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Brand Name:
Ventolin
Generic Name:
Salbutamol
Indications:
Prevention
 
and treatment of bronchospasm in patients with reversible obstructiveairway disease.
Drug Classification:
Bronchodilator 
Mechanism of Action:
Relaxes bronchial smooth muscle by acting on beta
2
-adrenergicreceptors.
Dosage:
 Adults and children over 13 years:
1 to 2 inhalations q 4 to 6 hours.Oral tablets
-
-- 2 to 4 mg t.i.d. or q.i.d. Maximum 8 mg q.i.d. 
Children 6 to 13 years:
2 mg (1 teaspoonful) t.i.d. or q.i.d. 
Children 2 to 5 years:
0.1 mg/kg t.i.d. 
 Adults over 65:
2 mg t.i.d. or q.i.d. 
 Adults:
2 inhalations 15 minutes before exercise.
Special Precaution:
Thyrotoxicosis. Inhaled salbutamol prep are not appropriate for managingpremature labour. Pregnancy, lactation.
Pregnancy Risk Category:
C
 Adverse Reactions:
 
CNS 
: tremor, nervousness, dizziness, insomnia, headache. 
CV 
: tachycardia, palpitations, hypertension
EENT 
: drying and irritation of nose and throat (with inhaled form). 
GI 
: heartburn, nausea, vomiting 
Other 
: muscle cramps
Contraindications:
Threatened abortion during 1
st
or 2
nd
trimesters of pregnancy. Toxemia of pregnancy, antepartum hemorrhage, placenta previa.
Form:
Tablet - 2mg; Inhaler - 100µg/inhalation; Syrup - 2mg/5ml
Nursing Responsibilities:
 Ø Warn patient about the possibility of paradoxical bronchospasm. If this occurs, the drugshould be discontinued immediately.Ø Patients may use tablets and aerosol concomitantly. Monitor closely for toxicity.Ø Albuterol reportedly produces less cardiac stimulation than other sympathomimetics,especially isoproterenol.Ø Elderly patients usually require a lower dose.Ø Store drug in light-resistant container 
Brand Name
:Riomet
Generic Name
: Metformin HCl
Indications
: Type 2 Diabetes inadequately controlled by diet and exercise alone
Drug Classification
: Oral hypoglycemic agent
Mechanism of action
: Decreases hepatic production of glucoseDecreases intestinal absorption of glucoseIncreases sensitivity to insulinMaintenance of blood sugar without hypoglycemia
Dosage
: Initially 500 mg every 12 hrs. given w/ morning or evening meals, dose maybegradually increased to a max of 2250 mg daily.
Special precaution
: Elderly, hepatic and renal impairment
Pregnancy Risk Category
: B
 
Adverse Reaction
: Anorexia, nausea and vomiting, diarrhea, lactic acidosis, decreased vit B12absorption.
Contraindications
: Renal impairment, CHF requiring pharmacologic treatment, acute or chronicmetabolic acidosis.
Form
: Tab 500 mg x 100’s. 850 mg x 100’s.
Nursing Responsibilities
: Monitor patient for neuroleptic malignant syndrome: altered mentalstatus, autonomic instability, muscle rigidity and hyperpyrexia.Stop drug for 4 days before diagnostic skin testing because antihistamines can prevent, reduce,or mask positive skin test response.Pronounced sedative effect limits use in many ambulatory patients.Promethazine is used as an adjunct to analgesics. It has no analgesic activity.Reduce GI distress by giving drug with food or milk.Drug maybe mixed with Meperidine in same syringe.I.M. injection is the preferred parenteral route of administration.
Brand Name:
Xylocaine
Generic Name:
Lidocaine (hydrochloride)
Indications:
Ventricular arrhythmias caused by MI, cardiac manipulation, or cardiac glycosides
Drug Classification
: Anti-arrhythmics
Mechanism of Action:
A class IB anti-arrhythmic that decreases the depolarization, automaticity,and excitability in the ventricles during the diastolic phase by direct action on the tissues,especially the Purkinje network.
Dosage:
Adult: 50 to 100 mg by IV bolus at 25 to 50 mg/minute.
Special precaution
: Renal, cardiac, or hepatic failure; diabetes mellitus
Pregnancy Risk Category
: B
Adverse Reactions
:confusion, tremor, lethargy, somnolence, stupor, restlessness anxiety,hallucinations, nervousness, seizure. CV: hypotension, bradychardia, new or worsenedarrhythmias EENT: tinnitus, blurred or double vision. GI: vomiting Respiratory: Respiratorydepression and arrest Skin: soreness at injection site Other: anaphylaxis, sensation of cold
Contraindications:
hypersensitive to the amide-type local anesthesics and in those with Adams-Stokes syndrome
Form:
injection for IV – 1%(10mg/ml), 2%(20 mg/ml)
Nursing Responsibilities
:
•
 
Monitor drug level and for toxicity
•
 
Monitor patient’s response, especially blood pressure and electrolytes
•
 
Stop infusion and notify prescriber if arrhythmias worsen or ECG changes
•
 
If signs of toxicity such as dizziness occur, stop at once and inform prescriber 
•
 
Use cautiously and in reduced dosages in patients with complete or second degreeheart block or sinus bradychardia
Brand Name:
Cardizem
Generic Name:
Diltiazem hydrochloride
Indications and Dosages:
•
 
Management of Prinzmetal’s or variant angina or chronic stable angina pectorisAdults: 30mg P.O. qid Before meals and h.s.
•
 
Hypertension: 60 to 120 mg P.O. bid
 
•
 
Atrial fibrillation or flutter; paroxysmal supraventricular tachycardia: 0.25 mg/kg I.V. asbolus injection over 2 minutes.
Drug Classification:
Antianginals
Mechanism of Action:
A calcium channel blocker that inhibits calcium ion influx across cardiacand smooth-muscle cells, decreasing myocardial contractility and oxygen demand. Also dilatescoronary arteries and arterioles.
Pregnancy Risk Category:
C
Contraindications:
Contraindicated in patients hypersensitive to drug and in those with sicksinus syndrome or second-or third –degree AV block in the absence of an artificial pacemaker,ventricular tachycardia, systolic blood pressure below 90 mm Hg, acute MI, or pulmonarycongestion. I.V. preparations are contraindicated in patients who have atrial fibrillation or flutter with an accessory bypass tract, as in Wolff-Parkinson-White syndrome or short PR intervalsyndrome.
Forms:
 
•
 
Capsules (extended release): 120mg,180 mg, 240 mg, 300 mg, 360 mg
•
 
Capsules (sustained release): 60 mg, 90 mg, 120 mg, 180 mg, 240 mg,300 mg, 360mg, 420 mg
•
 
Injection: 5mg/ml (25mg and 50mg)
•
 
Injection:25 mg
•
 
Tablets: 30mg,60 mg, 90 mg, 120 mg
Nursing Responsibilities:
 
•
 
Use cautiously in elderly patients and in those with heart failure or impaired hepatic or renal function
•
 
Monitor blood pressure and heart rate when starting therapy and during dosageadjustments.
Brand Name:
 
Dilantin
 
Generic Name
: Phenytoin
Indications
: Control of status epilepticus of the tonic-clonic (grand mal) and psychomotor (temporal lobe) seizures. Prevention and treatment of seizures occurring during neurosurgery.
Drug Classification
: Anticonvulsants
Mechanism of Action
: Unknown. A hydantoin derivative that probably stabilizes neuronalmembranes and limits seizure activity by either increasing efflux or decreasing influx of sodiumions across cell membranes in the motor cortex during generation of nerve impulses.
Dosage
: Adult Initially 100 mg tid. Maintenance: 300-400 mg daily. Childn ≥ (greater than or equal to) 6 yr Initially 100 mg tid, subsequent dosage should be adjusted according to therapeuticresponse, <6 yr 30 mg bid, may be increased to 30 mg tid or qid.
Special precaution
: Severe myocardial insufficiency, hepatic impairment, porphyria. A.
Pregnancy Risk Category
: D
Contraindications
: Patients with a history of hypersensitivity to hydantoin products. Sinusbradycardia, sino-atrial block, 2nd and 3rd degree AV block and patients with Adams-Stokessyndrome because of phenytoin's effect on ventricular automaticity.
Forms
: Cap 30 mg
Nursing Responsibilities:
 
•
 
Use only clear solution for injection. A slight yellow color is acceptable. Don't refrigerate.
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