Drug Study

DRUG STUDY Classification: ANTI-INFECTIVES-Quinolones

KARLEEN L. JARO

GENERIC NAME Ciprofloxaci n BRAND NAME Ciprobay

INDICATION

ACTION

Infections of the resp. tract, middle ear,paranas al sinuses, eyes, kidneys, urinary tract

Inhibits bacterial DNA gyrase thus preventing replication in susceptible bacteria

CONTRAINDICATIO N Drugs that inhibit peristalsis. Infants and children, growing adolescents. Pregnancy and lactation

DOSAGE 250-500mg BID

PRECAUTION/ ADVERSE REACTION

NURSING CONSIDERATIO N

PRECAUTION Severe and persistent diarrhea during and after treatment

>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

ADVERSE RXN Common:Nausea, diarrhea, vomiting, rash Uncommon: Anorexia, headache,dizzine ss, fever, GI and abdominal pain, flatulence, confusion, vertigo

Classification: GASTROINTESTINAL DRUGS-Laxatives

KARLEEN L. JARO

GENERIC NAME

LACTULOSE

INDICATION

Constipatio n, BRAND NAME salmonello duphalac sis. Treatment DOSAGE of hepatic Infants: 5 ml encephalo Children: pathy 1-6 y/o- 510ml 7-14y/o15ml 15-45y/o- 1530ml.

ACTION

Inhibits bacterial DNA gyrase thus preventin g replicatio n in susceptib le bacteria

CONTRAINDICATIO N

Pt who require a low lactose diet. Galactosemia deficiency. Intestinal obstruction.

Dose given in 3 days


PRECAUTION: Lactose intolerance, diabetes Adverse Rxn: Abdominal discomfort associated with flatulence and intestinal cramps. Nausea, vomiting, diarrhea on prolonged use.

NURSING CONSIDERATION

>Assess condition before therapy and reassess regularly thereafter to monitor drug’s effectiveness >Monitor pt for any adverse GI reactions, nausea,vomiting,diar rhea, >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

Treatment levocetirizin of e symptoms associated with allergic BRAND conditions NAME (including Xyzal ocular symptoms)

CONTRAINDICATIO N

ACTION Longacting nonsedating antihistami ne that selectively inhibits peripheral HI receptors

Pts with severe renal impairment, pts with rare problems of galactose intolerance

DOSAGE Adult and adolescents more than 12 yrs- 1 tab/day Pedia: 6-12 yrs- 1 tab/ day Classification: ANTI-INFECTIVES-Penicillins

PRECAUTION/ ADVERSE REACTION PRECAUTION Adjustment of dose is recommended in elderly pts w/ compromised renal function. Lactation. ADVERSE RXN Dry mouth, headache, fatigue, rhinitis, abdominal pain, migraine

NURSING CONSIDERATIO N >obtain pt hx inc. drug hx and any unkown allergies >monitor pulse, BP, respiration > observe dizziness and excessive sedation

KARLEEN L. JARO

GENERIC NAME

Amoxicillin BRAND NAME Amoxil DOSAGE Adult: 250500mg every 8 hours Children: 2040mg/kg/d ay divided dosage given every 8 hrs

INDICATION

ACTION

CONTRAINDICATION

Infections of the resp. tract, skin & skin structures,paran asal sinuses, genitourinary tract, otitis media, sinusitis, meningitis,septic emia

Prevents bacterial cell wall synthesis during replication .

Hypersensitivity to penicillins, cephalosporins. Not used to treat pneumonia, bacteremia pericarditis during acute stage.



PRECAUTION: Hypersensitivit y: 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 diarrheashld be discontinue

Classification: CARDIOVASCULAR DRUGS-Calcium Antagonist

KARLEEN L. JARO

GENERIC NAME felodipine BRAND NAME Plendil DOSAGE Adult: 250500mg every 8 hours Children: 2040mg/kg/da y divided dosage given every 8 hrs

INDICATION Treatment of hypertensio n

ACTION Inhibits calcium ion influx across cell membrane, resulting in inhibition of excitation/ contraction.

CONTRAINDICATION Sick sinus syndrome, second or third-degree Av block except with functioning pacemaker, hypotension hypotension with systolic BP<90mmHg

PRECAUTION/ ADVERSE REACTION ADVERSE RXN: Peripheral edema, hypotension, syncope, MI, angina, tachycardia, headache, dizziness, lightheadedness, nausea, vomiting, sinusitis, wheezing cough, sneezing

NURSING CONSIDERATION >assess fluid volume status, adequacy of pulses, pitting edema, dehydration, hypotension, hypotension, dry mouth >monitor cardiac status: BP, pulse, respiration >Assess for angina pain: duration,intensity, aggravating aggravating factors

Classification: CARDIOVASCULAR DRUGS-Angiotensin II Antagonist

KARLEEN L. JARO

GENERIC NAME

TELMISART AN BRAND NAME Pritor DOSAGE Adult: 2080mg daily, usual starting dose 40mg daily

INDICATION

Treatment of hypertension

ACTION

Blocks the vasoconstricti ve ans aldosteroneone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the ATI receptor in many tissues

CONTRAINDICATION

Hypersensitivity, pregnancy, lactation. Severe hepatic or renal impairment



PRECAUTION: >assess pt’s Can cause condition death to the before therapy fetus if used on >Assess for the 2nd heart failure trimester, >Assess for safety in obstructive children not jaundice yet established >monitor for possible drug ADVERSE RXN induced Diarrhea and adverse rxn angioedema. >close Sinusitis, monitoring of pharyngitis, BP and pulse upper resp. tract infection, back pain

Classification: ANTI-DIARRHEALS

KARLEEN L. JARO

GENERIC NAME

Loperamid e HCl BRAND NAME IMODIUM DOSAGE Adult: initially 2 cap; subsequent dose a cap after every stool

INDICATION

ACTION

CONTRAINDICATION

Symptomati c 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 RXN Hypersensitivit y 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

KARLEEN L. JARO

Classification: CENTRAL NERVOUS SYSTEM DRUGS-Anti-anxiety ( Anticonvulsant/Hypnotics/Sedat Anticonvulsant/Hypnotics/Sedatives/Anxiolytics) ives/Anxiolytics) GENERIC NAME

DIAZEPAM BRAND NAME Valium DOSAGE Adult: 250500mg every 8 hours Children: 2040mg/kg/da y divided dosage given every 8 hrs

INDICATION

ACTION

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

CONTRAINDICATION

Hypersensitivity. Dependence, withdrawal symptoms


PRECAUTION: Hypersensitivi ty: cardiorespirat ory insufficiency, pregnancy, lactation ADVERSE RXN Dizziness, 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

KARLEEN L. JARO

Classification: DIETARY/NUTRITIONAL DRUGS-Vitamins and Minerals GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION



KARLEEN L. JARO

Calcium carbonate BRAND NAME Calci-Aid

Antacid, calcium supplement, osteoporosis

Decreases total acid load of GI tract. Increase esophageal sphincter tone

Hypercalcemia, bone tremors, severe renal failure,hypersensit ivity

PRECAUTION: History of stone formation, pregnancy ADVERSE RXN Constipation, flatulence, diarrhea, renal dysfunction, acid rebound

DOSAGE Adult: 1-2 capsules daily Pedia: 1-2 tablets daily

> 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 contraindicate d

Classification: ANTI-ASTHMA GENERIC NAME

INDICATION

ACTION

CONTRAINDICATI ON



KARLEEN L. JARO

Salbutamol BRAND NAME Ventolin vilmax DOSAGE Adult: 8mg tablet BID Pedia: 3-12 yrs 4mg 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

Hype Hypers rsen ensi siti tivi vity ty

PREC PRECAU AUTI TION ON:: Hyperthyroidism ,DM, cardiovascular disease ADVERSE RXN Fine 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 GENERIC NAME

INDICATION

ACTION

CONTRAINDICATI ON



KARLEEN L. JARO

orlistat BRAND NAME Xenical DOSAGE Adult: 1 cap with each main meal

Long-term treatmentof obese and overweight patients with risk factors and comorbiditi, associated with obesity including hypercholesterolemia, NIDD, impaired glusoce tolerance, hypertension and reduction of visceral fat

Inhibits the absorptio n of dietary fat

Chronic malabsorption syndrome

PRECAUTION: Children <18 yrs, pregnancy, lactation, shld be given with caution to diabetic pt.

> 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

ADVERSE RXN Oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation. Fecal incontinence

Classification: ANALGESICS GENERIC NAME

INDICATION

ACTION

CONTRAINDICATIO N


NURSING CONSIDERATIO N

KARLEEN L. JARO

Mefenamic acid BRAND NAME Dolfenal DOSAGE Adult: start with 75150mcg BID Severe HPN 300mg BID

Relief of pain including muscular, rheumatic, traumatic, dental, postop and postpartum pain, headache, migraine, fever, dysmenorrhe a

Aspirin-like drug that has analgesic,antipy retic, & antiinflammatory 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 disease ADVERSE RXN GI 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 GENERIC NAME

INDICATION

ACTION

CONTRAINDICATI ON



KARLEEN L. JARO

chloroquine BRAND NAME chlorofoz

Antacid, calcium suppleme nt, osteoporo sis

DOSAGE Adult: initially four 250mg tablet followed by 2 tab after 6-8 hrs, then2 tab daily for 2 days

Inhibits the perioxidativ e activity of heme, and disrupt its nonenzyma tic polymerizat ion to hemozin

Presence of retinal or visual field changes

PRECAUTION: Hepatic disease, alcoholism, monitor complete blood count ADVERSE RXN Headache, 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 GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION



KARLEEN L. JARO

bisacodyl BRAND NAME Dulcolax DOSAGE Adult: 2 tab at bedtime or 30 mins before breakfast, max 4 tabs Pedia: greater than 4 yrs- 1 tab Suppository: Pedia – 5mg Adult- 10mg

Constipatio n, relief of evacuation in hemorrhoid s, 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 RXN Occasional 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 GENERIC NAME

INDICATION

ACTION

CONTRAINDICATI ON



KARLEEN L. JARO

Carbocisteine BRAND NAME Loviscol DOSAGE Capsule: Adult: 250mg 2 caps, 500mg 1 cap TID Suspension: Adult – 15ml; Pedia: 612yrs: 5ml, 2-5 yrs: 1.252.5 ml Syr: 6-12yrs: 10ml 2-5 yrs: 2.5ml Drops: 12-24mos: 1.25ml, 911mos: 1ml, 6-8mos: 0.75ml, 3-5mos: .50ml, <3mos: 0.25ml All doses 3-4x/ day

Acute/chro nic 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. Hypersensitivit y to carbocisteine

PRECAUTION: Hx of peptic ulcer, hypothyroidis m ADVERSE RXN Nausea, 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 GENERIC NA NAME

INDICATION

ACTION

CONTRAINDICATI ON

PRECAUTIO N/


KARLEEN L. JARO

ADVERSE REACTION

Amiodarone Hcl BRAND NAME Cordarone DOSAGE Tab: initially 3 tab/day maintenance: 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

PRECAUTI ON: Goiter, CHF, respirator y disease ADVERSE RXN Bradycard ia, 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

KARLEEN L. JARO

GENERIC NAME

metoclopramide BRAND NAME Plasil DOSAGE Adult 10mg 3x/day pedia: 15-20yrs 5-10mg 3x/day 5-14yrs: 2.5-5mg 3x/day 3-4yrs: 3mg 23x/day 1-2yrs: 1mg 23x/day Under 1 yr: 1mg 2x/day

INDICATION

ACTION

CONTRAINDICATION

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, lactation, pts. With breast cancer


PRECAUTIO N: Activities requiring mental alertness, elderly, lactation ADVERSE RXN Restlessnes s, 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 GENERIC NAME

INDICATION

ACTION

CONTRAINDICATIO N

PRECAUTION/ ADVERSE


KARLEEN L. JARO

REACTION

metropolol BRAND NAME Neobloc DOSAGE Adult : 50mg BID or 100 mg OD

Hypertensi on, 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 vertigo ADVERSE RXN Occasionally 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

INDICATIO N

phenobarbit al

Shortterm treatment of insomnia, longterm treatment of generalize d toniclonic seizures

BRAND NAME luminal DOSAGE 100-320mg. max 600mg daily

ACTION

Depressant and anticonvulsant effects may be related to its ability to increase the inhibitory activity of GABA on nerve impulses

CONTRAINDICATIO N

Hypersensitivity to barbiturates, pregnancy, severe renal, hepatic, resp. impairment


PRECAUTION: Impaired renal, hepatic cardiac or resp. functions ADVERSE RXN Dizziness, 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

Nystatin BRAND NAME Mycostatin DOSAGE 4-6ml susp 4x/day or 12 tabs 3x/day Infants: 2ml pedia susp 4x/day

INDICATIO N

Antifungal antibiotic used for prophylax is and treatment of candidiasi s of the skin and mucous membran es

ACTION

Interferes with fungal DNA replication: binds sterols in fungal cell membrane, w/c increases permeability, resulting in leaking of cell nutrients

CONTRAINDICATIO N

hyper ypers sens ensitivit vity


PRECA ECAUTION: Discontinue if sensitization occurs ADVERSE RXN Diarrhea, 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 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 Q1015 min (Peds 0.05mg/kg)

INDICATION

ACTION

Helps to reduce - Antidote to saliva and overdosage with fluid in the cholinergic respiratory substances tract. (nerve gases, May also poisonous be used to treat a mushroom) slow heartbeat - Pre-op or medication to insecticide reduce salivary or and resp. tract mushroom secretions. poisoning

CONTRAINDICATION

SIDE EFFECTS

Contraindicated 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

NURSING CONSIDERATION •

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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

Pediatric: 0.02mg/kg (minimum 0.1mg

Classification: Andrenergics

KARLEEN L. JARO

GENERIC NAME Dobutamin e HCL

BRAND NAME Dobutrex

Infusion rate: 2.5-10 mcg/kg/min

INDICATION Increased cardiac output in short-term treat ment of cardiac decompensati on caused by depressed contractility, such as during refractory heart failure; adjunctive therapy in cardiac surgery

ACTION

CONTRAINDICATI ON


SIDE EFFECTS

Before starting dobutamine therapy: (1) give a plasma volume expander to correct hypovolemia hypovolemia (2) give cardiac glycoside Continuously monitor ECG, blood pressure, pulmonary artery wedge pressure, cardiac output and urine output Monitor Electrolyte 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

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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 hypersensitive to drug and in those with idiopathic hypertrophic subaortic stenosis Use cautiously in patients with history of hypertension because drug may increase pressor response Use cautiously in patients with history of sulfite sensitivity .

Increased heart rate, hypertension, Angina, phlebitis, nonspecific chest pain, palpitations, hypotension, nausea, vomiting, shortness of breath, hypersensitivit y reactions

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KARLEEN L. JARO

site

Classification: Antihistamine/ Antihistamine/ anti allergic GENERIC NAME

INDICATION

ACTION

CONTRAINDICATI ON

SIDE EFFECTS


KARLEEN L. JARO

Diphenhydra mine HCl BRAND NAME Benadryl DOSAGE Capule/syrup

Adult: 50 mg tid-qid. Children >20 lb: 12.5-25 mg tidqid

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

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Antihistami ne that reduces allergic reactions, motion sickness and vertigo (dizziness and loss of balance), and Parkinson's disease

Premature & newborn infants; asthma attack; lactation

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CV & CNS effects Blood disorders GI disturbances Antimusc arinic effects Allergic 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

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Classification: Antagonist and antidotes GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION

SIDE EFFECTS/ ADVERSE REACTION


KARLEEN L. JARO

Naloxone hydrocholori de BRAND NAME Narcan DOSAGE Adult : 0.4 -2 mg IV q2 to 3 mins. p.r.n.

Displaces Known previously suspected administer narcotic ed induced narcotic respiratory analgesics depression from their including that receptors. cause by Has no pentazocine pharmacol and ogic propaxyphene activity of its own

Patient known to be hypersensitive to naloxone hydrochloride

Tachycardia Hypertension Nausea Vomiting Tremors

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 NA NAME

Hyoscine-Nbutylbromide BRAND NAME

Buscopan DOSAGE Adult & childn >6 yr 1-2 tab 3-5 times daily. Amp Acute attacks of colicky pain Adolescent >12 yr 12 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

INDICATION

indicated for the control of abdominal pain (colic) associated with spasmodic colic, flatulent colic

ACTION

CONTRAINDICATION

Relieve cramps or spasms of the stomach,in testines, and bladder

Myasthenia gravis, megacolon. Parenteral Untreated narrowangle glaucoma, prostate hypertrophy w/ urinary retention, mechanical stenosis of GIT, tachycardia

SIDE EFFECTS/ ADVERSE REACTION xerostomi

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a tachycardi

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a 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 •

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NURSING CONSIDERATION Drug compatibility should be monitored closely in patients requiring adjunctive therapy Avoid driving & operating machinery after parenteral administration Avoid strict heat

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KARLEEN L. JARO

wt/day.

Classification: CNS stimulant

GENERIC NAME

INDICATION

ACTION

CONTRAINDICATI ON

SIDE EFFECTS/ ADVERSE REACTION


KARLEEN L. JARO

Citicoline BRAND NAME

Somazine amp DOSAGE

125 mg/mL 12 inj/day.

CVD in acute & recovery phase, symptoms & signs of cerebral insufficiency (dizziness, memory loss, poor concentration, disorientation, recent cranial trauma & their sequelae.)

250 mg/mL 1 inj/day

- 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 tyrosinehydroxylase.

Parasympathetic hypertonia

Gastrointestinal disorders

•Somazine must not be administered along with medicaments containing meclophenoxate

Classification: Loop Diuretic

KARLEEN L. JARO

GENERIC NAME Furosemide BRAND NAME

INDICATION acute pulmonary edema edema hypertension

Lasix DOSAGE Adult:

Initially 1/2-1-2 tab/day Maintenance: 1/2-1 tab/day

ACTION inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle

CONTRAINDICATI ON Anuria hepatic coma & precoma severe hypokalemia &/or hyponatremia hypovolemia w/ or w/o hypotension Hypersensitivity Hypersensitivity to furosemide or sulfonamides

SIDE EFFECTS

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NURSING CONSIDERATION 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

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vertigo, dizziness, headache, paresthesia, orthostatic hypotension, thrombophlebitis, abdominal pain, hypokalemia, anemia muscle spasm

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20-40 mg IV/IM Children:

2 mg/kg

body/wt

Classification: Anri- ulcer

KARLEEN L. JARO

GENERIC NAME Ranitidine HCL BRAND NAME

Xantac DOSAGE 50 mg by slow IV then 0.1250.25 mg/kg/hr as continuous IV infusion

INDICATION

ACTION

•Duodenal and gastric ulcers

Completely inhibits action of histamine on the H2 at receptor sites of parietal cells, decreasing gastric acid secretions

•Maintenance therapy for gastric and duodenal ulcer •GERD •Erosive esophagitis

CONTRAINDICATI ON Contraindicated 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

SIDE EFFECTS • Vertigo, malaise, headache, blurred vision, jaundice, burning and itching at injection site

NURSING CONSIDERATION •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.

•Heartburn •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

KARLEEN L. JARO

Classification: Nutrional Agents (Calorics) GENERIC NAME Dextrose BRAND NAME DOSAGE Dosage depends on fluid and caloric requirements

INDICATION

ACTION

Fluid replacement and caloric supplementati on in patient who can’t maintain adequate oral intake or who is restricted from doing so.

Minimize glyconeogenesi s and promotes anabolism in patients who can’t receive sufficient oral caloric intake.

CONTRAINDICATI ON Hyperglycemia, diabetic coma, intracranial or intra spinal hemorrhage or delirium tremens.

SIDE EFFECTS •

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Mental confusion, unconsciousne ss in hyperosmolar nonketotic syndrome. Pulmonary edema Glycosuria, osmotic diuresis Metabolic: hyperglycemia , hypervolemia Rapid termination after long term infusion may cause hypoglycemia rebound

NURSING CONSIDERATION Use cautiously in cardiac or pulmonary disease, hypertension, renal insufficiency 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. •

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KARLEEN L. JARO

hyperinsuline mia. Sloughing and tissue necrosis

Classification: Classification: Electrolytes Electrolytes and replacement solutions solutions GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION

SIDE EFFECTS


KARLEEN L. JARO

Calcium gluconate BRAND NAME

Hypocalcemia, hypocalcemic tetany, magnesium toxicity, hypoparathyroidism

Replaces and maintains calcium

Hypercalcemia, ventricular fibrillation, renal canaliculi

Kalcinate

GI irritation hemorrhage constipation vomiting thirst renal canaliculi hypercalcemia polyuria

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Use cautiously in patients with sarcoidosis and renal or cardiac disease and in digitalized patients. monitor blood calcium level frequently.

DOSAGE Tablets 500 mg, 650 mg, 975 mg, 1 g (contains 90 mg elemental calcium/g)

Classification : Non narcotic /analgesics and antipyretic/ antipyretic/ antiplatelet GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION

ADVERSE REACTION


KARLEEN L. JARO

Mild pain/fever

Aspirin (acetylsalicylic acid)

Arthritis

BRAND NAME

Reduce risk of heart attack in patient with previous MI or unstable angina

Aspilet

Produces analgesia by an ill defined effect on the hypothalamus and by blocking generation of pain impulses (peripheral action)

GI ulcer GI bleeding Patients with bleeding disorders Aspirin hypersensitivity Vit.K deficiency

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DOSAGE Fever/mild pain:

Prolonged bleeding time Tinnitus Hearing loss Nausea,vomiting GI distress Occult bleeding Abnormal liver function Rash 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.

ADVERSE REACTION


Also impedes clotting by blocking prostaglandin synthesis which prevents formation of plateletaggregating substances.

325-650 mg P.O q4 hours; p.r..n unstable angina: 325 P.O once/daily

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Classification : Antihypertensives GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION

KARLEEN L. JARO

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Clonidine hydrochloride BRAND NAME

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Essential renal and malignant hypertension

Catapres

Inhibits central vasomotor centers, thereby decreasing sympatheric outflow.

Patient hypersensitive to clonidine

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DOSAGE

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01-02 mg P.O B.

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drowsiness dizziness fatigue sedation nervousness headache orthostatic hypotension bradycardia urine retetion impotence transient glucose intolerance (after large dose) constipation pruritis 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 defribrillation to prevent arcing •

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Classification : Antianginals GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION

ADVERSE REACTION


KARLEEN L. JARO

Nifedipine BRAND NAME

•Vasospastic angina, classic chronic stable angina pectoris •Hypertension

Adalat DOSAGE Adults: Initial: 10-30mg PO TID Maximum: 120180mg

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

Hypertension: 30-60mg PO

Dizziness, lightheadedness, headache, weakness, peripheral edema, flushing, nausea, Syncope, nervousness, hypotension, palpitations, nasal congestion, diarrhea, constipation, abdominal discomfort, muscle cramps, dyspnea, pulmonary edema, cough, rash, puritus

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Don’t give immediate-release form within 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, hypotension, MI, and death may result Monitor blood pressure regularly, especially in patients who take beta blockers or antihypertensive antihypertensive Watch for symptoms of heart failure

Classification : Antianginals GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION

SIDE EFFECTS


KARLEEN L. JARO

Nicardipine BRAND NAME

Chronic stable angina

Cardipine

DOSAGE Initially 20 mg P.O Tid hypertension 20 to 40 mg P.O t.i.d increase dosage depends on the patients response

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

Dizziness Headache Paresthesis Drowsiness Peripheral edema Palpitations Tachycardia Nausea Dry mouth Abdominal discomfort Rash Flushing

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Patients with hepatic impairment should receive lower dose

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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 GENERIC NAME

INDICATION

ACTION

CONTRAINDICATION

SIDE EFFECTS


KARLEEN L. JARO

Dexamethasone BRAND NAME Dexon

Inflammation of corticosteroidresponsive dermatoses

Diffuses across cell membrane and complexes with specific cytoplasmic receptors

Patient had an allergic reaction previously. Have an active peptic ulcer Have an active herpes simplex fungal or mycobacterial mycobacterial infection ot the eye, ear infection

DOSAGE The initial dosage varies from 0.75 to 9 mg a day depending on the disease being treated

antiinflammatory effects in disorders of many organ systems

Increased appetite Weight gain Water retention Increased WBC Hypokalemia Skin rash Dizziness Insomia Headache

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.

Active tuberculosis Have psychoneurosis or psychosis

Treatment should be continued for a few days after clearing of lesions to prevent recurrence

KARLEEN L. JARO

Drug Study

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