drug study
DESCRIPTION
Drug Study with detailsTRANSCRIPT
DRUGSTUDY
Classification: ANTI-INFECTIVES-Quinolones
KARLEEN L. JARO
GENERIC NAME
INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
Ciprofloxacin
BRAND NAMECiprobay
DOSAGE250-500mg BID
Infections of the resp. tract, middle ear,paranasal sinuses, eyes, kidneys, urinary tract
Inhibits bacterial DNA gyrase thus preventing replication in susceptible bacteria
Drugs that inhibit peristalsis. Infants and children, growing adolescents. Pregnancy and lactation
PRECAUTIONSevere and persistent diarrhea during and after treatment
ADVERSE RXNCommon:Nausea, diarrhea, vomiting, rashUncommon:Anorexia, headache,dizziness, fever, GI and abdominal pain, flatulence, confusion, vertigo
>Assess pt for previous sensitivity reaction>Assess pt for any s/s of infection before & during treatment>Assess for adverse reactions >assess pt. & family’s knowledge of drug therapy
Classification: GASTROINTESTINAL DRUGS-Laxatives
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTION
NURSING CONSIDERATION
LACTULOSE
BRAND NAMEduphalac
DOSAGEInfants: 5 mlChildren:1-6 y/o- 5-10ml 7-14y/o- 15ml15-45y/o- 15-30ml.
Dose given in 3 days
Constipation, salmonellosis. Treatment of hepatic encephalopathy
Inhibits bacterial DNA gyrase thus preventing replication in susceptible bacteria
Pt who require a low lactose diet. Galactosemia deficiency. Intestinal obstruction.
PRECAUTION:Lactose intolerance, diabetes
Adverse Rxn:Abdominal discomfort associated with flatulence and intestinal cramps. Nausea, vomiting, diarrhea on prolonged use.
>Assess condition before therapy and reassess regularly thereafter to monitor drug’s effectiveness >Monitor pt for any adverse GI reactions, nausea,vomiting,diarrhea,>Assess for adverse reactions >for pt. with hepatic encelopathy: regularly assess mental condition>monitor I & O>monitor for Inc. glucose level in diabetic pts
Classification: ANTI-ALLERGICS_Anti-histamine
KARLEEN L. JARO
GENERIC NAME
INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
levocetirizine
BRAND NAMEXyzal
DOSAGEAdult and adolescents more than 12 yrs- 1 tab/dayPedia: 6-12 yrs- 1 tab/ day
Treatment of symptoms associated with allergic conditions (including ocular symptoms)
Long-acting non-sedating antihistamine that selectively inhibits peripheral HI receptors
Pts with severe renal impairment, pts with rare problems of galactose intolerance
PRECAUTIONAdjustment of dose is recommended in elderly pts w/ compromised renal function. Lactation.
ADVERSE RXNDry mouth, headache, fatigue, rhinitis, abdominal pain, migraine
>obtain pt hx inc. drug hx and any unkown allergies>monitor pulse, BP, respiration> observe dizziness and excessive sedation
Classification: ANTI-INFECTIVES-Penicillins
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
Amoxicillin
BRAND NAMEAmoxil
DOSAGEAdult: 250-500mg every 8 hoursChildren: 20-40mg/kg/day divided dosage given every 8 hrs
Infections of the resp. tract, skin & skin structures,paranasal sinuses, genitourinary tract, otitis media, sinusitis, meningitis,septicemia
Prevents bacterial cell wall synthesis during replication.
Hypersensitivity to penicillins, cephalosporins. Not used to treat pneumonia, bacteremia pericarditis during acute stage.
PRECAUTION:Hypersensitivity: rxn range from mild to life threatening
ADVERSE RXN:Dizziness, fatigue, insomnia, skin rashes, itchy eyes, sore or dry mouth, abnormal taste sensation, diarrhea, rectal bleeding
>obtain pt’s hx of allergy >Assess pt for any s/s of infection >Assess for pt’s sensitivity to penicillin ot other cepalosporins >assess for allergic rxn during therapy>Assess for bowel pattern, if diarrhea- shld be discontinue
Classification: CARDIOVASCULAR DRUGS-Calcium Antagonist
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATIONfelodipine
BRAND NAMEPlendil
DOSAGEAdult: 250-500mg every 8 hoursChildren: 20-40mg/kg/day divided dosage given every 8 hrs
Treatment of hypertension
Inhibits calcium ion influx across cell membrane, resulting in inhibition of excitation/ contraction.
Sick sinus syndrome, second or third-degree Av block except with functioning pacemaker, hypotension with systolic BP<90mmHg
ADVERSE RXN:Peripheral edema, hypotension, syncope, MI, angina, tachycardia, headache, dizziness, lightheadedness, nausea, vomiting, sinusitis, wheezing cough, sneezing
>assess fluid volume status, adequacy of pulses, pitting edema, dehydration, hypotension, dry mouth >monitor cardiac status: BP, pulse, respiration >Assess for angina pain: duration,intensity, aggravating factors
Classification: CARDIOVASCULAR DRUGS-Angiotensin II Antagonist
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
TELMISARTAN
BRAND NAMEPritor
DOSAGEAdult: 20-80mg daily, usual starting dose 40mg daily
Treatment of hypertension
Blocks the vasoconstrictive ans aldosterone-one-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the ATI receptor in many tissues
Hypersensitivity, pregnancy, lactation. Severe hepatic or renal impairment
PRECAUTION:Can cause death to the fetus if used on the 2nd trimester, safety in children not yet established
ADVERSE RXNDiarrhea and angioedema. Sinusitis, pharyngitis, upper resp. tract infection, back pain
>assess pt’s condition before therapy >Assess for heart failure >Assess for obstructive jaundice>monitor for possible drug induced adverse rxn>close monitoring of BP and pulse
Classification: ANTI-DIARRHEALS
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
Loperamide HCl
BRAND NAMEIMODIUM
DOSAGEAdult: initially 2 cap; subsequent dose a cap after every stool
Symptomatic control of acute and chronic diarrhea
Acts on the nerve endings &/or intramural ganglia of the intestinal wall to decrease intestinal motility, resulting to prolonged retention of feces in the intestines
Those in whom constipation must be avoided, children less than 1 yr, hypersensitivity, abdominal distention
PRECAUTION:Hepatic dysfunction, chronic diarrhea, dehydration
ADVERSE RXNHypersensitivity reactions, flatulence, abdominal pain, distention or discomfort, nausea and vomiting
>assess pt’s bowel pattern >check response after 48 hrs >Assess hydration>assess for abdominal distention>inform pt. that dry mouth may be relieved by frequent sips of water, hard candy or sugarless gum
Classification: CENTRAL NERVOUS SYSTEM DRUGS-Anti-anxiety ( Anticonvulsant/Hypnotics/Sedatives/Anxiolytics)
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATIONDIAZEPAM
BRAND NAMEValium
DOSAGEAdult: 250-500mg every 8 hoursChildren: 20-40mg/kg/day divided dosage given every 8 hrs
Symptomatic relief of anxiety, agitation, tension
Facilitates/ potentiates the inhibitory activity of GABA at the limbic system and reticular formation to reduce anxiety, promote calmness and sleep
Hypersensitivity. Dependence, withdrawal symptoms
PRECAUTION:Hypersensitivity: cardiorespiratory insufficiency, pregnancy, lactation
ADVERSE RXNDizziness, fatigue, blurred vision, dependence, withdrawal reactions
> inform pt. that drug may be taken with food>advice pt. not to abruptly discontinue drug after long term use>advice pt. to avoid driving and activities that require alertness bec, drug can cause drowsiness>inform pt. that smoking may decrease effect
Classification: DIETARY/NUTRITIONAL DRUGS-Vitamins and Minerals
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
Calcium carbonate
BRAND NAMECalci-Aid
DOSAGEAdult: 1-2 capsules dailyPedia:1-2 tablets daily
Antacid, calcium supplement, osteoporosis
Decreases total acid load of GI tract. Increase esophageal sphincter tone
Hypercalcemia, bone tremors, severe renal failure,hypersensitivity
PRECAUTION:History of stone formation, pregnancy
ADVERSE RXNConstipation, flatulence, diarrhea, renal dysfunction, acid rebound
> administer as antacid 1 hr fter meal and at bed time>administer as supplement 1 ½ hrs after meal and at bed time >advice pt to increase fluids to 2L unless contraindicated
Classification: ANTI-ASTHMA
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
Salbutamol
BRAND NAMEVentolin vilmax
DOSAGEAdult: 8mg tablet BIDPedia: 3-12 yrs4mg tab BID
Reversible airway obstruction including bronchial asthma, chronic bronchitis
Facilitates/ potentiates the inhibitory activity of GABA at the limbic system and reticular formation to reduce anxiety, promote calmness and sleep
Hypersensitivity PRECAUTION:Hyperthyroidism,DM, cardiovascular disease
ADVERSE RXNFine tremor of skeletal muscle, feeling of tension, a compensory small increase in heart rate, headache, muscle cramps
> drug may be decrese sensitivity of spirometry used for diagnosis of asthma>syrup may be taken as young as age 2>monitor for evidence of allergic rxn
Classification: CARDIAC DRUGS-Centrally-acting Drugs
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
orlistat
BRAND NAMEXenical
DOSAGEAdult: 1 cap with each main meal
Long-term treatmentof obese and overweight patients with risk factors and comorbiditi, associated with obesity including hypercholeste-rolemia, NIDD, impaired glusoce tolerance, hypertension and reduction of visceral fat
Inhibits the absorption of dietary fat
Chronic malabsorption syndrome
PRECAUTION:Children <18 yrs, pregnancy, lactation,shld be given with caution to diabetic pt.
ADVERSE RXNOily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation. Fecal incontinence
> assess effectiveness of other medications pt may be taking (esp. anticoagulant)>pt. may experience dizziness or lightheadedness >advice pt to report persistens back pain, muscle, or joint pain, signs of resp. tract infection
Classification: ANALGESICS
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
Mefenamic acid
BRAND NAMEDolfenal
DOSAGEAdult: start with 75-150mcg BID
Severe HPN300mg BID
Relief of pain including muscular, rheumatic, traumatic, dental, post-op and postpartum pain, headache, migraine, fever, dysmenorrhea
Aspirin-like drug that has analgesic,antipyretic, & anti-inflammatory activities
Pregnancy & lactation, hypersensitivity, active ulceration or chronic inflammation of either upper or lower GIT, blood disorders, poor platelet function, kidney or liver impairment, children < 14 yrs
PRECAUTION:If rash occurs, administration should be stopped, asthmatics,Hx of liver and kidney diseaseADVERSE RXNGI discomfort, diarrhea or constipation, gas pain, nausea, vomiting, drowsiness
> assess pt.’s pain before therapy>monitor for possible drug induced adverse reactions>advice pt. not to take drug for more than 7 days>advice pt. to report immediately persistence or failure to relieve pain
Classification: ANTI-INFECTIVES
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING CONSIDERATION
chloroquine
BRAND NAMEchlorofoz
DOSAGEAdult: initially four 250mg tablet followed by 2 tab after 6-8 hrs, then2 tab daily for 2 days
Antacid, calcium supplement, osteoporosis
Inhibits the perioxidative activity of heme, and disrupt its nonenzymatic polymerization to hemozin
Presence of retinal or visual field changes
PRECAUTION:Hepatic disease, alcoholism, monitor complete blood count
ADVERSE RXNHeadache, nausea, vomiting, diarrhea, skin eruptions
>advice pt that compliance with dosage schedule & duration of tx are necessary>caution pt to avoid alcohol while taking drug >assess hepatic status (dec. appetite,jaundice, dark urine>instruct pt to use sunglasses in bright sunlight
Classification: GASTROINTESTINAL DRUGS-LAXATIVES
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
bisacodyl
BRAND NAMEDulcolax
DOSAGEAdult: 2 tab at bedtime or 30 mins before breakfast, max 4 tabsPedia: greater than 4 yrs- 1 tabSuppository:Pedia – 5mgAdult- 10mg
Constipation, relief of evacuation in hemorrhoids, prep for barium enema, pre and post-op
Increases peristalsis & motor activity of the small intestines by acting directly on the smooth muscles.
Nausea, vomiting or other symptoms of appendicitis, acute surgical abdomen, abdominal pain, ulcerative lesions of colon
PRECAUTION:Caution is advised during 1st 3 mos of pregnancy as well as administration to children < 4 yrs
ADVERSE RXNOccasional abdominal discomfort, soreness in anal region
> monitor frequency & character of stool>monitor occurrence of adverse rxn >swallow the tablet whole, do not crush or chew
Classification: RESPIRATORY DRUGS- MUCOKINETICS/EXPECTORANTS
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION PRECAUTION/ ADVERSE REACTION
NURSING CONSIDERATION
Carbocisteine
BRAND NAMELoviscol
DOSAGECapsule:Adult: 250mg 2 caps, 500mg 1 cap TIDSuspension:Adult – 15ml; Pedia: 6-12yrs: 5ml, 2-5 yrs: 1.25-2.5 mlSyr: 6-12yrs: 10ml2-5 yrs: 2.5mlDrops: 12-24mos: 1.25ml, 9-11mos: 1ml, 6-8mos: 0.75ml, 3-5mos: .50ml, <3mos: 0.25mlAll doses 3-4x/ day
Acute/chronic disorders of the upper & lower respiratory tract associated with the secretion & formation of excessive and viscid mucus
Reduces the viscosity of bronchial secretions & facilitate expectoration
active peptic ulcer. Hypersensitivity to carbocisteine
PRECAUTION:Hx of peptic ulcer, hypothyroidism
ADVERSE RXNNausea, headache, vomiting, anorexia, gastric discomfort, diarrhea, GI bleeding
>assess cough: type, frequency, character > advice medical consultation for persistent cough of more than 7 days>advice pt. to avoid smoking>suggest sugarless lozenges to decrease throat irritation and cough
Classification: CARDIOVASCULAR DRUGS- ANTI-ARRYTHMICS
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTION
NURSING CONSIDERATION
Amiodarone Hcl
BRAND NAMECordarone
DOSAGETab: initially 3 tab/day maintenance: 1-2 tab/day
Cardiac arrhythmias, ventricular rhythm disorders
Blocks sodium channels at rapid pacing frequencies, prolonging myocardial cell action potential and refractory period
Sinus bradycardia,. SA and AV blocks, pregnancy, hypersensitivity
PRECAUTION:Goiter, CHF, respiratory disease
ADVERSE RXNBradycardia, heart block, sinus arrest, flushing, fatigue, insomnia, headache
>assess cardiovascular status before therapy > loading dose with food to decrease nausea>instruct pt. that skin discoloration is reversible>advice pt. to wear sunglasses for photophobia, protective clothing to prevent burning
Classification: GASTROINTESTINAL DRUGS- ANTI-FLATULENTS
GENERIC NAME INDICATION ACTION CONTRAINDICATION PRECAUTION/ NURSING CONSIDERATION
KARLEEN L. JARO
ADVERSE REACTION
metoclopramide
BRAND NAMEPlasil
DOSAGEAdult 10mg 3x/day pedia: 15-20yrs 5-10mg 3x/day5-14yrs: 2.5-5mg 3x/day3-4yrs: 3mg 2-3x/day1-2yrs: 1mg 2-3x/dayUnder 1 yr: 1mg 2x/day
Gastrointestinal motility, nausea, vomiting of central and peripheral origin assoc. with surgery
Dopamine antagonist that acts by increasing receptor sensitivity and response of upper GIT tissues to acetylcholine
GI hemorrhage, epileptics, hypersensitivity, lactation, pts. With breast cancer
PRECAUTION:Activities requiring mental alertness, elderly, lactation
ADVERSE RXNRestlessness, drowsiness, fatigue, insomnia, headache, dizziness, nausea
>give 30 mins before meals and at bed time> assess mental status during treatment>tell pt. To avoid driving & other hazardous activities for at least 2 hrs>advice pt. to avoid alcohol and other CNS depressant that enhance sedating properties of this drug
Classification: CARDIOVASCULAR DRUGS- BETA-BLOCKERS
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING
CONSIDERATION
metropolol
BRAND NAMENeobloc
DOSAGEAdult : 50mg BID or 100 mg OD
Hypertension, chronic angina pectoris
Exerts mainly beta-1 adrenergic blocking activity but also blocks beta-2 receptors at high doses
AV blocks, cardiogenic shock, sinus bradycardia
PRECAUTION:Slowing of heart rate, occasionally severe bradycardia may lead to vertigoADVERSE RXNOccasionally fatigue, dizziness, headache, GI disturbance, skin rashes nausea
>tablet may be crashed or swallowed whole> instruct pt to take with meals >inform the pt that drug only controls but does not cure the disorder>tell the pt. not to discontinue drug abruptly can worsen angina
Classification: CNS DRUGS- HYPNOTICS/ SEDATIVES
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING CONSIDERATION
phenobarbital
BRAND NAMEluminal
DOSAGE100-320mg. max 600mg daily
Short-term treatment of insomnia, long- term treatment of generalized toni-clonic seizures
Depressant and anticonvulsant effects may be related to its ability to increase the inhibitory activity of GABA on nerve impulses
Hypersensitivity to barbiturates, pregnancy, severe renal, hepatic, resp. impairment
PRECAUTION:Impaired renal, hepatic cardiac or resp. functionsADVERSE RXNDizziness, headache, hangover, confusion in elderly, GI disturbances, allergic reactions, sedation and depression may occur
>instruct pt. to avoid alcohol and other CNS depressant to prevent inc. depression> withdrawal insomnia may occur after short-term use, insomnia improves in 1-3 nights >on empty stomach, 30-60 mins before bedtime for expected sleeplessness>advice pt to change positions slowly to prevent orthostatic hypotension
Classification: CARDIOVASCULAR DRUGS- ANTI-INFECTIVE ( ANTI-FUNGALS)
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/
ADVERSE REACTIONNURSING CONSIDERATION
Nystatin
BRAND NAMEMycostatin
DOSAGE4-6ml susp 4x/day or 1-2 tabs 3x/dayInfants: 2ml pedia susp 4x/day
Antifungal antibiotic used for prophylaxis and treatment of candidiasis of the skin and mucous membranes
Interferes with fungal DNA replication: binds sterols in fungal cell membrane, w/c increases permeability, resulting in leaking of cell nutrients
hypersensitivity PRECAUTION:Discontinue if sensitization occurs
ADVERSE RXNDiarrhea, GI distress, nausea, vomiting
>oral suspension, shake well before using> report persistent nausea and vomiting, diarrhea or if condition worsens>inform physician if pt is pregnant
Classification: Anticholinergic
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
Atropine SO4
BRAND NAME
Dose/Route:
0.5-1.0 mg IVP Q3-5min max of 0.04mg/kg (ETT 2-2.5 x dosage)
OPP: 2-5mg Q10-15 min (Peds 0.05mg/kg)
Pediatric: 0.02mg/kg (minimum 0.1mg
- Antidote to overdosage with cholinergic substances (nerve gases, poisonous mushroom)
- Pre-op medication to reduce salivary and resp. tract secretions.
Helps to reduce saliva and fluid in the respiratory tract.May also be used to treat a slow heartbeat or insecticide or mushroom poisoning
Contraindicated in patients with glaucoma, pyloric stenosis or prostatic hypertrophy, except in doses ordinarily used for preanesthetic medication.
Can cause blurred vision, dilated pupils, dry mouth, palpitations urinary retention, tachycardia drowsiness, and confusion
monitor level of consciousness
do not sit up or stand up quickly
advise patient to stay out of bright light
chew sugarless gums and suck hard candies to avoid mouth dryness
use lubricating drops is wearing contact lenses
avoid extreme heat
Classification: Andrenergics
KARLEEN L. JARO
GENERIC NAME
INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
Dobutamine HCL
BRAND NAME
Dobutrex
Infusion rate: 2.5-10 mcg/kg/min
Increased cardiac output in short-term treat ment of cardiac decompensation caused by depressed contractility, such as during refractory heart failure; adjunctive therapy in cardiac surgery
Stimulates heart’s beta1 receptors to increase myocardial contractility and stoke volume. At dosages, drug increases cardiac output by decreasing peripheral vascular resistance, Zeducing ventricular filling pressure and facilitating AV node therapeutic conduction
Contra indicated in patients hypersensitive to drug and in those with idiopathic hypertrophic subaortic stenosisUse cautiously in patients with history of hypertension because drug may increase pressor responseUse cautiously in patients with history of sulfite sensitivity
.
Increased heart rate, hypertension,Angina, phlebitis, nonspecific chest pain, palpitations, hypotension, nausea, vomiting, shortness of breath, hypersensitivity reactions
Before starting dobutamine therapy: (1) give a plasma volume expander to correct hypovolemia (2) give cardiac glycoside
Continuously monitor ECG, blood pressure, pulmonary artery wedge pressure, cardiac output and urine output
Monitor Electrolyte levels. Drug may lower potassium level
Do not confuse with Dopamine
Tell patient to report adverse reactions promptly, especially labored breathing and drug-induced headache
Instruct patient to report discomfort at IV insertion site
Classification: Antihistamine/ anti allergic
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
Diphenhydramine HCl
BRAND NAMEBenadryl
DOSAGECapule/syrup
Adult: 50 mg tid-qid. Children >20 lb: 12.5-25 mg tid-qid
Hay fever, urticaria, vasomotor rhinitis, angioneurotic edema, drug sensitization, serum & penicillin reaction, contact dermatitis, atopic eczema, other allergic dermatoses, pruritus, food sensitivity, parkinsonism, motion sickness
Antihistamine that reduces allergic reactions, motion sickness and vertigo (dizziness and loss of balance), and Parkinson's disease
Premature & newborn infants; asthma attack; lactation
CV & CNS effects
Blood disorders
GI disturbances
Antimuscarinic effectsAllergic reactions
Special precaution for
Narrow-angle glaucoma stenosing peptic ulcer pyloroduodenal
obstruction symptoms of prostatic
hypertrophy or bladder-neck obstruction
History of bronchial asthma
increased intraocular pressure
hyperthyroidism CV disease or
hypertension. Pregnancy. Avoid operating vehicles or machinery
Classification: Antagonist and antidotes
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATIONSIDE EFFECTS/
ADVERSE REACTION NURSING CONSIDERATION
Naloxone hydrocholoride
BRAND NAMENarcan
DOSAGEAdult : 0.4 -2 mg IV q2 to 3 mins.p.r.n.
Known suspected narcotic induced respiratory depression including that cause by pentazocine and propaxyphene
Displaces previously administered narcotic analgesics from their receptors. Has no pharmacologic activity of its own
Patient known to be hypersensitive to naloxone hydrochloride
TachycardiaHypertension
NauseaVomitingTremors
Safest drug to use when cause respiratory depression is uncertain.
Monitor respiratory depth and rate. Be prepared to provide O2, ventilation and resuscitative measures.
Also been shown to improve circulation in refractory shock
Classification: Antispasmodic
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS/ ADVERSE REACTION
NURSING CONSIDERATION
Hyoscine-N-butylbromide
BRAND NAMEBuscopan
DOSAGEAdult & childn >6 yr 1-2 tab 3-5 times daily. Amp Acute attacks of colicky pain Adolescent >12 yr 1-2 amp IV, IM or SC several times daily. Max: 100 mg aily.
Infant & young childn Severe cases: 0.3-0.6 mg/kg body wt by slow IV, IM or SC several times daily. Max: 1.5 mg/kg body wt/day.
indicated for the control of abdominal pain (colic) associated with spasmodic colic, flatulent colic
Relieve cramps or spasms of the stomach,intestines, and bladder
Myasthenia gravis, megacolon. Parenteral Untreated narrow-angle glaucoma, prostate hypertrophy w/ urinary retention, mechanical stenosis of GIT, tachycardia
xerostomia
tachycardia
urinary retention
allergic & skin reactions
rarely dyspnea (in patients w/ history of bronchial asthma or allergy)
parenteral visual accommodation disturbance
infrequently inj site pain (after IM inj),
rarely anaphylactoid reactions &
anaphylactic shock
Drug compatibility should be monitored closely in patients requiring adjunctive therapy
Avoid driving & operating machinery after parenteral administration
Avoid strict heat
Classification: CNS stimulant
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS/ ADVERSE REACTION
NURSING CONSIDERATION
Citicoline
BRAND NAME
Somazine amp
DOSAGE
125 mg/mL 1-2 inj/day.
250 mg/mL 1 inj/day
CVD in acute & recovery phase, symptoms & signs of cerebral insufficiency (dizziness, memory loss, poor concentration, disorientation, recent cranial trauma & their sequelae.)
- Citicoline is an interneuronal communication enhancer. It increases the neurotransmission levels because it favors the synthesis and production speed of dopamine in the striatum, acting then as a dopaminergic agonist thru the inhibition of tyrosine-hydroxylase.
Parasympathetic hypertonia Gastrointestinal
disorders
•Somazine must not be administered along with medicaments containing meclophenoxate
Classification: Loop Diuretic
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
Furosemide
BRAND NAME
Lasix
DOSAGEAdult:
Initially 1/2-1-2 tab/day Maintenance: 1/2-1 tab/day
20-40 mg IV/IM
Children: 2 mg/kg body/wt
acute pulmonary edemaedemahypertension
inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle
Anuria hepatic coma
& precoma severe
hypokalemia &/or hyponatremia
hypovolemia w/ or w/o hypotension
Hypersensitivity to furosemide or sulfonamides
vertigo, dizziness, headache, paresthesia, orthostatic hypotension, thrombophlebitis, abdominal pain, hypokalemia, anemiamuscle spasm
To prevent nocturia, give preparation in the morning and early in the afternoon
Watch for signs of hpokalemia
do not confuse with Torsemide or Lasix with Lonox
advise patient to take drug with food to prevent GI upset
inform patient of possible need for potassium or magnesium supplements
Classification: Anri- ulcer
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
Ranitidine HCL
BRAND NAME
Xantac
DOSAGE50 mg by slow IV then 0.125-0.25 mg/kg/hr as continuous IV infusion
•Duodenal and gastric ulcers
•Maintenance therapy for gastric and duodenal ulcer
•GERD
•Erosive esophagitis
•Heartburn
Completely inhibits action of histamine on the H2 at receptor sites of parietal cells, decreasing gastric acid secretions
Contraindicated in patients hypersensitive to drug and those with porphyria
•Use cautiously in patients with hepatic dysfunction. Adjust dose in patients with impaired renal function
• Vertigo, malaise, headache, blurred
vision, jaundice, burning and itching at
injection site
•Assess patient for abdominal pain. Note presence of blood in emesis, stool, or gastric aspirate
•Ranitidine may be added to total parenteral nutrition solution
•Instruct patient on proper use of OTC preparation as indicated.
•Remind patient to take once daily prescription drug at bedtime for best results
•Instruct patient to take without regard to meals because absorption isn’t affected by food
Classification: Nutrional Agents (Calorics)
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTSNURSING
CONSIDERATION
Dextrose
BRAND NAME
DOSAGEDosage depends on fluid and caloric requirements
Fluid replacement and caloric supplementation in patient who can’t maintain adequate oral intake or who is restricted from doing so.
Minimize glyconeogenesis and promotes anabolism in patients who can’t receive sufficient oral caloric intake.
Hyperglycemia, diabetic coma, intracranial or intra spinal hemorrhage or delirium tremens.
Mental confusion, unconsciousness in hyperosmolar nonketotic syndrome.
Pulmonary edema Glycosuria,
osmotic diuresis Metabolic:
hyperglycemia, hypervolemia
Rapid termination after long term infusion may cause hypoglycemia rebound hyperinsulinemia.
Sloughing and tissue necrosis
Use cautiously in cardiac or pulmonary disease, hypertension, renal insufficiency urinary obstruction and hypovolemia.
Never infuse concentrated solutions rapidly, may cause hyperglycemia and fluid shift.
Monitor glucose level carefully. Prolonged therapy can cause depletion of pancreatic insulin production and secretion.
Classification: Electrolytes and replacement solutions
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
Calcium gluconate
BRAND NAME
Kalcinate
DOSAGETablets 500 mg, 650 mg, 975 mg, 1 g (contains 90 mg elemental calcium/g)
Hypocalcemia, hypocalcemic tetany, magnesium toxicity, hypoparathyroidism
Replaces and maintains calcium
Hypercalcemia, ventricular fibrillation, renal canaliculi
GI irritationhemorrhageconstipationvomiting thirstrenal canaliculihypercalcemiapolyuria
Use cautiously in patients with sarcoidosis and renal or cardiac disease and in digitalized patients.
monitor blood calcium level frequently.
Classification: Non narcotic /analgesics and antipyretic/ antiplatelet
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION
Aspirin (acetylsalicylic acid)
BRAND NAME
Aspilet
DOSAGEFever/mild pain:
325-650 mg P.O q4 hours; p.r..n
unstable angina:
325 P.O once/daily
Mild pain/fever
Arthritis
Reduce risk of heart attack in patient with previous MI or unstable angina
Produces analgesia by an ill defined effect on the hypothalamus and by blocking generation of pain impulses (peripheral action)
Also impedes clotting by blocking prostaglandin synthesis which prevents formation of platelet-aggregating substances.
GI ulcer GI bleeding
Patients with bleeding disordersAspirin hypersensitivity
Vit.K deficiency
Prolonged bleeding time
TinnitusHearing lossNausea,vomiting GI distressOccult bleedingAbnormal liver
functionRash Bruising
Hypersensitivity manifested by asthma and anaphylaxis
Give milk, food antacid or large glass of water to reduce GI adverse reactions.
Warn patients taking prescription drugs to check with doctor before taking OTC combination containing aspirin.
Watch out for petechiae, bleeding gums, signs of GI bleeding.
Maintain adequate fluid intake.
Obtain hemoglobin and prothrombin test periodically.
Classification: Antihypertensives
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION
Clonidine hydrochloride
BRAND NAME
Catapres
DOSAGE01-02 mg P.O B.
Essential renal and malignant hypertension
Inhibits central vasomotor centers, thereby decreasing sympatheric outflow.
Patient hypersensitive to clonidine
drowsinessdizzinessfatiguesedationnervousnessheadacheorthostatic
hypotensionbradycardiaurine retetion impotencetransient glucose
intolerance (after large dose)
constipationpruritis
dermatitis
Monitor blood pressure and pulse rate.
May be given rapidly lower blood pressure in some hypertensive emergencies.
Rising slowly and avoid sudden position change to prevent orthostatic hypotension.
Remove patch before defribrillation to prevent arcing
Classification: Antianginals
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION
Nifedipine
BRAND NAME
Adalat
DOSAGEAdults:Initial: 10-30mg PO TIDMaximum: 120-180mg
Hypertension:30-60mg PO
•Vasospastic angina, classic chronic stable angina pectoris
•Hypertension
Thought to inhibit calcium ion influx across cardiac and smooth-muscle cells, decreasing contractility and oxygen demand. Also may dilate coronary arteries and arteriole
•Contraindicated in patients hypersensitive to drug
•Use cautiously in patients with heart failure or hypotension and in elderly patients. Use extended-release tablets cautiously in patients with severe GI narrowing
Dizziness, light-headedness, headache, weakness, peripheral edema, flushing, nausea, Syncope, nervousness, hypotension, palpitations, nasal congestion, diarrhea, constipation, abdominal discomfort, muscle cramps, dyspnea, pulmonary edema, cough, rash, puritus
Don’t give immediate-release form within 1 week of acute MI or in acute coronary syndrome
Alert: despite the previously widespread SL use nifedipine capsule, avoid this route of administration. Excessive hypotension, MI, and death may result
Monitor blood pressure regularly, especially in patients who take beta blockers or antihypertensive
Watch for symptoms of heart failure
Classification: Antianginals
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
Nicardipine
BRAND NAME
Cardipine
DOSAGEInitially
20 mg P.O Tid
hypertension20 to 40 mg P.O t.i.d increase dosage depends on the patients response
Chronic stable angina
Inhibits calcium ion influx across cardiac and smooth muscle cells, thus decreasing myocardial contractility and oxygen demand and coronary arteries and arterioles.
Patient who are hypersensitive to nicardipine
DizzinessHeadacheParesthesisDrowsinessPeripheral
edemaPalpitationsTachycardiaNauseaDry mouthAbdominal
discomfortRashFlushing
Patients with hepatic impairment should receive lower dose
Monitor blood pressure.
Allow atleast 3 days between dosage adjustment to achieve steady plasma levels.
Advise patient to report immediately if experiencing chest pain
Classification: Corticosteroids
KARLEEN L. JARO
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
Dexamethasone
BRAND NAME
Dexon
DOSAGE
The initial dosage varies from 0.75 to 9 mg a day depending on the disease being treated
Inflammation of corticosteroid-responsive dermatoses
anti-inflammatory effects in disorders of many organ systems
Diffuses across cell membrane and complexes with specific cytoplasmic receptors
Patient had an allergic reaction previously.Have an active peptic ulcerHave an active herpes simplex fungal or mycobacterial infection ot the eye, ear infection
Active tuberculosis
Have psychoneurosis or psychosis
Increased appetiteWeight gainWater retentionIncreased WBCHypokalemiaSkin rashDizzinessInsomiaHeadache
Stop drug and notify doctor if patient develops signs of systemic absorption.
Before applying, gently wash skin to prevent damage to skin rub medication gently.
Treatment should be continued for a few days after clearing of lesions to prevent recurrence
KARLEEN L. JARO