Para

Biogesic, Panadol, Tylenol Uses: 1. 2. 3. Control of pain due to headache, earache, dysmenorrhea, arthralgia, myalgia, musculoskeletal pain, arthritis, immunizations, teething, tonsillectomy O reduce fever in viral and bacterial infections As a substitute for aspirin in upper GI disease, bleeding disorders clients in anticoagulant therapy and gouty arthritis

Action
1. 2. 3. 4. 1. 2. 3. 4. Decreases fever by a hypothalamic effect leading to sweating and vasodilation Inhibits pyrogen effect on the hypothalamic-heat-regulating centers Inhibits CNS prostaglandin synthesis with minimal effects on peripheral prostaglandin synthesis Does not cause ulceration of the GI tract and causes no anticoagulant action. Renal Insufficiency Anemia Per Orem: 325-650mg q4h up to a maximum of 1 gram q6h. Suppositories: 650mg q4h not to exceed 4 grams a day for up to 10 days

Contraindications:

Dosage:

Nursing Considerations: 1. 2. 3. 4. 5. 6. 7. 8. 9. Do not exceed 4gm/24hr. in adults and 75mg/kg/day in children. Do not take for >5days for pain in children, 10 days for pain in adults, or more than 3 days for fever in adults. Extended-Release tablets are not to be chewed. Monitor CBC, liver and renal functions. Assess for fecal occult blood and nephritis. Avoid using OTC drugs with Acetaminophen. Take with food or milk to minimize GI upset. Report N&V. cyanosis, shortness of breath and abdominal pain as these are signs of toxicity. Report paleness, weakness and heart beat skips

10. Report abdominal pain, jaundice, dark urine, itchiness or clay-colored stools.

11. Phenmacetin may cause urine to become dark brown or wine-colored. 12. Report pain that persists for more than 3-5 days 13. Avoid alcohol. 14. This drug is not for regular use with any form of liver disease.

Diphenhydramine

Generic name: diphenhydramine Brand name: Benadryl Preparations: PO 25-50 mg q4-6 hr, 50mg 20-30 mins before bedtime CLASSIFICATION: Antiparkinsonian drug ACTION: Antagonizes the effect of histamine at H1 receptor sites; does not bind or inactivate histamine INDICATION / USES: parkinsonism or drug-induced extrapyramidal effects COMMON ADVERSE EFFECTS: CNS: headache, fatigue, anxiety, tremors, vertigo, confusion, depression, seizures, hallucinations CV: tachycardia, palpitations, orthostaic hypotension, heart failure EENT: blurred vision GI: dry mouth, nausea, vomiting, constipation, flatulence GU: urinary hesitancy or frequency, urine retention Hematologic: leukopenia Skin: photosensitivity, dermatitis

CONTRA-INDICATIONS: cardiac disease or hypertension glaucoma gastric or duodenal ulcers NURSING CONSIDERATIONS: 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. Explain to the client that arising quickly form a lying or sitting position may cause orthostatic hypotension. When taking these medications, the client needs to have blood cells counts, renal function, hepatic function, and blood pressure monitored. Adverse effects of these drugs occur more commonly in elderly clients. Explain to the client that use of these drugs in warm weather may increase the likelihood of heatstroke.
Nursing Considerations: 1. 2. 3. 4. 5. 6. 7. 8. 9. Give full prophylactic dose 30min. prior to travel if used as a prophylaxis for motion sickness Take similar doses with meals and at bedtime Do not use more than 2 weeks to treat insomnia For IV, may give undiluted Do not exceed IV rate of 25mg/minute Drug causes drowsiness. Avoid activities requiring mental alertness Use sun protection as it may cause photosensitivity Use sugarless candy/gum to diminish dry mouth effects Avoid alcohol and other CNS depressants

10. Stop therapy 72-96 hr. prior to skin testing. Report adverse effect and lack of response