The document provides drug study information on the antiulcer medications lansoprazole (Prevacid), cimetidine (Tagamet HB), and famotidine (Pepcid). It includes sections on the generic and brand names, classifications, mechanisms of action, indications, contraindications, adverse reactions, dosages, and nursing considerations for each drug. The document was submitted by a nursing student as part of the requirements for a pharmacology course to their clinical instructor.
The document discusses diabetes mellitus and its treatment. It aims to review the disease process of diabetes, discuss the role of insulin and different types of oral anti-diabetic agents. Insulin comes from various sources and works by lowering blood glucose levels. There are several classes of oral hypoglycemic agents that work through different mechanisms of action, including sulphonylureas, biguanides, thiazolidinediones, meglitinides, and alpha-glucosidase inhibitors. The nursing process is also outlined for caring for patients with diabetes.
The document outlines the 10 rights of medication administration that nurses must follow to safely administer medications to patients. These include always verifying the patient's identity, medication, dosage, and route before administering and documenting properly after administering. Nurses must also inform patients and their representatives about the medication and obtain consent when possible.
Total parenteral nutrition (TPN), also known as parenteral nutrition, is a method of providing nutrition intravenously. It involves administering proteins, carbohydrates, fats, vitamins and minerals to patients who cannot ingest or absorb adequate nutrition orally or enterally. TPN aims to prevent and treat nutritional deficiencies while allowing bowel rest. It requires close monitoring to prevent complications such as infection, fluid overload, and electrolyte imbalances. Blood work is often ordered frequently when starting TPN to monitor for refeeding syndrome. Strict aseptic technique must be used when administering TPN to reduce the risk of infection.
This document discusses parental nutrition, including its definition, indications, administration routes, formulation, and documentation. Parental nutrition involves infusing nutrients directly into the circulatory system to bypass the gastrointestinal tract. It is indicated for patients who cannot receive adequate nutrition enterally due to GI dysfunction. Formulations provide nitrogen, amino acids, energy sources like dextrose and lipids, electrolytes, trace elements, and vitamins. Components are individualized for each patient's needs. Monitoring is important when on parental nutrition.
This document summarizes various classes of cardiovascular drugs used to treat conditions like hypertension, angina, myocardial infarction, shock, and arrhythmias. It describes the mechanisms of action, common drugs, indications, contraindications, side effects, and nursing considerations for beta-blockers, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, and other antihypertensive drugs.
Insulin is a hormone produced by the pancreas that allows cells to use glucose for energy. There are two main types of diabetes based on insulin production and resistance. Insulin can be administered through injection into subcutaneous tissue using a syringe or insulin pen, through infusion into intravenous fluids in a hospital setting, or through inhalation though this route has safety concerns. Proper administration of insulin involves rotating injection sites, preparing and labeling insulin correctly, using proper injection technique, and taking precautions to prevent adverse effects like hypoglycemia.
Drugs used in gastro intestinal disorders- Mr. pannehabdou panneh
This document discusses drugs used to treat various gastrointestinal disorders grouped into four categories: antidiarrheals and flatulants, antiemetics and emetics, laxatives, and anti-peptic ulcer disease drugs. It provides details on common drugs in each category, their mechanisms of action, clinical uses, adverse drug reactions and interactions. The document concludes with references used in compiling the information.
The document discusses the assessment and management of unconscious patients. It defines unconsciousness as a state of reduced awareness and responsiveness. Causes can include head injuries, tumors, overdoses, infections, and more. Levels of consciousness are assessed using scales like the Glasgow Coma Scale. Nursing priorities for unconscious patients include airway maintenance, skin care, range of motion exercises to prevent contractures, and careful monitoring for any changes in condition.
The document discusses diabetes mellitus and its treatment. It aims to review the disease process of diabetes, discuss the role of insulin and different types of oral anti-diabetic agents. Insulin comes from various sources and works by lowering blood glucose levels. There are several classes of oral hypoglycemic agents that work through different mechanisms of action, including sulphonylureas, biguanides, thiazolidinediones, meglitinides, and alpha-glucosidase inhibitors. The nursing process is also outlined for caring for patients with diabetes.
The document outlines the 10 rights of medication administration that nurses must follow to safely administer medications to patients. These include always verifying the patient's identity, medication, dosage, and route before administering and documenting properly after administering. Nurses must also inform patients and their representatives about the medication and obtain consent when possible.
Total parenteral nutrition (TPN), also known as parenteral nutrition, is a method of providing nutrition intravenously. It involves administering proteins, carbohydrates, fats, vitamins and minerals to patients who cannot ingest or absorb adequate nutrition orally or enterally. TPN aims to prevent and treat nutritional deficiencies while allowing bowel rest. It requires close monitoring to prevent complications such as infection, fluid overload, and electrolyte imbalances. Blood work is often ordered frequently when starting TPN to monitor for refeeding syndrome. Strict aseptic technique must be used when administering TPN to reduce the risk of infection.
This document discusses parental nutrition, including its definition, indications, administration routes, formulation, and documentation. Parental nutrition involves infusing nutrients directly into the circulatory system to bypass the gastrointestinal tract. It is indicated for patients who cannot receive adequate nutrition enterally due to GI dysfunction. Formulations provide nitrogen, amino acids, energy sources like dextrose and lipids, electrolytes, trace elements, and vitamins. Components are individualized for each patient's needs. Monitoring is important when on parental nutrition.
This document summarizes various classes of cardiovascular drugs used to treat conditions like hypertension, angina, myocardial infarction, shock, and arrhythmias. It describes the mechanisms of action, common drugs, indications, contraindications, side effects, and nursing considerations for beta-blockers, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, and other antihypertensive drugs.
Insulin is a hormone produced by the pancreas that allows cells to use glucose for energy. There are two main types of diabetes based on insulin production and resistance. Insulin can be administered through injection into subcutaneous tissue using a syringe or insulin pen, through infusion into intravenous fluids in a hospital setting, or through inhalation though this route has safety concerns. Proper administration of insulin involves rotating injection sites, preparing and labeling insulin correctly, using proper injection technique, and taking precautions to prevent adverse effects like hypoglycemia.
Drugs used in gastro intestinal disorders- Mr. pannehabdou panneh
This document discusses drugs used to treat various gastrointestinal disorders grouped into four categories: antidiarrheals and flatulants, antiemetics and emetics, laxatives, and anti-peptic ulcer disease drugs. It provides details on common drugs in each category, their mechanisms of action, clinical uses, adverse drug reactions and interactions. The document concludes with references used in compiling the information.
The document discusses the assessment and management of unconscious patients. It defines unconsciousness as a state of reduced awareness and responsiveness. Causes can include head injuries, tumors, overdoses, infections, and more. Levels of consciousness are assessed using scales like the Glasgow Coma Scale. Nursing priorities for unconscious patients include airway maintenance, skin care, range of motion exercises to prevent contractures, and careful monitoring for any changes in condition.
This document discusses antidysrhythmic drugs, which are used to treat and prevent disturbances in heart rhythm. It describes the Vaughan Williams classification system used to classify these drugs into four main classes based on their effects on the heart's electrical conduction system and action potential. Class I drugs block sodium channels in different ways, Class II drugs are beta blockers, Class III drugs prolong repolarization, and Class IV drugs are calcium channel blockers. Common antidysrhythmic drugs are also discussed along with their mechanisms of action, indications, and important nursing considerations for monitoring patients on these medications.
A pressure ulcer is an injury to the skin caused by prolonged pressure that cuts off blood flow. Ulcers are common in people who are confined to beds or wheelchairs and cannot shift positions to relieve pressure. Factors like limited mobility, incontinence, poor nutrition, and aging can increase risk. Ulcers are staged from 1 to 4 based on their depth, with stage 1 being the least severe. Preventing ulcers involves regularly shifting positions, using special beds and cushions, keeping skin clean and moisturized, and addressing other risk factors through diet and exercise.
Gentamicin is an aminoglycoside antibiotic commonly used to treat early and late onset neonatal sepsis. It is effective against many gram-negative bacteria. Gentamicin is administered intravenously over 30 minutes, with dosage and interval depending on gestational and postnatal age. Therapeutic drug monitoring includes checking peak and trough levels. Adverse effects include nephrotoxicity and ototoxicity. Research is exploring using gentamicin to suppress cystic fibrosis mutations. Gentamicin use in the NICU requires careful monitoring and coordination between the medical team and nursing staff.
- Fundamentals of Nursing: history of nursing
- Florence Nightingale
- Nursing & Midwifery Council. (2015). the code: Professional standards of practice and behaviour for nurses and midwives.
- What is Critical Thinking?
- Why is Critical Thinking Important to Nurses?
- Complex thinking
- Important concepts in nursing
- The nursing process: Assessment
o Data collection: Objective & Subjective data
o Methods of Data Collection
Observation
Vital signs
BMI
• How to calculate
• Classification of BMI according to WHO
MAUC
Homeostasis
The interview
Samples
Information from the patient
Glascow scale
Physical examination
• Inspection
• Palpation
• Percussion
• Auscultation
Patient record
o The aims of assessment/rational for conducting a nursing assessment
o Holistic assessment
o Pressure sores
The Water low scale
o Medical history & Nursing history
o The environment during patient assessment
o Asking questions
The document provides an overview of pancreatitis including:
- The signs and symptoms of acute and chronic pancreatitis including abdominal pain, nausea, vomiting, and weight loss.
- The causes of pancreatitis including gallstones, alcohol use, autoimmune diseases, and genetic factors.
- The diagnostic tests used including blood tests, imaging like CT scans, and endoscopy.
- The management of acute pancreatitis focuses on pain control, IV fluids, antibiotics if infected, and diet restriction. Chronic pancreatitis management centers on pain control, insulin if diabetic, pancreatic enzymes, and sometimes surgery.
- Complications can include kidney failure, infection, pseudocysts, malnutrition, and diabetes.
This document discusses medication administration and intravenous (IV) therapy. It covers pharmacology principles, medication routes, ensuring safe administration, medical direction, IV fluid composition and types, techniques for peripheral IV insertion and maintenance, special considerations for pediatrics and older adults, and potential complications. The key aspects are following medication administration rights and protocols, using proper aseptic technique, choosing the right IV solution and site based on patient condition, and monitoring for potential local reactions or occlusions.
The document discusses parenteral nutrition (PN), also known as intravenous feeding. PN involves infusing nutrients directly into the bloodstream and bypassing the gastrointestinal tract. It summarizes the main components of PN including carbohydrates, protein, fat, electrolytes, vitamins and minerals. It provides guidelines on calculating and monitoring nutrient needs and doses for different patient populations, such as neonates and adults. Complications associated with PN administration involving catheter types and infections are also reviewed.
This document provides an overview of parenteral nutrition. It defines parenteral nutrition as nutrition given through a route other than the gastrointestinal tract, such as through central or peripheral intravenous lines. The document outlines the indications for parenteral nutrition, including when the gastrointestinal tract is non-functional, as well as contraindications. It describes the components of parenteral nutrition including carbohydrates, amino acids, lipids, electrolytes, vitamins and minerals. The document also discusses guidelines for calculating nutrient requirements and infusion schedules for parenteral nutrition. Potential complications are also summarized.
Losartan is an angiotensin II receptor blocker used to treat hypertension. It works by competitively inhibiting the binding of angiotensin II to AT1 receptors, preventing vasoconstriction and lowering blood pressure. Common side effects include dizziness, hypotension, and hyperkalemia. Losartan has drug interactions with NSAIDs, potassium supplements, and lithium that can increase the risk of hyperkalemia and lithium toxicity. It is classified as pregnancy category D and contraindicated in pregnant women.
Hypervolemia, also known as fluid overload, is a condition where there is too much fluid in the blood. It is usually the result of an underlying health problem such as heart failure, cirrhosis, kidney failure, or medications. Common symptoms include edema, tiredness, high blood pressure, and shortness of breath. Treatment involves diuretics and addressing the underlying cause. Nursing care focuses on monitoring the patient's response to diuretics through weight, intake and output measurements, and educating them on diet.
This document discusses insulin therapy for diabetes, including indications, types of insulin, regimens, devices, side effects, and special considerations. It indicates insulin therapy is used for type 1 diabetes, gestational diabetes, and type 2 diabetes not adequately controlled by oral medications or with acute complications. Insulin regimens discussed include twice daily, multiple injection, and continuous subcutaneous insulin infusion. Devices covered are insulin syringes, pens, pumps, and inhaled insulin. Side effects mentioned are hypoglycemia, weight gain, edema, antibodies, allergy, and lipodystrophy.
Hemodialysis and peritoneal dialysis are two types of dialysis used to replicate kidney function for patients with kidney failure. Hemodialysis uses a machine to filter waste from the blood outside of the body through a semipermeable membrane, while peritoneal dialysis introduces fluid into the abdomen to draw waste from the blood vessels within. Both aim to control fluid balance and remove toxins when the kidneys are unable to do so, helping to correct conditions like fluid overload, electrolyte imbalances, and metabolic acidosis. Key differences between the two include that hemodialysis requires vascular access while peritoneal dialysis uses a permanent catheter, and that hemodialysis is done at a center several times a week
Technical discussion on clindamycin tabletAsiful alam
The document discusses a technical presentation on clindamycin tablet formulation. It provides background on clindamycin, including its mechanism of action, indications, adverse effects and objectives for developing a clindamycin tablet. It analyzes the international and national market for clindamycin formulations. It also performs a SWOT analysis for developing a clindamycin tablet and discusses challenges with the formulation based on an unpublished study. The summary concludes it may be difficult to develop a clindamycin tablet that can be practically administered due to potential issues with tablet size and disintegration times.
This document discusses Percutaneous Endoscopic Gastrostomy (PEG) tubes, which are feeding tubes placed through the abdominal wall into the stomach endoscopically. It covers what a PEG tube is, how they are placed, types of feedings through PEG tubes, benefits of PEG feeding, management after insertion, routine PEG tube care, potential complications, and major complications. The overall purpose is to provide information on PEG tubes, their use, and nursing management of patients with PEG tubes.
Teicoplanin is an antibiotic used to treat serious infections caused by staphylococci or streptococci that cannot be treated by other less toxic agents. It works by inhibiting the growth of susceptible bacteria. Common brands include Celplanin and Targocid. Teicoplanin is administered intravenously or intramuscularly and primarily excreted unchanged through urine. Potential side effects include diarrhea, vomiting, rash, and renal impairment. Renal and liver function, hematological parameters, and plasma concentration should be monitored during treatment.
A comprehensive presentation on Total parenteral nutrition(TPN) to facilitate easy -learning for medical , dental , pharmacology and biotechnology students.
This health teaching plan outlines diabetes education for relatives of patients and community members. The 25 minute session at SMS Hospital in Jaipur on March 16th will use a lecture and discussion format to cover key topics about diabetes mellitus like definitions, causes, symptoms, diagnosis, prevention, and complications. Specific objectives include defining diabetes, listing risk factors and types, describing signs and symptoms, explaining diagnosis, describing prevention methods, and complications. A variety of teaching methods and audiovisual aids will be used to engage participants and evaluate learning.
This document discusses perioperative care and defines the three phases as preoperative, intraoperative, and postoperative. It outlines nursing responsibilities and goals in each phase, including assessment, monitoring for complications, education, and promoting patient well-being and recovery.
Nursing Education: Appetite Stimulants for Elderly PatientsPaul Pasco
A handout I formulated to bolster nursing education during an internship/Advanced Pharmacy Practice Experience (APPE) in medication safety at a hospital.
This document presents a case study of a 21-year-old male patient admitted to the hospital with duodenal ulcer. Objective findings from examinations confirmed the diagnosis of duodenal ulcer seen on endoscopy. The patient's history of irregular eating habits and skipping meals contributed to ulcer development. A treatment plan was developed using pantoprazole, sucralfate, tramadol, ondansetron, and magnesium hydroxide to treat the ulcer and relieve symptoms while monitoring for drug toxicity and therapeutic response through follow-up endoscopy. Patient education focused on the disease, medication use, and importance of regular eating.
This document discusses antidysrhythmic drugs, which are used to treat and prevent disturbances in heart rhythm. It describes the Vaughan Williams classification system used to classify these drugs into four main classes based on their effects on the heart's electrical conduction system and action potential. Class I drugs block sodium channels in different ways, Class II drugs are beta blockers, Class III drugs prolong repolarization, and Class IV drugs are calcium channel blockers. Common antidysrhythmic drugs are also discussed along with their mechanisms of action, indications, and important nursing considerations for monitoring patients on these medications.
A pressure ulcer is an injury to the skin caused by prolonged pressure that cuts off blood flow. Ulcers are common in people who are confined to beds or wheelchairs and cannot shift positions to relieve pressure. Factors like limited mobility, incontinence, poor nutrition, and aging can increase risk. Ulcers are staged from 1 to 4 based on their depth, with stage 1 being the least severe. Preventing ulcers involves regularly shifting positions, using special beds and cushions, keeping skin clean and moisturized, and addressing other risk factors through diet and exercise.
Gentamicin is an aminoglycoside antibiotic commonly used to treat early and late onset neonatal sepsis. It is effective against many gram-negative bacteria. Gentamicin is administered intravenously over 30 minutes, with dosage and interval depending on gestational and postnatal age. Therapeutic drug monitoring includes checking peak and trough levels. Adverse effects include nephrotoxicity and ototoxicity. Research is exploring using gentamicin to suppress cystic fibrosis mutations. Gentamicin use in the NICU requires careful monitoring and coordination between the medical team and nursing staff.
- Fundamentals of Nursing: history of nursing
- Florence Nightingale
- Nursing & Midwifery Council. (2015). the code: Professional standards of practice and behaviour for nurses and midwives.
- What is Critical Thinking?
- Why is Critical Thinking Important to Nurses?
- Complex thinking
- Important concepts in nursing
- The nursing process: Assessment
o Data collection: Objective & Subjective data
o Methods of Data Collection
Observation
Vital signs
BMI
• How to calculate
• Classification of BMI according to WHO
MAUC
Homeostasis
The interview
Samples
Information from the patient
Glascow scale
Physical examination
• Inspection
• Palpation
• Percussion
• Auscultation
Patient record
o The aims of assessment/rational for conducting a nursing assessment
o Holistic assessment
o Pressure sores
The Water low scale
o Medical history & Nursing history
o The environment during patient assessment
o Asking questions
The document provides an overview of pancreatitis including:
- The signs and symptoms of acute and chronic pancreatitis including abdominal pain, nausea, vomiting, and weight loss.
- The causes of pancreatitis including gallstones, alcohol use, autoimmune diseases, and genetic factors.
- The diagnostic tests used including blood tests, imaging like CT scans, and endoscopy.
- The management of acute pancreatitis focuses on pain control, IV fluids, antibiotics if infected, and diet restriction. Chronic pancreatitis management centers on pain control, insulin if diabetic, pancreatic enzymes, and sometimes surgery.
- Complications can include kidney failure, infection, pseudocysts, malnutrition, and diabetes.
This document discusses medication administration and intravenous (IV) therapy. It covers pharmacology principles, medication routes, ensuring safe administration, medical direction, IV fluid composition and types, techniques for peripheral IV insertion and maintenance, special considerations for pediatrics and older adults, and potential complications. The key aspects are following medication administration rights and protocols, using proper aseptic technique, choosing the right IV solution and site based on patient condition, and monitoring for potential local reactions or occlusions.
The document discusses parenteral nutrition (PN), also known as intravenous feeding. PN involves infusing nutrients directly into the bloodstream and bypassing the gastrointestinal tract. It summarizes the main components of PN including carbohydrates, protein, fat, electrolytes, vitamins and minerals. It provides guidelines on calculating and monitoring nutrient needs and doses for different patient populations, such as neonates and adults. Complications associated with PN administration involving catheter types and infections are also reviewed.
This document provides an overview of parenteral nutrition. It defines parenteral nutrition as nutrition given through a route other than the gastrointestinal tract, such as through central or peripheral intravenous lines. The document outlines the indications for parenteral nutrition, including when the gastrointestinal tract is non-functional, as well as contraindications. It describes the components of parenteral nutrition including carbohydrates, amino acids, lipids, electrolytes, vitamins and minerals. The document also discusses guidelines for calculating nutrient requirements and infusion schedules for parenteral nutrition. Potential complications are also summarized.
Losartan is an angiotensin II receptor blocker used to treat hypertension. It works by competitively inhibiting the binding of angiotensin II to AT1 receptors, preventing vasoconstriction and lowering blood pressure. Common side effects include dizziness, hypotension, and hyperkalemia. Losartan has drug interactions with NSAIDs, potassium supplements, and lithium that can increase the risk of hyperkalemia and lithium toxicity. It is classified as pregnancy category D and contraindicated in pregnant women.
Hypervolemia, also known as fluid overload, is a condition where there is too much fluid in the blood. It is usually the result of an underlying health problem such as heart failure, cirrhosis, kidney failure, or medications. Common symptoms include edema, tiredness, high blood pressure, and shortness of breath. Treatment involves diuretics and addressing the underlying cause. Nursing care focuses on monitoring the patient's response to diuretics through weight, intake and output measurements, and educating them on diet.
This document discusses insulin therapy for diabetes, including indications, types of insulin, regimens, devices, side effects, and special considerations. It indicates insulin therapy is used for type 1 diabetes, gestational diabetes, and type 2 diabetes not adequately controlled by oral medications or with acute complications. Insulin regimens discussed include twice daily, multiple injection, and continuous subcutaneous insulin infusion. Devices covered are insulin syringes, pens, pumps, and inhaled insulin. Side effects mentioned are hypoglycemia, weight gain, edema, antibodies, allergy, and lipodystrophy.
Hemodialysis and peritoneal dialysis are two types of dialysis used to replicate kidney function for patients with kidney failure. Hemodialysis uses a machine to filter waste from the blood outside of the body through a semipermeable membrane, while peritoneal dialysis introduces fluid into the abdomen to draw waste from the blood vessels within. Both aim to control fluid balance and remove toxins when the kidneys are unable to do so, helping to correct conditions like fluid overload, electrolyte imbalances, and metabolic acidosis. Key differences between the two include that hemodialysis requires vascular access while peritoneal dialysis uses a permanent catheter, and that hemodialysis is done at a center several times a week
Technical discussion on clindamycin tabletAsiful alam
The document discusses a technical presentation on clindamycin tablet formulation. It provides background on clindamycin, including its mechanism of action, indications, adverse effects and objectives for developing a clindamycin tablet. It analyzes the international and national market for clindamycin formulations. It also performs a SWOT analysis for developing a clindamycin tablet and discusses challenges with the formulation based on an unpublished study. The summary concludes it may be difficult to develop a clindamycin tablet that can be practically administered due to potential issues with tablet size and disintegration times.
This document discusses Percutaneous Endoscopic Gastrostomy (PEG) tubes, which are feeding tubes placed through the abdominal wall into the stomach endoscopically. It covers what a PEG tube is, how they are placed, types of feedings through PEG tubes, benefits of PEG feeding, management after insertion, routine PEG tube care, potential complications, and major complications. The overall purpose is to provide information on PEG tubes, their use, and nursing management of patients with PEG tubes.
Teicoplanin is an antibiotic used to treat serious infections caused by staphylococci or streptococci that cannot be treated by other less toxic agents. It works by inhibiting the growth of susceptible bacteria. Common brands include Celplanin and Targocid. Teicoplanin is administered intravenously or intramuscularly and primarily excreted unchanged through urine. Potential side effects include diarrhea, vomiting, rash, and renal impairment. Renal and liver function, hematological parameters, and plasma concentration should be monitored during treatment.
A comprehensive presentation on Total parenteral nutrition(TPN) to facilitate easy -learning for medical , dental , pharmacology and biotechnology students.
This health teaching plan outlines diabetes education for relatives of patients and community members. The 25 minute session at SMS Hospital in Jaipur on March 16th will use a lecture and discussion format to cover key topics about diabetes mellitus like definitions, causes, symptoms, diagnosis, prevention, and complications. Specific objectives include defining diabetes, listing risk factors and types, describing signs and symptoms, explaining diagnosis, describing prevention methods, and complications. A variety of teaching methods and audiovisual aids will be used to engage participants and evaluate learning.
This document discusses perioperative care and defines the three phases as preoperative, intraoperative, and postoperative. It outlines nursing responsibilities and goals in each phase, including assessment, monitoring for complications, education, and promoting patient well-being and recovery.
Nursing Education: Appetite Stimulants for Elderly PatientsPaul Pasco
A handout I formulated to bolster nursing education during an internship/Advanced Pharmacy Practice Experience (APPE) in medication safety at a hospital.
This document presents a case study of a 21-year-old male patient admitted to the hospital with duodenal ulcer. Objective findings from examinations confirmed the diagnosis of duodenal ulcer seen on endoscopy. The patient's history of irregular eating habits and skipping meals contributed to ulcer development. A treatment plan was developed using pantoprazole, sucralfate, tramadol, ondansetron, and magnesium hydroxide to treat the ulcer and relieve symptoms while monitoring for drug toxicity and therapeutic response through follow-up endoscopy. Patient education focused on the disease, medication use, and importance of regular eating.
Pantoprazole is a proton pump inhibitor used to treat GERD, erosive esophagitis, and Zollinger-Ellison syndrome. It works by inhibiting the hydrogen-potassium ATPase pump in the stomach's parietal cells to suppress gastric acid secretion. Common side effects include headache, diarrhea, and nausea. Pantoprazole has drug interactions with atazanavir, ceritinib, dipyridamole, ketoconazole, and methotrexate that require dose adjustments or alternative treatment. Overdose symptoms include hypoactivity, ataxia, and tremors, treated with supportive care and discontinuing the drug.
This document provides information on drugs used to treat peptic ulcer disease. It discusses proton pump inhibitors like omeprazole, pantoprazole, and rabeprazole which work by inhibiting acid production in the stomach. It also covers H2 receptor antagonists like ranitidine, cimetidine, and famotidine which block histamine receptors and reduce acid secretion. Other drug classes discussed are anticholinergics which decrease stomach motility, and misoprostol which has antisecretory and mucosal protective properties. The document provides details on the mechanisms, indications, dosages, and side effects of these various antiulcer drugs.
Non-steroidal anti-inflammatory drugs (NSAIDs) work by inhibiting the synthesis of prostaglandins. There are several classes of NSAIDs including salicylates, para-aminophenol derivatives, pyrazolone derivatives, phenylpropionic acid derivatives, and oxicams. NSAIDs are well absorbed orally and highly protein bound. They are metabolized in the liver and excreted primarily in the bile. NSAIDs are indicated for reducing inflammation and pain in conditions like arthritis but can increase risks in pregnant women or those with gastrointestinal or liver issues. Common side effects include gastrointestinal distress and bleeding.
This document discusses several classes of drugs that act on the gastrointestinal tract, including their mechanisms of action, indications, and side effects. It covers antacids, H2 receptor antagonists, proton pump inhibitors, emetics, antiemetics, anticholinergic agents, and provides examples of specific drugs within each class. The overall objective is for student nurses to broaden their knowledge of how these various drugs impact the gastrointestinal system.
Ranitidine is a gastro-intestinal agent that inhibits histamine H2 receptors.
The histamine H2 receptor antagonist ranitidine is used to treat erosive esophagitis, Zollinger-Ellison syndrome, gastric ulcers, GERD, and duodenal ulcers.
The first document discusses the use of digoxin including indications, dosages, side effects and nursing implications such as monitoring pulse and electrolyte levels. The second document covers the anticoagulant warfarin including contraindications, side effects and teaching patients to avoid foods and activities that could increase bleeding risk. The third document provides information on the loop diuretic furosemide including classifications, side effects, and nursing implications like assessing for dehydration and electrolyte imbalances.
Antituberculosis Drugs 1 Manisacan Et Al( Midterm 2)guest151c
The document summarizes guidelines for treating tuberculosis using three lines of antituberculosis drugs. First-line drugs like isoniazid and rifampin are usually effective but second and third-line drugs may be needed if resistance develops. The drugs have various mechanisms of action and are always used together to improve outcomes and prevent resistance. Close monitoring is needed due to potential adverse effects and drug interactions that require dosage adjustments.
This document summarizes information about the drug aspirin, including its pharmacological name, trade names, actions, pharmacokinetics, indications, contraindications, dosage, precautions, side effects, and nursing responsibilities. It describes aspirin's mechanism for reducing pain and inflammation. It provides details on aspirin's absorption, metabolism, half-life, and protein binding. Recommended dosages for adults, adolescents and children are listed. Common side effects include stomach pain, nausea, vomiting, dizziness and headache. Nurses should carefully assess patients for cautions and contraindications and monitor for adverse effects.
This document discusses antibiotics that are commonly used in pediatric dentistry. It provides formulas for calculating drug dosages for pediatric patients based on their age and weight. It then describes several classes of antibiotics including penicillin, clindamycin, amoxicillin, cephalosporins, and macrolides. For each drug class and individual drug, it discusses indications, contraindications, dosages, side effects, and formulations. The document aims to guide practitioners in appropriately prescribing antibiotics to pediatric patients for odontogenic infections and other dental conditions.
GERD ( Gasrtro-esophageal reflux disease )
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.
And Case study at the end
Recent advances in diabetic gastroparesisViraj Shinde
This document discusses current and emerging medical therapies for gastroparesis. It begins by introducing gastroparesis and its symptoms. The main current treatments include prokinetics like metoclopramide and domperidone, antiemetics, dietary changes, and correcting underlying conditions in diabetics. Emerging therapies target serotonin receptors, motilin receptors, accommodation, pyloric function, and more. Several drug candidates are discussed, including TD-5108, prucalopride, and motilin receptor agonists without antibiotic activity.
Material, Vincent M.(Drug Study in Respiratory System)-converted.pdfVincent Material
This document provides a summary of four bronchodilator drugs: albuterol, salmeterol, tiotropium, and corticosteroids. For each drug, the summary includes the generic and brand names, classification, mechanism of action, indications for use, contraindications, potential adverse reactions, dosage guidelines, and important nursing considerations. The full document provides more detailed information on the pharmacology, proper administration, and patient education for each medication.
The document describes a 67-year-old male patient presenting with dyspnea, constipation, anorexia, abdominal pain and headache. Examination finds the patient semiconscious and oriented with abdominal discomfort and tender abdomen. Laboratory investigations show abnormal renal function, electrolyte imbalance and signs of infection. The patient is diagnosed with septic shock with acute renal failure of unknown etiology. Treatment includes antibiotics, diuretics, bronchodilators and corticosteroids to address infection, fluid overload and organ dysfunction with the goals of improving quality of life and preventing further health complications.
The document discusses drugs that affect the gastrointestinal system. It covers drugs that affect GI secretions like histamine receptor blockers, proton pump inhibitors, antacids, mucosal protectants and prostaglandin analogs. It provides details on the mechanisms of action, indications, side effects and nursing considerations for various classes of drugs including H2 receptor blockers, antacids, proton pump inhibitors and the mucosal protectant sucralfate.
This document discusses various drugs that affect the gastrointestinal system. It covers drugs that affect GI secretions like antacids, H2 receptor blockers, proton pump inhibitors, mucosal protectants, and prostaglandin analogs. It also discusses laxatives, which are used to increase bowel movements, and are classified based on their mechanisms of action. Common side effects and nursing considerations are provided for each drug class.
NoAcid-D (Famotidine) is a histamine-2 blocker. It works by decreasing the amount of acid the stomach produces by blocking the histamine receptors in your stomach responsible for triggering acid production.
The document describes a randomized clinical trial that evaluated the effectiveness of oral contraceptives for treating dysmenorrhea in adolescent girls. The trial found that oral contraceptives provided significant relief from dysmenorrhea pain compared to placebo and were well-tolerated. Overall, the study demonstrated oral contraceptives to be an effective treatment option for dysmenorrhea in adolescent girls.
The document provides guidelines for administering gastrointestinal medications including antacids, H2 receptor antagonists, proton pump inhibitors, and other agents. It discusses the classifications, mechanisms of action, indications for use, administration considerations, interactions, and side effects of these various classes of GI medications.
Similar to Material, Vincent M.(Drug Study in GastroIntestinal System)-converted.pdf (20)
This document provides sample meal menus for different diets tailored for various age groups. It includes menus for a gluten-free diet, purine-restricted diet, and general meals. The menus specify breakfast, lunch, snack, and dinner options that are appropriate for each diet and age range, including school-age, adolescent, adult and elderly individuals. The meals suggest gluten-free and low-purine protein, grain, vegetable and fruit options to meet the dietary needs for each group.
The document summarizes a student's reflection on two virtual lectures about nursing research basics delivered by Dr. Rizal Angelo Natoza Grande. In the first lecture, Dr. Grande discussed key research concepts like paradigms, hypotheses, and ethics. In the second lecture, he explained research processes like quantitative and qualitative methods, sampling techniques, and statistical analysis. The student found the lectures informative and helpful for their nursing studies and future career. They were grateful for the opportunity to learn from an expert and receive research book copies.
(VINCENT M. MATERIAL) PRELIMINARY EXAM NEW NSTP 1 2021-2022 1st Semester-conv...Vincent Material
This document contains a preliminary examination for a National Service Training Program (NSTP) course. It includes multiple choice and true/false questions about NSTP laws and components. It also asks students to identify Filipino values and differentiate between nationalism and patriotism. The student provides insights about the pandemic's impact on the Philippine economy and health system in 2 sentences each.
This document provides sample meal menus for different diets - a gluten-free diet, purine-restricted diet, and regular diet - tailored for different age groups: school-age, adolescent, adult and elderly. The menus include breakfast, morning snack, lunch, afternoon snack and dinner options that are appropriate for each diet and age category. The document aims to provide dietary guidelines and meal ideas for managing special diets.
- Daniel is a Filipino man who fell in love with Enrique, a Dutch man, after Enrique saved Daniel from drowning. They began a long-distance relationship.
- After Daniel's family disowned him for being gay, Enrique helped Daniel move to Amsterdam to start a new life together. However, Enrique's father also disapproved of their relationship.
- Daniel and Enrique built a life together in Amsterdam through hard work. They eventually married and adopted three children after same-sex marriage was legalized in the Netherlands.
This document is a letter of consent for a research study on the psychosocial affectations and coping strategies of COVID-19 survivors in Lipa City, Philippines. It requests participants to answer questions about their profile, coping strategies used during their illness, and psychosocial impacts experienced. It assures participants that their participation and responses will remain confidential and optional. The letter is signed by the research advisers to obtain informed consent from participants.
Vincent M. Material is a nurse who needs to discuss treatment options for his patient, Mr. Brylle Zaffiro. Mr. Zaffiro is experiencing increased breathlessness, palpitations, and chest pain. His blood test results show his blood count is lower than normal. The nurse believes these symptoms are due to his low blood count and pre-existing heart condition. The nurse recommends a blood transfusion as the strongest option to address his anemia and risk of worsening condition, along with potential future iron treatment.
This document provides drug information on oxytocin, codeine sulfate, and lidocaine hydrochloride. It includes sections on the generic and brand names, classifications, mechanisms of action, indications, contraindications, adverse reactions, dosages, and nursing considerations for each drug. The nursing considerations sections outline important aspects of patient monitoring, teaching, and safety precautions when administering these drugs.
A new mother experienced mild cramping and back/thigh pain during her pregnancy. She noticed clear discharge with blood streaks and asked the nurse questions about her symptoms. The nurse assessed the mother's knowledge deficit and created a care plan to address her short and long-term goals of understanding her physical and psychological changes during pregnancy. The nurse's interventions included education, addressing the mother's questions, and involving her in decision making.
Vincent m. material (case study and ncp toxoplasmosis)Vincent Material
Toxoplasmosis is caused by infection with the Toxoplasma gondii parasite, which is commonly found in cat feces. Infection usually occurs by eating undercooked meat contaminated with the parasite, exposure to infected cat feces, or mother-to-child transmission during pregnancy. While most healthy people have no symptoms, toxoplasmosis can cause flu-like symptoms and serious complications for infants, pregnant women, and those with weakened immune systems. Treatment involves antibiotics and prevention through hygienic practices and avoiding contact with cat feces.
This document discusses the categorical syllogism, which is a deductive argument composed of three categorical propositions using only three distinct terms. It provides examples and outlines 8 rules for making valid categorical syllogisms, including that they must have only 3 terms, each term must occur in two propositions, and the conclusion's terms must be distributed as in the premises. It also describes the 4 figures of categorical syllogisms based on the arrangement of terms, and the valid moods for each figure defined by the propositions' quantity and quality.
This document defines medical terminology prefixes, roots, and suffixes and their meanings. It is organized alphabetically and provides the following information for each entry:
- The prefix, root, or suffix
- A brief definition or meaning of the term
Some key points are:
- Prefixes usually indicate a location, number, or other modifier. Roots refer to an organ system, condition or other medical meaning. Suffixes often indicate a process, condition, or occupational role.
- Combining forms are built from prefixes, roots and suffixes to describe anatomical structures, diseases, procedures and other medical concepts.
- Understanding the individual elements provides insight into the overall meaning of medical terms.
This document defines key terms related to disease and infection. It discusses how pathogens can cause disease through mechanical invasion, toxin production, or immune response stimulation. It also outlines the typical stages of infection, including incubation period, prodrome, illness period, decline and recovery. Localized, systemic and focal infections are defined, as are acute, chronic and latent conditions. Signs, symptoms and asymptomatic disease are also distinguished.
The document discusses the Philippine declaration of independence on June 12, 1898 when the Filipino people raised their flag as a symbol of triumph over foreign invasion. It acknowledges the bravery and courage of Philippine heroes who helped the country attain its long-desired freedom. Recognizing this history demonstrates gratitude and admiration for the past, and it is important to continue pursuing the path laid out by early heroes to avoid wasting their efforts.
Course outline understanding the self(college edition)Vincent Material
This document outlines the course for Understanding the Self at the College of Nursing at LIPA City Colleges. The course will help students learn to manage their time wisely and understand themselves better. It is divided into sections on the self from various perspectives like philosophy and psychology in the prelims; unpacking the material, physical, and sexual self in the midterm; and managing and caring for one's spiritual, political, and digital self in the finals, with the goal of helping students become better students, set goals, and take charge of their health.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Material, Vincent M.(Drug Study in GastroIntestinal System)-converted.pdf
1. In Partial Fulfillment
Of The Requirements for the Subject
Pharmacology
AY 2020 – 2021
Submitted by:
Vincent M. Material
BSN 2
Submitted to:
Ms. Maria Teresa Ira Bandelaria, MAN, RN, MHoA
NCM 107 Clinical Instructor
December 3, 2020
DRUG STUDY
Lipa City Colleges
College of Nursing
2.
3. Antacid preparations serve to neutralize gastric acid after it is
secreted. These still-helpful agents have a continuing role in
treating mild, occasional heartburn and supplementing
prescription drugs in more severe disease. They are traditional,
cheap, handy, and relatively safe – although they are not without
risks and side effects can occur.
4. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
lansoprazole
Brand Name:
Prevacid
CLASSIFICA-
TION:
Pharmacologic
class: Gastric
acid pump
inhibitor
Therapeutic
class: Antiulcer
drug
Pregnancy risk
category B
Inhibits activity
of proton pump
in gastric
parietal cells,
decreasing
gastric acid
production
➣Active duodenal
ulcer
➣Maintenance of
healed duodenal
ulcer
➣H. pylori
eradication, to
reduce risk of
duodenal ulcer
recurrence
➣Benign gastric
ulcer
➣Gastric ulcer
associated with
NSAIDs
➣To reduce risk
of NSAID-
associated gastric
ulcer
➣Gastroesophage
al reflux disease
➣Erosive
esophagitis
➣To maintain
healing of erosive
esophagitis
➣Pathologic
● Hypersensitivity to
drug or its
components
Use cautiously in:
● phenylketonuria
(orally disintegrating
tablets), severe
hepatic impairment
● elderly patients
● pregnant or
breastfeeding
patients
● children younger
than age 18.
• CNS: headache,
confusion,
anxiety,
malaise,
paresthesia,
abnormal
thinking,
depression,
dizziness,
syncope,
cerebrovascul
ar accident
• CV: chest pain,
hypertension,
hypotension,
myocardial
infarction,
shock
• EENT: visual
field deficits,
otitis media,
tinnitus,
epistaxis
• GI: nausea,
diarrhea,
abdominal pain,
cholelithiasis,
ulcerative colitis,
Dosages
➣Active duodenal ulcer
Adults: 15 mg P.O. daily
for 4 weeks
➣Maintenance of healed
duodenal ulcer
Adults: 15 mg P.O. daily
➣H. pylori eradication, to
reduce risk of duodenal
ulcer recurrence
Adults: In triple therapy,
30 mg lansoprazole
P.O., 1 g amoxicillin P.O.,
and 500 mg
clarithromycin P.O. q 12
hours for 10 or 14 days.
In dual therapy, 30 mg
lansoprazole P.O. and 1 g
amoxicillin P.O. q 8 hours
for 14 days.
➣Benign gastric ulcer
Adults: 30 mg P.O. daily
for up to 8 weeks
➣Gastric ulcer associated
Patient monitoring
● Monitor for GI adverse
reactions.
● Assess nutritional
status and fluid balance
to identify significant
problems.
Patient teaching
● Instruct patient to
take before meals.
● If patient has difficulty
swallowing, tell him to
open delayed-release
capsule and sprinkle
contents onto small
amount of soft food
(such as applesauce
or pudding). Emphasize
that he must not crush
or chew drug.
● Tell patient to take
orally disintegrating
tablet by placing it on
tongue and letting it
disintegrate.
● Instruct patient to
take oral suspension
5. hypersecretory
conditions
(including
Zollinger-Ellison
syndrome)
➣Frequent
heartburn (two or
more times a
week)
esophageal
ulcer,
hematemesis,
stomatitis,
dysphagia, GI
hemorrhage
• GU: renal
calculi, erectile
dysfunction,
Abnormal
menses, breast
tenderness,
gynecomastia
• Hematologic:
anemia
• Musculoskelet
al: hip, wrist,
spine fractures
(with long-term
daily use)
• Respiratory:
cough,
bronchitis,
asthma
• Skin: urticaria,
alopecia, acne,
pruritus,
photosensitivity
with NSAIDs
Adults: 30 mg P.O. once
daily for up to 8 weeks
➣To reduce risk of
NSAID-associated gastric
ulcer
Adults: 15 mg P.O. daily
for up to12 weeks
➣Gastroesophageal reflux
disease
Adults and children
ages 12 to 17:
15 mg P.O. daily for up to
8 weeks
Children ages 1 to 11
weighing more
than 30 kg (66 lb): 30
mg P.O. daily for up to 12
weeks
Children ages 1 to 11
weighing 30 kg
(66 lb) or less: 15 mg
P.O. daily for up to 12
weeks
➣Erosive esophagitis
Adults and children
ages 12 to 17: 30 mg
P.O. daily for up to 8
weeks. Some patients
may require 8 additional
weeks.
by emptying packet
contents into container
with 2 tbsp water. Tell
him to stir contents well
and drink immediately.
● Advise patient to
minimize GI upset by
eating small, frequent
servings of food and
drinking plenty of fluids.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs, foods, and herbs
mentioned above.
6. Children ages 1 to 11
weighing more than 30
kg (66 lb): 30 mg P.O.
daily for up to 12 weeks
Children ages 1 to 11
weighing 30 kg
(66 lb) or less: 15 mg
P.O. daily for up to 12
weeks
➣To maintain healing of
erosive esophagitis
Adults: 15 mg P.O. daily
➣Pathologic
hypersecretory conditions
(including Zollinger-Ellison
syndrome)
Adults: Initially, 60 mg
P.O. daily, to a maximum
of 90 mg P.O. b.i.d.
Divide daily dosages over
120 mg.
➣Frequent heartburn (two
or more times a week)
Adults: 15 mg P.O.
(delayed-release
capsule) daily up to 14
days
Dosage adjustment
● Significant hepatic
insufficiency
7. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
cimetidine
Brand Name:
Tagamet HB
CLASSIFICA-
TION:
Pharmacologic
class:
Histamine2-
receptor
antagonist
Therapeutic
class: Antiulcer
drug
Pregnancy risk
category B
Competitively
inhibits
histamine
action at
histamine2-
receptor sites of
gastric parietal
cells, thereby
inhibiting
gastric acid
secretion
➣Active duodenal
ulcer (short-term
therapy)
➣Active benign
gastric ulcer
(shortterm
therapy)
➣Gastric
hypersecretory
conditions (such
as Zollinger-
Ellison syndrome)
intractable ulcers
➣Heartburn; acid
indigestion
➣Erosive
gastroesophageal
reflux
disease
● Hypersensitivity to
drug
● Alcohol intolerance
Use cautiously in:
● renal impairment
● elderly patients
● pregnant or
breastfeeding
patients.
• CNS: confusion,
dizziness,
drowsiness,
hallucinations,
agitation,
psychosis,
depression,
anxiety,
headache
• GI: diarrhea
• GU: reversible
erectile
dysfunction,
gynecomastia
Availability
Oral liquid: 200 mg/5 ml,
300 mg/5 ml
Tablets: 200 mg, 300 mg,
400 mg, 600 mg, 800 mg
Dosages
➣Active duodenal ulcer
(short-term therapy)
Adults and children
older than age 16:
800 mg P.O. at bedtime,
or 300 mg P.O. q.i.d. with
meals and at bedtime, or
400 mg P.O. b.i.d.
Maintenance dosage is 400
mg P.O. at bedtime.
➣Active benign gastric
ulcer (shortterm therapy)
Adults and children
older than age 16:
800 mg P.O. at bedtime or
300 mg P.O. q.i.d. with
meals and at bedtime
➣Gastric hypersecretory
conditions (such as
Zollinger-Ellison
Patient monitoring
● Monitor creatinine
levels in patients with
renal insufficiency or
failure.
● Assess elderly or
chronically ill patients
for confusion (which
usually resolves once
drug therapy ends).
Patient teaching
● Inform patient with
gastric ulcer that ulcer
may take up to 2
months to heal. Advise
him not to discontinue
therapy, even if he feels
better, without first
consulting prescriber.
Ulcer may recur if
therapy ends too soon.
● Advise patient not to
take over-thecounter
cimetidine for more
than 2 weeks
continuously, except
with prescriber’s advice
and supervision.
8. syndrome)
intractable ulcers
Adults and children
older than age 16:
300 mg P.O. q.i.d. with
meals and at bedtime
➣Erosive
gastroesophageal reflux
disease
Adults and children
older than age 16:
1,600 mg P.O. daily in
divided doses (800 mg
b.i.d. or 400 mg q.i.d.) for
12 weeks
➣Heartburn; acid
indigestion
Adults and children
older than age 16:
200 mg (two tablets of
over-thecounter product
only) P.O. up to b.i.d.
Give maximum dosage no
longer than 2 weeks
continuously, unless
directed by prescriber.
Dosage adjustment
● Renal impairment
● As appropriate, review
all other significant
adverse reactions and
interactions, especially
those related to the
drugs, tests, foods,
herbs, and behaviors
mentioned above.
9. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
famotidine
Brand Name:
Pepcid
CLASSIFICA-
TION:
Pharmacologic
class:
Histamine2-
receptor
antagonist
Therapeutic
class: Antiulcer
drug
Pregnancy risk
category B
Blocks action of
histamine at
histamine2-
receptor sites in
gastric parietal
cells, inhibiting
gastric acid
secretion
and stabilizing
pepsin
➣Active duodenal
ulcers and benign
gastric ulcers
➣Prophylaxis of
duodenal ulcers
➣Gastroesophage
al reflux disease
➣Gastric
hypersecretory
conditions (such
as Zollinger-
Ellison syndrome)
➣Hospitalized
patients with
pathologic
hypersecretory
conditions or
ulcers; patients
who can’t take
oral drugs
➣Prevention or
treatment of
heartburn, acid
indigestion, and
sour stomach
(Pepcid AC only)
● Hypersensitivity to
drug or other
histamine2-
receptor antagonists
Use cautiously in:
● renal impairment
with prolonged
QT interval and
seizures (very rare)
● elderly patients
● pregnant or
breastfeeding
patients.
• CNS: dizziness,
headache,
paresthesia,
asthenia,
fatigue,
insomnia,
somnolence,
psychic
disturbances
• CV: palpitations,
arrhythmias,
AV block
• GI: nausea,
vomiting,
diarrhea,
constipation,
dry mouth,
anorexia,
cholestatic
jaundice,
abdominal pain
• GU: decreased
libido
• Hematologic:
agranulocytosi
s,
pancytopenia,
leukopenia,
Availability
Gelcaps: 10 mg
Oral suspension: 40 mg/5
ml
Solution for injection: 10
mg/ml, 20 mg/50 ml of
normal saline solution
Tablets: 10 mg, 20 mg, 40
mg
Tablets (chewable): 10 mg
Tablets (orally
disintegrating): 20 mg,
40 mg
Dosages
➣Active duodenal ulcers
and benign gastric ulcers
Adults: 40 mg P.O. once
daily at bedtime or 20 mg
P.O. b.i.d. for up to 8
weeks
➣Prophylaxis of duodenal
ulcers
Adults: 20 mg P.O. once
daily at bedtime
➣Gastroesophageal reflux
Patient monitoring
● Assess patient for GI
signs and symptoms.
● Monitor blood urea
nitrogen and creatinine
levels in patients with
renal impairment.
✓ Monitor patient for
prolonged QT interval
and seizures, which
have been reported
very rarely in patients
with impaired renal
function whose
famotidine dosage or
dosing interval may not
have been adjusted
appropriately. Also
monitor patient for
arrhythmia and AV
block.
✓ Monitor patient for
signs and symptoms of
epidermal necrolysis,
Stevens-Johnson
syndrome, and
hematologic or
respiratory changes.
10. thrombocytop
enia (rare)
• Hepatic: liver
enzyme
abnormalities,
• hepatitis
• EENT: orbital
edema,
conjunctival
• redness, tinnitus
• Musculoskelet
al:
musculoskeletal
pain,muscle
cramps,
arthralgia
• Respiratory:
bronchospasm
, interstitial
pneumonia
• Skin: flushing,
acne, dry skin,
rash, urticaria,
alopecia,
pruritus;
epidermal
necrolysis and
Stevens-
Johnson
syndrome
(very rare)
• Other: altered
taste, fever,
pain at injection
disease
Adults: 20 mg P.O. b.i.d.
for up to 6 weeks.
Maximum dosage is 40 mg
b.i.d. for up to 12 weeks.
Children ages 1 to 16: 1
mg/kg P.O. daily in two
divided doses, to a
maximum of 40 mg b.i.d.
Infants ages 3 months
to 1 year: 0.5 mg/kg P.O.
b.i.d. for up to 8 weeks
Infants younger than
age 3 months: 0.5 mg/kg
P.O. once daily for up to 8
Weeks
➣Gastric hypersecretory
conditions (such as
Zollinger-Ellison
syndrome)
Adults: Initially, 20 mg
P.O. q 6 hours, increased
as needed to 160 mg q 6
Hours
➣Hospitalized patients
with pathologic
hypersecretory conditions
or ulcers; patients who
can’t take oral drugs
Adults: 20 mg I.V. q 12
hours
Patient teaching
● Tell patient that drug
is most effective when
taken at bedtime.
● Inform patient that
pain relief may not
begin until several days
after therapy starts.
✓ Instruct patient to
take drug exactly as
prescribed and to
immediately report
cardiovascular signs and
symptoms, seizures,
and hematologic or
respiratory changes.
● Tell female patient to
inform prescriber if she
is pregnant of
breastfeeding.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
tests mentioned above.
11. site, hyper
sensitivity
reactions
including
anaphylaxis
and
angioedema
➣Prevention or treatment
of heartburn, acid
indigestion, and sour
stomach (Pepcid AC only)
Adults: For prevention, 10
mg P.O. 1 hour before
eating, or 10-mg chewable
tablet 15 minutes before
eating, to a maximum of
20 mg/24 hours for up to
2 weeks. For symptomatic
treatment, 10 mg P.O.
once or twice daily.
Dosage adjustment
● Renal impairment
12. An antiflatulent (or deflatulent) agent is a drug used for the
alleviation or prevention of excessive intestinal gas, i.e.,
flatulence.
13. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
simethicone
Brand Name:
GasAid
CLASSIFICA-
TION:
Pharmacologic
class:
Methylated
linear siloxane
mixture
Therapeutic
class:
Antiflatulent,
antifoam agent
Pregnancy risk
category NR
Causes gas
bubbles to
coalesce and
allows gas to
pass through GI
tract via
belching or
passing of
flatus. Silicone
antifoam
spreads on
surface of
aqueous liquids,
forming a film
of low surface
tension that
causes foam
bubbles to
collapse.
➣Excess gas in
GI tract after
surgery or from
air swallowing,
dyspepsia, peptic
ulcer, or
diverticulitis
● Hypersensitivity to
drug
● Intestinal
perforation or
obstruction
Use cautiously in:
● abdominal pain of
unknown cause
(especially when
accompanied by
fever).
None significant Availability
Capsules: 95 mg, 125 mg
Capsules (liquid-filled): 125
mg, 166 mg
Drops: 40 mg/0.6 ml, 40 mg/1
ml, 95 mg/1.425 ml
Suspension: 40 mg/0.6 ml, 50
mg/5 ml
Tablets: 60 mg, 62.5 mg, 80
mg, 95 mg
Tablets (chewable): 40 mg, 80
mg, 125 mg, 150 mg, 166 mg
Dosages
➣Excess gas in GI tract after
surgery or from air swallowing,
dyspepsia, peptic ulcer, or
diverticulitis
Adults and children older
than age 12:
40 to 125 mg P.O. q.i.d. after
meals and at bedtime, up to
500mg/day
Children ages 2 to 12: 40
mg P.O. q.i.d., up to 240
mg/day
Children younger than age
2: 20 mg P.O. q.i.d.
Patient
monitoring
● Monitor GI status
to assess drug
efficacy.
Patient teaching
● Tell patient to
take after meals
and at bedtime as
needed.
● Caution patient
not to take dose
higher than
indicated on
package unless
prescriber approves.
14. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
activated
charcoal
Brand Name:
Actidose
CLASSIFICA-
TION:
Pharmacologic
class: Carbon
residue
Therapeutic
class:
Antiflatulent,
Antidote
Pregnancy risk
category C
Binds to
poisons, toxins,
irritants, and
drugs, forming
a barrier
between
particulate
material and GI
mucosa that
inhibits
absorption of
this material in
GI tract. As an
antiflatulent,
reduces
intestinal gas
volume and
relieves
related
discomfort.
➣Poisoning
➣Flatulence
None
Use cautiously in:
● patients who have
aspirated corrosives
or hydrocarbons and
are vomiting.
• GI: nausea,
vomiting,
diarrhea,
constipation,
black stools,
intestinal
obstruction
Availability
Capsules: 260 mg
Granules: 15 g/120 ml
Liquid: 15 g/120 ml, 50
g/240 ml, 208 mg/1 ml
Oral suspension: 12.5 g/60
ml, 15 g/75 ml, 25 g/120 ml,
30 g/120 ml, 50 g/240 ml
Powder: 15, 30, 40, 130, 240
g/container
Dosages
➣Poisoning
Adults: 25 to 100 g P.O. (or
1 g/kg, or about 10 times the
amount of poison ingested)
as a suspension in 120 to
240 ml (4 to 8 oz) of water
Children: Initially, 1 to 2
g/kg P.O. (or 10 times the
amount of poison ingested)
as a suspension in 120 to
240 ml (4 to 8 oz) of water
➣Flatulence
Adults: 600 mg to 5 g P.O.
as a single dose, or 975 mg
to 3.9 g in divided doses
Patient monitoring
● Monitor patient for
constipation.
● If patient vomits
soon after receiving
dose, ask prescriber if
dose should be
repeated.
Patient teaching
● Instruct patient to
drink six to eight
glasses of fluid daily
to prevent
constipation.
● Tell patient that
stools will be black as
charcoal is excreted
from body.
● As appropriate,
review all other
significant
and life-threatening
adverse reactions and
interactions,
especially
those related to the
drugs and foods
mentioned above.
15. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
lansoprazole
Brand Name:
Prevacid
CLASSIFICA-
TION:
Pharmacologic
class: Gastric
acid pump
inhibitor
Therapeutic
class: Antiulcer
drug
Pregnancy risk
category B
Inhibits activity
of proton pump
in gastric
parietal cells,
decreasing
gastric acid
production
➣Active duodenal
ulcer
➣Maintenance of
healed duodenal
ulcer
➣H. pylori
eradication, to
reduce risk of
duodenal ulcer
recurrence
➣Benign gastric
ulcer
➣Gastric ulcer
associated with
NSAIDs
➣To reduce risk
of NSAID-
associated gastric
ulcer
➣Gastroesophage
al reflux disease
➣Erosive
esophagitis
➣To maintain
healing of erosive
esophagitis
➣Pathologic
hypersecretory
● Hypersensitivity to
drug or its
components
Use cautiously in:
● phenylketonuria
(orally disintegrating
tablets), severe
hepatic impairment
● elderly patients
● pregnant or
breastfeeding
patients
● children younger
than age 18.
• CNS: headache,
confusion,
anxiety,
malaise,
paresthesia,
abnormal
thinking,
depression,
dizziness,
syncope,
cerebrovascul
ar accident
• CV: chest pain,
hypertension,
hypotension,
myocardial
infarction,
shock
• EENT: visual
field deficits,
otitis media,
tinnitus,
epistaxis
• GI: nausea,
diarrhea,
abdominal pain,
cholelithiasis,
ulcerative colitis,
esophageal
Dosages
➣Active duodenal ulcer
Adults: 15 mg P.O. daily
for 4 weeks
➣Maintenance of healed
duodenal ulcer
Adults: 15 mg P.O. daily
➣H. pylori eradication, to
reduce risk of duodenal
ulcer recurrence
Adults: In triple therapy,
30 mg lansoprazole
P.O., 1 g amoxicillin P.O.,
and 500 mg
clarithromycin P.O. q 12
hours for 10 or 14 days.
In dual therapy, 30 mg
lansoprazole P.O. and 1 g
amoxicillin P.O. q 8 hours
for 14 days.
➣Benign gastric ulcer
Adults: 30 mg P.O. daily
for up to 8 weeks
➣Gastric ulcer associated
with NSAIDs
Patient monitoring
● Monitor for GI adverse
reactions.
● Assess nutritional
status and fluid balance
to identify significant
problems.
Patient teaching
● Instruct patient to
take before meals.
● If patient has difficulty
swallowing, tell him to
open delayed-release
capsule and sprinkle
contents onto small
amount of soft food
(such as applesauce
or pudding). Emphasize
that he must not crush
or chew drug.
● Tell patient to take
orally disintegrating
tablet by placing it on
tongue and letting it
disintegrate.
● Instruct patient to
take oral suspension
by emptying packet
16. conditions
(including
Zollinger-Ellison
syndrome)
➣Frequent
heartburn (two or
more times a
week)
ulcer,
hematemesis,
stomatitis,
dysphagia, GI
hemorrhage
• GU: renal
calculi, erectile
dysfunction,
Abnormal
menses, breast
tenderness,
gynecomastia
• Hematologic:
anemia
• Musculoskelet
al: hip, wrist,
spine fractures
(with long-term
daily use)
• Respiratory:
cough,
bronchitis,
asthma
• Skin: urticaria,
alopecia, acne,
pruritus,
photosensitivity
Adults: 30 mg P.O. once
daily for up to 8 weeks
➣To reduce risk of
NSAID-associated gastric
ulcer
Adults: 15 mg P.O. daily
for up to12 weeks
➣Gastroesophageal reflux
disease
Adults and children
ages 12 to 17:
15 mg P.O. daily for up to
8 weeks
Children ages 1 to 11
weighing more
than 30 kg (66 lb): 30
mg P.O. daily for up to 12
weeks
Children ages 1 to 11
weighing 30 kg
(66 lb) or less: 15 mg
P.O. daily for up to 12
weeks
➣Erosive esophagitis
Adults and children
ages 12 to 17: 30 mg
P.O. daily for up to 8
weeks. Some patients
may require 8 additional
weeks.
Children ages 1 to 11
contents into container
with 2 tbsp water. Tell
him to stir contents well
and drink immediately.
● Advise patient to
minimize GI upset by
eating small, frequent
servings of food and
drinking plenty of fluids.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs, foods, and herbs
mentioned above.
17. weighing more than 30
kg (66 lb): 30 mg P.O.
daily for up to 12 weeks
Children ages 1 to 11
weighing 30 kg
(66 lb) or less: 15 mg
P.O. daily for up to 12
weeks
➣To maintain healing of
erosive esophagitis
Adults: 15 mg P.O. daily
➣Pathologic
hypersecretory conditions
(including Zollinger-Ellison
syndrome)
Adults: Initially, 60 mg
P.O. daily, to a maximum
of 90 mg P.O. b.i.d.
Divide daily dosages over
120 mg.
➣Frequent heartburn (two
or more times a week)
Adults: 15 mg P.O.
(delayed-release
capsule) daily up to 14
days
Dosage adjustment
● Significant hepatic
insufficiency
18. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
bismuth
subsalicylate
Brand Name:
Pepto-Bismol
CLASSIFICA-
TION:
Pharmacologic
class:
Adsorbent
Therapeutic
class:
Antidiarrheal,
antibiotic,
antiulcer drug
Pregnancy risk
category C
Promotes
intestinal
adsorption of
fluids and
electrolytes and
decreases
synthesis of
intestinal
prostaglandins.
Adsorbent
action removes
irritants from
stomach and
soothes irritated
bowel lining.
Also shows
antibacterial
activity to
eradicate
Helicobacter
pylori.
➣Adjunctive
therapy for mild
to moderate
diarrhea, nausea,
abdominal
cramping,
heartburn, and
indigestion
accompanying
diarrheal illnesses
➣Ulcer disease
caused by H.
pylori
● Hypersensitivity to
aspirin
● Elderly patients
with fecal impaction
● Children or
adolescents during or
after recovery from
chickenpox or flulike
illness
Use cautiously in:
● diabetes mellitus,
gout
● patients taking
concurrent aspirin
● elderly patients
● pregnant or
breastfeeding
patients
● infants.
• EENT: tinnitus,
tongue
discoloration
• GI: nausea,
vomiting,
diarrhea,
constipation,
gray-black
stools, fecal
impaction
• Respiratory:
tachypnea
• Other:
salicylate
toxicity
Availability
Liquid: 130 mg/15 ml, 262
mg/15 ml, 525 mg/15 ml
(maximum strength)
Tablets: 262 mg
Tablets (chewable): 262
mg, 300 mg
Dosages
➣Adjunctive therapy for
mild to moderate diarrhea,
nausea, abdominal
cramping, heartburn, and
indigestion accompanying
diarrheal illnesses
Adults: Two tablets or 30
ml P.O.(15 ml of maximum
strength) q 30 minutes, or
two tablets or 60 ml
(30 ml of extra/maximum
strength) q 60 minutes as
needed. Don’t exceed
4.2 g in 24 hours.
Children ages 9 to 12:
One tablet or 15 ml P.O.
(7.5 ml of maximum
strength) q 30 to 60
minutes. Don’t exceed
2.1 g in 24 hours.
Patient monitoring
● Monitor fluid intake
and electrolyte levels.
● Monitor stool
frequency and
appearance.
● Assess infants and
debilitated patients for
fecal impaction.
Patient teaching
● Instruct patient to
chew tablets or dissolve
them in mouth before
swallowing.
● Inform patient that
drug may turn stools
gray-black temporarily.
● Tell patient to notify
prescriber if he has
diarrhea with fever for
more than 48 hours.
● As appropriate, review
all other significant
adverse reactions and
interactions, especially
those related to the
drugs and tests
mentioned above.
19. Children ages 6 to 9: 10
ml (5 ml of maximum
strength) P.O. q 30 to 60
minutes. Don’t exceed
1.4 g in 24 hours.
Children ages 3 to 6: 5
ml (2.5 ml of maximum
strength) P.O. q 30 to 60
minutes. Don’t exceed
704 mg in 24 hours.
➣Ulcer disease caused by
H. pylori
Adults: Two tablets or 30
ml P.O. q.i.d.
(15 ml of maximum
strength)
20. H₂ antagonists, sometimes referred to as H2RAs and also
called H₂ blockers, are a class of medications that block the
action of histamine at the histamine H₂ receptors of the parietal
cells in the stomach. This decreases the production of stomach
acid.
21. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
famotidine
Brand Name:
Pepcid
CLASSIFICA-
TION:
Pharmacologic
class:
Histamine2-
receptor
antagonist
Therapeutic
class: Antiulcer
drug
Pregnancy risk
category B
Blocks action of
histamine at
histamine2-
receptor sites in
gastric parietal
cells, inhibiting
gastric acid
secretion
and stabilizing
pepsin
➣Active duodenal
ulcers and benign
gastric ulcers
➣Prophylaxis of
duodenal ulcers
➣Gastroesophage
al reflux disease
➣Gastric
hypersecretory
conditions (such
as Zollinger-
Ellison syndrome)
➣Hospitalized
patients with
pathologic
hypersecretory
conditions or
ulcers; patients
who can’t take
oral drugs
➣Prevention or
treatment of
heartburn, acid
indigestion, and
sour stomach
(Pepcid AC only)
● Hypersensitivity to
drug or other
histamine2-
receptor antagonists
Use cautiously in:
● renal impairment
with prolonged
QT interval and
seizures (very rare)
● elderly patients
● pregnant or
breastfeeding
patients.
• CNS: dizziness,
headache,
paresthesia,
asthenia,
fatigue,
insomnia,
somnolence,
psychic
disturbances
• CV: palpitations,
arrhythmias,
AV block
• GI: nausea,
vomiting,
diarrhea,
constipation,
dry mouth,
anorexia,
cholestatic
jaundice,
abdominal pain
• GU: decreased
libido
• Hematologic:
agranulocytosi
s,
pancytopenia,
leukopenia,
Availability
Gelcaps: 10 mg
Oral suspension: 40 mg/5
ml
Solution for injection: 10
mg/ml, 20 mg/50 ml of
normal saline solution
Tablets: 10 mg, 20 mg, 40
mg
Tablets (chewable): 10 mg
Tablets (orally
disintegrating): 20 mg,
40 mg
Dosages
➣Active duodenal ulcers
and benign gastric ulcers
Adults: 40 mg P.O. once
daily at bedtime or 20 mg
P.O. b.i.d. for up to 8
weeks
➣Prophylaxis of duodenal
ulcers
Adults: 20 mg P.O. once
daily at bedtime
➣Gastroesophageal reflux
Patient monitoring
● Assess patient for GI
signs and symptoms.
● Monitor blood urea
nitrogen and creatinine
levels in patients with
renal impairment.
✓ Monitor patient for
prolonged QT interval
and seizures, which
have been reported
very rarely in patients
with impaired renal
function whose
famotidine dosage or
dosing interval may not
have been adjusted
appropriately. Also
monitor patient for
arrhythmia and AV
block.
✓ Monitor patient for
signs and symptoms of
epidermal necrolysis,
Stevens-Johnson
syndrome, and
hematologic or
22. thrombocytop
enia (rare)
• Hepatic: liver
enzyme
abnormalities,
• hepatitis
• EENT: orbital
edema,
conjunctival
• redness, tinnitus
• Musculoskelet
al:
musculoskeletal
pain,muscle
cramps,
arthralgia
• Respiratory:
bronchospasm
, interstitial
pneumonia
• Skin: flushing,
acne, dry skin,
rash, urticaria,
alopecia,
pruritus;
epidermal
necrolysis and
Stevens-
Johnson
syndrome
(very rare)
• Other: altered
taste, fever,
pain at injection
disease
Adults: 20 mg P.O. b.i.d.
for up to 6 weeks.
Maximum dosage is 40 mg
b.i.d. for up to 12 weeks.
Children ages 1 to 16: 1
mg/kg P.O. daily in two
divided doses, to a
maximum of 40 mg b.i.d.
Infants ages 3 months
to 1 year: 0.5 mg/kg P.O.
b.i.d. for up to 8 weeks
Infants younger than
age 3 months: 0.5 mg/kg
P.O. once daily for up to 8
Weeks
➣Gastric hypersecretory
conditions (such as
Zollinger-Ellison
syndrome)
Adults: Initially, 20 mg
P.O. q 6 hours, increased
as needed to 160 mg q 6
Hours
➣Hospitalized patients
with pathologic
hypersecretory conditions
or ulcers; patients who
can’t take oral drugs
Adults: 20 mg I.V. q 12
hours
respiratory changes.
Patient teaching
● Tell patient that drug
is most effective when
taken at bedtime.
● Inform patient that
pain relief may not
begin until several days
after therapy starts.
✓ Instruct patient to
take drug exactly as
prescribed and to
immediately report
cardiovascular signs and
symptoms, seizures,
and hematologic or
respiratory changes.
● Tell female patient to
inform prescriber if she
is pregnant of
breastfeeding.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
tests mentioned above.
23. site, hyper
sensitivity
reactions
including
anaphylaxis
and
angioedema
➣Prevention or treatment
of heartburn, acid
indigestion, and sour
stomach (Pepcid AC only)
Adults: For prevention, 10
mg P.O. 1 hour before
eating, or 10-mg chewable
tablet 15 minutes before
eating, to a maximum of
20 mg/24 hours for up to
2 weeks. For symptomatic
treatment, 10 mg P.O.
once or twice daily.
Dosage adjustment
● Renal impairment
24. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
cimetidine
Brand Name:
Tagamet HB
CLASSIFICA-
TION:
Pharmacologic
class:
Histamine2-
receptor
antagonist
Therapeutic
class: Antiulcer
drug
Pregnancy risk
category B
Competitively
inhibits
histamine
action at
histamine2-
receptor sites of
gastric parietal
cells, thereby
inhibiting
gastric acid
secretion
➣Active duodenal
ulcer (short-term
therapy)
➣Active benign
gastric ulcer
(shortterm
therapy)
➣Gastric
hypersecretory
conditions (such
as Zollinger-
Ellison syndrome)
intractable ulcers
➣Heartburn; acid
indigestion
➣Erosive
gastroesophageal
reflux
disease
● Hypersensitivity to
drug
● Alcohol intolerance
Use cautiously in:
● renal impairment
● elderly patients
● pregnant or
breastfeeding
patients.
• CNS: confusion,
dizziness,
drowsiness,
hallucinations,
agitation,
psychosis,
depression,
anxiety,
headache
• GI: diarrhea
• GU: reversible
erectile
dysfunction,
gynecomastia
Availability
Oral liquid: 200 mg/5 ml,
300 mg/5 ml
Tablets: 200 mg, 300 mg,
400 mg, 600 mg, 800 mg
Dosages
➣Active duodenal ulcer
(short-term therapy)
Adults and children
older than age 16:
800 mg P.O. at bedtime,
or 300 mg P.O. q.i.d. with
meals and at bedtime, or
400 mg P.O. b.i.d.
Maintenance dosage is 400
mg P.O. at bedtime.
➣Active benign gastric
ulcer (shortterm therapy)
Adults and children
older than age 16:
800 mg P.O. at bedtime or
300 mg P.O. q.i.d. with
meals and at bedtime
➣Gastric hypersecretory
conditions (such as
Patient monitoring
● Monitor creatinine
levels in patients with
renal insufficiency or
failure.
● Assess elderly or
chronically ill patients
for confusion (which
usually resolves once
drug therapy ends).
Patient teaching
● Inform patient with
gastric ulcer that ulcer
may take up to 2
months to heal. Advise
him not to discontinue
therapy, even if he feels
better, without first
consulting prescriber.
Ulcer may recur if
therapy ends too soon.
● Advise patient not to
take over-thecounter
cimetidine for more
than 2 weeks
continuously, except
with prescriber’s advice
25. Zollinger-Ellison
syndrome)
intractable ulcers
Adults and children
older than age 16:
300 mg P.O. q.i.d. with
meals and at bedtime
➣Erosive
gastroesophageal reflux
disease
Adults and children
older than age 16:
1,600 mg P.O. daily in
divided doses (800 mg
b.i.d. or 400 mg q.i.d.) for
12 weeks
➣Heartburn; acid
indigestion
Adults and children
older than age 16:
200 mg (two tablets of
over-thecounter product
only) P.O. up to b.i.d.
Give maximum dosage no
longer than 2 weeks
continuously, unless
directed by prescriber.
Dosage adjustment
● Renal impairment
and supervision.
● As appropriate, review
all other significant
adverse reactions and
interactions, especially
those related to the
drugs, tests, foods,
herbs, and behaviors
mentioned above.
26. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
ranitidine
hydrochloride
Brand Name:
Zantac
CLASSIFICA-
TION:
Pharmacologic
class:
Histamine2-
receptor
antagonist
Therapeutic
class: Antiulcer
drug
Pregnancy risk
category B
Reduces gastric
acid secretion
and
increases gastric
mucus and
bicarbonate
production,
creating a
protective
coating
on gastric
mucosa
➣Active duodenal
ulcer
➣To maintain
healing of
duodenal ulcers
➣Benign gastric
ulcer
➣Active duodenal
and gastric ulcers
➣To maintain
healing of
duodenal and
gastric ulcers
➣Erosive
esophagitis
➣Gastroesophage
al reflux disease
➣Pathologic
hypersecretory
conditions,
including
Zollinger-Ellison
syndrome
➣Hospitalized
patients with
pathologic
hypersecretory
conditions,
● Hypersensitivity to
drug or its
components
● Alcohol intolerance
(with some oral
products)
● History of acute
porphyria
Use cautiously in:
● renal or hepatic
impairment, heart
rhythm disturbances,
phenylketonuria
(effervescent tablets)
● elderly patients
● pregnant or
breastfeeding
patients.
• CNS: headache,
agitation,
anxiety
• GI: nausea,
vomiting,
diarrhea,
constipation,
abdominal
discomfort or
pain
• Hematologic:
reversible
granulocytope
nia and
thrombocytop
enia
• Hepatic:
hepatitis
• Skin: rash
• Other: pain at
I.M. injection
site, burning or
itching at I.V.
site,
hypersensitivity
reaction
Availability
Capsules (liquid-filled): 150
mg, 300 mg
Solution for injection: 25
mg/ml in 2-, 6-, and 40-ml
vials
Solution for injection (pre-
mixed): 50 mg/50 ml in
0.45% sodium chloride
Syrup: 15 mg/ml
Tablets: 150 mg, 300 mg
Tablets (effervescent): 150
mg
Dosages
➣Active duodenal ulcer
Adults: 150 mg or 10 ml
P.O. b.i.d., or 300 mg or 20
ml P.O. daily, or 50 mg
I.V. or I.M. q 6 to 8 hours
➣To maintain healing of
duodenal ulcers
Adults: 150 mg or 10 ml
P.O.
➣Benign gastric ulcer
Adults: 150 mg or 10 ml
Patient monitoring
● Assess vital signs.
● Monitor CBC and
liver function tests.
Patient teaching
● Tell patient he may
take oral drug with or
without food. Advise
him to take once-
daily prescription
drug at bedtime.
● Instruct patient to
dissolve EFFERdose
in 6 to 8 oz of water
before taking.
● Caution patient to
avoid driving and
other hazardous
activities until he
knows how drug
affects concentration
and alertness.
● Tell patient smoking
may decrease drug
effects.
● As appropriate,
review all other
27. including
Zollinger-Ellison
syndrome;
intractable
duodenal ulcers;
patients
who can’t
receive oral drugs
P.O. b.i.d. For maintenance,
150 mg or 10 ml P.O. or 50
mg I.V. or I.M. q 6 to 8
hours.
➣Active duodenal and gastric
ulcers
Children ages 1 month to
16 years: 2 to 4 mg/kg/day
P.O., up to a maximum of
300 mg/day
➣To maintain healing of
duodenal and gastric ulcers
Children ages 1 month to
16 years: 2 to 4 mg/kg/day
P.O., up to a maximum of
150 mg/day
➣Erosive esophagitis
Adults: 150 mg or 10 ml
P.O. q.i.d.
Children ages 1 month to
16 years: 5 to 10 mg/kg
P.O. daily in two divided
doses
➣Gastroesophageal reflux
disease
Adults: 150 mg or 10 ml
P.O. b.i.d.
Children ages 1 month to
16 years: 5 to10 mg/kg P.O.
daily in two divided doses
significant and life-
threatening adverse
reactions and
interactions,
especially
those related to the
drugs, tests, herbs,
and behaviors
mentioned above.
28. ➣Pathologic hypersecretory
conditions, including
Zollinger-Ellison syndrome
Adults: 150 mg or 10 ml
P.O. b.i.d., adjusted
according to patient’s
needs. In severe cases, up to
6 g/day may be needed.
Continue therapy as long as
indicated.
➣Hospitalized patients with
pathologic
hypersecretory conditions,
including Zollinger-Ellison
syndrome; intractable
duodenal ulcers; patients
who can’t receive oral drugs
Adults: 50 mg I.M. q 6 to 8
hours, or 50 mg intermittent
I.V. bolus q 6 to 8 hours, or
50 mg intermittent I.V.
infusion q 6 to 8 hours.
Children ages 1 month to
16 years: 2 to 4 mg/kg/day
I.V. in divided doses q 6 to 8
hours, up to a maximum of
50 mg q 6 to 8 hours
Dosage adjustment
● Renal or hepatic
impairment
● Debilitated patients
29. Proton-pump inhibitors are members of a class of medications
whose main action is a profound and prolonged reduction of
stomach acid production. Within the class of medications, there is
no clear evidence that one agent works better than another. They
are the most potent inhibitors of acid secretion available.
30. DRUG DATA MECHANISM
OF ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
lansoprazole
Brand Name:
Prevacid
CLASSIFICA-
TION:
Pharmacologi
c class:
Gastric acid
pump inhibitor
Therapeutic
class:
Antiulcer drug
Pregnancy risk
category B
Inhibits
activity of
proton pump
in gastric
parietal cells,
decreasing
gastric acid
production
➣Active
duodenal ulcer
➣Maintenance
of healed
duodenal
ulcer
➣H. pylori
eradication, to
reduce risk
of duodenal
ulcer
recurrence
➣Benign
gastric ulcer
➣Gastric ulcer
associated with
NSAIDs
➣To reduce
risk of NSAID-
associated
gastric ulcer
➣Gastroesopha
geal reflux
disease
➣Erosive
esophagitis
➣To maintain
healing of
● Hypersensitivity to
drug or its
components
Use cautiously in:
● phenylketonuria
(orally disintegrating
tablets), severe
hepatic impairment
● elderly patients
● pregnant or
breastfeeding patients
● children younger
than age 18.
• CNS: headache,
confusion,
anxiety,
malaise,
paresthesia,
abnormal
thinking,
depression,
dizziness,
syncope,
cerebrovascul
ar accident
• CV: chest pain,
hypertension,
hypotension,
myocardial
infarction,
shock
• EENT: visual
field deficits,
otitis media,
tinnitus,
epistaxis
• GI: nausea,
diarrhea,
abdominal pain,
cholelithiasis,
ulcerative colitis,
Availability
Capsules (delayed-release): 15
mg, 30 mg
Granules for oral suspension
(delayedrelease,
enteric-coated): 15 mg, 30 mg
Prevpac (combination product
for Helicobacter
pylori infection): daily pack
containing two 30-mg
lansoprazole capsules, four
500-mg amoxicillin capsules,
and two 500-mg clarithromycin
tablets
Prevacid NapraPAC 375
(combination product for
reducing risk of ulcers from
nonsteroidal anti-inflammatory
drugs
[NSAIDs]): weekly pack
containing seven 15-mg
Prevacid capsules and
fourteen 375-mg Naprosyn
tablets
Prevacid NapraPAC 500
(combination product for
reducing risk of ulcers from
NSAIDs): weekly pack
Patient monitoring
● Monitor for GI
adverse reactions.
● Assess nutritional
status and fluid
balance to identify
significant problems.
Patient teaching
● Instruct patient to
take before meals.
● If patient has
difficulty swallowing,
tell him to open
delayed-release
capsule and sprinkle
contents onto small
amount of soft food
(such as applesauce
or pudding).
Emphasize that he
must not crush or
chew drug.
● Tell patient to take
orally disintegrating
tablet by placing it on
tongue and letting it
disintegrate.
31. erosive
➣Frequent
heartburn (two
or more
times a week)
esophagitis
➣Pathologic
hypersecretory
conditions
(including
Zollinger-Ellison
syndrome)
esophageal
ulcer,
hematemesis,
stomatitis,
dysphagia, GI
hemorrhage
• GU: renal
calculi, erectile
dysfunction,
abnormal
menses, breast
tenderness,
gynecomastia
• Hematologic:
anemia
• Musculoskelet
al: hip, wrist,
spine fractures
(with long-term
daily use)
• Respiratory:
cough,
bronchitis,
asthma
• Skin: urticaria,
alopecia, acne,
pruritus,
photosensitivity
containing seven 15-mg
Prevacid capsules and
fourteen 500-mg Naprosyn
tablets
Prevacid SoluTab (delayed-
release,
orally disintegrating tablet): 15
mg, 30 mg
Dosages
➣Active duodenal ulcer
Adults: 15 mg P.O. daily for 4
weeks
➣Maintenance of healed
duodenal ulcer
Adults: 15 mg P.O. daily
➣H. pylori eradication, to
reduce risk of duodenal ulcer
recurrence
Adults: In triple therapy, 30
mg lansoprazole P.O., 1 g
amoxicillin P.O., and 500 mg
clarithromycin P.O. q 12 hours
for 10 or 14 days. In dual
therapy, 30 mg lansoprazole
P.O. and 1 g amoxicillin P.O. q
8 hours for 14 days.
➣Benign gastric ulcer
Adults: 30 mg P.O. daily for up
to 8 weeks
● Instruct patient to
take oral suspension
by emptying packet
contents into
container with 2 tbsp
water. Tell him
to stir contents well
and drink
immediately.
● Advise patient to
minimize GI upset
by eating small,
frequent servings of
food and drinking
plenty of fluids.
● As appropriate,
review all other
significant and life-
threatening adverse
reactions and
interactions,
especially
those related to the
drugs, foods, and
herbs mentioned
above.
32. ➣Gastric ulcer associated with
NSAIDs
Adults: 30 mg P.O. once daily
for up to 8 weeks
➣To reduce risk of NSAID-
associated gastric ulcer
Adults: 15 mg P.O. daily for up
to 12 weeks
➣Gastroesophageal reflux
disease
Adults and children ages 12
to 17: 15 mg P.O. daily for up
to 8 weeks
Children ages 1 to 11
weighing more than 30 kg
(66 lb): 30 mg P.O. daily for
up to 12 weeks
Children ages 1 to 11
weighing 30 kg (66 lb) or
less: 15 mg P.O. daily for up
to 12 weeks
➣Erosive esophagitis
Adults and children ages 12
to 17: 30 mg P.O. daily for up
to 8 weeks. Some patients may
require 8 additional weeks.
Children ages 1 to 11
weighing more than 30 kg
(66 lb): 30 mg P.O. daily for
up to 12 weeks
33. Children ages 1 to 11
weighing 30 kg (66 lb) or
less: 15 mg P.O. daily for up
to 12 weeks
➣To maintain healing of erosive
esophagitis
Adults: 15 mg P.O. daily
➣Pathologic hypersecretory
conditions (including Zollinger-
Ellison syndrome)
Adults: Initially, 60 mg P.O.
daily, to a maximum of 90 mg
P.O. b.i.d. Divide daily dosages
over 120 mg.
➣Frequent heartburn (two or
more times a week)
Adults: 15 mg P.O. (delayed-
release capsule) daily up to 14
days
Dosage adjustment
● Significant hepatic
insufficiency
34. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
omeprazole
magnesium
Brand Name:
Prilosec
CLASSIFICA-
TION:
Pharmacologic
class: Proton
pump inhibitor
Therapeutic
class: Antiulcer
drug
Pregnancy risk
category C
Reduces gastric
acid secretion
and increases
gastric mucus
and bicarbonate
production,
creating
protective
coating on
gastric mucosa
and easing
discomfort from
excess gastric
acid
➣Gastro
esophageal reflux
disease
➣Erosive
esophagitis
➣Short-term
treatment of
active duodenal
ulcer
➣To reduce risk
of duodenal ulcers
caused by
Helicobacter
pylori
➣Gastric ulcers
➣Pathologic
hypersecretory
conditions,
including
Zollinger-Ellison
syndrome
➣Frequent
heartburn (two or
more episodes a
week)
● Hypersensitivity to
drug or its
components
Use cautiously in:
● hepatic disease
● hypomagnesemia
● concurrent use of
clopidogrel (avoid
use)
● pregnant or
breastfeeding
patients
● children (safety not
established).
• CNS: dizziness,
headache,
asthenia
• GI: nausea,
vomiting,
diarrhea,
constipation,
abdominal pain
• Metabolic:
hypomagne
semia
• Musculoskelet
al: back pain;
fractures of hip,
wrist, spine
(with long-term
daily use)
• Respiratory:
cough, upper
respiratory
tract infection
• Skin: rash
Availability
Capsules (delayed-
release): 10 mg, 20 mg,
40 mg
Powder for oral suspension
(delayedrelease):
2.5 mg, 10 mg in packets
Tablets (delayed-release):
20 mg
Dosages
➣Gastroesophageal reflux
disease
Adults: 20 mg P.O.
(capsules, powder) daily
for 4 weeks
➣Erosive esophagitis
Adults: 20 mg P.O.
(capsules, powder)
daily for 4 to 8 weeks
➣Short-term treatment of
active duodenal ulcer
Adults: 20 mg P.O.
(capsules, powder) daily
for 4 weeks. Some
patients may need 4
Patient monitoring
● Assess vital signs.
● Check for abdominal
pain, emesis, diarrhea,
or constipation.
● Evaluate fluid intake
and output.
● Watch for elevated
liver function test
results (rare).
● Monitor magnesium
level before starting
drug and periodically
thereafter in patients
expected to be on long-
term treatment or who
take proton pump
inhibitors with other
drugs such as digoxin or
drugs that may cause
hypomagnesemia.
Patient teaching
● Tell patient to take 30
to 60 minutes before a
meal, preferably in
morning.
● Instruct patient to
35. additional weeks of
therapy.
➣To reduce risk of
duodenal ulcers caused by
Helicobacter pylori
Adults: 40 mg P.O.
(capsules) daily in
morning, given with
clarithromycin t.i.d. for 2
weeks; then 20 mg daily
for 2 weeks
➣Gastric ulcers
Adults: 40 mg P.O.
(capsules) daily for 4 to 8
weeks
➣Pathologic
hypersecretory conditions,
including Zollinger-Ellison
syndrome
Adults: Initially, 60 mg
P.O. (capsules) daily; may
increase up to 120 mg
t.i.d. Divide daily dosages
above 80 mg.
➣Frequent heartburn (two
or more episodes a week)
Adults ages 18 and
older: 20 mg P.O. (OTC
tablets, capsules, or
powder) daily for 14 days
swallow capsules or
tablets whole and not to
chew or crush them. If
he can’t swallow
capsule, tell him he may
open it, carefully
sprinkle and mix entire
contents into 1 tbsp of
cool applesauce, and
swallow immediately
with glass of water.
● Instruct patient on
how to use delayed-
release oral suspension:
Empty contents of a
2.5-mg packet of
powder into a container
with 5 ml of water or
10-mg packet of powder
into a container with 15
ml of water; don’t use
other liquids or foods.
Stir and allow drug to
thicken for 2 to
minutes. Stir well and
drink within 30 minutes.
If any drug remains
after drinking, add more
water to container, stir,
and drink immediately.
● Inform patient taking
OTC delayedrelease
tablets for heartburn
that full effect may take
36. 1 to 4 days. Advise him
not to take tablets for
more than 14 days
without consulting
health care professional.
● Advise patient to
avoid St John’s wort
while taking this drug.
● Caution patient to
avoid driving and other
hazardous activities
until he knows how drug
affects concentration
and alertness.
● As appropriate, review
all other significant
adverse reactions and
interactions, especially
those related to the
drugs and tests
mentioned above.
37. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
esomeprazole
magnesium
Brand Name:
Nexium
CLASSIFICA-
TION:
Pharmacologic
class: Proton
pump inhibitor
Therapeutic
class: Antiulcer
agent
Pregnancy risk
category C
Reduces gastric
acid production
by inhibiting
enzyme activity
in gastric
parietal cells,
preventing
transport of
hydrogen ions
into gastric
lumen
➣Treatment of
gastroesophageal
reflux disease
(GERD); healing
of erosive
esophagitis
➣Treatment of
GERD;
maintenance of
healing of erosive
esophagitis
➣Symptomatic
GERD
➣Helicobacter
pylori eradication
to decrease risk
of duodenal ulcer
recurrence
➣Treatment of
pathological
hypersecretory
conditions
including
Zollinger-Ellison
syndrome
● Hypersensitivity to
proton pump
Inhibitors
Use cautiously in:
● severe hepatic
impairment
● increased risk of
hip, wrist, and spine
fractures
● pregnant or
breastfeeding
patients
● children younger
than age 18 (safety
not established).
• CNS: headache,
dizziness,
asthenia,
vertigo, apathy,
anxiety,
paresthesia,
insomnia,
abnormal
dreams
• EENT: sinusitis,
epistaxis
• GI: nausea,
vomiting,
diarrhea,
constipation,
abdominal pain,
flatulence, dry
mouth
• Metabolic:
hypomagne
semia
• Musculoskelet
al: hip, wrist,
spine fractures
(with long-term
daily use)
• Respiratory:
upper
Availability
Capsules (delayed-
release): 20 mg, 40 mg
Powder for delayed-release
oral suspension: 2.5-mg,
5-mg, 10-mg, 20-mg, 40-
mg packets
Dosages
➣Treatment of
gastroesophageal
reflux disease (GERD);
healing of erosive
esophagitis
Children ages 1 month
to younger than 1 year
weighing 3 kg (6.5 lb)
to 5 kg: 2.5 mg P.O. daily
for up to 6 weeks
Adults: 20 to 40 mg P.O.
once daily for 4 to 8 weeks
Children ages 1 month
to younger than 1 year
weighing more than 7.5
kg to 12 kg (16.5 to 26
lb): 10 mg P.O. daily for
up to 6 weeks
Children ages 1 month
Patient monitoring
● Monitor neurologic
status, especially for
dizziness, headache,
paresthesia, and
asthenia.
● Watch for signs and
symptoms of EENT and
respiratory infections.
● Assess nutritional and
hydration status in light
of adverse GI effects.
● Check for rash and
other signs of
hypersensitivity.
● Monitor liver function
test results if patient is
on long-term therapy.
● Continue to monitor
patients periodically
who are expected to be
on prolonged treatment
or who take proton
pump inhibitors with
drugs such as digoxin or
drugs that may cause
hypomagnesemia.
38. respiratory tract
infection, cough
• Skin: rash,
inflammation,
urticaria,
pruritus,
alopecia, dry
skin
to younger than 1 year
weighing more than 5
kg (11 lb) to 7.5 kg: 5
mg P.O. daily for up to 6
weeks
Children ages 1 to 11
weighing 20 kg (44 lb)
or more: 10 or 20 mg
P.O. daily for 8 weeks
Children ages 1 to 11
weighing less than 20
kg (44 lb): 10 mg P.O.
daily for 8 weeks
➣Treatment of GERD;
maintenance of healing of
erosive esophagitis
Adults: 20 mg P.O. once
daily
➣Symptomatic GERD
Adults: 20 mg P.O. once
daily for 4 weeks
Children ages 12 to 17:
20 or 40 mg P.O. daily for
up to 8 weeks
Children ages 1 to 11:
10 mg P.O. daily for up to
8 weeks
➣Helicobacter pylori
eradication to decrease
risk of duodenal ulcer
recurrence
Patient teaching
● Instruct patient to
take drug 1 hour before
or 2 hours after a meal.
● If patient has trouble
swallowing capsule, tell
him to open it, sprinkle
pellets into soft food
(such as applesauce),
and take right away.
● Instruct patient to
recognize and report
signs or symptoms of
hypomagnesemia.
● Caution patient to
avoid driving and other
hazardous activities
until he knows how drug
affects concentration
and alertness.
● Advise female patient
to tell prescriber if she’s
pregnant of
breastfeeding.
● As appropriate, review
all other significant
adverse reactions and
interactions, especially
those related to the
drugs and tests
mentioned above.
39. Adults: 40 mg P.O. once
daily for 10 days, given in
combination with
amoxicillin 1,000 mg b.i.d.
for 10 days and with
clarithromycin 500 mg
b.i.d. for 10 days
➣Treatment of
pathological
hypersecretory conditions
including Zollinger-Ellison
syndrome
Adults: 40 mg P.O. b.i.d.
➣Risk reduction of NSAID-
associated gastric ulcer
Adults: 20 or 40 mg P.O.
once daily for up to 6
months
40. Antidiarrheals are the name given to certain types of medicines
that stop or slow diarrhea. Antidiarrheals only relieve the
symptoms of diarrhea, such as an increased frequency and
urgency when passing stools, they do not eliminate the cause of
it.
41. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
loperamide
hydrochloride
Brand Name:
Imodium
CLASSIFICA-
TION:
Pharmacologic
class: Piperidine
derivative
Therapeutic
class:
Antidiarrheal
Pregnancy risk
category B
Inhibits
peristalsis of
intestinal wall
musculature
and intestinal
contents.
Also reduces
fecal volume,
increases
fecal bulk, and
minimizes fluid
and electrolyte
loss.
➣Acute diarrhea
➣Acute diarrhea
(treated with
overthe-counter
loperamide)
➣Chronic
diarrhea
● Hypersensitivity to
drug
● Abdominal pain of
unknown cause
(especially with
fever)
● Acute diarrhea
caused by
enteroinvasive
Escherichia coli,
Salmonella, or
Shigella
● Acute ulcerative
colitis
● Bloody diarrhea
with temperature
above 38.3 °C (101
°F) (with OTC
product)
● Pseudo
membranous colitis
associated with
broad-spectrum
antiinfectives
● Children younger
than age 6
Use cautiously in:
• CNS:
drowsiness,
dizziness
• GI: nausea;
vomiting;
constipation;
abdominal pain,
distention, or
discomfort; dry
mouth; toxic
megacolon (in
patients with
acute
ulcerative
colitis)
• Other: allergic
reactions
Availability
Capsules: 2 mg
Solution: 1 mg/5 ml
Tablets: 2 mg
Tablets (chewable): 2 mg
Dosages
➣Acute diarrhea
Adults: Initially, 4 mg
P.O., then 2 mg after
each loose stool. Usual
maintenance dosage is 4
to 8 mg P.O. daily in
divided doses, not to
exceed 16 mg daily.
Children ages 8 to 12
or weighing more than
30 kg (66 lb): Initially, 2
mg P.O. t.i.d., then 1
mg/10 kg after each loose
stool, not to exceed 6 mg
daily
Children ages 6 to 8 or
weighing 20 to 30 kg
(44 to 66 lb): Initially, 2
mg P.O.b.i.d., then 1
mg/10 kg after each loose
stool, not to exceed 4 mg
Patient monitoring
✓ Watch for signs and
symptoms of abdominal
distention, which may
signal toxic megacolon
in patient with
ulcerative colitis.
● Assess bowel
movements to evaluate
drug efficacy and
determine need for
repeat doses.
● Monitor stool cultures
as indicated.
● Check stool for occult
blood as indicated.
● Evaluate fluid intake
and output.
● Stay alert for CNS
effects, especially in
children.
Patient teaching
● Stress importance of
maintaining high fluid
intake to prevent
dehydration.
✓ Instruct patient or
42. ● hepatic disease
● elderly patients
● pregnant or
breastfeeding
patients
● children.
daily
Children ages 2 to 5 or
weighing 13 to 20 kg
(29 to 44 lb): Initially, 1
mg P.O. t.i.d., then 1
mg/10 kg after each loose
stool, not to exceed 3 mg
daily
➣Acute diarrhea (treated
with overthe-counter
loperamide)
Adults and children
ages 12 and older:
Two caplets with 4 to 8 oz
water after first loose
stool, then one caplet
(with 4 to 8 oz water)
after each subsequent
loose stool. Don’t exceed
four caplets in 24 hours.
Or give equivalent dosage
in liquid form.
Children ages 9 to 11
who weigh 27 to
43 kg (60 to 95 lbs):
One caplet with 4 to 8 oz
water after first loose
stool, then 1⁄2 caplet
(with 4 to 8 oz water)
after each subsequent
loose stool. Don’t exceed
three caplets in 24 hours.
Or give equivalent dosage
parents to report fever,
mucus in stool, or
history of hepatic
disease before using
drug.
✓ Caution patient or
parents to discontinue
drug if symptoms
worsen or diarrhea lasts
longer than 2 days.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs, herbs, and
behaviors mentioned
above.
43. in liquid form.
Children ages 6 to 8
who weigh 22 to
27 kg (48 to 59 lbs):
One caplet with 4 to 8 oz
water after first loose
stool, then 1⁄2 caplet with
4 to 8 oz water after each
subsequent loose stool.
Don’t exceed two caplets
in 24 hours. Or give
equivalent dosage in
liquid form.
Children younger than
age 6: Consult physician.
➣Chronic diarrhea
Adults: Initially, 4 mg
P.O., then 2 mg after
each loose stool; reduce
dosage as tolerated.
Don’t exceed 16 mg
daily for more than 10
days.
44. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
diphenoxylate
hydrochloride
and atropine
sulfate(co-
phenotrope )
Brand Name:
Lomotil
CLASSIFICA-
TION:
Pharmacologic
class:
Anticholinergic,
meperidine
congener
Therapeutic
class:
Antidiarrheal
Acts on smooth
muscle of GI
tract by
decreasing
peristalsis,
which inhibits
motility. (Small
amount of
atropine is
added to reduce
abuse
potential.)
➣Diarrhea ● Hypersensitivity to
drug
● Obstructive
jaundice
● Diarrhea
associated with
pseudomembranous
colitis or entero
toxinproducing
bacteria
● Angle-closure
glaucoma
● Concurrent MAO
inhibitor use
● Children younger
than age 2
Use cautiously in:
● inflammatory
bowel disease;
prostatic
hypertrophy; severe
hepatic disease
(use with extreme
caution)
● concurrent use of
drugs that cause
physical
• CNS: dizziness,
confusion,
drowsiness,
headache,
insomnia,
nervousness
• CV: tachycardia
• EENT: blurred
vision, dry eyes
• GI: nausea,
vomiting,
constipation,
epigastric
distress, ileus,
dry mouth
• GU: urinary
retention
• Skin: flushing
Availability
Liquid: 2.5 mg
diphenoxylate and
0.025 mg atropine/5 ml
Tablets: 2.5 mg
diphenoxylate and
0.025 mg atropine
Dosages
➣Diarrhea
Adults: Initially, 5 mg
P.O. three to four
times daily, then 5
mg/day as needed
(not to exceed 20
mg/day). Decrease
dosage when desired
response occurs.
Children: Initially, 0.3 to
0.4 mg/kg P.O. (liquid
only) daily in four divided
doses. Decrease dosage
when desired response
occurs.
Dosage adjustment
● Elderly patients
Patient monitoring
✓ Assess for and report
abdominal distention
and signs or symptoms
of decreased peristalsis.
● Watch for signs and
symptoms of
dehydration.
● Assess frequency and
consistency of bowel
movements.
Patient teaching
● Instruct patient to
report persistent
diarrhea.
● Caution patient to
avoid driving and other
hazardous activities
until he knows how drug
affects concentration
and alertness.
● Tell patient that
prolonged use may lead
to dependence.
● As appropriate, review
all other significant
adverse reactions and
45. Controlled
substance
schedule V
Pregnancy risk
category C
dependence; history
of physical drug
dependence
● elderly patients
● pregnant or
breastfeeding
patients
● children (safety not
established in
children younger
than age 12).
interactions, especially
those related to the
drugs, tests, herbs, and
behaviors mentioned
above.
46. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
octreotide
acetate
Brand Name:
Sandostatin
CLASSIFICA-
TION:
Pharmacologic
class:
Somatostatin
Analog
Therapeutic
class:
Antidiarrheal
Pregnancy risk
category B
Suppresses
secretion of
serotonin,
serotonin
metabolites,
and gastro
hepatic
peptides,
increasing fluid
and electrolyte
absorption from
GI tract. Also
suppresses
growth
hormone,
insulin, and
glucagon.
➣Diarrhea and
flushing
associated with
carcinoid tumors
➣Diarrhea caused
by vasoactive
intestinal peptide
tumors (VIPomas)
➣Acromegaly
● Hypersensitivity to
drug or its
components
Use cautiously in:
● gallbladder
disease, renal
impairment,
hyperglycemia or
hypoglycemia,
fat malabsorption
● pregnant or
breastfeeding
patients
● children.
• CNS: dizziness,
drowsiness,
fatigue,
headache,
weakness
• CV: edema,
bradycardia,
conduction
abnormalities,
arrhythmias
• EENT: vision
disturbances
• GI: nausea,
vomiting,
diarrhea,
abdominal
pain,
cholelithiasis, fat
malabsorption
• Skin: flushing
• Metabolic:
hypothyroidism,
hyperglycemia,
hypoglycemia
• Other: injection
site pain
Availability
Depot injection: 10 mg, 20
mg, 30 mg
Injection: 0.05 mg/ml, 0.1
mg/ml, and 0.5 mg/ml in
1-ml ampules; 0.2 mg/ml
and 1 mg/ml in 5-ml vials
Dosages
➣Diarrhea and flushing
associated with carcinoid
tumors
Adults: 100 to 600 mcg
(Sandostatin)
subcutaneously or I.V.
daily in two to four
divided doses for 2 weeks.
Then, depending on
response, 20 mg (LAR
Depot) I.M. q 4 weeks for
2 months.
➣Diarrhea caused by
vasoactive intestinal
peptide tumors (VIPomas)
Adults: 200 to 300 mcg
(Sandostatin)
subcutaneously or I.V.
Patient monitoring
● Assess bowel sounds
and stool frequency
and consistency.
● Monitor vital signs and
fluid intake and output.
Stay alert for
dehydration or edema.
● Evaluate diabetic
patient for
hypoglycemia or
hyperglycemia.
● Know that in women
with active acromegaly,
normalization of growth
hormone and insulin-
like growth factor-1
may restore fertility.
Patient teaching
● Tell patient being
treated for carcinoid
tumor to keep track of
number of daily stools
or flushing episodes.
● Instruct patient to
weigh himself daily and
report significant
47. daily in two to four
divided doses for 2 weeks.
Then, depending on
response, 20 mg (LAR
Depot) I.M. q 2 weeks for
2 months.
➣Acromegaly
Adults: 50 to 100 mcg
(Sandostatin)
subcutaneously or I.V.
two or three times daily.
Then, depending on
response, 20 mg (LAR
Depot) I.M. q 4 weeks for
3 months. Then adjust
based on growth hormone
levels.
Dosage adjustment
● Renal impairment
changes.
● Advise female with
childbearing potential to
use adequate
contraception while
taking drug.
● If patient will use drug
at home, teach correct
methods for injection,
storage, and needle
disposal.
● Caution patient to
avoid driving and other
hazardous activities
until he knows how drug
affects concentration,
vision, and alertness.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs, tests, and foods
mentioned above.
48. Laxatives are substances that either loosen stool or stimulate a
bowel movement. They can also accelerate intestinal transit,
which helps speed up the movement of the digestive tract to
spur a bowel movement.
49. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
bisacodyl
Brand Name:
Dulcolax
CLASSIFICA-
TION:
Pharmacologic
class: Stimulant
Laxative
Therapeutic
class: Laxative
Pregnancy risk
category B
Unclear.
Thought to
stimulate
colonic
mucosa,
producing para
sympathetic
reflexes that
enhance
peristalsis and
increase water
and electrolyte
secretion,
thereby causing
evacuation of
colon.
➣Constipation;
bowel cleansing
for childbirth,
surgery, and
endoscopic
examination
● Hypersensitivity to
drug
● Intestinal
obstruction
● Gastroenteritis
● Appendicitis
Use cautiously in:
● hypersensitivity to
tannic acid
● severe
cardiovascular
disease, anal or
rectal fissures
● pregnant or
breastfeeding
patients.
• CNS: dizziness,
syncope
• GI: nausea,
vomiting,
diarrhea (with
high doses),
abdominal pain,
burning
sensation in
rectum (with
suppositories),
laxative
dependence,
protein-losing
enteropathy
• Metabolic:
hypokalemia,
fluid and
electrolyte
imbalances,
tetany,
alkalosis
• Musculoskelet
al: muscle
weakness (with
excessive use)
Availability
Enema: 0.33 mg/ml, 10
mg/ml
Powder for rectal solution:
1.5 mg bisacodyl and 2.5 g
tannic acid
Suppositories (rectal): 5
mg, 10 mg
Tablets (enteric-coated): 5
mg
Dosages
➣Constipation; bowel
cleansing for childbirth,
surgery, and endoscopic
examination
Adults and children
ages 12 and older:
5 to 15 mg P.O. or 10 mg
P.R. as a single dose
Children older than age
3: 5 to 10 mg or 0.3
mg/kg P.O. as a single
dose
Children ages 2 and
older: 5 to 10 mg
P.R. as a single dose
Children younger than
Patient monitoring
● Assess stools for
frequency and
consistency.
● Monitor patient for
electrolyte imbalances
and dehydration.
Patient teaching
● Instruct patient to
swallow (not chew)
enteric-coated tablets
no sooner than 1 hour
before or after ingesting
antacids or dairy
products. Tell him not
to chew tablets.
● Advise patient not to
use bisacodyl or other
laxatives habitually
because this may lead
to laxative dependence.
● Suggest other ways to
prevent constipation,
such as by eating more
fruits, vegetables, and
whole grains to increase
dietary bulk and by
50. age 2: 5 mg P.R. as a
single dose
drinking 8 to 10 glasses
of water daily.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs, tests, and foods
mentioned above.
51. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
calcium
polycarbophil
Brand Name:
Equalactin
CLASSIFICA-
TION:
Pharmacologic
class: Bulk-
forming
Agent
Therapeutic
class: Laxative
Pregnancy risk
category NR
Absorbs water,
thereby
expanding and
increasing bulk
and moisture
content
of stool;
increased bulk
promotes
peristalsis
and bowel
movement.
➣Constipation
➣Diarrhea;
irritable bowel
syndrome
● GI obstruction
● Difficulty
swallowing
Use cautiously in:
● pregnant or
breastfeeding
patients
● children.
• CV: chest pain
• GI: nausea,
vomiting,
abdominal pain,
flatulence, rectal
bleeding,
intestinal
obstruction
• Respiratory:
difficulty
breathing
• Other: laxative
dependence
Availability
Tablets: 500 mg
Tablets (chewable): 500
mg, 1,250 mg
Dosages
➣Constipation
Adults and children
ages 12 and older:
1 g P.O. q.i.d. as needed.
Maximum dosage is 6 g
daily.
Children ages 7 to 12:
500 mg P.O. one to three
times daily as needed.
Maximum dosage is 3 g
daily.
Children ages 3 to 6:
500 mg P.O. b.i.d. as
needed. Maximum dosage
is 1.5 g daily.
➣Diarrhea; irritable bowel
syndrome
Adults and children
ages 12 and older:
1 g P.O. q.i.d. as needed.
Maximum dosage is 6 g
Patient monitoring
✓ Monitor patient for
difficulty breathing and
signs and symptoms of
intestinal obstruction.
● Assess for rectal
bleeding and for failure
to respond to drug.
● Monitor fluid intake
and output, and assess
hydration status
regularly.
Patient teaching
● Instruct patient to
take each dose with at
least 8 oz of water or
other fluid.
● Advise patient to
space doses at least
2 hours apart from
other drugs.
✓ Urge patient to seek
immediate medical
attention if he
experiences chest pain,
vomiting, difficulty
breathing, or rectal
52. daily.
Children ages 7 to 12:
500 mg P.O. one to three
times daily as needed.
Maximum dosage is 3 g in
a 24-hour period.
Children ages 3 to 6:
500 mg P.O. b.i.d. as
needed. Maximum dosage
is 1.5 g daily.
bleeding.
● Advise patient to tell
prescriber if he’s taking
other drugs or if he has
abdominal pain, nausea,
vomiting, or a sudden
change in bowel habits
lasting 2 weeks or
longer.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs and herbs
mentioned above.
53. Most patients are given antinausea medication, called
an antiemetic, before chemotherapy is
administered. Antiemetics are used to block the nerve impulse
that travels from the blood or stomach to the brain (where the
vomiting center is located).
54. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
dolasetron
mesylate
Brand Name:
Anzemet
CLASSIFICA-
TION:
Pharmacologic
class: Selective
serotonin
subtype 3 (5-
HT3) receptor
antagonist
Therapeutic
class:
Antiemetic
Pregnancy risk
category B
Blocks serotonin
activation at
receptor sites in
vagal nerve
terminals and in
chemoreceptor
trigger zone in
CNS, decreasing
the vomiting
reflex
➣Chemotherapy-
induced nausea
and vomiting
➣Prevention or
treatment of
postoperative
nausea and
vomiting
● Hypersensitivity to
drug
● Arrhythmias
Use cautiously in:
● risk factors for
prolonged cardiac
conduction intervals
● pregnant or
breastfeeding
patients
(safety not
established).
• CNS: headache
(increased in
cancer
patients),
dizziness,
fatigue, syncope
• CV: bradycardia,
tachycardia,
ECG changes,
hypertension,
hypotension
• GI: diarrhea,
constipation,
dyspepsia,
abdominal pain
• GU: urinary
retention,
oliguria
• Skin: pruritus,
rash
• Other: chills,
fever, decreased
appetite
Availability
Injection: 12.5 mg/0.625-
ml ampules,
20 mg/ml in 5-ml vials
Tablets: 50 mg, 100 mg
Dosages
➣Chemotherapy-induced
nausea and vomiting
Adults: 100 mg P.O. 1
hour before chemotherapy
or 1.8 mg/kg I.V. 30
minutes before
chemotherapy
Children ages 2 to 16:
1.8 mg/kg P.O. within 1
hour before chemotherapy
or 1.8 mg/kg I.V. (not to
exceed 100 mg) 30
minutes before
chemotherapy
➣Prevention or treatment
of postoperative nausea
and vomiting
Adults: 100 mg P.O.
within 2 hours before
surgery or 12.5 mg I.V. 15
Patient monitoring
● Monitor closely for
excessive diuresis.
✓ Watch for ECG
changes, including
prolonged PR interval
and widened QRS
complex, especially in
patients receiving
antiarrhythmics
concurrently.
Patient teaching
● Instruct patient to
take drug 1 to 2 hours
before chemotherapy.
● Inform patient that
drug commonly causes
headache.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs and tests
mentioned above.
55. minutes before cessation
of anesthesia (for
prevention) or as soon as
nausea or vomiting begins
(for treatment)
Children ages 2 to 16:
1.2 mg/kg P.O. (up to 100
mg/dose) within 2 hours
before surgery or 0.35
mg/kg I.V. (up to 12.5
mg) 15 minutes before
cessation of anesthesia
(for prevention) or as soon
as nausea or vomiting
begins (for treatment)
56. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
dronabinol
Brand Name:
Marinol
CLASSIFICA-
TION:
Pharmacologic
class:
Cannabinoid
Therapeutic
class:
Antiemetic
Controlled
substance III
Pregnancy risk
category B
Unknown. May
exert antiemetic
effect
by inhibiting
vomiting control
mechanism
in medulla
oblongata.
➣Prevention of
nausea and
vomiting caused
by chemotherapy
➣Appetite
stimulant
● Hypersensitivity to
cannabinoids or
sesame oil
● Breastfeeding
Use cautiously in:
● hypertension, heart
disease, bipolar
disorder,
schizophrenia, drug
abuse,
seizures
● pregnant patients.
• CNS:
drowsiness,
anxiety,
impaired
coordination,
irritability,
depression,
headache,
hallucinations,
memory loss,
paresthesia,
ataxia, paranoia,
disorientation,
nightmares,
speech
difficulties,
syncope,
suicidal
ideation
• CV: tachycardia,
hypotension,
hypertension
• EENT: visual
disturbances,
tinnitus
• GI: dry mouth
• Skin: facial
flushing,
Availability
Capsules: 2.5 mg, 5 mg,
10 mg
Dosages
➣Prevention of nausea
and vomiting caused by
chemotherapy
Adults and children:
Initially, 5 mg/m2P.O. 1 to
3 hours before
chemotherapy. Repeat
dose q 2 to 4 hours after
chemotherapy, up to four
to six doses per day. If 5-
mg/m2 dose is ineffective
and patient has no
significant adverse
reactions, dosage may be
increased in increments of
2.5 mg/m2 to a maximum
dosage of 15 mg/m2.
➣Appetite stimulant
Adults and children:
Initially, 2.5 mg P.O.
b.i.d.May reduce dosage to
2.5 mg/day given as a
Patient monitoring
● Monitor vital signs for
hypotension and
tachycardia.
✓ Check for adverse
CNS reactions. Report
significant depression,
paranoid reaction, or
emotional lability.
● Monitor nutritional
status and hydration.
Patient teaching
● Teach patient about
drug’s significant
adverse CNS and
cardiovascular effects.
Emphasize that he
should take it only as
prescribed and needed.
✓ Advise patient (and
significant other) to
immediately report
depression, suicidal
thoughts, paranoid
reactions, seizures, and
other serious CNS
reactions.
57. diaphoresis single evening or bedtime
dose. Maximum dosage is
10 mg P.O. b.i.d.
● Caution patient to
avoid driving and other
hazardous activities
until he knows how drug
affects concentration
and alertness.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs and behaviors
mentioned above.
58. DRUG DATA MECHANISM OF
ACTION
INDICATIONS CONTRAINDICATIONS ADVERSE
REACTIONS
DOSAGE NURSING ACTIONS &
CONSIDERATIONS
Generic
Name:
trimetho-
benzamide
hydrochloride
Brand Name:
Tigan
CLASSIFICA-
TION:
Pharmacologic
class:
Anticholinergic
Therapeutic
class:
Antiemetic
Pregnancy risk
category C
Unclear.
Thought to
block dopamine
receptors and
emetic impulses
in
chemoreceptor
trigger zone,
preventing
nausea and
vomiting.
➣Nausea and
vomiting
● Hypersensitivity to
drug
● Parenteral form in
children
Use cautiously in:
● renal impairment,
arrhythmias,
encephalitis,
gastroenteritis,
dehydration,
electrolyte
imbalances
● concurrent alcohol
use
● elderly or
debilitated patients
● pregnant or
breastfeeding
patients
● children with
known or suspected
viral illnesses.
• CNS:
drowsiness,
dizziness,
headache,
depression,
disorientation,
parkinsonian
symptoms,
coma, seizures
• CV: hypotension
• EENT: blurred
vision
• Hematologic:
blood
dyscrasias
• Hepatic:
jaundice
• Musculoskelet
al: muscle
cramps,
opisthotonos
• Skin: rash,
urticaria,
flushing
• Other: pain and
stinging at I.M.
injection site,
hypersensitivity
Availability
Capsules: 300 mg
Injection: 100 mg/ml in 2-
ml ampoules and prefilled
syringes and in 20-ml vials
Dosages
➣Nausea and vomiting
Adults: 300 mg P.O. three
to four times daily or 200
mg I.M. three to four
times daily
Dosage adjustment
● Renal impairment
Patient monitoring
● Monitor neurologic
status, especially
for parkinsonian
symptoms and other
serious adverse
reactions.
● Assess CBC and liver
function tests. Watch
for blood dyscrasias and
jaundice.
● Evaluate injection site
for pain and stinging.
● Closely monitor
patient’s nutritional and
hydration status. Report
continuing nausea.
Patient teaching
● Advise patient to take
as needed for nausea
and vomiting, but only
as prescribed.
● Tell patient to contact
prescriber promptly if
nausea persists despite
therapy.
● Instruct patient to
59. reaction minimize nausea and
vomiting by eating
small, frequent servings
of healthy food and
drinking plenty of fluids.
● Advise patient to
avoid alcohol.
● Caution patient to
avoid driving and other
hazardous activities
until drug effects are
known.
● As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
drugs and behaviors
mentioned above.