Sunteți pe pagina 1din 15

Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

FUROSEMID Edema Rapid-acting potent Treatment of CV: Postural hypotension, History of Assessment & Drug Effects
E Adult: PO 20–80 sulfonamide "loop" edema dizziness with excessive hypersensitivity to
(fur-oh'se- mg in 1 or more diuretic and diuresis, acute hypotensive
associated furosemide or • Observe patients receiving
mide) divided doses up to antihypertensive episodes, circulatory collapse.
with CHF, sulfonamides; parenteral drug carefully; closely
600 mg/d if with Metabolic: Hypovolemia,
monitor BP and vital signs.
Fumide , needed IV/IM 20– pharmacologic cirrhosis of dehydration, hyponatremia increasing oliguria,
Sudden death from cardiac arrest
Furomide , 40 mg in 1 or more effects and uses liver, and hypokalemia, hypochloremia anuria, fluid and has been reported.
Lasix, divided doses up to almost identical to kidney metabolic alkalosis, electrolyte
600 mg/d those of ethacrynic hypomagnesemia, • Monitor BP during periods of
Luramide disease, depletion states; diuresis and through period of
Child: PO 2 acid. Exact mode hypocalcemia (tetany),
mg/kg, may be of action not including hyperglycemia, glycosuria, hepatic coma; dosage adjustment.
Classification • Observe older adults closely
s: increased by 1–2 clearly defined; nephrotic elevated BUN, hyperuricemia. pregnancy
during period of brisk diuresis.
ELECTROLY mg/kg q6–8h (max: decreases renal syndrome. GI: Nausea, vomiting, oral (category C),
6 vascular resistance and gastric burning, anorexia, Sudden alteration in fluid and
TIC AND May be used lactation. electrolyte balance may
mg/kg/dose) IV/I and may increase diarrhea, constipation,
WATER
M 1 mg/kg, may be renal blood flow
for abdominal cramping, acute precipitate significant adverse
BALANCE management reactions. Report symptoms to
AGENT; increased by 1 pancreatitis, jaundice.
mg/kg q2h if of Urogenital: Allergic physician.
LOOP • Lab tests: Obtain frequent
DIURETIC needed (max: hypertension, interstitial nephritis,
mg/kg/dose) irreversible renal failure, blood count, serum and urine
alone or in electrolytes, CO2, BUN, blood
Neonate: PO 1–4 urinary frequency.
combination sugar, and uric acid values
mg/kg q12– Hematologic: Anemia,
24h IV/IM 1–2 with other leukopenia, thrombocytopenic during first few months of
mg/kg q12–24h antihypertensi purpura; aplastic anemia, therapy and periodically
ve agents, and agranulocytosis (rare). Special thereafter.
Hypertension Senses: Tinnitus, vertigo, • Monitor for S&S of
for treatment
Adult: PO 10–40 feeling of fullness in ears, hypokalemia.
of • Monitor I&O ratio and pattern.
mg b.i.d. (max: 480 hearing loss (rarely
mg/d) hypercalcemia permanent), blurred vision. Report decrease or unusual
. Has been Skin: Pruritus, urticaria, increase in output. Excessive
used exfoliative dermatitis, purpura, diuresis can result in dehydration
concomitantly photosensitivity, porphyria and hypovolemia, circulatory
cutanea tarde, necrotizing collapse, and hypotension.
with mannitol Weigh patient daily under
angiitis (vasculitis). Body as a
for treatment Whole: Increased standard conditions.
of severe perspiration; paresthesias; • Monitor urine and blood
cerebral activation of SLE, muscle glucose & HbA1C closely in
edema, spasms, weakness; diabetics and patients with
particularly in thrombophlebitis, pain at IM decompensated hepatic cirrhosis.
injection site. Drug may cause hyperglycemia.
meningitis.
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

BUMETANI TABLETS Inhibits Treatment of Electrolyte and fluid Bumetanide is Assessment


DE reabsorption of edema associated changes: Excess water loss, contraindicated in
(byou-MET- Adults: 0.5-2 mg both sodium and with CHF, dehydration, electrolyte anuria. Although  History: Allergy to
ah-nyd) once daily; if chloride in the nephrotic depletion including Bumetanide can be bumetanide, electrolyte
response is proximal tubule syndrome, hypokalemia, hypochloremia, used to induce diuresis depletion, anuria, severe renal
Bumex, inadequate, a and the ascending hepatic disease. hyponatremia, hypovolemia, in renal insufficiency, failure, hepatic coma, SLE,
Bumetanide, second dose or loop of Henle. Adjunct to treat thromboembolism, any marked increase in gout, diabetes mellitus, lactation
Burinex third dose may be Possible activity in pulmonary circulatory collapse. Otic: blood urea nitrogen or  Physical: Skin color,
given at 4-5 hr the proximal tubule edema. Tinnitus, reversible and creatinine, or the lesions; edema; orientation,
Classification intervals up to a to promote Especially useful irreversible hearing development of oliguria reflexes, hearing; pulses,
s: LOOP maximum of phosphate in clients impairment, deafness, vertigo during therapy of baseline ECG, BP, orthostatic
DIURETIC 10mg/day excretion. refractory to (with sense of fullness in the patients with BP, perfusion; R, pattern,
Onset- PO: 30-60 other diuretics. ears) CV: Reduction in blood progressive renal adventitious sounds; liver
IV, IM min Peak Effect, Investigational:tr volume may cause circulatory disease, is an indication evaluation, bowel sounds;
PO: 1-2 hr. eatment of adult collapse and vascular for discontinuation of urinary output patterns; CBC,
Adults: 0.5-1 mg; Duration, PO: 4-6 nocturia. Not thrombosis and embolism treatment with serum electrolytes (including
if response is hr (dose- effective in especially in geriatric Bumetanide. calcium), blood sugar, liver and
inadequate, a dependent) males with patients. Hypotension, ECGS Bumetanide is also renal function tests, uric acid,
second or third prostatic changes, chest pain. CNS: contraindicated in urinalysis
dose may be given Onset- IV: Several hypertrophy. Asterixis, encephalopathy with patients in hepatic coma Interventions
at 2-3 hr intervals minutes. Peak preexisting liver disease, or in states of severe  Give with food or milk
up to a maximum Effect, IV: 15-30 vertigo, headache, dizziness. electrolyte depletion to prevent GI upset.
of 10 mg/day. min. Duration, IV: GI: Upset stomach, dry until the condition is  Mark calendars or use
Initiate PO dosing 3.5-4 hr mouth, N&V, diarrhea, GI improved or corrected. reminders if intermittent therapy
a soon as possible. pain. GU: Premature Bumetanide is is best for treating edema.
ejaculation, difficulty contraindicated in  Give single dose early in
maintaining erection, renal patients hypersensitive day so increased urination will
failure. Musculoskeletal: to this drug. not disturb sleep.
Arthritic pain, weakness,  Avoid IV use if oral use
muscle cramps, fatigue. is possible.
Hematologic:  Arrange to monitor
Agranulocytosis, serum electrolytes, hydration,
thrombocytopenia. Allergic: liver function during long-term
Pruritus, urticaria, rashes. therapy.
Miscellaneous: Sweating,  Provide diet rich in
hyperventilation, rash, nipple potassium or supplemental
tenderness, photosensitivity, potassium.
pain following parenteral use.
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

LACTULOSE Adult: PO Lactulose promotes Constipation, Lactulose may produce Lactulose is >Assess condition before therapy
(lak' tyoo lose) Constipation peristalsis by salmonellosis. gaseous distention with contraindicated in and reassess regularly thereafter to
Initial: 10-20 g (15- producing an For the flatulence or belching and Galactosaemia, monitor drug’s effectiveness
30 mL)/day. Max: osmotic effect in prevention and abdominal discomfort such as undiagnosed abdominal >Monitor patient for any adverse
Cephulac, 45 mL (or 40 g of the colon with treatment of cramping in about 20% of pain or vomiting, GI reactions,
Chr the reconstituted resultant distention. portal-systemic patients. Excessive dosage can organic constipation nausea,vomiting,diarrhea,
onul oral In hepatic encephalopathy, lead to diarrhea with potential like intestinal >Assess for adverse reactions
ac, formulation)/day. encephalopathy, it including the complications such as loss of obstruction, stricture, >for pt. with hepatic encelopathy:
Con Hepatic reduces absorption stages of hepatic fluids, hypokalemia, and malignancy or regularly assess mental condition
stila encephalopathy of ammonium ions pre-coma and hypernatremia. Nausea and hypercalcaemia. It >monitor I & O
c, 60-100 g (90-150 and toxic coma. vomiting have been reported. should also not be used >monitor for Inc. glucose level in
Con mL)/day in 3 nitrogenous together with drugs that diabetic patients
stul divided doses; compounds, causes constipation like
ose, adjust accordingly. resulting in reduced effects.
Dup Rectal Hepatic blood ammonia
hala encephalopathy concentrations.
c, Mix 200 g (300 mL Onset: 48 hr.
Eva w/ 700 mL water or Absorption: Not
lose 0.9% NaCl as a appreciable (oral).
retention enema. Metabolism: Via
Classification: Retain enema for colonic flora to
laxative 30-60 mins; repeat lactic acid and
4-6 hrly until oral acetic acid.
medication can be Excretion: Faeces,
administered. urine (as
unchanged drug).
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

SPIRONOLACTONE Adult: PO Oedema Spironolactone promotes Essential Gastro-intestinal Acute renal  Educate to avoid
Initial: 100 mg/day, diuresis in patients with hypertension, disorders: abdominal insufficiency, hazardous activity such
Brand Name: Aldazide up to 400 mg/day oedema or ascites. oedema and pain, vomiting, nausea, significant driving untl response to
based on response. Spironolactone acts in the ascites of diarrhoea, gastro- impairment of renal drug is known.
Drug Class : Diuretics, Hepatic cirrhosis distal portion of the renal congestive intestinal disturbance. function, anuria,
Other w/ ascites and tube by competitive heart failure, Body as a whole: hyperkalemia or  Take with meals; avoid
Antihypertensives oedema Depending inhibition of aldosterone, a cirrhosis of the asthenia, fever, sensitivity to excessive ingestion of
on urinary Na/K sodium-retaining, liver, the anaphylactoid reaction, spironolactone, food high in potassium
ratio: If >1: Initial: potassium-excreting nephrotic malaise. thiazide diuretics or to or use of salts
100 mg/day and if hormone. syndrome, Skin and appendages: other sulfonamide- substitutes.
<1: Initial: 200-400 Isobutylhydrochlorothiazide idiopathic rash, pruritis, dermatitis, derived
mg/day. Diagnosis promotes sodium and water oedema. photosensitivity. drugs.sulfonamide-  Diuretic effect may be
of primary excretion by inhibiting Nervous system disorders: derived medicines. delayed 2-3 days and
hyperaldosteronism sodium and chloride dizziness, headache, maximum hypertensive
400 mg/day for 3-4 reabsorption in the kidney paraesthesia. may be delayed 2-
wk. Pre-op tubule. Psychiatric disorders: 3weeks; monitor I and
management of The combination of impotence. O ratios and daily
hyperaldosteronism spironolactone and Neoplasm: breast weight, BP, serum
100-400 mg/day. isobutylhydrochlorothiazide neoplasm, including electrolyte s (K, Na)
HTN As provides an effective malignancy. and renal function.
monotherapy: 25- treatment for many patients Metabolic and nutritional
50 mg/day, up to who would not respond to disorders: electrolyte
100 mg/day if either drug alone. The disturbances.
needed. Severe combination results in an Reproductive disorders:
CHF W/ ACE additive diuretic effect breast disorders,
inhibitor and loop since both drugs will menstrual disorders.
diuretic: Initial: increase sodium and water Haematological
12.5-25 mg/day, up excretion by acting in disorders:
to 50 mg/day after different parts of the renal thrombocytopenia
8 wk. Diuretic- tubule.
induced
hypokalaemia 25-
100 mg/day.
Hirsutism 50-200
mg/day.
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

FLUMAZENIL Adult: IV Antagonizes the effects of Indicated for the Nausea, vomiting, Hypersensitivity.
Benzodiazepine- benzodiazephines on the complete or dizziness, blurred vision, Patients receiving
(FLOO-may-ze-nil) induced sedation CNS by competitively partial reversal headache, flushing; benzodiazepines for
Brand Name: Initial: 200 mcg inhibiting their action at the of the sedative anxiety, fear and agitation control of a
Romazicon followed by 100- benzodiazephine rcognition effects of (following too rapid potentially life-
200 mcg at site on the benzodiazepines reversal of sedation); threatening condition
Classification: intervals of 60 GABA/benzodiazephine in cases where seizures (especially in such as status
benzodiazepine seconds to a max receptor complex. Does not general epileptics); transient epilepticus and
antagonist total of 1 mg if antagonize the CNS effects anesthesia has increases in BP and heart control of intracranial
needed. Usual of the ethanol, general been induced rate. pressure. Severe
range: 0.3-1 mg. anesthetics, barbiturates, or and/or intoxication with
opiates. Depending on the maintained with tricyclic and related
Benzodiazepine dose, there will be partial or benzodiazepines, antidepressants.
overdose Initial: complete antagonism of where sedation
200 mcg; an sedation, impaired recall, has been
additional dose of and psychomotor produced with
300 mcg can be impairment. benzodiazepines
given 30 sec later for diagnostic
followed by doses and therapeutic
of 500 mcg at 1- procedures, and
min intervals if for the
needed, up to a management of
total dose of 3 mg. benzodiazepine
overdose.
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

INTERFERON Adult: SC Renal cell Interferon alfa-2a is the • Interferon alfa- Depressive illness, Hypersensitivity. History of depression
ALFA carcinoma In an product of recombinant 2a (Roferon-A) is suicidal behaviour, Autoimmune (monitor for signs).
escalating dose of 3 DNA technology using FDA-approved to irritability, insomnia, hepatitis, hepatic Perform regular
(IN-TER-FEER-ON- million u 3 times/wk strains of genetically treat hairy cell anxiety. Flu-like decompensation. neuropsychiatric
AL-FAH) for 1 wk, then 9 million engineered Escherichia leukemia, AIDS- symptoms. Headache, monitoring. Seizure
u 3 times/wk for 1 wk, coli. Activity is related Kaposi's dizziness, disorders and/or
ROFERON-A then 18 million u 3 expressed as sarcoma, and chronic paraesthesia, compromised CNS
times/wk thereafter for International Units, myelogenous confusion, impaired function. Preexisting or any
Classification: 3-12 mth. Chronic which are determined leukemia. concentration, history of cardiac disease.
Antineoplastic, hepatitis B 2.5-5 by comparing the • Interferon alfa- alteration in taste or Monitor CBC prior to and
miscellaneous million u/m2 3 antiviral activity of the 2b is approved for smell. GI during therapy.
times/wk for 4-6 mth. international reference the treatment of hairy disturbances. Dryness Myelosuppression or
Chronic hepatitis C W/ standard of human cell leukemia, of oropharynx, concurrent use of
ribavirin: 3-4.5 million leukocyte interferon. malignant melanoma, epistaxis, rhinitis, myelosuppressive drugs.
u 3 times/wk for 6 mth. Interferons bind to condylomata arrhythmia, sinusitis. Hypothyroidism,
Monotherapy: 3 million specific receptors on acuminata, AIDS- Inj site reaction, hyperthyroidism, DM.
u 3 times/wk for 12 the cell surface, related Kaposi's alopecia, rash, dry Perform ophthalmological
mth. Hairy cell resulting in inhibition sarcoma, chronic skin or pruritus. exam on patients with
leukaemia 3 million of virus replication in hepatitis C, and Conjunctivitis, preexisting ophthalmologic
u/day for 16-24 wk. virus-infected cells, chronic hepatitis B. menstrual disorders (e.g. diabetic or
Maintenance: 3 million suppression of cell • Ribavirin irregularity, visual hypertensive retinopathy).
u 3 times/wk, up to 24 proliferation, increase combined with disturbances. Monitor patients with
wk. AIDS related in the phagocytic interferon alfa-2b, Coughing, dyspnoea. impaired renal function.
Kaposi's sarcoma In an activity of interferon alfacon-1 Myalgia, joint or Creatinine clearance <50
escalating dose of 3 macrophages, and (Infergen), pegylated bone pain, arthritis or ml/min. May impair ability
million u/day for 3 enhancement of the interferon alfa-2b, or polyarthritis. Bone to drive or operate
days, 9 million u/day toxic effects of pegylated interferon marrow depression. machinery. Pregnancy and
for 3 days, 18 million leukocytes for target alpha-2a, all are Potentially Fatal: lactation.
u/day for 3 days, and 36 cells. approved for the Marked increase in
million u/day (if treatment of chronic triglyceride levels, GI
tolerated) on days 10- hepatitis C. haemorrhage, severe
84. thereafter max • Interferon infections, pulmonary
tolerated dose (up to 36 beta-1b (Betaseron) infiltrates or
million u) 3 times/wk. and interferon beta- pulmonary function
Chronic myeloid 1a (Avonex) are impairment.
leukaemia In an approved for the
escalating dose of 3 treatment of multiple
million u/day for 3 sclerosis.
days, 6 million u/day • Interferon alfa-
for 3 days, and 9 n3 (Alferon-N) is
million u/day thereafter. approved for the
For responders after 12 treatment of genital
wk: Continue treatment and perianal warts
until haematological caused by human
response is complete or papillomavirus
up to 18 mth. Follicular (HPV).
lymphoma As adjunct • Interferon
to chemotherapy: 6 gamma-1B
million u/ m2/day on (Actimmune) is
days 22-26 of each 28- approved for the
day cycle. Cutaneous treatment of chronic
T-cell lymphoma In an granulomatous
escalating dose of 3 disease, and severe,
million u/day for 3 malignant
days, then 9 million osteopetrosis.
u/day for 3 days, and
then 18 million u/day to
complete 12 wk of
treatment. Thereafter,
max tolerated dose (up
to 18 million u) 3
times/wk for at least 12
mth in responders.
Melanoma 3 million u 3
times/wk for 18 mth.
Start treatment no later
than 6 wk after surgery.
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility


LAMIVUDINE Adult: PO HIV Lamivudine, a nucleoside Epivir. In Abdominal pain, nausea, Hypersensitivity. Discontinue use if there is
(3TC) infection 300 analogue, is phosphorylated combination vomiting, diarrhoea, Lactation. rapid increase in
mg/day. Chronic in the body to the active with other insomnia, cough, nasal aminotransferase levels,
(lah-MIH-vyou-deen) hepatitis B 100 mg triphosphate form. In the antiretroviral symptoms, arthralgia, progressive hepatomegaly,
once daily. active form, it inhibits drugs for the muscle pain, headache, or metabolic or lactic
Epivir, Epivir-HBV hepatitis B virus treatment of fever, rash, alopecia, acidosis of unknown origin.
polymerase and HIV HIV infection. malaise, increased Discontinue use if clinical
Classification: reverse transcriptase Epivir-HBV. 1. creatinine phosphokinase signs, symptoms or lab
Antiviral, nucleoside enzymes. chromic and alanine abnormalities suggestive of
reverse transcriptase Absorption: Rapidly hepatitis B aminotransferase, pancreatitis develop.
inhibitor. absorbed from the GI tract, associated with peripheral neuropathy. Hepatomegaly or other risk
delayed if taken with food evidence of Rarely rhabdomyolysis, factors for hepatic
(oral); peak plasma hepatitis B pancreatitis, hepatitis. impairment. Monitor
concentrations after 1 hr. replication and Neutropenia and anaemia hepatic function in chronic
Distribution: Crosses the active liver (in combination with hepatitis B patients.
blood-brain barrier and inflammation. 2. zidovudine), Exclude HIV infection prior
placenta; enters breast milk. Hepatitis B in thrombocytopenia, to hepatitis B therapy.
Protein-binding: Up to children 2-17 increases in LFTs. Renal impairment.
36%. years of age Paronychia. Angioedema, Pregnancy.
Metabolism: Intracellular; urticaria, and
low hepatic metabolism. anaphylactoid reaction.
Excretion: Via urine (as Potentially Fatal: Lactic
unchanged drug); 5-7 hr acidosis associated with
(elimination half-life). severe hepatomegaly and
hepatic steatosis.
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

ADEFOVIR Oral Adefovir dipivoxil is an Chronic Nausea, dyspepsia, Lactation. Pregnancy; elderly; child;
acyclic nucleoside reverse hepatitis B. abdominal pain, renal or hepatic
Hepsera Chronic hepatitis B transciptase inhibitor. The flatulence, diarrhoea, impairment. HIV antibody
Adult: >18 yr: 10 diester function is asthenia, headache. testing to be performed
mg once daily. hydrolyzed and Pruritus, skin rashes, before initiation due to
Classification: anti- subsequently and respiratory effects possible resistance
viral agent Renal impairment: phosphorylated to the active e.g. cough, pharyngitis development in untreated
Haemodialysis adefovir diphosphate. The and sinusitis. HIV infection. Increased
patients: 10 mg active metabolite inhibits Potentially Fatal: risk of hepatotoxicity in
every 7 days after HBV DNA polymerase Lactic acidosis, severe females, obese patients and
dialysis. (reverse transcriptase) and hepatomegaly with with prolonged treatment.
hence inhibits viral steatosis, hepatotoxicity, Monitor renal function
replication. It can be used nephrotoxicity. every 3 mth; hepatitis B
in patients with lamivudine- biochemical, viral and
resistant hepatitis B. serological markers every 6
Absorption: Rapidly mth and LFTs. Discontinue
converted to adefovir after therapy if liver function
oral admin. Bioavailability worsens, severe
59%. Plasma concentration hepatomegaly, steatosis or
peaks after 0.6-4 hr. unexplained metabolic or
Distribution: Widely lactic acidosis. Monitor
distributed to body tissues. hepatic function for several
Protein binding: >4%. mth in patients whose
Excretion: Renal. Terminal antihepatitis therapy is
elimination half-life: 7 hr. discontinued as acute
exacerbations of hepatitis
may occur.
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

RIBAVIRIN Adult: PO Dosage Ribavirin is a synthetic Ribavirin is used Oral: Increased serum Hypersensitivity. Patients with extensive
depends on the product nucleoside which has in combination bilirubin and uric acid, Pregnancy and hepatic fibrosis; renal
(rye-ba-VYE-rin) used and patient's body inhibitory action against with injectable haemolytic anaemia, lactation. Unstable impairment; anaemias.
wt. Rebetol (Schering- respiratory syncytial virus, interferon alfa- reticulocytosis, cardiac disease, Monitor CBC at the start
Plough): W/ influenza virus and herpes 2b, anorexia, dyspepsia, haemoglobinopathies of, and regularly during
peginterferon alfa-2b, simplex virus. The peginterferon nausea, irritability, or CrCl <50 ml/min. treatment. Ensure
Therapeutic Class: recommended dose: mechanism of action is not alfa-2a, or dyspnoea, pharyngitis, Severe hepatic contraception during
Antiviral 800 mg/day. W/ clear. It may act at several peginterferon skin rashes, pruritus and impairment or treatment and for at least 6
interferon alfa-2b, sites including cellular alfa-2b to treat headache, abdominal decompensated liver mth after treatment
Pharmacologic recommended dose: 1 enzymes to interfere with chronic hepatitis cramps, fatigue, cirrhosis. Men whose cessation in women and
Class: Viral RNA g/day (for patients ≤75 viral nucleic acid synthesis. C infection. The metallic taste, increased female partners are female partners of male
Polymerase kg) or 1.2 g/day (for The mono- and triphosphate combination of thirst, GI complaints, pregnant. Children and patients. Increased risk of
Inhibitor patients >75 kg). To be derivatives are known to be ribavirin and mood changes, adolescents with a fatal and nonfatal MI in
given in 2 divided responsible for the antiviral peginterferon insomnia. High dose history of, or existing patients with anaemia.
doses for 48 wk action of the compound. alfa-2b is used may cause reduction in psychiatric disorders.
Chemical Class: (treatment-naive Absorption: Rapidly to treat adults haemoglobin,
Guanosine patients) or 24 wk absorbed from the GI tract; and children 3 haematocrit and RBC
Nucleoside Analog (patients who have peak plasma concentrations years of age and count. Aerosol:
failed interferon alfa-2b after 1-2 hr (oral). Oral older who show Deterioration in
monotherapy). Copegus bioavailability: about 45- symptoms of pulmonary function,
(Roche): W/ 65%. Absorbed from the liver damage. bacterial pneumonia and
peginterferon alfa-2a. resp tract (inhalation). Ribavirin is an pneumothorax, BP fall,
Dosage depends on Distribution: Crosses the antiviral agent cardiac arrest, anaemia,
viral genotype. For blood-brain barrier; present that treats reticulocytosis,
genotype 1 or 4: 1 in sperm and RBC (high hepatitis C conjunctivitis, skin rash.
g/day (patients <75 kg) concentrations). virus. Eye irritation due to
or 1.2 g/day (patients Metabolism: Extensively deposited drug
≥75 kg); for genotype 2 hepatic via (infrequent).
or 3: 800 mg/day. For phosphorylation; converted
coinfection w/ HIV: to the mono-, di- and
800 mg/day (regardless triphosphate derivatives.
of viral genotype). To Excretion: Mainly in the
be given in 2 divided urine (as unchanged drug
doses for 48 wk and metabolites).
(genotype 1 or 4 or HIV Elimination half-life: 2 hr
coinfection) or 24 wk (β phase), 20-50 hr
(genotype 2 or 3). (terminal phase).
Drug Name Dosage & Route and Action Side Effects Contraindication Nursing Responsibility
indication

CEFAZOLIN Adult: IV/IM Cefazolin binds to one or more Superinfection; nausea, Hypersensitivity. Impaired renal function;
Susceptible infections of the penicillin-binding vomiting, abdominal pain, pregnancy, lactation. Consider
Classification: 0.5-1 g 6-12 hrly. Max: proteins (PBPs) which inhibits anorexia, diarrhoea; rash, possibility of
Cephalosporins 6 g/day, up to 12 g/day the final transpeptidation step leukopenia, pseudomembranous colitis in
in severe infections. of peptidoglycan synthesis in thrombocytopaenia, patients who present with
Surgical prophylaxis bacterial cell wall, thus haemorrhage, elevated diarrhoea after antimicrobial
1 g 30-60 mins pre-op, inhibiting biosynthesis and transaminases. usage. Risk of seizures in
followed by 0.5-1 g arresting cell wall assembly Potentially Fatal: patients on high doses,
during surgery for resulting in bacterial cell death. Anaphylactic reaction; especially in renally impaired
lengthy procedures. Absorption: Poorly absorbed pseudomembranous colitis. patients. May decrease
Continue w/ 0.5-1 g 6- from the GI tract (oral). prothrombin activity; monitor
8 hrly post-op for 24 Distribution: Bile (high prothrombin time in patients at
hr. concentrations); bone; ascitic, risk e.g. those on anticoagulant
pleural and synovial fluids; treatment, prolonged
CSF (small amounts). Crosses antimicrobial treatment or
the placenta into the foetal those with renal or hepatic
circulation; enters the breast impairment.
milk (low concentrations).
Protein-binding: 85%
Excretion: Via the urine by
glomerular filtration, with
some renal tubular secretion (as
unchanged); 80% of a dose
within 24 hr (IM). Removed to
some extent by haemodialysis.
Drug Name Dosage & Route Action Side Effects Contraindication Nursing Responsibility
and Indication

URSODEOXYCHOLIC ACID Adult: PO Ursodeoxycholic acid Diarrhoea, pruritus, Calcified and pigment Cholestyramine, charcoal
Dissolution of suppresses hepatic synthesis nausea, vomiting, gallstones, radio opaque and antacids may reduce
cholesterol-rich and secretion of cholesterol gallstone calcification. gallstones. effectiveness. Aluminum-
Classification: Cholagogues, gallstones 6-12 and also inhibits intestinal Nonfunctioning gall based antacids may reduce
Cholelitholytics & Hepatic mg/kg/day as a single absorption of cholesterol. bladders; chronic liver absorption. Oestrogens and
Protectors dose at bedtime after Absorption: Rapidly and and peptic ulcer disease. clofibrate may counteract
radiological completely absorbed from Inflammatory disease of effectiveness of
disappearance of the GI tract. colon and small ursodeoxycholic acid by
stones. Max: 15 Distribution: Protein intestine. Pregnancy. increasing cholesterol
mg/kg. Primary binding: 96-98%. Undergoes elimination in bile. Possible
biliary cirrhosis 10- enterohepatic recycling. increase in ciclosporin
15 mg/kg/day in 2-4 Metabolism: Partly serum concentration.
divided doses. conjugated in the liver before Decreased effectiveness of
Prevention of being excreted into the bile. dapsone. Possible decrease
gallstones in patients Free and conjugated forms in serum ciprofloxacin and
undergoing rapid wt undergo 7a-dehydroxylation nitrendipine.
loss 300 mg twice to lithocholic acid under the
daily. influence of gut bactera.
Some are reabsorbed and
then further conjugated and
sulfated by the liver.
Excretion: Faeces.
Drug Name Dosage & Route Action Indication Side Effects Contraindication Nursing Responsibility

ACETAMINOPHEN Acetaminophen belongs to Acetaminophen Acute overdosage Hypersensitivity. If overdose is suspected,


The oral dose for a class of drugs called is used for the produce a dose- contact your local poison
adults is 325 to 650 mg analgesics (pain relievers) relief of fever as dependent potentially control center or
Classification: every 4 to 6 hours. The and antipyretics (fever well as aches fatal hepatocellular emergency room
Analgesics maximum daily dose is reducers). The exact and pains damage. immediately. US residents
(Non-Opioid) & 4 grams. The oral dose mechanism of action of associated with can call the US National
Antipyretics for a child is based on acetaminophen is not many conditions. Poison Hotline at 1-800-
the child's age, and the known. Acetaminophen Acetaminophen 222-1222. Canada
range is 40-650 mg relieves pain by elevating relieves pain in residents can call a
every 4 hours. the pain threshold, that is, mild arthritis but provincial poison control
by requiring a greater has no effect on center. Symptoms of
When administered as amount of pain to develop the underlying overdose may include:
a suppository, the adult before a person feels it. It inflammation, nausea, vomiting,
dose is 650 mg every 4 reduces fever through its redness, and increased sweating,
to 6 hours. For action on the heat- swelling of the yellowing eyes/skin, dark
children, the dose is regulating center of the joint. If the pain urine, severe
80-325 mg every 4 to 6 brain. Specifically, it tells is not due to stomach/abdominal pain,
hours depending on the center to lower the inflammation, extreme tiredness.
age. body's temperature when acetaminophen
the temperature is is as effective as
elevated. The FDA aspirin. It is as
approved acetaminophen effective as the
in 1951. non-steroidal
antiinflammatory
drug ibuprofen
(Motrin) in
relieving the
pain of
osteoarthritis of
the knee. Unless
directed by
physician,
acetaminophen
should not be
used for longer
than 10 days.
Drug Name Dosage & Route Action Side Effects Contraindication Nursing Responsibility
And Indication

CIMETIDINE Adult: PO Benign Cimetidine competitively Diarrhoea, Hypersensitivity,


gastric and duodenal inhibits histamine at H2- dizziness, lactation.
Classification: ulceration Initial: 800
mg/day at bedtime.
receptors of the gastric tiredness, rash,
Antacids,
Antireflux Agents Duodenal ulcers: ≥4 parietal cells resulting in headache, CNS
& Antiulcerants wk. Gastric ulcer: ≥6 decreased gastric acid disturbances,
wk. Maintenance: 400 secretion, gastric volume arthralgia, myalgia,
mg 1-2 times/day. and hydrogen ion gynaecomastia,
Stress ulceration of
upper GI tract 200-400
concentration. It is a alopoecia, blood
mg 4-6 hrly. potent inhibitor of dyscrasias,
Prevention of acid metabolism in the hepatic nephritis, hepatitis,
aspiration during mixed-function oxidase pancreatitis,
general anesth 400 mg systems. It is also used in granulocytopenia,
90-120 mins before
induction of anesth and
patients with pancreatic hypersensitivity
up to 400 mg 4 hrly if insufficiency to reduce reactions.
needed. Gastro- the breakdown of
oesophageal reflux pancreatic enzyme
disease 400 mg 4 supplements.
times/day. Zollinger-
Onset: 1 hr.
Ellison syndrome 300-
400 mg 4 times/day. Duration: 4-6 hr.
Non-ulcer dyspepsia Absorption: Readily
Up to 200 mg 4 absorbed from the GI
times/day. Prophylaxis tract; peak plasma
of nocturnal heartburn
concentrations after 1-3
100 mg at night.
Pancreatic hr. Food delays the rate
insufficiency 0.8-1.6 and slightly decreases
g/day in 4 divided extent of absorption.
doses. IV Stress Distribution: Widely
ulceration of upper GI distributed in the body;
tract 200 mg 4-6 hrly
crosses the placental
barrier and appears in
breast milk. Protein-
binding: 20%.
Metabolism: Partially
hepatic; converted to the
sulfoxide and to
hydroxymethylcimetidine.
Excretion: Urine (as
unchanged); 2 hr
(elimination half-life).