Drug Study

Drug name

General classification

Mechanism of action

Contraindication

Side effect

Nursing responsibility

Generic Name: ACETAMINOPHEN Brand Name: TEMPRA

Analgesics (NonOpioid) & Antipyretics

Tempra is acetaminophen (paracetamol), a safe and effective analgesic-antipyretic. It is a not salicylate. It contains no phenacetin or caffeine. It has no effect on prothrombin time. Tempra is particularly valuable for use in patients who do not tolerate aspirin well because it is less likely to cause GI distress.

Patients with a known hypersensitivity to acetaminophen (paracetamol). Longterm use of acetaminophen (paracetamol) in patients with anemia or with cardiac, pulmonary, renal and/or hepatic disease.

Generally, side effects o to acetaminophen (paracetamol) are mild, though hematological reactions have been reported. Skin rasheso and other allergic o reactions occur occasionally.
o o

If to be given as analgesia, assess onset, type, location, duration of pain.

Can be given without regards to meals.

Tablets can be crushed.

o o

Assess temperature directly before and 1 hour after giving medication.

o o

If respirations are <12/min (<20/min in children), withhold the medication and contact the physician.

o o

Evaluate for

therapeutic response: relief of pain, stiffness, swelling; increasing in joint mobility; reduced joint tenderness; improve grip strength.
o o

Therapeutic blood serum level: 10-30 mcg/mL; toxic serum level: >200 mcg/mL.

Drug name Amoxicillin

General classification Antibiotic

Mechanism of action Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death

Contraindication Contraindicated with allergy to cephalosporins or penicillins, or other allergens

Side effect CNS lethargy, hallucinations, seizures GI glossitis, stomatitis, gastritis, sore mouth, furry tongue (black hairy), nausea, vomiting, diarrhea (bloody), enterocolitis,pseudo membranous colitis, nonspecific hepatitis GU nephritis Hematologic anemia, thrombocytopenia, leucopenia, neutropenia, prolonged bleeding time Hypersensitivity rash, fever, wheezing, anaphylaxis Others superinfections: oral and rectal moniliasis, vaginitis

Nursing responsibility Culture infected area prior to treatment; reculture area if response is not expected Give in oral preparations only; amoxicillin is not affected by food Continue therapy for at least 2 days after signs of infection have disappeared; continuation for 10 full days is recommended Use corticosteroids or antihistamines for skin reactions

Drug name GENERIC NAME: Metoclopramid e BRAND NAME: Plasil

General classification GIT Regulators, Antiflatulents & AntiInflammatories / Antiemetics

Mechanism of action Metoclopramide, a dopamine antagonist, stimulates motility of the upper gastrointestinal tract without stimulating gastric, biliary or pancreatic secretions. Its mode of action is unclear. It seems to sensitize tissues to the action of acetylcholine. The effect of metoclopramide on motility is not dependent on intact vagal innervation but it can be abolished by anticholinergic drugs. Metoclopramide increases the tone and amplitude of gastric (especially antral) contractions, relaxes the pyloric sphincter and the duodenum and jejunum, resulting in accelerated gastric emptying and

Contraindication Patients with a history of hypersensitivity to metoclopramide or any of the components of Plasil. Metoclopramide should not be used whenever stimulation of gastrointestinal motility might be dangerous eg, in the presence of gastrointestinal hemorrhage, mechanical obstruction or perforation. Metoclopramide is contraindicated in patients with pheochromocytoma because the drug may cause a hypertensive crisis, probably due to release of catecholamines from the tumor. Such hypertensive crises may be controlled by phentolamine. Metoclopramide should not be used in epileptics or patients receiving other CNS:

Side effect

Nursing responsibility monitor BP carefully during IV administration keep diphenhydrami ne injection readily available in case extrapyramidal reactions occur have phenotolamine readily available in case of hypertensive crisis take drug exactly as prescribed use of alcohol, sleep remedies, or sedatives can cause serious sedation. report involuntary

restlessness ,drowsiness, fatigue, insomnia, dizziness, anxiety CV: transient hypertensio nGI:na us ea , diarrhea

intestinal transit. It increases the resting tone of the lower esophageal sphincter.

drugs which are likely to cause extrapyramidal reactions, since the frequency and severity of seizures or extrapyramidal reactions may be increased.

movement of the face, eyes, and limbs

Nursing Care Plan

Name of patient: S.W Date and Time Assessment Diagnosis

Diagnosis: DHF Planning Intervention Rationale Evaluation

8/20/11 5am

S> (none) O> > Temp of 39.8 > Flushed skin > Skin warm to touch

Hyperthermia r/t physiological factors secondary to dengue hemorrhagic fever

Short Term:

Independent: To obtain baseline data To evaluate effects & extent of hyperthermia

After 4 hours of NI, pts temperature will Monitor Vital Signs decrease from 39.8 to 37. Assess neurologic response, note LOC & orientation, reaction to stimuli, papillary reactions & presence of seizures Note presence / absence of sweating Wrap extremities with bath towels Provide TSB q 15 minutes Apply local ice packs in axilla

To monitor heat & fluid loss To minimize shivering To reduce body temperature To reduce body temperature in areas of high blood

Instruct client to have bed rest Instruct client to increase OFI

flow To reduce metabolic demands / oxygen consumption To prevent dehydration To support circulating blood volume and tissue perfusion To restore normal body temperature To determine effectiveness of interventions done

Reassess temperature q 15 minutes Dependent:

Administer replacement fluids Administer antipyretics