mam ena

8/6/2019 mam ena

1/8

DRUG ACTION INDICATION ADVERSE

EFFECTS

CONTRAINDICATIONS NURSING

CONSIDERATIONS

KETOROLAC

TROMETHAMINE(Toradol) 30 mgIV q6 x 4 doses (-) ANST

Classification: NSAID

Inhibit

prostaglandinsynthesis toproduce anti-

inflammatory,analgesic and

antipyreticeffects.

Short-termmanagementofmoderately

severe, acutepain for

single-dosetreatment.

Headache Dizziness Visual

disturbances

Nausea Abdominal

pain Dyspepsia Vomiting Dyspnea Rash flatulence

Contraindicated inpatients hypersensitive todrug and in those withhistory of aspirin or

NSAID inducedasthma, urticarial or

other allergic reactions. Avoid use during last

trimester of pregnancy.

Drug isnt recommendedfor children or breast-feeding women.

Use cautiously inpatients with history of

peptic ulcer disease,renal dysfunction,hypertension, heart

failure, or fluid retention.

Sustained-release form isntrecommended for patientsin acute pain.

Because NSAIDs impairsynthesis of renalprostaglandins, they can

decrease renal blood flowand lead to reversible renal

impairment, especially in

patients with renal or heartfailure or liver dysfunction,in elderly patients, and in

those taking diuretics.Monitor these patients

closely. Check renal and hepatic

function every 6 months or

as indicated. Drug decreases platelet

adhesion and aggregation,and can prolong bleeding

time about 3-4 mins. frombaseline.

NSAIDs may mask signsand symptoms of infectionbecause of their antipyreticand anti-inflammatory

actions. Serious GI toxicity,

including peptic ulcers andbleeding, can occur in

patient taking NSAIDs,

despite lack of symptoms.

8/6/2019 mam ena

2/8

DRUG ACTION INDICATIONS ADVERSEEFFECTS

CONTRAINDICATIONS NURSINGCONSIDERATIONS

ACETYLCYSTEINE

(Fluimucil) 200 mg 1sachet in 200 ml waterper orem q 6 x 3 days

Classification:

Mucolytic Agent

Acetyl-L-cysteine

(NAC), activeingredient ofFluimucil, exerts an

intensive mucolytic-fluidifying action on

mucous andmucopurulent

secretions, bydepolymerizing the

mucoproteiccomplexes and the

nucleic acids whichconfer viscosity to

the vitreous andpurulent component

of the sputum and ofthe secretions.

Treatment ofrespiratoryaffectionscharacterized by

thick and viscoushypersecretions:

acute bronchitis,chronic

bronchitis and itsexacerbations;

pulmonaryemphysema,

mucoviscidosisand

bronchieactasis.

Bronchospasm

Angioedemarashespruritus

NauseaVomiting

FeverSyncope

SweatingArthralgia

blurred visiondisturbances of liver

function.

Known hypersensitivityto acetylcesteine. AsAcetylcysteine(Fluimucil) granules

and tablets containaspartame, it is

contraindicated inpatients suffering from

phenylketonuria.

Patients sufferingfrom bronchialasthma must bestrictly monitored

during thetherapy. Should

bronchospasmoccur, the

treatment must besuspended

immediately. Itshould be used

with caution inasthmatic patients

and patients with ahistory of peptic

ulceration.

8/6/2019 mam ena

3/8

DRUG ACTION INDICATIONS ADVERSEEFFECTS


HYDRALAZINE

(Apresoline) 1 mgTIV forBP > 140/90

Classification:Antihypertensive

A direct-acting

peripheralvasodilator thatrelaxes arteriolar

smooth muscle.

Severe essentialhypertension

Preeclampsia oreclampsia

Headache Dizziness Orthostatic

hypotension

Tachycardia Angina pectoris Palpitations Nasal

congestion Nausea Vomiting Anorexia Constipation Rash

Contraindicated inpatients hypersensitiveto drug.

Contraindicated inthose with coronaryartery disease or mitral

valvular rheumaticheart disease.

Use cautiously inpatients with suspected

cardiac disease, strokeor severe renal

impairment and inthose taking other

antihypertensives.

Monitor patients bloodpressure, pulse rate, andbody weight frequently.Drug may be given with

diuretics and betablockers to decrease

sodium retention andtachycardia and to

prevent angina attacks. Monitor patient closely

for signs and symptomsoflupuslike syndrome

(sore throat, fever,muscle, joint aches, rash),

and notify prescriberimmediately if they

develop.

8/6/2019 mam ena

4/8

DRUG ACTION INDICATION ADVERSEEFFECTS


FUROSEMIDE

(Lasix) 20 mg TIV q8 x 3 doses

Classification:Loop-Diuretics

A potent loop

diuretic that inhibitssodium and chloridereabsorption at the

proximal and distaltubules and the

ascending loop ofHenle.

Hypertension Headache Dizziness Thrombophlebitis Orthostatic

hypotension Frequent urination Hepatic

dysfunction

Muscle spasm Hyperglycemia hypocalcemia

Contraindicated inpatients hypersensitiveto drug and in thosewith anuria.

Use cautiously inpatients with hepatic

cirrhosis and in thoseallergic to

sulfonamides.

To preventnocturia, give P.O.and I.M.preparations in the

morning. Givesecond dose in

early afternoon. Monitor weight,

blood pressure,and pulse rate

routinely withlong-term use and

during diuresis.Use can lead to

profound waterand electrolyte

depletion. Monitor fluidintake and outputand electrolyte,

BUN, and carbondioxide levels

frequently. Watch for signs of

hypokalemia, suchas muscle

weakness andcramps.

Store tablets in alight-resistant

container toprevent

discoloration.

8/6/2019 mam ena

5/8



NALBUPHINE

HCL

(Nubain) 10 mg IV q4 x 6 doses

Classification:

Opioid Analgesic

Binds with

opiate receptorsin the CNS,altering

perception andemotional

response to pain.

Moderate tosevere pain

Headache Sedation Depression Restlessness Nervousness Dizziness Hallucinations Delusions Hypertension Hypotension Tachycardia Bradycardia Cramps Nausea Vomiting Constipation U

rinary urgency Respiratorydepression

Burning


Use cautiously inpatients those withemotional instability,

impaired ventilation,hepatic or renal disease

Reassess patients levelof pain at least 15-30minutes after parenteraladministration.

Drug as act as an opioidantagonist & may cause

withdrawal syndrome.For patients who have

received long-termopioids, give 25% of the

usual dose initially.

Watch for signs of

withdrawal. Drug causes respiratory

distress, which at 10 mgis equal to respiratory

depression produced by10 mg of morphine.

Monitor circulatory,respiratory status &

bladder & bowelfunction. If respirations

are shallow or rate isbelow 12breaths/minute,

withhold dose and notifyprescriber.

Constipation is often.Make sure stool softener

is ordered. Psychological and

physical dependencemay occur with

prolonged use.

8/6/2019 mam ena

6/8



PARACETAMOL

(Biogesic)37.5 C/ 325 mg 1 tabq 6 for 3 days

Classification:

Analgesic &Antipyretic

Produce analgesia by

blocking painimpulses byinhibiting synthesis

of prostaglandin inthe CNS or of other

substances thatsensitize pain

receptors tostimulation. The

drug relieve feverthrough central

action in thehypothalamic heat-

regulating center.

Mild pain orfever

Rash Urticaria Hypoglycemia Hemolytic anemia jaundice


Many OTC andprescriptionproducts containacetaminophen; be

aware ofcalculating total

daily dose.


EFFECTS


CONSIDERATIONS

CEFUROXIME

SODIUM

(Zinacef) 750 mg IV

q 8 x 3 doses

Classification:Antibiotic

Second-generation

cephalosporin thatinhibits cell-wall

synthesis, promotingosmotic instability,

usually bactericidal.

Perioperativeprevention

Lower-respiratorytract infection

Phlebitis Nausea Anorexia

Vomiting Diarrhea Hemolytic anemia Temperature

elevation Maculopapular

rashes

Contraindicated topatients hypersensitiveto drug or other

cephalosporins. Use cautiously in

patient hypersensitiveto penicillin because of

possibility ofcross0sensitivity with

other beta-lactamantibiotics.

Use cautiously inbreastfeeding women.

Before givingdrug, ask of he isallergic to

cephalosporin orpenicillin.

Obtain specimenfor culture and

sensitivity beforegiving first dose.

8/6/2019 mam ena

7/8



GENTAMICIN

SULFATE

(Garamycin) IV OD x2 doses

Classification:

AminoglycosideAntibiotic

Inhibits protein

synthesis by bindingdirectly to the 30Sribosomal subunit;

bactericidal.

Serious infectioncaused bysensitive strainsofPseudomonas

aeruginosa,E.Coli,

Staphylococcus.

Fever Headache Lethargy Confusion Dizziness Hearing loss Hypotension Blurred vision Vomiting Nausea Anemia Muscle-twitching Apnea Rash

Contraindicated inpatient hypersensitiveto drug and otheraminoglycosides.

Use cautiously inpatients with impaired

renal function.

Obtain specimenfor culture andsensitivity beforegiving first dose.

Evaluate patientshearing before and

during therapy.Notify prescriber if

patient complainshearing loss.

Weigh patient andreview renal

function beforetherapy begins.

Therapy usuallycontinues for 7-10

days. If noresponse occurs in

3-5 days, stoptherapy and obtain

new specimens forculture and

sensitivity testing.

8/6/2019 mam ena

8/8


EFFECTS


CONSIDERATIONS

TRAMADOL HCL

(Ultram)

mam ena

Documents