Drug Order Mechanism of Action Indications/Contraindications Side Effects Nursing Consideration

Omeprazole-Proton Inhibits gastric acid Indications: CNS: headache, dizziness  Give before meals, usually in the morning.
Pump Inhibitor secretion
Treatment and prevention of CV: generally minimal acute CV risk, but  Monitor for abdominal pain, diarrhea, or
gastrointestinal ulcer long-term use may increase fracture risk black stools.
(osteoporosis) and low magnesium
 Watch for signs of low magnesium or B12
GI: abdominal pain,diarrhea, deficiency in long-term use.
Contraindications:
nausea,vomiting,flatulence,
 Use cautiously in liver problems.
7/27/25 Hypersensitivity to omeprazole or constipation; risk of C. difficile infection
any component; caution or avoid in with prolonged use  Avoid alcohol and spicy food.
3:40 pm
severe hepatic impairment; PPI may
Skin: rash  Educate patient to take as prescribed and
40mg IV OD mask symptoms of gastric
report unusual symptoms
malignancy Respiratory: upper respiratory infection,
cough  Long-term use may increase fracture risk.

Paracetamol- Inhibits prostaglandin Indications: CNS: Headache  Check dosage – Do not exceed 4g per day
Analgesic, Antipyretic synthesis in the CNS to (adults).
Mild to moderate pain, fever. CV: Hypotension (rare)
reduce pain and fever.
 Assess pain or fever – Monitor
GI: Nausea, liver damage (high dose)
effectiveness.
7/27/25
Contraindications: Skin: Rash, allergic reactions
 Monitor liver function – Especially in long-
3:40 pm
Severe liver disease, hypersensitivity Respiratory: Rare allergic respiratory term use or high doses.
reactions
300 mg IV q4 PRN  Check for alcohol use – Increases risk of
liver damage.

 Watch for overdose signs – Nausea,

7/28/25
vomiting, sweating, confusion.
600 mg IV q6
 Give with or after food – To reduce gastric
irritation (if oral).

 Educate patient – Avoid other meds

containing paracetamol.

 Record administration – Time, dose, and

route.

HNBB(Hyoscine N- Relaxes smooth muscle Indications: CNS: Dizziness, restlessness  Check for allergy – Assess for any known
Butylbromide)- in the GI tract and allergy to anticholinergics.
Abdominal cramps, spasms, irritable CV: Palpitations, tachycardia
Anticholinergic urinary tract
bowel, renal colic.  Monitor vital signs – Watch for increased
GI: Dry mouth, constipation
heart rate or low blood pressure.
Skin: Allergic rash
7/27/25  Assess abdominal pain – Rule out surgical
Contraindications:
Respiratory: Dry throat (rare) causes before giving.
3:40 pm
Glaucoma, myasthenia gravis,
 Watch for side effects – Dry mouth, blurred
10 mg IV q8 PRN megacolon, urinary retention.
vision, constipation, or urinary retention.

 Give before meals if ordered – For best

antispasmodic effect.

 Educate the patient – Advise to avoid

driving due to possible drowsiness or
 blurred vision.

 Hydration – Encourage fluid intake to avoid

constipation.

Betahistine- Anti- Improves blood flow in Indications: CNS: Headache  Assess vertigo and hearing loss – Monitor
histamine the inner ear to reduce symptoms before and during treatment.
Meniere’s disease, vertigo, tinnitus CV: Hypotension (rare)
vertigo.
 Check blood pressure – Betahistine may
GI: Nausea, dyspepsia
cause mild hypotension.
Contraindications: Skin: Rash
 Monitor for GI upset – Nausea or
7/27/25
Pheochromocytoma, peptic ulcer, Respiratory: Bronchospasm (rare) indigestion is common; give with food if
3:40 pm bronchial asthma (caution) needed.

24 mg tablet BID PRN  Avoid in peptic ulcer patients – It may

worsen ulcers.

 Use caution in asthma – Can cause

bronchospasm in rare cases.

 Educate patient – Inform about proper

dose, timing, and not to stop suddenly.

 Watch for allergic reactions – Report rash,

itching, or breathing difficulty.

 Avoid alcohol – It may increase side effects

like dizziness.
Vitamin B Complex Provides essential B Indications: CNS: Tingling, nervousness (rare)  Assess nutritional status – Check for signs of
vitamins needed for deficiency (fatigue, neuropathy, anemia).
Vitamin B deficiency, neuropathy, CV: Flushing
metabolism, nerve, and
general wellness  Check for allergies – Especially to B vitamins
red blood cell function. GI: Nausea
or components.
7/27/25 Skin: Itching, rash
 Monitor lab values – Such as B12, folate,
3:40 pm Respiratory: Rare hypersensitivity and hemoglobin levels.
Contraindications:
tablet OD  Give with food – To prevent stomach upset.
Hypersensitivity to B vitamins
 Educate the patient – On proper dose and
importance of adherence.

 Watch for side effects – Like nausea, mild

diarrhea, or skin rash.

 Caution in renal/liver issues – Adjust dose if

needed.

 Avoid alcohol – It reduces absorption and

effectiveness.

PNSS-Normal Saline An isotonic intravenous Indications: CNS: Headache, Restlessness  Check doctor's order – Confirm type,
Solution Sodium fluid used for the amount, and rate of infusion.
Source of Electrolytes, Hydration CV: Hypertension(from fluid overflow),
Chloride replenishment of fluid
Tachycardia  Inspect solution – Ensure it's clear and free
and electrolytes.
from particles.
GI: Nausea(rare), Vomiting (if electrolyte
Contraindications:
imbalance occurs)  Verify IV site – Look for signs of
Contraindicated in inflammation or infiltration.
Skin: rash(rare)
patients with a  Monitor vital signs – Watch for changes in
Respiratory: Shortness of breath,
history of BP, pulse, and temperature.
Pulmonary Edema(from rapid or
 hypersensitivity to excessive infusions)  Observe for fluid overload – Watch for
edema, crackles in lungs, or shortness of
the drug or any
breath.
excipients from
 Assess for electrolyte imbalance – Especially
the dosage form. sodium levels.

 Use correct rate and pump setting – Avoid

rapid infusion unless ordered.

 Document – Record time, amount infused,

and patient response.

Celecoxib- COX-2 Specifically inhibits Indications: CNS: headache, dizziness (less common).  Check for allergies – Especially to
inhibitor NSAID prostaglandin synthesis sulfonamides, NSAIDs, or aspirin.
Osteoarthritis, rheumatoid arthritis, CV: increased risk of myocardial
via COX-2 without
ankylosing spondylitis, acute pain in infarction, stroke, new or worsening  Assess pain and inflammation – Monitor
significant COX-1
adults, dysmenorrhea, familial hypertension, fluid retention, edema effectiveness regularly.
7/28/25 inhibition →
adenomatous polyposis extension,
anti-inflammatory, GI: abdominal pain, nausea, diarrhea,  Monitor for GI symptoms – Watch for
200 mg Oral BID juvenile RA.
analgesic, antipyretic gastrointestinal bleeding or perforation abdominal pain, bleeding, or ulcers.
effects. (though lower than nonselective
 Check blood pressure – Celecoxib may
NSAIDs).
Contraindications: increase BP.
Skin: hypersensitivity rash, SJS, TEN;
Hypersensitivity to celecoxib or sulfa  Monitor kidney function – Especially in
discontinue at first sign.
drugs; history of severe NSAID older adults or those with kidney issues.
reactions (e.g. Stevens–Johnson); Respiratory: bronchospasm possible in
 Educate patient – Take with food to reduce
active cardiovascular disease or high NSAID-sensitive asthma.
stomach upset; don’t mix with other
CV risk (MI, stroke); peptic ulcer
Renal: fluid retention, hypertension- NSAIDs.
disease; severe hepatic or renal
related renal impairment.
impairment; third trimester  Watch for signs of cardiovascular issues –
pregnancy. Like chest pain, shortness of breath, or
 swelling.

 Avoid alcohol – Increases risk of stomach

bleeding.

 Report rash or allergic reaction – Could

indicate a serious condition like Stevens-
Johnson syndrome.

Ketorolac- inhibits both COX-1 and Indications: CNS: drowsiness, dizziness, headache,  Assess pain level before and after
Nonsteroidal anti- COX-2 → decreases rarely abnormal thinking administration.
Short-term management of
inflammatory drug prostaglandin synthesis
moderate to severe pain CV: fluid retention, hypertension,  Monitor for GI bleeding (e.g., black stools,
→ analgesic, anti-
(postoperative, procedural pains), increased risk of heart failure in abdominal pain).
inflammatory,
dysmenorrhea, musculoskeletal predisposed patients; risk of myocardial
7/29/25 antipyretic effects  Check the renal function (BUN, creatinine)
pain; antipyretic usage; adjunct to infarction or stroke (less than COX-2 but
before giving.
30 mg IV q8 opioids. still).
 Do not exceed 5 days of use – risk of kidney
GI: abdominal pain, nausea, dyspepsia,
and GI damage.
GI bleeding, ulceration, perforation
Contraindications:
 Give with food to reduce stomach upset.
Skin: rash, rare SJS or Stevens-Johnson
Hypersensitivity to ketorolac or
syndrome  Avoid with other NSAIDs or anticoagulants
other NSAIDs; active peptic ulcer
(↑ bleeding risk).
disease or GI bleeding; Respiratory: bronchospasm in
peri-operative setting (especially NSAID-sensitive individuals; anaphylaxis  Monitor for signs of allergic reaction,
before major surgery); renal possible especially in patients with asthma.
impairment; history of  Use cautiously in elderly – increased risk of
Renal: acute kidney injury, reduced renal
cerebrovascular bleeding; asthma side effects.
perfusion
with NSAID sensitivity; bleeding
 Ensure adequate hydration – helps protect
disorders; congestive heart failure;
kidneys.
pregnancy third trimester;
 breastfeeding caution.  Educate patient not to take additional OTC
NSAIDs.

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