REPUBLIC OF THE PHILIPPINES
ISABELA STATE UNIVERSITY
COLLEGE OF NURSING
Name: GALASINAO, ANDREA MONIQUE RATON
Course, Year & Section: BSN 1A
Submitted to: PROF. RYAN M. AMIGO
BRAND/GENERI
C NAME
MOA
PARACETAMOL
Paracetamol exhibits
analgesic action by
peripheral blockage of
pain impulse
generation. It
produces antipyresis
by inhibiting the
hypothalamic heatregulating center. Its
weak antiinflammatory activity
is related to inhibition
of prostaglandin
synthesis in the CNS.
DOSAGE OF ROUTE
AND FREQUENCY
Intravenous
Adult: 33-50 kg: 15
mg/kg 4-6 hourly if
needed.
Max: 3 g daily. >50 kg:
1 g 4-6 hourly if
needed.
Max: 4 g daily.
Administer by infusion
over 15 minutes.
INDICATIONS
Fever, Mild to
moderate pain
CONTRA
INDICATION
✓ Hypersensitivity.
Severe hepatic
impairment or
active liver
disease (IV).
ADVERSE
EFFECT
CNS:
✓
✓
✓
✓
✓
✓
✓
CV:
Child: Full-term
neonates and children
<10 kg: 7.5 mg/kg as a
single dose, at least 4
hourly. Max: 30
mg/kg/day; 10-33 kg:
15 mg/kg as a single
✓
✓
✓
SIDE EFFECTS
NURSING
RESPONSIBILITIES
• Observe 12 rights of giving
allergic reaction,
medication and assess the
including a rash or
Agitation
patient's vital signs as
swelling
anxiety,
baseline data.
✓ rash
dizziness
✓ blood disorders
• Perform hand washing
insomnia
✓
liver
and
kidney
headache
technique before and
damage (when
pyrexia
after giving medication.
taken at higher
fatigue
• Assess patient's fever or
than
pain: type of pain,
recommended
location, intensity,
doses)
hypotension
duration, temperature,
peripheral
and diaphoresis
edema
periorbital
• Assess allergic reactions
edema
rash urticaria, if these
occur, drug may have to
be discontinued.
✓
GI:
✓
✓
✓
✓
✓
dose, at least 4 hourly.
Max: 2 g daily; 33-50
kg: 15 mg/kg as a single
dose, at least 4 hourly.
Max: 3 g daily; >50 kg:
Same as adult dose.
Oral
Adult: 0.5-1 g 4-6
hourly.
Max: 4 g daily.
Child: 1-2 months 3060 mg 8 hourly. Max:
60 mg/kg/day; 3-<6
months 60 mg. 6
months to <2 years 120
mg; 2-<4 years 180
mg; 4-<6 years 240
mg; 6-<8 years 240 or
250 mg; 8-<10 years
360 or 375 mg; 10-<12
years 480 or 500
mg; 12-16 years 480 or
750mg. Administer 4-6
hourly if necessary.
Max: 4 doses in 24
hours
Fever, Mild to
moderate pain
nausea,
vomiting
diarrhea
dyspepsia
abdominal pain
Respiratory:
✓ abnormal breath
✓ sound, dyspnea
✓ hypoxia
✓ atelectasis
✓ pleural effusion
Hematologic:
✓ thrombocytopenia
✓ hemolytic anemia
✓ neutropenia
✓ leukopenia
✓ pancytopenia
Hepatic:
✓ jaundice
✓ hepatotoxicity
Metabolic:
✓ hypoglycemic coma
Skin:
✓ rash
✓ urticarial
Other:
✓ hypersensitivity
reactions (such as
fever)
• Tell parents/patient
not to use for marked
fever (temp higher
than 103.1 F or 39.5C),
fever persisting longer
than 3 days, or
recurrent lever unless
directed by prescriber.
• Teach patient to
recognize signs of
chronic overdose
bleeding, bruising
malaise, fever, sore
throat.
• Reassess pain and refer
to attending physician
if pain worsens
• Evaluate and document
findings
Rectal
Adult: As supp: 0.5-1 g
4-6 hourly. Max: 4 g
daily.
Child: 3 months to <1
year 60-125 mg; 1-<5
years 125-250 mg: 5<12 years 250-500
mg; 12-17 years 500
mg. Given 4-6 hourly if
needed.
Max: 4 doses/day.
Fever, Mild to
moderate pain
Potentially Fatal:
✓ Hepatotoxicity
✓ acute renal
tubular necrosis
✓ acute
generalised
exanthematous
pustulosis
(AGEP)
✓ StevensJohnson
syndrome (SJS)
✓ Toxic epidermal
necrolysis (TEN)
BRAND/GENERIC
NAME
MOA
IBUPROFEN
Ibuprofen, an
NSAID, has
analgesic, antiinflammatory
and antipyretic
properties. It
inhibits
cyclooxygenase1 and 2 (COX-1
and -2) enzymes,
thereby also
inhibiting
prostaglandin
synthesis.
DOSAGE OF
ROUTE AND
FREQUENCY
Intravenous
Adult: Initially,
400 mg then,
400 mg 4-6
hourly or 100200 mg 4
hourly, as
needed.
Max: 3.2 g
daily.
Child: 6 months
to <12 years 10
mg/kg over 10
minutes 4-6
hourly, as
needed; 12-17
years 400 mg
over 10
minutes 4-6
hourly.
Max: 2.4 g daily
(Max 400
mg/dose).
INDICATIONS
Fever
CONTRA INDICATION
✓ Hypersensitivity to
ibuprofen,
paracetamol or
other NSAIDs.
✓ Active or history of
peptic ulceration
or hemorrhage
(including history
of gastrointestinal
bleeding related to
previous NSAID
therapy)
✓ Severe heart
failure (NYHA Class
IV),
cerebrovascular or
other active
bleeding
✓ Coagulation
disorders
✓ History of
ulcerative colitis or
Crohn’s disease
✓ Bronchial asthma,
urticaria or
allergic-type
ADVERSE EFFECT
✓
✓
✓
✓
✓
✓
✓
✓
✓
Significant:
Anaphylactoid reactions
risk of hyperkaliemia,
oedema
HTN
liver function
abnormalities
anemia
blurred vision
scotomata
changes in color vision
Rarely, severe blood
dyscrasias (e.g.
agranulocytosis,
thrombocytopenia,
aplastic anemia).
Ear and labyrinth
disorders:
✓ Tinnitus
Gastrointestinal
disorders:
✓ Nausea
✓ Vomiting
✓ Diarrhea
SIDE EFFECTS
Common:
✓ Dizziness
✓ Stomach and
abdominal pain
✓ Heartburn
✓ Constipation
✓ Nausea
✓ Rash
✓ Ringing in the
ears
✓ Swelling
(edema)
✓ Fluid retention
✓ Headache
✓ Vomiting
✓ Skin peeling
✓ Sun sensitivity
(photosensitivit
y reactions)
✓ Serious:
✓ Acute renal
failure
NURSINGS
RESPONSIBILITY
✓ Assess peripheral
edema using girth
measurements,
volume
displacement, and
measurement of
pitting edema.
✓ Report increased
swelling in feet
and ankles or a
sudden increase
in body weight
due to fluid
retention.
✓ Be alert for signs
of drug- induced
hepatitis,
including
anorexia,
abdominal pain,
severe nausea
and vomiting,
yellow skin or
eyes, skin rashes,
flu-like
Oral
Adult: As
conventional
tab or cap: 200400 mg 4-6
hourly as
needed.
Max: 1.2 (OTC)
or 3.2 g daily.
Mild to moderate
pain
✓
✓
✓
✓
Max duration:
10 days (OTC).
As modifiedrelease tab or
cap: Up to 1.6 g
once daily
(evening). If
needed, may
further increase
to 2.4 g daily in
2 divided doses.
Child: As
conventional
tab or cap: ≥6
months 4-10
mg/kg daily 6-8
hourly.
Max: 400
mg/dose, 40
✓
✓
✓
✓
reactions to aspirin
or other NSAIDs
Active alcoholism
Treatment of perioperative pain in
the setting of
coronary artery
bypass graft
(CABG) surgery
Spinal cord injury
(IV)
Children <18 years
of age
Severe hepatic and
renal failure
3rd trimester of
pregnancy (oral)
Pregnancy and
lactation (IV)
Concomitant use
with paracetamolor NSAIDcontaining drugs
(e.g. cyclooxygenase-2
inhibitors, aspirin
(doses >75 mg
daily).
✓
✓
✓
✓
✓
✓
Flatulence
Constipation
Dyspepsia
Heartburn
abdominal pain
enterocolitis (IV).
General disorders and
administration site
conditions:
✓ Fluid retention.
Infections and infestations
✓ Sepsis (IV)
Injury, poisoning and
procedural complications:
✓ Injection site reactions.
Investigations:
✓ Increased BUN (IV).
Metabolism and nutrition
disorders:
✓ Decreased appetite;
✓ hypoalbuminemia,
✓ hypoglycemia
✓ hypocalcemia,
✓ hypokalemia
✓ hypernatremia
✓ adrenal insufficiency (IV).
Nervous system
disorders:
✓ Headache
✓ Dizziness
✓ Agranulocytosis
✓ Aplastic anemia
✓ Erythematous
macular rashes
✓ Hemolytic
anemia (with or
without positive
direct
antiglobulin test
results)
✓ Neutropenia
✓ Thrombocytope
nia (with or
without rash)
✓ Toxic epidermal
necrolysis (Lyell
syndrome).
symptoms, and
muscle/joint
pain.
✓ Assess pain and
other variables
(range of motion,
muscle strength)
to document
whether this drug
is successful in
helping manage
the patient's pain
and decreasing
impairments.
✓ Assess heart rate,
ECG, and heart
sounds,
especially during
exercise Report
any rhythm
disturbances or
symptoms of
increased
Arrhythmias,
including
palpitations,
chest discomfort,
shortness of
breath, fainting,
and
fatigue/weakness
✓ Assess blood
pressure (BP)
periodically and
✓ intraventricular
hemorrhage (IV).
mg/kg daily. As
modifiedrelease tab or
cap: ≥12
years Same as
adult dosage.
Rectal
=
Child: As 60 or
125 mg
suppository: ≥3
-9
months weighin
g 6-8 kg: 60 mg
6-8 hourly up to
3 doses
daily; >9
months to 2
years weighing
8-12.5 kg: 60
mg 6 hourly up
to 4 doses
daily; >2-4
years weighing
12.5-17 kg: 125
mg 6-8 hourly
up to 3 doses
daily; >4-6
years weighing
17-20.5 kg: 125
mg 6 hourly up
to 4 doses daily.
As 75 mg
Psychiatric disorders:
✓ Nervousness
Fever, Mild to
moderate pain
Renal and urinary
disorders:
✓ Hematuria
✓ UTI
Respiratory, thoracic and
mediastinal disorders:
✓ Apnea
✓ Cough
✓ respiratory infection
Skin and subcutaneous
tissue disorders:
✓ Rashes
✓ Pruritus
✓ skin irritation (IV)
compare to
normal values
✓ Be alert for signs
of prolonged
bleeding time
such as bleeding
gums,
nosebleeds, and
unusual or
excessive
bruising.
✓ Monitor signs of
kidney
dysfunction such
as painful
urination or
blood in the
urine.
suppository: ≥8
-12
months weighin
g 7.5-10 kg: 75
mg up to 3
times daily; >12
months to 3
years weighing
10-15 kg: 75 mg
up to 4 times
daily.