32

DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effect
DERMATOLOGIC:

Nursing Responsibility

P O T A S S I U M C H L O R I D E

K A L I U M D U R U L E

Potassium Supplement

Principal intracellular cat ion, essential of intracellular isotonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscles, maintenance of normal kidney functions and correction of imbalances in acidbase metabolism.

Prevention and correction of potassium with acidosis, use potassium acetate, bicarbonate, citrate, or gluconate.

16-24 or 40-80 mEq/ day PO

1 tab OD

Contraindicated with allergy to tartrazine, aspirin (tartrazine is found in some preparations marketed as KaonCL, Klor-Con); theraphy with potassium-sparing diuretics or aldosteroneinhibiting agents; severe renal impairement with oliguria, anuria, azotemia; untreated addisons disease, hyperkalemia; adynamia episodica hereditaria; acute dehydration; heat cramps; GI disorders that delay passage in the GI tract.

Observe 10 rights in giving medication, GI: Right to: Nausea, vomiting, -Medication diarrhea, -Time abdominal -Route discomfort, GI -Client obstruction, GI -Assessment bleeding, GI - Dosage ulceration or -Evaluation perforation. -Client Education -DocumentaHEMATOLOGIC: Tion Hyperkalemia-Refuse increased serum Administer oral potassium, ECG drug after meals or changes (peaking with food and full of T waves, loss glass of water to of P waves, decrease GI upset. depression of ST Tell the patient to segment, not chew or crush prolongation of tablets; have patient Qtc interval) swallow tablet whole. Tell the patient LOCAL: that he may Tissue sloughing, experience side local necrosis, effects such as local phlebitis, Nausea, vomiting and and venospasm diarrhea. with injection. Rash

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Tell the patient to report tingling of the hand or feet, unusual tiredness or weakness, feeling of heaviness in legs, abdominal pain. Monitor serum potassium before and during therapy.

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DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

A Z I T H R O M Y C I N

Z I T H R O M A X

Macrolide Anti-infective

Bactericidal and bacteriostatic. Inhibits protein synthesis after binding with 50S ribosomal subunit of susceptible organisms.

Treatment of lower respiratory infections; acute bacterial of COPD, community acquired pneumonia.

Immediate 500mg -release: 1tab P.O 500 mg OD orally as a single dose on the first day followed by 250 mg orally once a day on days 2 through 5 for mild infections

Hypersensitivity to drug, erythromycin or other macrolide anti-infective.

CNS: headache, dizziness, drowsiness, fatigue, vertigo. CV: chest pain, palpitation. GI: diarrhea, nausea, vomiting, abdominal pain, dyspepsia, flatulence, psuedomembrano us colitis GU: nephritis, candidiasis METABOLIC: hyperglycemia, hyperkalemia SKIN: rashes, photosensitivity, angioedema.

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client -Assessment - Dosage -Evaluation -Client Education -DocumentaTion -Refuse Assess for signs and symptoms of infection. Administer on an empty stomach--1 hr before or 23 hr after meals. Food affects the absorption of this drug. Instruct patient no to take any medication without consulting prescriber. Instruct patient to immediately

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report adverse reactions promptly such as severe watery diarrhea, severe nausea and vomiting and mouth sores. Inform patient that he may experienced these side effects: cramping, headache, stomach cramping Remind patient to complete entire course of therapy as ordered, even after symptoms improve.

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DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

F U R O S E M I D E

L A S I X

Loop diuretics Inhibit sodium and chloride reabsorption from ascending loop of Henle and distal renal tubules

For hypertension, renal disease.

40 mg IV over 1-2 minute or may be increased to 80 mg IV over 12 minute if reponse is unsatisfact ory after 1 hour

40 mg IVTT stat dose .

Severe sodium and water depletion, hypersensitivity to Sulpfonamides and Furosemide, hypokalemia, hyponatremia, anuria

CNS: headache, dizziness, lethargy, restlessness, paresthesia, lightheadeness, drowsiness. CV: orthostatic hypotension, tachycardia, volume depletion arrhythmias, hypotension, EENT: blurred vision, hearing loss, tinnitus GI: diarrhea, nausea, vomiting, constipation, abdominal pain, dyspepsia, anorexia, acute

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client -Assessment - Dosage -Evaluation -Client Education -DocumentaTion -Refuse Closely monitor for BP and vital signs because it causes hypotension. Monitor intake and output Encourage patient to eat potassiumrich foods daily (e.g., bananas, oranges, peaches, dried dates) to reduce or prevent potassium depletion.

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pancreatitis . GU: excessive and frequent urination, nocturia, glycosuria, bladder spasm,, oliguria, interstitial nephritis HEPATIC: jaundice. METABOLIC: hyperglycemia hyeruricemia, dehydration, hypokalemia, hypocalcemia, hypochloremic acidosis SKIN: rashes, diaphoresis, pruruitus, OTHERS: pain , fever,

Advise patient to avoid sudden change of movement as it causes dizziness and orthostatic hypotension. Advise patient to contact health care professional immediately if rash, muscle weakness, cramps, nausea, dizziness, numbness, or tingling of extremities occurs.

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DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

C E T R I Z I N E

A L V I X

Antihistamine

Potent specific histamine (H1) receptor antagonist; inhibits histamine release and eosinophil chemotaxis during inflammation,l leading to reduced swelling and decrease inflammatory response.

Management of seasonal and perennial allergic rhinitis, allergies, hay fever.

5mg10mg BID

1 tab now Contra indicated then OD with allergy to any antihistamine, hydroxyzine.

CNS: somnolence, sedation CV: palpitation, edema, dizzines GI: nausea, diarrhea, abdominal pain, constipation, dry mouth RESPIRATORY: bronchospasm, pharynchitis OTHER: fever, photosensitivity, rash, myalgia, arthralgia, angioedema, fatigue

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client -Assessment - Dosage -Evaluation -Client Education -DocumentaTion -Refuse Give the medication without regard to food. Arrange humidifier if thickening of secretions, nasal dryness become bothersome; encourage intake of fluids. Inform about the different side effects of the drug. Instruct to report

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difficulty of breathing, tremors, loss of coordination, and irregular heart beat.

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DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

A C E T Y L C Y S T E I N E

E X F L E M

Antidote Mucolytic

Mucolytic activity: Splits links in the mucoproteins contained in respiratory mucus secretions, decreasing the viscosity of the mucus.

Mucolytic adjuvant therapy for abdominal, viscid, or inspissated mucus secretions in acute and chronic bronchopulmonary disease.

140mg PO 60mg 1 tab + 100cc H20 OD

Contra indicated with allergy to acetylcysteine.

To prevent or Antidote for lessen hepatic acetaminophen injury that may hepatotoxicity: occur after Protects liver cells ingestion of by maintaining cell potentially function and hepatotoxic dose of detoxifying acetaminophen. acetaminophen metabolites.

Observe 10 rights in giving medication, Right to: -Medication HYPERSENSITI -Time VITY: -Route urticaria -Client -Assessment RESPIRATORY: - Dosage bronchospasm, -Evaluation especially with -Client Education asthma patient -DocumentaTion OTHER: -Refuse rhinorrhea Be careful with the dilutions to be Antidote: given. DERMATOLOGI Prepare fresh C: solutions and use it rash within 1 hour. Do not administer GI: diuretics. nausea, vomiting, Instruct to report other GI difficulty of breathing symptoms or nausea. Mucolytic: GI: nausea, stomatitis OTHER: anaphylactoid reaction

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DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

C A P T O P R I L

P R I M A S E

ACE inhibitor Antihypertens ive

Blocks ACE from converting angiotensin I to angiotensine II, a powerful vasoconstrictor leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increasing prostaglandins synthesis also maybe involved in the antihypertensive action.

Treatment of hypertension.

25mg PO BID or TID

25mg tab BID

Contra indicated with allergy to captopril, history of angioedema.

CV: tachycardia, angina pectoris, heart failure, MI, Raymunds syndrome, hypotension in salt or volumedepleted patients DERMATOLOG Y: alopecia, rash, pruritus, scalded mouth, sensation, pemphigoidlike reaction, exfoliative dermatitis, photosensitivity GI: gastric irritation, aphthous ulcers, peptic ulcer, dysgeuria, cholestatic

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client -Assessment - Dosage -Evaluation -Client Education -DocumentaTion -Refuse Monitor patient for drop in BP secondary to reduction in fluid volume. Instruct the patient to take 1 hour before meals, do not take with food. Inform to report mouth sores, some throat, fever, chills, swelling of the hands

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jaundice, hepatocellular injury, anorexia, constipation GU: proteinuria, renal insufficiency, renal failure, oliguria, urinary frequency HEPATOLOGIC: neuropenia, agranulocytosis, thrombocytopenia , haemolytic anemia, pancytopenia OTHER: cough, malaise, dry mouth, lynphadenopathy

or feet, irregular heart beat, chest pains, swelling of the face, eyes, lips, or tongue, and difficulty in breathing.

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DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

D I G O X I N

Antiarrhythmi c Inotropic

Strenghtens myocardial contraindications and slows conduction through SA and AV nodes.

Heart failure, paroxysmal supraventricular tachycardia, atrial fibrillation and flutter.

0.25mg IV 5mg IV OD now then 25mg 1 tab OD

Contraindicated with patient with hypersensitivity to the drug or any of its components and in those with digitalis-induced toxicity, ventricular fibrillation, or ventricular yachycardia unless caused by heart failure.

CNS: Agitation, dizziness, fatigue, generalized muscle weakness, hallucinations, headache, malaise, paresthesia, stupor, vertigo CV: Arrhythmia, heart failure, hypotension EENT: Blurred vision, diplopia, light flashes, photophobia, yellow-green halos around visual images GI:

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client -Assessment - Dosage -Evaluation -Client Education -DocumentaTion -Refuse Monitor potassium level carefully. Tell patient to eat potassium-rich food. Inform the patient about the different side effects that may experience. Inform to report if experience

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Anorexia, diarrhea, nausea, vomiting

DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

P A R A C E T A M O L

B I O G E S I C

Non-narcotic Analgesic Antipyretic

Inhibits pyrogen effect on the hypothalamicheat-regulating centers. And inhibits CNS prostaglandin synthesis with minimal effects on peripheral prostaglandin synthesis.

Decreases fever by a hypothalamic effect leading to sweating and vasodilation.

325650mg every 4 hours up to a maximum of 1 gram every 6 hours

500mg 1 tab every 4 hours PRN

Contraindicated Minimal GI with patient with upset. renal insufficiency Methemoglobin and anemia. emia Hemolytic Anemia Neutropenia Thrombocytope nia Pancytopenia Leukopenia Urticaria CNS stimulation Hypoglycemic coma Jaundice Glissitis Drowsiness Liver Damage

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client -Assessment - Dosage -Evaluation -Client Education -DocumentaTion -Refuse Monitor CBC, liver and renal functions. Assess for fecal occult blood and nephritis. Take with food or milk to minimize GI upset. Report N&V.

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cyanosis, shortness of breath and abdominal pain as these are signs of toxicity. Report paleness, weakness and heart beat skips Report abdominal pain, jaundice, dark urine, itchiness or clay-colored stools. Report pain that persists for more than 3-5 days . This drug is not for regular use with any form of liver disease.

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DRUG STUDY
Generic Name Brand Name Classification Anticholinergic Antimuscarinic Bronchodilator Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

I P R A T R O P I U M B R O M I D E

C O M B I V E N T

Parasympatholytic

Anticholinergic; chemically related to atropine which blocks vagally, mediated reflexes by antagonizing the action of acetylcholine. Causes bronchodilations and inhibits secretion from serous and seromucous glands lining the nasal mucosa.

Bronchodilator for maintenance treatment of bronchospasm associated with COPD (solution, aerosol).

500mcg TID-QID

5mg IV now then 25mg 1 tab OD

Contraindicated in patients with a history of hypersensitivity to atropine or its derivatives, soybean or peanut allergy.

GENERAL: Headache, pain, influenza, chest pain GI: Nausea, GI distress, dry mouth RESPIRATORY: Bronchitis, dyspnea, cough, pneumonia, bronchospasm, pharyngitis, sinusitis, rhinitis OTHER: Back pain, chest pain, palpitations, rash

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client -Assessment - Dosage -Evaluation -Client Education -DocumentaTion -Refuse Ensure adequate hydration; control environment temperature to prevent hyperexia. Have patient void before taking the medication. Inform the patient about the different

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side effects that may occur. Report rash, eye pain, difficulty voiding, palpitation, and vision change. DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

S U L T A M I C I L L I N

U N A S Y N

Antibiotic

Used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

375750mg BID

75mg 1 tab BID

Contraindicated in individuals with a history of hypersensitivity reactions to any of the penicillins

fever sore throat headache with a severe blistering, peeling, and red skin rash diarrhea that is watery or bloody; or fever, chills, body aches, flu symptoms. nausea vomiting stomach pain bloating, gas vaginal itching or discharge;; itching; swollen, black, or "hairy" tongue;

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client -Assessment - Dosage -Evaluation -Client Education -DocumentaTion -Refuse May taken with or without food.

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thrush (white patches or inside your mouth or throat); or pain, swelling, or other irritation where the needle is placed.

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DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

N A P R O X E N + O M E P R A Z O L

S K E L A N P R O T E C T

NSAIDs Analgesic (nonopioid)

Analgesic, antiinflammatory, and antipyretic activities largely related to inhibition of prostaglandin synthesis; exact mechanism of action is unknown.

It reduces swelling, 250inflammation and 500mg PO pain, and is used for TID the relief of mild to moderately severe pain accompanied by inflammation.

5mg IV now then 25mg 1 tab OD

Contraindicated with patient with allergy to naproxen, other NSAIDs, and salicylates.

Observe 10 rights in giving medication, Right to: -Medication -Time -Route DERMATOLOGI -Client C: -Assessment Rash, sweating, - Dosage stomatitis -Evaluation -Client Education GI: -DocumentaNausea, dyspnea, Tion GI pain, diarrhea, -Refuse vomiting, Instruct to take constipation, drug with meal or flatulence food. Instruct the GU: patient not to chew, Renal cut or crush the impairement, drug. hematuria, Inform the patient dysuria about the different CNS: Headache, dizziness, insomnia, fatigue, tiredness

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side effects that HEMATOLOGIC may occur. : Report sore Bleeding platelet throat, fever, rash, inhibition wih weight gain, change higher doses, in vision, and black aplastic anemia, tarry stool. menorrhagia RESPIRATORY: Dyspnea, hemoptysis, bronchospasm, rhinitis OTHER: Peripheral edema DRUG STUDY
Generic Name Brand Name Classification Mode of Action Indication Usual Dose Actual Dose Contraindication Side Effects Nursing Responsibilities

S P I R O N O L A C T O N E

A L D A Z I D E

Aldosterone antagonist; Potassiumsparing diuretic

Competitively blocks the effects of aldosterone in the renal tubule, causing loss of sodium and water and retention of potassium.

25, 50, Diagnosis and 100mg maintenance of primary hypertension. Treatment of hypokalemia in patients who would be at risk if hypokalemia occurred.

tab OD Contraindicated with allergy to spironolactone, hyperkalemia, renal disease, anuria, amiloride or triamterene use.

Observe 10 rights in giving medication, Right to: -Medication -Time -Route -Client DERMATOLOGI -Assessment C: - Dosage Rash, urticaria -Evaluation -Client Education GI: -DocumentaCramping, Tion diarrhea, dry -Refuse CNS: Dizziness, headache, drowsiness, fatigue, ataxia, confusion

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+ B U L T I Z I D E

Give daily doses early so that increasing urination GU: doesnt interfere Impotence, with sleep. irregular menses, Avoid giving amenorrhea, food rich in postmenopausal potassium. bleeding Weigh patient on a regular basis, at HEMATOLOGIC the same time and : in the same Hyperkalemia, clothing, and hyponatremia, record. agranulocytosis Inform the patient about the side OTHER: effects of the drug. Deepening of the Report weight voice, birsutism change of more than 3 pounds in 1 day, swelling in ankles or fingers, dizziness, and muscle weakness or cramps. mouth, thirst, vomiting