DRUG STUDY

Digoxin Brand Name: Lanoxin Classification: Cardiac glycoside Dosage: 25 mg Route: TIV Frequency: OD
ACTION INDICATION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION

Increases intracellular calcium and allows more calcium to enter the myocardial cell during depolarization via a sodiumpotassium pump mechanism; this increases force of contraction, increases renal perfusion, decreases heart rate and decreases AV node conduction velocity.

Treatment of heart failure, atrial fibrillation, ventricular dilatation, supraventric ular arrhythmias

Contraindicated with allergy to cardiac glycosides, ventricular tachycardia, ventricular fibrillation, heart block, sick sinus syndrome, acute MI, renal insufficiency and electrolyte abnormalities.

CNS: headache,weakne ss, drowsiness, visual disturbances, mental status change CV: arrhythmias GI: GI upset, anorexia

Monitor apical pulse rate for one full minute before administering the drug. Administer intravenous drug very slow IV over 5 minutes to avoid arrhythmias. Withhold the drug if pulse is less than 60 in adults more than 110 in adults Do not administer intramuscularly because it can cause severe pain Monitor the therapeutic drug level. Administer the drug without food if possible to avoid delayed absorption. Maintain emergency equipment and drugs: Potassium salts, Lidocaine for arrhythmias, phenytoin for seizures, atropine for bradycardia. Observe the patient for sign and symptoms of digitalis toxicity Weight patient daily and monitor intake and output.

Furosemide Brand Name: Lasix Classification: Loop Diuretics Dosage: 40 mg Route: TIV Frequency: q12
ACTION INDICATION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION

Inhibits sodium and chloride reabsorption at the proximal tubules, distal tubules, and ascending loop of Henle, leading to excretion of water together with sodium, chloride, and potassium

Treatment of edema associated with CHF, hepatic cirrhosis, renal disease, and hypertension

Contraindicated with allergy to furosemide, sulfonamides; allergy to tartrazine; anuria, severe renal failure; hepatic coma; pregnancy and lactation.

CNS: headache,dizziness, weakness, drowsiness, fatigue, blurred vision, irreversible hearing loss CV: orthostatic hypotension, volume depletion, cardiac arrhythmias, thrombophlebitis GI: nausea and vomiting, anorexia, oral and gastric irritation, constipation GU: polyuria, nocturia, urinary bladder spasm

Arrange to monitor sodium and potassium serum electrolytes. Administer early in the morning so that increased urination will not disturb sleep Administer with food or milk to prevent GI upset. Assess fluid volume status (urine, color, quality and specific gravity) Monitor for renal, cardiac, GI, pulmonary manifestations of hypokalemia Monitor daily weight to evaluate effectiveness of therapy.

Cefuroxime Sodium Brand Name: Zinacef Classification: Antibiotic Dosage: 750 mg Route: TIV Frequency: q8
ACTION INDICATION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION

Inhibits synthesis of bacterial cell wall, causing cell death.

Treatment of urinary tract infection caused by

Contraindicated with allergy to cephalosporinsor penicillins.

Escherichia coli, Klebsiella pneumoniae

CNS: headache, dizziness GI: nausea and vomiting, anorexia, diarrhea, abdominal pain GU: nephrotoxicity Hematologic: bone marrow depression

Culture infection site and arrange for sensitivity tests before and during therapy. Before giving, ask the patient about any allergic reaction to penicillin. Do skin test. Monitor patients serum creatinine levels to detect early signs of nephrotoxicity. Monitor renal status and function regularly. Administer the correct dosage and stress the importance of completing the full course and duration of therapy even though the patient experiences relief earlier in the treatment Give IV intermittently to prevent vein irritation. Changes site every 48 hrs. Assess IV injection sites frequently for signs of phlebitis. Discontinue if hypersensitivity reaction occurs. Have vitamin K available in case hypoprothrombinemia occurs.

Omeprazole Brand Name: Losec Classification: Proton pump inhibitor Dosage: 40 mg Route: TIV Frequency: q12
ACTION INDICATION CONTRAINDICATION ADVERSE REACTION NURSING CONSIDERATION

Supresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cell; blocks the final step of acid production.

Short-term treatment of active duodenal ulcers, GERD, erosive esophagitis and benign gastric ulcer

Contraindicated wit hypersensitivity to omeprazole or its components.

CNS: headache, dizziness, asthenia, insomnia, apathy, vertigo GI: diarrhea, abdominal pain, nausea, vomiting, dry mouth and tongue atrophy Respiratory: cough, stuffy nose, hoarseness and epistaxis

Administer before meals. Administer with antacid if necessary. Monitor therapeutic effectiveness and adverse reactions beginning and during therapy. Provide appropriate safety and comfort measures if CNS effect occurs to prevent injury. Assess GI system: bowel sounds, abdomen, and loss of appetite. Provide health teaching about the drug to enhance patients knowledge about drug therapy and promote compliance. Provide safety measures if CNS dysfunction happens. Monitor patient response to the drug, the effectiveness of the teaching plan and the measures to employ.