Name of Patient: _____________________________

Age: ________

Room No._________________ Hospital Number:_________________

Diagnosis/ Impression: _______________________________________________ Attending Physician: ________________________

DRUG STUDY
Name of Drug (Generic & Brand) Ketosteril Date Order ed July 16, 2011 Classification of Drug Dose/ Frequenc y 1 tab/ TID Mechanism of Action Specific Indication Contraindication Side Effects Toxic Effects Nursing Precaution

Ketoanalogs; Essential amino acids

Normalizes metabolic process, promotes recycling product exchange. Reduces ion concentration of potassium, magnesium and phosphate.

Protein energy malnutrition Prevention and treatment of conditions caused by modified or insufficient protein metabolism in chronic renal failure

Allergy and hypersensitivity to any content of this drug Hypercalcemia Disturbed amin o acid metaboli sm Caution use for patietn with phenylketonuri a

Hypercalcemia may develop

Evaluate for any contraindicati ons Take drug as prescribed Warn the patient about possible side effects and how to recognize them Give with food if GI upset occurs Frequently assess for hypercalcemi a

Salbutamol

July 17, 2011

Anti-asthmatic Bronchodilator

1 neb q 6hrs

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

To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD) Quick relief for bronchospas m For the prevention of exerciseinduced bronchospas m Long-term control agent for patients with chronic or persistent bronchospas m

Hypersensitivity to adrenergic amines Hypersensitivity to fluorocarbo ns

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

Cardiac disease including coronary insufficiency, a history of stroke, coron ary artery disease and cardiac arrhythmias Hypertension Hyperthyroidis m Diabetes Glaucoma Geriatric patients older individuals are at higher risk for adverse reactions and may require lower dosage Pregnancy especially near term Lactation Children less than 2 years of age because safety of its use has not been

established Excess inhaler use which may lead to tolerance and paradoxical bronchospas m Furosemide July 17, 2011 Electrolytic and Water Balance Agent; Loop Diuretic 20 mg/ OD 2 days Rapid-acting Treatment of Furosemide is potent edema contraindicated in sulfonamide associated with patients with loop diuretic CHF, cirrhosis anuria and in and of liver, and patients with a antihypertensi kidney disease, history of ve with including nephro hypersensitivity to pharmacologic tic syndrome. furosemide. effects and May be used for uses almost management identical to of hypertension, those of alone or in ethacrynic aci combination d. Exact mode with other of action not antihypertensive clearly agents, and for defined; treatment of decreases hypercalcemia. renal vascular resistance and may increase renal blood flow. Common side effects of furosemide include low blood pressure, dehydra tion and electrolyt e depletion (for example, sodium, potassium). Less common side effects include jaundice, ringing in the ears (tinnitus), sensitivity to light (photophobia), ra sh, pancreatitis, n ausea,diarrhea, a bdominal pain, and dizziness. Increased blood sugar and uric acid levels also may occur. Administer with food to prevent upset. Reduce dosage if given with other antihypertensi ves. Measure and monitor fluid changes.

Aluminum Hydroxide (Alutab)

July 16, 2011

Antacids, Antireflux Agents & Antiulcerants

1 tab/ TID

Alumunium hydroxide acts on the HCl in the stomach by neutralization, forming aluminium chloride salt and water.

Duodenal ulcer Peptic ulcer Hyperphosphat remia Stress gastritis prophylaxis

Hypersensitivity to aluminium salts.

Spironolactone

July 14, 2011

potassiumsparing diuretic

20 mg/ TID

Spironolacton e inhibits the action of aldosterone thereby causing the kidneys to excrete salt and fluid in the urine while retaining potassium.

Used primarily to treat lowrenin hypertension, hypokalemia, and Conn's syndrome.

Spironolactone is contraindicated for patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, or hyperkalemia.

Chronic renal impairment; CHF; oedema; cirrhosis and low Na diets; patients with recent GI haemorrhage. Administer 2-3 hrs before/after another medication to minimise drug interactions. ide effects of Monitor Intake spironolactone and Output include headache and daily , diarrhea, weight during cramps, therapy. drowsiness, rash, nausea, vomiting, Monitor BUN, serum impotence, irregu lar menstrual creatinine and periods, and electrolytes irregular hair during therapy. growth. Fluid and Discontinue 3 electrolytes days before a imbalance (for glucose example, low tolerance test sodium, low because of risk magnesium, and high of severe potassium) may hyperkalemia. occur, so patients Monitor should be platelet count monitored and differential carefully. leukocyte.

Constipation; intestinal obstruction (with large doses); phosphate depletion may occur with prolonged admin or large doses.

Losartan

July 14, 2011

cardiovascular 500 mg / agent; OD angiotensin ii receptor antagonist; antihypertensi ve

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

Losartan is used Losartan is for treating contraindicated in hypertension, patients who are left ventricular hypersensitive to hypertrophy any component of (increase in this product. muscle) and diabetic nephropathy (kidney disease). It may be used alone or in combination with other drugs.

Enlargement of the breasts (gynecomastia) may also occur and is related to dose and duration of therapy. In clinical studies Volumethe overall depleted incidence of side patients effects was including similar to placebo. patients on Side effects diuretics and reported salt restriction; included diarrhea, renal artery muscle stenosis; elderly; cramps,dizziness, renal or hepatic insomnia, and impairment. nasal congestion. Monitor serumLosartan also potassium may cause concentration. apersistent cough, increase serum potassium, and angioedema. Losartan may reduce kidney function in some patients and should not be used by patients who have bilateral renal artery stenosis (narrowi ng of both arteries going to the

Cefuroxime

July 16, 2011

Antiinfective; antib iotic; secondgeneration cephalosporin

750 mg q 8hrs

Cefuroxime binds to bacterial membranes. It inhibits synthesis of bacterial cell wall.

kidneys). Rare cases of rhabdomyolysis (muscle breakdown) have been reported. Cefuroxime is Contraindicated in Mild diarrhea o o used to treat patients with o Mild abdominal otitis media, known allergy to cramping respiratory tract, the cephalosporin o Vaginal genitourniary group of candidiasis tract, antibiotics. gynecologic, Solutions o Nausea o skin, and bone containing o Serum sickness infections. It is dextrose may be reaction (joint also used in the contraindicated in pain, fever) treatment of patients with o Allergic reactions speticemia, hypersensitivity to bacterial corn products. o Thrombophlebitis o meningitis, gonorrhea, and other gonococcal infections.

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 antibioticassociated

colitis. Monitor input and output and renal function reports for nephrotoxicity. Be alert for superinfection: severe genital or anal pruritus, abdominal pain, severe mouth soreness, moderate to severe diarrhea.