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241603963 drug-study-final


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241603963 drug-study-final

  1. 1. Get Homework/Assignment Done Homework Help Research Paper help Online Tutoring click here for freelancing tutoring sites DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES
  2. 2. Generic Name Potassium Chloride Brand Name Kalium Durule Classification Electrolyte Sub Classification Dosage 1 tab Route oral Frequency Every 8 hours Form Tablet Color White Principal intracellular cation of most body tissues participates in a number of physiologic processes – maintaining intracellular tonicity; transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscle; maintenance of normal renal functi on; also plays a role in carbohydrate metabolism and various enzymatic reactions.  Prevention and correction of potassium deficiency; when associated with alkalosis, use potassium chloride; when associated acidosis, use potassium acetate bicarb onate, citrate, or gluconate.  Contraindicated with allergy to tartrazine, aspirin (t artrazine is found in some preparations marketed as Kaon- Cl, Klor-Con); therapy with potassium-sparing diuretics or aldosterone- inhibiting agents; severerenal impair ment with oliguria, anuria, azotemia; untreated Addison’s disease; hyperkalemia; adynamiaepisodica hereditaria; acute dehydration; heat cramps; GI disorders that delay passage in the GI tract.  Use cautiously with cardiac disorders, especially if treated with cardiac glycosides, pregnancy and lactation. Adverse Effects:  Dermatologic: Rash  GI: Nausea, vomiting, diarrhea, abdomina l discomfort, GI obstruction, GI bleeding, GI ulceration or perforation.  Hematologic: Hyperkalemia- increased serum potassium, ECG changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of OTC interval).  Local: Tissue sloughing, local necrosis, local phlebitis, and venospasm with injection. Side Effects:  Confusion, anxiety, feeling like you might pass out  Uneven heartbeat  Extreme thirst,  Consider the 10 Golden Rights of administering medication  Arrange for serial serum potassium levels before and during therapy  Administer oral drugs after meals or with food and a full glass of water to decrease GI upset.  Caution patient not to chew or crush tablet; have patient swallow tablet whole.  Caution patient that expanded wax matrix capsules will be found in stool.  Caution patient not to use salt substitutes.  Ask the patient to have periodic blood tests and medical evaluation.  Tell the patient to report tingling of hands or feet, unusual tiredness or weakness, feeling of
  3. 3. increased urination  Leg discomfort  Muscle weakness or limp feeling  Numbness or tingly feeling in your hands or feet, or around your mouth  Severe stomach pain, ongoing diarrhea or vomiting  Black, bloody, or tarry stools; or  Coughing up blood or vomit that looks like coffee grounds heaviness in the legs, severe nausea, vomiting, abdominal pain, black or tarry stool. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES
  4. 4. Generic Name Metronidazole Brand Name Flagyl Classification Amebicide, Antibacterial, Antibiotic, Antiprotozoal Sub Classification Dosage 500mg/tablet Route Oral Frequency Thrice a day (TID) Form Tablet Color White  Bactericidal: inhibits DNA synthesis in specific (obligate) anaerobes, causing cell death; antiprotozoal- trichomonacidal , amebicidal: Biochemical mechanism of action is not known.  Acute infection with susceptible anaerobic bacteria  Acute intestinal amebiasis  Amebic liver abscess  Trichomoniasis (acute and partners of patients undergoing colorectal surgery  Unlabeled uses: Prophylaxis for patients undergoing gynecologic, abdominal surgery, hepatic encephalopathy, Crohn’s disease; antibiotic- associated pseudo membranous colitis, treatment of Gardnerella vaginalis, giardiasis (use recommended by the CDC); infected decubitus ulcers; perioral dermatitis  Contraindicated with hypersensitivity to metronidazole; pregnancy ( do not use for trichomoniasis in first trimester)  Use continuously with CNS diseases, hepatic diseases, candidiasis (moniliasis), blood dyscrasias, lactation. Adverse Effect:  CNS: Headache, dizziness, ataxia, vertigo, incoordiantio n, insomnia, seizures, peripheral neurophaty, fatigue  GI: Unpleasant metallic taste, anorexia, nausea, vomiting, diarrhea, GI upset, cramps  GU: Dysuria, incontinence, darkening of the urine  Local: Thrombophle bitis (IV); redness, burning, dryness, and skin irritation (topical)  Others: Severe, disulfiram- like interaction  Consider the 10 Golden Rights of administering medication  Tell the patient to take full course drug therapy; take the drug with food if GI upset occur.  Tell the patient not to take alcohol (beverages or preparations containing alcohol, cough syrups) for 24-72 hr of drug use; severe reactions may occur.  Caution the patient that their urine may be darker in color than usual; this is expected  Tell the patient that they may
  5. 5. with alcohol, candidiasis (superinfectio n) Side Effects:  Numbness or tingling in your hands or feet;  White patches or sores inside your mouth or on your lips;  Pain or burning when you urinate;  Diarrhea that is watery or bloody;  Vision problems, pain behind your eyes;  Trouble concentrating, slurred speech, mood or behavior changes, tremors, muscle twitching, seizure (convulsions);  Fever, chills, experience this side effects like: Dry mouth with strange metallic taste (frequent mouth care, sucking sugarless candies may help); nausea, vomiting, diarrhea (eat frequent small meals)  Tell the patient to report severe GI upset, dizziness, unusual fatigue or weakness, fever, chills.
  6. 6. muscle pain, confusion, headache, sore throat, neck stiffness, increased sensitivity to light, drowsiness, nausea and vomiting; or  Severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES
  7. 7. Generic Name Metoclopramide Brand Name Reglan Classification Antiemetic, Dopaminergic blocker, GI stimulant Sub Classification Dosage 1 ampule Route Parenteral Frequency TID/ q6 Form Liquid ampule Color Clear  Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions, appears to sensitize tissues to action of acetylcholin e, relaxes pyloric sphincter which when combined with effects on motility, accelerates gastric emptying and intestinal transit; little effect on gallbladder or colon motility; increases lower esophageal sphincter pressure; has sedative properties,  Relief symptoms of acute and recurrent diabetic gastroparesis.  Short term therapy (4- 12weeks) for adults with symptomatic gastro esophageal reflux who fail to respond to conventional therapy  Prophylaxis of postoperative nausea and vomiting when nasogastric suction is undesirable  Contraindicated with allergy to metaclopramide, GI hemorrhage, mechanical obstruction or perforation; pheochromocytoma (may cause hypertensive crisis); epilepsy.  Use continuously with previously detected breast cancer (one third of such tumors are prolactin dependent); lactation, pregnancy; fluid overload; renal impairment. Adverse Effects:  CNS: Restlessness, drowsiness, fatigue, lasitudes, insomnia, extrapyramidalreact ion, parkinsonism- like reactions, akathisia, dystonia, myoclonus, dizziness, anxiety  CV: Transient hypertension  GI: Nausea, diarrhea Side Effects:  tremors, or restless muscle movements in your eyes, tongue, jaw, neck, arms, or legs  mask-like appearance of the face  very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out  depressed mood, thoughts of suicide or hurting yourself  hallucinations,  Consider the 10 Golden Rights of administering medication  Asses if the patient has historyof allergies tometocloprami de.  ·Monitor BP carefully during IVadministratio n.  Monitor extrapyramidal reactions and consultphysician if they occur.  Monitor patients with diabetes, arrange for alteration in insulin dose or timing ifdiabetic control is comprisedby alterations in timing of food absorption.  Keep diphenhydramin e injection readily available in case extrapyramidal reaction occur (50mg IM)
  8. 8. induces release of prolactin. anxiety, agitation, jittery feeling, trouble staying still  swelling, fluid retention  jaundice (yellowing of your skin or eyes)  seizure (convulsions) Less serious side effects may include:  feeling restless, drowsy, tired, or dizzy  headache, sleep problems (insomnia)  nausea, vomiting, diarrhea  breast tenderness or swelling  changes in your menstrual periods  urinating more than usual  Have phentolamine readily available in case of hypertensive crisis (most likely to occur with undiagnosed pheochromocyto ma)  Do not use alcohol, sleep remedies, or sedatives; serious sedation could occur.  Tell the patient that they may experience these side effects: drowsiness, dizziness (do not drive or perform other task that requires alertness); restlessness, anxiety, depression, headache, insomnia (reversible); nausea, diarrhea.  Tell the patient to report involuntary
  9. 9. movement of the face, eyes, or limbs, severe depression, and severe diarrhea.
  10. 10. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Furosemide Brand Name Lasix Classification Loop Diuretics Sub Classification Dosage 10mg Route Parenteral Frequency STAT Form Liquid ampule Color Clear Inhibits reabsorption of sodium chloride from the proximal and distal tubules and ascending limb of the loop of Henle, leading to a sodium-rich diuresis.  Oral, IV: Edema associatedwit h heart failure, cirrhosis,rena l disease.  IV: acute Pulmonary Edema  Oral: hypertension  Contraindicated with allergy to furosemide, sulfonamides, allergy to tartrazine (in oral solution); anuria, severe renal failure; hepatic coma; pregnancy; lactation.  Use cautiously with SLE, gout, diabetes mellitus. Adverse Effects:  CNS: dizziness, vertigo, paresthesias, xanthopsia, weakness, headache, drowsiness, fatigue, blurred vision, tinnitus, irreversible hearing loss  CV: orthostatic hypotension, volume depletion, cardiac arrhythmias, thrombophlebitis  Dermatologic: photosensitivity, rash, pruritus, urticaria, purpura, exfoliative, dermatitis, erythema multiforme  GI: nausea, anorexia, vomiting, oral and gastric irritation, constipation, diarrhea, acute pacreatitis, jaundice  GU: polyuria, nocturia, glycosuria, urinary bladder spasm.  Hematologic: leukopenia, anemia, thrombocytopenia, fluid and electrolytes imbalance, hyperglycemia, hyperuricemia  Consider the 10 Golden Rights of administering medication  Profound dieresis with water and electrolyte depletion can occur, careful medical supervision is required.  Administer with food or milk to prevent GI upset.  Reduce dosage if given with other anti hypertensive; readjust dosage gradually as BP responds.  Give early in the day so that increase urination will not disturb sleep.  Do not mix parenteral solution with highly acidic
  11. 11.  Others: Muscle cramps and muscle spasm Side Effects: Common side effects of furosemide:  low blood pressure  dehydration  electrolyte depletion (for example, sodium, potassium) Less common side effects include :  jaundice,  ringing in the ears (tinnitus)  sensitivity to light (photophobia)  rash  pancreatitis  nausea  diarrhea  abdominal pain  dizziness  Increased blood sugar  increase uric acid level salutions with pH below 3.5  Do not expose to light, which may discolor tablets or solution; do not use discolored drug or solution.  Discard diluted solutions after 24 hr.  Measure and record weight to monitor fluid change  Arrange to monitor serum electrolytes, hydration, liver and renal function.  Arrange with potassium rich diet or supplemental potassium as needed.  Tell the patient that they may experience this side effects: increased volume and frequency of
  12. 12. urination; dizziness, feeling faint on arising, drowsiness (avoid rapid position changes; hazardous activities, like driving and consumption of alcohol); sensitivity to sun light( use sun glasses, wear protective clothing, or use sunscreen; increased thirst (suck on sugarless lozenges; use frequent mouth care); loss of body potassium(a potassium rich diet or potassium supplement will be needed).  Tell the patient to report loss or gain of more than
  13. 13. 1.5kg in 1 day, swelling in the ankle or fingers, unusual bleeding or bruising, dizziness, trembling, numbness, fatigue, muscle weakness or cramps.
  14. 14. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Omeprazole Brand Name Zefxon Classification: Antisecretory drug Proton pump inhibitor Sub Classification Dosage 40mg Route Parenteral Frequency twice a day (BID) Form Powder in vial, diluted with sterile water Color Cloudy Gastric acid pump inhibitor suppresses gastric acid secretion by specific inhibition of the hydrogen potassium ATPase enzymes system at the secretory surface of the gastric parietal cells; blocks the finalstep acid production.  Short term treatment of active duodenal ulcer.  Treatment of heartburn or symptoms of GERD  Short term treatment of active benign gastric ulcer  GERD, severe erosive esophagitis, poorly responsive symptomatic GERD  Long term therapy: treatment of pathologic hypersecretory conditions (Zollinger Ellison’s syndrome, multiple adenomas, systemic mastocytosis)  Eradication of H. pylori with amoxicillin or metronidazole  Contraindicated with hypersensitivity to Omeprazole or it’s components  Use cautiously with pregnancy, lactation Adverse Effects:  CNS: headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities  Dermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skin.  GI: diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy  Respiratory: URI symptoms, cough, epistaxis  Others: cancer in preclinical studies, back pain, fever Side Effects:  Dizziness (avoid driving or performing hazardous tasks)  headache (request medications)  Consider the 10 Golden Rights of administering medication  Assess other medications patient may be taking for effectiveness and interactions (especially those dependent on cytochrome P450 metabolism or those dependent on acid environment for absorption).  Monitor therapeutic effectiveness and adverse reactions at beginning of therapy and periodically throughout therapy.  Assess GI system: bowel sounds every 8hours, abdomen for pain and swelling,
  15. 15. and clarithromycin  nausea  vomiting  diarrhea (maintain proper nutrition)  symptoms of URI  cough (do not self- medicate; consult with your health care provider if uncomfortable). appetite loss.  Monitor hepatic enzymes: AST, ALT, increased alkaline phosphatase during treatment.  Tell the patient to report if experiencing this side effects: dizziness, headache, nausea, vomiting, diarrhea.
  16. 16. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECT AND SIDE EFFECT NURSING RESPONSIBILITIES Generic Name Ambroxol HCL Brand Name Ambrolex Classification Mucolytic Sub Classification Dosage 75mg Route Oral Frequency Once a day Form Capsule Color Half white and half green It makes phlegm in the airways thinner and less sticky. It does this by increasing the body's natural production of surfactant. This contributes to a secretomotoric effect: it helps the cilia - tiny hairs that line the respiratory tract - to transport the phlegm out of the lungs. Adjuvant therapy in patients with abnormal, viscid, or in spissated mucous secretions in acute and chronic broncho pulmonary diseases, and in pulmonary complications of cystic fibrosis and surgery, tracheostomy, and atelectasis. There is no absolute contraindication but in patient with gastric ulceration relative caution should be observed. Adverse Effect:  Occasional gastrointestinal side effects may occur but these are almost invariably mild  Rashes  Fatigue  Dry mouth  Rhinorrhea  Constipation  Dysuria  Contact dermatitis  Consider the 10 Golden Rights of administering medication  Monitor S/Sx of aspiration of excess secretions and for bronchospasm.  Have suction apparatus immediately available.  Tell the client to report difficulty with clearing the airway or any other respiratory distress.  Tell the client to report if experiencing this side effects: GI upset, rashes, fatigue, dry mout.
  17. 17. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIO NS ADVERSE EFFECT AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Cefuroxime Sodium Brand Name Zinacef Classification Antibiotic, Cephalosporin Sub Classification Second generation Dosage 750mg Route Parenteral Frequency q8 Form powder in vial, diluted with sterile water Color Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death.  Lower respiratory infections caused by S. pneumonia, S. aureus, E. coli, Klebsiella pneumonia, H. influenza, S. pyogenes  Dermatologic infections caused by S. aureus, S. pyogenes, E. coli, K. pneumonia, Enterobacter  UTIs caused by E. coli, K. pneumonia  Uncomplicated and disseminated gonorrhea caused by N. gonorrhoeae  Septicimia caused by S.  Contraindicate d with allergy to cephalosporins or penicillins  Use continuously with renal failure, lactation, pregnancy Side Effects  Diarrhea, stomach upset  Difficulty of breathing  Anusual tiredness or fatigue  Pain at injection site Adverse Effect:  CNS: headache, dizziness, lethargy, paresthesias  GI: nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomenbranou se colitis, hepatotoxicity  GU: Nephrotoxicity  Hematologic:  Consider the 10 Golden Rights of administering medication  Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated.  Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results. Monitor periodically BUN and creatinine clearance.  Do skin test before
  18. 18. Light yellow pneumonia, S. aureus, E. coli, K pneumonia, H. influenza  Meningitis caused by S. pneumoniae, H. influenza, S. aureus, N. meningitides  Bone and joint infections due to S. aureus  Perioperative prophylaxis  Treatment of acute bacterial maxillary sinusitis in patients 3-mo 12yr Bone marrow depression  Hypersensitivity: ranging from rash to fever to anaphylaxis; serum sickness reaction  Local: pain, abcess at injection site, phlebitis, inflammation of IV site  Others: superinfection, disulfram- like reaction with alcohol administering the drug  Inspect IV injection sites frequently for signs of phlebitis.  Monitor for manifestations of hypersensitivity. Discontinue drug and report their appearance promptly.  Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.  Tell the client to report loose stools or diarrhea promptly.  Tell the client to avoid alcohol while taking this drug and for 3days after because severe reaction often occurs.
  19. 19. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIO NS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Paracetamol Brand Name Biogesic Classification Non- narcotic analgesic, Antipyretic Sub Classification Dosage 300mg Route P.O Frequency PRN Form Ttablet Color Orange  Decreases fever by a hypothalamic effect leading to sweating and vasodilation  Inhibits pyrogen effect on the hypothalamic- heat-regulating centers  Inhibits CNS prostagla ndin synthesis with minimal effects on peripheral pros taglandin synth esis  Does not cause ulceration of the GI tract and causes no anticoagulant action  Control of pain due to headache, earache, dysmenorrhea, arthralgia, myalgia, musculoskeletal pain, arthritis, immuni zations, teething, tonsillectomy  Reduce fever in viral and bacterial infe ctions  As a substitute for aspirin in upper GI disease, bleeding disorders clients in anticoagulant therapy and gouty arthritis  Anemia, cardiac & pulmonary disease. Hepatic or severe renal disease.  Liver toxicity (hepatocyte necrosis) may occur with doses not far beyond labeled dosing. Side Effects:  Minimal GI upset, methemoglo binemia, hemolytic anemia, neutropenia, thrombocyto penia, pancytopenia , leucopenia,ur ticaria, CNS stimulation, hypoglycemi c coma, jaundice, glissitis, drowsiness, liver damage Adverse Effect  Allergic skin reactions & GI disturbances.  Consider the 10 Golden Rights of administering medication  Monitor CBC, liver and renal functions.  Assess for fecal occult blood and nephritis.  Tell the patient to avoid using OTC drugs with Acetaminoph en  Tell the patient to take the drug with food or milk to minimize GI upset.  Tell the client to report N&V. cyanosis, shortness of breath and abdominal pain as these are signs of toxicity.  Tell the client to report paleness, weakness and heart beat skips
  20. 20.  Tell the client to report abdominal pain, jaundice, dark urine, itchiness or clay- colored stools.  Tell the client that Phenmacetin may cause urine to become dark brown or wine- colored.  Tell the client to report pain that persists for more than 3-5 days  Tell the client that this drug is not for regular use with any form of liver disease because it might cause further damage.
  21. 21. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIO NS ADVERSE EFFECT AND SIDE EFFECT NURSING RESPONSIBILITIES Generic Name Aminoleban Brand Name Classification V06DD - Amino acids, incl. combinations with polypeptides ; Used as general nutrients. Sub Classification Dosage 500mg Route Parenteral Frequency q8 Form Liquid Color Clear  Given to normalize the amino acid, carbohydr ates, fats, vitamins and minerals in the plasma  Hepatic encephalopathy due to acute or chronic liver diseases & of - ve nitrogen balance when adequate nutrition PO or gastro duodenal tube is impossible or undesirable.  Patient with abnormal amino acid metabolism (since the infuse amino acids are not adequately metabolized, the patient clinical condition may be worsened.)  Severe renal disorders Adverse Effect:  Cardiovascular: Chest discomfort, & palpitation.  Hypersensitivity: rare skin eruptions  Gastrointestinal: occasional nausea and vomiting  Others: occasional chills, fever, headache Side Effects:  Hypoglycemia may occur and  hyperammonemia has been reported.  Hypersensitivity reactions such as skin rash may occur rarely.  Nausea, vomiting, chest discomfort and palpitations may occur infrequently.  Large doses and rapid  Consider the 10 Golden Rights of administering medication  Asses’ patient’s condition before starting the therapy.  Be alert to adverse reaction.  Monitor patient temperature.  If GI reaction occur monitor patient hydration.  Tell the patient to report if felt this side effects: nausea, vomiting, chest discomfort, palpitation occur.
  22. 22. administration may lead to acidosis.  Chills, fever and headache may infrequently occur.
  23. 23. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATI ONS ADVERSE EFFECT AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Sinutab extra- strength Brand Name Sinutab Forte Classification phenylpropanola mine, combinations ; Belongs to the class of systemic sympathomimeti c preparations used as nasal decongestant Sub Classification Dosage 1 cap Route oral Frequency TID Form Capsule Color Red and yellow  Sinutab Extra- Strength is a fixed-dose combination capsule containing the following 3 active ingredients: Phenylpropanola mine HCl (PPA) or Phenylephrine: A systemic decongestant to relieve clogged nose and sinuses.  Chlorphenamine Maleate or Phenyltoloxamine Citrate: An antihistamine/anti allergy.  Paracetamol: A pain killer, as well as an antipyretic (for fever).  Temporary relief of sinus headache; promote nasal and sinus drainage; help relieve runny nose, facial pain, malaise and fever often associated with colds, influenza, acute and chronic sinusitis, allergic rhinitis (hay fever) and vasomotor rhinitis.  Patients who are hypersensiti ve or allergic to any of the components of Sinutab Extra- Strength. Unless otherwise advised by a physician, during pregnancy and lactation, patients with severe kidney disease or who are taking other medications containing PPA. Adverse Effect:  chest pain, rapid pulse, fast or uneven heart rate;  confusion, hallucinations, severe nervousness;  tremor, seizure (convulsions);  easy bruising or bleeding, unusual weakness;  little or no urinating;  nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay- colored stools, jaundice (yellowing of your skin or eyes); or  Dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety,  Consider the 10 Golden Rights of administering medication  Tell the patient not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death.  Instruct the patient that this medication could not use if she/he are allergic to acetaminophen, chlorpheniramine, or pseudoephedrine.  Inform patient that she need to avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen, and can increase certain side effects of chlorpheniramine.  Explain to the patient that there’s a side effects that
  24. 24. chest pain, shortness of breath, uneven heartbeats, seizure). Side Effect:  dizziness, drowsiness;  mild headache, blurred vision;  dry mouth, nose, or throat;  constipation;  feeling nervous;  sleep problems (insomnia); she may experience upon taking the medication such as blurred vision or impair your thinking or reactions.  If other unwanted effects not previously listed occur, consult a physician.
  25. 25. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATION S ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Ketorolac Tromethamine Brand Name Toradol Classification nonsteroidal anti- inflammatory agents, nonopioid analgesics Sub Classification pyrroziline carboxylic acid Dosage 30 mg Route Parenteral Frequency q8 Form Liquid ampule Color Clear  Inhibits prostaglandin synthesis, producing peripherally mediated analgesia.  Also has antipyretic and anti- inflammatory properties. Therapeutic Effects: Decreased pain.  Short-term manageme nt of pain (not to exceed 5 days total for all routes combined).  Contraindicated in:  Hypersensitivity  Cross-sensitivity with other NSAIDs may exist  Pre- or perioperative use  Known alcohol intolerance (injection only)  Perioperative pain from coronary artery bypass graft (CABG) surgery .  Use Cautiously in:  Cardiovascular disease or risk factors for cardiovascular disease (may ↑ risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, especially with prolonged Adverse Effects:  CNS: drowsiness, abnormal thinking, dizziness, euphoria, headache.  Respiratory: asthma, dyspnea.  CV: edema, pallor, vasodilation.  GI: GI bleeding, abnormal taste, diarrhea, dry mouth, dyspepsia, GI pain, nausea.  GU: oliguria, renal toxicity, urinary frequency.  Dermatologic: exfoliative dermatitis, Stevens Johnson Syndrome, toxic  Consider the 10 Golden Rights of administering medication Assessment Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria. Pain: Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration. Lab Test Considerations: Evaluate liver function tests, especially AST and ALT, periodically in patients receiving prolonged therapy. May cause ↑ levels. tell the patient that it may cause prolonged bleeding time that may persist for 24-48 hr following discontinuation of therapy. Inform the patient that it may cause ↑ BUN, serum creatinine, or
  26. 26. use)  History of GI bleeding  Renal impairment (dosage reduction may be required) necrolysis pruritus, purpura, sweating, urticaria.  Hematology: prolonged bleeding time.  Local: injection site pain.  Neurology: paresthesia.  Misc: allergic reactions including, anaphylaxis Side Effects:  chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;  black, bloody, or tarry stools;  coughing up blood or vomit that looks like coffee grounds;  swelling or rapid weight potassium concentrations. . Implementation Do not confuse Toradol (ketorolac) with Torecan (thiethylperazine) or tramadol (Ultram). Administration in higher-than-recommended doses does not provide increased effectiveness but may cause increased side effects. Duration of ketorolac therapy, by all routes combined, should not exceed 5 days Use lowest effective dose for shortest period of time. Coadministration with opioid analgesics may have additive analgesic effects and may permit lower opioid doses. . PO: Ketorolac therapy should always be given initially by the IM or IV route. Use oral therapy only as a continuation of parenteral therapy.  injection, 0.9% NaCl. Patient/Family Teaching Instruct patient on how and when to ask for pain
  27. 27. gain;  urinating less than usual or not at all;  nausea, stomach pain, low fever, loss of appetite, dark urine, clay- colored stools, jaundice (yellowing of the skin or eyes);  fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;  the first sign of any mouth sores or skin rash, no matter how mild;  pale skin, easy bruising, severe tingling, numbness, pain, muscle weakness; or  fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or medication. Instruct patient to take medication exactly as directed. Take missed doses as soon as remembered if not almost time for next dose. Do not double doses. Do not take more than prescribed or for longer than 5 days. May cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known. Caution patient to avoid the concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional. Advise patient to inform health care professional of medication regimen prior to
  28. 28. seizure (convulsions). Less serious side effects may include:  upset stomach, mild nausea or vomiting, diarrhea, constipation;  mild heartburn, stomach pain, bloating, gas;  dizziness, headache, drowsiness;  sweating; or  ringing in your ears. treatment or surgery. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain) occurs. . Evaluation/Desire d Outcomes Decrease in severity of pain. Patients who do not respond to one NSAID may respond to another.
  29. 29. DRUG MECHANISM OF ACTION INDICATION CONTRAINDICATIO NS ADVERSE EFFECTS AND SIDE EFFECTS NURSING RESPONSIBILITIES Generic Name Perindopril Brand Name Coversyl plus Classification Antihypertensive Sub Classification ACE Inhibitor Dosage 1 cap Route oral Frequency BID Form Tablet Color White  Antihypertensive . Pharmacology: Perindopril is an ACE-inhibitor that works by widening the blood vessels, which makes it easier for the heart to pump blood through them. Indapamide is a diuretic that causes an increase in the amount of urine produced. Each of the active ingredients of Coversyl Plus reduces blood pressure and work together to control blood pressure.  Treatment of essential hypertensio n  Allergy to perindopril or other ACE- inhibitors, or to indapamide or any other sulfonamides.  History or presence of wheezing, swelling of the face or tongue, intense itching or severe skin rashes with previous ACE- inhibitor treatment, or other circumstances (eg, angioedema). Severe liver diseases or if suffering from hepatic encephalopathy ; severe kidney disease, or on dialysis; low or high blood potassium; Adverse Effect:  CNS: dizziness, asthenia, sleep disorder, paresthesia, depression, somnolence,ner vousness, headache.  CV: palpitati ons, edema, chest pain, ab normal ECG.  EENT:rhinitis, sinusitis, ear infection, pharyngitis, tinnitus.  GI: dyspepsia, diarrhea, abdominalpain, nausea, vomi ting, flatulenc e.  GU: proteinur ia, urinarytrac t infection, m alesexual dysfunction, menstrual disorder.  Consider the 10 Golden Rights of administering medication  Assess patient’s condition.  Don’t let the patient to take this if she has an allergy to penidopril. And if she has a history of wheezing, swelling of the face or tongue, intense itching or severe skin rashes.  Explain to patient what was the medication for, and what are the side effects that she may encounter.  Instruct the patient to consult her doctor if she experiencing unwanted effect.
  30. 30. untreated decompensated heart failure (severe water retention, difficulty in breathing); children.  Use in pregnancy & lactation: Cove rsyl Plus should not be used during the first 3 months of pregnancy and must not be taken from the 4th month of pregnancy. When pregnancy is planned or confirmed, the switch to an alternative treatment should be initiated as soon as possible. Do not take Coversyl Plus if breastfeeding.  Musculoskele tal: back pain, hyperonia, neck pain, joint pain, myalgia, arthritis, arm or leg pain  Respiratory: cough, upper respiratory infection  Skin: Rash  Other: viral infection, injury, seasonal allergy Side Effect:  Cough, often described as dry and irritating, shortness of breath, discomfort on exertion.  Headache, dizziness, vertigo, pins and needles.  Changes in the rhythm or rate of the heart beat, fast or irregular heart beat
  31. 31.  Stroke, myocardial infarction, angina pectoris (a feeling of tightness, pressure or heaviness in the chest).  Feeling tired or lethargic.  Tinnitus (persistent noise in the ears), vision disturbances.  Hypotension, flushing, impaired peripheral circulation, nose bleeds.  Nausea, vomiting, taste disturbances, indigestion, diarrhoea, constipation or stomach pain.  Muscle cramps.  Rash, pruritus (itching).  Eosinophilic pneumonia.  Hepatitis.  Renal failure.  Bleeding or bruising more
  32. 32. easily than normal caused by a low blood platelet count , frequent infections such as fever, severe chills, sore throat or mouth ulcers caused by a lack of white blood cells, pancytopenia (a rare type of anaemia).  Decreased blood sugar levels.  Fainting.