DRUG STUDY

DATE ORDERED & STARTED GENERIC NAME & TRADE/BRAND NAME JULY 21, 2013 PARACETAMOL 500mg/tab 1tab PO q4 Inhibits the synthesis of the prostaglandins that may serve as mediators or pain and fever, primarily in the CNS. I: Mild pain. Fever. C: Previous hypersensitivity; products containing alcohol, aspartame, saccharin, sugar, or tartrazine (FDC yellow dye#5) Severe Reduce fever and hypoglycemia, headache oliguria, urticaria Assess overall health status and alcohol usage before administering paracetamol. Pain: Assess type, location, and intensity prior to and 30-60min following administration Fever: Assess fever, note presence of associated signs (diaphoresis, tachycardia, and malaise) Evaluate hepatic, hematologic, and renal function periodically Assess patient routinely for epigastric or abdominal pain and frank or occult blood in the stool and emesis. Monitor CBC Administer drug on empty stomach TEACH CLIENT Monitor for severe, persistent constipation Increase fluids, dietary bulk to relieve constipation PHARMACOLOGIC INDICATION AND ADVERSE ACTION OF DRUG CONTRAINDICATIONS EFFECTS OF THE DRUG DESIRED ACTION ON CLIENT NURSING RESPONSIBILIES

JULY 21, 2013 OMEPRAZOLE (Prilosec) 40mg NOW & OD TIV

Brings to an enzyme on gastric parietal cells in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen.

I: Reduction of risk of GI bleeding in critically ill patients C: Hypersensitivity

Fatigue, dizziness, headache, abdominal pain

Reduce the risk of pain and GI bleeding

JULY 21, 2013 CEFUROXIME 500mg/tab 1tab BID PO

Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gramnegative and grampositive bacteria, with expanded activity against gramnegative bacteria.

I: Moderate to severe infections, including those of skin, bone, joints, urinary or respiratory tract C: Hypersensitivity to cephalosporins or penicillins

Seizures, rashes, diarrhea, cramps, nausea

To reduce the development of drugresistant bacteria

Avoid liquids and foods that can cause gastric irritation : caffine-containing beverages, alcohol, certain fats, spices Assess allergy to cephalosporins Observe patient for signs and symptoms of anaphylaxis Monitor vital signs, urine output, and laboratory results. Report abnormal findings. Instruct client to report any side effects from use of oral cephalosporin drugs Advise client the tablet should be swallowed whole.

JULY 22, 2013

Binds to mu-opioid receptors. Inhibits reuptake of TRAMADOL + serotonin and PARACETAMOL norepinephrine in the 37.5mg/ 325mg tab CNS. BID PO

I: Moderate to moderately Dizziness, severe pain nausea, fatigue, C: Hypersensitivity headache, abdominal pain, constipation, diarrhea, dry mouth, vomiting, anorexia, anxiety, confusion, insomnia, nervousness,

To decreased pain

Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration. Assess BP & RR before and periodically during administration. Respiratory depression has not occurred with recommended doses. Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk and with laxatives to minimize constipating effects.

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Monitor patient for seizures. May occur within recommended dose range. Risk increased with higher doses and inpatients taking antidepressants, analgesics, or other durgs that decrese the seizure threshold. Maintain fluids and electrolytes Use sterile infusion set Assess patient's hydration status Regulate fluid as prescribed Monitor signs and symptoms of fluid volume excess and fluid volume deficit Monitor I&O Monitor IV site for infiltration or phlebitis TEACH CLIENT To recognize signs and symptoms of fluid volume excess and deficit How to measure I&O How to weigh himself /herself Use sterile infusion set Assess patient's hydration status Regulate fluid as prescribed Monitor signs and symptoms of fluid volume excess and fluid volume deficit Monitor I&O

JULY 21, 2013 D5NSS Each 100mL contains 5g of dextrose monohydrate and 300 mg of sodium chloride Hypertonic Solution

Hypertonic solutions contain a high concentration of solute relative to another solution( e.g. the cells cytoplasm) when a cell is placed in a hypertonic solution, the water diffuses out of the cell to shrivel.

I: For replacement or maintenance of fluid and electrolytes C: Hypersensitivity

JULY 22, 2013 D5LR Lactated Ringers Solution with 5%Dextrose Hypertonic

Hypertonic solutions contain a high concentration of solute relative to another solution( e.g. the cells cytoplasm) when a cell is placed in a hypertonic solution, the water

I: Treatment for persons needing extra calories who cannot tolerate fluid overload. Treatment for shock. C: Hypersensitivity

Maintain fluid and electrolyte balance

Solution

diffuses out of the cell to shrivel.

Monitor IV site for infiltration or phlebitis TEACH CLIENT To recognize signs and symptoms of fluid volume excess and deficit How to measure I&O How to weigh himself/herself