drugs study orig

DRUGS ACTION INDICATION CONTRAINDICATIONADVERSE EFFECTS

NURSING RESPONSIBILITY

Generic NameNorepinephrine

Brand NameLEVOPHED

ClassificationCV Drugs(Cardiac

Glycosides)

Dosageamp - 1mg/4ml

Powerful peripheral vasoconstrictor (alpha-adrenergic action) & as potent inotropic stimulator of the heart & dilator of coronary arteries (beta-adrenergic action).

Blood pressure control in certain acute hypotensive states. As an adjunct in the treatment of cardiac arrest and profound hypotension.

Pregnancy(Category D)

Ischemic injuryBradycardiaArrythmiasAnxietyTransient-

headacheRespiratory

difficultyExtravasation

necrosis at injection site

Plasma volume depletion on prolonged administration

Monitor VS, ECG, I&O ratio, cyanosis, neurological status & adverse effects during therapy.

Assess for signs of extravasation (eg. Blanching & Coolness of skin over vein) at infusion site.

Inform pt. to inform physician if using drugs such as Sodium Bicarbonate, MAOI’s, Trycyclics, Oxytocics, Anti-histamine.

Advise pt. to notify nurse if IV site feels cool or painful.

Caution pt. to avoid sudden position changes to prevent Orthostatic Hypotension.



Generic NameBromazepam

Brand NameLEXOTAN

ClassificationCNS Drugs

(Benzodiazepines)

Dosagetab 1.5mg

Depress the CNS, probably by potentiating GABA, an inhibitory neurotransmitter. Produces skeletal muscle relaxation by inhibiting spinal poly-synaptic afferent pathways.

Anxiety & tension states; Depressive mood; Nervous tension; Agitation & Insomnia.Functional disturbances of the CV & Respiratory systems, GIT, GUT.Adjuvant to psychotherapy in psychoneurosis.


LactationMyasthenia GravisHypersensitivity

Acute AnxietyInsomniaExcitation

(Discontinue) Hallucinations

Assess degree of anxiety & level of sedation.

Monitor VS, adverse effects, laboratory examination, doses for elderly, malnourished pt. with liver or renal function, & w/ CV diseases.

Caution pt. to avoid taking alcohol or other CNS depressants concurrently with this medication.

Advise pt. that drug may impair ability to drive vehicles & to operate machinery.

Teach pt. that during course of therapy, tolerance to sedative effects usually develops.



Generic NamePhenobarbital

Brand NameLUMINAL

ClassificationCNS Drugs(Hypnotics-

SedativeBarbiturates)

Dosageamp

130mg/1ml

Depressant & anticonvulsant effects may be related to its ability to increase &/or mimic the inhibitory activity of GABA on nerve impulses (depress CNS synaptic transmission & increase seizure activity threshold in the motor cortex). As a sedative, it may also interfere with the transmission of impulses from the thalamus to the brain cortex.

Short treatment of Insomnia.Long treatment of generalized tonic-clonic & cortical focal seizures.Emergency control of acute convulsions.Pre-anesthetic sedation.


Hypersensitivityto Barbiturates

PorphyriaSevere Renal, Hepatic,

or Respiratory impairment

DizzinessHeadacheHangoverConfusion

(elderly)Paradoxical

excitationExacerbation of

pre-existing pain

HypotensionBradycardiaGI disturbancesAllergic

reactionBlood

DyscrasiasSedation &

DepressionProlonged

administration results to folate deficiency & megaloblastic anemia

Assess pt. condition (mental status) before therapy & regularly thereafter to monitor drug effectiveness.

Assess seizures activity: type, location, duration & character.

Monitor VS & for possible drug induced adverse reactions.

Instruct pt. to monitor for & report drug induced adverse reactions.


Advise pt. to avoid sudden position changes to prevent Orthostatic Hypotension.

DRUGS ACTION INDICATIONCONTRAINDICATIO

NADVERSE EFFECTS


Generic NameMagnesium

Sulfate(MgSO4)

Brand NameMAGNESIUM

SULFATE

ClassificationCNS Drugs

(Anticonvulsant)

Dosagevial 5g/20ml

May decrease acetylcholine released by nerve impulses but anticonvulsant mechanism is unknown.

AnticonvulsantLowers ICPHypomagnesemia pt.’s receiving TPN; SeizuresAcute nephritis in children; EpilepsyGlomerulonephritis or HypothyroidismElectrolyte additive;Inhibits uterine contractions in tocolysis.Treatment of life-threatening arrhythmias such as atypical ventricular tachycardia

Pt.’s with heart block or myocardial damage.

FlushingSweatingHypotensionMuscular

WeaknessSedationConfusion


Monitor respiration: RR-16/min, renal status: I&O ratio, possible drug induced adverse reactions & magnesium toxicity.



Generic NameMorphine

Brand NameMORPHINE SULFATE

ClassificationAnalgesics,

Antipyretics,Muscle

Relaxants(Opiates &

Antagonists)

Dosageamp 16mg/1ml

Binds with opiod receptors in the CNS causing alteration of both perception of and emotional response to pain through unknown mechanism.

Relief of mod. to severe acute and chronic pain.Renal, intestinal colic; Cancer; MIPulmonary Edema due to increase pulmonary congestion; AntitussiveNarcotic; Hypnotic; Sedative

PregnancyHypersensitivity

Existing Intestinal Obstruction (Ileus)

AnastomosesAsthma

Brain damageEpilepsy

Chronic alcohol abuseTreatment w/

AntidepressantSevere obstruction of the

gut

Allergic Reactions

GI disturbancesUrinary

retentionDepressionDelirium &

Convulsion Nausea Xerostomia Emesis Anorexia Facial Flushing Chills Palpitations Syncope General

Asthenia Cardiac

Failure Headache Vertigo Perspiration Mood swings Insomnia

Assess pain: location, type, character, intensity before therapy & regularly thereafter to monitor drug effectiveness.

Monitor for allergic reactions, respiratory depression, possible drug induced adverse reactions, I&O ratio & CNS changes.

Warn pt. about performing activities without assistance.

Advise pt. to report any symptoms of allergic reactions.

Caution pt. to avoid CNS depressants for at least 24hrs after taking the drug.

GUDLUCK.!!! =P



Generic NameNALBUPHINE

Brand NameNubain


Antipyretics,Muscle

Relaxants(Opiates &

Antagonists)

Dosageamp 10mg/1ml

Binds w/ opiate receptors in the CNS; ascending pain pathways in limbic system, thalamus, midbrain, hypothalamus, altering perception of and emotional response to pain.Relieves pain.

Relief of mod. to severe pain.Pre-operatively analgesia.Supplement to balanced anesthesia.Surgical and Obstetrical Anesthesia.


Hypersensitivity

SedationDrowsinessSweatingNauseaDry mouthDizzinessHeadacheVomiting

Assess pt. condition (mental status) & pain: location, type, character, intensity before therapy & regularly thereafter to monitor drug effectiveness.

Monitor VS, respiratory depression, allergic reactions, & possible drug induced adverse reactions.


Advise pt. to avoid sudden position changes to prevent Orthostatic Hypotension & getting up without assistance.



Generic NameIsosorbideDinitrate

/Mononitrate

Brand NameISOKETISORDIL

ClassificationCV Drugs

(Anti-anginal Drugs–Organic

Nitrates)

Dosagetab 5mg

amp 5mg/2ml

Increase supply of oxygen to the heart by dilating both the arteries & veins which supply the heart itself.

Preventive & long-term treatment of angina pectoris/post MI angina.Treatment of severe CHF in combination w/ cardiac glycosides, diuretics, ACE-inhibitors, arterial vasodilators, pulmonary hypertension.

Acute MI w/ low-filling pressures (except in ICU

w/ continuous hemodynamic monitoring)

Left heart failure w/ low-filling pressures

ShockVery low BP

Transient Hypoxemia

Headache Decrease BP Rise in PR Dizziness Weakness Nausea Vomiting Transient skin

disordersAllergic

reactions

Assess for pain: location, type, character, intensity.

Monitor BP, PR during treatment.

Caution pt. to make position changes slowly to prevent Orthostatic Hypotension.

Warn pt. to avoid alcohol & OTC medications unless approved by the doctor.

Inform pt. that the drug may be taken before stressful activity.

Advise pt. to avoid hazardous activities if dizziness occurs & sudden position changes to prevent Orthostatic Hypotension.



Generic NameIsoxsuprine

HCl

Brand NameISOXILAN

ClassificationCNS Drugs(cerebral &peripheral

vasodilators)

Dosagetab 10mg

Chemically similar to sympathomimetic amines & often described as beta adrenergic agonist.

Peripheral & cerebral vascular insufficiency w/ spastic component showing symptom (eg. Dizziness, Forgetfulness, Confusion, Visual, Auditory, Speech abnormalities, Coldness & Numbness of limbs, Color changes, Ischemic ulcers.)Raynaud’s Disease.Cerebrovascular Insufficiency.Uterine hypermotility disorders.

Renal arterial hemorrhageHeart Disease

Severe AnemiaPremature Labor

Should not be administered immediately

inpost-partum

Transient Flushing & Palpitations

HypotensionRashesGI disturbancesMaternal

pulmonary edema

Fetal Tachycardia

Dizziness

Assess pt. condition (mental status) before therapy.

Monitor possible drug induced adverse reactions.

DRUGS ACTION INDICATIONCONTRAINDICATIO

NADVERSE EFFECTS


Generic NameMefenamic

Acid

Brand NameISTAN


Antipyretics,Muscle

Relaxants(NSAID’s)

Dosagecap 500mg

Aspirin-like drug that has analgesic, antipyretic & anti-inflammatory activities. These activities appear to be due to its ability to inhibit cyclooxygenase & also antagonize certain effects of prostaglandins.Displays central & peripheral activities.

Relief of pain including muscular, rheumatic, traumatic, dental, post-operative & post-partum pain, headache, migraine, fever & dysmenorrhea.Therapy should not exceed 7 days.

Pregnancy & LactationHypersensitivity

Active ulceration of lower or upper GI tract

GI discomfort:DiarrheaConstipationGas painNauseaVomitingDrowsinessDizziness

Assess for pain: location, type, character, intensity.


Instruct pt. not to take drug for more than 7 days.

Advice pt. to immediately report persistence or failure to relieve pain.



Generic NamePhytomenadione

Brand NameKONAKION


(Hemostatics)

Dosageamp 10mg/1ml

Synthetic analog of Vit.K which is essential for hepatic synthesis of blood clotting factors II, VII, IX & X.

Vitamin K compounds are used in the treatment & prevention of hemorrhage associated with Vit. K deficiency.

Pronounced allergic diathesis

Infants <1yr.

HypotensionCyanosisHeadacheDizzinessPruritic

erythematosus plaques at IM site

RashUrticariaAnaphylactic

reactions


Assess for bleeding.Monitor Pro-time

during treatment to determine dosage effectiveness & possible drug induced adverse reactions.

Teach pt. necessary foods high in Vit.K to be included in the diet.

Caution pt. not to use OTC medications unless directed by the physician.

Advice pt. to avoid use of hard toothbrush, flossing, razors, & sharp objects until treatment is terminated.



Generic NameKetorolac

Brand NameKORTEZOR/KETODOL


Antipyretics,Muscle

Relaxants(NSAID’s)

Dosageamp 30mg/1ml

Analgesic, anti-inflammatory & antipyretic. Inhibits prostaglandin synthesis by inhibition of cyclo-oxygenase enzyme.It also inhibits leukotriene synthesis, help stabilize lysosomal membranes & exert anti-bradykinin activity.

Ophthalmic:Treatment of allergic conjunctivitis & for prophylaxis & reduction of inflammation & associated symptoms following ocular surgery.Short-term management of moderate to severe acute post-operative pain.

Active peptic ulcer disease

GI bleeding or perforationModerate to severe renal

impairmentHypovolemia

Labor & DeliveryHypersensitivity to aspirin or NSAID’s

Ophthalmic: Transient stinging & burning on instillation, ocular irritation

Allergic reaction

GI ulceration, bleeding, perforation

Post-operative bleeding

Acute renal failure

HypertensionNauseaDizzinessSweatingEdemaInjection site

pain

Assess pt.’s pain before & 1hr after treatment: type, location, intensity & ROM.

Assess for hypersensitivity reactions.


Advice pt. to report persistence or worsening of pain.

Instruct pt. to use caution when driving because drowsiness & dizziness may occur.

Caution pt. that this drug may cause eye redness & burning if soft contact lenses are worn.

Generic NameDigoxin

Brand NameLANOXIN

ClassificationCV Drugs(Cardiac

Glycosides)

Dosagetab 0.25mg

Inhibits sodium-potassium activated adenosine triphosphatase, thereby allowing influx of calcium into the intracellular space.

Chronic cardiac failure w/ atrial fibrillationVentricular dilatationSupraventricular arrhythmias.

Hypersensitivity2nd degree atrioventicular

block especially w/ history of Stroke-Adams

attackHypertrophic obstructive

cardiomyopathy

AnorexiaGI disturbancesCNS effectsAtrial

tachycardiaGynecomastia

Assess & document apical pulse for 1full min before giving drug. If pulse <60bpm in adult or <90bpm in an infant or significantly different, reassess after 1hr, inform the physician.

Monitor cardiac status, electrolytes, renal function & ECG continuously during parenteral loading doses & w/ suspected toxicity.


Advise pt. to maintain a Na-restricted diet & take K supplements to prevent toxicity.

DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

EFFECTS RESPONSIBILITYGeneric Name

Furosemide

Brand NameLASIX


(Loop Diuretics)

Dosagetab 40mg

Inhibits Na & Cl reabsorption at the proximal tubules, distal tubules & ascending loop of Henley leading to excretion of water together w/ Na, Cl, & K.DiureticAnti-hypertensive

Treatment of edema associated with CHF, hepatic cirrhosis, & renal disease, HPN.

Hypersensitivity to sulfonylurea

Anuria

Orthostatic Hypotension

Thrombophlebtis

Chronic aortitis

Vertigo Headache Dizziness Restlessne

ss Fever Photosensi

tivity Urticaria Metabolic

Alkalosis Muscle

Spasm Weakness

Assess pt. condition (mental status) before therapy.

Assess fliud volume status, tinnitus, hearing loss.

Monitor VS, renal function, CNS, GI, & integumentary.

Instruct pt. to take w/ food or milk if GI symptom of nausea & anorexia occur.

Teach pt. to take record of own BP, PR & weight.

Advise pt. to wear protective clothing & sunscreen to prevent photosensitivity.

Instruct pt. to lie down when dizziness occurs.

Avoid sudden position changes to prevent Orthostatic HPN.



Generic NameAluminum Hydroxide,Magnesium Hydroxide

Brand NameMAALOX

ClassificationGI Drugs(Antacids,Anti-reflux

Agent, Anti-ulcerants)

Dosageplain 1 tab

Neutralizes gastric acidity thus reduces the total acid load of the GI tract. The elevated gastric pH reduces pepsin activity, strengthens gastric mucosal barrier & increases esophageal sphincter tone.

Peptic, Gastric, Duodenal ulcers; Hyperphospha-temia in chronic renal failure; reflux esophagilitis, hyperacidity, heartburn, stress ulcer prevention in critically ill, GERD.

Severe DebilitationKidney Failure

HypophosphatemiaPartial intestinal

ObstructionAppendicitis

Fecal ImpactionConstipation

ConstipationDiarrheaStomach crampsFecal ImpactionN/V Hypophosphatemia Hypomagnesemia Intestinal

Obstruction in larger doses

Assess pt.’s discomfort before therapy & regularly thereafter to monitor drug effectiveness.

Assess pain symptoms.Monitor for possible

drug induced adverse reactions

Instruct pt. to increase fluids to 2000mL/day unless contraindicated.

Instruct to avoid phosphate-containing foods.

Instruct pt. that the stools may appear white or speckled, constipation may result.

Instruct pt. to separate other medications by 2hrs.



Generic NameEperisone HCl

Brand NameMYONAL

ClassificationGI Drugs

(Anti-spasmodic)

Dosage1tab 50mg

Acts by relaxing both skeletal muscles & vascular smooth muscles.Demonstrates a variety of effects such as reduction of myotomia, improvement of circulation, & suppression of the pain reflex.

Spastic Paralysis in cerebrovascular disease; Improvement of muscular hypertonic symptoms in conditions such as cervical syndrome, lumbago.

HypersensitivityPregnancy & Lactation

ShockAnaphylactic

reactionsSteven Johnson

syndromeToxic

Epidermal Necrosis

AnemiaSleepinessHeadacheN/VAnorexiaAbdominal PainUrinary

retention

Monitor for renal function.

Advise pt. to report adverse reactions.

Caution pt. to avoid hazardous activities like driving or using machinery.



Generic Name

Brand Name

Classification

Dosage

drugs study orig

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