DRUG NAME

ACTION

INDICATION

CONTRAINDICATION

ADVERSE REACTION -dizziness -headache -blurred vision -hypotension -hypertension -tachycardia -edema -chest pain -urticaria -nausea -anorexia -dry mouth -thirst -diuresis

mannitol

BRAND NAME Osmitrol

DOSAGE 75 cc Q8

Increases osmotic pressure of plasma in glomerular filtrate, inhibiting tubular reabsorption of water andelectrolytes (including sodium and potassium). These actions enhance water flow from various tissuesand ultimately decrease intracranial and intraocular pressures

-Prevention and treatment of the oliguric phase of renal failure. -Reduction of intracranial pressure and treatment of cerebral edema; of elevated IOP when the pressure cannot be lowered by other means. -Promotion of the urinary excretion of toxic substances

-Contraindicated with anuria due to severe renal disease -Use cautiously with pulmonary congestion, active intracranial bleeding, dehydration, pregnancy and lactation.

NURSING RESPONSIBILITIES - Do not expose solutions to low temperatures; crystallization may occur. If crystals are seen, warm bottle in a hot water bath, then cool to body tempterature before administering. -Monitor serum electrolytes periodically.

ROUTE Intravenous CLASSIFICATION Osmotic Diuretic

-urine retention -fluid and electreolyte imbalances

DRUG NAME Kalium durule

ACTION

INDICATION -Prevention and correction of potassium deficiency.

CONTRAINDICATION -contraindicated with allergy to tatrazine, asirin therapy with

Principal intracellular cation; essential for

ADVERSE REACTION -Rash -Nausea -vomiting

NURSING RESPONSIBILITIES -Monitor I&O ratio and pattern in patients

BRAND NAME Potassium Chloride

DOSAGE 500 mg, 595 mg tablets;

ROUTE Oral

maintenance of intracellular isotonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscles, maintenance of normal kidney function, and for enzyme activity. Plays a prominent role in both formation and correction of imbalances in acid base metabolism.

-IV treatment of cardiac dysrhytmmias due to cardiac glycosides

potassium sparing diuretics or aldosterone-inhibiting agents; severe renal impairment with oliguria, anuria, azotemia. -Use datiously with cardiac disorders, especially if treated with cardiac glycosides, pregnancy and lactation.

-Diarrhea -abdominal discomfort -GI obstruction -GI perforation -Hyperkalemia

receiving the parenteral drug. If oliguria occurs, stop infusion promptly and notify physician. Lab test: Frequent serum electrolytes are warranted. -Monitor for and report signs of GI ulceration (esophageal or epigastric pain or hematemesis). Be alert for potassium intoxication. -Take drug with food and a full glass of water to decrease GI upset.

CLASSIFICATION electrolytic and water balance agent

DRUG NAME

ACTION

INDICATION -Adjunct to diet to lower blood glucose with type 2

CONTRAINDICATION Contraindicated with allergy to metformin; CHF; diabetes

ADVERSE REACTION Endocrine:Hypoglycemia, lactic acidosis Anorexia, nausea,vomit

metformin hydrochloride

Exact mechanism is not understood;

NURSING RESPONSIBILITIES Monitor urine or serum glucose levels frequently to

BRAND NAME

DOSAGE

possibly increases peripheral utilization of glucose,increases production of insulin, decreases hepatic glucose production and alters intestinalabsorption of glucose.

(non\u2013insulindependent) diabetes mellitus in patients > 10 yr; extended release in patients > 17 yr -As part of combination therapy with a sulfonylurea or insulin when either drug alone cannot control glucose levels in patients with type 2 diabetes mellitus

ROUTE

CLASSIFICATION Antidiabetic

complicated by fever, severe infections, severe trauma, major surgery, ketosis, acidosis, coma (use insulin); type 1 (insulin-dependent), serious hepatic impairment, serious renal impairment, uremia, thyroid or endocrine impairment, glycosuria, hyperglycemia associated with primary renal disease; labor and delivery (if metformin is used during pregnancy, discontinue drug at least 1 mo before delivery); lactation (safety not established).

ing, epigastric discomfort, heartburn, diarrhea Allergic skin reactions, eczema, pruritus, erythema, urticaria

determine effectiveness of drug and dosage Arrange for transfer to insulin therapy during periods of high stress (infections, surgery, trauma). Use IV glucose if severe hypoglycemia occurs as a result of overdose

DRUG NAME

ACTION

INDICATION CHF Atrial fibrillation

CONTRAINDICATION Digitalis toxicity, ventricular tachycardia/fibrilla tion, obstructive cardiomyopathy. Arrhythmias due to accessory pathways (e.g. Wolff-ParkinsonWhite syndrome).

ADVERSE REACTION -Extra beats, anorexia, nausea and vomiting. -Diarrhea in elderly dizziness, drowsiness, restlessness, nervousness, agitation and amnesia, visual disturbances, gynecomastia, local irritation (IM/SC inj), rapid IV admin may lead to vasoconstriction and transient

Digoxin BRAND NAME Lanoxin

DOSAGE 0.1250.25 mg/day PO.

ROUTE

has positive inotropic activity characterized by an increase in the force of myocardial contraction. It also reduces the conductivity of the heart through the atrioventricular (AV) node. Digoxin also exerts direct action on vascular smooth muscle and indirect effects mediated primarily by the autonomic nervous system and an increase in vagal activity.

NURSING RESPONSIBILITIES Monitor apical pulse for 1 min before administering; hold dose if pulse < 60 in adult or < 90 in infant; retake pulse in 1 hr. If adult pulse remains < 60 or infant < 90, hold drug and notify prescriber. Note any change from baseline rhythm or rate. -Avoid IM injections, which may be very painful -Do not stop taking this drug without notifying your health care provider. -Do not start taking any prescription or over-the-counter products without talking to your health care provider. Some combinations may increase the risk of digoxin toxicity and may put you at risk of adverse reactions. -Report unusually slow pulse, irregular pulse, rapid weight gain, loss of appetite, nausea, diarrhea, vomiting, blurred or

CLASSIFICATION Cardiac glycoside,

hypertension. -Potentially Fatal: Cardiac arrhythmias in combination with heart block.

yellow vision, unusual tiredness and weakness, swelling of the ankles, legs or fingers, difficulty breathing.

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