Drug Study_case Pre FINAL

7/30/2019 Drug Study_case Pre FINAL

1/14

DRUG STUDY

GENERIC NAME: Furosemide

BRAND NAME: Lasix

40mg IV

Classification Action Indication Contraindication Adverse Effect Nursing Intervention

Loop Diuretic Inhibitsreabsorption

of sodium and

chloride from

the proximal

and distal

tubules and

ascending

limb of the

loop of Henle,

leading tosodium-rich

diuresis.

Oral, IV:Edema,

associated

with heart

failure, renal

disease.

Contraindicatedwith allergy to

furosemide,

sulfonamides;

allergy to

tartrazine; anuria,

severe renal failure,

hepatic coma,

pregnancy,

lactation.

CNS: dizziness, vertigo,

weakness,

headache,fatigue

CV: Orthostatic,

hypotension, cardiac

arrhythmias,

thrombophlebitis

DERMATOLOGIC: rash,

pruritus

GI: nausea,

constipation, vomitingGU: urinary bladder

spasm

HEMATOLOGIC:

leukopenia, anemia,

thrombocytopenia

OTHER: muscle cramps

and muscle spasm

Administer withfood or milk to

prevent GI upset.

Reduce dosage ifgiven with other

antihypertensives;

readjust dosage

gradually as BP

responds.

Give early in the dayso that increasedurination will not

disturb sleep.

Avoid IV use if oraluse is at all possible.

Arrange forpotassium-rich diet

or supplemental

potassium as

needed.


2/14

DRUG STUDY

GENERIC NAME: Metoclopramide

BRAND NAME: maxolon, reglan

10mg IV q8 PRN


Antiemetic Stimulatesmotility of

upper GI tract

without

stimulating

gastric, biliary

or pancreatic

secretions;

appears to

sensitize

tissues toaction of

acetylcholine;

accelerate

gastric

emptying and

intestinal

transit; has

sedative

properties.

Relief ofsymptoms of

acute and

recurrent

diabetic

gastroparesis

.

Unlabeleduses:

Improvement

of lactation;treatment of

nausea and

vomiting of a

variety of

etiologies:

Emesis

during

pregnancy

and labor,

gastric ulcer,

anorexia

nervosa.


metoclopramide;

GI hemorrhage,

mechanical

obstruction or

perforation;

extrapyramidal

reactions.

Use cautiously withpreviouslydetected breast

cancer; lactation,

pregnancy, fluid

overload; renal

impairment.

CNS: restlessness,

drowsiness, fatigue,

lassitude

CV: transient

hypertension

GI: nausea, diarrhea

Monitor BP carefullyduring IV

administration.

Monitor forextrapyramidal

reactions, and

consult physician if

they occur.

Assess mental status:depression, anxiety,

irritability duringtreatment.


3/14

DRUG STUDY

GENERIC NAME: Ranitidine Hydrochloride

BRAND NAME: gen-ranitidine, zantac

50mg IV q8


Histamine-2

antagonist

Competitivelyinhibits the

action of

histamine at

the H2

receptors of

the parietal

cells of the

stomach,

inhibiting

basal gastricacid secretion

and gastric

acid secretion

that is

stimulated by

foods, insulin,

histamine,

and gastrin.

Short-termtreatment of

active

duodenal

ulcer.

Treatment ofheartburn,

acid

indigestion,

sour

stomach.


ranitidine,

lactation.

CNS: headache,

dizziness, insomnia

CV: tachycardia,

bradycardia

DERMATOLOGIC: rash

GI: constipation,

diarrhea, nausea,

vomiting, abdominal

pain

GU: decreased libido

HEMATOLOGIC:leukopenia,

pancytopenia

LOCAL: pain at IM site

local burning or itching

at IV site

OTHER: arthralgias

Administer oral drugwith meals and at

bed time.

Decrease doses inrenal and liver

failure.

Provide concurrentantacid therapy to

relieve pain.

Administer IM doseundiluted, deep intolarge muscle group.

Arrange for regularfollow-up, including

blood test, to

evaluate effects.


4/14

DRUG STUDY

GENERIC NAME: Methylergonovine Maleate

BRAND NAME: methergine

200microgram IV q4


Oxytoxic A partialagonist or

antagonist at

alpha

receptors; as a

result, it

increases the

strength,

duration and

frequency of

uterinecontractions.

Routinemanagement

after delivery

of the

placenta.

Treatment ofpostpartum

atony and

hemorrhage;

subinvolution

of the uterus. Uterine

stimulation

during the

second stage

of labor

following the

delivery of

the anterior

shoulder,

under strict

medical

supervision.


methylergonovine,

hypertension,

toxemia, lactation,

pregnancy.

Use cautiously withsepsis, obliterate

vascular disease,

hepatic or renal

impairment.

CNS: dizziness,

headache

CV: hypertension,

palpitations, chest

pain, dyspnea

GI: nausea, vomiting

Administer by IMinjection or orally

unless emergency

requires IV use.

Complications are

more frequent with

IV use.

Monitor postpartumwomen for BP

changes and amount

and character ofvaginal bleeding.

Discontinue if sign oftoxicity occur.

Avoid prolonged useof the drug.

Monitor prolactinlevels and for

decreased breast

milk production.


5/14

DRUG STUDY

GENERIC NAME: Mefenamic Acid

BRAND NAME: ponstel

500g/cap TID


NSAID Anti-inflammatory,

analgesic, and

antipyretic

activities

related to

inhibition of

prostaglandin

synthesis;

exact

mechanismsof action are

not known.

Relief ofmoderate

pain when

therapy will

not exceed 1

week.

Contraindicatedwith

hypersensitivity to

mefenamic acid,

aspirin allergy, and

as treatment of

perioperative pain

with coronary

artery bypass

grafting.

Use cautiously withasthma, GI

bleeding,

hypertension, heart

failure, pregnancy,

lactation.

CNS: headache,

dizziness, insomnia,

fatigue

DERMATOLOGIC: rash,

sweating

GI: nausea, vomiting,

dyspepsia,

constipation, GI pain,

diarrhea

GU: renal impairment

HEMATOLOGIC:bleeding, aplastic

anemia, decreased Hgb

of Hct

RESPIRATORY:

dyspnea,

bronchospasm,

rhinitis.

OTHER: anaphylactoid

reactions to

anaphylactic shock.

Give with milk orfood to decrease GI

upset.

Discontinue drug andconsult the health

care provider if rash,

diarrhea, or digestive

problems occur.

Report sore throat,fever, weight gain,

right upperabdominal pain,

flulike symptoms.


6/14

DRUG STUDY

GENERIC NAME: Celecoxib

BRAND NAME: celebrex

200mg PO


NSAID Inhibitsprostaglandin

synthesis by

selectively

inhibiting

cyclooxygenas

e 2 (COX-2),

an enzyme

needed for

biosynthesis

Managementof acute pain.

Treatmentfor primary

dysmenorrhe

a.

Use cautiously withimpaired hearing,

hepatic and CV

conditions.

CNS: headache,

dizziness, insomnia,

fatigue

CV: MI, CVA

DERMATOLOGIC: rash,

pruritus, sweating

GI: nausea, vomiting,

dyspepsia, GI bleed

HEMATOTOLIC:

leukopenia,

pancytopeniaOTHER: anaphylactoid

reactions to

anaphylactic shock.

Administer drug withfood or after meals if

GI upset occurs.

Establish safetymeasures if CNS or

visual disturbances

occur.

Provide furthercomfort measures to

reduce pain.


7/14

DRUG STUDY

GENERIC NAME: Ampicillin

BRAND NAME: principen

1gram IV q 6


Antibiotic Bactericidalaction against

sensitive

organism;

inhibits

synthesis of

bacterial cell

wall, causing

cell death.

Treatment ofinfections

caused by

susceptible

strains of

shigella,

salmonella,

Escherichia

coli, Neisseria,

gonorrhoeae.

Contraindicat

ed with

allergies to

penicillins,

cephalosporin

s or other

allergens.

Use cautiouslywith renal

disorders.

CNS: lethargy, seizures

CV: heart failure

GI: gastritis, sore mouth,

nausea, vomiting, diarrhea

GU: nephritis

HEMATOLOGIC: anemia,

leukopenia, neutropenia,

prolonged bleeding time

HYPERSENSITIVITY: rash,

fever, wheezing

LOCAL: pain, phlebitis,thrombosis at injection site

OTHER: super infections

oral and rectal moniliasis,

vaginitis

Culture infected areabefore treatment:

reculture area if

response is not as

expected.

Check IV site carefullyfor signs of

thrombosis or drug

reaction.

Do not give IMinjections in the samesite; atrophy can

occur. Monitor

injection site.

Administer oral drugon an empty stomach,

1 hour before or 2

hour after meals with

a full glass of water;

do not give with fruit

juice or soft drinks.

Identify urine output;if decreasing, notifyprescriber (may

indicated

nephrotoxocity)


8/14

DRUG STUDY

GENERIC NAME: Gentamicin Sulfate

BRAND NAME: cidomycin, garamycin

80mg IV q8


Antiinfective Interferewith protein

synthesis in

bacterial cell

by binding

ribosomal

subunit,

causing

misreading

of genetic

code,inaccurate

peptide

sequence

forms in

protein

chain,

causing

bacterial

death.

Bacterial effectsfor the following

organisms:

Pseudomonas

aeruginosa,

Klebsiella,

Escherichia coli,

Enterobacter,

Shigella, Bacillus

anthracis.


any

aminoglycosides

.

Use cautiouslywith renal or

hepatic disease,

fungal infection,

burn patients,

active infectionwith herpes,

varicella.

CNS:Ototoxicity,

numbness, tingling,

seizures

CV: Palpitations,

hypotension,

hypertension

GI:Nausea, vomiting,

anorexia

GU:Nephrotoxicity

HEMATOLOGIC:

Leukemoid reaction,leukopenia,

eosinophilia,

pancytopenia

HYPERSENSITIVITY:

Purpura, rash, itching

LOCAL: Pain, irritation

OTHER: Apnea, fever

Assess patient forprevious sensitivity

reaction.

Monitor I&Oratio:urinalysis daily for

proteinuria; report

sudden change in urine

output.

Culture infected areabefore therapy.

Avoid long-termtherapies because ofincreased risk of

toxicities. Reduction in

dose may be clinically

indicated

Patients with edema orascites may have lower

peak concentrations due

to expanded extracellular

fluid volume.

Ensure adequatehydration of patientbefore and during

therapy.


9/14

DRUG STUDY

GENERIC NAME: Oxytocin

BRAND NAME:syntocinon

I.V.: 10 units by I.V. infusion in1000 mL of intravenous fluid


Oxytocic Oxytocincauses potent

and selective

stimulation

of uterine and

mammary

gland smooth

muscles produ

cing sustained

contractions

Induces laborand milk

ejection and

reduces

post

partum blee

ding

Induction oflabor at term;

control

of postpartum b

leeding; adjunctive

therapy in

management

of abortion

Contraindicatedin patients hype

rsensitive to the

drug or any of its

component.

Alsocontraindicated in

cephalopelvic

disproportion

or delivery that

requiresconversion, as

intranverse lie;

in fetal distress

when delivery isnt

imminent;

in prematurity

and in severe

toxemia, hypertonic

uterine patterns,

total

placenta previa or

vasa previa.

CV: hypertension;

Increased heart rate,

systemic venous return,

and cardiac output, and

arrhythmias

CNS: seizures, coma from

water intoxication

GI: Nausea, vomiting,

GU: titanic uterine

contractions,

abruption placentae, impaired uterine blood

flow, pelvic hematoma

Hematologic:a

fibrinogenemiaRespiratory:

anoxia, asphyxia

Monitor and recorduterine contractions,

heart rate, BP, intrauterine

pressure, fetal heart rate,

and blood loss q15.

Be alert for adversereaction

Monitor I/O. Antidiureticeffect may lead to fluid

overload, seizures, and coma

Never give oxytocinsimultaneously by more thanone route.

If contractions are lessthan 2 minutes apart,

iftheyreabove 50mm Hg, or

if they last 90secondsor longer,

stop infusion, and turn patient

on her side, and notify

prescriber.


10/14

DRUG STUDY

GENERIC NAME: Diclofenac

BRANDNAME: voltaren

I.V.: 10 units by I.V. infusion in1000 mL of intravenous fluid


Anti-inflammatory

NSAID

Inhibits prostaglandin

sythetase to

cause

antipyretic

andanti-

inflammator

y effects:

the exact

mechanism

is unknown.

Diclofenac isindicated in

painful

inflammatory

conditions

associated with

musculoskeletal

system,

dysmenorrhoea,

during post

operative andpost traumatic

period. It is

given in chronic

inflammatory

conditions like

Rheumatoid

arthritis and

osteoarthritis.

Contraindicatedwith allergy

to NSAIDs,

significant renal

impairment, preg

nancy, lactation

Use cautiouslywith impaired

hearing,

allergies, hepatic,CV, GI conditions,

and in

elderly patients.

CNS: Headache,

dizziness, somnolence,

Insomnia, fatigue,

tiredness, dizziness,

tinnitus, ophthalmic

effects.

Dermatologic: Rash,

pruritus, sweating, dry

mucous membranes,

stomatitis.

GU: Dysuria, renalimpairment.

GI: Nausea, dyspepsia,

GI pain, diarrhea,

vomiting, constipation,

flatulence.

Hematologic:

Bleeding, platelet

inhibition with higher

doses.

Other: Peripheral

edema, anaphylactoid

reactions to fatalanaphylactic shock.

Administer drug with foodor after meals if GI up set

occurs.

Arrangefor ophthalmologic exam

during long-term therapy.

Instituteemergency procedure

if overdose occurs.

Monitor BP forhypertension and blood

sugar for hyperglycemia

Monitor weight andreport gains > 1kg..


11/14

DRUG STUDY

GENERIC NAME: Nalbuphine

BRANDNAME: Nalbuphine hydrochloride

10mg slow IV q8

Classification ACTION INDICATION CONTRAINDICATION ADVERSE REACTION NURSING RESPONSIBILITIES

Opioid analgesic Binds withopiate

receptors

in the CNS,

altering

both

perception

of and

emotionalresponse

to pain

Moderate tosevere pain

Contraindicated with

hypersensitivit

y to

nalbuphine,

sulphites

Caution:

Emotionallyunstable

patient

History ofnarcotic abuse

CNS: headache,

restlessness, dizziness

GI: Nausea and

vomiting

GU: Urinary urgency

Respiratory:

Respiratory distress

Ask about thehypersensitivity to

nalbuphine

Note for changes ofpupil size, pulse,

reflexes

Advised patient toreport severe nausea,

vomiting, shortness ofbreathing, difficulty of

breathing

Constipation is oftensevere with

maintenance therapy.

Make sure stool

softener or other

laxative is ordered.

Reassess patients levelof pain at least 15 to 30

minutes after

parenteral

administration..


12/14

DRUG STUDY

GENERIC NAME: Clindamycin

BRANDNAME: tidact

150mg

Classification Action Indication Contraindication Adverse Effects Nursing Intervention

Antibiotic Hinders orkills

susceptible

bacteria.

Treatment ofserious

infection

Contraindicated in patients

with

hypersensitivit

y to

Clindamycin or

Linmomycin

CNS: headache

GI: abdominal

pain, diarrhea

GU: UTI

SKIN:

maculopapular

OTHER: pain,

erythema

Culture infection sitebefore therapy

Administer oral drugwith a full glass of

water or with food to

prevent esophageal

irritation

Do not give IMinjectons of more than

600 mg; inject deep

into large muscle to

avoid serious problems

Do not use for minorbacterial or viral

infections


13/14

DRUG STUDY

GENERIC NAME: Paracetamol

BRANDNAME: panadol

300mg

Classification Action Indication Contraindication Adverse Effects Nursing Intervention

Antipyretics and

analgesic

Thought toproduce

analgesia by

blocking pain

impulses by

inhibiting

synthesis of

prostaglandi

n in the CNS

or other

substancesthat

sensitized

pain

receptors to

stimulation.

The drug

may relieve

fever

through

central

action in the

hypothalami

c heat-

regulating

center.

For mild pain orfever

Contraindicatedto patient with

long term

alcohol use

because

therapeutic

doses cause

hepatotoxicity.

CNS: Headache

CV: Chest pain, Dyspnea

GI: Hepatic toxicity and

failure, jaundice

Hypersensitivity: rash,

fever

Do not exceedrecommended dosage

Reduce dosage withhepatic impairment

Give drug with food if GIupset occurs

Discontinue drug ifhypersensitivity reactionsoccur

Use liquid form forchildren and patients

who have difficulty

swallowing.

Warn patient that highdoses or unsupervised

long term use can cause

liver damage.


14/14

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