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peristalsis. Infants and children, growing adolescents. Pregnancy and lactation PRECAUTION/ ADVERSE REACTION PRECAUTION Severe and persistent diarrhea during and after treatment ADVERSE RXN Common:Nausea, diarrhea, vomiting, rash Uncommon: Anorexia, headache,dizzine ss, fever, GI and abdominal pain, flatulence, confusion, vertigo NURSING CONSIDERATIO N >Assess pt for previous sensitivity reaction >Assess pt for any s/s of infection before & during treatment >Assess for adverse reactions >assess pt. & familys knowledge of drug therapy
INDICATION Infections of the resp. tract, middle ear,paranas al sinuses, eyes, kidneys, urinary tract
ACTION Inhibits bacterial DNA gyrase thus preventing replication in susceptible bacteria
KARLEEN L. JARO
LACTULOSE BRAND NAME duphalac DOSAGE Infants: 5 ml Children: 1-6 y/o- 510ml 7-14y/o15ml 15-45y/o- 1530ml. Dose given in 3 days
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 drugs effectiveness >Monitor pt for any adverse GI reactions, nausea,vomiting,diar rhea, >Assess for adverse reactions >for pt. with hepatic encelopathy: regularly assess mental condition >monitor I & O >monitor for Inc. glucose level in diabetic pts
KARLEEN L. JARO
Classification: ANTI-ALLERGICS_Anti-histamine GENERIC NAME levocetirizin e BRAND NAME Xyzal DOSAGE Adult and adolescents more than 12 yrs- 1 tab/day Pedia: 6-12 yrs- 1 tab/ CONTRAINDICATIO N Pts with severe renal impairment, pts with rare problems of galactose intolerance PRECAUTION/ ADVERSE REACTION PRECAUTION Adjustment of dose is recommended in elderly pts w/ compromised renal function. Lactation. ADVERSE RXN Dry mouth, headache, fatigue, rhinitis, abdominal pain, migraine NURSING CONSIDERATIO N >obtain pt hx inc. drug hx and any unkown allergies >monitor pulse, BP, respiration > observe dizziness and excessive sedation
INDICATION Treatment of symptoms associated with allergic conditions (including ocular symptoms)
KARLEEN L. JARO
day
Classification: ANTI-INFECTIVES-Penicillins
GENERIC NAME INDICATION ACTION CONTRAINDICATION PRECAUTION/ ADVERSE REACTION NURSING CONSIDERATION
KARLEEN L. JARO
Amoxicillin BRAND NAME Amoxil DOSAGE Adult: 250500mg every 8 hours Children: 2040mg/kg/d ay divided dosage given every 8 hrs
Infections of the resp. tract, skin & skin structures,paran asal sinuses, genitourinary tract, otitis media, sinusitis, meningitis,septic emia
Hypersensitivity to penicillins, cephalosporins. Not used to treat pneumonia, bacteremia pericarditis during acute stage.
PRECAUTION: Hypersensitivit y: 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 pts hx of allergy >Assess pt for any s/s of infection >Assess for pts sensitivity to penicillin ot other cepalosporins >assess for allergic rxn during therapy >Assess for bowel pattern, if diarrheashld be discontinue
KARLEEN L. JARO
felodipine BRAND NAME Plendil DOSAGE Adult: 250500mg every 8 hours Children: 2040mg/kg/da y divided dosage given every 8 hrs
Treatment of hypertensio n
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
KARLEEN L. JARO
TELMISART AN BRAND NAME Pritor DOSAGE Adult: 2080mg daily, usual starting dose 40mg daily
Treatment of hypertension
Blocks the vasoconstricti ve ans aldosteroneone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the ATI receptor in many tissues
PRECAUTION: Can cause death to the fetus if used on the 2nd trimester, safety in children not yet established ADVERSE RXN Diarrhea and angioedema. Sinusitis, pharyngitis, upper resp. tract infection, back pain
>assess pts 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
GENERIC NAME INDICATION ACTION CONTRAINDICATION PRECAUTION/ ADVERSE REACTION NURSING CONSIDERATION
KARLEEN L. JARO
Loperamid e HCl BRAND NAME IMODIUM DOSAGE Adult: initially 2 cap; subsequent dose a cap after every stool
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 RXN Hypersensitivit y reactions, flatulence, abdominal pain, distention or discomfort, nausea and vomiting
>assess pts 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
KARLEEN L. JARO
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATION
NURSING CONSIDERATION
DIAZEPAM BRAND NAME Valium DOSAGE Adult: 250500mg every 8 hours Children: 2040mg/kg/da y divided dosage given every 8 hrs
Facilitates/ potentiates the inhibitory activity of GABA at the limbic system and reticular formation to reduce anxiety, promote calmness and sleep
PRECAUTION: Hypersensitivi ty: cardiorespirat ory insufficiency, pregnancy, lactation ADVERSE RXN Dizziness, 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
KARLEEN L. JARO
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATION
NURSING CONSIDERATION
Calcium carbonate BRAND NAME Calci-Aid DOSAGE Adult: 1-2 capsules daily Pedia: 1-2 tablets daily
PRECAUTION: History of stone formation, pregnancy ADVERSE RXN Constipation, flatulence, diarrhea, renal dysfunction, acid rebound
> administer as antacid 1 hr fter meal and at bed time >administer as supplement 1 hrs after meal and at bed time >advice pt to increase fluids to 2L unless contraindicate d
Classification: ANTI-ASTHMA
KARLEEN L. JARO
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATI ON
NURSING CONSIDERATION
Salbutamol BRAND NAME Ventolin vilmax DOSAGE Adult: 8mg tablet BID Pedia: 3-12 yrs 4mg tab BID
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 RXN Fine 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
KARLEEN L. JARO
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATI ON
NURSING CONSIDERATION
orlistat BRAND NAME Xenical DOSAGE Adult: 1 cap with each main meal
Long-term treatmentof obese and overweight patients with risk factors and comorbiditi, associated with obesity including hypercholesterolemia, NIDD, impaired glusoce tolerance, hypertension and reduction of visceral fat
PRECAUTION: Children <18 yrs, pregnancy, lactation, shld be given with caution to diabetic pt. ADVERSE RXN Oily 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
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATIO N
NURSING CONSIDERATIO N
Mefenamic acid BRAND NAME Dolfenal DOSAGE Adult: start with 75150mcg BID Severe HPN 300mg BID
Relief of pain including muscular, rheumatic, traumatic, dental, postop and postpartum pain, headache, migraine, fever, dysmenorrhe a
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 disease ADVERSE RXN GI 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
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATI ON
NURSING CONSIDERATION
chloroquine BRAND NAME chlorofoz DOSAGE Adult: initially four 250mg tablet followed by 2 tab after 6-8 hrs, then2 tab daily for 2 days
Inhibits the perioxidativ e activity of heme, and disrupt its nonenzyma tic polymerizat ion to hemozin
PRECAUTION: Hepatic disease, alcoholism, monitor complete blood count ADVERSE RXN Headache, 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
KARLEEN L. JARO
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATION
NURSING CONSIDERATION
bisacodyl BRAND NAME Dulcolax DOSAGE Adult: 2 tab at bedtime or 30 mins before breakfast, max 4 tabs Pedia: greater than 4 yrs- 1 tab Suppository: Pedia 5mg Adult- 10mg
Constipatio n, relief of evacuation in hemorrhoid s, 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 RXN Occasional 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
KARLEEN L. JARO
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATI ON
NURSING CONSIDERATION
Carbocisteine BRAND NAME Loviscol DOSAGE Capsule: Adult: 250mg 2 caps, 500mg 1 cap TID Suspension: Adult 15ml; Pedia: 612yrs: 5ml, 2-5 yrs: 1.252.5 ml Syr: 6-12yrs: 10ml 2-5 yrs: 2.5ml Drops: 12-24mos: 1.25ml, 911mos: 1ml, 6-8mos: 0.75ml, 3-5mos: .50ml, <3mos: 0.25ml All doses 3-4x/ day
Acute/chro nic disorders of the upper & lower respiratory tract associated with the secretion & formation of excessive and viscid mucus
PRECAUTION: Hx of peptic ulcer, hypothyroidis m ADVERSE RXN Nausea, 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
KARLEEN L. JARO
metoclopramide BRAND NAME Plasil DOSAGE Adult 10mg 3x/day pedia: 15-20yrs 5-10mg 3x/day 5-14yrs: 2.5-5mg 3x/day 3-4yrs: 3mg 23x/day 1-2yrs: 1mg 23x/day Under 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
PRECAUTIO N: Activities requiring mental alertness, elderly, lactation ADVERSE RXN Restlessnes s, 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
KARLEEN L. JARO
GENERIC NAME
INDICATION
ACTION
CONTRAINDICATIO N
NURSING CONSIDERATION
Exerts mainly beta-1 adrenergic blocking activity but also blocks beta-2 receptors at high doses
PRECAUTION: Slowing of heart rate, occasionally severe bradycardia may lead to vertigo ADVERSE RXN Occasionally 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
KARLEEN L. JARO
GENERIC NAME
INDICATIO N
ACTION
CONTRAINDICATIO N
NURSING CONSIDERATION
Depressant and anticonvulsant effects may be related to its ability to increase the inhibitory activity of GABA on nerve impulses
PRECAUTION: Impaired renal, hepatic cardiac or resp. functions ADVERSE RXN Dizziness, 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
KARLEEN L. JARO
GENERIC NAME
INDICATIO N
ACTION
CONTRAINDICATIO N
NURSING CONSIDERATION
Nystatin BRAND NAME Mycostatin DOSAGE 4-6ml susp 4x/day or 12 tabs 3x/day Infants: 2ml pedia susp 4x/day
Antifungal antibiotic used for prophylax is and treatment of candidiasi s of the skin and mucous membran es
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 RXN Diarrhea, 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
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 Q1015 min (Peds 0.05mg/kg) Pediatric: 0.02mg/kg (minimum 0.1mg
INDICATION
ACTION
Helps to reduce saliva and fluid in the respiratory tract. May also be used to treat a slow heartbeat or insecticide or mushroom poisoning
CONTRAINDICATION
Contraindicated in patients with glaucoma, pyloric stenosis or prostatic hypertrophy, except in doses ordinarily used for preanesthetic medication.
SIDE EFFECTS
Can cause blurred vision, dilated pupils, dry mouth, palpitations urinary retention, tachycardia drowsiness, and confusion
NURSING CONSIDERATION
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
- Antidote to overdosage with cholinergic substances (nerve gases, poisonous mushroom) - Pre-op medication to reduce salivary and resp. tract secretions.
Classification: Andrenergics
KARLEEN L. JARO
INDICATION
Increased cardiac output in short-term treat ment of cardiac decompensati on caused by depressed contractility, such as during refractory heart failure; adjunctive therapy in cardiac surgery
ACTION
Stimulates hearts 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
CONTRAINDICATI ON
Contra indicated in patients hypersensitive to drug and in those with idiopathic hypertrophic subaortic stenosis Use cautiously in patients with history of hypertension because drug may increase pressor response Use cautiously in patients with history of sulfite sensitivity .
SIDE EFFECTS
NURSING CONSIDERATION
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
BRAND NAME
Dobutrex
Increased heart rate, hypertension, Angina, phlebitis, nonspecific chest pain, palpitations, hypotension, nausea, vomiting, shortness of breath, hypersensitivit y reactions
KARLEEN L. JARO
site
Classification: Antihistamine/ anti allergic GENERIC NAME INDICATION ACTION CONTRAINDICATI ON SIDE EFFECTS NURSING CONSIDERATION
KARLEEN L. JARO
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
Antihistami ne that reduces allergic reactions, motion sickness and vertigo (dizziness and loss of balance), and Parkinson's disease
CV & CNS effects Blood disorders GI disturbances Antimusc arinic effects Allergic 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
KARLEEN L. JARO
Displaces Known previously suspected administer narcotic ed induced narcotic respiratory analgesics depression from their including that receptors. cause by Has no pentazocine pharmacol and ogic propaxyphene activity of its own
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 indicated for the control of abdominal pain (colic) associated with spasmodic colic, flatulent colic
CONTRAINDICATION Myasthenia gravis, megacolon. Parenteral Untreated narrowangle glaucoma, prostate hypertrophy w/ urinary retention, mechanical stenosis of GIT, tachycardia
NURSING CONSIDERATION Drug compatibility should be monitored closely in patients requiring adjunctive therapy Avoid driving & operating machinery after parenteral administration Avoid strict heat
Hyoscine-Nbutylbromide
BRAND NAME
Buscopan
DOSAGE Adult & childn >6 yr 1-2 tab 3-5 times daily. Amp Acute attacks of colicky pain Adolescent >12 yr 12 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
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
KARLEEN L. JARO
wt/day.
Classification: CNS stimulant CONTRAINDICATI ON SIDE EFFECTS/ ADVERSE REACTION NURSING CONSIDERATION
GENERIC NAME
INDICATION
ACTION
KARLEEN L. JARO
Citicoline
BRAND NAME Somazine amp DOSAGE 125 mg/mL 12 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 tyrosinehydroxylase.
Parasympathetic hypertonia
Gastrointestinal disorders
KARLEEN L. JARO
INDICATION
acute pulmonary edema edema hypertension
ACTION
inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle
CONTRAINDICATI ON
Anuria hepatic coma & precoma severe hypokalemia &/or hyponatremia hypovolemia w/ or w/o hypotension Hypersensitivity to furosemide or sulfonamides
SIDE EFFECTS
vertigo, dizziness, headache, paresthesia, orthostatic hypotension, thrombophlebitis, abdominal pain, hypokalemia, anemia muscle spasm
NURSING CONSIDERATION
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
KARLEEN L. JARO
INDICATION
Duodenal and gastric ulcers Maintenance therapy for gastric and duodenal ulcer GERD Erosive esophagitis Heartburn
ACTION
Completely inhibits action of histamine on the H2 at receptor sites of parietal cells, decreasing gastric acid secretions
CONTRAINDICATI ON
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
SIDE EFFECTS
Vertigo, malaise, headache, blurred vision, jaundice, burning and itching at injection site
NURSING CONSIDERATION
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 isnt affected by food
KARLEEN L. JARO
INDICATION
Fluid replacement and caloric supplementati on in patient who cant maintain adequate oral intake or who is restricted from doing so.
ACTION
Minimize glyconeogenesi s and promotes anabolism in patients who cant receive sufficient oral caloric intake.
CONTRAINDICATI ON
Hyperglycemia, diabetic coma, intracranial or intra spinal hemorrhage or delirium tremens.
SIDE EFFECTS
Mental confusion, unconsciousne ss in hyperosmolar nonketotic syndrome. Pulmonary edema Glycosuria, osmotic diuresis Metabolic: hyperglycemia , hypervolemia Rapid termination after long term infusion may cause hypoglycemia rebound
NURSING CONSIDERATION
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.
KARLEEN L. JARO
KARLEEN L. JARO
Calcium gluconate
BRAND NAME
Kalcinate
DOSAGE Tablets 500 mg, 650 mg, 975 mg, 1 g (contains 90 mg elemental calcium/g)
Use cautiously in patients with sarcoidosis and renal or cardiac disease and in digitalized patients. monitor blood calcium level frequently.
KARLEEN L. JARO
Mild pain/fever
Arthritis Reduce risk of heart attack in patient with previous MI or unstable angina
BRAND NAME
Aspilet
Produces analgesia by an ill defined effect on the hypothalamus and by blocking generation of pain impulses (peripheral action)
GI ulcer GI bleeding Patients with bleeding disorders Aspirin hypersensitivity Vit.K deficiency
DOSAGE
Fever/mild pain: 325-650 mg P.O q4 hours; p.r..n unstable angina: 325 P.O once/daily
Also impedes clotting by blocking prostaglandin synthesis which prevents formation of plateletaggregating substances.
Prolonged bleeding time Tinnitus Hearing loss Nausea,vomiting GI distress Occult bleeding Abnormal liver function Rash 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
GENERIC NAME INDICATION ACTION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION
KARLEEN L. JARO
drowsiness dizziness fatigue sedation nervousness headache orthostatic hypotension bradycardia urine retetion impotence transient glucose intolerance (after large dose) constipation pruritis 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
GENERIC NAME INDICATION ACTION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION
KARLEEN L. JARO
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, lightheadedness, headache, weakness, peripheral edema, flushing, nausea, Syncope, nervousness, hypotension, palpitations, nasal congestion, diarrhea, constipation, abdominal discomfort, muscle cramps, dyspnea, pulmonary edema, cough, rash, puritus
Dont 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
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
KARLEEN L. JARO
DOSAGE
Initially 20 mg P.O Tid hypertension 20 to 40 mg P.O t.i.d increase dosage depends on the patients response
Inhibits calcium ion influx across cardiac and smooth muscle cells, thus decreasing myocardial contractility and oxygen demand and coronary arteries and arterioles.
Dizziness Headache Paresthesis Drowsiness Peripheral edema Palpitations Tachycardia Nausea Dry mouth Abdominal discomfort Rash Flushing
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
GENERIC NAME INDICATION ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION
KARLEEN L. JARO
Diffuses across cell membrane and complexes with specific cytoplasmic receptors
Patient had an allergic reaction previously. Have an active peptic ulcer Have an active herpes simplex fungal or mycobacterial infection ot the eye, ear infection
Increased appetite Weight gain Water retention Increased WBC Hypokalemia Skin rash Dizziness Insomia Headache
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