drug study

DRUGSTUDY

Classification: ANTI-INFECTIVES-Quinolones

KARLEEN L. JARO

GENERIC NAME

INDICATION ACTION CONTRAINDICATIONPRECAUTION/

ADVERSE REACTIONNURSING

CONSIDERATION

Ciprofloxacin

BRAND NAMECiprobay

DOSAGE250-500mg BID

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

Inhibits bacterial DNA gyrase thus preventing replication in susceptible bacteria

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

PRECAUTIONSevere and persistent diarrhea during and after treatment

ADVERSE RXNCommon:Nausea, diarrhea, vomiting, rashUncommon:Anorexia, headache,dizziness, fever, GI and abdominal pain, flatulence, confusion, vertigo

>Assess pt for previous sensitivity reaction>Assess pt for any s/s of infection before & during treatment>Assess for adverse reactions >assess pt. & family’s knowledge of drug therapy

Classification: GASTROINTESTINAL DRUGS-Laxatives

KARLEEN L. JARO

GENERIC NAME INDICATION ACTION CONTRAINDICATIONPRECAUTION/

ADVERSE REACTION

NURSING CONSIDERATION

LACTULOSE

BRAND NAMEduphalac

DOSAGEInfants: 5 mlChildren:1-6 y/o- 5-10ml 7-14y/o- 15ml15-45y/o- 15-30ml.

Dose given in 3 days

Constipation, salmonellosis. Treatment of hepatic encephalopathy

Inhibits bacterial DNA gyrase thus preventing replication in susceptible bacteria

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

PRECAUTION:Lactose intolerance, diabetes

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

>Assess condition before therapy and reassess regularly thereafter to monitor drug’s effectiveness >Monitor pt for any adverse GI reactions, nausea,vomiting,diarrhea,>Assess for adverse reactions >for pt. with hepatic encelopathy: regularly assess mental condition>monitor I & O>monitor for Inc. glucose level in diabetic pts

Classification: ANTI-ALLERGICS_Anti-histamine

KARLEEN L. JARO

GENERIC NAME

INDICATION ACTION CONTRAINDICATIONPRECAUTION/


CONSIDERATION

levocetirizine

BRAND NAMEXyzal

DOSAGEAdult and adolescents more than 12 yrs- 1 tab/dayPedia: 6-12 yrs- 1 tab/ day

Treatment of symptoms associated with allergic conditions (including ocular symptoms)

Long-acting non-sedating antihistamine that selectively inhibits peripheral HI receptors

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

PRECAUTIONAdjustment of dose is recommended in elderly pts w/ compromised renal function. Lactation.

ADVERSE RXNDry mouth, headache, fatigue, rhinitis, abdominal pain, migraine

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

Classification: ANTI-INFECTIVES-Penicillins

KARLEEN L. JARO



CONSIDERATION

Amoxicillin

BRAND NAMEAmoxil

DOSAGEAdult: 250-500mg every 8 hoursChildren: 20-40mg/kg/day divided dosage given every 8 hrs

Infections of the resp. tract, skin & skin structures,paranasal sinuses, genitourinary tract, otitis media, sinusitis, meningitis,septicemia

Prevents bacterial cell wall synthesis during replication.

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

PRECAUTION:Hypersensitivity: rxn range from mild to life threatening

ADVERSE RXN:Dizziness, fatigue, insomnia, skin rashes, itchy eyes, sore or dry mouth, abnormal taste sensation, diarrhea, rectal bleeding

>obtain pt’s hx of allergy >Assess pt for any s/s of infection >Assess for pt’s sensitivity to penicillin ot other cepalosporins >assess for allergic rxn during therapy>Assess for bowel pattern, if diarrhea- shld be discontinue

Classification: CARDIOVASCULAR DRUGS-Calcium Antagonist

KARLEEN L. JARO



CONSIDERATIONfelodipine

BRAND NAMEPlendil


Treatment of hypertension

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

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

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

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

Classification: CARDIOVASCULAR DRUGS-Angiotensin II Antagonist

KARLEEN L. JARO



CONSIDERATION

TELMISARTAN

BRAND NAMEPritor

DOSAGEAdult: 20-80mg daily, usual starting dose 40mg daily

Treatment of hypertension

Blocks the vasoconstrictive ans aldosterone-one-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the ATI receptor in many tissues

Hypersensitivity, pregnancy, lactation. Severe hepatic or renal impairment

PRECAUTION:Can cause death to the fetus if used on the 2nd trimester, safety in children not yet established

ADVERSE RXNDiarrhea and angioedema. Sinusitis, pharyngitis, upper resp. tract infection, back pain

>assess pt’s condition before therapy >Assess for heart failure >Assess for obstructive jaundice>monitor for possible drug induced adverse rxn>close monitoring of BP and pulse

Classification: ANTI-DIARRHEALS

KARLEEN L. JARO



CONSIDERATION

Loperamide HCl

BRAND NAMEIMODIUM

DOSAGEAdult: initially 2 cap; subsequent dose a cap after every stool

Symptomatic control of acute and chronic diarrhea

Acts on the nerve endings &/or intramural ganglia of the intestinal wall to decrease intestinal motility, resulting to prolonged retention of feces in the intestines

Those in whom constipation must be avoided, children less than 1 yr, hypersensitivity, abdominal distention

PRECAUTION:Hepatic dysfunction, chronic diarrhea, dehydration

ADVERSE RXNHypersensitivity reactions, flatulence, abdominal pain, distention or discomfort, nausea and vomiting

>assess pt’s bowel pattern >check response after 48 hrs >Assess hydration>assess for abdominal distention>inform pt. that dry mouth may be relieved by frequent sips of water, hard candy or sugarless gum

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

KARLEEN L. JARO



CONSIDERATIONDIAZEPAM

BRAND NAMEValium


Symptomatic relief of anxiety, agitation, tension

Facilitates/ potentiates the inhibitory activity of GABA at the limbic system and reticular formation to reduce anxiety, promote calmness and sleep

Hypersensitivity. Dependence, withdrawal symptoms

PRECAUTION:Hypersensitivity: cardiorespiratory insufficiency, pregnancy, lactation

ADVERSE RXNDizziness, fatigue, blurred vision, dependence, withdrawal reactions

> inform pt. that drug may be taken with food>advice pt. not to abruptly discontinue drug after long term use>advice pt. to avoid driving and activities that require alertness bec, drug can cause drowsiness>inform pt. that smoking may decrease effect

Classification: DIETARY/NUTRITIONAL DRUGS-Vitamins and Minerals

KARLEEN L. JARO



CONSIDERATION

Calcium carbonate

BRAND NAMECalci-Aid

DOSAGEAdult: 1-2 capsules dailyPedia:1-2 tablets daily

Antacid, calcium supplement, osteoporosis

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

Hypercalcemia, bone tremors, severe renal failure,hypersensitivity

PRECAUTION:History of stone formation, pregnancy

ADVERSE RXNConstipation, flatulence, diarrhea, renal dysfunction, acid rebound

> administer as antacid 1 hr fter meal and at bed time>administer as supplement 1 ½ hrs after meal and at bed time >advice pt to increase fluids to 2L unless contraindicated

Classification: ANTI-ASTHMA

KARLEEN L. JARO



CONSIDERATION

Salbutamol

BRAND NAMEVentolin vilmax

DOSAGEAdult: 8mg tablet BIDPedia: 3-12 yrs4mg tab BID

Reversible airway obstruction including bronchial asthma, chronic bronchitis

Facilitates/ potentiates the inhibitory activity of GABA at the limbic system and reticular formation to reduce anxiety, promote calmness and sleep

Hypersensitivity PRECAUTION:Hyperthyroidism,DM, cardiovascular disease

ADVERSE RXNFine tremor of skeletal muscle, feeling of tension, a compensory small increase in heart rate, headache, muscle cramps

> drug may be decrese sensitivity of spirometry used for diagnosis of asthma>syrup may be taken as young as age 2>monitor for evidence of allergic rxn

Classification: CARDIAC DRUGS-Centrally-acting Drugs

KARLEEN L. JARO



CONSIDERATION

orlistat

BRAND NAMEXenical

DOSAGEAdult: 1 cap with each main meal

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

Inhibits the absorption of dietary fat

Chronic malabsorption syndrome

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

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

> assess effectiveness of other medications pt may be taking (esp. anticoagulant)>pt. may experience dizziness or lightheadedness >advice pt to report persistens back pain, muscle, or joint pain, signs of resp. tract infection

Classification: ANALGESICS

KARLEEN L. JARO



CONSIDERATION

Mefenamic acid

BRAND NAMEDolfenal

DOSAGEAdult: start with 75-150mcg BID

Severe HPN300mg BID

Relief of pain including muscular, rheumatic, traumatic, dental, post-op and postpartum pain, headache, migraine, fever, dysmenorrhea

Aspirin-like drug that has analgesic,antipyretic, & anti-inflammatory activities

Pregnancy & lactation, hypersensitivity, active ulceration or chronic inflammation of either upper or lower GIT, blood disorders, poor platelet function, kidney or liver impairment, children < 14 yrs

PRECAUTION:If rash occurs, administration should be stopped, asthmatics,Hx of liver and kidney diseaseADVERSE RXNGI discomfort, diarrhea or constipation, gas pain, nausea, vomiting, drowsiness

> assess pt.’s pain before therapy>monitor for possible drug induced adverse reactions>advice pt. not to take drug for more than 7 days>advice pt. to report immediately persistence or failure to relieve pain

Classification: ANTI-INFECTIVES

KARLEEN L. JARO


ADVERSE REACTIONNURSING CONSIDERATION

chloroquine

BRAND NAMEchlorofoz

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

Antacid, calcium supplement, osteoporosis

Inhibits the perioxidative activity of heme, and disrupt its nonenzymatic polymerization to hemozin

Presence of retinal or visual field changes

PRECAUTION:Hepatic disease, alcoholism, monitor complete blood count

ADVERSE RXNHeadache, nausea, vomiting, diarrhea, skin eruptions

>advice pt that compliance with dosage schedule & duration of tx are necessary>caution pt to avoid alcohol while taking drug >assess hepatic status (dec. appetite,jaundice, dark urine>instruct pt to use sunglasses in bright sunlight

Classification: GASTROINTESTINAL DRUGS-LAXATIVES

KARLEEN L. JARO



CONSIDERATION

bisacodyl

BRAND NAMEDulcolax

DOSAGEAdult: 2 tab at bedtime or 30 mins before breakfast, max 4 tabsPedia: greater than 4 yrs- 1 tabSuppository:Pedia – 5mgAdult- 10mg

Constipation, relief of evacuation in hemorrhoids, prep for barium enema, pre and post-op

Increases peristalsis & motor activity of the small intestines by acting directly on the smooth muscles.

Nausea, vomiting or other symptoms of appendicitis, acute surgical abdomen, abdominal pain, ulcerative lesions of colon

PRECAUTION:Caution is advised during 1st 3 mos of pregnancy as well as administration to children < 4 yrs

ADVERSE RXNOccasional abdominal discomfort, soreness in anal region

> monitor frequency & character of stool>monitor occurrence of adverse rxn >swallow the tablet whole, do not crush or chew

Classification: RESPIRATORY DRUGS- MUCOKINETICS/EXPECTORANTS

KARLEEN L. JARO

GENERIC NAME INDICATION ACTION CONTRAINDICATION PRECAUTION/ ADVERSE REACTION


Carbocisteine

BRAND NAMELoviscol

DOSAGECapsule:Adult: 250mg 2 caps, 500mg 1 cap TIDSuspension:Adult – 15ml; Pedia: 6-12yrs: 5ml, 2-5 yrs: 1.25-2.5 mlSyr: 6-12yrs: 10ml2-5 yrs: 2.5mlDrops: 12-24mos: 1.25ml, 9-11mos: 1ml, 6-8mos: 0.75ml, 3-5mos: .50ml, <3mos: 0.25mlAll doses 3-4x/ day

Acute/chronic disorders of the upper & lower respiratory tract associated with the secretion & formation of excessive and viscid mucus

Reduces the viscosity of bronchial secretions & facilitate expectoration

active peptic ulcer. Hypersensitivity to carbocisteine

PRECAUTION:Hx of peptic ulcer, hypothyroidism

ADVERSE RXNNausea, headache, vomiting, anorexia, gastric discomfort, diarrhea, GI bleeding

>assess cough: type, frequency, character > advice medical consultation for persistent cough of more than 7 days>advice pt. to avoid smoking>suggest sugarless lozenges to decrease throat irritation and cough

Classification: CARDIOVASCULAR DRUGS- ANTI-ARRYTHMICS

KARLEEN L. JARO


ADVERSE REACTION


Amiodarone Hcl

BRAND NAMECordarone

DOSAGETab: initially 3 tab/day maintenance: 1-2 tab/day

Cardiac arrhythmias, ventricular rhythm disorders

Blocks sodium channels at rapid pacing frequencies, prolonging myocardial cell action potential and refractory period

Sinus bradycardia,. SA and AV blocks, pregnancy, hypersensitivity

PRECAUTION:Goiter, CHF, respiratory disease

ADVERSE RXNBradycardia, heart block, sinus arrest, flushing, fatigue, insomnia, headache

>assess cardiovascular status before therapy > loading dose with food to decrease nausea>instruct pt. that skin discoloration is reversible>advice pt. to wear sunglasses for photophobia, protective clothing to prevent burning

Classification: GASTROINTESTINAL DRUGS- ANTI-FLATULENTS

GENERIC NAME INDICATION ACTION CONTRAINDICATION PRECAUTION/ NURSING CONSIDERATION

KARLEEN L. JARO

ADVERSE REACTION

metoclopramide

BRAND NAMEPlasil

DOSAGEAdult 10mg 3x/day pedia: 15-20yrs 5-10mg 3x/day5-14yrs: 2.5-5mg 3x/day3-4yrs: 3mg 2-3x/day1-2yrs: 1mg 2-3x/dayUnder 1 yr: 1mg 2x/day

Gastrointestinal motility, nausea, vomiting of central and peripheral origin assoc. with surgery

Dopamine antagonist that acts by increasing receptor sensitivity and response of upper GIT tissues to acetylcholine

GI hemorrhage, epileptics, hypersensitivity, lactation, pts. With breast cancer

PRECAUTION:Activities requiring mental alertness, elderly, lactation

ADVERSE RXNRestlessness, drowsiness, fatigue, insomnia, headache, dizziness, nausea

>give 30 mins before meals and at bed time> assess mental status during treatment>tell pt. To avoid driving & other hazardous activities for at least 2 hrs>advice pt. to avoid alcohol and other CNS depressant that enhance sedating properties of this drug

Classification: CARDIOVASCULAR DRUGS- BETA-BLOCKERS

KARLEEN L. JARO



CONSIDERATION

metropolol

BRAND NAMENeobloc

DOSAGEAdult : 50mg BID or 100 mg OD

Hypertension, chronic angina pectoris

Exerts mainly beta-1 adrenergic blocking activity but also blocks beta-2 receptors at high doses

AV blocks, cardiogenic shock, sinus bradycardia

PRECAUTION:Slowing of heart rate, occasionally severe bradycardia may lead to vertigoADVERSE RXNOccasionally fatigue, dizziness, headache, GI disturbance, skin rashes nausea

>tablet may be crashed or swallowed whole> instruct pt to take with meals >inform the pt that drug only controls but does not cure the disorder>tell the pt. not to discontinue drug abruptly can worsen angina

Classification: CNS DRUGS- HYPNOTICS/ SEDATIVES

KARLEEN L. JARO



phenobarbital

BRAND NAMEluminal

DOSAGE100-320mg. max 600mg daily

Short-term treatment of insomnia, long- term treatment of generalized toni-clonic seizures

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

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

PRECAUTION:Impaired renal, hepatic cardiac or resp. functionsADVERSE RXNDizziness, headache, hangover, confusion in elderly, GI disturbances, allergic reactions, sedation and depression may occur

>instruct pt. to avoid alcohol and other CNS depressant to prevent inc. depression> withdrawal insomnia may occur after short-term use, insomnia improves in 1-3 nights >on empty stomach, 30-60 mins before bedtime for expected sleeplessness>advice pt to change positions slowly to prevent orthostatic hypotension

Classification: CARDIOVASCULAR DRUGS- ANTI-INFECTIVE ( ANTI-FUNGALS)

KARLEEN L. JARO



Nystatin

BRAND NAMEMycostatin

DOSAGE4-6ml susp 4x/day or 1-2 tabs 3x/dayInfants: 2ml pedia susp 4x/day

Antifungal antibiotic used for prophylaxis and treatment of candidiasis of the skin and mucous membranes

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

hypersensitivity PRECAUTION:Discontinue if sensitization occurs

ADVERSE RXNDiarrhea, GI distress, nausea, vomiting

>oral suspension, shake well before using> report persistent nausea and vomiting, diarrhea or if condition worsens>inform physician if pt is pregnant

Classification: Anticholinergic

KARLEEN L. JARO

GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION

Atropine SO4

BRAND NAME

Dose/Route:

0.5-1.0 mg IVP Q3-5min max of 0.04mg/kg (ETT 2-2.5 x dosage)

OPP: 2-5mg Q10-15 min (Peds 0.05mg/kg)

Pediatric: 0.02mg/kg (minimum 0.1mg

- Antidote to overdosage with cholinergic substances (nerve gases, poisonous mushroom)

- Pre-op medication to reduce salivary and resp. tract secretions.

Helps to reduce saliva and fluid in the respiratory tract.May also be used to treat a slow heartbeat or insecticide or mushroom poisoning

Contraindicated in patients with glaucoma, pyloric stenosis or prostatic hypertrophy, except in doses ordinarily used for preanesthetic medication.

Can cause blurred vision, dilated pupils, dry mouth, palpitations urinary retention, tachycardia drowsiness, and confusion

monitor level of consciousness

do not sit up or stand up quickly

advise patient to stay out of bright light

chew sugarless gums and suck hard candies to avoid mouth dryness

use lubricating drops is wearing contact lenses

avoid extreme heat

Classification: Andrenergics

KARLEEN L. JARO

GENERIC NAME

INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION

Dobutamine HCL

BRAND NAME

Dobutrex

Infusion rate: 2.5-10 mcg/kg/min

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

Stimulates heart’s beta1 receptors to increase myocardial contractility and stoke volume. At dosages, drug increases cardiac output by decreasing peripheral vascular resistance, Zeducing ventricular filling pressure and facilitating AV node therapeutic conduction

Contra indicated in patients hypersensitive to drug and in those with idiopathic hypertrophic subaortic stenosisUse cautiously in patients with history of hypertension because drug may increase pressor responseUse cautiously in patients with history of sulfite sensitivity

.

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

Before starting dobutamine therapy: (1) give a plasma volume expander to correct hypovolemia (2) give cardiac glycoside

Continuously monitor ECG, blood pressure, pulmonary artery wedge pressure, cardiac output and urine output

Monitor Electrolyte levels. Drug may lower potassium level

Do not confuse with Dopamine

Tell patient to report adverse reactions promptly, especially labored breathing and drug-induced headache

Instruct patient to report discomfort at IV insertion site

Classification: Antihistamine/ anti allergic

KARLEEN L. JARO


Diphenhydramine HCl

BRAND NAMEBenadryl

DOSAGECapule/syrup

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

Hay fever, urticaria, vasomotor rhinitis, angioneurotic edema, drug sensitization, serum & penicillin reaction, contact dermatitis, atopic eczema, other allergic dermatoses, pruritus, food sensitivity, parkinsonism, motion sickness

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

Premature & newborn infants; asthma attack; lactation

CV & CNS effects

Blood disorders

GI disturbances

Antimuscarinic effectsAllergic reactions

Special precaution for

Narrow-angle glaucoma stenosing peptic ulcer pyloroduodenal

obstruction symptoms of prostatic

hypertrophy or bladder-neck obstruction

History of bronchial asthma

increased intraocular pressure

hyperthyroidism CV disease or

hypertension. Pregnancy. Avoid operating vehicles or machinery

Classification: Antagonist and antidotes

KARLEEN L. JARO

GENERIC NAME INDICATION ACTION CONTRAINDICATIONSIDE EFFECTS/

ADVERSE REACTION NURSING CONSIDERATION

Naloxone hydrocholoride

BRAND NAMENarcan

DOSAGEAdult : 0.4 -2 mg IV q2 to 3 mins.p.r.n.

Known suspected narcotic induced respiratory depression including that cause by pentazocine and propaxyphene

Displaces previously administered narcotic analgesics from their receptors. Has no pharmacologic activity of its own

Patient known to be hypersensitive to naloxone hydrochloride

TachycardiaHypertension

NauseaVomitingTremors

Safest drug to use when cause respiratory depression is uncertain.

Monitor respiratory depth and rate. Be prepared to provide O2, ventilation and resuscitative measures.

Also been shown to improve circulation in refractory shock

Classification: Antispasmodic

KARLEEN L. JARO

GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS/ ADVERSE REACTION


Hyoscine-N-butylbromide

BRAND NAMEBuscopan

DOSAGEAdult & childn >6 yr 1-2 tab 3-5 times daily. Amp Acute attacks of colicky pain Adolescent >12 yr 1-2 amp IV, IM or SC several times daily. Max: 100 mg aily.

Infant & young childn Severe cases: 0.3-0.6 mg/kg body wt by slow IV, IM or SC several times daily. Max: 1.5 mg/kg body wt/day.

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

Relieve cramps or spasms of the stomach,intestines, and bladder

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

xerostomia

tachycardia

urinary retention

allergic & skin reactions

rarely dyspnea (in patients w/ history of bronchial asthma or allergy)

parenteral visual accommodation disturbance

infrequently inj site pain (after IM inj),

rarely anaphylactoid reactions &

anaphylactic shock

Drug compatibility should be monitored closely in patients requiring adjunctive therapy

Avoid driving & operating machinery after parenteral administration

Avoid strict heat

Classification: CNS stimulant

KARLEEN L. JARO

GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS/ ADVERSE REACTION


Citicoline

BRAND NAME

Somazine amp

DOSAGE

125 mg/mL 1-2 inj/day.

250 mg/mL 1 inj/day

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

- Citicoline is an interneuronal communication enhancer. It increases the neurotransmission levels because it favors the synthesis and production speed of dopamine in the striatum, acting then as a dopaminergic agonist thru the inhibition of tyrosine-hydroxylase.

Parasympathetic hypertonia Gastrointestinal

disorders

•Somazine must not be administered along with medicaments containing meclophenoxate

Classification: Loop Diuretic

KARLEEN L. JARO


Furosemide

BRAND NAME

Lasix

DOSAGEAdult:

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

20-40 mg IV/IM

Children: 2 mg/kg body/wt

acute pulmonary edemaedemahypertension

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

Anuria hepatic coma

& precoma severe

hypokalemia &/or hyponatremia

hypovolemia w/ or w/o hypotension

Hypersensitivity to furosemide or sulfonamides

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

To prevent nocturia, give preparation in the morning and early in the afternoon

Watch for signs of hpokalemia

do not confuse with Torsemide or Lasix with Lonox

advise patient to take drug with food to prevent GI upset

inform patient of possible need for potassium or magnesium supplements

Classification: Anri- ulcer

KARLEEN L. JARO


Ranitidine HCL

BRAND NAME

Xantac

DOSAGE50 mg by slow IV then 0.125-0.25 mg/kg/hr as continuous IV infusion

•Duodenal and gastric ulcers

•Maintenance therapy for gastric and duodenal ulcer

•GERD

•Erosive esophagitis

•Heartburn

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

Contraindicated in patients hypersensitive to drug and those with porphyria

•Use cautiously in patients with hepatic dysfunction. Adjust dose in patients with impaired renal function

• Vertigo, malaise, headache, blurred

vision, jaundice, burning and itching at

injection site

•Assess patient for abdominal pain. Note presence of blood in emesis, stool, or gastric aspirate

•Ranitidine may be added to total parenteral nutrition solution

•Instruct patient on proper use of OTC preparation as indicated.

•Remind patient to take once daily prescription drug at bedtime for best results

•Instruct patient to take without regard to meals because absorption isn’t affected by food

Classification: Nutrional Agents (Calorics)

KARLEEN L. JARO

GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTSNURSING

CONSIDERATION

Dextrose

BRAND NAME

DOSAGEDosage depends on fluid and caloric requirements

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

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

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

Mental confusion, unconsciousness in hyperosmolar nonketotic syndrome.

Pulmonary edema Glycosuria,

osmotic diuresis Metabolic:

hyperglycemia, hypervolemia

Rapid termination after long term infusion may cause hypoglycemia rebound hyperinsulinemia.

Sloughing and tissue necrosis

Use cautiously in cardiac or pulmonary disease, hypertension, renal insufficiency urinary obstruction and hypovolemia.

Never infuse concentrated solutions rapidly, may cause hyperglycemia and fluid shift.

Monitor glucose level carefully. Prolonged therapy can cause depletion of pancreatic insulin production and secretion.

Classification: Electrolytes and replacement solutions

KARLEEN L. JARO


Calcium gluconate

BRAND NAME

Kalcinate

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

Hypocalcemia, hypocalcemic tetany, magnesium toxicity, hypoparathyroidism

Replaces and maintains calcium

Hypercalcemia, ventricular fibrillation, renal canaliculi

GI irritationhemorrhageconstipationvomiting thirstrenal canaliculihypercalcemiapolyuria

Use cautiously in patients with sarcoidosis and renal or cardiac disease and in digitalized patients.

monitor blood calcium level frequently.

Classification: Non narcotic /analgesics and antipyretic/ antiplatelet

KARLEEN L. JARO

GENERIC NAME INDICATION ACTION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION

Aspirin (acetylsalicylic acid)

BRAND NAME

Aspilet

DOSAGEFever/mild pain:

325-650 mg P.O q4 hours; p.r..n

unstable angina:

325 P.O once/daily

Mild pain/fever

Arthritis

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

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

Also impedes clotting by blocking prostaglandin synthesis which prevents formation of platelet-aggregating substances.

GI ulcer GI bleeding

Patients with bleeding disordersAspirin hypersensitivity

Vit.K deficiency

Prolonged bleeding time

TinnitusHearing lossNausea,vomiting GI distressOccult bleedingAbnormal liver

functionRash Bruising

Hypersensitivity manifested by asthma and anaphylaxis

Give milk, food antacid or large glass of water to reduce GI adverse reactions.

Warn patients taking prescription drugs to check with doctor before taking OTC combination containing aspirin.

Watch out for petechiae, bleeding gums, signs of GI bleeding.

Maintain adequate fluid intake.

Obtain hemoglobin and prothrombin test periodically.

Classification: Antihypertensives

KARLEEN L. JARO


Clonidine hydrochloride

BRAND NAME

Catapres

DOSAGE01-02 mg P.O B.

Essential renal and malignant hypertension

Inhibits central vasomotor centers, thereby decreasing sympatheric outflow.

Patient hypersensitive to clonidine

drowsinessdizzinessfatiguesedationnervousnessheadacheorthostatic

hypotensionbradycardiaurine retetion impotencetransient glucose

intolerance (after large dose)

constipationpruritis

dermatitis

Monitor blood pressure and pulse rate.

May be given rapidly lower blood pressure in some hypertensive emergencies.

Rising slowly and avoid sudden position change to prevent orthostatic hypotension.

Remove patch before defribrillation to prevent arcing

Classification: Antianginals

KARLEEN L. JARO


Nifedipine

BRAND NAME

Adalat

DOSAGEAdults:Initial: 10-30mg PO TIDMaximum: 120-180mg

Hypertension:30-60mg PO

•Vasospastic angina, classic chronic stable angina pectoris

•Hypertension

Thought to inhibit calcium ion influx across cardiac and smooth-muscle cells, decreasing contractility and oxygen demand. Also may dilate coronary arteries and arteriole

•Contraindicated in patients hypersensitive to drug

•Use cautiously in patients with heart failure or hypotension and in elderly patients. Use extended-release tablets cautiously in patients with severe GI narrowing

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

Don’t give immediate-release form within 1 week of acute MI or in acute coronary syndrome

Alert: despite the previously widespread SL use nifedipine capsule, avoid this route of administration. Excessive hypotension, MI, and death may result

Monitor blood pressure regularly, especially in patients who take beta blockers or antihypertensive

Watch for symptoms of heart failure

Classification: Antianginals

KARLEEN L. JARO


Nicardipine

BRAND NAME

Cardipine

DOSAGEInitially

20 mg P.O Tid

hypertension20 to 40 mg P.O t.i.d increase dosage depends on the patients response

Chronic stable angina

Inhibits calcium ion influx across cardiac and smooth muscle cells, thus decreasing myocardial contractility and oxygen demand and coronary arteries and arterioles.

Patient who are hypersensitive to nicardipine

DizzinessHeadacheParesthesisDrowsinessPeripheral

edemaPalpitationsTachycardiaNauseaDry mouthAbdominal

discomfortRashFlushing

Patients with hepatic impairment should receive lower dose

Monitor blood pressure.

Allow atleast 3 days between dosage adjustment to achieve steady plasma levels.

Advise patient to report immediately if experiencing chest pain

Classification: Corticosteroids

KARLEEN L. JARO


Dexamethasone

BRAND NAME

Dexon

DOSAGE

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

Inflammation of corticosteroid-responsive dermatoses

anti-inflammatory effects in disorders of many organ systems

Diffuses across cell membrane and complexes with specific cytoplasmic receptors

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

Active tuberculosis

Have psychoneurosis or psychosis

Increased appetiteWeight gainWater retentionIncreased WBCHypokalemiaSkin rashDizzinessInsomiaHeadache

Stop drug and notify doctor if patient develops signs of systemic absorption.

Before applying, gently wash skin to prevent damage to skin rub medication gently.

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

KARLEEN L. JARO

drug study

Documents

adverse reactions

adverse gi reactions

diabetes adverse rxn

treatment adverse rxn

jaro generic

ciprofloxaci n brand

adverse rxn dry mouth

vertigo nursing consideratio