66750257 drug-study
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Narcotan® - Concise Prescribing Information
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See related Narcotan inj informationAbbreviation Index
Manufacturer Troikaa Pharma
Distributor Pharmasan
Contents Naloxone HCl
Indications Used to reverse opioid central depression, including
resp depression, induced by natural or synthetic
opioids in the following situations: Treatment of
known or suspected opioid overdose. Post-op
following the use of opioids during surgery. In
neonates following the administration of opioid
analgesics to the mother during labor.
Dosage Opioid overdose Initially, 0.4-2 mg IV repeated at
intervals of 2-3 min if necessary. Childn 10 mcg/kg
body wt IV then up to 100 mcg/kg if necessary.
Doses may be administered via IM or SC. Post-op
100-200 mcg (1.5-3 mcg/kg) IV at 2-min intervals.
Opioid-induced depression Neonates 10 mcg/kg
IV, IM or SC inj then repeat at intervals of 2-3 min or
a single IM dose of 60 mcg/kg.
Special
Precautions
Physically-dependent or recipient of large doses of
opioids. Cardiac problems or patients receiving
cardiotoxic drugs.
Adverse
Drug
Reactions
Nausea, vomiting, hypotension, HTN, cardiac
arrhythmias, pulmonary edema, seizures.
View ADR Monitoring Form
Pregnancy
Category
(US FDA)Category B: Either animal-reproduction studies
have not demonstrated a foetal risk but there are no
OxyContin® - Concise Prescribing Information
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> Contraindications> Warnings> Special Precautions> Adverse Drug Reactions> Drug Interactions> Pregnancy Category (US FDA)> Caution For Usage
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Related Information
See related OxyContin PR tab informationAbbreviation Index
Manufacturer Mundipharma
Distributor Zuellig
Contents Oxycodone HCl
Indications Moderate to severe pain.
Click to view OxyContin detailed prescribing
infomation
Dosage Individualize treatment using a progressive plan
of pain management eg outlined by WHO. To
be swallowed whole & not to be broken,
chewed or crushed. Opioid-naive adult Starting dose: 10 mg 12 hrly.
Click to view OxyContin detailed prescribing
infomation
Overdosage View OxyContin overdosage for action to be
taken in the event of an overdose.
Administration May be taken with or without food (Swallow
whole, do not break/chew/crush. Taking broken,
chewed or crushed tab leads to rapid release &
absorption of a potentially fatal dose of
oxycodone.).
Contraindications Significant resp depression, acute or severe
bronchial asthma or hypercarbia. Patient w/ or
suspected of having paralytic ileus. Lactation.
Click to view OxyContin detailed prescribing
infomation
Warnings For additional cautionary notes to warn of the
potential risk of using the medicine... click to
view OxyContin detailed prescribing infomation
Special
Precautions
The 80-mg tab is for opioid-tolerant patients
only. Acute alcoholism, adrenocortical
insufficiency, CNS depression or coma, delirium
tremens, debilitated patients, kyphoscoliosis
associated w/ resp depression, myxedema or
hypothyroidism, prostatic hypertrophy or
urethral stricture, severe hepatic, pulmonary or
renal impairment, toxic psychosis & patients
taking MAOIs. May obscure the diagnosis or
clinical course in patients w/ acute abdominal
conditions. May aggravate convulsions in
patients w/ convulsive disorders or seizures in
some clinical settings. Pregnancy & childn.
Click to view OxyContin detailed prescribing
infomation
Adverse Drug Resp depression & arrest, apnea, circulatory
Reactions depression, hypotension or shock. Constipation,
nausea, somnolence, dizziness, vomiting,
pruritus, headache, dry mouth, sweating,
asthenia.
View ADR Monitoring Website
Drug Interactions Additive effects w/ sedatives or hypnotics,
general anesth, phenothiazines, tranquilizers,
neuroleptics, antidepressants & alcohol.
Agonist/antagonist analgesics ie pentazocine,
nalbuphine, butorphanol, buprenorphine.
Silgram® - Concise Prescribing Information
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Related Information
See related Silgram informationAbbreviation Index
Manufacturer YSS
Distributor Cathay Drug
Contents Per 375 mg vial Ampicillin 250 mg, sulbactam
125 mg. Per 750 mg vial Ampicillin 500 mg,
sulbactam 250 mg. Per 1.5 g vial Ampicillin 1 g,
sulbactam 500 mg
Indications Treatment of upper & lower resp tract
infections, gynecological infections & as a
prophylaxis to reduce the risk of infections
following surgery caesarian & birth.
Dosage Adult 1.5-3 g 6 hrly. Acute pelvic inflammatory disease 3 g 6 hrly in conjunction
w/ doxycycline (100 mg 12 hrly by oral or IV).
Parenteral regimen may be discontinued 24 hrs
after clinical improvement; oral doxycycline
should be continued to complete the 14 days of
therapy. Childn ≥1 yr 300 mg/kg daily by IV
infusion in equally divided doses 6 hrly; ≥1 mth
Mild to moderate infection 100-150 mg/kg
daily in 4 divided doses.
Contraindications Hypersensitivity.
Special
Precautions
Patients w/ mononucleosis. Superinfections
involving pseudomonas & candida (discontinue
the drug).
Adverse Drug Serious anaphylactoid reactions.
Reactions View ADR Monitoring Form
Drug Interactions Probenecid, allopurinol, aminoglycosides.
View more drug interactions with Silgram
Pregnancy
Category (US
FDA)Category B: Either animal-reproduction studies
have not demonstrated a foetal risk but there
are no controlled studies in pregnant women or
animal-reproduction studies have shown an
adverse effect (other than a decrease in fertility)
that was not confirmed in controlled studies in
women in the 1st trimester (and there is no
evidence of a risk in later trimesters).
MIMS Class PenicillinsATC
Classification
J01CR04 - Sultamicillin ; Belongs to the class of
penicillin combinations, including beta-
lactamase inhibitors. Used in the
Delivery room
Comxytocin® - Concise Prescribing Information
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Related Information
See related Comxytocin infusion informationAbbreviation Index
Manufacturer Rotexmedica
Distributor Commerz
Contents Oxytocin
Indications Induction or stimulation of labor in hypotonic
uterine inertia. Prevention & treatment of
postpartum uterine atony & hemorrhage. Early
stages of pregnancy as an adjunctive therapy
for the management of incomplete, inevitable or
missed abortion.
Dosage Induction or enhancement of labor IV drip infusion 10 iu added to 1 L physiologic saline
electrolyte soln. For patients whom infusion of
NaCl must be avoided use 5% dextrose soln as
diluent. Initial infusion rate 1-4 mU/min (2-8
drops/min). Gradually increase at intervals not
<20 min, until a contraction pattern similar to
that of normal labor is established. Max rate: 20
mU/min (40 drops/min). Caesarean section 5
iu by slow IV inj immediately after delivery.
Prevention of post-partum uterine hemorrhage 5 iu slow IV after delivery of the
placenta. Treatment of post-partum uterine hemorrhage 5-10 iu IM or 5 iu slow IV followed
in severe cases by IV infusion of 5-20 iu of
oxytocin in 500 mL of non-hydrating diluent.
Missed abortion 5 iu IM or slowly IV. If
necessary, follow by IV infusion 20-40 mU/min.
Contraindications Hypertonic uterine contraction, mechanical
obstruction to delivery, fetal distress. Significant
cephalopelvic disproportion, fetal
malpresentation, placenta previa, placental
abruption, cord presentation or prolapse,
overdistension or impaired resistance of the
uterus to rupture as in multiple pregnancy,
polyhydramnios, grand multiparity & in uterine
scar. Do not use for prolonged period in
patients w/ oxytocin-resistant uterine inertia,
severe pre-eclamptic toxemia or severe CV
disorder.
Special
Precautions
Administration should only be under hospital
condition & qualified medical supervision. For
induction & enhancement of labor administer
only as an IV infusion. Carefully monitor fetal
heart rate & uterine motility. Caution use in
borderline cephalopelvic disproportion,
secondary uterine inertia, mild to moderate
degrees of pregnancy-induced HTN or cardiac
disease & patients >35 yr or w/ history of lower-
uterine-segment Caesarean section. Avoid
tumultous labor in fetal death in utero &/or
meconium-stained amniotic fluid. For the
prevention & treatment of uterine hemorrhage,
avoid rapid IV inj.
Adverse Drug
Reactions
Uterine spasm in low doses. High doses may
result in uterine overstimulation that may cause
fetal distress, asphyxia & death, or may lead to
hypertonicity, tetanic contractions, soft tissue
damage or rupture of the uterus. Rapid IV bolus
inj may cause short-lasting hypotension
accompanied w/ flushing & reflex tachycardia.
View ADR Monitoring Form
Drug Interactions prostaglandin, inhalation anesthetics eg
cyclopropane or halothane, sympathomimetic
vasoconstrictor agent.
View more drug interactions with Comxytocin
Medisyl® - Concise Prescribing Information
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Manufacturer Korea United Pharma
Distributor Scheeling Pharma Care Link
Contents Methylergometrine maleate
Click to view methylergometrine information
Indication &
Dosage
For details on therapeutic uses and relevant dosage
relating to the methylergometrine ... Click to view
methylergometrine
Pregnancy
Category
(US FDA)Category C: Either studies in animals have
revealed adverse effects on the foetus (teratogenic
or embryocidal or other) and there are no controlled
studies in women or studies in women and animals
are not available. Drugs should be given only if the
potential benefit justifies the potential risk to the
foetus.
MIMS Class Drugs Acting on the UterusATC
Classification
G02AB01 - Methylergometrine ; Belongs to the
class of ergot alkaloids. Used to induce abortion or
augment labour and to minimize blood loss from the
placental site.
Poison
Schedule [?]Rx
Presentation/PackingForm Packing/Price Photo
Medisyl injection Medisyl 200 mcg/1 mL x 10's (P916.5)Manufacturer: Korea
United Pharma
Distributor: Scheeling Pharma Care Link
Related Medisyl inj information:Drugs interacting with MedisylFind Medisyl in other countriesSearch Medisyl in GoogleSearch Medisyl in PubMed
Oxitone® - Concise Prescribing Information
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See related Oxitone infusion informationAbbreviation Index
Manufacturer Harson
Distributor Phil Pharmawealth
Contents Oxytocin
Indications Induction of labor, stimulation of labor in
hypotonic uterine inertia; management of
missed & incomplete abortion; postpartum
hemorrhage in patients who do not respond to
ergometrine.
Dosage IV drip infusion 1 u of oxytocin in 1 L 5%
dextrose soln delivers approx 1 milliunit/min
when infused at a rate of 1.5 drops/min.
Induction or stimulation of labor Physiological oxytocin infusion: 2-5
milliunits/min. Pharmacological oxytocin
infusion: Initially 1.53 milliunits/min adjusted
gradually until contractions occur every 2-5 min;
infusion rate: Max 12 milliunits/min. Oxytocin
titration: Initially 1 milliunit/min, then double the
rate of flow every 20 min, until contractions last
40-50 sec occurring at intervals of 2-3 min.
Doses of oxytocin up to 128 milliunits/min have
been used. Missed abortion 10-20 u/500 mL of
5% dextrose soln increasing by 10-20 u/500 mL
every hr to a max of 100 u/500 mL if necessary.
Infusion rate: 10-30 drops/min.
Contraindications Hypertonic uterine inertia, mechanical
obstruction to delivery, failed trial labor, severe
toxemia, predisposition to amniotic fluid
embolism, fetal distress & placenta previa.
Special
Precautions
Caution should be exercised in patients with
parity & previous caesarian section. CV
disorders.
Adverse Drug
Reactions
Uterine spasm, very high dose may cause
violent uterine contractions leading to uterine
rupture, tissue damage & asphyxia of the fetus.
View ADR Monitoring Form
Drug Interactions Prostaglandins may potentiate the effects of
oxytocin.
View more drug interactions with Oxitone
Pregnancy
Category (US
FDA)Category X: Studies in animals or human
beings have demonstrated foetal abnormalities
or there is evidence of foetal risk based on
human experience or both, and the risk of the
use of the drug in pregnant women clearly
outweighs any possible benefit. The drug is
contraindicated in women who are or may
become pregnant.
MIMS Class Drugs Acting on the UterusATC
Classification
H01BB02 - Oxytocin ; Belongs to the class of
oxytocin and analogues. Used in posterior
pituitary lobe hormone preparations.
Poison Schedule [?]
Rx
Presentation/Packing
Roxipan® - Concise Prescribing Information
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> Contraindications> Warnings
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Manufacturer Panpharma-Meinz
Distributor Panpharma-Meinz
Contents Oxytocin
Indications Induction & augmentation of labor, to control
postpartum bleeding & uterine hypotonicity in
the 3rd stage of labor & to promote lactation in
cases of faulty milk ejection.
Click to view Roxipan detailed prescribing
infomation
Dosage Induction or enhancement of labor Drip infusion Initially, 1-4 milliunits/min (2-8
drops/min). May be gradually increased at
intervals not <20 min, until a contraction pattern
similar to normal labor is established.
Caesarean section 5 iu by slow IV inj
immediately after delivery. Prevention of postpartum uterine hemorrhage 5 iu by slow
IV after delivery of the placenta. Treatment of postpartum uterine hemorrhage 5-10 iu IM or
5 iu slow IV, followed in severe cases by IV
infusion of 5-20 iu in 500 mL of non-hydrating
diluent at the rate necessary to control uterine
atony. Incomplete, inevitable or missed abortion 5 iu IM or slow IV if necessary
followed by IV infusion at the rate of ≥20-40
milliunits/min.
Click to view Roxipan detailed prescribing
infomation
Overdosage View Roxipan overdosage for action to be taken
in the event of an overdose.
Contraindications Do not administer by IV bolus. Prolonged use in
patients w/ oxytocin-resistant uterine inertia,
severe preeclamptic toxemia or severe CV
disorders. Hypertonic uterine contractions,
mechanical obstruction to delivery, fetal
distress. Significant cephalopelvic disproportion,
fetal malpresentation, placenta praevia & vasa
praevia, placental abruption cord presentation
or prolapse, overdistention or impaired
resistance of the uterus to rupture as in multiple
pregnancy, polyhydramnios, grand multiparity &
presence of a uterine scar. Infusion via the
same apparatus as blood or plasma.
Click to view Roxipan detailed prescribing
infomation
Warnings For additional cautionary notes to warn of the
potential risk of using the medicine... click to
view Roxipan detailed prescribing infomation
Special
Precautions
Careful monitoring of fetal heart rate & uterine
motility. Caution in the presence of borderline
cephalopelvic disproportion, secondary uterine
inertia, mild to moderate degrees of pregnancy-
induced HTN or cardiac diseases, ≥35 yr or w/
a history of lower-uterine-segment cesarean
section. Water intoxication w/ prolonged
administration of high doses. Avoid rapid IV inj.
Careful monitoring in the concomitant
administration w/ prostaglandins.
Click to view Roxipan detailed prescribing
infomation
Adverse Drug
Reactions
Uterine spasm at low doses. Fetal distress,
asphyxia & death, hypertonicity, tetanic
contractions, soft tissue damage or rupture of
the uterus at high doses. Water intoxication
(headache, anorexia, nausea, vomiting &
abdominal pain), lethargy, drowsiness,
unconsciousness & grand mal type seizure, low
blood electrolyte conc. Acute short-lasting
hypotension w/ flushing & reflex tachycardia w/
rapid IV bolus inj.
View ADR Monitoring Website
Drug Interactions Prostaglandins. Inhalation anesth eg
cyclopropane or halothane. Sympathomimetic
vasoconstrictor agents. Soln containing Na
metabisulfite.
View more drug interactions with Roxipan
DRUG STUDY 1. Generic Name:Methylergonovine maleate Brand Name: Methergine Classification: Oxytocic
Therapeutic Actions: • A partial agonist or antagonist at alpha receptors; as a result, it increases the strength, duration, and frequency of uterine contractions. Indications: • Routine management after delivery of the placenta. • Treatment of postpartum atony and hemorrhage; subinvolution of the uterus. • Uterine stimulation during the second stage of labor following the delivery of the anterior shoulder, under strict medical supervision. Contraindications • Contraindicated with allergy to methylergonovine, hypertension, toxemia, lactation, pregnancy. Adverse Effects:
CNS: Dizziness, headache, tinnitus, diaphoresisCV: Transient hypertension, palpitations, chest pains, dyspneaGI: Nausea and vomiting
Nursing Considerations: • Assess history of allergy to the drug. • Administer by IM injection or orally unless emergency requires IV use. Complications are more frequent with IV use. • Monitor postpartum women for BP changes and amount and character of vaginal bleeding. • Avoid prolonged use of the drug. • Teach client to report difficulty breathing, headache, numb or cold extremities, severe abdominal cramping.
Generic Name:Dinoprostone (prostaglandin E2)Brand Name: Cervidil Classification: Prostaglandin; abortifacient Therapeutic Actions: •
Stimulates the myometrium of the pregnant uterus to contract; similar to thecontractions of the uterus during labor, thus evacuating the contents of theuterus.Indications: • Termination of pregnancy 12-20 wks from the first day of the LMP. • Evacuation of the uterus in the management of missed abortion or intrauterine fetal death up to 28 wk gestational stage • Initiation of cervical ripening before induction of labor Contraindications: • Contraindicated with allergy to prostaglandins; acute PID; active cardiachepatic; pulmonary, renal disease; women in whom prolonged uterinecontractions are inappropriate.Adverse Effects: CNS: Headache, paresthesias, anxiety, weakness, syncope, dizzinessCV: Hypotension, arrthymias, chest painFetal: Abnormal heart ratesGI: vomiting, diarrhea, nauseaRespiratory: Coughing, dyspneaNursing Considerations: • Monitor uterine tone and vaginal discharge throughout the procedure and several days after the procedure. • Ensure adequate hydration throughout the procedure. Be prepared to support patient through labor. Give oxytocin infusion 6- 12 hr after dinoprostone. • Teach client to report severe pain, difficulty breathing, palpitations, eye pain, rash.
3. Generic Name:OxytocinBrand Name: Pitocin Classification: Oxytocic; hormone Therapeutic Actions: • Synthetic form of an endogenous hormone produced in the hypothalamusand stored in the posterior pituitary; stimulates the uterus, especially thegravid uterus just before parturition, and causes myoepithelium of the lactealglands to contract, which results in milk ejection in lactating women.Indications: • Antepartum: to initiate or improve uterine contractions to achieve earlyvaginal delivery; stimulation or reinforcement of labor in selected cases ofuterine inertia; management of inevitable or incomplete abortion; 2nd
trimester abortion• Postpartum: to produce uterine contractions during the third stage of labor to control postpartum bleeding or hemorrhage • Lactation defieciency Contraindications: • Significant cephalopelvic disproportion, unfavorable fetal positions orpresentations, obstetric emergencies that favor surgical intervention,prolonged use in severe toxemia, uterine inertia, hypertonic uterine patterns,induction or augmentation of labor when vaginal delivery is contraindicated,previous cesarian section.Adverse Effects: CV: cardiac arrhythmias, PVCs, hypertension, subarachnoid hemorrhageFetal effects: fetal bradycardia, neonatal jaundice, low Apgar scoresGI: nauseas, vomiting
GU: postpartum hemorrhage, uterine rupture, pelvic hematoma, uterinehypertonicity, spasmNursing Considerations: • Ensure fetal position and size and absence of complications that are contraindicated with oxytocin therapy • Ensure continuous observation for induction of labor; fetal monitoring is preferred. • Regulate rate of oxytocin delivery; monitor rate and strength of contractions • Monitor BP during administration 4. Generic Name:Lidocaine hydrochlorideBrand Name: Dilocaine Classification: Local anesthetic Therapeutic Actions: • Blocks the generation and conduction of action potentials in sensory nervesby reducing sodium permeability, reducing height and rate of rise of theaction potential, increasing excitation threshold, and slowing conductionvelocityIndications: • Infiltration anesthesia, peripheral and sympathetic nerve blocks, central nerve blocks, spinal and caudal anesthesia Contraindications: • Contraindicated with allergy to lidocaine or amide-type local anesthetics, CHF cardiogenic shock, 2nd or 3rd degree AV blocks Adverse Effects:
CNS: headache, backache, septic meningitis, persistent sensoryCV: hypotensionDermatologic: urticaria, pruritus, erythema, edemaGU: urinary retention, urinary or fecal incontinenceNursing Considerations: • Check drug concentrations carefully • Establish safety precautions if CNS changes occur • Teach client to report difficulty speaking, thick tongue, numbness, tingling, difficulty breathing, pain or numbness at site, swelling or pain at site 5. Generic Name:Terbutaline SulfateBrand Name:Brethine Classification: Tocolytic Therapeutic Actions:
- In low doses, acts relatively selectively at beta 2-adrenergic receptors tocause bronchodilation and relax the pregnant uterus; at higher doses, beta 1selectivity is lost and the drug acts at beta 2 receptors to cause typicalsympathomimetic cardiac effectsIndications: - Tocolytic to prevent preterm labor Contraindications: - Contraindicated with hypersensitivity to terbutaline, tachyarrythmias, tachycardia, hypertension, lactation. Adverse Effects: CNS: restlessness, apprehension, anxiety, fear, CNS stimulation, hyperkinesias,insomnia, tremorsCV: cardiac arrhythmias, palpitations, angina pain, changes in BP and ECGGI: Nausea, vomiting, heartburn, unusual or bad tasteRespiratory: Respiratory difficulties, pulmonary edema, coughing,
bronchospasmNursing Considerations:- Use minimal doses for minimal periods of time; drug tolerance can occur - Maintain a beta-adrenergic blocker on standby in case cardiac arrhythmias occur - Teach client to report chest pain, dizziness, insomnia, weakness, tremor 6. Generic Name:Carboprost tromethamineBrand Name:Hemabate Classification: Prostaglandin; Abortifacient Therapeutic Actions: Stimulates the myometrium of the pregnant uterus to contract; similar to thecontractions of the uterus during labor, thus evacuating the contents of theuterus.Indications: - Termination of pregnancy 13-20 wk from the first day of the LMP - Evacuation of the uterus in instance of missed abortion or intrauterine fetal death in the 2nd trimester - Postpartum hemorrhage due to uterine atony unresponsive to conventional methods Contraindications: - Contraindicated with allergy to prostaglandin preparations, acute PID; active cardiac,hepatic, pulmonary, renal disease Adverse Effects: CNS: headache, paersthesias, flushing, anxiety, weakness, syncope, dizziness
CV: hypotension, arrhythmias, chest painGI: vomiting, diarrhes, nauseaNursing Considerations: - Assess allergy to the drug - Monitor uterine tone and vaginal discharge during procedure and several days after to assess drug effects and recovery - Ensure adequate hydration Generic Name:Nalbuphine hydrochlorideBrand Name: Nubain Classification: Narcotic agonisy-antagonist analgesic Therapeutic Actions:
- Nalbuphine acts as an agonist at specific opioid receptors in the Cns toproduce analgesia, sedation but also acts to cause hallucinations and is anantagonist at mu receptorsIndications: - Relief of moderate to severe pain - For obstetric analgesia during labor and delivery Contraindications: - Contraindicated with hypersensitivity to nalbuphine, sulfites; lactation Adverse Effects: CNS: sedation, clamminess, sweating, headache, nervousness, restlessness,depression, crying, confusion, faintness, hostility, unusual dreams, hallucinations,euphoria, blurred visionCV: hypotension, hypertension, bradycardia, tachycardiaDermatologic: itching, burning, urticariaGI: N/V, cramps, dyspepsia, bitter taste, dry mouthGU: Urinary urgencyRespiratory: Respiratory depression, dyspnea, asthmaNursing Considerations: - Assess hypersensitivity to the drug
- Provide narcotic antagonist, facilitates for assisted or controlled respiration on standby in case of respiratory depression - Reassure patient about addiction liability; most patients who receive opiates for medical reasons do not develop dependence syndrome - Inform clients about these side effects: dizziness, sedation, drowsiness, impaired visual acuity, nausea, loss of appetite 8. Generic Name:Magnesium sulfateBrand Name: Epsom salt Classification: electrolyte; anticonvulsant; laxarive Therapeutic Actions: - Cofactor of many enzyme systems involved in neuromuscular transmission and muscular excitability Indications: - Preeclampsia/eclampsia - Inhibition of premature labor Contraindications:
- Contraindicated with allergy to magnesium product; heart block, myocardialdamage, abdominal pain, N/V, acute surgical abdomen, fecal impaction,hepatitis. DO NOT GIVE 2 HR PRECEEDING DELIVERY BECAUSE OF RISK OFMAGNESIUM TOXICITY IN THE NEONATE.Adverse Effects: CNS: weakness, dizziness, fainting, sweatingCV: palpitationsGI: excessive bowel activity, perianal irritationMetabolic: Magnesium intoxication, hypocalcemia with tetanyNursing Considerations: - Assess history of allergy to the drug and other contraindications- Reserve IV use in eclampsia for immediate life- threatening situations
- Monitor magnesium levels during parenteral therapy- Monitor knee-jerk reflex before repeated parenteral administration, ifhappens, do not administer because respiratory failure may occur
- Do not give orally with abdominal pain, N/V Generic Name:Butorphanol tartrate Brand Name: stadol Classification: Narcotic agonist- antagonist analgesic Therapeutic Actions: - Acts as an agonist at opioid receptors in the CNS to produce analgesia, sedation, but also acts to produce hallucinations; has low abuse potential Indications: - Relief of moderate to severe pain - To supplement balances anesthesia and to relieve prepartum pain Contraindications: - Contraindicated with hypersensitivity to butorphanol, physical dependence on a narcotic analgesic, pregnancy lactation Adverse Effects: CNS: sedation, clamminess, sweating, headache, vertigo, dizziness, lethargy,confusion, unusual dreams, agitation, euphoria, hallucinationsCV: Palpitations, increase or decrease in blood pressureDermatologic: Ras, hives, pruritus, flushing, warmth, sensitivity to coldEENT: diplopia, blurred visionGI: N/VRespiratory: slow, shallow respirationNursing Considerations: - Assess history of allergy to butorphanol , depression DM, lactation, and dependence
- Monitor diet for presence of caffeine- containing foods that may contribute to overdose - Inform patients that these side effects may occur: diuresis, restlessness, insomnia, muscular tremors, light- headedness, nausea, abdominal pain - Remind patient to report abnormal heart rate, dizziness, palpitations 10.Generic Name:MisoprostolBrand Name: Cytotec Classification: Prostaglandin Therapeutic Actions:
- A synthetic prostaglandin E1 analog; inhibits gastric acid secretion andincreases bicarbonate and mucus production, protecting the lining of thestomachIndications: - With mifepristone as an abortifacient - Cervical ripening and labor induction Contraindications: - History of allergy to prostaglandins; pregnancy; lactation Adverse Effects: GI: nausea, diarrhea, abdominal pain, flatulence, vomiting, dyspepsia, constipation GU: Miscarriage, excessive bleeding, spotting, cramping, menstrual disorders Nursing Considerations: - Assess history of allergy to the drug - Report severe diarrhea, spotting, or menstrual pain, severe menstrual bleeding Generic Name: Midazolam hydrochlorideBrand Name: Versed
Classification:Benzodiazepine (short-acting); CNS depressantTherapeutic actions:
- Exact mechanisms of action not understood; acts mainly at the limbicsystem and reticular formation; potentiates the effects of GABA, aninhibitory neurotransmitter; anxiolytic and amnesia effects occur atdoses below those needed to cause sedation, ataxia; has little effect oncortical function.Indications - IV or IM: Sedation, anxiolysis, and amnesia prior to diagnostic,therapeutic, or endoscopic procedures or surgery - Induction of general anesthesia - Continuous sedation of intubated and mechanically ventilated patientsas a component of anesthesia or during treatment in the critical care setting - Unlabeled uses: Treatment of epileptic seizure or refractory status epilepticus Contraindications and cautions - Contraindicated with hypersensitivity to benzodiazepines; psychoses,acute narrow-angle glaucoma, shock, coma, acute alcoholicintoxication; pregnancy (cleft lip or palate, inguinal hernia, cardiacdefects, microcephaly, pyloric stenosis have been reported when usedin first trimester; neonatal withdrawal syndrome reported in
infants);neonates.- Use cautiously in elderly or debilitated patients; with impaired liver or kidney function, lactation. Adverse effects CNS: Transient, mild drowsiness (initially); sedation, depression, lethargy,apathy, fatigue, light-headedness, disorientation, restlessness, confusion,crying, delirium, headache, slurred speech, dysarthria, stupor, rigidity,tremor, dystonia, vertigo, euphoria, nervousness, difficulty in concentration,vivid dreams, psychomotor retardation, extrapyramidal symptoms; mildparadoxical excitatory reactions (during first 2 wk of treatment), visual andauditory disturbances, diplopia, nystagmus, depressed hearing, nasalcongestionCV: Bradycardia, tachycardia, CV collapse, hypertension, hypotension,palpitations, edemaDermatologic: Urticaria, pruritus, skin rash, dermatitisGI: Constipation, diarrhea, dry mouth, salivation, nausea, anorexia, vomiting,difficulty in swallowing, gastric disorders, elevations of blood enzymes: LDH,alkaline phosphatase, AST, ALT, hepatic dysfunction, jaundiceGU: Incontinence, urinary retention, changes in libido, menstrualirregularitiesHematologic: Decreased Hct, blood dyscrasiasOther: Phlebitis and thrombosis at IV injection sites, hiccups, fever,
diaphoresis, paresthesias, muscular disturbances, gynecomastia; pain,burning, and redness after IM injectionDependence: Drug dependence with withdrawal syndrome when drug isdiscontinued (more common with abrupt discontinuation of higher dosageused for longer than 4 mo)Nursing considerations - History: Hypersensitivity to benzodiazepines; psychoses, acutenarrow-angle glaucoma, shock, coma, acute alcoholic intoxication withdepression of vital signs; elderly or debilitated patients; impaired liveror kidney function; pregnancy, lactation
Generic Name:FresofolBrand Name: Propofol Classification:sedative hypnotic; anesthetic agentTherapeutic Actions: - Propofol is a short-acting hypnotic. Its mechanism of action has not been well-defined. Indications: - induction of general anesthesia in adults and in pediatric patients greater than 3 years of age
- maintenance of anesthesia utilizing balanced techniques with otherappropriate agents such as opioids and inhalation anesthetics in adultsand pediatric patients greater than 2 months of age- produce sedation or amnesia as a supplement to local or regional anesthetics Contraindications:
- Contraindicated in pediatric patients for monitored anesthesia care(MAC) sedation or for sedation in intensive care; epileptics; usecautiously in lactationAdverse Effects: CV: Arterial hypotension; decreased systemic vascular resistance,myocardial blood flow, and oxygen consumption, palpitations, tachycardiaRespiratory: apnea, hyperventilation, bradypnea, dyspnea, wheezing,swelling of throat
CNS: increased ICP, lethargy, drowsiness, euphoria, hallucinations, blurredvision, anxiety, tension, seizure, lightheadedness, faintingDERM: skin rash, flushing, urticariaNursing Considerations: - Assess history of allergy to the components of the drug.- Use safety precautions after administration.- Advise patient that mental alertness, coordination, and physicaldexterity may be impaired for some time after administration. - For IV, do not mix with other therapeutic agents prior to administration. Avoid mixing blood or plasma in same IV catheter. - Minimize pain associated with administration by infusing into larger veins. - Should be administered only by personnel who are trained in administration of general anesthesia and familiar with drug. - Shake well before use. Do not use if there is evidence of separation of phases of emulsion.
Generic Name:Hyoscine-N-butylbromideBrand Name: Buscopan Classification:Antispasmodic; AnticholinergicTherapeutic Actions: - acts by interfering with the transmission of nerve impulses by acetylcholine in the parasympathetic nervous system. Indications:
- Buscopan Tablets are indicated for the relief of spasm of the genito-urinary tract or gastro- intestinal tract and for the symptomatic relief ofIrritable Bowel SyndromeContraindications:
- Buscopan Tablets should not be administered to patients withmyasthenia gravis, megacolon and narrow angle glaucoma. Inaddition, they should not be given to patients with a knownhypersensitivity to hyoscine-N-butylbromide or any other component ofthe product.Adverse Effects: CNS: dizziness, anaphylactic reactions, anaphylactic shock, increased ICP, disorientation,restlessness, irritability, dizziness, drowsiness, headache, confusion,hallucination, delirium, impairedmemoryCV: hypotension, tachycardia, palpitations, flushingGI: Dry mouth, constipation, nausea, epigastric distressDERM: flushing, dyshidrosisGU: Urinary retention, urinary hesitancyResp: dyspnea, bronchial plugging, depressed respirationEENT: mydriasis, dilated pupils, blurred vision, photopobia, increased