DRUG NAME DOSAGE MECHANISM OF INDICATION CONTRA- ADVERSE NURSING RESPONSIBILITIES

ACTION INDICATION REACTIONS

Ipratropium 1 vial 3-4x a Combivent Inhalation For the Patients with cardiac Fatigue, abdominal pain, Assessment and Drug Effects:
Bromide- day Solution is a management of tachyarrhythmias, hypertension, dyspepsia, 1.monitor respiratory status; auscultate
Salbutamol combination of the bronchospasm hypertrophic tachycardia, sinusitis, lungs before and after inhalation
Sulfate anticholinergic in patients obstructive dysuria, and urinary 2. report treatment failure (exacerbation
(Combivent) bronchodilator, suffering from cardiomyopathy and retention blurred vision, of respiratory symptoms) to physician
ipratropium bromide, chronic patients with a taste perversion, dry
and the beta2- obstructive history of mouth, paradoxical Patient and Family Education:
adrenergic pulmonary hypersensitivity to bronchospasm, bronchitis, 1. do not allow the solution/ mist to
bronchodilator, disease (COPD) any of its components angina, arrhythmia, enter the eyes
salbutamol sulfate. who requires or to atropine or its lightheadedness, 2. Consult a doctor immediately in the
Ipratropium bromide is regular derivatives. drowsiness, insomnia, event of acute, rapidly worsening
a quaternary treatment with dizziness, vertigo, CNS dyspnea. In addition, the patient should
ammonium derivative both stimulation, weakness, be warned to seek medical advice should
of atropine and is an ipratropium and itching, rash, flushing, a reduced response become apparent.
anticholinergic drug salbutamol. alopecia, hypotension, 3. The concomitant use of Combivent
which has increased blood pressure, with other sympathomimetic agents is
bronchodilator gastrointestinal distress, not recommended since such combined
properties. vomiting, diarrhea, use may lead to deleterious
Salbutamol produces edema, constipation and cardiovascular effects.
bronchodilation urinary difficulty 4. Eye pain or discomfort, blurred
through stimulation of vision, visual halos or colored images in
beta2-adrenergic association with red eyes from
receptors in bronchial conjunctival and corneal congestion may
smooth be signs of acute narrow-angle
muscle, thereby glaucoma. Should any
causing relaxation of combination of these symptoms develop,
muscle fibres. This treatment with miotic drops should be
action is manifested by initiated and specialist
an increase in advice sought immediately.
pulmonary 5. Allow 30-60 sec between puffs for
function as optimum results.
demonstrated by 6. Wait 5 min between this and other
spirometric inhaled medications.
measurements. 7. rinse mouth after medication puffs to
reduce bitter taste
DRUG NAME DOSAGE MECHANISM OF INDICATION CONTRA- ADVERSE REACTIONS NURSING
ACTION INDICATION RESPONSIBILITIES
Ranitidine Ranitidine • Inhibits the action of Treatment and Hypersensitivity, • CNS: • Assess patient for
50mg TIV histamine at the H2 prevention of Cross-sensitivity may Confusion, dizziness, epigastric or abdominal
Adult: 150mg receptor site located heartburn, acid occur; some oral drowsiness, hallucinations, pain and frank or occult
twice a day or primarily in gastric indigestion, and sour liquids contain headache blood in the stool, emesis,
300mg at once parietal cells, resulting stomach. alcohol and should be or gastric aspirate.
a day in inhibition of gastric avoided in patients • CV: • Nurse should know that it
acid secretion. with known Arrhythmias may cause false-positive
intolerance. results for urine protein;
• In addition, • GI: test with sulfosalicylic
ranitidine bismuth Use Cautiously in: Altered taste, black tongue, acid.
citrate has some constipation, dark stools, • Inform patient that it may
antibacterial action • Renal impairment diarrhea, drug-induced cause drowsiness or
against H. pylori. • Geriatric patients hepatitis, nausea dizziness.
(more • Inform patient that
susceptible to adverse • GU: increased fluid and fiber
CNS reactions) Decreased sperm count, intake may minimize
• Pregnancy or impotence constipation.
Lactation • Advise patient to report
onset of black, tarry stools;
• ENDO:
fever, sore throat; diarrhea;
Gynecomastia
dizziness; rash; confusion;
or hallucinations to health
• HEMAT: car professional promptly.
Agranulocytosis, Aplastic • Inform patient that
Anemia, neutropenia, medication may
thrombocytopenia temporarily cause stools
and tongue to appear gray
• LOCAL: black.
Pain at IM site

• MISC:
Hypersensitivity reactions,
vasculitis
DRUG NAME DOSAGE MECHANISM OF INDICATION CONTRA- ADVERSE REACTIONS NURSING
ACTION INDICATION RESPONSIBILITIES
Flutocasone Fluticasone Glucocorticoid with a It is used by Known Candidiasis or dryness of ASSESSMENT
inhalation 1-2x high topical anti- inhalation for the hypersensitivity to mouth and throat. • Assess pt’s condition before
daily inflammatory potency. prophylaxis of the fluticasone Hoarseness. Suppression of therapy.
It has a strong affinity symptoms of asthma; propionate or any adrenal function, growth • Assess active infection and
for and agonist activity also by nasal spray ingredient in the retardation in children. assess if
at human for allergic rhinitis. formulation. immunocompromised
glucocorticoid • Assess pulmonary and cardiac
receptors. status.
• Monitor possible adverse
reaction
PLANNING
• Store at controlled room
temperature away from direct
sunlight
IMPLEMENTATION
• Advise that the drug is for
long term maintenance
• Instruct proper way of drug
inhalation
• Instruct to rinse mouth after
each inhalation to prevent oral
candidiasis.
• Instructs to immediately
report decreasing effect of
inhaled beta agonist
• Instruct to report drug
induced adverse reaction
DRUG NAME DOSAGE MECHANISM OF INDICATION CONTRA- ADVERSE REACTIONS NURSING
ACTION INDICATION RESPONSIBILITIES
Ampicillin 1-2 g a day in Interferes with cell Treatment of Hypersensitivity to Thromboplebitis at injection ASSESSMENT
divided doses wall synthesis of respiratory tract and penicillin, site, dizziness, fatigue, • Obtain patients history
every 6 hours susceptible organisms, soft tissue infection. cephalosporin or insomia, reversible • Assess signs and symptoms of
preventing bacterial Bacterial meningitis. imipenem. hyperactivity infection
multiplication, it also Septicemia and • Obtain baseline data of WBC
renders cell wall gonoccocal infection • Obtain C&S before drug
osmotically unstable caused by susceptible therapy
and burst due to microorganisms; • Assess sensitivity reactions
osmotic pressure. prophylaxis in rape
• Assess allergic reactions
Deactivated by beta- victims and for
lactamase, an enzyme bacterial • Monitor renal function
produced by resistant. endocarditis. • Monitor blood studies
• Assess for overgrowth of
infection
PLANNING
• Give in even doses round the
clock
• IM route reconstitute with
125mg/0.9 – 1.2mL;
500mg/1.2 – 1.8mL; 1g/2.4 –
7.4mL; 2g/6.8mL
• Give by direct IV over 3-5
mins in lower dosage
IMPLEMENTATION
• Instruct to take medications as
prescribed
• Advise to monitor adverse
reaction
• Instruct pt if diarrhea with
blood or pus occur notify
physician
DRUG NAME DOSAGE MECHANISM OF INDICATION CONTRA- ADVERSE REACTIONS NURSING
ACTION INDICATION RESPONSIBILITIES
Budesonide Children: 1- Exerts a local anti Used for Hypersensitivity to Nasal irritation/bleeding; ASSESSMENT
2mg inflammatory effect by management of budesonide. burning; stinging; sneezing; • Obtain patients history
maintenance depression of bronchial asthma and pharingitis. • Assess respiratory status
0.5-1mg migaration of symptomatic • Check for oral candidiasis
Adult: 0.5- polymorphonuclear management of GI: dry mouth, indigestion, • Be alert for bronchospasm
1mg leukocytes and seasonal or perennial rash, face and tongue edema, • Carefully assess presence of
maintenance fibroblasts; reversal of allergic rhinitis. pruritus, bronchospasm. viral infection
0.25-5mg increased capillary
• Regularly assess intraocular
permeability and
pressure
Tubuhaler: lysosomal
PLANNING
400-1600mcg stabilization. It does
divided in 2-4 not suppress • Do not crush, break or chew
divided doses hypothalamus and the capsule
pituitary function. • Store at 15-39 degrees Celsius
(59-86F)
IMPLEMENTATION
• Instruct how to use nasal
inhaler himself
• Teach pt to notify physician
of pharyngitis, nasal bleeding
• Instruct pt not to exceed
recommemded dosage;
adrenal suppression may
occur
• Instruct pt to prevent
exposure to infections,
especially viral.
 Pamantasan ng Lungsod ng Pasay
College of Nursing and School of Midwifery

EMPHYSEMA

Submitted by:
Madeliene Kae R. Estanislao
BSN IV-2

Submitted to:
Mrs. Bautista