VII.

DRUG STUDY Name of Drug Generic: Brand Name: Biogesic Classifications: Non-opioid analgesic Date Administered Route of Administration 500 mg tablet P.O General Action Its main mechanism of action is the inhibition of cyclooxygena se (COX), an enzyme responsible for the production of prostaglandin s, which are important mediators of inflammation, pain and fever. Indications/ Purpose To relieve mild to moderate pain. It is also used to bring down a high temperature. Clients Reaction temperature is 36.5

Nursing Responsibility: Monitor for signs and symptoms of hepatotoxicity, even with moderate acetaminophen doses, especially in individuals with poor nutrition. Do not take other medications containing acetaminophen without medical advice; overdosing and chronic use can cause liver damage and other toxic effects. Do not use for fever persisting longer than 3 days ,fever over 39.5 C(103 F), or recurrent fever

Name of Drug

Date Administere d

Route of Administration 1 cap O.D P.O

General Action

Indications/ Purpose

Clients Reaction

Generic name: Ferrous Sulfate Brand Name: Ferrous sulfate

Mineral for antianemia Vital for hemoglobin regeneration, specifically it enables the RBC development and oxygen transport via hemoglobin It elevates the serum iron concentration, which then helps to form Hgb or trapped in the reticuloendothelial cells for storage and eventual conversion to

Preventing or treating low levels of iron in the blood.

Dark brown stool

usable form of iron. Nursing Responsibility: Administer vitamins with food to prevent GI upset. Caution on intake of chamomile, feverfew, peppermint and St. Johns wort for it interfere with the absorption of iron and other minerals. Increased effect of iron with vitamin C, decreased effect of tetracycline, antacids, penicillamine Clients Reaction

Name of Drug

Date Administere d

Route of

General Action

Indications/ Purpose To reduce after load in severe CHF ( with nitrates); and severe essential hypertension (parenteral to lower blood pressure quickly).

Generic name: Hydrazaline Hydrochloride Brand Name: Apresoline, Classification: Antihypertensive

Administration 5mg IVTT Directly relaxes arteriolar smooth muscle

No signs of irritation and adverse reactions.

Nursing Responsibilty: Give slowly and repeat as necessary, generally q 4 to 6 hours. Switch to oral antihypertensive as soon as possible. Use cautiously in cardiac diseases, CVA, or severe renal impairment and in those taking other hypertensive. Monitor patients Vital signs and body weight frequently. Some clinicians combine hydralazine therapy with diuretics agents to decrease sodium retention and tachycardia, and to prevent anginal attacks.

 Watch patient closely for signs of lupus erythematosus-like syndrome (sore throat, fever, muscle and joint aches, skin rash). Teach patient about his disease and therapy. Explain the importance of taking this drug as prescribed, e ven when hes feeling well. Tell outpatient not to discontinue this drug suddenly, but to call the doctor if unpleasant adverse reactions occurs Inform the patient that orthostatic hypotension can be minimized by rising slowly and avoiding sudden position changes Clients Reaction

Name of Drug

Date Administere d

Route of Administration 4mg incorporate in a 100cc D5W Via Solucet 5 mg deep IM on each buttocks

General Action

Indications/ Purpose Prevention or control of seizures in preeclampsia or eclampsia

Generic name: Magnesium Sulfate Brand Name: Sulfamag Classification: Anticonvulsant, miscellaneous; and laxative saline

May decrease acetylcholine released by nerve impulses, but its anticonvulsant mechanism is unknown

No signs of irritation and adverse reactions

Nursing Responsibility: Use cautiously in impaired renal function, myocardial damage, and heart block, and in women in labor. Drug can decrease the frequency and the force of uterine contraction. Keep I.V. calcium glucanate available to reverse magnesium intoxication; however, use cautiously in patients

undergoing digitalization due to danger of arrhythmias. I.V. use: Monitor vital signs every 15 mins. When giving drug I.V. Watch for respiratory depression and signs of heart block. Respirations should should be approximately 16/mins before each dose given. Monitor I & O. urine output should be 100ml or more in 4 hr period before each dose. Check blood magnesium levels after repeated doses. Disappearance of knee-jerk and patellar reflexes is a sign of pending magnesium toxicity. Maximum infusion rate is 150mg/min. rapid drip will induce uncomfortable feeling of heat. Clients Reaction

Name of Drug

Date Administere d

Cefazolin Brand Name Cefacidal, Classification: Antimicrobial and antiparasitic agents

Route of Administratio n 1gr IVTT

General Action

Indications/ Purpose Cefazolin is mainly used to treat bacterial infections of the skin. It can also be used to treat moderately severe bacterial infections. It is clinically effective against infections caused by staphylococci and streptococci species of Gram positive bacteria. These organisms are common on normal

Inhibits cell wall synthesis, promoting osmotic instability. Usually bactericidal.

No signs of irritation and adverse reactions.

human skin

Nursing Responsibility: Use cautiously in impaired renal function and in those with history of sensitivity to penicillin. Ask patient if hes ever had any reaction to cephalosporin or penicillin therapy before administering first dose Avoid doses greater than 4 g daily in patients with severe renal impairment. Obtain specimen for culture and sensitivity test before first dose. Therapy may begin pending test results. Because of long duration of effect, most infections can be treated with dose q 8 hrs. Not as painful as other cephalosporin when given I.M. I.V. use: alternate injection sites if I.V. therapy last longer than 3 days Considered the first-generation cephalosporin of choice by most authorities. With large doses or prolonged therapy, monitor for superinfection, especially in high risk patients. Reconstituted cefazolin sodium is stable for 24 hrs at room temp. or 96 hours under refrigerator. these indicate hemolytic anemia Clients Reaction

Name of Drug

Date Administere d

Route of

General Action

Indications/ Purpose Ketorolac is indicated for short-term management of pain (up to five days maximum).

Generic name: Ketorolac Brand Name: Toradol Classification: non-steroidal antiinflammatory drug

Administration 30mg IVTT The primary mechanism of action responsible for ketorolac's antiinflammatory, antipyretic and analgesic effects is the inhibition of prostaglandin

The patient responded well with no signs of irritation and adverse reactions

synthesis by competitive blocking of the the enzyme cyclooxygenase (COX). Like most NSAIDs, ketorolac is a non-selective COX inhibitor. As with other NSAIDs, the mechanism of the drug is associated with the chiral S form. Conversion of the R enantiomer into the S enantiomer has been shown to occur in the metabolism of buprofen; it is unknown whether it occurs in the metabolism of Ketorolac

Nursing Responsibility: Use as a part of a regular analgesic schedule rather than on an as needed basis. If given on p.r.n. basis, base the size of a repeat dose on duration of pain relief

from previous dose. If the pain returns within 3-5 hours, the next dose can be increased by up to 50% (as long as the total daily dose is not exceeded). If the pain does not return for 812 hr, the next dose can be decreased by as much as 50% or the dosing interval can be increased to q 8-12 hr. Shortening the dosing intervals recommended will lead to an increased frequency and duration of side effects. Correct hypovolemia prior to administering. Protect the injection from light Document indications for therapy, onset, location, pain intensity/level, and characteristics of the symptoms. Note any previous experience with NSAIDs and the results. Determine any renal or liver dysfunction; assess hydration. Avoid alcohol, ASA, and all OTC agents without approval. Report any unusual bruising/bleeding, weight gain, swelling of feet and ankle, increased joint pain, change in urine patterns or lack of response. Clients Reaction

Name of Drug

Date Administere d

Route of

General Action

Indications/ Purpose Essential hypertension alone or in combination with other antihypertensives.

Generic name: Amlodipine Brand Name: Norvasc Classification: Calcium Channel Blocker

Administration 10 mg tab OD Amlodipine inhibits P.O the transmembrane calcium influx with greater effects on vascular smooth muscle than on cardiac muscle. Its main action is to cause peripheral arterial vasodilatation and therapy a

No signs of irritation and adverse reactions

reduction in after load and blood pressure. Hence, it reduces myocardial oxygen demand more by an indirect effect than direct on cardiac muscle. Reflex tachycarida does not occur due to slow onset of action

Nursing Responsibility Monitor patient carefully (BP cardiac rhythm and output) while adjusting drug to therapeutic dose; use special caution if patient has CHF. Monitor BP carefully if patient is also on nitrates Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term therapy. Administer drugs without regard to meals .Take with meals if upset stomach occurs Tell patient to report irregular heartbeat, shortness of breath, swelling of the hands or feet, pronounce dizziness, & constipation Clients Reaction

Name of Drug

Date Administere d

Route of Administration

General Action

Indications/ Purpose

Generic name: Ascorbic acid (Vitamin C) Brand Name: Ascorbic acid Classification: Anti oxidant

1tab OD

Toxicodynamics Hyperoxaluria may result after administration of ascorbic acid Ascorbic acid may cause acidification ofthe urine, occassionally leading toprecipitation of urate,cystine, or oxalate stones,the synthesis of adrenal steroidhormones, in tyrosine metabolism, in the conversion of folic acid tofolinic acid, in carbohydrate metabolism, inthe synthesis of lipids andproteins, in iron metabolism,in resistanceto infection, and in cellular respiration. Vitamin C mayact as a free oxygen radicalscavenger. The usefulness of the antioxidant Propertiesof vitamin C in reducing

Ascorbic acid is recommended for prevention and treatment of scurvy (disorder caused by lack of vitamin C)

No signs of irritation and adverse reactions

coronary heart disease were found not to be significant.

Nursing Responsibility: Use cautiously in G6PD deficiency.

Name of Drug

Date Administere d

Route of Administration

General Action

Indications/ Purpose

Clients Reaction

Methyldopa Brand Name: Aldomet

Although its mechanism of action has yet to be conclusively demonstrated, the antihypertensive effect of methyldopa probably is due to its metabolism to alphamethylnorepinephrine, which then lowers arterial pressure by stimulation of central inhibitory alpha-adrenergic receptors, false neurotransmission, Hypertension.

Medication is well tolerated, no adverse effect noted

and/or reduction of plasma renin activity. Methyldopa has been shown to cause a net reduction in the tissue concentration of serotonin, dopamine, norepinephrine, and epinephrine. Nursing Responsibility: -To avoid injury related to dizziness or fainting, take the first dose at bedtime. -To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position. -This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. -Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased. Your doctor may adjust the dose of this medication when you start or stop using other blood pressure medications. -An allergic reaction must be watch out closely(difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); a very slow heart rate (fewer than 60 beats per minute); unusually high or low blood pressure (fainting, a severe headache, flushing of your face); chest pain; uncontrollable movements of your arms, legs and face.

Name of Drug

Date Administere d

Route of Administration

General Action

Indications/ Purpose This medication is used to treat constipation

Clients Reaction

Generic Senna Concentrate 8.6mg + docusate sodium 50 mg Brand name Senokot S/ Pericolace

Promotes incorporation of water into stool, resulting in a softer fecal mass. May also promote electrolyte and water secretion in the colon.

Patient has an ease in defecating

Nursing Responsibility: -Increase OFI -Encouraged a normal bowel habit -Advice to eat high in fiber foods -Advise patient to use it in a short time due to elec. imbalance and dependence Name of Drug Date Route of General Action Indications/ Clients

Reaction Administere d Citicholine Brand: Somazine Administration For post CVA/ Stroke, Treatment on elderly, for faster improvement on thinking ability and those with an impaired or brain damaged. Purpose CIticholine is a supplement used to improve thinking, learning and memory

Patient slowly regain normal status; oriented in time, space and person

Nursing Responsibility: - take medication as prescribed -take medication on time -Monitor patient neurologic status -Note if theres a signs of slurring of speech -Note for adverse reaction -Watch out for adverse reaction such as allergic reaction