Drug Name

Dosage, Route, Frequency, Time Dosage: 500mg 1tab

Mechanism of Action

Indication

Contraindication

Side Effect/ Adverse Reactions

Nursing Responsibilities

Generic Name: Cefuroxime

Route: Oral Brand name: Frequency: Ceftin BID Time: 8am, 8pm Specific Classificatio n: Antiinfective, Antibiotic

Inhibits bacterial wall synthesis, rendering cell wall osmotically unstable, leading to cell death by binding to cell wall membrane.

Urinary tract infections, Otitis media, Severe infections

Sensitivity to cephalosporins Renal Failure

CNS: Headache, dizziness, lethargy, paresthesias GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomembran ous colitis, liver toxicity Hematologic: Bone marrow depression: decreased WBC, decreased platelets, decreased Hct GU: Nephrotoxicity Hypersensitivity: Ranging from rash to fever to anaphylaxis, serum sickness reaction

Assess patient for signs and symptoms of infection Assess for anaphylaxis: rash, urticaria, chills, fever, dyspnea Assess bowelpattern daily Monitor for bleeding Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes

Drug Name

Dosage, Route, Frequen cy, Time

Mechanism of Action

Indication and Contraindication Contraindication:

Side Effects

Nursing Responsibilities

Generic Name: FUROSEMIDE Brand Name: Lasix

Dosage: 500mg 1tab Route:

Specific Classification: Diuretics

Oral Frequen cy: BID Time: 8am, 8pm

A potent loop diuretic that inhibit sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle

Indication: Acute pulmonary edema, edema, hypertension

Contraindicate d to patients hypersensitivit y to drug and in those with anuria Use cautiously in patients with hepatic cirrhosis and in those allergic to sulfonamidfes. Use furosemide during pregnancy only if potential benefits to mother clearly out weight risks to fetus.

CNS: vertigo, headache, dizziness, paresthesia, weakness, restlessness,fever. CV: orthostatic, hypotension; thrombophlebitis with I.V administration EENT: transient deafness, blurred or yellowed vision GI: abdominal discomfort and pain, diarrhea, anorexia, nausea, vomiting, constipation Hepatic: Hepatic Dysfunction Metabolic: volume depletion and dehydration, asymptomatic hyperuricemia, impaired glucose intolerance, hypokalemia, hypochloremic alkalosis, fluids and electrolyte imbalance

Observe 10 Rs in giving medication. Monitor weight, blood pressure, and pulse rate routinely with long term use and during rapid dieresis. Furosemide can lead to profound and electrolyte depletion. Monitor fluid intake and output and electrolyte, BUN, and carbon dioxide level frequently. Watch for signs of hypokalemia such as muscle weakness and cramps Advise patient to immediately report ringing ears, severe abdominal pain, or soar throat and fever which may indicate furosemide toxicity

Musculoskeletal: muscle spasm Skin: dermatitis, purpura, photosensitivity, transient pain at I.V injection site

Drug Name

Dosage, Route, Frequency, Time Dosage: 600mg Route:

Mechanism of Action

Indication

Contraindication

Side Effect/ Adverse Reactions Chest pain Dyspnea Rash Fever Acute kidney failure Jaundice Acute kidney failure Hepatic toxicity and failure.

Nursing Responsibilities Monitor for S&S of hepatotoxicity, evenwith moderateacetam inophen doses,especially inindividuals with poornutrition. Do not take othermedication s (e.g., coldpreparation s)containingacet aminophenwith out medicaladvice; overdosingand chronic use cancause liver damageand other toxiceffects. Do not use for feverpersisting longer than3 d, fever over 39.5C (103 F), orrecurrent fever Store at room temperature away from heat

Generic Name: Paracetamol

Brand name: Aeknil

IV Frequency: Q6

Produces analgesia by blocking pain umpulse by inhibiting synthesis of prostaglandin in CNS that synthesize pain receptor to stimulation.

Used for the relief of fever, headaches, and other and pains regarding surgical wound.

Contraindicated with allergy to acetaminophen or any component. Use cautiously with impaired hepatic function, chronis alcoholism, and pregnancy lactation.

Specific Classification: Analgesic and Antipyretic

Time: 8am, 2pm, 8pm, 2am

and moisture.

GENERIC NAME

DOSAGE

INDICATION

MECHANISM OF ACTION Citicoline activates the biosynthesis of structural phospholipids in the neuronal membrane, increases cerebral metabolism and increases the level of various neurotransmitters, including acetylcholine and dopamine. Citicoline has shown neuroprotective effects in situations of hypoxia and ischemia.

CONTRAINDICATION Patients with parasympathetic hypertonia.

ADVERSE EFFECT

NURSING RESPONSIBILITIES

Generic name: Citicoline Brand name: Zynapse Specific Classification:

Dosage: 600mg Route: IV Frequency : Q6 Time: 8am, 2pm, 8pm, 2am

Diseases, accelerates the recovery of consciousness and overcoming motor deficit.

Treatment of cerebrovascular accident in acute and recovery phase, symptoms and signs of cerebral insufficiency eg, dizziness, memory loss, poor concentration, disorientation, recent cranial trauma and their sequelae.

citicoline may exert a stimulating action of the parasympathetic, as well as a fleeting and discrete hypotensor effect Gastrointestinal disorders. Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, or rash, Low blood pressure (faintness, dizziness), Slow or fast heart beat, Headache, Nausea, vomiting, or diarrhea (loose BMs)

Watch out for hypotensive effects Somazine must not be administered along with medicaments containing Verify the doctors order. Assess allergy to warfarin. Do not use drug if the ptient is pregnant (use contraceptives). Monitor closely PT ratio and INR. Administer the drug in IV form if the client can not take it orally. Document the procedure.

Neurovascular enhancer. Pharmacology: Piracetam acts

selectively upon the telencephalon by improving its associative function. It increases the energy output of the brain cell and activates its neurophysiological potentialities, especially in deficit conditions. Nootropil is virtually nontoxic and has no stimulating, sedative or neurovegetative activities.

Drug Name

Dosage, Route, Frequency, Time Dosage: 50mg Route:

Mechanism of Action

Indication

Contraindication

Side Effect/ Adverse Reactions CNS: Dizziness, vertigo, headache, stimulation, anxiety, confusion, coordination, disturbances Cardio: Vasodilatation

Nursing Responsibilities

Generic Name: Tramadol

Brand name: Dolcet

IV Frequency: Q6 Time:

Binds to -opiate receptors in the CNS causing inhibition of ascending pain pathways, altering the perception of and response to pain; also inhibits the reuptake of norepinephrine and serotonin, which also modifies the ascending pain pathway.

Moderate to severe pain and management of pain in the operation site.

Hypersensitivity to tramadol, opioids, or any component of the formulation; opioiddependent patients; acute intoxication with alcohol, hypnotics, centrally-acting analgesics, opioids, or psychotropic drugs

GIT: Dry mouth, nausea and vomiting, diarrhea, constipation, flatulence, abdominal pain Urinary: Urinary retention

Specific Classification: Analgesic

6am, 12nn, 6pm, 12mn

Monitor for central nervous system changes. Monitor input and output. Check for decreasing output that may indicate retention. Assess change in bowel pattern. Increase oral bulk and fluids to prevent constipation Instruct patient to change position slowly Warn ambulatory patient to be careful or call for assistance in getting out of the bed or walking. Provide safety for the patient by reducing hazards or obstacles.

DRUG, DOSAGE & ROUTE Lactulose 30 cc syrup OD HS 8pm

MECHANISM OF ACTION

INDICATIONS

CONTRAINDICATIONS

SIDE EFFECTS

ADVERSE REACTIONS

DRUG INTERACTION S DRUG-DRUG Do not administer other laxatives with lactulose.

NURSING RESPONSIBILITIES

Laxative, Ammonia reduction drug

The drug passes unchanged into the colon where bacteria break it down to organic acids that increase the osmotic pressure in the colon and slightly acidify the colonic contents, resulting in an increase in stool water content, stool softening, laxative action. This also results in migration of blood ammonia into the colon contents with subsequent trapping and expulsion of feces.

Treatment of constipation.

Contraindicated with allergy to lactulose, low-galactose diet.

Abdominal fullness, flatulence, belching.

GI Transient flatulence, distention, intestinal cramps, belching, diarrhea, nausea.

History Allergy to lactulose, low-galactose diet. diabetes, pregnancy, and lactation.

Prevention and treatment of portalsystemic encephalopathy.

Use cautiously with diabetes, pregnancy, and lactation. Other Acid-base imbalances

DRUG-FOOD May be taken with fruit juice or milk to increase palatability. Physical Abdominal examination, bowel sounds, serum electrolytes, serum ammonia levels.

Do not freeze laxative form. Ask patient to report diarrhea, severe belching, abdominal fullness.

DRUG ORDER (Generic name, brand name, classification, dosage, route, frequency)

MECHANISM OF ACTION

CONTRAINDICATIONS INDICATIONS

ADVERSE EFFECTS OF THE DRUG CNS; headache, dizziness, asthenia, vertigo,

NURSING RESPONSIBILITIES/ PRECAUTIONS

Short-term Generic Name: Omeprazole Gastric-acid pump inhibitor: suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production. treatment of active duodenal cancer Short-term treatment of active benign gastric ulcer Eradication of Helicobacter Pylori First-line therapy for treatment of heartburn or symptoms of GERD.

Contraindicated with hypersensitivity to omeprazole or its components.

Assessment: 1. History :hypersensitivity to omeprazole or any of its components; pregnancy, lactation 2. Physical: skin lesions; reflexes; urinary output; abdominal examination; respiratory auscultation

insomnia, apathy, anxiety, paresthesias, dream abnormalities

Brand Name: Tansinel

Classification: Antisecretory drug

Dermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skin

Interventions: 1. Administer before meals. 2. Administer antacids with, if needed.

Dosage: 20 mg 1 cap BID

GI: diarrhea,

3. Have regular

abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy Respiratory: URI symptoms, cough, epistaxis

medical follow-up visits. 4. Report severe headache, worsening of symptoms, fever, chills.

Name Generic Name: Metoclopramide Product Name: Plasil

Class Antiemetics

Dosage/ Route 10 mg IV push

Mode of Action Blocks dopamine receptors in chemoreceptor trigger zone of the CNS. Stimulates motility of the upper GI tract and accelerates gastric emptying. Decreased symptoms of gastric stasis. Easier passage of nasogastric tube into small bowel.

Indication -Treatment and prevention of nausea and vomiting. -Management of esophageal reflux

Contraindication -Hypersensitivity to Plasil -Possible GI obstruction or hemorrhage -seizure disorders -parkinsons disease -renal impairment

Side Effects/ Adverse Reaction CNS: drowsiness, extrapyramidal reactions, restlessne ss, NEUROLEPTIC MALIGNANT SYNDROME, anxiety, depression, irritability, tardive dyskinesia. CV: arrhythmias (supraventricular tachycardia, bradyca rdia), hypertension, hypotension. GI: constipation, diarrhea, dry mouth, nausea. Endo: gynecomastia. Hematology: methemoglobinemia , neutropenia, leukopenia, agranulocytosis.

Nursing Responsibilities -Assess patient for nausea, vomiting, abdominal distention, and bowel sounds before and after administration. - Advise patient to avoid concurrent use of alcohol and other CNS depressant while taking this medication. -Advise patient to notify health care professional immediately if involuntary movement of eyes, face or limbs occurs.

Name

Class

Generic Name:

Osmotic diuretics

Dosage/ Route/ Time 25 mg 1 tab Oral HS

Mode of Action

Indicati on Contr aindic ated with aoma. Or severe CNS depre ssion, allerg y to quieti apine, lactati on. Use cautio usly in patien ts with, CV diseas es, hypot ensio n, hepati c impai rment, seizur es, expos ure to extre me

Contraindicatio n -Active bleeding within the skull, except during a craniotomy (intracranial bleeding) -Fluid accumulation in the air-filled sacs of the lungs (pulmonary oedema) -Heart failure -Kidney failure, preventing production of urine (anuria) -Severe dehydration

Side Effects/ Adverse Reaction

Nursing Responsibilities

Elevates plasma osmolality, causing water to flow from tissues, such as brain and eyes, and from CSF, into extracellular fluid, thereby decreasing intracranial and intraocular pressure. As an osmotic diuretic, mannitol increases the osmolarity of glomerular filtrate, which decreases water reabsorption. This leads to increased excretion of water, sodium, chloride, and toxic substances. As an irrigant, mannitol minimizes the hemolytic effects of water used as an irrigant and reduces the movement of hemolyzed blood from the urethra to the systemic circulation, which prevents hemoglobinemia and serious renal complications.

Manitol Product Name: Osmitrol, Resectisol

CNS: Chills, dizziness, fever, headache, seizures CV: Angina-like Chest pain, heart failure, hypertension, tachycardia, thrombophlebitis, hypotension, vascular overload EENT:Blurred vision, dry mouth, rhinitis GI:Diarrhea, nausea, thirst, vomiting, dry mouth GU:Polyuria, urine retention Metabolic: Dehydration Musculoskeletal: Respiratory: Pulmonary edema Skin: Extravasation with edema and tissue necrosis, rash, urticaria, local pain Other:hyperkalemia, hypernatremia, hypervolemia, hypokalemia, hyponatremia (dilutional), metabolic acidosis, water intoxication)

- If crystals form in mannitol solution exposed to low temperature, place solution in hot-water bath to redissolve crystals. - During I.V. infusion of mannitol, monitor vital signs, central venous pressure, and fluid intake and output every hour. Measure urine output with indwelling urinary catheter, as appropriate. - Check weight and monitor BUN and serum creatinine electrolyte levels daily. - Provide frequent mouth care to relieve thirst and dry mouth.

heat, auton omic instab ility, tardiv e dyski nesia. Thyro id diseas e.

Drug name Generic name: Insulin Lispro

Drug class General classification: antidiabetic agent (fast-acting)

Drug dosage dosage: 20 u route: subcutaneous injection

Drug action allows the body to properly use sugar from the diet. It replaces the insulin that your body no longer produces, thereby lowering your blood sugar

Drug indication Treatment of diabetes mellitus

Contraindication allergic to insulin having episode of hypoglycemia

Adverse effects Hypoglycemia with symptoms: chills, cold sweats, blurred vision, dizziness, drowsiness, shaking, fast heartbeat, weakness, headache, fainting, tingling of the hands/feet, or hunger Hypokalemia

Nursing consideration Note: Frequency of blood glucose monitoring is determined by the type of insulin regimen and health status of the patient. Notify physician promptly for presence of acetone with sugar in the urine; may indicate onset of ketoacidosis. Acetone without sugar in the urine usually signifies insufficient carbohydrate intake. Monitor for hypoglycemia (see Appendix F) at time of peak action of insulin. Onset of hypoglycemia (blood sugar: 50 40 mg/dL) may be rapid and sudden. Check BP, I&O ratio, and blood glucose and ketones every hour during treatment for ketoacidosis with IV insulin.

Brand name: Humalog frequency: qPM

Give patients with severe hypoglycemia glucagon, epinephrine, or IV glucose 10% 50%. As soon as patient is fully conscious, give oral carbohydrate (e.g., dilute corn syrup or orange juice with sugar, Gatorade, or Pedialyte) to prevent secondary hypoglycemia.

Drug name Generic name: Domeperidone

Drug class General classification: Anti-emetic and anti-vertigo

Drug dosage dosage: 1 tab route: per orem

Drug action a dopamine-receptor blocking agent. Its action on the dopamine-receptors in the chemo-emetic trigger zone produces an antiemetic effect.

Drug indication Acute and longNausea and vomiting Non-ulcer dyspepsia Migraine

Contraindication Hypersensitivity. GI haemorrhage, obstruction and perforation, patients with prolactin releasing pituitary hormone, chronic admin or routine prophylaxis of postoperative nausea and vomiting.

Adverse effects Allergic reactions, such as rash or urticaria, have been reported. Abdominal cramps have been Dystonic reactions (extrapyramidal phenomena) Reversible raised serum prolactin levels have been observed which may lead to galactorrhoea and gynaecomastia. Hypertensive crises in patients with phaeochromocytoma

Nursing consideration Assess for extra-pyramidal effects such as jerking and tongue protrusion. Check for hypotension.

Brand name: Motilium

frequency: TID