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Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES


University town, Catarman, N. Samar
COLLEGE OF NURSING
DRUG ANALYSIS
Name of Patient:
Patient Abcd
270788
Age: 49y/o Gender:
F
Civil Status:
MS/W AP:
Dr.Nochete
NAME OF
DRUG

SPECIFIC
ACTION(S)

INDICATION(
S)

Date Admitted:
M
CONTRAINDICATION(S
)

11/20/2015
Address:
DRUG
INTERACTION(
S)

Chief Complaint:

Bleeding, Profuse

Biri, Northern Samar

ADVERSE
REACTION(S)

SPECIFIC
PRECAUTION(S)

Case Number:
Ward:

NURSING
RESPONSIBILITI
ES

Generic
Name:
TRANEXAMIC
ACID

Brand
Name:

Hemostan

Dosage:
500mg

Route:
PO

Frequency:
q 8

Classificatio
n:

Anti-fibrinolytic,
antihemorrhagi
c

Tranexamic
acid is a
synthetic
derivative of
the amino
acid lysine. It
exerts its
antifibrinolyti
c effect
through the
reversible
blockade of
lysine-binding
sites on
plasminogen
molecules.
Antifibrinolytic
drug inhibits
endometrial
plasminogen
activator and
thus prevents
fibrinolysis
and the
breakdown of
blood clots.
The
plasminogenplasmin
enzyme
system is
known to
cause
coagulation

For
bleeding

Allergic
reaction to
the drug or
hypersensiti
vity.
Presence of
blood clots
(eg, in the
leg, lung,
eye, brain),
have a
history of
blood clots,
or are at risk
for blood
clots.
Current
administrati
on of factor
IX complex
concentrates
or antiinhibitor
coagulant
concentrates

Anti-inhibitor
coagulant
complex or
Factor IX
complex:
Concurrent
use may
increase the
risk of
thrombotic
complications
.
Contraceptive
s, estrogencontaining,
oral or
Estrogens:
Concurrent
use with
tranexamic
acid may
increase the
potential for
thrombus
formation.

CNS:
Confusion,
Severe or
persistent
headache,
Slurred
speech,
vision
changes.
Respiratory:
Chest pain,
Coughing up
blood,
Shortness of
breath.
Integumenta
ry: Severe
allergic
reactions
such as
rash, hives,
itching,
dyspnea,
tightness in
the chest,
swelling of
the mouth,
face, lips or
tongue
GU:
Decreased
urination
MS: Severe

Use cautiously in
patients who are using
birth pills and other
types of birth control
should n Anti-inhibitor
coagulant complex or
Factor IX complex:
ot use this medication.
This medicine may
cause serious allergic
reaction including
anaphylaxis.

Observe five
Rs in drug
administration
Be alert for the
unusual change
in bleeding
pattern should
be immediately
reported to the
physician.
For women who
are taking
tranexamic acid
to control
heavy bleeding,
the medication
should only be
taken during
the menstrual
period.
The medication
can be taken
with or without
meals.
Swallow
Tranexamic
Acid whole with
plenty of
liquids. Do not
break, crush, or
chew before
swallowing.
Inform the
client that

defects
through lytic
activity on
fibrinogen,
fibrin and
other clotting
factors. By
inhibiting the
action of
plasmin
(finronolysin).
the antifibrinolytic
agents
reduce
excessive
breakdown of
fibrin and
effect
physiological
hemostasis.

STUDENT NURSE:

or persistent
body
malaise.

Others: Calf
pain,
swelling or
tenderness.

CLINICAL INSTRUCTOR:

he/she should
inform the
physician
immediately if
the following
severe side
effects occur:
Tightness of
chest
Swelling of
mouth, lips, or
tongue.
Calf pain
Vision changes
Shortness of
breath.

Republic of the Philippines


UNIVERSITY OF EASTERN PHILIPPINES
University town, Catarman, N. Samar
COLLEGE OF NURSING
DRUG ANALYSIS
Name of Patient: Patient Abc
270788
Age: 49y/o
Gender:
F
AP: Dr.Nochete
NAME OF
DRUG

SPECIFIC
ACTION(S)

Date Admitted:
Civil Status:

INDICATION(S
)

11/20/2015
M

CONTRAINDICATION(S)

Address:

Chief Complaint:

Bleeding, Profuse

Biri Northern Samar

DRUG
INTERACTION(S)

ADVERSE
REACTION(S)

Case Number:

Ward:

MS/W

SPECIFIC
PRECAUTION(
S)

NURSING
RESPONSIBILITIE
S

Generic
Name:
Mefenamic
Acid
Brand Name:
Ponstel
Dosage:
500g
Route:
PO
Frequency:
TID

Anthranilic

acid
derivative.
Like ibuprofen
inhibits
prostaglandin
synthesis and
affects
platelet
function. No
evidence that
it is superior
to aspirin.

Pain

Contraindicate
d to patient
hypersensitive
to drug.

Contraindicated
to patients
with
inflammatory
intestinal
diseases.

Contraindicated
to patient with
renal failure.

Classification
:
NSAID
( Non-steroidal
antiInflammatory
Drug)

Ace inhibitors: may


diminish the
antihypertensive
effect of ACE
inhibitors. This
interaction should be
given consideration in
patients taking
NSAIDs concomitantly
with ACE-inhibitors.
Aspirin: When
PONSTEL (mefenamic
acid) is administered
with aspirin, its
protein binding is
reduced, although the
clearance of free
PONSTEL (mefenamic
acid) is not altered.
The clinical
significance of this
interaction is not
known; however, as
with other NSAIDs,
concomitant
administration of
MEFENAMIC ACID and
aspirin is not
generally
recommended
because of the
potential of increased
adverse effects.
Diuretics: Clinical
studies, as well as
post marketing
observations, have
shown that PONSTEL
(mefenamic acid) can
reduce the natriuretic

CNS:
Drowsiness,
insomnia,
dizziness,
nervousness,
confusion,
headache.
GI: Severe
diarrhea,
ulceration, and
bleeding;
nausea,
vomiting,
abdominal
cramps, flatus,
constipation,
hepatic toxicity.
Hematologic:
Prolonged
prothrombin
time,
severe autoimm
une hemolytic
anemia (longterm use),
leukopenia,
eosinophilia,
agranulocytosis,
thrombocytopeni
c purpura,
megaloblastic
anemia,
pancytopenia,
bone marrow

Use
cautiously in
patients with
asthma or
frequent
runny or
stuffed nose.

Observe five
Rs in drug
administration.
Assess patients
who develop
severe diarrhea
and vomiting
for dehydration
and electrolyte
imbalance.
Lab tests: With
long-term
therapy (not
recommended)
obtain periodic
complete blood
counts, Hct and
Hgb, and
kidney function
tests.
Discontinue
drug promptly
if diarrhea,
dark stools,
hematemesis,
ecchymoses,
epistaxis, or
rash occur and
do not use
again. Contact
physician.
Notify
physician if
persistent GI

effect-of furosemide
and thiazides in some
patients. This
response has been
attributed to inhibition
of
renal prostaglandin sy
nthesis. During
concomitant therapy
of NSAIDs, the patient
should be observed
closely for signs of
renal failure.
Lithium: NSAIDs
have produced an
elevation of plasma
lithium levels and a
reduction in renal
lithium clearance. The
mean minimum
lithium concentration
increased 15% and
the renal clearance
decreased by
approximately 20%.
These effects have
been attributed to
inhibition of renal
prostaglandin
synthesis by
the NSAID. Thus,
when NSAIDs and
lithium are
administered
concurrently, subjects
should be observed
carefully for signs of
lithium toxicity.
Methotrexate:
NSAIDs have been
reported to

hypoplasia.
Urogenital:
Nephrotoxicity,
dysuria,
albuminuria,
hematuria,
elevation of
BUN.
Skin: Urticaria,
rash, facial
edema.
Spec Senses:
Eye irritation,
loss of color
vision
(reversible),
blurred vision,
ear pain.
Body Whole:
Perspiration.
CV: Palpitation.
Respiratory:
Dyspnea; acute
exacerbation of
asthma.

discomfort,
sore throat,
fever, or
malaise occur.
Do not drive or
engage in
potentially
hazardous
activities until
response to
drug is known.
It may cause
dizziness and
drowsiness.

competitively inhibit
methotrexate
accumulation in
rabbit kidney slices.
This may indicate that
they could enhance
the toxicity of
methotrexate. Caution
should be used when
NSAIDs are
administered
concomitantly with
methotrexate.
Warfarin: The effects
of warfarin and
NSAIDs on GI bleeding
are synergistic, such
that users of both
drugs together have a
risk of serious GI
bleeding higher than
users of either drug
alone.
Antacids: In a single
dose study (n=6),
ingestion of an
antacid containing
1.7-gram of
magnesium hydroxide
with 500-mg of
mefenamic acid
increased the Cmax
and AUC of
mefenamic acid by
125% and 36%,
respectively.1
Drug/Laboratory
Test Interactions:
Ponstel (mefenamic
acid) may
prolong prothrombin

STUDENT NURSE:

time. Therefore, when


the drug is
administered to
patients receiving
oral anticoagulant dru
gs, frequent
monitoring of
prothrombin time is
necessary.
A false-positive
reaction for urinary
bile, using the diazo
tablet test, may result
after mefenamic acid
administration. If
biliuria is suspected,
other diagnostic
procedures, such as
the Harrison spot test,
should be performed.

CLINICAL INSTRUCTOR:

Republic of the Philippines


UNIVERSITY OF EASTERN PHILIPPINES
University town, Catarman, N. Samar
COLLEGE OF NURSING
DRUG ANALYSIS
Name of Patient: Patient Abc
Date Admitted:
Age: 49y/o Gender:
F
Civil Status:
M
MS/W
AP:Dr.Nochete
NAME OF
DRUG

Generic
Name:
Cefazolin
sodium
Brand
Name:
Ancep
Dosage:
1g
Route:
TIV
Frequency:
q8

Classificati
on:

SPECIFIC ACTION(S)
Cefazolin

Inhibits cell-wall
synthesis

Promoting osmotic
instability

Hinders/kills susceptible
bacteria

11/20/2015
Address:

DRUG
INTERACTION(
S)

CONTRAINDICATION(S)

INDICATION(S)
Pire operative
prevention in
contaminated
surgery.

Chief Complaint: Bleeding, Profuse


Biri Northern Samar

Contraindicated
to patient
hypersensitive
to drug.

Contraindicated to
patients with
inflammatory
intestinal
diseases.
Contraindicated to
patient with
renal failure.

ADVERSE
REACTION(S)

Ace
inhibitors:
may diminish
the
antihypertens
ive effect of
ACE
inhibitors.
Probenecid:
decreases
renal
elimination of
cefazolin

CNS: dizziness,
headache,
malaise
GI: nausea,
vomiting,
diarrhea,
glossitis,
dyspepsia

Respiratory:
Dyspnea
Skin:

Erythematous
D
rashes

Case Number:
Ward:

SPECIFIC
PRECAUTION
(S)

Use
cautiously
in patients
with
asthma or
frequent
runny or
stuffed
nose.

270788

NURSING
RESPONSIBILIT
IES

Observe five Rs
in drug

administration
Ask patient
about previous
reaction to
cephalosporin
or penicillin
before starting

the therapy
If GI reaction
occurs, monitor

hydration.
Lab tests:
Perform culture
and sensitivity
testing prior to
and during

NSAID
(Nonsteroidal
antiinflammatory
drug)

therapy.Therap
y may be
initiated

pending results.
Monitor I&O
rates and
pattern: Be
alert to
changes in
BUN, serum

creatinine.
Prompt
attention
should be given
to onset of
signs of
hypersensitivity

.
Promptly report
the onset of
diarrhea.
Pseudomembra
nous colitis, a
potentially lifethreatening
condition, starts

with diarrhea.
Report
promptly any
signs or
symptoms of
superinfection
such as easy
bruising and

nosebleeds.

STUDENT NURSE:

CLINICAL INSTRUCTOR:
Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES
University town, Catarman, N. Samar
COLLEGE OF NURSING
DRUG ANALYSIS

Name of Patient: Patient Abc


Date Admitted:
270788
Age: 49y/o Gender:
F
Civil Status:
M
AP: Dr.Nochete
NAME OF
DRUG

SPECIFIC ACTION(S)

INDICATION(S)

11/20/2015

Chief Complaint:

Address:

Biri, Northern Samar

CONTRAINDICATION(S)

DRUG
INTERACTION
(S)

Bleeding, Profuse

ADVERSE
REACTION(S)

Case Number:

Ward:

MS/W

SPECIFIC
PRECAUTION
(S)

NURSING
RESPONSIBILIT
IES

Generic
Name:
Ferrous
Sulfate
Brand
Name:
Sorbifer
Dosage:
1 tab
Route:
PO
Frequency:
BID
Classificati
on:
Antianemic

Ferrous Sulfate is an
essential component
in the formation of
hemoglobin,
myoglobin and
enzymes. It is
necessary for effective
erythropoiesis and
transport or utilization
of oxygen.

The prevention Patients


Drug:

or treatment of
ANTACIDS
receiving
iron deficiency
decrease iron
repeated blood
anemia due to
absorption;
transfusions;
inadequate
iron
anemia not
diet,
decreases
malabsorption
absorption of
due to iron
pregnancy, and
TETRACYCLIN
deficiency.
blood loss.
ES,
ciprofloxacin,
ofloxacin;
chloramphen
icol may
delay iron's
effects; iron
may
decrease
absorption of
penicillamine
.
Food: Food
decreases
absorption of
iron; ascorbic
acid (vitamin
C) may
increase iron
absorption.

GI:
Constipation,
gastric
irritation, N&V,
abdominal
cramps,
anorexia,
diarrhea, and
dark-colored
stools. These
effects may be
minimized by
administering
preparations
as a coated
tablet.
Soluble iron
preparations
may stain the
teeth.

Use
cautiously
in patients
with a
history of
hypersensi
tivity to
drug.
In
pregnant
and
lactating
women.

Observe 5rs
in drug
administration
.
Store all forms
at room
temperature.
Give between
meals with
water but may
give with
meals if
gastrointestin
al discomfort
occurs.
Transient
staining of
mucous
membranes
and teeth will
occur with
liquid iron
preparation.
To avoid,
place liquid on
the back of
the tongue
with dropper
or use straw.
Avoid
simultaneous
administration
of antacids or

tetracycline.

Do not
crush
sustainedrelease
preparations.

Eggs and
milk inhibit
absorption.

Monitor
serum iron,
total ironbinding
capacity,
reticulocyte
count,
hemoglobin,
and ferritin.

Monitor
daily pattern
of bowel
activity and
stool
consistency.

Assess for
clinical
improvement,
record of relief
of symptoms
(fatigue,

irritability,
pallor,
paresthesia,
and
headache).

STUDENT NURSE:

CLINICAL INSTRUCTOR:

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