Drug Study

Generic Name: Hyoscine N-butyl Bromide

Brand Name: Classification: Ordered Dose: Mode Of Action:

Buscopan Gastro-intestinal antispasmodic 20mg 1amp IVTT now It's a competitive antagonist of the actions of acetylcholine and other muscarinic agonists. Hyoscine works by relaxing the muscle that is found in the walls of the stomach, intestines and bile duct (gastrointestinal tract) and the reproductive organs and urinary tract (genitourinary tract) Indications: This medication is used to relieve bladder or intestinal spasms. Contraindications: Hypersensitivity to hyoscine butylbromide, Patients with prostatic enlargement, paralytic ileus or pyloric stenosis, ulcerative colitis, closed angle glaucoma Drug Interactions: Anticholinergic agents Antihistamines Monoamine oxidase inhibitors Tricyclic antidepressants Competitively blocks prokinetic agents Side Effect: Nausea, vomiting, loss of appetite, constipation, dry mouth, rash, itching, swelling of the hands or feet, trouble breathing, increased pulse, dizziness, diarrhea, vision problems, eye pain CNS: light-headedness, dizziness, sedation, euphoria, dysphoria, delirium, insomnia, agitation, anxiety, fear, hallucinations, disorientation, mood changes, lethargy, weakness, headache, tremor CV: peripheral circulatory collapse, tachycardia,

Adverse Effects:

bradycardia, arrhythmia, palpitations, hypertension, hypotension Dermatologic: pruritus, urticaria, bronchospasm, edema GI: nausea, vomiting, dry mouth, anorexia, constipation, GU: ureteral spasm, urinary retention, oliguria, decreased libido MAJOR: respiratory depression, apnea, circulatory depression, respiratory arrest, shock, cardiac arrest

Nursing Responsibilities:

Bibliography:

Inform patient that drug may cause blurred vision. Instruct patient to report if she experiences such symptom. Assess for parkinsonism and Extra-pyramidal symptoms. Assess for urinary hesitancy Assess for constipation. Caution patient to avoid alcohol because it may increase CNS depression. As appropriate, review all other significant adverse reactions and interactions Give only prescribed dosage Do not take left over medications for other disorders Keep out the reach of children MIMS 113th edition 2007 http://home.intekom.com/pharm/quatrom/q-hyosc.html http://www.medicinenet.com/hyoscine_butylbromideoral/page2.htm http://www.netdoctor.co.uk/medicines/100000395.html

Generic Name:

Phytonadione

Brand Name: Classification: Ordered Dose: Mode Of Action:

Hema K Fat soluble vitamin; antifibrinolytic agent 1amp now Vitamin K is required for the liver to make factors that are necessary for blood to properly clot (coagulate), including factor II (prothrombin), factor VII (proconvertin), factor IX (thromboplastin component), and factor X (Stuart factor). Preoperatively: to activate clotting factors to decrease chances of bleeding during surgical procedure

Indications:

Contraindications: Hypersensitivity to benzyl alcohol, Drug Interactions: Coumarin and indanedione derivatives Side Effect: Adverse Effects: Nursing Responsibilities: No known side effects for this drug; bruising and bleeding are less likely to happen. No known adverse effects reported Instruct patient to take only prescribed order If a dose is missed, take as soon as remembered unless almost time for the next dose Cooking does not destroy substantial amounts of Vitamin K Caution patient to avoid IM injection and activities leading to injury Patient should not drastically alter diet while taking Vitamin K Use a soft toothbrush until coagulation effect is corrected Advise patient to report any signs of bleeding/bruising Patient should be advised not to take OTC drugs without advice of health care provider Advise patient to inform health care provider of medication regimen prior to treatment or surgery Emphasize importance of frequent lab test to monitor coagulation factors MIMS 113th edition 2007 http://www.nlm.nih.gov/medlineplus/druginfo/natural/patien t-vitamink.html http://www.drugs.com/enc/vitamin-k.html

Source

Generic Name:

Celecoxib

Brand Name:

Arcoxia

Classification:

COX-2 Selective Inhibitor

Ordered Dose:

400mg/cap 1cap OD PRN

Mode Of Action:

Indications:

Arcoxia reduces pain and inflammation by blocking COX-2, an enzyme in the body.Arcoxia does not block COX-1, the enzyme involved in protecting the stomach from ulcers.Other anti-inflammatory medicines (NSAIDS) block both COX-1 and COX-2.Arcoxia relieves pain and inflammation with less risk of stomach ulcers compared to NSAID relief of acute pain

Contraindications: Hypersensitivity to arcoxia and its ingredients such as Celecooxib

Drug Interactions:

warfarin, a medicine used to prevent blood clots rifampicin, an antibiotic used to treat tuberculosis and other infections water pills (diuretics) ACE inhibitors and angiotensin receptor blockers, medicines used to lower high blood pressure or treat heart failure lithium, a medicine used to treat a certain type of depression birth control pills hormone replacement therapy methotrexate, a medicine used to suppress the immune system Nausea, vomiting, diarrhea, Headache, Rash, Blurred vision, Difficulty in sleeping, Muscle cramps, Fatigue

Side Effect:

Adverse Effects:

CNS: headache, malaise, dizziness, hallucinations, insomnia, vertigo, anxiety, drowsiness, confusion CV: bradycardia, tachycardia, hypertension Dermatologic: rash, urticaria GI: constipation, diarrhea, nausea, anorexia, vomiting, abdominal pain, hepatic dysfunction, jaundice GU: gynecomastia, impotence Hematologic: leucopenia, granulocytopenia, thrombocytopenia, pancytopenia Local: pain at IM site, local burning pain at injection site Take Arcoxia only when prescribed by your doctor. For the relief of chronic musculoskeletal pain the recommended dose is 60 mg once a day. If you have mild liver disease, you should not take more than 60 mg a day. If you have moderate liver disease, you should not take more than 60 mg every other day. When taking the tablets, swallow them with a glass of water. Do not halve the tablet. Take your Arcoxia at about the same time each day. Taking Arcoxia at the same time each day will have the best effect. It will also help you remember when to take

Nursing Responsibilities:

Bibliography:

the dose. It does not matter if you take Arcoxia before or after food. Do not use Arcoxia for longer than your doctor says. Do not take a double dose to make up for the dose that you missed. If you get an infection while taking Arcoxia, tell your doctor. Arcoxia may hide fever and may make you think, mistakenly, that you are better or that your infection is less serious than it might be. MIMS 113th edition 2007 http://www.drugs.com/arcoxia.html http://arcoxia-side-effects.com/

Generic Name:

Tramadol hydrochloride

Brand Name: Classification: Ordered Dose: Mode Of Action:

Ultram Central acting analgesic 100mg 1tab PO Binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin; causes many effects similar to opioids but doesnt cause respiratory depression Relief of moderate to severe pain.

Indications:

Contraindications: Hypersensitivity to tramadol or opioids or intoxication with alcohol, opioids, or psychoactive drugs Drug Interactions: Decreased effectiveness with carbamezapine Increased risk of tramadol toxicity with MAOIs Side Effect: Dizziness, sedation, drowsiness, impaired visual acuity, nausea, loss of appetite Adverse Effects: CNS: sedation, dizziness, headache, confusion, dreaming, anxiety, seizures

Nursing Responsibilities:

CV: hypotension, tachycardia, bradycardia, Dermatologic: pruritus, urticaria, sweating, pallor GI: nausea, vomiting, dry mouth, flatulence, constipation, Other: potential for abuse, anaphylactoid reactions Control environment ( temp, light, noise) Limit use in patients with past or present history of addiction or dependence to opioids Caution patient not to chew or crush tablet Keep opioid antagonist readily available in case of emergency Instruct post-op patients that drug suppress cough reflex Monitor bowel function and arrange laxatives for constipation Institute safety precautions (side rails, assistive device) Provide frequent, small meals if GI upset occurs Provide back rubs, positioning, and other non pharmacological measures to alleviate pain Take drug exactly as prescribed Avoid alcohol, antihistamines, sedatives, tranquilizers while taking this drug 2005 Lippincotts Nursing Drug Guide http://www.webmd.com/drugs/drug-11276Ultram+Oral.aspx http://www.drugs.com/ultram.html http://www.medicinenet.com/tramadol/article.htm

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