ESOMEPRAZOLE

Republic of the Philippines
Cebu Normal University

Osmeña Blvd., Cebu City, 6000, Philippines
College of Nursing
Telephone No.: (+63 32) 254 4837
Email: cn@cnu.edu.ph
Website: www.cnu.edu.ph
DRUG
STUDY
Patient’s Initials: B.T. Date of Admission: November 2, 2021 Diagnosis: Subarachnoid hemorrhage secondary to ruptured aneurysm
Age: 49 y.o. Height: 5’5 ft. Weight: 74 kg Clinical Intervention: Surgical Clipping of ruptured aneurysm_________
Sex: Female Ward: Neuro ____ Bed No: 6 Name of Physician: Dr. Al Garay
Mechanism of
Drug Information Classification Indication Contraindication Side Effects Nursing Responsibilities
Action
Generic Name: Therapeutic Pharmacodynamics General Indications Contraindications: CNS: headache. Before:
Esomeprazole Classification: or Mechanism of  GERD/erosive  Hypersensitivity  Check doctor’s order
antiulcer agents Action: esophagitis. to esomeprazole Derm: cutaneous  Assess routinely for epigastric or
Trade Name: Binds to an enzyme  Reduction in or related drugs lupus abdominal pain and frank or occult
Nexium Pharmacological on gastric parietal risk of (benzimidazoles) erythematosus. blood in the stool, emesis, or gastric
Classification: cells in the presence rebleeding  Hypersensitivity aspirate.
Minimum Dose: proton-pump of acidic gastric pH, following GI: Clostridium  Explain the right dosage, route, full
20 mg once daily inhibitors preventing the final therapeutic Precautions: difficile-associated course of medication, use of drug
transport of hydrogen endoscopy for  Severe hepatic diarrhea (CDAD), and side effects
Maximum Dose: Pregnancy Risk ions into the gastric acute bleeding impairment; abdominal pain,  May cause hypomagnesemia.
40 mg once daily Classification: lumen. gastric or  Patients using constipation, Monitor serum magnesium prior to
Patient’s dose: C duodenal ulcers high-doses for >1 diarrhea, dry and periodically during therapy
40 mg IV OD Therapeutic Effect:  Hypersecretory mouth, flatulence,
year (↑ risk of hip,
Diminished conditions, nausea. During:
wrist, or spine
Route: accumulation of acid including  Verify the patient’s identity.
IV in the gastric lumen fractures) F and E:  IV: reconstitute each vial with 5 mL
Zollinger-Ellison
with lessened  Patients using hypomagnesemia
syndrome of 0.9% NaCl, LR or D5W. Do not
Availability: gastroesophageal therapy for >3 yr (especially if
 With amoxicillin administer solutions that are
Delayed-release reflux. Healing of and (↑ risk of vitamin treatment duration
discolored or contain a precipitate.
capsules: 20 mg, duodenal ulcers. clarithromycin B12 deficiency) ≥3 mo). Stable at room temperature for up to
40 mg Decreased incidence to eradicate  OB, Lactation: 12 hr.
Certification Date: 1 February 2021

SDF-CON-304-070-00
Recertification due date: 24 January 2024
For verification of the certificate please

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College of Nursing
Telephone No.: (+63 32) 254 4837
Delayed-release of gastric ulcer Helicobacter use only if GU: acute  Rate: Administer over at least 3 min.
tablets: 20 mg during continuous pylori in potential benefit interstitial nephritis.  Monitor patient’s reaction to
Delayed-release NSAID therapy. duodenal ulcer outweighs medication
oral suspension disease or potential risk Hemat: vitamin B12  Maintain aseptic technique.
packets: 2.5 history of deficiency.
mg/pkt, 5 mg/pkt, Pharmacokinetics: duodenal ulcer After:
10mg/pkt, 20 Absorption: 90% disease Drug Interactions: MS: bone fracture.  Always flush I.V. line with normal
mg/pkt, 40 mg/pkt absorbed following  Decrease risk  May ↓ levels of saline solution injection, lactated
Powder for oral administration; of gastric ulcer atazanavir and Misc: systemic Ringer’s injection, or 5% dextrose
injection (requires food ↓ absorption during nelfinavir; avoid lupus injection before and after giving
reconstitution Distribution: continuous concurrent use erythematosus esomeprazole intravenously.
and further unknown NSAID therapy. with either of  Discontinue if hypersensitivity
dilution): 20 Metabolism:  Heartburn these reaction occurs
mg/vial, 40 mg/vial Extensively occurring  Monitor bowel function. Diarrhea,
antiretrovirals.
metabolized in the ≥twice/wk. abdominal cramping, fever, and
Content: liver.  May ↑ levels and
risk of toxicity of bloody stools should be reported
NEXIUM I.V. for Excretion: <1% Patient’s promptly as a sign of C. difficile-
Injection contains excreted unchanged Indications: saquinavir (may
associated diarrhea (CDAD)
esomeprazole in urine Stress ulcer need to ↓ dose of
 Caution to avoid doing activities
sodium 21.3 mg prophylaxis for saquinavir).
requiring alertness and until
or 42.5 mg Onset: critically-ill patients  May ↓ absorption response to medication is known.
equivalent to PO – rapid following of drugs requiring May cause occasional dizziness
esomeprazole 20 IV – rapid neurologic injury acid pH,  Advise patient to avoid alcohol,
mg or 40 mg, for the prevention including products containing aspirin or
edetate disodium Peak: of clinically ketoconazole, NSAIDs, and foods that may cause
1.5 mg and sodium PO – 1.6 hr important stress- itraconazole, an increase in GI irritation.
hydroxide q.s. for IV – end of infusion related
pH adjustment. ampicillin  Advise to report onset of black, tarry
gastrointestinal
Duration: esters, iron stools; diarrhea; abdominal pain; or
bleeding (CIB)
PO – 24 hr salts, erlotinib, persistent headache promptly

SDF-CON-304-070-00

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College of Nursing
Telephone No.: (+63 32) 254 4837
IV – 24 hr and  Instruct to notify if fever and

mycophenolate diarrhea develop, especially if stool
Drug half-life: mofetil. contains blood, pus, or mucus.
Children (1– 11 yrs):  May ↑ levels of Advise not to treat diarrhea without
0.42– 0.88 hr digoxin and consultation.
Adults: 1.0– 1.5 hr.  Advise patient to notify health care
methotrexate.
professional if signs of
 May ↑ risk of
hypomagnesemia (seizures,
bleeding with
dizziness, abnormal or fast
warfarin heartbeat, jitteriness, jerking
(monitor INR and movements or shaking, muscle
PT). weakness, spasms of the hands
 Voriconazole and feet, cramps or muscle aches,
may ↑ levels. spasm of the voice box) occur.
 May ↓ the  Document the procedure.
antiplatelet
effects of
clopidogrel;
avoid concurrent
use.
 May ↑ levels
ofcilostazol;
consider ↓ dose
of cilostazol
from 100 mg
twice daily to 50
mg twice daily.
 Rifampin may ↓

SDF-CON-304-070-00

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College of Nursing
Telephone No.: (+63 32) 254 4837
levels and may ↓

response (avoid
concurrent use).
 Hypomagnesemi
a ↑ risk of
digoxin toxicity.
 May ↑ levels of
tacrolimus
Drug-Natural
Products:
 St. John’s wort
may ↓ levels and
may decrease
response; avoid
concurrent use
References:
 Kizior, R. J., & Hodgson, K. J. (2019). Saunders Nursing Drug Handbook 2019. Elsevier.
 RxList. (2021, June 3). Nexium I.V. (Esomeprazole Sodium): Uses, Dosage, Side Effects, Interactions, Warning. https://www.rxlist.com/nexium-iv-drug.htm#description
 Vallerand, A., & Sanoski, C. (2019). Davis's Drug Guide for Nurses (16th ed.). F.A. Davis Company.

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College of Nursing
Telephone No.: (+63 32) 254 4837
PRODUCT ASSESSMENT RUBRICS FOR DRUG STUDY
Student Name: Rosales, Gwyn A. Year/Section: BSN – 4B Date: _____________ Score: ___/30
Directions: Please select the appropriate rating using the following descriptions.
Element Very Satisfactory Satisfactory Needs Improvement Comments

Drug ☐ Accurately presented all of the patient and drug information ☐ Accurately presented most of the patient and drug ☐ Accurately presented some of the patient and drug information
Information (name [brand & generic], dosage [patient’s dose; min. & max], information related to the case. 1 missing information or error related to the case. 2 or more missing information or errors noted.
(10%) frequency, route, availability, contents) related to the case. [3] noted. [2] [1]
Classification ☐ Accurately presented the classification (therapeutic and ☐ Accurately presented the classification related to the drug ☐ Inaccurately presented the classification related to the drug.
(10%) pharmacologic) related to the drug. [3] but with 1 irrelevant information or error noted. [2] Classification is not relevant to the drug. [1]
Indication ☐ Accurately presented the indication/s (general & patient- ☐ Accurately presented the indication/s related to the drug but ☐ Inaccurately presented the indication/s related to the drug.
(10%)
specific) related to the drug. [3] with 1 irrelevant information or error noted. [2] Indication is not relevant to the drug. [1]
Mechanism of ☐ Accurately presented the mechanism of action ☐ Accurately presented the mechanism of action of the drug ☐ Inaccurately presented the mechanism of action of the drug.
Action (10%) (pharmacokinetics, pharmacodynamics) of the drug. [3] but with 1 irrelevant information or error noted. [2] Mechanism of action is not relevant to the drug. [1]
☐ Accurately presented all of the common contraindications ☐ Accurately presented most of the common contraindications ☐ Accurately presented some of the common contraindications
Contraindication related to the drug. [3] related to the drug. 1 missing information or error noted. [2] related to the drug. 2 or more missing information or errors noted.
(10%) [1]
Side Effects ☐ Accurately presented all of the common side effects related to ☐ Accurately presented most of the common side effects ☐ Accurately presented some of the common side effects related
(10%) the drug. [3] related to the drug. 1-2 missing information or errors noted. [2] to the drug. 3 or more missing information or errors noted. [1]
Nursing ☐ Accurately presented all of the common nursing ☐ Accurately presented most of the common nursing ☐ Accurately presented some of the common nursing
Responsibilities responsibilities (before, during, and after) related to the drug. [9] responsibilities related to the drug. 1-2 missing information or responsibilities related to the drug. 3 or more missing information
(30%) errors noted. [7] or errors noted. [3]
☐ Presented at least 2 sources that are updated (within 5 years), ☐ Presented only one source that is updated (within 5 years), ☐ No source was presented. Sources are not updated (more than 5
References
relevant, and credible. [3] relevant, and credible. Other sources are not updated, credible years), relevant, and credible. [1]
(10%)
or relevant. [2]
Sub-score = ____ = ____ = ____
Evaluated by:
_______________________________________

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College of Nursing
Telephone No.: (+63 32) 254 4837
Signature over Printed Name of Clinical Instructor

SDF-CON-304-070-00

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Republic of the Philippines

Cebu Normal University

Certification Date: 1 February 2021

For verification of the certificate please

Registration No. 52Q18778 check and type the registration number)

Certification Date: 1 February 2021

For verification of the certificate please

Registration No. 52Q18778 check and type the registration number)

IV – 24 hr and  Instruct to notify if fever and

Certification Date: 1 February 2021

For verification of the certificate please

Registration No. 52Q18778 check and type the registration number)

levels and may ↓

Certification Date: 1 February 2021

For verification of the certificate please

Registration No. 52Q18778 check and type the registration number)

PRODUCT ASSESSMENT RUBRICS FOR DRUG STUDY

Element Very Satisfactory Satisfactory Needs Improvement Comments

Certification Date: 1 February 2021

For verification of the certificate please

Registration No. 52Q18778 check and type the registration number)

Signature over Printed Name of Clinical Instructor

Certification Date: 1 February 2021

For verification of the certificate please

Registration No. 52Q18778 check and type the registration number)

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