Drugs Action Indication Contraindicatio

n
Adverse Efect Nursing responsibilities

Trade Name:
Lantus
Generic
Name:
Insulin
Dosage:
10 u
Frequency:
OD
Route:
!
"nti#
dia$etes%
&ormones
Lo'er $lood
glucose $y
stimulating
glucose u(ta)e
in s)eletal
muscle *at%
in&i$iting
&e(atic glucose
(roduction+
Treatment o* ty(e 1
,insulin#de(endent-
dia$etes
Treatment o* ty(e .
,non/insulin#
de(endent- dia$etes
t&at cannot $e
controlled $y diet or
oral agents
Regular insulin
in0ection: Treatment o*
se1ere )etoacidosis or
dia$etic coma
Treatment o*
&y(er)alemia 'it&
in*usion o* glucose to
(roduce a s&i*t o*
(otassium into t&e
cells
Treatment o* adult
(atients 'it& ty(e .
dia$etes '&o require
$asal insulin control o*
&y(erglycemia
Treatment o* adults
and c&ildren 2 3 yr
'&o require $aseline
insulin control
4ontraindicated
'it& allergy to
(or) (roducts
,1aries 'it&
(re(arations5
&uman insulin not
contraindicated
'it& (or) allergy-+
6se cautiously
'it& (regnancy
,)ee( (atients
under close
su(er1ision5 rigid
control is desired5
*ollo'ing deli1ery%
requirements
may dro( *or .7/
8. &r% rising to
normal le1els
during ne9t 3 ')-5
lactation ,monitor
mot&er care*ully5
insulin
requirements
may decrease
during lactation-+
:y(ersensiti1ity:
Ras&% ana(&yla9is
or angioedema
Local: "llergy;local
reactions at
in0ection site;
redness% s'elling%
itc&ing5 usually
resol1es in a *e'
days to a *e'
'ee)s5 a c&ange in
ty(e or s(ecies
source o* insulin
may $e tried5
li(odystro(&y5
(ruritus
<eta$olic:
:y(oglycemia5
)etoacidosis
Gi1e maintenance doses
su$cutaneously% rotating
in0ection sites regularly to
decrease incidence o*
li(odystro(&y5 gi1e regular
insulin I= or I< in se1ere
)etoacidosis or dia$etic coma+
Do not gi1e insulin in0ection
concentrated I=5 se1ere
ana(&ylactic reactions can
occur+
tore insulin in a cool (lace
a'ay *rom direct sunlig&t+
Re*rigeration is (re*erred+ Do
not *ree>e insulin+ Insulin
(re?lled in glass or (lastic
syringes is sta$le *or 1 ')
re*rigerated5 t&is is a sa*e 'ay
o* ensuring (ro(er dosage *or
(atients 'it& limited 1ision or
'&o &a1e (ro$lems 'it&
dra'ing u( insulin+
<onitor urine or serum glucose
le1els *requently to determine
e@ecti1eness o* drug and
dosage+ Aatients can learn to
ad0ust insulin dosage on a
sliding scale $ased on test
results+
Bee( li*e su((ort equi(ment
and glucose readily a1aila$le to
deal 'it& )etoacidosis or
&y(oglycemic reactions+
"d1ice (atient to a1oid alco&ol5
serious reactions can occur+
Re(ort *e1er% sore t&roat%
1omiting% &y(oglycemic or
&y(erglycemic reactions% ras&+
4e*uro9ime
,4e*tin-
8C0mg
"nti#
in*ecti1es
Dind to
$acterial cell
'all
mem$rane%
causing cell
deat&
Dactericidal
action
Treatment o*
It is e@ecti1e *or
t&e treatment o*
(enicillinase#
(roducingNeisseria
gonorr&oea,AANG-+
E@ecti1ely treats
$one and 0oint
in*ections%
$ronc&itis%
meningitis%
gonorr&ea% otitis
media%
(&aryngitisFtonsilliti
s% sinusitis% lo'er
res(iratory tract
in*ections% s)in and
so*t tissue
in*ections% urinary
tract in*ections% and
is used *or surgical
(ro(&yla9is%
reducing or
eliminating
in*ection+
:y(ersensiti1ity
to
ce(&alos(orins
and related
anti$iotics5
(regnancy
,category D-%
lactation+
"na(&yla9is
"ngioedema
To9ic
e(idermal
necrolysis
4utaneous
1asculitis
interstitial
ne(&ritis
(ancyto(enia
agranulocyto
sis
t&rom$ocyto
(enia
leuco(enia
neutro(enia
anemia
&emolytic
sei>ures
Before:
Determine &istory
o* &y(ersensiti1ity reacti
ons to ce(&alos(orins%
(enicillins% and &istory o*
allergies% (articularly to
drugs% $e*ore t&era(y is
initiated+
La$ tests: Aer*orm
culture and sensiti1ity
tests $e*ore initiation o*
t&era(y and (eriodically
during t&era(y i*
indicated+ T&era(y may
$e instituted (ending
test results+ <onitor
(eriodically D6N and
creatinine clearance+
During:
Ins(ect I< and I=
in0ection sites *requently
*or signs o* (&le$itis+
<onitor *or
mani*estations
o* &y(ersensiti1ity ,see
"((endi9 F-+ Discontinue
drug and re(ort t&eir
a((earance (rom(tly+
<onitor IGO rates and
(attern: Es(ecially
im(ortant in se1erely ill
(atients recei1ing &ig&
doses+ Re(ort any
signi?cant c&anges+
Re(ort onset o* loose
stools or diarr&ea+
"lt&oug&
(seudomem$ranous
colitis ,see igns G
ym(toms% "((endi9 F-
rarely occurs% t&is
(otentially li*e#
t&reatening com(lication
s&ould $e ruled out as
t&e cause o* diarr&ea
during and a*ter
anti$iotic t&era(y+
After:
Instruct (atient to ta)e
medication around t&e
cloc) at e1enly s(aced
times and to ?nis& t&e
medication com(letely%
e1en i* *eeling $etter
"d1ise (atient to re(ort
signs o* su(erin*ection
and allergy
Instruct (atient to noti*y
&ealt& (ro*essional i*
*e1er and diarr&ea
de1elo(
:ydrocortiso
ne
,:ydrocortiso
ne "cetate-
100mg
4orticosteroi
d% s&ort
acting%
Glucocorticoi
d%
<ineralocorti
coid% "drenal
cortical
&ormone
,&ydrocortiso
ne-%
:ormonal
agent
Enters target
cells and $inds
to cyto(lasmic
rece(tors5
initiates many
com(le9
reactions t&at
are res(onsi$le
*or its anti#
inHammatory%
immunosu((re
ssi1e
,glucocorticoid-
% and salt#
retaining
,mineralocortic
oid- actions+
ome actions
may $e
undesira$le%
de(ending on
drug use+
Re(lacement t&era(y
in adrenal cortical
insuIciency
J :y(ercalcemia
associated 'it& cancer
J &ort#term
inHammatory and
allergic disorders% suc&
as r&eumatoid
art&ritis% collagen
diseases ,LE-%
dermatologic diseases
,(em(&igus-% status
ast&maticus% and
autoimmune disorders
ystemic
administration:
in*ections%
es(ecially
tu$erculosis%
*ungal in*ections%
ame$iasis%
&e(atitis D%
1accinia% or
1aricella% and
anti$iotic#
resistant
in*ections5 )idney
disease ,ris) to
edema-5 li1er
=ertigo
:eadac&e
Aarest&esias
Insomnia
4on1ulsions
Asyc&osis
:y(otension
&oc)
:y(ertension
Em$olism
cardiac
arr&yt&mias
secondary to
electrolyte
distur$ances
ystemic administration
Gi1e daily $e*ore K "<
to mimic normal (ea)
diurnal corticosteroid
le1els and minimi>e :A"
su((ression+
(ace multi(le doses
e1enly t&roug&out t&e
day+
Do not gi1e I< in0ections
i* (atient &as
t&rom$ocyto(enic
(ur(ura+
Rotate sites o* I<
re(ository in0ections to
J :ematologic
disorders##
t&rom$ocyto(enic
(ur(ura%
eryt&ro$lasto(enia
J Tric&inosis 'it&
neurologic or
myocardial
in1ol1ement
J 6lcerati1e colitis%
acute e9acer$ations o*
multi(le sclerosis% and
(alliation in some
leu)emias and
lym(&omas
J Intra#articular or so*t#
tissue administration:
"rt&ritis% (soriatic
(laques
J Retention enema: For
ulcerati1e colitis%
(roctitis
J Dermatologic
(re(arations: To
relie1e inHammatory
and (ruritic
mani*estations o*
dermatoses t&at are
steroid res(onsi1e
disease% cirr&osis%
&y(ot&yroidism5
ulcerati1e colitis
'it& im(ending
(er*oration5
di1erticulitis5
recent GI surgery5
acti1e or latent
(e(tic ulcer5
inHammatory
$o'el disease
,ris)s
e9acer$ations or
$o'el
(er*oration-5
&y(ertension%
4:F5
t&rom$oem$olitic
tendencies%
t&rom$o(&le$itis%
osteo(orosis%
con1ulsi1e
disorders%
metastatic
carcinoma%
dia$etes mellitus5
lactation+
J Retention
enemas%
a1oid local atro(&y+
6se minimal doses *or
minimal duration to
minimi>e ad1erse
e@ects+
Ta(er doses '&en
discontinuing &ig&#dose
or long#term t&era(y+
"rrange *or increased
dosage '&en (atient is
su$0ect to unusual
stress+
6se alternate#day
maintenance t&era(y
'it& s&ort#acting
corticosteroids '&ene1er
(ossi$le+
Do not gi1e li1e 1irus
1accines 'it&
immunosu((ressi1e
doses o* &ydrocortisone+
Aro1ide antacids
$et'een meals to &el(
a1oid (e(tic ulcer+
J "norectal cream%
su((ositories: To
relie1e discom*ort o*
&emorr&oids and
(erianal itc&ing or
irritation
intrarectal *oam:
systemic *ungal
in*ections% recent
intestinal surgery%
e9tensi1e ?stulas+
J To(ical
dermatologic
administration:
*ungal%
tu$ercular%
&er(es sim(le9
s)in in*ections5
1accinia%
1aricella5 ear
a((lication '&en
eardrum is
(er*orated5
lactation+
Dutamirate
ul*ate
,inecod-
C00mg
"ntitussi1e
"cts centrally
on $rain ,1agus
ner1e- or
locally on t&e
res(iratory
tract to
su((ress t&e
coug& reHe9+
6sed *or acute
coug& o* any
etiology+
6sed *or (re and
(ost o( coug&
sedation *or
surgical
(rocedures and
$roc&osco(y+
:y(ersensiti1ity
to drug
"ssess coug& ty(e and
*requency+
<onitor t&e ad1erse
reactions+
"ssess (atients 1ital
signs+
"ssess slee( (atterns+
Instruct (atient to coug&
e@ecti1ely% sit u(rig&t
and ta)e se1eral dee(
$reat&s $e*ore
attem(ting+
"d1ice (atient to
minimi>e coug& to
(re1ent irritants+
4aution (atient to a1oid
any acti1ities requiring
alertness until res(onse
to medication is )no'n+
"ntonio <arcelo 4+ Ramire>
DN # 7.1