DRUG

MECHANISM OF ACTION

INDICATIONS

CONTRAINDICATION

ADVERSE EFFECTS

NURSING RESPONSIBILITIES/ PRECAUTIONS

Generic: Furosemide Brand: Lasix Classification: DIURETICS Dosage: 0.65 mg Route: IV Frequency: OD

Acts on the ascending loop of Henle in the kidney; inhibiting reabsorption of electrolytes sodium and chloride, causing excretion of sodium, calcium, magnesium, chloride, water and some potassium

Edema in CHF, nephritic syndrome, ascites

Hypersensitivity to sulfonamides. Anuria, hypovolemia, infants, lactation, electrolyte depletion

                   

Headache Fatigue Weakness Vertigo Paresthesias Orthstatic hypotension Chest pain loss of hearing ear pain tinnitus blurred vision nausea diarrhea dry mouth vomiting anorexia cramps polyuria cramps stiffness

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Assess patient for tinnitus, hearing loss, ear pain Monitor for renal, cardiac, neiurologic, GI, pulmonary manifestation of hypokalemia: acidic urine, decreased urine osmolality, nocturia, polyuria and polydipsia Monitor for CNS, GI, cardiovascular, integumentary, neurologic manifestations of hypocalcemia: personality changes, anxiety, disturbances Give drug with food if GI( upset occurs. Take drug only for complaints indicated. Avoid over use of over the counter preparations.

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CONTRAINDICATION

SIDE EFFECT

NURSING RESPONSIBILITIES

Generic: Acetaminophen Brand: Paracetamol Classification: Anti-pyretic, Analgesic Dosage: 300mg/amp Frequency: Form: Ampule Route: IV

Fever, Relief of mild to moderate pain like headaches, muscular aches and pain, toothache, colds, earache, fever due to tonsillectomy, inoculations, and vaccinations.

Inhibits prostaglandin synthesis in the CNS and blocks the pain impulse through a peripheral action. It acts on the hypothalamic heat-regulating center, producing peripheral vasodilation. It results in antipyresis and produces analgesic effect.

Contraindicated in patients hypersensitive to drug.

Anorexia, nausea, diaphoresis, weakness, cramping, heartburn, abdominal distension, hypersensitivity reactions.

1. If to be given as analgesia, assess onset, type, location, duration of pain. 2. Can be given without regards to meals. Tablets can be crushed. Sustained-release or enteric-coated cannot be crushed or chewed. 3. Assess temperature directly before and 1 hour after giving medication. 4. If respirations are <12/min (<20/min in children), withhold the medication and contact the physician. 5. Evaluate for therapeutic response: relief of pain, stiffness, swelling; increasing in joint mobility; reduced joint tenderness; improve grip strength. 6. Consult physician for use in children less than 2 years old; oral use more than 5 days for children, more than 10 days for adults, or fever more than 3 days. 7. Report ringing in ears and persistent GI pain. 8. Severe, recurrent pain or high continuous fever may indicate serious illness.

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NURSING RESPONSIBILITIES
Before administering, make sure patient is not allergic to penicillins or cephalosporins. High-fat meals increased drug bioavailability. Take medication as prescribed, even after feeling better. Take oral form with food. If suspension is being used, shake the container well before measuring dose. Notify prescriber about rashes or superinfections. Notify prescriber about loose stools or diarrhea. Question for history of allergies, particularly cephalosporins and penicillins. Give without regards to meals. If GI upset occurs give with food or milk. Assess mouth for white patches on mucous membranes and tongue. Monitor bowel activity and stool consistency carefully. Mild GI effects may be tolerable but increasing severity may indicate onset of antibiotic-associated colitis. Monitor input and output and renal function reports for nephrotoxicity.

Generic: Cefuroxime Brand: Ambixime Classification: Antibiotic, AntiInfectives Dosage: 750mg Frequency: q8 Route: IV

Used to treat otitis media, respiratory tract, genitourniary tract, gynecologic, skin, and bone infections. It is also used in the treatment of speticemia, bacterial meningitis, gonorrhea, and other gonococcal infections.

Secondgeneration cephalosporin that inhibits cellwall synthesis, promoting osmotic instability; usually bactericidal.

Use cautiously in patients hypersensitive to penicillin because of possibility of crosssensitivity with other beta-lactam antibiotics.

        

Diarrhea Nausea Rash Pain Fever Headache Anorexia Vomiting Anemia

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ACTION

CONTRAINDICATION

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Generic: Kalium Durule Brand: Classification: potassium Supplement, Electrolyte Dosage: Frequency: QID Form: Tablet Route: Oral

Prevention and correction of potassium deficiency; when associated with alkalosis, use potassium chloride; when associated with acidosis, use potassium acetate, bicarbonate, citrate, or gluconate

Principal intracellular cation of most body tissues, participates in a number of physiologic processes maintaining intracellular tonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscle, maintenance of normal renal function; also plays a role in carbohydrate metabolism and various enzymatic reactions.

Contraindicated with allergy to tartrazine, aspirin (tartrazine is found in some preparations marketed as Kaon-Cl, Klor-Con); severe renal impairment with oliguria, anuria, azotemia; untreated Addison s disease; hyperkalemia; adynamia episodica hereditaria; acute dehydration; heat cramps; GI disorders that delay passage in the GI tract.

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Rash Nausea Vomiting Diarrhea abdominal discomfort Tissue sloughing

 Take drug after meals or with food and a full glass of water to decrease GI upset. Do not chew or crush tablets, swallow tablets whole. Mix or dissolve oral liquids, soluble powders, and effervescent tablets completely in 3 8 ounces of cold water, juice, or other suitable beverage, and drink it slowly. Take the drug as prescribed; do not take more than prescribed.  Do not use salt substitutes.  You may find wax matrix capsules in the stool. The wax matrix is not absorbed in the GI tract.  You may experience these side effects: Nausea, vomiting, diarrhea (taking the drugs with meals, diluting them further may help).  Report tingling of the hands or feet, unusual tiredness or weakness, feeling of heaviness in the legs, severe nausea, vomiting, abdominal pain, black or tarry stools, pain at IV injection site.

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ACTION

CONTRAINDICATION

SIDE EFFECT
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NURSING RESPONSIBILITIES Record the characteristics of cough and bronchial secretions before starting the therapy. Obtain and record baseline vital signs. Observe for and record any gastrointestinal symptoms before starting therapy. May be taken with food to minimize gastric irritation.

Generic: Zertin Brand: Erdorstein Classification: Mucolytic Dosage: 300mg Frequency: BID Form: Capsule Route: oral

Treatment of acute & chronic bronchopul monary diseases, rhinosinusitis , laryngophary ngitis or exacerbation s of these chronic diseases in association w/ mucus production & transport.

Modulates mucus production and viscosity and increases mucociliary transport, thereby improving expectoration

Hepatic disorders & abnormalities, renal insufficiency, homocystinuria, phenylketonuria.

 Gastric burning  Nausea  Dyspepsia  Headache

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INDICATION

ACTION

CONTRAINDICATION

SIDE EFFECT
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NURSING RESPONSIBILITIES Take drug with meals. Do not stop taking drug unless instructed to do so by a health care provider. Avoid use of over-the-counter medications. Advise the diabetic patient to promptly report changes in glucose. You may experience these side effects: Depression, dizziness, light-headedness (avoid driving or performing dangerous activities; getting up and changing positions slowly may help ease dizziness). Report difficulty breathing, swelling of extremities, changes in color of stool or urine, very slow heart rate, continued dizziness.

Generic: Carvedilol

Hypertension, alone or with other oral Brand: Coreg drugs, especially Classification: diuretics Alpha- and Treatment of betamild to severe adrenergic CHF of ischemic blocker, or Antihypertens cardiomyopathi ive c origin with digitalis, Dosage: diuretics, ACE 0.25tab/ inhibitors tab Left ventricular dysfunction Frequency: (LVD) after MI BID Form: Tablet Route: Oral

Carvedilol causes vasodilation by blocking the activity of -blockers, mainly at alpha-1 receptors. It exerts antihypertens ive effect partly by reducing total peripheral resistance and vasodilation. It is used in patients with renal impairment, NIDDM or IDDM.

Hypersensitivity; severe chronic heart failure, bronchial asthma or related bronchospastic conditions; severe hepatic impairment. Patients with NYHA class IV cardiac failure, 2nd or 3rd AV block, sick sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock or severe bradycardia. Lactation.

 Bradycardia  angina pectoris,  hypotension  allergy  malaise  nervousness  dry mouth  anemia  sweating  fatigue  arthralgia  dizziness  Diarrhea  Nausea  Vomiting  insomnia,  weight gain  abnormal vision  rhinitis

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DRUG

INDICATION

ACTION

CONTRAINDICATION

SIDE EFFECTS/ ADVERSE EFFECTS CNS: Lethargy, hallucinations, seizures GI: Glossitis, stomatitis, gastrilis, sore mouth, furry tongue, black hairy tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomembraneous colitis, nonspecific hepatitis GU: Nephritis-oliguria, proteinuria, hematuria, casts, azotemia, pyuria Hematologic: Anemia, thrombocytopenia, leucopenia, neutropenia, prolonged bleeding time. Hypersensitivity reactions: Rash, fever, wheezing, anaphylaxis Local: Pain, phlebitis, thrombosis at injection site, Jarish-Herxheimer reaction when used to treat syphilis Other: Superinfections; sodium overload, leading to heart failure.

NURSING RESPONSIBILITY

Generic Name: Penicillin G Aqueous Brand Name: Penicillin G Classification: Antibiotic, penicillin Dose: 150,000 units/kg/day Frequency: TID Form: Ampule Route: IV

Treatment of severe infections caused by sensitive organisms: streptococci, pneumococci, Neisseria gonorrhaeae, Treponema pallidum, meningococci, Actinomyces israelli, Clostridium perfringens, and tetani, Leptotrichia buccalis (Vincents disease), Spirillum minus or Streptobacillus moniliformis, Listeria moncytogenes, Fusobacterium fusiformisans, Pasteurella multocida, Erysipelothrix insidiosa, Escherichia coli, Enterobacter aerogenes, Alcaligenes faecalis, Salmonella, Shigella, Proteus mirabilis, Corynebacterium diphtheriae, Bacillus anthracis; Treatment of syphilis, gonococcal infections

Inhibits synthesis of cell wall of sensitive organisms, causing cell death.

Allergy to penicillins, cephalosporins, imipenem, beta-lactamase inhibitors, other allergens

1. Assess the patients history to allergy to penicillins, cephalosporins, imipenem, betalactamase inhibitors, other allergens, renal disease, lactation and pregnancy. 2. Monitor intake and output. Dehydration decreases drug excretion and may raise blood level of penicillin G to dangerously high levels causing kidney damage. GI disturbances may lead to dehydration. 3. Culture infection before beginning treatment; reculture if response is not as expected.. 4. Continue the treatment for 4872 hours after the patient is asymptomatic. 5. Monitor serum electrolytes and cardiac status if penicillin G is given by IV infusion. Sodium or potassium preparations have been associated with severe electrolyte imbalances. 6. Keep epinephrine, IV fluids, vasopressors, bronchodiators, oxygen, and emergency equipment readily available in case of serious hypersensitivity reaction. 7. Instruct the patient to report any unusual bruising, bleeding, nausea and vomiting, sore mouth, diarrhea, rash, fever, difficulty breathing, adverse side effects, or lack of improvement.

DRUG

INDICATION

ACTION

CONTRAINDICATI ON Hypersensitivity to adrenergic amines; Hypersensitivity to fluorocarbons

SIDE EFFECTS/ ADVERSE EFFECTS Nervousness Restlessness Tremor Headache Insomnia Chest pain Palpitations Angina Arrhythmias Hypertension Nausea and vomiting Hyperglycemia Hypokalemia

NURSING RESPONSIBILITY

Generic Name: Albuterol Brand Name: Salbutamol Classification: Bronchodilator, adrenergics Dose: 0.1-0.15 mg/kg/dose Frequency: TID, QID Form: Solution Route: Inhalation

1. To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD) 2. Quick relief for bronchospasm 3. For the prevention of exercise-induced bronchospasm 4. Long-term control agent for patients with chronic or persistent bronchospasm

It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles.

1. Assess lung sounds, PR and BP before drug administration and during peak of medication. 2. Observe fore paradoxical spasm and withhold medication and notify physician if condition occurs. 3. Administer PO medications with meals to minimize gastric irritation. 4. Extended-release tablet should be swallowed-whole. It should not be crushed or chewed. 5. If administering medication through inhalation, allow at least 1 minute between inhalation of aerosol medication. 6. Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth. 7. Inform the patient that Albuterol may cause an unusual or bad taste.

DRUG Generic: Losartan Brand: Cozaar Classification: Angiotensin II receptor blocker (ARB), Antihypertens ive Dosage: 50mg/tab Frequency: BID Route: per orem

INDICATION

ACTION Angiotensin II receptor (type AT1) antagonist acts as a potent vasoconstrictor and primary vasoactive hormone of the renin angiotensin aldosterone system.

CONTRAINDICATION Contraindicated with hypersensitivity to losartan, pregnancy (use during the second or third trimester can cause injury or even death to the fetus), lactation.

SIDE EFFECT

NURSING RESPONSIBILITIES

Treatment of hypertension, alone or in combination with other antihypertensive agents Treatment of diabetic neuropathy with an elevated serum creatinine and proteinuria in patients with type 2 diabetes and a history of hypertension

Headache, dizziness, syncope, insomnia, Hypotension, Rash, urticaria, pruritus, alopecia, dry skin, Diarrhea, abdominal pain, nausea, constipation, dry mouth, URI symptoms, cough, sinus disorders, Cancer in preclinical studies, back pain, fever, gout, muscle weakness

 Administer without regard to meals.  Alert surgeon and mark patient's chart with notice that losartan is being taken. The blockage of the reninangiotensin system following surgery can produce problems. Hypotension may be reversed with volume expansion.  Monitor patient closely in any situation that may lead to a decrease in blood pressure secondary to reduction in fluid volume--excessive perspiration, dehydration, vomiting, diarrhea--excessive hypotension can occur.

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NURSING RESPONSIBILITIES

Generic Name: metoprolol

Competitively blocks beta-adrenergic receptors in the heart and juxtaglomerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues and the excitability of the heart, decreasing cardiac output and the release of renin, and lowering BP; acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone. y y y

Brand Name: Lopressor, Toprol XL

Classification Beta1selective adrenergic blocker Antihypertensive

Hypertension , alone or with other drugs, especially diuretics Immediaterelease tablets and injection: Prevention of reinfarction in MI patients who are hemodynami cally stable or within 3 10 days of the acute MI Treatment of angina pectoris

Contraindicated in patients with sinus bradycardia (HR < 45 beats/min), secondor third-degree heart block (PR interval > 0.24 sec), cardiogenic shock, CHF, systolic BP < 100 mm Hg;

 Dizziness  Fatigue  sleep disturbance s  slurred speech  Rash

y y

Do not discontinue drug abruptly after long-term therapy (hypersensitivity to catecholamines may have developed, causing exacerbation of angina, MI, and ventricular arrhythmias). Taper drug gradually over 2 wk with monitoring. Ensure that patient swallows the ER tablets whole; do not cut, crush, or chew them Consult physician about withdrawing drug if patient is to undergo surgery (controversial). Give oral drug with food to facilitate absorption. Provide continual cardiac monitoring for patients receiving IV metoprolol.