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DRUG STUDY

GENERIC
NAME &
TRADE
NAME

CLASSIFICAT
ION

Generic
Antipyretic
Name:
Analgesic
Acetaminop
hen
Trade
Name: Oral:
Aceta,
Apacet,
Atasol
(CAN),
Genapap,
Genebs,
Liquiprin,
Mapap,
Panadol,
Tapanol,
Tempra,
Tylenol
Suppositori
es: Abenol
(CAN),
Acephen

INDICATIO
NS
Analgesicantipyretic
in patients
with aspirin
allergy,
hemostatic
disturbance
s, bleeding
diatheses,
upper GI
disesase,
gouty
arthritis
Arthritis and
rheumatic
disorders
involve
musculoskel
etal pain
common
cold, flu,
other viral
and
bacterial
infections
with pain
and fever

MECHANI
SM OF
ACTION
Antipyretic
: Reduces
fever by
acting
directly on
the
hypothala
mic heatregulating
center to
cause
vasodilatio
n and
sweating,
which
helps
dissipate
heat.

ROUTE/FREQUENCY/D
OSAGE
Adults: PO or PR
By suppository, 325-650
mg q 4-6 hrs or
PO, 1000 mg tid or qid.
Do not exceed 4g/day
Pediatric: PO or PR
Doses may be repeated
4-5 times/day; do not
exceed five doses in 24
hr; give PO or by
suppository.

ADVERSE
REACTIONS/SI
DE EFFECTS
CNS: Headache
CV: Chest pain,
dyspnea,
myocardial
damage when
doses of 5-8
g/day are
ingested daily for
several weeks or
when dosage of
4gday are
ingested for 1
year.
GI: Hepatic
toxicity and renal
failure, jaundice
GU: Acute renal
failure, renal
tubular necrosis
HEMATOLOGIC:
Methemoglobine
mia-cyanosis;
hemolytic
anemiahematuria,
anuria;
neutropenia,
leucopenia,

DRUG-TODRUG, FOODTO-DRUG
INTERACTION
Increased
toxicity with
longterm,
excessive
ethanol
ingestion

NURSING
CONSIDERATIONS/PA
TIENT TEACHING
Do not exceed the
recommended dosage.

Consult physician if
needed for < 3 yr; if
needed for longer than
10 days; if continued
Increased
fever, severe or
hypoprothrombin recurrent pain occurs
emic effect of
(possible serious
oral
illness).
anticoagulants
Avoid using multiple
Increased risk of preparations containing
hepatotoxicity
acetaminophen.
and possible
Carefully check all OTC
decreased
products. They may
therapeutic
contain acetaminophen,
effects with
and serious overdose
barbiturates,
can occur. If OTC drugs
carbamazepine, is needed, consult
hydantoins,
health care provider.
rifampin,
sulfinpyrazone
Give drug with food if
GI upset occurs.
Possible
delayed or
Discontinue drug if
decreased
hypersensitivity
effectiveness
reaction occurs.
with
anticholinergics
Report rash, unusual
bleeding or bruising.

pancytopenia,
thrombocytopeni
a, hypoglycemia
HYPERSENSITI
VITY: Rash,
fever

Possible
reduced
absorption of
acetaminophen
with activated
charcoal
Possible
decreased
effectiveness
with zidovudine

DRUG STUDY
Generic/Trade Name
Omeprazole(omepron
)

Classification
*Antiulcer
drugs

Indication

Action

Side/Adverse Effects

*Symptomatic
gastroesophageal
reflux disease (or
GERD) without
esophageal
lesions.
*Erosive
esophagitis and
accompanying
symptoms
caused by
GERDs.
*Maintenance of
healing erosive
esophagitis.
*Pathologic
hypersecretory
conditions.
Duodenal ulcers.

*Inhibits
activity of acid
(proton) pump
and binds to
hydrogenpotassium
adenosin
triphosphatase
at sedretory
surface of
gastric parietal
cells to block
formation of
gastric acid.

*CNS: asthenia,
dizziness, headache.
*GI: abdominal pain,
constipation, diarrhea,
flatulence, nausea, and
vomiting.
*MUSCULOSKELETAL:
Backpain,
*RESPIRATORY:
Cough, upper
respiratory tract
infection,
*SKIN: rash

Drug Interaction
*Ampicillin esters, iron
derivatives,
ketokonazole: may
cause poor
bioavailability of these
drugs because they
need a low gastric PH
for optimal absorption.
Avoid using together.
*Diazepam,fosphenytoin,
phenytoin, warfarin: may
decrease hepatic
clearance, possibly
leading to increased
levels of these drugs.
Monitor levels of drugs.

Route,
Dosage,
Frequency
*20mg
capsule
once a day

Nursing
Consideration
*Dosage
adjustment
may be
necessary in
Asians and
patients with
hepatic
impairment.
*Drug
increases its
own
bioavailability
with repeated
doses. Drug
is unstable in
gastric acid;
less drug is
lost by
hydrolysis
because drug
increases
gastric pH.
*Gastrin level
rises in most
patients
during the 1st
2 weeks of
therapy.

Reference: Nursing 2008 Drug Handbook 28 th Edition.

DRUG STUDY
Generic/Trade
Name
Phytomenadione
/
konakion

Classification

Indication

*Haemostatics *Hemorrhage or
threatened
hemorrhage as a
result of severe
hypoprothrombinemi
a (ie, deficiency of
coagulation factors II,
VII, IX, X) due, for
instance, to
overdosage of
anticoagulants of the
dicoumarol type or
their combination with
phenylbutazone or to
other forms of
hypovitaminosis K
(eg, obstructive
jaundice, liver and
intestinal disorders,
prolonged
administration of
antibiotics,
sulfonamides or
salicylates).
Prophylaxis and
treatment of
hemorrhagic disease
of the newborn.

Action
*Vitamin K1 is a
coagulationpromoting factor. As
a component of a
liver carboxylase
system, it is involved
in the carboxylation
of the coagulation
factors II
(prothrombin), VII, IX
and X, and of the
coagulation inhibitors
protein C and protein
S in the postribosomal
phase.Anticoagulant
s of the dicoumarol
type inhibit reduction
of vitamin K1
(quinone form) to
vitamin K1
hydroquinone and
also prevent the
vitamin K1 epoxide
which arises after the
carboxylation
reaction from being
reduced to the
quinone form.

Side/Adverse
Effects
*cause severe,
shock-like
reactions.
the veins may
become irritated
or phlebitis
tenderness.
anaphylactoid
reactions .

Drug Interaction
* Dicoumarol
and its
derivatives
antagonize the
effect of vitamin
K on postribosomal
carboxylation of
certain
coagulation
factors and
inhibitors.

Route, Dosage,
Frequency
*10mg slow IVTT
every 1 dose

Nursing
Consideration
*Administer
slowly.
*regular
monitoring of
prothrombin
values until
coagulation
returns to
normal.
*Monitor BP,
pulse rate
and heart
rate
*Monitor urine
output

DRUG STUDY
Generic/Trade
Name
dopamine

Classification
*Alpha and
Beta
*Adrenergic
*Agonist

Indication
*Correction of
hemodynamic
imbalances

Action
*Dopamine
stimulates
dopaminergic
receptors at
lower doses
producing renal
and mesenteric
vasodilation
while at higher
doses stimulate
both
dopaminergic
and adrenergic
receptors
producing
cardiac
stimulation and
renal
vasodilation. It
increases heart
rate and force of
contraction. At
low infusion
rates
vasodilatation
occurs in the
renal,
mesenteric,
coronary and
cerebral beds.
At higher rates
vasoconstriction
in skeletal
muscles and a

Side/Adverse
Drug Interaction
Effects
*CNS: headache, *Cyclopropane and
dizziness
halogenated
hydrocarbon
*CV: tachycardia, anaesthetics may
sensitise
hypotension,
myocardium to
vasoconstriction,
dopamine and
hypertension,
precipitate
dsypnea,
ventricular
bradycardia.
Irregular
heart arrhythmias. MAO
inhibitors prolong
beat
and increase
*GI: nausea and dopamine effects.
Ergots potentiate
vomiting,
vasoconstriction
action of dopamine.
Alpha-blockers
unmask dopamine's
beta action.

Route, Dosage,
Frequency
*Dopamine 20cclhr
side drip

Nursing
Consideration
*Monitor BP, pulse
rate and heart
rate
*Monitor urine
output
*Assess for
blanching
*Monitor
pulmonary artery
catheter

rise in BP.

DRUG STUDY
Generic/Trade
Name

Classification

Indication

Cefuroxime/Zetagal *Cephalosporins *Cefuroxime is


a 2nd
generation
cephalosporin
antibiotic used
in the treatment
of susceptible
infections.
These have
included bone
and joint
infections,
bronchitis (and
other lower
respiratory tract
infections),
gonorrhea,
meningitis,
otitis media,
peritonitis,
pharyngitis,
sinusitis, skin
infections
(including soft
tissue
infections) and
urinary tract
infections. It is
also used as
prophylaxis for
surgical
infection.

Action

Side/Adverse
Effects

*Cefuroxime is
widely distributed
in the body
including pleural
fluid, sputum,
bone, synovial fluid
and aqueous
humor, but only
achieves
therapeutic
concentrations in
the CSF when the
meninges are
inflamed. It crosses
the placenta and
has been detected
in breast milk. It is
excreted
unchanged, by
glomerular filtration
and renal tubular
secretion and high
concentrations are
achieved in the
urine. Following
injection, most of a
dose of cefuroxime
is excreted within
24 hrs, the majority
within 6 hrs..
Plasma
concentrations are
reduced by

*Gastrointestinal
disturbances
including diarrhea,
nausea and
vomiting have
occurred in some
patients receiving
cefuroxime axetil.
There have been
rare reports of
erythema
multiforme,
Stevens-Johnson
syndrome and
toxic epidermal
necrolysis.

Drug
Interaction
*Probenecid
reduces the
renal
clearance of
cefuroxime.

Route, Dosage,
Frequency

Nursing
Consideration

*750 mg IVTT every


8 hours

*Cefuroxime
should not be
given to patients
who are
hypersensitive to
cefuroxime or to
cephalosporines.
About 10% of
penicillin-sensitive
patients may also
be allergic to
cephalosporins
although the true
incidence is
uncertain. Great
care should be
taken if it is to be
given to such
patients. Caution
is also necessary
in patients with a
history of allergy.
It should be given
with caution to
patients with renal
impairment; a
dosage reduction
may be
necessary. Renal

dialysis.

and hematological
status should be
monitored
especially in
prolonged drug
use and highdose therapy

DRUG STUDY
Generic/Trade
Name

Voluven [IV
infusion]

Classification

*B05AA07 Hydroxyethylstarch
; Belongs to the
class of blood
substitutes and
plasma protein
fractions. Used as
blood substitutes.

Indication

*Therapy and
prophylaxis of
hypovolemia;
acute
normovolemic
hemodilution
technique
(ANH).

Action

*Voluven contains
hydroxyethyl starch
in a colloidal
solution which
expands plasma
volume when
administered
intravenously.
Hydroxyethyl
starch is a
derivative of thin
boiling waxy corn
starch, which
mainly consists of
a glucose polymer
(amylopectin)
predominately
composed of -1-4connected glucose
units with several
-1-6-branches.
Substitution of
hydroxyethyl
groups on the
glucose units of the
polymer reduces
the normal
degradation of

Side/Adverse
Effects

*Medicinal
products
containing
hydroxyethyl
starch may lead to
anaphylactoid
reactions
(hypersensitivity,
mild influenza-like
symptoms,
bradycardia,
tachycardia,
bronchospasm,
non-cardiac
pulmonary
edema) in very
rare cases..
*Pruritus (itching)
after prolonged
administration of
high dosages is a
known
undesirable effect
of hydroxyethyl
starches.

Drug
Interaction

Route, Dosage,
Frequency

*No
interactions
with other
drugs or
nutritional
products are
known to
date. Please
refer to
Adverse
Effects
section
concerning
the
concentration
of serum
amylase
which can rise
during
administration
of
hydroxyethyl
starch and
can interfere
with the
diagnosis of
pancreatitis

*500cc @25
gtts/min

Nursing
Consideration

*Fluid overload
caused by
overdose should
be avoided in
general.
Particularly for
patients with
cardiac
insufficiency or
severe kidney
dysfunctions, the
increased risk of
hyperhydration
must be taken
into
consideration;
dosage must be
adapted. In cases
of severe
dehydration, a
crystalloid
solution should
first be given.It is
important to
supply sufficient
fluid and to
regularly monitor

amylopectin by amylase in the


body.

kidney function
and fluid balance

DRUG STUDY
GENERIC
NAME &
TRADE
NAME
Furosemide

CLASSIFIC
ATION

INDICATION
S

Loop
diuretic

Acute
pulmonary
edema

MECHANI
SM OF
ACTION

A potent
drug that
inhibits
sodium
Edema
and
Hypertension chloride
reabsorptio
n at the
proximal
distal
tubules
and the
ascending
loop of
Henle.

ROUTE/FREQUENCY/
DOSAGE
10.0 mg slow IVTT

ADVERSE
REACTIONS/SID
E EFFECTS

DRUG-TO-DRUG,
FOOD-TO-DRUG
INTERACTION

NURSING
CONSIDERATIONS/P
ATIENT TEACHING

CNS: vertigo,
headache,
dizziness,
paresthesia,
weakness,
restlessness,

Amino glycoside
antibiotics,
cisplatin: may
increase
ototoxicity. Use

Advise patient to take


drug with food to
prevent GI upset, and
to take drug in

fever.
CV:

orthostatic
hypotension,
thrombophlebitits
with I.V.
administration.

together
cautiously.
o Amphotericin B,
corticosteroids,
corticotrophin,
metolazone: may

increase risk of
EENT:

transient hypokalemia.
deafness, blurred Monitor potassium
or yellowed
level closely.
vision, tinnitus.
o Ant diabetics:
GI:

abdominal
may decrease
discomfort and
hypoglycemic
pain, diarrhea,
effects. Monitor
anorexia, nausea, glucose
vomiting,
level.
constipation,
o
pancreatitis.
Antihypertensive:
GU:

nocturia,
may increase risk

the morning to prevent


the frequent need to
urinate at night. If
patient needs
second dose, tell him
or her to take it early
in the afternoon, 6-8
hrs after
morning dose.
Inform

patient of
possible need for
potassium or
magnesium
supplements.
Instruct

patient to
stand slowly to
prevent orthostatic
dizziness, and to limit
alcohol intake and
stenous exercise in

polyuria frequent
urination, oliguria.

of hypotension.
Use together

hot weather to avoid


worsening

Hematologic:

agranulocytosis,
aplastic anemia,
leukopenia,

cautiously.
Decrease
antihypertensive
dose if needed.

dizziness upon
standing quickly.

thrombocytopenia
, azotemia,
anemia.

o Cardiac
glycosides,
neuromuscular
blockers: may
increase toxicity of

Hepatic:

hepatic
dysfunction,
jaundice.
Metabolic:

volume depletion
and dehydration,
asymptomatic
hyperurecemia,
impaired glucose
tolerance,
hypokalemia,
hypochloremic
alkalosis,
hyperglycemia,
dilutional
hyponatremia,
hypocalcemia,
hypomagnesemia
.

these drugs from


furosemide
induced
hypokalemia.
Monitor potassium
level.
o Chlorothiazide,
chlorthalidone,
hydrochlorothiazid
e, indapamide,
metolazone: may
cause excessive
diuretic response,
causing serious
electrolyte
abnormalities or
dehydration.
Adjust doses

Advise

patient to
immediately report
ringing in the ears,
severe abdominal
pain, or sore throat
and fever, these
symptoms may
indicate toxicity.
ALERT:

Discourage
patient from storing
different types of drugs
in the same
container, increasing
risk of drug errors. The
most popular
strengths of this
drug and digoxin are
white tablets about
equal in size.
Tell

patient to check
with prescriber or
pharmacist before
taking OTC drugs.
Teach

patient to
avoid direct sunlight

Musculoskeleta

l: muscle spasm.
Skin:

dermatitis,
purport,
photosensitivity
reactions,
transient pain at
I.M.
injection site.

carefully and
monitor patient for
signs and
symptoms of
excessive diuretic
response.
o Ethacrynic acid:
may increase risk
of ototoxicity.
Avoid using
together.
o Lithium: may
decrease lithium
excretion resulting
in lithium toxicity.
Monitor lithium
level.
o NSAIDS: may
inhibit diuretic
response. Use
together
cautiously.
o Phenytoin: may
inhibit diuretic
effect of
furosemide. Use
together
cautiously.

and to use protective


clothing and a
sun block because of
risk of photosensitivity.

o Propanolol: may
increase
propanolol level.
Monitor patient
closely.
o Salicylates: may
cause salicylate
toxicity. Use
together
cautiously.
o Sucralfate: may
reduce diuretic
and hypertensive
effect. Discourage

DRUG STUDY
GENERIC
NAME &
TRADE
NAME
Famotidine
:
Famotidine:
Pepcid,
Pepcid AC
(nonprescrip
tion)

CLASSIFIC
ATION
H2 receptor
antagonist

INDICATION
S

Effective
treatment of
GERD and
Peptic Ulcers
in children
(FAMOTIDIN
E ONLY)
Effective

treatment of
Peptic Ulcer
Disease:
relief of
symptoms,
acceleration
of healing,
prevention of
recurrence
Control

of
Hypersecreto
ry Stomach
Disorders
Treatment

of Reflux
Esophagitis

MECHANI
SM OF
ACTION

ROUTE/FREQUENCY/
DOSAGE

Competitiv
ely inhibits
the action
of
antihistami
ne on the
H2 at the
receptor

Short-term treatment for


benign gastric ulcer

sites of
parietal
cells,
decreasing
gastric
acid
secretions.

Gastroesophageal

reflux disease ( GERD)

o Children ages 1-16:


0.5 mg/kg/day P.O. at
bedtime or
divided b.i.d., up to 40
mg daily.

o Children ages 1-16:


1mg/kg/day P.O. divided
twice
daily up to 40 mg b.i.d.

ADVERSE
REACTIONS/SID
E EFFECTS

DRUG-TO-DRUG,
FOOD-TO-DRUG
INTERACTION

NURSING
CONSIDERATIONS/P
ATIENT TEACHING

Drug-induced
hepatitis

None significant.

Instruct patient in
proper use of OTC
product if appropriate.

Bone

marrow
depression
(Lowered white
blood cells or
hemoglobin),rare

Warn

patient with
PKU that Peptic AC
chewable tablets
contain

Confusion

(particularly in
compromised
elderly with some
of these drugs)

phenylalanine.

Low

blood
platelet counts (all
the above are
case report to
rare effects)

Remind

patient that
prescription drugs
most effective is taken
at bedtime.

Abnormal

heart
rhythm changes
(slow heart beat
or atrioventricular
block)
Bronchospasm,

rare

Tell

patient to take
prescription drug with
a snack, if desired.

Tell patient taking 20


mg twice daily to take
one dose at bedtime.
Advise

patient to
limit use of
prescription drug no
longer than 8 weeks,
unless

Treatment

of Heartburn

Impotence

ordered by the
prescriber, and OTC
drug no longer than 2
weeks.
With

prescribers
knowledge. Let patient
take antacids together
especially at
the beginning of
therapy when pain is
severe.
Urge

patient to
avoid cigarette
smoking because it
may increase gastric
acid
secretion and worsen
disease.
Advise

patient to
report abdominal pain
or blood in stools or
vomit.

DRUG STUDY
GENERIC
NAME &
TRADE
NAME
Tranexamic
Acid
Brand
name:
Cyklokapron

CLASSIFIC
ATION

INDICATION
S

Antifibrinolyt
Used for
ic,
antihemorrh short term
control of
agic
bleeding on
hemophiliacs
and used in
other
bleeding
control that is
required

MECHANI
SM OF
ACTION
Tranexami
c acid
competitiv
ely inhibits
activation
of
plasminog
en, thereby
reducing
conversion
of
plasminog
en to
plasmin
(fibrinolysi
n), an
enzyme
that
degrades
fibrin clots,
fibrinogen,
and other
plasma
proteins,
including
the

ROUTE/FREQUENCY/
DOSAGE
mild to moderate pain,
fever
o Children ages 6-8 yrs
old: 320 mg P.O. q 4-6
hrs, p.r.n

ADVERSE
REACTIONS/SID
E EFFECTS

DRUG-TO-DRUG,
FOOD-TO-DRUG
INTERACTION

NURSING
CONSIDERATIONS/P
ATIENT TEACHING

Blurred vision or
other changes in
vision

Anti-inhibitor
coagulant complex
or Factor IX
complex (although
tranexamic

Antifibrinolytic agents
are ineffective in
bleeding caused by
loss of vascular

hypotension

(dizziness or
lightheadedness;
unusual tiredness
or weakness)
may be
associated with
too-rapid
intravenous
administration
thrombosis

or
thromboembolism
(pains in chest,
groin, or legs
[especially
calves]; severe,
sudden
headache;
sudden and
unexplained
shortness of

acid is often used


in conjunction with
clotting factor
replacement for
the
perisurgical
management of
hemophilic
patients,
concurrent use
may
increase the risk
of thrombotic
complications.)
Contraceptives,

estrogencontaining, oral or
Estrogens
(concurrent use
with

integrity; a definite
clinical diagnosis or
confirmation of
hyperfibrinolysis
(hyperplasminemia)
via laboratory studies
is required before
tranexamic acid
is used to treat
hemorrhage.
Carcinogenicity/Tum

origenicity
Pregnancy

Tranexamic acid
crosses the placenta.
Breast-feeding
tranexamic acid is
distributed into breast
milk; concentrations

procoagula
nt factors
V and VIII.
Tranexami
c acid also
directly
inhibits
plasmin
activity, but
higher
doses are
required
than are
needed to
reduce
plasmin
formation.
In vitro, the
antifibrinol
ytic
potency of
tranexamic
acid is
approximat
ely 5 to 10
times that
of
aminocapr
oic acid.
In

patients

breath, slurred
speech, vision
changes, and/or
weakness or
numbness in arm

tranexamic acid
may increase the
potential for
thrombus
formation)

or leg; sudden
loss of
coordination)
depending on site
of thrombus

Thrombolytic

agents (the
actions of
tranexamic acid
and of
thrombolytic

formation or
embolization
Diarrhea

Nausea

vomiting

Incidence

unknown

agents [e.g.,
alteplase (tissuetype plasminogen
activator,
recombinant; tPA),
anistreplase
(anisoylated
plasminogenstreptokinase
activator complex;

Unusual

menstrual
discomfort
APSAC),
caused by clotting streptokinase, or
of menstrual fluid urokinase] are
mutually
antagonistic;
although

controlled studies
to demonstrate its
efficacy have not

reach approximately
1% of the maternal
plasma concentration
Ophthalmological

examinations,
including tests for
visual acuity, color
vision,
eyeground, and visual
fields

with
hereditary
angioedem
a,
inhibition
of the
formation
and

been done in
humans,

activity of
plasmin by
tranexamic
acid may
prevent
attacks of
angioedem
a by

thrombolytic
agent.

decreasing
plasmininduced
activation
of the first
compleme
nt protein.

tranexamic acid
may be useful in
treating severe
hemorrhage
caused by a