Drug Order | Mechanism of action | Indication | Adverse Reaction | Contraindication | Nursing Consideration | Generic Name: Methergine Brand Name: Methylergonovine Maleate Classification: Oxytocic, Lactation stimulants | Methylergonovine, like other ergot alkaloids, produces arterial vasoconstriction by stimulation of alpha-adrenergic and serotonin receptors and inhibition of endothelial-derived relaxation factor release. It is a less potent vasoconstrictor than ergotamine. | This medication is a synthetic analogue of ergonovine, prescribed for treating postpartum hemorrhage. It works by increasing uterine contractions.

| Most Common- High/low blood pressure, epilepsy and headache.
CNS- Dizziness, hallucinations and ringing in the ear.
G.Il- Nausea, vomiting, foul taste and diarrhea.
Heart- Chest pain, palpitations and slow heart rate.
Respiratory- Nasal congestion and difficulty in breathing.
Potentially Fatal- Shock. |

| Contraindicated in patients with high blood pressure due to pregnancy and hypersensitivity. | Check vitals every 15minutes and contractions carefully. Check the protocol /policy of the health care agency and follow then. |

Drug Order | Mechanism of action | Indication | Adverse Reaction | Contraindication | Nursing Consideration | Generic Name: Oxytoxin Brand Name: Fetusin Classification: Oxytoxic | Oxytocin stimulates the contraction of smooth muscle in the uterus and alveoli of the lactating brest. At coitus, uterine stimulation by oxytocin causes peristaltic activity that assists the migration of spermatozoa. During parturition, the hormone enhances the uterine contractions. | Oxytocin is used antepartum when an early vaginal delivery is desired. It is the drug of choice for the maintenance of labor once the pregnancy is at term and used frequently when there is prolonged uterine inertia than when labor is only somewhat sluggish. For controlling postpartum hemorrhage and promote uterine involution. | Hypotension or hypertension
Tachycardia
Dysrhythmias
Angina pectoris
Anxiety
Seizure
Nausea and vomiting
Allergic reaction
Uterine rupture (from excessive administration) | Significant cephalopelvic disproportion; infavorable fetal positions, in obstetrical emergencies where the benefits to risk ration for either the fetus or the mother favors surgical intervention; in cases of fetal distress where delivery is not imminent; hypersensitivity to the drug. | Check vitals every 15minutes and contractions carefully. Check the protocol /policy of the health care agency and follow then. |

Drug Order | Mechanism of action | Indication | Adverse Reaction | Contraindication | Nursing Consideration | Generic Name: Ketorolac Brand Name: Toradol Classification: Nonsteroidal anti-inflammatory agents, nonopioid analagesics Dose: 30mg/amp1 amp IM | - Inhibits prostaglandin synthesis, producing peripherally mediated analgesia
- Also has antipyretic and anti-inflammatory properties.
- Therapeutic effect:Decreased pain | Short term management of pain (not to exceed 5 days total for all routes combined) | CNS:
1) drowsiness
2) abnormal thinking
3) dizziness
4) euphoria
5) headache-
- RESP:
1) asthma
2) dyspnea
- CV:
1) edema
2) pallor
3) vasodilationGI:
1) GI Bleeding
2) abnormal taste
3) diarrhea
4) dry mouth
5) dyspepsia
6) GI pain
7) nausea | - Hypersensitivity-Cross-sensitivity with other NSAIDs may exist¨Pre- or perioperative use- Known alcohol intoleranceUse cautiously in:1) History of GI bleeding2) Renal impair-ment (dosage reduction may be required)3) Cardiovascular disease | - Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria.
- Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration. |

Drug Order | Mechanism of action | Indication | Adverse Reaction | Contraindication | Nursing Consideration | Generic Name: Clonidine Hydrochloride Brand Name: catapres Classification: Anti-hypertensive Dose: 10mg/1tab Route: Oral | Clonidine stimulates alpha-2 receptors in brain stem which results in reduced sympathetic outflow from the CNS and a decrease in peripheral resistance leading to reduced BP and pulse rate. It does not alter normal hemodynamic response to exercise at recommended dosages. | -Hypertension, used alone or as part of combination therapy-Treatment of severe pain in cancer patients in combination with opiates; epidural more effective with neuropathic pain (Duraclon) | Dry mouth, drowsiness, dizziness, headache, constipation, impotence, vivid dreams, urinary retention; dry, itching, burning sensation in the eye; fluid or electrolyte imbalance, GI upset, paralytic ileus, orthostatic hypotension, weakness, sedation, pruritus, | Hypersensitivity. Disorders of cardiac pacemaker activity and conduction. Pregnancy and lactation. | Do not discontinue abruptly; discontinue therapy by reducing the dosage gradually over 2–4 days to avoid rebound hypertension, tachycardia, flushing, nausea, vomiting, cardiac arrhythmias (hypertensive encephalopathy and death have occurred after abrupt cessation of clonidine) |

Drug Order | Mechanism of action | Indication | Adverse Reaction | Side effects | Nursing Consideration | Generic Name: Acetaminophen Classification: * Antipyretic * Analgesic (nonopioid) | * Antipyretic: Reduces fever by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating, which helps dissipate heat. * Analgesic: Site and mechanism of action unclear. | * Analgesic-antipyretic in patients with aspirin allergy, hemostatic disturbances, bleeding diatheses, upper GI disease, gouty arthriti * Common cold, flu, other viral and bacterial infections with pain and fever * | * CNS: Headache * CV: Chest pain, dyspnea, myocardial damage when doses of 5–8 g/day are ingested daily for several weeks or when doses of 4 g/day are ingested for 1 yr * GI: Hepatic toxicity and failure, jaundice * GU: Acute kidney failure, renal tubular necrosis | Dizziness, Nausea, vomting | * Give drug with food if GI upset occurs. * Discontinue drug if hypersensitivity reactions occur. * Treatment of overdose: Monitor serum levels regularly, N-acetylcysteine should be available as a specific antidote; basic life support measures may be necessary. * |