythema route and right documentation
multiforme, StevensJ during administration
ohnson syndrome

 Other: allergic reaction,

drug fever,
superinfection,
anaphylaxis
6) DESOGESTREL/ - Desogestrel enters the - Oral desogestrel is used - Contraindicated to patient  Drug: Common Drug  Common adverse Assessment / Drug
ETHINYL ESTRADIOL cell passively and acts in combination with allergy or interactions effects: Acne, breast Effects/Health Teachings
by binding selectively with ethinylestradiol as a hypersensitivity to the include Smoking, abnormal tenderness and breast
Dosage Form: Tablet to the progesterone contraceptive agent for drug. vaginal bleeding, carcinomas enlargement, an - History: Known allergies to the
receptor and the prevention of - (estrogenic), hypercalcemia increased or decreased drug, and contraindicated
generating low pregnancy. in breast cancer, sex drive. mood conditions.
Route: Oral androgenic activity. Its hypertension, changes, headache and
binding produces an - Desogestrel is part of the thromboembolism/cardiova migraine, nausea or - Counsel the patient to take pill
Required Dosage and effect like a combined oral scular, hepatic neoplasms, vomiting., small fluid- with some daily routine
Timing: transcription factor contraceptives that liver disease filled sacs (cysts) on activity, such as with breakfast
and thus, it produces contain a mix of estrogen thromboembolism, your ovaries – these are or brushing teeth every
75mcg daily (q24hrs) for 28 modifications in the and progestin which usually harmless and morning, or at bedtime, to
days mRNA synthesis inhibit ovulation.  Disease: Breast cancer, disappear without make it easier to remember to
family history of breast treatment. take it every day. The pill
- The effects of cancer, tumor that is works best if taken at about
desogestrel are divided dependent on estrogen for the same time every day. This
on reproductive growth a condition with low is especially important to
including modification thyroid hormone levels, prevent irregular bleeding.
of luteinizing hormone diabetes, low levels of
and follicle stimulating parathyroid hormone, high - Advised the patient if miss two
hormone, declines on cholesterol, high amount of or more pills, continue to take
the onset of triglyceride in the blood, one pill per day and use a
menstruation, and inherited disorder of back-up method of birth
increases the viscosity continuing episodes of control.
of the vaginal fluid; and swelling, deficiency of anti-
on metabolic that clotting agents, increased - Advised the patient to
includes increase risk of blood clotting discontinue drug if any
insulin secretion and depression, a clot in the hypersensivity or severe
resistance, increased small veins that carry blood adverse effects occurs.
lipase activity, and to or from the retina of the
increased fat eye optic disk edema, high
deposition. blood pressure, a heart
attack, coronary artery
disease a clot in the lung,
heart valve disease, a stroke,
obstruction of a blood vessel
by a blood clot
thrombophlebitis, an
inflamed vein due to a blood
clot, blood clot in a deep vein
of the extremities, at risk for
formation of blood clots,
liver problems, disease of the
gallbladder, recent
operation, tobacco smoking,
increased cardiovascular
event risk, protein C
deficiency disease, migraine
with aura.
  Food: Patients who
regularly
consume grapefruit or
grapefruit juice should be
monitored for adverse
effects and altered plasma
concentrations of drugs that
undergo significant
presystemic metabolism by
CYP450 3A4.

7) DICLOFENAC - NSAID drug that has - Used for acute or long- - Contraindicated to patient  Drug: May interact with this  CNS: Headache, Assessment / Drug
potent anti- term treatment of mild to with allergy or drug include: aliskiren, ACE hyperactivity, Effects/Health Teachings
Dosage Form: Suppository inflammatory, moderate pain, including hypersensitivity to the inhibitors (such as captopril, hypertonia, seizures,
analgesic and Dysmenorrhea , drug or other NSAID. lisinopril), angiotensin II confusion. - History: Known allergies to the
antipyretic actions. Rheumatoid arthritis receptor blockers (such as drug, and contraindicated
Route: Rectal
Osteoarthritis, - Active peptic ulcer valsartan, losartan),  GI: GI bleeding, peptic conditions.
- It inhibits the enzyme, Ankylosing spondylitis , corticosteroids (such as ulceration.
Required Dosage and cyclooxygenase, thus - Treatment of preoperative prednisone), cidofovir, - Physical: Skin color and
Timing: resulting in reduced - Treatment of actinic pain in CABG surgery. lithium, methotrexate,  GU: hematuria, renal, lesions; orientation, reflexes,
synthesis of keratosis in conjunction "water pills" (diuretics such oral candidiasis ophthalmologic and
100mg BID q12hrs for 2 prostaglandin with sun avoidance - 3rd trimester of as furosemide). dysfunction, acute renal audiometric evaluation,
days precursors. pregnancy. failure peripheral sensation; P, edema;
- Ophthalmic:  Disease: Asthma fluid R, adventitious sounds; liver
Postoperative - Topical: Not to be applied retention, GI toxicity, rash,  Hematologic: evaluation; CBC, clotting times,
inflammation from onto damaged or non- renal toxicities, thrombosis, Thrombocytopenia, renal function tests, LFTs,
cataract extraction intact skin. porphyria, anemia, trombocytosis, serum electrolytes, stool
hepatotoxicity, leukopenia, hemolytic guaiac.
hyperkalemia, hypertension, anemia, transient
platelet aggregation elevation of hepatic Interventions:
inhibition. enzyme.
- Be aware that patient may be
 Food: None  Metabolic: at increased risk for CV events,
hyperglycemia GI bleed, and renal
 This medication may increase insufficiency; monitor
the risk of bleeding when  Skin: toxic epidermal accordingly.
taken with other drugs that necrolysis, erythema - Administer drug with food or
also may cause bleeding. multiforme, StevensJ after meals if GI upset occurs.
ohnson syndrome - Arrange for periodic
ophthalmologic examination
 Other: allergic reaction, during long-term therapy.
drug fever, - Ensure right name, right drug,
superinfection, right dose, and right time, right
anaphylaxis route and right documentation
during administration
 Pain and tissue damage
at Inj site (IM); local
irritation (rectal);
transient burning and
stinging (ophthalmic).
8) DOCUSATE SODIUM - A laxative and an - Indicated for the - Contraindicated to patient  Drug: May drugs containing  Body as a whole: Assessment:
anionic detergent that treatment of constipation with allergy or phenolphthalein. Rash, itching/swelling
supposedly promotes associated with dry, hard hypersensitivity to the (especially of the - History of known allergy to the
Dosage Form: Tablet incorporation of water stools or opioid induced drug.  Disease: appendicitis or face/tongue/throat), drug, and contraindicated
and fats into stool constipation .
acute abdominal pain, fecal severe dizziness, diseases.
through a reduction in Caution use: impaction trouble breathing.
Route: Oral surface tension, Interventions and Teaching
resulting in softer fecal - History of  Food: Mineral oil. points:
Required Dosage and mass severe abdominal
Timing: pain, nausea, vomiting, - Advise the patient not to
sudden change in bowel exceed recommended dose.
100mg q8h BID for 30 days. habits over the previous 2
PRN if constipation. weeks. - Monitor and advise patient to
- Nausea or vomiting use report any severe adverse
for longer than 7 days effects.
when self-medicating
- Advised the patient to
discontinue drug if any
hypersensivity occurs.

9) ENOXAPARIN - Enoxaparin increases - A prescription medicine - Contraindicated to patient  Drug: Common Drug  CNS: Headache, fever, Assessment / Drug
Thrombin Time (TT) used to prevent and treat with allergy or interactions includes: confusion. Effects/Health Teachings
Dosage Form: Injection and activated partial symptoms of blood clot hypersensitivity to the Nonsteroidal anti-
thromboplastin time (Deep Vein Thrombosis drug. inflammatory drugs  CV: Edema, pheriperal - Assess history of known
Route: Subcutaneous (aPTT), preventing and or DVT) and chest pain (NSAIDs), such as aspirin, edema allergies and contraindication
reducing (angina). - Active major bleeding ibuprofen, or naproxen. of the drug to the patient.
thromboembolic Thrombocytopenia with a These drugs can decrease  GI: Nausea, diarrhea.
Required Dosage and complications such as - It may be used alone or positive in vitro test for - Monitor patients for signs and
platelets. If you taken with
Timing: DVT, pulmonary with other medication anti-platelet antibody in enoxaparin, this puts the symptoms of neurological
 GU: hematuria, renal,
embolism, and the presence of patient at higher risk for oral candidiasis impairment during treatment
40mg daily at 6pm once a ischemic cardiac enoxaparin sodium bleeding. Platelet inhibitors, dysfunction, acute renal or immediately following
day for 9 days complications. such as clopidogrel, failure diagnostic lumbar puncture,
- Hypersensitivity to prasugrel, ticagrelor, or spinal or epidural anesthesia.
heparin or pork products. dipyridamole.  Hematologic:
Thrombocytopenia, - Periodic monitoring of CBC e.g.
 Disease: Hemophilia, liver trombocytosis, platelet counts, stool occult
disease, peptic ulcer disease, hemorrhage, blood tests. Monitor vascular
retinopathy, subacute ecchymosis, bleeding access sites for signs of
bacterial endocarditis, active complications and bleeding or haematoma during
bleeding, hypertension, renal hypochromic anemia. treatment.
dysfunction,
thrombocytopenia, - Advise patient to immediately
prematurity hypertension  Skin: Irritation, pain, report any unusual bleeding
kidney disease. hematoma, erythema at tendency or bruising; black
injection site, rash, tarry stool or pinpoint red spot
 Food: None urticuria, on her skin.

 Other: Angioedema, - Teach patient how to recognize

anaphylaxis signs and symptoms of severe
adverse effects and instruct
him to report these right away.
 - Ensure right name, right drug,
right dose, and right time, right
route and right documentation
during administration.

10) FENTANYL CITRATE - Produces strong - Intravenous or - Contraindicated to patient  Drug: Common Drug  Common side effects: Assessment / Drug
analgesia through its intramuscular injections with allergy or interactions include certain Nausea, vomiting, Effects/Interventions
activation of opioid are indicated for short hypersensitivity of the pain medications (mixed constipation,
Dosage Form: Injection receptors. It has a term analgesia during drug or other opoid opioid agonist-antagonists lightheadedness, - Assess history of known
duration of action of induction, maintenance, agonist. such as butorphanol, dizziness, drowsiness, allergies and contraindication
several hours and a and recovery from nalbuphine, pentazocine), or headache of the drug to the patient.
Route: Epidural wider therapeutic general or regional  Should be administered naltrexone, samidorphan. - Baby is managed by a Nurse
index as patients anesthesia. only by persons  Most common serious with neonatal IV drug
Required Dosage and develop tolerance to specifically trained in the  Disease: Impaired GI adverse reactions certification.
Timing: opioids. use of intravenous motility, infectious diarrhea, reported to occur with - Evaluate baby's need for and
anesthetics and liver disease, prematurity, fentanyl are respiratory response to medication.
50mcg/ml continous @ - Binds to opioid management of the acute alcohol intoxication, depression, apnea, - Assess IV site closely for signs
10ml/hy infusion rate of the receptors, especially respiratory effects of drug dependence, rigidity, and of extravasation.
bundle is 5-15ml/hr for 4 the mu opioid potent opioids. gastrointestinal obstruction, bradycardia; if these - Assess for signs of adverse
days receptors, which are hypotension, intracranial remain untreated, reactions.
coupled to G- pressure, respiratory, respiratory arrest, - Continuous cardio respiratory
proteins. Activation of depression, fever, adrenal circulatory depression and blood pressure
opioid receptors insufficiency, biliary spasm, or cardiac arrest could monitoring.
causes GTP to be hypothyroidism, renal occur. - Monitor oxygen saturations.
exchanged for GDP on dysfunction, seizure - Ensure right name, right drug,
the G-proteins which in disorders, urinary retention, right dose, and right time, right
turn down regulates arrhythmias. route and right documentation
adenylate cyclase, during administration.
reducing  Food: None
concentrations of -
CAMP.
11) FERROUS - Elevates the serum - Prevention and treatment - Contraindicated with  Drug: Common Drug  BODY AS A WHOLE: Assessment:
SULPHATE concentration, and is of iron deficiency allergy to any ingredient; interactions includes: Dizziness, nausea &
then converted to Hgb anemias. sulphate allergy; antibiotics , vomiting , nasal - History of known allergy to any
Dosage Form: Tablet or trapped in the hemochromatosis, bisphosphonates, levodopa, congestion, dyspnea, infredient, sulphite -skin
reticuloendot helial - Dietary supplement for hemosiderosis , methyldopa, thyroid hypotension, muscle lesions, color; gums teeth
cells for storage and iron haemolytic anemias. replacement drugs. cramps, flushing, (color); bowel sounds; CBC,
Route: Oral
eventual conversion to staining of teeth, black HGB, Hct, serum ferritin and
a usable form of iron  Disease: Hemophilia, liver stools iron levels
Required Dosage and disease, peptic ulcer disease,
Timing: retinopathy, subacute Interventions and Teaching
bacterial endocarditis, active points:
1 tab daily right away after bleeding, hypertension, renal
breakfast once a day for 28 dysfunction, - Advise the patient not to
days thrombocytopenia, exceed recommended dose.
prematurity hypertension
kidney disease. - Inform patient that defecating
black stools is normal
 Food: None
- Monitor and advise patient to
report any severe adverse
effects.
 - Advised the patient to
discontinue drug if any
hypersensivity occurs.

12) LIDOCAINE 5% - Blocks the generation - Infiltration anesthesia, - Contraindicated with  Drug: Severe interactions of  CNS: headache, Assessment / Drug
OINTMENT and conduction of peripheral and allergy to lidocaine or lidocaine include: backache, septic Effects/Health Teachings
action potentials in sympathetic nerve blocks, amide-type local Bupivacaine liposome, meningitis, persistent
Dosage Form: Ointment central nerve blocks, anesthetics, CHF dofetilide, eliglustat, - Assess history of known
sensory nerves by sensory
spinal and caudal cardiogenic shock, 2nd or flibanserin, lomitapide. allergies and contraindication
reducing sodium anesthesia 3rd degree AV blocks of the drug to the patient.
Route: Topical permeability, reducing  CV: hypotension
Serious interactions include:
height and rate of rise Axitinib, bosutinib, - Check drug concentrations
Required Dosage and of the action potential, cobimetinib, eliglustat,  Dermatologic: carefully
Timing: increasing excitation fentanyl, fentanyl intranasal, urticaria, pruritus, - Establish safety precautions if
threshold, and slowing fentanyl iontophoretic, erythema, edema CNS changes occur
Apply once a day for 30 days conduction transdermal system,
PRN if in pain. velocity fentanyl, transdermal,  GU: urinary retention, - Teach client to report difficulty
fentanyl, transmucosal, speaking, thick tongue,
urinary or fecal
fluvoxamine, fosamprenavir, numbness, tingling, difficulty
ivabradine, ivacaftor, incontinence breathing, pain or numbness at
mefloquine, naloxegol, site, swelling or pain at site.
olaparib, pefloxacin,
phenytoin, pimozide,
pomalidomide.

 Disease:

Cardiovascular dysfunction
Proarrhythmic effects
Hepatic dysfunction
Renal dysfunction
Seizures
Sinus/AV node dysfunction
Electrolyte imbalance

 Food: None
13) MEPERIDINE - Primarily a kappa- - Used to control moderate - Contraindicated  Drug: May interact with this  Common side effects: Assessment / Drug
opiate receptor agonist to severe pain. in patients that are drug include: certain pain Nausea, vomiting, Effects/Interventions
Dosage Form: Injection and also has local actively receiving or have medications (mixed opioid constipation, sweating,
been exposed during the agonist-antagonists such as - Assess history of known
anesthetic effects. lightheadedness,
Route: Intramuscular past 14 days to butorphanol, nalbuphine, allergies and contraindication
- A synthetic opiate monoamine oxidase dizziness, or of the drug to the patient.
pentazocine), naltrexone,
agonist belonging to inhibitors (MAOI) because samidorphan. Taking MAO drowsiness may occur.
Required Dosage and the phenylpiperidine of unpredictable severe inhibitors with this - Ensure right name, right drug,
Timing: class. Meperidine may and occasionally fatal medication may cause a right dose, and right time, right
produce less smooth reactions such as coma, serious (possibly fatal) drug route and right documentation
100mg IM (q4h) for 2 days: muscle spasm, severe respiratory interaction during administration.
PRN if in pain. constipation, and depression, hypotension,
depression of the cyanosis, and acute  Disease: Acute asthma or - May cause alterations in
narcotic overdose. other obstructive airway mentation, hypotension,
cough reflex than
disease, acute respiratory constipation, nausea, vomiting
equivalent doses of - Assess vital signs prior to
depression, abnormal heart
morphine. The onset of rhythms, blockage of the administration and frequently
action is lightly more gastrointestinal tract, during administration
rapid than with particularly paralytic ileus,
morphine, and the seizure, head injury, brain - Use caution if patient is
duration of action is tumour, or increased receiving MAOIs
slightly shorter. pressure inside the head or
spinal cord, taken an MAO - Ensure availability of Narcan
inhibitor within the past 14 (naloxone) as the antidote for
days, severe depression, opioid agonists.
suspected abdominal
conditions which may - Can cause seizure
require surgery.
- May increase pancreatic
 Food: Alcohol enzyme levels

- Assess bowel function

14) METHYLERGOMETR - Acts directly on the - Use for management after - Contraindicated to patient - Drug: May interact with GI: Nausea, vomiting Assessment & Drug Effects
INE MALEATE smooth muscle of the delivery of placenta and hypersensitive to ergot conivaptan, epinephrine, (especially with IV doses).
uterus and increases for postpartum atony, preparations. imatinib, isoniazid, - Assess history of known
the tone, rate, and subinvolution, and nefazodone, zileuton, CV: Severe hypertensive allergies and contraindication
Dosage Form: Injection amplitude of rhythmic hemorrhage. With full - Use with caution to induce antibiotics, antidepressants, episodes, bradycardia. of the drug to the patient.
contractions through obstetric supervision, labor; use prior to antifungals, cold - Monitor vital signs
binding and the may be used during delivery of placenta; or allergy medicines that Body as a Whole: Allergic (particularly BP) and uterine
Route: Intramuscular resultant antagonism second stage of labor. threatened spontaneous contain decongestants, heart phenomena including response during and after
of the dopamine D1 abortion; prolonged use; or blood pressure shock, ergotism. parenteral administration of
Required Dosage and receptor. uterine sepsis; medications, hepatitis methylergonovine until
Timing: hypertension; toxemia; C medications, HIV/AIDS me partum period is stabilized
- Thus, it induces a rapid lactation dications, migraine (about 1–2 h).
0.2mg as directed by MD for and sustained tetanic headache medicines, - Notify physician if BP
one time after delivery of uterotonic effect which - Use in postpartum women nitrates, or other ergot suddenly increases or if there
the placenta. shortens the third with preeclampsia should medicines. are frequent periods of uterine
stage of labor and only be considered if the relaxation.
reduces blood loss. benefits outweigh the  Disease: Cardiovascular - Administer by IM injection or
risks. dysfunction, hypertension, orally unless emergency
liver and renal disease. requires IV use. Complications
are more frequent with IV use.
  Food: None - Ensure right name, right drug,
right dose, and right time, right
route and right documentation
during administration

Patient & Family Education

- Report severe cramping for

increased bleeding.
- Report any of the following:
Cold or numb fingers or toes,
nausea or vomiting, chest or
muscle pain.
- Ensure right name, right drug,
right dose, and right time, right
route and right documentation
during administration

15) METOCLOPROMIDE - Antiemetic effects by - Used for symptomatic - Contraindicated to  Drug: May interact with this  Common side effects: Assessment / Drug
inhibiting dopamine treatment of both acute patient with allergy or drug include: certain pain Headache, confusion, Effects/Health Teachings
Dosage Form: Injection D2 and serotonin 5- and recurrent diabetic hypersensitivity of the medications (mixed opioid trouble sleeping,
HT3 receptors in the gastroparesis, in addition agonist-antagonists such as dizziness, restlessness, - Assess history of known
drug.
chemoreceptor trigger to the treatment of butorphanol, nalbuphine, sleepiness, exhaustion allergies and contraindication
Route: Intramuscular - Patient with history of
zone (CTZ) located in gastroesophageal reflux pentazocine), naltrexone, of the drug to the patient.
the area postrema of disease (GERD) in gastrointestinal bleeding, samidorphan. Taking MAO  Serious side effects:
Required Dosage and the brain. patients who have failed obstruction and inhibitors with this - Monitor vital signs, compare
Timing: - Increases gastric to respond to traditional perforation. medication may cause a - Depression and suicide with patient’s normal or
emptying by therapy. Pheochromocytoma, serious (possibly fatal) drug - Neuroleptic malignant previous readings.
10mg IM q4hrs for 2 days: decreasing lower interaction syndrome (nervous
seizures, depression,
PRN if nausea and vomiting esophageal sphincter system disorder). - Ensure right name, right drug,
parkinson disease, history
(LES) pressure. It also  Disease: Acute asthma or right dose, and right time, right
of tardive dyskinesia. Symptoms can include:
exerts effects on the other obstructive airway route and right documentation
area postrema of the disease, acute respiratory High fever, stiff muscles, during administration
brain, preventing and depression, abnormal heart confusion, fast or
relieving the symptoms rhythms, blockage of the irregular heart rate, - Do not use with GI obstruction
of nausea and gastrointestinal tract, increased sweating
vomiting. In addition, particularly paralytic ileus, - Monitor severe adverse effects
this drug increases seizure, head injury, brain - Tardive dyskinesia, a such as arrhythmias, blood
gastrointestinal tumour, or increased movement disorder that pressure alterations,
motility without pressure inside the head or can be permanent. hematologic alterations, facial
increasing biliary, spinal cord, taken an MAO movements, sedation.
Symptoms can include
gastric, or pancreatic inhibitor within the past 14
secretions repeated, - Monitor liver function tests
days, severe depression,
suspected abdominal uncontrollable
conditions which may movements such as:
require surgery. movement in the face,
such as blinking,
 Food: Alcohol grimacing, or sticking
out your tongue, slow or
fast, jerky movements of
the arms and legs
  Parkinsonism
(symptoms similar to
those caused by
Parkinson’s disease).
Symptoms can include:
shaking, body stiffness,
slow movement, trouble
keeping your balance,
blank stare with an
open mouth

 Allergic reaction.
Symptoms can include:
rash, hives, trouble
breathing, swelling of
your tongue, lips, or
throat

 Hyperprolactinemia
(increased levels of the
hormone prolactin).
Symptoms can include:
menstrual problems or
vaginal dryness in
women. erectile
dysfunction, decreased
body hair and muscle
mass, and increased
breast size in men

 Hallucinations

16) MISOPROSTOL - A synthetic - Misoprostol is indicated  Contraindicated to patient  Drug: May interact with  Body as a whole: Assessment / Drug
prostaglandin E1 as a tablet to reduce the with allergy or aluminum Aches/pains, asthenia, Effects/Health Teachings
Dosage Form: Suppository analog that stimulates risk of NSAID induced hypersensitivity to the hydroxide/magnesium fatigue, fever, chills,
prostaglandin E1 gastric ulcers but not drug. carbonate, aluminum rigors, weight changes - Assess history of known
receptors on parietal duodenal ulcers in high hydroxide/ magnesium allergies and contraindication
Route: Rectal
cells in the stomach to risk patients.  Confirmed or suspected trisilicate, citric acid/  Skin: Rash, dermatitis, of the drug to the patient.
reduce gastric acid ectopic pregnancy glucono-delta- alopecia, pallor, breast
Required Dosage and secretion.3 Mucus and Also formulated in lactone/magnesium - Monitor vital signs, compare
-
pain
Timing: bicarbonate secretion combination with  Presence of IUD carbonate, magnesium with patient’s normal or
are also increased diclofenac to treat gluconate and oxytocin.  Special senses: previous readings.
1000mcg once a day for 1 along with thickening symptoms of  Women with uterine Abnormal taste,
day of the mucosal bilayer osteoarthritis or infections, severe anemia,  Disease: Cardiavascular abnormal vision, - Take blood pressure when
so the mucosa can rheumatoid arthritis in cardiovascular and Disease conjunctivitis, deafness, possible.
generate new cells. patients with a high risk cerebrovascular diseases, tinnitus, earache.
- Misoprostol binds to of developing gastric coagulopathy, and  Food: None - Note patient’s individual
smooth muscle cells in ulcers. hypertension  Respiratory: Upper physiological response to
the uterine lining to respiratory tract bleeding such as changes in
 increase the strength - Used off label for the infection, bronchitis, menstruation, weakness,
and frequency of management of Misoprostol increases effects bronchospasm , restlessness, and pallor.
contractions as well as miscarriages, prevention of oxytocin by dyspnea , pneumonia,
degrade collagen and of post partum pharmacodynamic epistaxis . - Monitor intake and output
reduce cervical tone. hemorrhage, and is also synergism. Avoid or Use (I&O), and correlate with
used alone or in Alternate Drug. Misoprostol  CV: Chest pain, edema, weight changes.
combination with may augment the effects diaphoresis,
mifepristone in other oxytocic agents, especially hypotension, - Maintain bed rest. Schedule
countries for first when given less than 4 hours hypertension, activities to provide
trimester abortions. before initiating oxytocin. arrhythmia, phlebitis, undisturbed rest periods.
increased cardiac
enzymes, syncope, - Increase oral fluid intake to
myocardial infarction prevent occurrence UTI.
(some fatal),
thromboembolic events. - Administer with food to
prevent GI upset. – Advise
 Gastrointestinal: against doing activities
diarrhea and abdominal requiring mental alertness.
pain, nausea, flatulence,
dyspepsia, vomiting and
constipation, GI

17) MULTIVITAMINS - A combination of many - An essential nutrient,  Contraindicated to patient  Drug: Antacids, calcium  Common side effects: Assessment / Drug
different vitamins that prescribed for patients with allergy or supplement. Headache upset GI, Effects/Health Teachings
Dosage Form: Tablet are normally found in with vitamin hypersensitivity to the slight nausea and
foods and other natural deficiency. Normally drug or contents.  Disease: Cardiovascular unpleasant taste. - Assess history of known
Route: Oral sources. provided in combination Disease, volume overload. allergies and contraindication
- Used to with dietary minerals. of the drug to the patient.
provide vitamins that  Food: Milk or dairy
Required Dosage and are not taken in - Advised patient to void taking
products
Timing: through the diet. similar vitamin supplements
together to avoid vitamin
1 tablet q24hrs for 28 days overdose which may result in
serious life-threatening side
effects.

- Advised patient not to take the

drug together with milk or
dairy products for better
absorption of the drug. Take 1-
2 hours before meal or in
between meals.

- Advised the patient to

discontinue drug if any
hypersensivity occurs.
18) OXYTOCIN - Synthetic form of an - Antepartum: To initiate - Contraindicated in  Drug: May interact with  CV: Cardiac Assessment / Drug
endogenous hormone or improve uterine patients hypersensitive to mefloquine. arrhythmias, PVCs, Effects/Health Teachings
Dosage Form: Injection produced in the contractions to achieve the drug or any of its hypertension,
early vaginal delivery; component.  Disease: Cardiovascular subarachnoid - Assess history of known
hypothalamus
Route: Intravenous, IM stimulation or Disease, volume overload. hemorrhage. allergies and contraindication
and stored in the reinforcement of labor in - Contraindicated in of the drug to the patient.
posterior pituitary; selected cases of uterine cephalopelvic  Fetal effects: Fetal
 Food: None
stimulates the uterus, inertia; management of disproportion or delivery bradycardia, neonatal - Monitor and record uterine
especially the inevitable or incomplete that requires conversion, jaundice, low Apgar contractions, heart rate, BP,
gravid uterus just abortion; 2nd trimester as in tranverse lie; in fetal scores intrauterine pressure, fetal
before parturition, and abortion. distress when delivery heart rate, and blood loss q15.
causes myoepithelium isn’t imminent; in  GI: nauseas, vomiting
Required Dosage and of the lacteal - Postpartum: To produce prematurity and in severe - Be alert for adverse reaction.
Timing: uterine contractions toxemia, hypertonic  GU: Postpartum
glands to contract,
during the third stage of uterine patterns, total hemorrhage, uterine - Monitor I/O.
which results in milk labor to control placenta previa or vasa
40units IV continuous @ rupture, pelvic
ejection in lactating postpartum bleeding or previa. - Antidiuretic effect may lead to
125ml/hr. incorporated hematoma, uterine
women. hemorrhage. Lactation hypertonicity, spasm fluid overload, seizures, and
with Lactated Ringers
deficiency. - Contraindicated in fetal coma.
1000ml for 1 day. distress.
- Never give oxytocin
10 units IM for 1 time after simultaneously by more than
delivery of the anterior one route.
shoulder of the baby
- If contractions are less than 2
minutes apart, if they’re above
50mm Hg ,or if they last 90
seconds or longer, stop
infusion, and turn patient on
her side, and notify physician.

- Ensure right name, right drug,

right dose, and right time, right
route and right documentation
during administration

References:
https://www.drugs.com/drug-interactions
https://reference.medscape.com
https://go.drugbank.com
https://www.rxlist.com