Drug Analysis

Brand

Name Nexium Generic Name esomeprazole

Indications Treatment of GERD/erosive esophagitis. As part of combination treatment for duodenal ulcer associated with H. pylori

Contraindications Contraindicated with hypersensitivity to esomeprazole, or other proton ump inhibitors.

Use cautiously with hepatic dysfunction, pregnancy and lactation.

Mechanism of Action Binds to an enzyme on gastric parietal cells in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. Therapeutic effects: Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux

Dosage 20 mg PO OD (for healing of symptomatic GERD)

 Side

effects/Adverse effects CNS: headache GI: abdominal pain, constipation, diarrhea, dry mouth, flatulence, nausea

Nursing Responsibilities Instruct patient to take drug at least 1 hour before meals Instruct atient to report severe headache, worsening of symptoms, fever, chills, darkening of the skin, changes in color of urine or stool. For GI symptoms such as nausea and vomiting, instruct patient to have small, frequent meals.

 Brand

Name Benadryl Name Diphenyhydramine

Generic

 Indications

Relief of allergic symptoms caused by histamine release including: anaphylaxis, allergic rhinitis, allergic dermatoses. Parkinsons disease or drug-induced extrapyramidal effects. Antitussive Contraindications Relief of allergic symptoms caused by histamine release including: anaphylaxis, allergic rhinitis, allergic dermatoses. Parkinsons disease or drug-induced extrapyramidal effects. Antitussive

Mechanism of Action Antagonizes the effects of histamine. Significant CNS depressant and anticholinergic properties. Therapeutic Effects: Relief of acute dystonic reactions. Prevention of motion sickness. Suppression of cough.

Dosage PO 25-50 mg q4-6 hr, 50 mg20-30 mins before bedtime

 Side

effects Drowsiness, dizziness, headache, anorexia, dry mouth

Adverse

effects Tremors, vertigo, depression, seizures, hallucinations, nausea, vomiting

 Nursing

Responsibilities Caution the client that the medication may cause drowsiness, creating difficulties or hazards or other activities that require alertness
Tell

the client to take the medication with food to decrease GI upset

 Brand

Name Bricanyl Name Terbutaline

Generic

 Indications

Used as bronchodilator in reversible airway obstruction due to asthma or COPD. Unlabeled Use: Used to arrest preterm labor
Contraindications

Hypersensitivity to adrenergic amines.

 Mechanism

of Action A beta-adrenergic agonist that results in the accumulation of cyclic adenosine monophosphate (cAMP). Results of increased levels of cAMP at beta-adrenergic receptors include: bronchodilation, CNS and cardiac stimulation, diuresis, gastric acid secretion.
Dosage

Tocolysis (arrest of preterm labor) PO 2.5mg q 4-6 hr until delivery

 Side

effects Nervousness, restlessness, headache, anxiety, tachycardia, palpitations, hypertension

Adverse

effects Arrhythmias, angina, pulmonary edema, nausea and vomiting, hypokalemia

 Nursing

Responsibilities Preterm Labor: Monitor maternal pulse and blood pressure, frequency and duration of contractions, and fetal heart rate. Notify physician if contractions persist or increase in frequency or duration or if symptoms of maternal or fetal distress occur.

 Brand

Name Metoprolol Name

Generic

Betaloc

 Indications

Hypertension. Angina pectoris. Prevention of MI Contraindications Acute heart failure; pulse less than 45 beats/minute; cardiogenic shock; hypersensitivity to metoprolol, or other beta blockers; severe peripheral arterial disorders; sick sinus syndrome

 Mechanism

of Action Blocks beta-adrenergic receptors. Therapeutic Effects: Decreased blood pressure and heart rate
Dosage

50 mg TAB

 Side

effects Fatigue, weakness, anxiety, dizziness, drowsiness

Adverse

effects Bradycardia, CHF, pulmonary edema

Nursing Responsibilities Monitor blood pressure, ECG, and pulse frequently during therapy

Monitor intake and output ratios and daily weights. Assess routinely for signs and symptoms of CHF (dyspnea, rales/crackles, weight gain, peripheral edema, jugular venous distention)

 Brand

Name Atro-Pen Name atropine

Generic

Indications Given preoperatively to derease oral and respiratory secretions. Treatment of sinus bradycardia and heart block. Adjunctive therapy in the management of peptic ulcer and irritable bowel syndrome

Contraindications Contraindicated in Hypersensitivity;angleclosure glaucoma; acute haemorrhage; tachycardia secondary to cardiac insufficiency; obstructive disease of GI tract

Mechanism of Action Inhibits the action of acetylcholine at muscarinic cholinergic receptors that mediate the effect of parasympathetic postganglionic, depressing salivary and bronchial secretions, dilating the bronchi, inhibiting gastric acid secretion, and relaxing the pupil

Dosage 0.4-0.6 mg PO, IM, IV, or subcutaneously

 Side

effects Drowsiness, blurred vision, tachycardia, dry mouth, urinary hesitancy, nausea & vomiting
Adverse

effects Paralytic ileus, heartburn, nasal congestion

 Nursing

Responsibilities Assess vital signs and ECG tracings frequently during drug therapy
Ensure Take

adequate hydration

as prescribed, 30 minutes before meals