FAR EASTERN UNIVERSITY INSTITUTE OF NURSING

DRUG STUDY
(St. Vincent Hospital)

DRUG NAME

DRUG CLASSIFICATION
Corticosteroid, Glucocorticoid, Hormone

INDICATIONS
-Hypercalcemia associated w/ cancer -Short-term management of various inflammatory and allergic disorders, such as rheumatoid arthritis -Hematologic disorders -Trichinosis w/ neurologic or myocardial involvement -Respiratory inhalant: control of bronchial asthma requiring corticosteroids -Ophthalmic preparations: Inflammation of the lid, conjunctiva, cornea, and globe

TIME AND DOSAGE

Oral- 0.75-9 mg/day. -Suppresion test for Cushings syndrome: 1mg at 11pm; assay plasma cortisol at 8am the next day. For greater accuracy, give 0.5mg every 6hr for 48hr, and collect 24hr urine to determine 17hydroxycorticosteroid (17-OHCS) excretion.

ADVERSE/SIDE EFFECTS
CNS: Seizures, vertigo, headaches CV: Hypertension, heart failure Endocrine: Growth retardation, decreased carbohydrate tolerance, DM GI: Peptic or esophageal ulcer, pancreatitis GU: Amenorrhea, irregular menses Hematologic: Fluid electrolyte disturbances Hypersensitivity: hypersensitivity rx. Musculo.: Muscle weakness Side Effect: Difficulty sleeping; feeling of a whirling motion; increased appetite; increased sweating; indigestion; mood changes; nervousness.

NURSING CONSIDERATIONS
-History for systemic administration -History for ophthalmic preparations Physical for systemic administration -Physical for topical dermatologic preparations Interventions: -for systemic administration, do not give drug to nsg. Mothers Teaching points: -Systemic administration -Intra-articular administration -Topical -Ophthalmic

Generic Name: Dexamethasone Brand Name: Aeroseb-Dex, ApoDexamethasone (CAN), Decadron, Dexasol

DRUG NAME
Generic Name: Ceftazidime Brand Name: Ceptaz, Fortaz, Tazicef, Tazidime

DRUG CLASSIFICATION
Antibiotic, Cephalosporin (Third generation)

INDICATIONS
-Lower resp. infections caused Pseudomonas aeruginosa -UTIs caused by P. aeruginosa -Gynecologic infections caused by E. coli -Skin and skin structure infections Septicimea caused by P. aeruginosa Bone and joint infections caused by P. aeruginosa, Klebsiella, Enterobacter, S. aureus

TIME AND DOSAGE

Adults: usual dose, 1g (range 250 mg-2g) every 8-12hr IM or IV. Do not exceed 6 g/day. Dosage will vary with infection.

ADVERSE/SIDE EFFECTS
CNS: headache, dizziness, lethargy, paresthesias GI: Nausea, vomiting, diarrhea, anorexia GU: Nephrotoxicity Hematologic: Bone marrow depression Hypersensitivity: Ranging from rash to fever to anaphylaxis Local: Pain Other: Super infections, disulfiram-like reaction w/ alcohol Side effects: Diarrhea; headache; nausea; numbness or tingling of skin; stomach pain; vomiting

NURSING CONSIDERATIONS
-History: Hepatic and renal impairment, lactation, pregnancy -Physical: Skin status, LFTs, renal function tests, culture of affected area, sensitivity tests Interventions: -Culture infection site, and arrange for sensitivity test Teaching points: -Avoid alcohol while taking this drug and for 3 days after bec. Severe rxs often occur

DRUG NAME
Generic Name: Morphine Sulfate Brand Name: Kadian Durable

DRUG CLASSIFICATION
Opioid agonist analgesic

INDICATIONS
-Relief of moderate to severe acute and chronic pain -Preoperative medication to sedate and allay apprehension -Analgesic adjunct during anesthesia -Component of most preparations that are oral alcoholic solutions used for chronic severe pain Unlabeled use: Relief of pain associated with MI

TIME AND DOSAGE

Adults Oral: One third to one-sixth as effective as parenteral administration bec. Of fist-pass metabolism; 10-30 mg every 4hr PO. CR, ER, and SR: 30mg every 4hr PO. CR, ER, and SR: 30 mg q 8-12hr PO or as directed by physician; Kadian: 20-100mg PO daily 24-hr release system; MS Contin; 200 mg PO every 12hr

ADVERSE/SIDE EFFECTS
CNS: Light-headedness, dizziness, sedation CV: Facial flushing, peripheral circulatory collapse Dermatologic: Pruritis, urticaria, laryngospasm GI: Nausea, vomiting, dry mouth GU: Ureteral spasm Local: Tissue irritation and induration Major Hazards: Respiratory depression, apnea, shock, cardiac arrest Side Effects: Shallow breathing, slow heartbeat; seizure (convulsions); cold, clammy skin; confusion; severe weakness or dizziness; or Feeling light-headed, fainting.

NURSING CONSIDERATIONS
-History: Hypersensitivity to opioids, diarrhea caused by poisoning -Physical: T; skin color, texture, lesions, orientation, reflexes Interventions: -Caution pt. not to chew or crush CR, ER, or SR prep. And ensure appropriate use of these forms Teaching Points: -Take this drug exactly as prescribed. -Swallow controlledrelease, extendedrelease

DRUG NAME
Generic Name: Allopurinol Brand Name: Aloprim, ApoAllopurinol (Can, Zyloprim

DRUG CLASSIFICATION
Antogout Drug

INDICATIONS
-Management of the signs and symptoms of primary and secondary gout -Management of patients with leukemia -Management of patients with recurrent calcium oxalate calculi -Orphan drug use Unlabeled uses: Amelioration of granulocyte suppression with 5FU

TIME AND DOSAGE

Adults: Gout and hyperuricemia: 100800mg/day PO in divided doses, depending on the severity of the disease Maintenace: Establish dose that maintains serum uric acid levels within normal limits.

ADVERSE/SIDE EFFECTS
CNS: Headache, drowsiness, peripheral neuropathy, neuritis, paresthesias Dermatologic: Rashesmaculopapular, scaly GI: nausea, vomiting, diarrhea GU: Exacerbation of gout and renal calculi Hematologic: Anemia, leucopenia

NURSING CONSIDERATIONS
-History: Allergy to allopurinol, blood dyscrasias, liver disease -Physical: Skin lesions, color, orientation, reflexes Interventions: -Administer drug ff. meals -Encourage pt. to drink 2.5-3 L/day to dec. the risk of renal stone development Teaching points: -Take the drug after meals. -Avoid over-thecounter medications.

DRUG NAME
Generic Name: Paracetamol (Acetaminophen ) Brand Name: Acephen

DRUG CLASSIFICATION
Analgesic (nonopioid), Antipyretic

INDICATIONS
-Temporary reduction of fever, temporary relief of minor aches and pains caused by common cold and influenza -Unlabeled use: Prophylaxis in children and patients at risk for seizures who are receiving DTP vaccination to reduce incidence of fever and pain.

TIME AND DOSAGE

Adults and children older than 12yr: PO or rectal suppositories: 325-650mg every 4-6hr PO, or 1.300mg ER tab every 8hr. Do not exceed 3,900 mg/day

ADVERSE/SIDEEFFECTS
CNS: Headache CV: Shest pain, dyspnea, myocardial damage when doses of 5-8g/day are ingested daily for several wks. GI: Hepatic toxicity and failure, jaundice GU: Acute renal failure, renal tubular necrosis Hematologic: Methemoglobinemiacyanosis; hemolytic anemia Hypersensitivity: Rash, fever Side Effects: fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; the first sign of any skin rash, no matter how mild; pain or bleeding when you urinate; nausea, upper stomach pain, itching, loss of appetite, weight loss, dark urine, claycolored stools, jaundice (yellowing of the skin or eyes); urinating less than usual or not at all; joint pain, flu symptoms;

NURSING CONSIDERATIONS
-History: Allergy to acetaminophen, impaired hepatic function, chronic alcoholism, pregnancy, lactation -Physical: Skin color, lesions; T; liver evaluation; CNC, LFTs, renal function tests Interventions: -Administer by direct IV if parenteral use is necessary Teaching pnts.: -Take drugs with meals if GI upset occurs