drug study MMMC

8/7/2019 drug study MMMC

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DRUG STUDY

GENERIC

NAME/BRANDNAME

DOSA

GE/ROUTE

CLASSIFICATI

ON

INDICATION CONTRAINDICATI

ON

ADVERSE

REACTIONS

NURSING

RESPONSIBILITIES

Genericname:

Allopurinol

Brandname:

LLANOL

100

mg OD

GoutPreparations

Primaryuncomplicatedhyperurecemia;mild gout; severetophaceous gout;uric acidnephropathy; uricacid nephrolithiasis;and in the

prevention of renalCalcium oxalatestones.

Allopurinolshould bediscontinued atthe firstappearance ofrash or anysign that mayindicate anallergic

reaction,painfulurination, bloodin the urine,irritation of theeyes, orswelling of thelips or mouth

Allopurinolmay increasethe frequencyof acute goutyattacks duringthe first 6-12months oftherapy.Prophylacticdoses ofcolchicineshouldtherefore beadministered

allergic skinreactions, GIdisturbances,diarrhea, and jointpain

monitor serum uricacid levels to evaluatedrugs effectiveness

monitor fluidintake and output; dailyurine output of at least 2liters and maintenance ofneutral or slightly alkalineurine are desirable

periodically

monitor CBC and hepaticand renal function,especially at start oftherapy, as ordered

If renalinsufficiency occurs at anytime during treatment, beprepared to reducedosage, as ordered.

Optimal benefitsmay require 2-6 weeks oftherapy. Because acutegouty attacks occur during

this time, concurrent use ofcolchicines may beprescribed prophylactically.

To minimize GIdisturbance, tell patient totake with or immediatelyafter meals.

Encourage thepatient to drink plenty offluids while taking this drugunless otherwisecontraindicated.


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concurrentlyduring the first3 - 6 months ofallopurinoltherapy.

Drowsinessmay occurduringallopurinoltherapy andmay impairone's ability toperformactivitiesrequiringmentalalertness.

Liverfunction tests(particularly inpatients withpreexistingliver disease),renal functiontests(particularly inpatients withimpaired renalfunction), and

complete bloodcell countsshould beperformedduring the firstfew months.Reduce thedosage ofallopurinol ortotally

Drug may causedrowsiness, tell patient notto drive or performhazardous tasks requiringmental alertness until CNSeffects of the drug are

known. If the patient istaking allopurinol fortreatment of recurrentcalcium oxalate stones,advise him to also reducehis dietary intake of animalprotein, sodium, refinedsugars, oxalate-rich foods,and calcium.

Tell patient todiscontinue at first sign ofrash, which may precedesevere hypersensitivity orother adverse reaction.Rash is more common inpatient taking diuretics andin those with renaldisorders. Tell the patientto report all adversereactions.


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discontinue thedrug ifevidence ofdeterioration inrenal function

occurs andpersists.

Allopurinolis rarelyindicated inchildren exceptin those withhyperuricemiasecondary toneoplasticdisease, cancerchemotherapy,

or geneticdisorders ofpurinemetabolism.

The effectof allopurinolon the humanfetus is notknown, and thedrug should beused duringpregnancy only

when clearlyneeded.

Sinceallopurinol andoxypurinol aredistributed intomilk, allopurinolshould be usedwith caution in


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nursing women.GenericName:budesonide

andformoterolinhalation

BrandNames:Symbicort

160mg neb

Corticosteroids

regular treatment ofasthma where useof a combination

(inhaledcorticosteroid andlong acting beta 2agonist) isappropriate

Hypersensitivity toinhaled lactose

Abdominalpain,conjunctivitis

(pinkeye), cough,

diarrhea,

ear infectionorinflammation,

fever,

fungalinfection inmouth,

headache,

nasal or sinusinflammation,

nosebleed,

pain, rash,

respiratoryinfection,

stomach orintestinalinflammation,

throatinflammation,

viralinfection,

vomiting,

wheezing

Taper systemicsteroids carefullyduring transfer to

inhalational steroids;deaths from adrenalinsufficiency haveoccurred.

Arrange for use ofdecongestant nosedrops to facilitatepenetration ifedema, excessivesecretions arepresent.

Prime unit beforeuse for PulmicortTurbuhaler; havepatient rinse mouthafter each use.

Use aerosol within6 mo of opening.Shake well beforeeach use.

Store Respulesupright andprotected from light;gently shake beforeuse; open envelopesshould be discardedafter 2 wk.

Generic Bronchodilators management of Hypertrophic Fine tremor of Use nebulizer


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name:ALBUTEROLSULFATEIPRATROPIUM BROMIDE

Brandname:Combivent

Nebq6

reversiblebronchospasmassociated withobstructive airwaydiseases in patients

who require morethan a singlebronchodilator

obstructivecardiomyopathy ortachyarrhythmia.History ofhypersensitivity to

soya lecithin orrelated foodproducts (for MDIonly).

skeletal muscle;palpitations;headache, dizziness,nervousness; drynessof mouth, throat

irritation; urinaryretention

mouthpiece instead offace mask to avoidblurred vision oraggravation of narrow-angle glaucoma.

Can mix albuterol innebulizer for up to 1hr. Ensure adequatehydration, controlenvironmentaltemperature toprevent hyperpyrexia. Have patient voidbefore takingmedication to avoidurinary retention.

Teach patient properuse of inhalator.

Brandname:Micardistablet

40mg/tabOD

Angiotensin IIAntagonists

Treatment ofessentialhypertension.

biliary obstructivedisorders, severehepaticimpairment.

Headache, upperresp tract infection,dizziness, fatigue.

Check the doctorsorder beforeadministering themedication.

Follow the 10 rightsof medicationadministration.

Observe proper handhygiene in givingmedications.

Instruct patient toget help ifunnecessary conditionhappens.

Inform the patientabout certain sideeffects.

Instruct the patientto inform the healthcare provider if
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condition does notimprove or if feelscondition does notchange.

Brandname:EssentialeFortecapsule

1 capbidAfterBPandaftersupper

Cholagogues,Cholelitholytics& HepaticProtectors

Acute and ChronicHepatitis: Dystrophyand cirrhosis of theliver, biliary stasisand hepatic coma.

Liver Damaged byToxins: Fatty liver(eg, in diabetes,tuberculosis andchronicrheumatism),

prophylaxis ofrecurrentgallstones, radiationdamage, nephroticsyndrome andgestoses.

No knowncontraindication

Abdominal pain,nausea, allergicreaction

Check the doctorsorder beforeadministering themedication.



Instruct patient toget help if

unnecessary conditionhappens.


Instruct the patientto inform the healthcare provider ifcondition does notimprove or if feelscondition does notchange.

Fenoflexcapsule 1 tab

3x aweek

DyslipidaemicAgents Treatment of types

IIa, IIb, III, IV & Vhyperlipoproteinemias.

Severe renaldysfunction,hepaticdysfunction egprimary biliarycirrhosis &unexplainedpersistent liverfunction,

Abdominal painback pain,headache,flu syndrome;abnormal liverfunction test,diarrhea,nausea, constipation;increased ALT, CPK &

For dilution ofsolution forintravenousinduction electrolytesolutions should notbe used.

Follow the 10 rights
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preexistinggallbladderdisease.

AST; rhinitis. of medicationadministration.


Omeproncapsule 20mg

cap 1tabbafterBP

Antacids,AntirefluxAgents &Antiulcerants

converted to activemetabolites thatirreversibly bindand inhibit H+-K+-ATPase (an enzymeon the surface ofgastric parietalcells). It inhibitstransport ofhydrogen ions into

the gastric lumen.Omeprazoleincreases thegastric pH andreduces gastric acidformation.

Symptomaticresponse toomeprazoletherapy does notrule out thepresence of agastricmalignancy.Atrophic gastritishas been noted

occasionally ingastric corpusbiopsies frompatients on long-term omeprazoletherapy.

Headache

Diarrhea

Abdominalpain

Nausea

Dizziness

Asthenia (lossof strength)

Vomiting

Constipation Upper

respiratorytract infection

Back pain

Rash

Cough

Give before meals

Do not crush orchew tablets, swallowwhole

Evaluate fortherapeutic responselike relief ofGastrointestinalsymptoms

Question if

Gastrointestinaldiscomfort, nausea,and diarrhea occurs.

SenokotTab

2 tab1tabHS asneces

saryforconstipation

Laxatives,Purgatives

Functionalconstipation ofhospitalized patient,O & G patient, post-

surgical, prenatal,postpartum,geriatric patient,functionalconstipation due tointake of certaindrugs, ped patient.

Acute surgicalabdomen,abdominal pain,nausea, vomiting

or symptoms ofappendicitis;intestinalhemorrhage orobstruction,persistentdiarrhea.

Mild abdominaldiscomfort; diarrheaw/ excessive loss ofwater & electrolytes

(high doses),

Assess baseline ofelimination.

Teach the patient how

to self administerlaxative.

Encourage patientnormalize bowelmovement.

Avamys Nasal Treatment of nasal back pain, cough, Check the doctors
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nasal spray 2sprayeachnostrilOD

Decongestants& Other NasalPreparations

& ocular symptomsofseasonal &perennial allergicrhinitis.

headache, minornosebleed, nasalsore, or sorethroat.

Epistaxis, nasalulceration.

order beforeadministering themedication.

Follow the 10 rightsof medication

administration. Observe proper handhygiene in givingmedications.

Instruct patient toget help ifunnecessary conditionhappens.


Instruct the patient

to inform the healthcare provider ifcondition does notimprove or if feelscondition does notchange.

Montelukast (kastair) 10mg

OD

Antiasthmatic& COPDPreparations

Treatment ofbronchial asthma,allergic rhinitisconcomitant to

bronchial asthma &allergic rhinitis.

Do not use fortreatment of acuteasthma attacks.

Rash, angio-edema,pruritus & urticaria.Dizziness, headache,dream abnomalities,hallucinations,

agitation includingaggressive behavior,paresthesia/hypoesthesia, drowsiness,insomnia, irritability,restlessness.Somnolence,dyspepsia, infectiousgastroenteritis,diarrhea, nausea &

Do not use thismedication if you areallergic tomontelukast.

Before usingmontelukast, tell yourdoctor if you areallergic to any drugs(especially aspirin).You may need a doseadjustment or specialtests to safely use thismedication.
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vomiting. Nasalcongestion, cough,influenza, upper respinfection, increasedserum alanine &

aspartateaminotransferase,pyuria.Asthenia/fatigue,myalgia, fever,trauma, dental &abdominal pain.

Take this medicationexactly as it wasprescribed for you. Donot take themedication in larger

amounts, or take it forlonger thanrecommended by yourdoctor. Follow thedirections on yourprescription label.

Ansimar 400mg tab 2xa day

Antiasthmatic& COPDPreparations

Bronchial asthma &pulmonary diseasew/ spastic bronchialcomponent.

Acute MI,hypotension,

Nausea, vomiting,epigastric pain,cephalalgia,irritability, insomnia,tachycardia,

extrasystole,tachypnea,

Use with caution inpatients withhypoxemia,hyperthyroidism,liver disease, renal

disease, in thosewith history of pepticulcer and in elderly.Frequently, patientswith CHF havemarkedly prolongeddrug serum levelsfollowingdiscontinuation ofAnsimar.

assess for allergic

reactionassess for breathsounds

should be given to apregnant womanonly if clearlyneeded.

Hydrocortis Corticosteroid Allergic states: Viral/fungal Muscle wasting, Establish
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one 100mg IVq8

Hormones / EyeCorticosteroids/ TopicalCorticosteroids

Control of severe orincapacitatingallergic conditionsintractable toadequate trials of

conventionaltreatment inasthma, atopicdermatitis, contactdermatitis, drughypersensitivityreactions, perennialor seasonal allergicrhinitis, serumsickness,transfusionreactions.

Gastrointestinaldiseases: To tidethe patient over acritical period of thedisease in regionalenteritis (systemictherapy) andulcerative colitis.

Hematologic

disorders:Acquired(autoimmune)hemolytic anemia,

infections,tubercular orsyphilitic lesions,bacterial infectionsunless used in

conjunction withappropriatechemotherapy.

weakness,osteoporosis. GIdisturbances andbleeding. Increasedappetite and delayed

wound healing.Bruising, striae,hirsutism, acne,flushing. Raisedintracranial pressure,headache,depression,psychosisHyperglycaemia,glycosuria, DM,obesity, moon-face,buffalo hump.

Suppression ofpituitary-adrenocorticalsystem.

baseline andcontinuing dataon BP, weight,fluid andelectrolyte

balance, andblood glucose.

Lab tests:Periodic serumelectrolytesblood glucose,Hct and Hgb,platelet count,and WBC withdifferential.

Monitor foradverse effects.

Older adultsand patientswith low serumalbumin areespeciallysusceptible toadverse effects.

Be alert to signsof hypocalcemia(see AppendixF).

Ophthalmoscopi

c examinationsarerecommendedevery 23 mo,especially ifpatient isreceivingophthalmicsteroid therapy.

Monitor for
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persistentbackache orchest pain;compressionand

spontaneousfractures oflong bones andvertebraepresenthazards.

Monitor for andreport changesin mood andbehavior,emotionalinstability, or

psychomotoractivity,especially withlong-termtherapy.

Be alert topossibility ofmaskedinfection anddelayed healing(antiinflammatory and

immunosuppressive actions).

Note: Doseadjustment maybe required ifpatient issubjected tosevere stress(seriousinfection,


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surgery, orinjury).

Note: Singledoses ofcorticosteroids

or use for ashort period(


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improve or if feelscondition does notchange.

arcoxia

4mg1 tabOD

NonsteroidalAnti-inflammatoryDrugs

Acute & chronic

treatment of thesigns & symptomsosteoarthritis & RA.Treatment ofankylosingspondylitis.Treatment of acutegouty arthritis &primarydysmenorrhea.Relief of acute &chronic pain.

History of

hypersensitivity toetoricoxib or to anyof the excipients ofArcoxia.

Active pepticulceration or activeGI bleeding.

Patients who haveexperiencedbronchospasm,

acute rhinitis,nasal polyps,angioneuroticedema, urticaria orallergic-typereactions aftertakingacetylsalicylic acidor NSAIDsincludingcyclooxygenase-2(COX-2) inhibitors.

Establishedischemic heartdisease, peripheralarterial diseaseand/orcerebrovasculardisease.

Immune System

Disorders:Hypersensitivityreactions includinganaphylactic/anaphylactoid reactions.

Psychiatric Disorders:Anxiety, insomnia,confusion,hallucinations.

Nervous System

Disorders: Dysgeusia.

Cardiac Disorders:Congestive heartfailure.

Vascular Disorders:Hypertensive crisis.

Respiratory, Thoracicand Mediastinal

Disorders:Bronchospasm.

GastrointestinalDisorders: Abdominalpain, oral ulcers,peptic ulcersincluding perforationand bleeding (mainlyin the elderly),

Check the doctors

order beforeadministering themedication.



Instruct patient toget help ifunnecessary condition

happens. Inform the patientabout certain sideeffects.

Instruct the patientto inform the healthcare provider ifcondition does notimprove or if feelscondition does notchange.
http://www.mims.com/Page.aspx?menuid=companionhome&ID=1669http://www.mims.com/Page.aspx?menuid=companionhome&ID=2698http://www.mims.com/Page.aspx?menuid=companionhome&ID=2698http://www.mims.com/Page.aspx?menuid=companionhome&ID=987http://www.mims.com/Page.aspx?menuid=companionhome&ID=1692http://www.mims.com/Page.aspx?menuid=companionhome&ID=1669http://www.mims.com/Page.aspx?menuid=companionhome&ID=2698http://www.mims.com/Page.aspx?menuid=companionhome&ID=2698http://www.mims.com/Page.aspx?menuid=companionhome&ID=987http://www.mims.com/Page.aspx?menuid=companionhome&ID=1692


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vomiting, pruritus,rash, urticaria,diarrhea.

HepatobiliaryDisorders: Hepatitis:

Skin andSubcutaneous TissueDisorders:Angioedema, rash,pruritus, Stevens-Johnson syndrome,urticaria.

Renal and UrinaryDisorders: Renalinsufficiencyincluding renalfailure, usuallyreversible upondiscontinuation oftherapy (seePrecautions)

drug study MMMC

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