Drug Study

Name of Drug [Generic Name]: BICALUTAMIDE

Brand Name: Apo-Bicalutamide, Casodex, Dom Bicalutamide, Gen-

Bicalutamide, Novo-Bicalutamide, PHLBicalutamide, PMS-
Bicalutamide, Ratio-Bicalutamide, Sandoz Bicalutamide

Chemical Classification: Nonsteroidal antiandrogen

Therapeutic Classification: Antineoplastic

Indication [specific problem of the patient managed by the drug]:

To treat prostate cancer

Dosage: 50 mg P.O. daily

Drug action: Antagonizes effects of androgen at cellular level by

binding to androgen receptors on target tissues

Adverse reactions
CNS: headache, weakness, dizziness, depression, hypertonia,
paresthesia, lethargy
CV: chest pain, peripheral edema, vasodilation, hypertension,
thromboembolic disease
EENT: pharyngitis, bronchitis
GI: nausea, vomiting, diarrhea, constipation, abdominal pain,
anorexia, dry mouth
GU: urinary tract infection, impotence
Musculoskeletal: bone and back pain
Respiratory: dyspnea, cough Skin: rash, alopecia Other: food
distaste, weight gain, edema, pain, hot flashes, flulike symptom

Nursing Responsibilities:
 Monitor prostate-significant antigen levels, CBC, and liver
and kidney function test results.
 If patient is receiving warfarin concurrently, evaluate
prothrombin time and International Normalized Ratio.

Patient teaching
 Instruct patient to take drug at same time each day, along
with prescribed LHRH analog.
 Tell patient that any drug-related hair loss should reverse
once therapy ends.
Name of Drug [Generic Name]: TRANEXAMIC ACID

Brand Name: Cyklokapron, Lysteda

Chemical Classification: Synthetic lysine amino acid derivative

Therapeutic Classification: Antifibrinolytic

Indication [specific problem of the patient managed by the drug]:

To treat cyclic heavy bleeding

Dosage:
Tablets: 1,300 mg
I.v. Infusion Initial: 10 mg/kg

Drug action: Displaces plasminogen from surface of fibrin by

binding to high-affinity lysine site of plasminogen. This
diminishes dissolution of hemostatic fibrin, which decreases
bleeding

Adverse reactions
CNS: Cerebral thrombosis, dizziness, fatigue, headache, migraine,
seizures
CV: Deep vein thrombosis, MI
EENT: Central retinal artery and vein obstruction, feeling of
tightness in throat, impaired color vision, ligneous
conjunctivitis, nasal and sinus congestion, sinusitis, visual
abnormalities
GI: Abdominal pain, diarrhea, nausea, vomiting
GU: Acute renal cortical necrosis
HEME: Anemia
MS: Arthralgia, back pain, muscle cramps and spasms, myalgia
RESP: Dyspnea, pulmonary embolism, respiratory congestion
SKIN: Allergic skin reactions, facial flushing
Other: Anaphylaxis, multiple allergies including seasonal

Nursing Responsibilities:
 Monitor patient closely for allergic reactions to tranexamic
acid such as dyspnea, a feeling of tightness in the throat,
and facial flushing that may require emergency medical
treatment.

Patient teaching
 Instruct patient to swallow tranexamic acid tablets whole,
without chewing or breaking them. Therapy shouldn’t exceed 5
days during menstruation.
 Tell patient to seek emergency care immediately if she has any
signs of allergic reaction, especially dyspnea, a feeling of
tightness in the throat, and facial flushing; she should stop
taking drug.
 Advise patient to report any changes in vision or ocular
discomfort.
Name of Drug [Generic Name]: OMEPRAZOLE

Brand Name: Losec (CAN), Prilosec, Zegerid

Chemical Classification: Substituted benzimidazole

Therapeutic Classification: Antiulcer

Indication [specific problem of the patient managed by the drug]:

To treat gastroesophageal reflux disease (GERD)

Dosage:
 Granules for Oral Suspension: 2.5 mg/packet, 10 mg/packet.
 Powder for Oral Suspension: 2 mg/mL.
 Capsules (Delayed-Release [PriLOSEC]): 10 mg, 20 mg, 40 mg.
 Tablets (Delayed-Release [PriLOSEC OTC]): 20 mg.

Drug action: Reduces gastric acid secretion and increases gastric

mucus and bicarbonate production, creating protective coating on
gastric mucosa and easing discomfort from excess gastric acid

Adverse reactions
 CNS: dizziness, headache, asthenia
 GI: nausea, vomiting, diarrhea, constipation, abdominal pain
 Metabolic: hypomagnesemia
 Musculoskeletal: back pain; fractures of hip, wrist, spine
(with long-term daily use)
 Respiratory: cough, upper respiratory tract infection
 Skin:rash

Nursing Responsibilities:
 Assess vital signs.
 Check for abdominal pain, emesis, diarrhea, or constipation.
 Evaluate fluid intake and output.
 Watch for elevated liver function test results (rare).
 Monitor magnesium level before starting drug and periodically
thereafter in patients expected to be on long-term treatment
or who take proton pump inhibitors with other drugs such as
digoxin or drugs that may cause hypomagnesemia.
Patient teaching
 Tell patient to take 30 to 60 minutes before a meal,
preferably in morning.
 Instruct patient to swallow capsules or tablets whole and not
to chew or crush them. If he can’t swallow capsule, tell him
he may open it, carefully sprinkle, and mix entire contents
into 1 tbsp of cool applesauce, and swallow immediately with
glass of water.
 Instruct patient on how to use delayed-release oral
suspension: Empty contents of a 2.5-mg packet of powder into a
container with 5 ml of water or 10-mg packet of powder into a
container with 15 ml of water; don’t use other liquids or
foods. Stir and allow drug to thicken for 2 to 3 minutes. Stir
well and drink within 30 minutes. If any drug remains after
drinking, add more water to container, stir, and drink
immediately.
 Inform patient taking OTC delayedrelease tablets for heartburn
that full effect may take 1 to 4 days. Advise him not to take
tablets for more than 14 days without consulting health care
professional.
 Advise patient to avoid St John’s wort while taking this drug.
 Caution patient to avoid driving and other hazardous
activities until he knows how drug affects concentration and
alertness.
 Name of Drug [Generic Name]: PARACETAMOL TRAMADOL

Brand Name: Apo-TraMADol ConZip Synapryn FusePaq Ultram

Chemical Classification: Centrally acting synthetic opioid.

Therapeutic Classification: Antipyretic, Analgesic.

Indication [specific problem of the patient managed by the drug]:

Management of moderate and severe pain

Dosage:
 Tablets (Immediate-Release) (Ultram): 50 mg.
 Capsules (Variable-Release) (ConZip): 100 mg (25 mg
immediate/75 mg extended), 200 mg (50 mg immediate/150 mg
extended), 300 mg (50 mg immediate/250 mg extended).
 Suspension, Oral(Synapryn FusePaq): 10 mg/mL.
 Tablets (Extended-Release) (Ultram ER): 100 mg, 200 mg, 300
mg.

Drug action: Tramadol is a centrally acting opioid analgesic

which binds to mu-opioid receptors and weakly inhibits the
reuptake of norepinephrine and serotonin. Paracetamol, a para-
aminophenol derivative, has analgesic, antipyretic and weak anti
inflammatory activity. Together, tramadol and paracetamol has
faster onset of action compared to tramadol alone and longer
duration of action compared to paracetamol alone.

Adverse reactions:
CNS: nausea, vomiting, anorexia, coma, convulsions, seizures
CV: cardiovascular collapse, cardiac arrhythmia, n hypotension
Respi: respiratory arrest, bradycardia, dyspnea, wheezing,
bronchospasm
Genitourinary: abdominal pain,acute renal failure

Nursing Responsibilities:
 Perform phtsical assesstment and obtain baseline data
 Assess patient for any allergy, past or present history of
dependence to the drug
 Instruct patient to take medicine on time with the right dosege
as prescribed.
 The drug can be taken without food. However, to decrease GI
upset, it can be
 Taken with meals.
 Instruct patient to take tablet, with a sufficient quantity of
liquid. It must not be crushed or chewed.
Name of Drug [Generic Name]: LEVOFLOXACIN

Brand Name: Apo-Levofloxacin , Iquix, Levaquin, Quixin

Chemical: Centrally acting synthetic opioid.

Therapeutic Classification: Analgesic.

Indication [specific problem of the patient managed by the drug]:

In oral and intravenous formulations, levofloxacin is indicated

in adults for the treatment of various infections caused by
susceptible bacteria, including infections of the upper
respiratory tract, lower respiratory tract, skin, skin
structures, urinary tract, and prostate.

Dosage:
 Infusion Premix: 250 mg/50 mL, 500 mg/100 mL, 750 mg/150 mL.
 Injection, Solution: 25 mg/mL.
 Ophthalmic Solution: 0.5%. Oral Solution: 25 mg/mL. Tablets:
250 mg, 500 mg, 750 mg.
 Tablet: 250mg, 500mg, 750mg

Drug action: Inhibits DNA enzyme gyrase in susceptible

microorganisms, interfering with bacterial cell replication,
repair.

Adverse reactions
CNS: dizziness, headache, insomnia, seizures CV: chest pain,
palpitations, hypotension EENT: photophobia, sinusitis,
pharyngitis GI: nausea, vomiting, diarrhea, constipation,
abdominal pain, dyspepsia, flatulence, pseudomembranous colitis
GU: vaginitis Hematologic: lymphocytopenia Metabolic:
hyperglycemia, hypoglycemia
Musculoskeletal: back pain, tendon rupture, tendinitis Skin:
photosensitivity Other: altered taste, reaction and pain at I.V.
site, hypersensitivity reactions including Stevens-Johnson
syndrome

Nursing Responsibilities:
 Check vital signs, especially blood pressure. Too-rapid
infusion can cause hypotension.
 Closely monitor patients with renal insufficiency.
 Monitor blood glucose level closely in diabetic patients.
 Assess for severe diarrhea, which may indicate
pseudomembranous colitis.
 Watch for hypersensitivity reaction. Discontinue drug
immediately if rash or other signs or symptoms occur.
 Watch for signs and symptoms of tendinitis or tendon rupture.

Patient teaching
 Tell patient to stop taking drug and contact prescriber if he
experiences signs or symptoms of hypersensitivity reaction
(rash, hives, or other skin reactions) or severe diarrhea
(which may indicate pseudomembranous colitis).
 Instruct patient to stop taking drug and notify prescriber
immediately if tendon pain, swelling, or inflammation occurs.
 Instruct patient not to take with milk, yogurt, multivitamins
containing zinc or iron, or antacids containing aluminum or
magnesium.
 Teach patient proper use of eye drops. Tell him to avoid
touching applicator tip to eye, finger, or any other object.
 Caution patient to avoid driving and other activities that
require mental alertness until CNS effects of drug are know
Name of Drug [Generic Name]: Sodium Chloride (NaCl)

Brand Name:

Chemical Classification:
Therapeutic Classification:

Indication [specific problem of the patient managed by the drug]:

hydration and provision of NaCl indeficiency states

Dosage: 1tab TID

Drug Action: Sodium and chloride — major electrolytes of the

fluid compartment outside of cells (i.e., extracellular) — work
together to control extracellular volume and blood pressure.
Disturbances in sodium concentrations in the extracellular fluid
are associated with disorders of water balance.

Adverse reactions:
CV: CHF, pulmonary edema, 5, edema.
FLUIDS AND ELECTROLYTES: hypernatremia, hypervolemia,
hypokalemia,

Nursing Responsibilities:
 Assess fluid balance (intake and output, daily weight, edema,
and lung sounds) throughout therapy
 Assess patient for symptoms of hyponatremia (headache,
tachycardia, dry mucous membranes, nausea, vomiting, muscle
cramps) or hypernatremia (edema, weight gain, hypertension,
tachycardia, fever flushed skin, mental irritability)
throughout therapy. Sodium is measured in relation to its
concentration to fluid in the body, and symptoms may change
based on patient’s hydration status.
 Lab test considerations: monitor serum sodium, potassium,
bicarbonate, and chloride concentrations and acid -base
balance periodically for patients receiving prolonged therapy
with sodium chloride.
 Monitor serum osmolarity in patients receiving hypertonic
saline solutions

Patient teaching
 Explain to patient the purpose of the infusion
 Advise patient at risk for dehydration due to exposure to
extreme temperatures when and how to take NaCl tablets. Inform
patients that undigested tablets may be passed in the stool;
oral electrolyte solutions are preferable.