MELISSA DAVID BSN2Y2-2B

DRUG GENERIC NAME: Calcium Gluconate

ACTION Electrolytes and replacement solutions Replaces calcium and maintain calcium level

INDICATION Hypocalcemic emergency Hypocalcemic tetany Dietary supplement

SIDE EFFECTS CNS:tingling sensations, sense of oppression or heat waves with I.V. CV:bradycardia , arrhythmias GI:constipation irritation, chalky taste, hemorrhage GU:polyuria, renal calculi METABOLIC: hypercalcemia SKIN:local reactions GI: Diarrhea, nausea, antibiotic-associated colitis. Skin: Rash, pruritus,

NURSING RESPONSIBILITIES Contraindicated in cancer Use all calcium product with patients with bone metastases extreme caution in digitalized and in those with ventricular patients and patients with fibrillation, hypercalcemia, sarcoidosis hypophosphatemia, or renal calculi. Double check that you are giving the correct form of calcium CONTRAINDICATION

GENERIC NAME: Cefuroxime

Bind to bacterial cell wall membrane, causing cell death Therapeutic Effects: Bactericidal action

It is effective for the treatment of penicillinase producing Neisseriagonorrhoea(PP NG).Effectively treats bone and joint infections, bronchitis,

Hypersensitivity to cephalosporins and related antibiotics; pregnancy(category B), lactation.

Before: Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated.

meningitis, gonorrhea, otitis media, pharyngitis /tonsillitis, sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used for surgical prophylaxis, reducing or eliminating infection

urticaria. Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance. Hemat: Hemolytic anemia MISC: Anaphylaxis Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy maybe instituted pending test results. Monitor periodically BUN and creatinine clearance. During: Inspect IM and IV injection sites frequently for signs of phlebitis. Monitor for manifestations of hypersensitivity Assess fluid status during therapy. Monitor daily weight, intake and output ratio. Monitor blood pressure and pulse before and during administration. Assess for allergy to sulfonamides.

GENERIC NAME: Furosemide

Inhibits the reabsorption of sodium and chloride from the loop of henle anddistal renal tubule. Increase renal excretion of water, sodium chloride, magnesium, hydrogen and calcium. Diereses and subsequent

Oral, IV: Edema associated with CHF, cirrhosis, renal disease IV: Acute pulmonary edema Oral: Hypertension

Fluid and electrolyte imbalance. Rashes, photosensitivity, nausea, diarrhoea, blurred vision, dizziness, headache, hypotension. Bone marrow depression (rare), hepatic dysfunction. Hyperglycaemia, glycosuria, ototoxicity.

Severe sodium and water depletion, hypersensitivity to sulphonamides and furosemide, hypokalaemia, hyponatraemia, precomatose states associated with liver cirrhosis, anuria or renal failure. Addisons disease.

mobilization of excess fluid.

GENERIC NAME: Digoxin BRAND NAME: Lanoxin

Inhibits sodiumpotassium-activated adenosine triphosphatase, promoting movement of calcium from extracellular to intracellular cytoplasm and strengthening myocardial contraction. Also acts on CNS to enhance vagal tone, slowing conduction through the SA and AV nodes.

Heart failure, paroxysmal supraventricular tachycardia, atrial fibrillation and flutter

Potentially Fatal: Rarely, sudden death and cardiac arrest. Hypokalaemia and magnesium depletion can cause cardiac arrhythmias CNS: fatigue, generalized muscle weakness, agitation, hallucinations, CV: Arrhythmias, heart block. EENT: Yellow-green halos around visual images, blurred vision, light flashes, photophobia diplopica. GI: anorexia, nausea

Contraindicated in patients hypersensitive to drug and in those with digitalis-induced toxicity, ventricular fibrillation, or ventricular tachycardia unless caused by heart failure. Patients with WolffParkinson-White syndrome unless the conduction accessory pathway has been pharmacologically or surgically disabled. Elderly patients and in those with acute MI, incomplete AV block, sinus bradycardia, PVCs, chronic constrictive pericarditis

Drug-induced arrhythmias may increase the severity of heart failure and hypotension. Before giving loading dose, obtain baseline data (heart rate and rhythm, blood pressure, and electrolytes)and ask patient about use of cardiac glycosides within the previous 2 to 3 weeks. Loading dose is usually divided over the first 24hours with approximately half the loading dose given in the first dose. Before giving drug, take apical-radial pulse for 1minute. Record and notify prescriber of significant changes (sudden increase or decrease in pulse rate, pulse deficit, irregular beats and,

GENERIC NAME: Mannitol

Increases osmotic pressure of plasma in glomerular filtrate, inhibiting tubular reabsorption of water and electrolytes (including sodium and potassium). These actions enhance water flow from various tissues and ultimately decrease intracranial and intraocular pressures.

Test dose for marked oliguria or suspected inadequate renal function, prevent acute renal failure during cardiovascular and other surgeries, acute renal failure, to reduce intracranial pressure and brain mass, reduce intraocular pressure, to promote dieresis in drug toxicity, irrigation during transurethral resection of prostate.

CNS: dizziness, headache, seizures CV: chest pain, hypotension, hypertension, tachycardia, thrombophlebitis, heart failure, vascularoverload EENT: blurred vision, rhinitis GI: nausea, vomiting, diarrhea, dry mouth GU: polyuria, urinary retention, osmotic nephrosis Metabolic: dehydration, water intoxication, hypernatremia, hyponatremia, hypovolemia,

Active intracranial bleeding (except during craniotomy), anuria secondary to severe renal disease, progressive heart failure, pulmonary congestion, renal damage, or renal dysfunction after mannitol therapy begins, severe pulmonary congestion or pulmonary edema, and severe dehydration.

particularly, regularization of a previously irregular rhythm). If these occur, check blood pressure and obtain a12-lead ECG. Thec ardiovascularstatus of the patient should becarefully evaluated before rapidly administering mannitol since sudden expansion of the extracellular fluid may lead to fulminating congestive heart failure. Shift of sodium-free intracellular fluid into the extracellular compartment following mannitol infusion may lower serum sodium concentration and aggravate pre-existing hyponatremia. By sustaining diuresis, mannitol administration may obscure and intensify inadequate hydration or hypovolemia. Electrolyte-free mannitol solutions should not be given conjointly with blood. If it is essential that blood be given simultaneously,

hypokalemia, hyperkalemia, metabolic acidosis GENERIC NAME: Paracetamol Decreases fever by Relief of mild to inhibiting the moderate pain, effects of pyrogens treatment of fever on the hypothalamic heat regulating center and by a hypothalamic action leading to sweating and vasodilation. Relieves pain by inhibiting prostaglandin synthesis at the CNS but does not have antiinflammatory action because of its minimal effect of peripheral prostaglandin synthesis. Hematologic: hemolytic anemia, neutropenia, leucopenia, pancytopenia. Hepatic: Jaundice Metabolic: Hypoglycemia Skin: rash, urticaria Contraindicated in patients hypersensitive to drug. Use cautiously in patients with long term alcohol use because therapeutic doses cause hepatotoxicity in these patients Use liquid form for children and patients who have difficulty swallowing. In children, dont exceed five doses in 24 hours. Advise patient that drug is only for short term use and to consult the physician if giving to children for longer than 5 days or adults for longer than 10 days. Advise patient or caregiver that many over the counter products contain acetaminophen; be aware of this when calculating total daily dose. Warn patient that high doses or unsupervised long term use can cause liver damage. Observe patients receiving large doses closely for at least 30 min to ensure that sedation is not excessive.

GENERIC NAME: Phenobarbital

General CNS depressant; barbiturates inhibit impulse conduction in the ascending

Oral or parenteral: Sedative Oral or parenteral: Hypnotic, treatment of insomnia for up to 2 wk

Somnolence, agitation, confusion, hyperkinesia, ataxia, vertigo, CNS depression,

Contraindicated with hypersensitivity to barbiturates, manifest or latent porphyria; marked liver impairment; nephritis;

RAS, depress the cerebral cortex, alter cerebellar function, depress motor output, and can produce excitation, sedation, hypnosis, anesthesia, and deep coma; at subhypnotic doses, has antiseizure activity, making it suitable for longterm use as an antiepileptic.

Oral: Long-term treatment of generalized tonic-clonic and cortical focal seizures Oral: Emergency control of certain acute seizures (eg, those associated with status epilepticus, eclampsia, meningitis, tetanus, and toxic reactions to strychnine or local anesthetics) Parenteral: Preanesthetic Parenteral: Treatment of generalized tonic-clonic and cortical focal seizures Parenteral: Emergency control of acute seizures (tetanus, eclampsia, epilepticus)

nightmares, lethargy, residual sedation (hangover), paradoxical excitement, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality Bradycardia, hypotension, syncope Nausea, vomiting, constipation, diarrhea, epigastric pain Rashes, angioneurotic edema, serum sickness, morbiliform rash, urticaria; rarely, exfoliative dermatitis

severe respiratory distress; previous addiction to sedative-hypnotic drugs (may be ineffective and may contribute to further addiction); pregnancy (fetal damage, neonatal withdrawal syndrome); lactation

Keep patient under constant observation when drug is administered IV, and record vital signs at least every hour or more often if indicated. Lab tests: Obtain liver function and hematology tests and determinations of serum folate and vitamin D levels during prolonged therapy. Monitor serum drug levels. Serum concentrations >50 mcg/mL may cause coma. Therapeutic serum concentrations of 1540 mcg/mL produce anticonvulsant activity inmost patients. These values are usually attained after 2 or 3 wk of therapy with a dose of 100200mg/d. Expect barbiturates to produce restlessness when given to patients in pain because these drugs do not have analgesic action. Be prepared for paradoxical responses and report promptly in older adult or debilitated

GENERIC NAME: Albuterol sulfate BRAND NAME: Salbutamol

In low doses, acts relatively selectively at beta 2 adrenergic receptors to cause bronchodilation and vasodilation; at higher doses, beta 2 selectivity is lost, and the drug acts at beta 2 receptors to cause typical sympathomimetic cardiac effect. Antasthmatic

Relief and prevention of brochospasm in patients with reversible obstructive airway disease. Inhalation: treatment of acute attacks of brochospasm. Prevention of exerciseinduced brochospasm. Unlabeled use: adjunct in treating serious hyperkalemia in dialysis patients; seems to lower potassium concentration when inhaled by patients on hemodialysis.

CNS: Nervousness Headache Insomnia CV: Tachycardia Palpitations Hypertension GI: Nausea Vomiting Heartburn Anorexia Metabolic: Hypokalemia

Contraindicated with hypersensitivity toalbuterol; tachyarrhythmias, tachycardia cause by digitalis Use minimal doses for intoxication. minimal periods; drug tolerance can occur with Use cautiously with diabetes prolonged used. mellitus; hyperthyroidism, history of seizure disorders. Maintain a adrenergic blocker (cardio selective beta blocker, such as atenolol, should be use with respiratory distress ) on standby incase cardiac arrhythmias occur.

patient and children (i.e., irritability, marked excitement [inappropriate tearfulness and aggression in children], depression, and confusion). Observe 10 rights in giving medications.

GENERIC NAME: Penicillin G

Interferes with bacterial cell wall synthesis during active multiplication,

Severe infections caused by sensitive organisms (streptococci)- URTI caused by sensitive streptococci- Treatment

CNS: Lethargy, hallucinations, seizures

Concentrations - Allergies to penicillins, cephalosporins, or other allergens

Before - Observe 15 rights of drug administration. - Reduce dosage with hepatic or renal failure.

causing cell wall death and resultant bactericidal activity against susceptible bacteria

of syphilis, bejel, congenital syphilis, pinta, yaws- Prophylaxis of rheumatic fever and chorea

GI: Glossitis, stomatitis, gastritis, sore mouth, furry tongue, black hairy tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomembranous colitis, nonspecific hepatitis GU: Nephritis Hematologic: Anemia, thrombocytopenia, leukopenia, neutropenia, prolonged bleeding itme Hypersensitivity: Rash, fever, wheezing, anaphylaxis Local: Pain, phlebitis, thrombos is at

Precaution - Renal disorders - Pregnancy - Lactation Drug interaction Drug to drug - Decreased effectiveness with tetracyclines -Inactivation of parenteral aminoglycosides (amikacin, gentamicin, kanamycin, neomycin, tobramycin)

- Assess for hypersensitivity to drug. - Assess for any contraindications to the drug. - Educate about side effects of drug. During - Drug is not for IV use. Do not inject or mix with other IV solutions - Give IM injection in upper outer quadrant of the buttock - Avoid contact with the needle. - Withdraw needle as quickly as possible to avoid discomfort - Stay with patient throughout whole duration of administration. After -Monitor client for at least 30minutes. - Arrange for regular followup, including blood tests, to evaluate effects. - Instruct to report difficulty breathing, rashes, severe pain at injection site, mouth sores, unusual bleeding or bruising.Instruct to take medication

injection site, Jarisch-Herxheimer reaction when used to treat syphilis Other: Super infections, sodium overload leading to heart failure GI: Nausea, vomiting, diarrhea, abdominal distension. WHOLE BODY: Pain, mental confusion, irritability, listlessness, paresthesias of extremities, muscle weakness and heaviness of limbs, difficulty in swallowing, flaccid paralysis. Urogenital: Oliguria, anuria. Hematologic: Hyperkalemia.

asdirected for the full course of therapy, even if feeling better.- Do proper documentation

GENERIC NAME: Potassium chloride BRAND NAME: Kalium durule

Principal intracellular cation; essential for maintenance of intracellular isotonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscles, maintenance of normal kidney function, and for enzyme activity. Plays a prominent role in both formation and correction of imbalances in acidase metabolism.

To prevent and treat potassium deficit secondary to diuretic or corticosteroid therapy. Also indicated when potassium is depleted by severe vomiting, diarrhea; intestinal drainage, fistulas, or malabsorption; prolonged diuresis, diabetic acidosis. Effective in the treatment of hypokalemic alkalosis(chloride, not the gluconate)

Severe renal impairment; severe hemolytic reactions; untreated Addisons disease; crush syndrome; early postoperative oliguria (except during GI drainage);a dynamic ileus; acute dehydration; heat cramps, hyperkalemia, patient receiving potassium-sparing diuretics, digitalis intoxication with AV conduction disturbance.

Make sure the powder are completely dissolve before giving Monitor renal function. after surgery, dont give drug until urine flow is established tell patient to take drug with or after meals with full glass of water of fruit juice to lessen GI distress

Respiratory: Respiratory distress. CV: Hypotension, bradycardia; cardiac depression, arrhythmias, or arrest; altered sensitivity to digitalis glycosides. ECG changes in hyperkalemia: Tenting (peaking) of T wave(especially in right precordial leads), lowering of R with deepening of S waves and depression of RST; prolonged P-R interval, widened QRS complex, decreased amplitude and disappearance of P waves, prolonged Q-T interval