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VII.

Drug Study
Drug

Generic Name:
Insulin
Classification:
Antidiabetic
Dosage:
8-14U
Route:
Subcutaneous
Frequency:
BID
Date ordered:
January 20, 2016
Date
discontinued:
Take home
medication

Indication

Action

Adjunct to diet
and exercise to
improve glycemic
control in adults
with Diabetes
Mellitus (DM).
Treatment of
insulin-resistant
patients with DM
requiring daily
doses of >200 U.

Decreases blood
glucose; by transport of
glucose into cells and the
conversion of glucose to
glycogen indirectly
increases blood pyruvate
and lactate, decreases
phosphate and
potassium.

Reference:
Pharmacology for
Nurses. A
Pathophysiologic
al Approach 2nd
ed. by: Adams
page 684

Side Effects and


Adverse Effects

Nursing Considerations

CNS: Confusion,
drowsiness,
sweating

Closely monitor
blood glucose
before each meal.

CV: Tachycardia,
Hypoglycemia,
Hypokalemia

Teach client to
rotate insulin
sites to prevent
lipodystrophy

Monitor vital
signs (increase in
pulse and blood
pressure are early
signs of
hypoglycemia)

Administer
approximately 30
minutes before
meals

Advise patient to
keep insulin and
equipment at all
times.

Teach patient
dosage, route,
mixing
instructions and
to keep record of
blood glucose.

Teach patient on
how to check
blood glucose
with a
glucometer.

Instruct patient to
carry candy or
lump of sugar to
treat
hypoglycaemia;
have glucagon
emergency kit

available; teach
how to use these

Drug

Generic Name:
Ferrous Sulfate
Classification:
Antianemic
Dosage:
1 tab
Route:
PO
Frequency:
OD
Date ordered:
January 16, 2016
Date
discontinued:
Take home
medication

Indication

Action

Side Effects and


Adverse Effects

During pregnancy,
approximately
twice the normal
amount of iron is
needed to meet
fetal and maternal
daily requirement.
The goal is to
prevent maternal
iron-deficiency
anemia.

Iron is an essential
component in the
physiological formation
of hemoglobin, adequate
amounts of which are
necessary for effective
erythropoiesis and the
resultant oxygen
transport capacity of the
blood. A similar function
is provided by iron in
myoglobin production.
Iron also serves as a
cofactor of several
essential enzymes,
including cytochromes
that are involved in
electron transport. Iron
is necessary for
catecholamine
metabolism and the
proper functioning of
neutrophils.

GI: Constipation;
dark or green stools;
diarrhea; loss of
appetite; nausea;
pain or upset;
vomiting

Reference:
Pharmacology. A
Patient-Centered
Nursing Process
Approach 8th
Edition
by: Kee, Hayes,
Mccuiston
Page 780

Advise patient
that a plan is
necessary for
diet; all food on
diet should be
eaten

Caution patient
that treatment is
lifelong, insulin
does not cure.

Nursing Considerations

Advice patient to
take medicine as
prescribed.

Caution patient
to make position
changes slowly
to minimize
orthostatic
hypotension.

Advise patient to
consult physician
if irregular
heartbeat,
dyspnea,
swelling of hands
and feet and
hypotension
occurs.

Inform patient
that angina
attacks may
occur 30 minutes
after
administration
due to reflex
tachycardia

MS: Stomach
cramps
CV: Hypotension,
dysrhythmia
CNS: Dizziness
Respiratory:
Dyspnea

Drug

Generic Name:
Isoxsuprine
Classification:
Vasodilator
Dosage:
4 amps
incorporate with
D5LR (500cc)
Route:
IV
Frequency:
8 hours
Date ordered:
January 15, 2016
Date
discontinued:
Take home

Indication

Action

Side Effects and


Adverse Effects

Isoxsuprine is
used for
management of
threatened
premature labor in
pregnancies of 20
or more weeks'
gestation. Use is
not recommended
prior to the 20th
week of
pregnancy. In
order for
isoxsuprine to be
most effective, it
is recommended
that therapy be
started as soon as
the diagnosis of
preterm labor is
confirmed.

Isoxsuprine produces
uterine relaxation
through a direct effect on
smooth muscles.

Integ: Allergic
reactions (skin rash)

Encourage
patient to comply
with additional
intervention for
hypertension like
proper diet,
regular exercise,
lifestyle changes
and stress
management

Give between
meals with water
but may give
with meals if GI
discomfort
occurs.

Monitor daily
pattern of bowel
activity and stool
consistency

Nursing Considerations

Advise patient to
take with meals
or milk to reduce
gastrointestinal
irritation.

Avoid smoking
as nicotine
constricts blood
vessels.

Advise the
patient to be
cautious when
getting up from a
lying or sitting
position, when
climbing stairs,
or if dizziness
occurs

Check with the


physician

Resp: Chest pain,


pulmonary edema
CV: Hypotension,
tachycardia
GI: Nausea,
vomiting
CNS: Dizziness,
fainting

medication

Reference:
Drugs.com
(http://www.drugs
.com/mmx/isoxsup
rinehydrochloride.htm
l)

immediately if
contractions
begin again or
water breaks.

Drug

Indication

Action

Generic Name:
Dexamethasone

Patients at risk for


preterm delivery
should receive
antenatal
corticosteroid
therapy.
Administration of
antenatal
corticosteroid
accelerates lung
maturation and
lung surfactant
development in
the fetus in utero,
decreasing the
incidence and
severity of
respiratory
distress syndrome
(RDS) and
increasing
survival of
preterm infants.

Given to prevent RDS in


preterm infants by
injecting mother before
delivery to stimulate
surfactant production in
fetal lung.

Classification:
Corticosteroid
Dosage:
6mg
Route:
IV
Frequency:
Q12 x 4 doses
Date ordered:
January 20, 2016
Date
discontinued:
January 23, 2016

Reference:
Pharmacology. A
Patient-Centered
Nursing Process
Approach 8th
Edition
by: Kee, Hayes,
Mccuiston
Page 792

Side Effects and


Adverse Effects

Monitor maternal
heart rate and
blood pressure
and uterine
activity.

Nursing Considerations

CNS: Insomnia,
nervousness,
headache, flushing,
mood swings,
anxiety

Monitor I&O
ratio; be alert for
decreasing
urinary output,
increasing edema

GI: Diarrhea,
abdominal
distention, nausea,
increase appetite,
weight gain

Assess infection:
fever, WBC even
after withdrawal
of medication;
drug masks
infection

Integ: Acne, poor


wound healing,

Teach to notify
doctor if
therapeutic
response
decreases;
dosage
adjustment may
be needed.

Teach not to
discontinue
abruptly or
adrenal crisis can
result.

Teach symptoms
of adrenal
insufficiency:
nausea, anorexia,
fatigue,
dizziness,
dyspnea,
weakness, joint
pain.

CV: Hypertension,
tachycardia, edema
MS: Arthralgia,
weakness
ENDO: Sodium and
fluid retention

Drug

Generic Name:
Methyldopa
Classification:
Antihypertensive
Dosage:
250mg
Route:
PO
Frequency:
BID
Date ordered:
January 17, 2016
Date
discontinued:
Take home
medication

Indication

Action

Side Effects and


Adverse Effects

Methyldopa is a
drug of first
choice for control
of mild to
moderate
hypertension in
pregnancy and is
the most widely
prescribed
antihypertensive
for this indication.
During long term
use in pregnancy,
methyldopa does
not alter maternal
cardiac output or
blood flow to the
uterus or kidneys,
and for all these
reasons is
generally
considered the
agent of choice
for chronic blood
pressure control in
pregnancy.

This drug decreases


sympathetic response
from the brainstem to the
peripheral vessels. It
stimulates the alphareceptors, which in turn
decreases sympathetic
activity; increases vagus
activity; decreases
cardiac output; and
decreases serum
epinephrine,
norepinephrine, and
renin release.

CNS: Drowsiness,
weakness, headache

Nursing Considerations

Monitor BP and
pulse if the drug
is being used for
hypertension;
notify prescriber
of changes

Monitor edema
in feet, legs
daily; monitor
I&O

Instruct patient
not to
discontinue drug
abruptly, or
withdrawal
symptoms may
occur: anxiety,
increased B/P,
headache,
insomnia,
increased pulse,
tremors, nausea,
sweating

Teach patient to
comply with
dosage schedule
even if feeling
better; drug
controls
symptoms, does
not cure

Caution patient
to change
position slowly,
to sitting or
standing position
to minimize
orthostatic
hypotension

CV: Bradycardia,
orthostatic
hypotension, edema
GI: Nausea,
vomiting, diarrhea,
constipation, dry
mouth
ENDO: Sodium and
water retention

Take the
medication with
food to avoid GI
irritation.

Reference:
Medscape
(http://www.meds
cape.com/viewarti
cle/406535_6)

Drug

Generic Name:
Multivitamins
Classification:
Multivitamins
Dosage:
1 tab
Route:
PO
Frequency:
OD
Date ordered:
January 16, 2016
Date
discontinued:
Take home
medication

Indication

Action

Side Effects and


Adverse Effects

Eating a healthy,
varied diet in
pregnancy will
help the patient to
get most of the
vitamins and
minerals she
needs.
It's best to get
vitamins and
minerals from the
food she eats, but
when she is
pregnant she will
need to take some
supplements as
well, to make sure
she get everything
she needs.

Treating or preventing a
lack of vitamins or
minerals before, during,
and after pregnancy, and
while breast-feeding. It
may also be used for
other conditions as
determined by your
doctor.
Prenatal multivitamin is
a vitamin and other
supplement combination.
It works by providing
vitamins and minerals to
the body to help meet
nutritional requirements.

GI: Constipation,
dark or green stools,
diarrhea, loss of
appetite, nausea,
vomiting

Reference:
NHS UK
(http://www.nhs.u
k/conditions/preg

MS: Stomach
cramps, pain or
upset
Integ: Severe
allergic reactions,
fever

Advise patient
that drug may
cause dizziness,
fainting;
lightheadedness
may occur during
1st few days of
therapy; that drug
may cause dry
mouth; use hard
candy, saliva
product, or
frequent rinsing
of mouth

Teach patient to
avoid hazardous
activities, since
drug may cause
drowsiness,
dizziness

Nursing Considerations

Food absorption
is faster when
taken on an
empty stomach
but may be taken
with food if GI
irritation occurs.

Take with a full


glass of water.

Do not take with


dairy products, it
may reduce the
potency of the
drug

nancy-andbaby/pages/vitami
ns-mineralssupplementspregnant.aspx)