DRUG STUDY

GENERIC CLASSIFIC DOSAG THERAPEUTIC INDICATION ADVERESE INTERACTIO CONTRAINDI NURSING

NAME/ ATION E/ ACTION REACTION/SIDE NS CATION IMPLICATION/
BRAND ROUTE/ EFFECT INTERVENTION
NAME FREQ.
 Short-acting  100 Suppresses Replacement CNS: headache, DRUG-DRUG:  Hypersentivity  Give oral form with
HYDROCORTIS Corticostero mg q inflammatory and therapy in nervousness, Loop and to drug food or milk to avoid
ONE SODIUM ids 8 hrs immune responses, adrenocortical vertigo, insomnia, diuretics,  Other GI upset
SUCCINATE  Anti- mainly by insufficiency; restlessness, hormonal immunosuppre  Give I.V. injection of
[SOLU- inflammator inhibiting migration hypercalcemia due increase ICP, contraceptives, ssant sodium succinate
CORTEF] y of leukocytes and to cancer;arthriris; seizure insulin, corticosteroids from over 30 sec. to
phagocytes and collagen disease; CV: hypotension, NSAID’s,  Hypertension, few min.
decreasing dermatologic hypertension, heart rifampin. osteoporosis,  Know that drug may
inflammatory disease; autoimmune failure, DRUG-Dx glaucoma, be given as
mediators and hematologic thrombophlebitis, TEST: renal & GI intermittent or
disorder; trichinosis; fat embolism, Ca, k, T3, T4, disease, continuous I.V. dilute
ulcerative colitis; arrhythmias cholesterol, cirrhosis in NSS, D5W, and
multiple sclerosis; EENT: glaucoma, glucose, digoxin  Pregnant D5NSS.
aspiration cataract, increase assay breastfeeding  Monitor BP, weight,
pneumonia ICP, epistaxis, nasal DRUG- patient and electrolytes.
congestion, HERBS:  Children age 6  As appropriate,
hoarseness, Gensing, and younger review all other
nasopharygeal/ echinacea significant and life-
esopharygeal fungat threatening adverse
infection. reactions and
GI: nausea and interaction, especially
vomiting, those related to the
abdominal drugs, tests, herbs,
distention, dry and behaviors.
mouth, rectal
bleeding, peptic
ulceration,
pancreatitis.
METAB: sodium
and fluid retention,
hypokalemia,
 hypocalemia,
hyperglycemia,
amenorrhea, growth
retardation,
hypothalamic-
pituitary
suppression.
Musculoskeletal:
osteoporosis,
muscle pain, loss of
muscle mass,
aseptic joinr
necrosis,
RESP: cough,
wheezing, rebound
congestion,
brochospasm.
SKIN: rash,
pruritus, urticaria,
acne, petechea.
Other:
anaphylaxis

 Fluoroquinon 500 mg Inhibits the enzyme  Acute bacterial CNS: dizziness, DRUG-DRUG:  Hypersensitito  To prepare I.V
LEVOFLOXACI e I.V. OD DNA gyrase in exacerbation of headache, insomnia, Antacids drug or infusion, use
N  Anti- susceptible gram- chronic bronchitis seizure containing qunolones compatible sol’n,
[LEVOFLOXA infective negative and gram-  Community- CV: chest pain, aluminum, or  Bradycardia such as 0.9% sodium
CIN] positive aerobics acquired palpitation, magnesium,  Acute chloride injection,
and anerobic pneumonia hypotension. cimetidine, myocardial D5% and 0.9% NSS,
bacteria, interfering  Nosocomial EENT: NSAID’s ischemia D5%W, D5%LR
with bacterial DNA pneumonia photophobia, DRUG-Dx  Renal sol’n.
synthesis. caused by sinusitis, TEST: impairment,  Infuse over 60-90
nethicillin- pharyngitis. Glucose, underlying minutes, depending
susceptible strains GI: nausea, lymphocytes, CNS disease to the dosage. Don’t
of staphylococcus vomiting, diarrhea, EEG  Elderly patient infuse with other
aureus. constipation, DRUG-FOOD: drugs.\avoid rapid or
 Acute bacterial abdominal pain, milk, yogurt. bolus I.V
sinusitis dyspepsia, DRUG- administration,
flatulence, HERBS:
  Uncomplicated pseudomembranou fennel, st. john’s because this may
skin to skin s coitis. wort cause severe
structure infection GU: vaginitis DRUG- hypotension.
 Complicated or HEMA: BEHAVIOR:  Flush I.V line before
uncomplicated lymphocytopenia sun exposure and after infusion.
UTI, acute METAB:  Check v/s, especially
pyelonephrits. hyperglycemia, BP. Too-rapid
 Chronic bacterial hypoglycemia infusion can cause
prostitis MUSC: back pain, hypotension.
 Conjunctivitis tendon rupture,  Closely monitor
 Corneal ulcer tendinitis patient with renal
 Inhalation anthrax SKIN: insufficiency.
photosensitivity  Assess severe
Other: altered taste, diarrhea, w/c may
pain on I.V site indicate
pseudomembranousc
olitis.
 Watch for
hypersensitivity
reaction. D/C
immediately if rash
or other sign and
symptoms occur.
PHYTONADIO  Vitamins 1 amp Promotes hepatic  Hypothrobinemia  Hyperbilirubine  GI: gastric  Contraindicat  Should be protected
NE  Anti- I.V. OD synthesis of  Prevention and mia (n infant); upset, unusual ed in from light
[VITAMIN K] haemorrhagi prothrombin, treatments of with parenteral taste. hypersensitiv
c proconvertin, hemorrhagic administration-  Derm: ity to drug or  Should not be allowed
plasma disease in new pain, sweeling, flushing, to its to freeze
thromblastin born. tenderness at rash, urticaria. components.  Should be stored at
component, and injection site; Hemat: (life- 25°C or below
stuart factor itching rash after hemolytic threatening
repeated anemia. reactions  Should not be used if
injection, Misc: allergic resembling turbid
transient flushing reactions, hypersensitiv
sensation, hyperbilirubin ity have
peculiar taste, emia occurred
anaphylactoid  (large doses during and
reaction. in very immediately
 premature after I.V
infants), injection).
kernicterus.  Use
cautiously in
pregnant or
breasetfeedin
g patient,
children,
neonates.
 Avoid P.O
use in
disorder that
may prevent
adequate
absorption.
PIPERACILLIN  Penicillin 2.25 gms. Piperacillin inhibits  Community-  CNS: headache DRUG-DRUG:  Hpersensivit  Ask patient about
SODIUM AND (extended- Q 8 hrs bacterial cell- wall acquired insomnia, Aminoglycoside y to allergy to penicillins.
TAZOBACTAM spectrum), I.V OD synthesis, resulting pneumonia agitation, ,aspirin, penicillin,  Dilute each gram
SODIUM beata- in cell death.  Rupture appendix dizziness, hormonal cephalospori with 5cc of diluents,
[PIPTAZ] lactamase Tazobactam  Peritonitis anxiety, contraceptive, n, such as sterile or
inhibitor increases  Pelvic depression, methotrexate, imipenems, bacteriostatic water
Anti- piperacillin efficacy inflammatory twitching, tetracyclines, or beta- injection, NSS, D5W,
infective disease coma,seizure. vecuronium lavtamase D5NSS, don’t use
 Skin and skin  CV: DRUG-Dx inhibitors LR.
structure infections hypertension, TEST:  Neonates  Shake vial until drug
 Nosocomial chest pain, Urine glucose  Heart failure dissolve. Dilute again
infection tachycardia. test, urine  Renal to a final vol. of 50
 EENT: rhinitis, protein, insufficiency cc, infuse over 30
glossitis eosinophils,  Seizure min.
 GI: nausea, granulocytes,  Bleeding  Assess neurologic
vomiting, Hgb, platelets disorder status especially for
diarrhea,  Uremia seizure.
constipation,  Hypokalemia  Monitor vital sign
dyspepsia,  Cystic and i&O
abdominal pai, fibrosis  Instruct client to
pseudomembra  Patient with report rash, hives,
nuous colitis. sodium severe diarrhea, black
 GU: proteinuria, restriction tongue, sore throat,
 hematuria,  Pregnant or fever, or unusual
vaginal breastfeeding bleeding or bruising
candidiasis, patient  Tell patient to
vaginitis, instruct to monitor I
oliguria, & O, annnd report
interstitial significant changes.
glomerulonephr  Kept patient
itis. monitored
 HEMA: anemia,
increased
bleeding, bone
marrow
defression,
leucopenia,
thrombocytopen
ia.
 METAB:
hypokalemia,
hypernatremia.
 RESP: dyspnea
 SKIN: rash,
pruritus
 Other: fever,
pain, edema,
inflammation, or
phlebitis at I.V
site,
superinfection,
hypersensitivity
reaction,
including serum
sickness and
anaphylais
PARACETAMO  Anti- 500 mg May cause  Temporary relief  Hemolytic anemia  Barbiturates,  Contraindicate  Assess patients pain
L pyretics 1 tab q 4 analgesia by of pain and  Leucopenia carbamapezin d with allergy
or temperature before
[BIOGESIC]  Pain reliever hrs/ 300 inhibiting CNS discomfort for  Neutropenia e, hydantoins, to
mg, 1 prostaglandin headache, fever, isoniazid, acetaminophe beginning treatment
 panyctopenia,
amp q 4 synthesis cold, flu, minor  Thrombosytopeni rifampin, n
 hrs muscular aches, a sulfinpyrazon  Be alert for signs of
Decreases fever by overexertion  liver damage, e: May reduce  Use cautiously
adverse reactions.
inhibiting the  jaundice, therapeutic with impaired
effects of pyrogens  hypoglycemia, effect and hepatic
on the rash enhance function,  Tell patient not to use
hypothalamic heat hepatotoxic chronic drug fever that’s
regulating centers effects of alcoholism, higher than 103.1 F
and by a acetaminophe pregnancy,
hypothalamic n with high lactation  Warn patient that high
action leading to doses or long- doses and
sweating and term use of unsupervised long
vasodilation these drugs. term use can cause
Avoid use liver damage
together.
 Lamotrigine: tell patient keep tract
Serum of daily oral drug
lamotrigine intake
concentration
s may be
reduced and
may decrease
therapeutic
effects.
 Warfarin:
May increase
hypoprothrom
bin-emic
effect with
long-term use
of high doses.
Monitor PT
and INR
closely.

Ethambutol  Anti-TB 1 tab AC Unknown, may  initial &  Leukopenia,  Neurotoxic  Alcoholism  Should be taken on
agent breakfast, interfere with
HCl 300 mg, continuation  Thrombocytope drugs  optic an empty stomach
AC lunch synthesis of one or
INH 75 mg, more bacterial phase of nia  Al-  neuritis, (Take 1 hr before
rifampicin metabolites, pulmonary &  Neutropenia containing  impaired or 2 hr after
altering RNA
150 mg extrapulmonar  anaphylactic/an antacids hepatic meals.)
synthesis during
cell devision y TB. aphylactoid  Phentolami function,  Administer in a
[MYRIN P] reaction ne  severe renal single daily dose;
 pemphigoid  coumarin- insufficienc must be used in
reaction type drugs y, combination with
 Anorexia  OCs  hyperuricem other anti-TB drug
 elevations of  sulfonylure ia  Take drug
serum uric acid a oral  gouty regularly; avoid
concentration antidiabetic arthritis missing dose. Do
 Dizziness agents  jaundice, not D/C this drug
 Hypoesthesia  phenobarb  retrobulbar without first
 Paresthesia  systemic β-  neuritis. consulting your
 decrease in adrenergic Patients w/ AP.
visual acuity blocking mental  Avoid aluminum-
 epigastric agents illness/defic containing antacids
distress  corticostero iency. within 1 hour of
 Constipation ids  Childn <13 taking drugs
 Nausea  digitalis yr.  Arrage to have a
 Vomiting glycoside  Pregnancy periodic medical
 abdominal pain  estramustin & lactation. check-ups, which
 metallic taste e will include an eye
 dry mouth  clofazimine examination
 liver  inandione  Instruct the client
impairment derivative about the effect of
 Pruritus anticoagula anti- tb drugs
 Rash nts,
 toxic epidermal  benzodiaze
necrolysis pines
 joint pain  hepatotoxic
 acute gout medications 
 Fever  or
 Lymphadenopat  parenteral
hy miconazole
  lupus-like  Cheese eg
 Rheumatoid Swiss or
 Stevens- Cheshire
Johnson &  fish eg tuna
 prostatic or sardines.
obstruction
syndrome
 Arthritic
symptoms.
 Fungal
overgrowth
 renal & hepatic
effect
 ; malaise
 menstrual
disturbances
 tinnitus.

Buclizine HCl  Appetite 1 tab OD  The mechanism by  Poor appetite  Drowsiness &  Reduce the  Angle  instruct client not to
Enhancers  which buclizine exerts take alcohol
25 mg, vit its antiemetic and  Underwt dulling of effectivenes closure
 take sips of water
B1  10 mg, vit antimotion sickness   anorexia mental s of l dopa. glaucoma,
effects is not precisely for dry mouth
B12 25 mcg, known but may be nervosa. For alertness CNS  prostatic
 monitor patient
vit B6  5 mg, related to its central nutritional  dry mouth, depressants,  hypertroph status
anticholinergic actions.
vit C 500 mg It diminishes vestibular support in post-  headache, alcohol. y  safety precaution
[APPEBON]
stimulation and op cases,  nausea,  primary
depresses labyrinthine
function. An action on  metabolic  jitteriness, hemochro
the medullary disorders &  tiredness. matosis.
chemoreceptive trigger
zone may also be convalescence.
involved in the
antiemetic effect.

Thiamin is used in all key

metabolic processes in the
nervous system, heart,
blood cells and muscles. It
helps convert
carbohydrates into energy
and is useful in the
treatment of nervous
disorders. It may also be
useful in treating certain
types of heart disease.

tamin B6 is a water
soluble vitamin that is
probably involved in more
bodily processes than any
other vitamin. It functions
as a coenzyme, helping to
speed up chemical
reactions in cells. It is
required by over 60
enzymes. There is
evidence that it also plays
a role in preventing and
treating many diseases
including heart disease.
Some women suffering
from premenstrual
syndrome (PMS) find that
supplementing with
Vitamin B6 brings relief
from their symptoms. It is
thought that this is down
to its role in clearing out
excess oestrogen from the
body.
Vitamin B6 is required for
Vitamin B12 to be
absorbed.

bsorption of Vitamin B12

by the body is a very
complicated process. Low
levels of stomach acid or
low levels of intrinsic
factor can lead to
deficiencies, which is why
people over the age of 50
may have difficulty
absorbing it from food.
However the body
generally has good
reserves of Vitamin 12.
Vitamin B12 is essential
for cell replication,
especially red blood cells.
 It maintains the protective
myelin sheath around
nerves, helps convert food
to energy, and plays a vital
role in the creation of
DNA and RNA, the
genetic material in cells.

ivabradin HCl  Ant-anginal 7.5 mg 1 Ivabradine is a pure  Symptomatic  Cardiovascular: Concomitant use not  Hypersensitivi  Monitor BP and pulse
recommended
[CORALAN] tab BID heart rate-lowering treatment bradycardia, QT prolonging ty, blood before therapy, during
agent, acting by of chronic stable palpitations, medicinal products pressure is dosage titration, and
selective and angina supraventricular - Cardiovascular QT <90mmHg; periodically
prolonging medicinal
specific inhibition pectoris in coronar extrasystoles products (e.g. sick sinus throughout therapy.
of the cardiac y artery  GI: nausea, quinidine, syndrome  Assess for signs of
pacemaker Ifcurrent diseasepatients w/ disopyramide,
constipation bepridil, sotalol,
CHF ( peripheral
that controls the normal sinus ibutilide, edema, crackles,
spontaneous rhythm. amiodarone). dyspnea, weight gain,
diastolic - Non cardiovascular
QT prolonging
jugular venous
depolarisation in medicinal products distention)
the sinus node and (e.g. pimozide,  Angina: Assess
regulates heart rate. ziprasidone,
sertindole,
location, duration,
The cardiac effects mefloquine, intensity and
are specific to the halofantrine, precipitating factors
sinus node with no pentamidine,
cisapride,
of patient's anginal
effect on intra- erythromycin IV). pain.
atrial, The concomitant use  Hypertension: Check
atrioventricular or of cardiovascular and
non cardiovascular frequency of refills to
intraventricular QT prolonging monitor adherence.
conduction times, medicinal products  Monitor serum
nor on myocardial with ivabradine
should be avoided potassium
contractility or since QT prolongation periodically.
ventricular may be exacerbated Hypokalemia
repolarisation by heart rate
reduction. If the increases the risk of
combination appears arrhythmias and
necessary, close should be corrected.
cardiac monitoring is
needed.
Pharmacokinetic
interactions
Cytochrome P450
3A4 (CYP3A4)
Ivabradine is
 metabolised by
CYP3A4 only and it
is a very weak
inhibitor of this
cytochrome.
Ivabradine was shown
not to influence the
metabolism and
plasma concentrations
of other CYP3A4
substrates (mild,
moderate and strong
inhibitors). CYP3A4
inhibitors and
inducers are liable to
interact with
ivabradine and
influence its
metabolism and
pharmacokinetics to a
clinically significant
extent. Drug-drug
interaction studies
have established that
CYP3A4 inhibitors
increase ivabradine
plasma
concentrations, while
inducers decrease
them. Increased
plasma concentrations
of ivabradine may be
associated with the
risk of excessive
bradycardia.

DIGOXIN  Cardiac 0.25 mg Increases forces  Heart failure CNS fatigue, DRUG-DRUG:  Uncontrolled  Assess apical pulse
[LANOXIN] glycoside 1 tab OD and velocity of  Tachyarrhythmias headache, asthenia Amiodarone, ventricular regularly for a full
 Inotropic myocardial  Atrial fibrillation CV: bradycardia, cyclosporine, arrhhythmias minutes. If rate is less
 Anti- contraction and  Flutter ECG changes, diclofenac  AV block than 60 beats/ min.
arrythmic prolongs refractory  Paroxysmal atrial arrhythnias Corticosteroids,  Idiophatic withhold dose and
period of tachycardia EENT: blurred or loop diuretica hypertrphic notify physician
atrioventricular yellow vision and thiazide, subaooortic  Monitoer for drug
(AV) node by GI: nausea and antacids, beta- stenosis toxicity (nausea and
increasing calcium vomiting, diarrhea adrenergic  Constrictive vomiting, visual
entry into GU: gynecomastia blockers pericarditis disturbances,
myocardial cell. HEMA: Thyroid  Supraventric arrhythmias, and
 Slows conduction thrombocytopenia hormones ular altered mental status).
through sinoatrial Other: decreased DRUG- Dx tachyarrhyth  Monitor ECG and
and AV nodes and appetite TEST: mias blood digoxin,
produces anti- Creatinine  Intrauterine potassium,
arrhythmic effect kinase, tachyarrhyth magnesium, calcium,
DRUG- mias creatinine
HERBS:  Renal  Stay alert for
Coffee seed, impairements hypocalcemia. Know
cola seed,  Hyperthyroid that digoxin toxicity,
ephedra, st.  Elderlt and may decreased
john’s wort patient digoxin efficacy
Ddobesity  Tell patient to take
drug at same time
everyday
 Teach patient how to
recognize and report
signs and symptoms
of digoxin toxicity
 Monitor BP and HR..
REBAMIPIDE  Antacids, 100 mg , Rebamipide is a  Acute gastritis & CNS: confusion,  Alkalinization  Contraindicat  Monitor for
[MUCOSTA]  Antireflux 1 tab OD mucosal protective acute dizziness, of gastric e in resolution of GI
Agents agent and is exacerbation of drowsiness, content hypersensitiv symptom
 Antiulcerant postulated to chronic gastritis. hallucination, decreases the ity to any  Assess CBC in liver
s decrease gastric Gastric ulcer peripheral- bioavailability anti-ulcer function tests
blood flow, neuropathy, brain of Fe, drugs and in  Assess constipation
prostaglandin stem dysfunction.  ketoconazole alcohol  Monitor electrolytes
biosynthesis and CV: hypotension, & intolerance levels as appropriate
decrease free arrhythmias, tetracyclines.  Renal
oxygen radicals cardiac arrest The impairment
GI: nausea, absorption of  Elderly
diarrhea, tetracyclines patient
constipation is further  Breastfeedin
HEMA: anemia, reduced by its g
neutropenia, chelation with
thrombocytopenia, Al & Mg ions
agranulocytopenia,
aplastic anemia
HEPATIC:
 hepatitis
Other: altered
tasye, pain at I.M
injection site,
hypersensitivity
DIBENCOZI  Appetite 1 cap OD Dibencozide Premature Chloramphen  Dibencozide  Take with food
enhancer Dibencozide seems icol interacts is a form of  Report any lactose
DE increases the babies to be safe for most vitamin B12,
with intolerance
[HERACLENE protein Low birth wt. people. There are no since it is a
DIBENCOZID
] "efficiency  retarded growth reported side effects. nutritional
Special E
coefficient" ie,  poor appetite in supplement
Precautions & and not a
the percentage of infant Warnings:  Dibenco
medication,
"bound nitrogen"  children & Pregnancy and zide is a form the side
for protein build- adult, adjuvant breast-feeding: of vitamin effect profiles
Not enough is B12. Vitamin and
up in the body to treatment of
known about the B12 is contraindicati
compared to TB & other use of dibencozide important for ons have not
"ingested chronic ailments during pregnancy been
producing
nitrogen" with Convalescence and breast-feeding.
new blood studied. 
food intake. The from acute Stay on the safe
side and avoid use. cells.
initial sign of infection or Chloramphen However, it is
important not
effectiveness is surgery Gastrointestinal icol might
to use it
manifested by a  Faulty nutrition (GI) conditions: decrease more often
marked increase in older people. Some GI new blood than
conditions, such as cells. Taking directed, as
in appetite.
ileal disease or chlorampheni too much
Thus, surgical removal of col for a long Vitamin B12
dibencozide part of the intestine, time might can cause
facilitates can reduce that health
decrease the
optimum amount of Vitamin problems
B12, including effects of
utilization of dibencozide, that is dibencozide
dietary protein absorbed from the on new blood
intake, intestine. cells. But
contributes to the most people
formation and only take
chlorampheni
repair of body
col for a short
tissues and time so this
 stimulates interaction
appetite. isn't a big
problem
LANAOPRAZOL  Antiulcer 30 mg , 1 Binds to an enzyme  Erosive  CNS: headache,  Drug with  Hypersensitivi  Assess patient
E agents, tab + 5 in the presence of esophagitis, dizziness pH-dependent ty routinely for
[PREVACID]  Proton- ml water acidic gastric pH, duodenal ulcers,  GI: abdominal absorption  Amoxicillin epigastric or
pump preventing the final active benign pain, diarrhea, kinetics  clarithomycin abdominal pain and
inhibitors transport of gastric ulcer, nausea  Warfarin for frank
hydrogen ions into short-term  Derm: rash.  Tacrolimus  or occult blood in
the gastric lumen.  treatment of  theophylline stool, emesis, or
Therapeutic effect: symptomatic gastric aspirate.
Diminished GERD, healing   Administer before
accumulation of and risk reduction meals. Capsules may
acid in the gastric of be opened and
lumen, NSAIDassociated sprinkled on 1
with lessened acid  gastric ulcer,  tbsp of applesauce,
reflux Pathologic pudding, cottage
hypersecretory cheese, or yogurt and
conditiond, swallowed
including  immediately for
 Zollinger-Ellison patients with
syndrome. difficulty
swallowing. Do not
crush or
 chew capsule
contents
 Advise patient to
avoid alcohol,
products containing
aspirin, or NSAIDs,
and foods that
 may cause an
increase in GI
irritation
Protein,  Fat/carbo 3 scoop Aflavoured liquid Provides  No side effect  Iron Lactise  Instruct client to mix
carbohydrate, in ½ consisting of mention supplementati intolerance 3 scoop of fresubin
hydrates/ complete &
vitamins glass of protein(milk), on Allergy on milkto ½ glass of
Protein, proteins/ water q carbohydrate(malto balanced any sterile water
carbohydrate, TID dextrinandsucrose), ingredients of  Use measuring cup
minerals/ nutrition; sole
vitamins vegetableoils(rapes the product  Maintain clean
vitamins, source of
[FRESBIN eedandsunfloweroil Hypsersensiti preparation
MILK] combinat s), minerals, nutrition (meal vity to milk
ions ; vitamins and trace replacement) or
 Used as elements food (diet)
general supplement.
nutrients.
FENOTEROL  Antiasthmati 1 neb q 8 Ipratropium  Prevention &  Fine tremor of  Other β-  Hypertroph Nursing
[BERODUAL] c & COPD hrs bromide-salbutamol
treatment of skeletal adrenergics, ic Responsibilities:
Preparations fixed-dose
combination (FDC) symptoms in muscles,  anticholiner obstructive >Before
maximizes the chronic  nervousness, gics,  cardiomyo
obstructive  restlessness,  xanthine pathy, administering,
response to
treatment in airway  palpitations; derivatives;  tachyarrhyt check for doctor’s
patients with disorders w/  less frequently  β-blockers; hmias. order.
bronchial asthma reversible bronc  tachycardia, diuretics; 
and chronic hospasm eg bro  dizziness or  digoxin,  Hypersensi >Give drug with
obstructive
nchial  headache.  MAOIs, tivity to right dosage, route,
pulmonary disease
(COPD) by asthma &  Dry mouth, tricyclic atropine- and time for
increasing esp chronic  throat irritation antidepressa like
bronchitis w/ or or nts; substances administration.
bronchodilation
through 2 distinctly w/o emphysem  allergic  halogenated or soya Prior to the
different a. reactions,  hydrocarbo lecithin or procedure:
mechanisms ie,  cough, n anesth related
anticholinergic  paradoxical food  Read the
(parasympatholytic)  bronchoconstric products  Doctor’s order
and β2-agonist
tion (rare).
before giving
 Urinary
retention may the medication
occur in to the patient,
particular,
and always
 in patients w/
preexisting remember the
outflow tract 10 R’s
obstruction.  Inform the
patient about the
action and the
purpose of the
drug.
 Before giving
the medication
ask the patient
first if she
already take the
medications or
not.
 Note if all the
medications are
available, if one
of the
medication are
not available
make a
prescription and
ask the patient’s
SO to buy it for
the patient.
 Check if the
nebulizer is
 functioning
 Prepare the drug
by diluting it
with distilled
water
During the procedure:
 Make sure that
the patient will take the
medications on time.
 If the
medication is an IV
route, make sure that
you administer it on
time.
 Always be at the
bedside of the patient in
order to help the patient
in taking her
medications.
 Follow the
directions on your
prescription label
 Monitor the
patient while inhaling
the atomized drug if it
is in proper place
  Instruct patient
to take medication as
directed for the full
course of therapy.
After the procedure:
 Instruct patient
to take medication at
evenly spaced times
and to finish the
medication completely.
 Observe for side
effects or allergies.
 Inform the
patient on the specific
time the medication is
to taken again.
 Inform patient
that increased fluid
intake and exercise may
minimize constipation
 Document.

FLUTICASONE  Prophylactic 1 neb q Glucocorticoid with  It is used by  Candidiasis  Ritovir  Primary  Advice patient that
[FLIXOTIDE] management 12 hrs a high topical anti- inhalation for the  dryness of mouth  Ketoconazole treatment of drug is for long term
for mild, inflammatory prophylaxis of the and throat  MOI severe acute maintenance.
moderate, potency. It has a symptoms of  Hoarseness  TCA asthmatic
severe strong affinity for asthma; also, is  Paradoxical  Beta2- attacks or  Tell the patient not
asthma and agonist activity administered by bronchospasm. adrenergic status to stop oral or
  Symptomati at human nasal spray in the  Cutaneous blocker asthmaticus inhaled long acting
c COPD glucocorticoid prophylaxis and hypersensitivity  diuretics when beta agonist.
receptors. treatment of reactions. intensive
allergic rhinitis.  Possible systemic measures are  Instruct patient on
 It is applied effects include required. the proper way of
topically in the suppression of When drug inhalation and
treatment of adrenal function, applied not to exceed dose
various skin growth topically: under any
diorders. retardation in rosacea, acne circumstances.
children and vulgaris,
adolescents, perioral  Instruct to rinse
decrease in bone dermatitis, mouth after
mineral density, perianal and inhalation.
 cataract and genital
glaucoma. pruritus.
Cutaneous
viral
infections
SALBUTAMOL  Therapeutic: 1 neb q 4 Is a beta2-  Treatment/  Tachycardia  Beta-blocker  Hypersensiti  Instruct the patient on
[VENTOLIN] bronchodilat hrs adrenergic agent prevention of  Dizziness  Diuretics ve reaction. the how to use the
ors, anti- which acts on bronchospasm  Palpitations  Digoxin  Urticania. nebulizer.
asthmatic airway smooth  headache,  MAO/TCA  Anginoedem  Instruct the patient on
 Pharmacolo muscle resulting in especially in a. the frequency of
gic: beta- relaxation. hypersensitive  Rashes nebulization.
adrenergics Salbutamol relaxes patients  Anaphylaxis.  Instruct the patient
agonist all smooth muscle  Cough  Oropharynge what to do during the
from the trachea to  Headache al edema asthma attack.
the terminal  Advice the client
 Nervousness
bronchioles and when to attend for
 Sinus
protects against all follow-up visits.
inflammation
bronchoconstrictor
challenges  Sore or dry throat
 Tremor
 Trouble sleeping
 Unusual taste in
mouth
 Vomiting
 Paradoxical
bronchospasm
  Hypokalemia
 Immediate
hypersensitivtity
reaction

FLUCONAZOL  Antifungal 200 mg 1 Binds to sterols in  Treatment of  CNS: Headache Drug-drug  Contraindicate Interventions
E cap q the fungal cell oropharyngeal,  GI: Nausea,  Increased d with  Culture infection
DIFLUCAN BID membrane, esophageal, vomiting, serum levels hypersensitivit prior to therapy;
changing vaginal, and diarrhea, and therefore y to begin treatment
membrane systemic abdominal pain therapeutic fluconazole, before lab results are
permeability; candidiasis  Other: Rash and toxic lactation. returned.
fungicidal or  Treatment of effects of  Use cautiously  Decrease dosage in
fungistatic cryptococcal cyclosporine, with renal cases of renal failure.
depending on meningitis phenytoin, impairment.  Infuse IV only; not
concentration and  Prophylaxis of benzodiazepi intended for IM or
organism. candidiasis in nes, oral SC use.
bone marrow hypoglycemi  Do not add
transplants cs, warfarin supplement
anticoagulant medication to
s, zidovudine fluconazole.
 Decreased  Administer through
serum levels sterile equipment at a
with maximum rate of
rifampin, 200 mg/hr given as a
theophylline, continuous infusion.
tacrolimus  Monitor renal
function tests
weekly, discontinue
or decrease dosage of
drug at any sign of
increased renal
toxicity.

Teaching points
 Drug may be given
orally or
intravenously as
 needed. The drug
will need to be taken
for the full course
and may need to be
taken long term.
 Use hygiene
measures to prevent
reinfection or spread
of infection.
 Arrange for frequent
follow-up while you
are using this drug.
Be sure to keep all
appointments,
including those for
blood tests.
 These side effects
may occur: Nausea,
vomiting, diarrhea
(eat frequent small
meals); headache
(analgesics may be
ordered).
 Report rash, changes
in stool or urine
color, difficulty
breathing, increased
tears or salivation.

TERGECEF  Cephalospor 200 mg 1 Third general  Bronchitis  Shock DRUG-DRUG:  Hpersensivit  Ask patient about
[TERGECEF] in cap BID cephalosporin that  bronchiectasis  Hypersensitivity Aminoglycoside y to allergy to penicillins.
 Anti- inhibits cell wall with infection,  hematologic ,aspirin, penicillin,  Dilute each gram
infective synthesis, secondary disorder hormonal cephalospori with 5cc of diluents,
promoting osmotic infections of  GI disorder contraceptive, n, such as sterile or
instability usual chronic  Vita. K methotrexate, imipenems, bacteriostatic water
bactericidal. respiratory tract deficiency. tetracyclines, or beta- injection, NSS, D5W,
diseases vecuronium lavtamase D5NSS, don’t use
 pneumonia DRUG-Dx inhibitors LR.
  Pyelonephritis TEST:  Neonates  Shake vial until drug
 Cystitis Urine glucose  Heart failure dissolve. Dilute again
 gonococcal test, urine  Renal to a final vol. of 50
urethritis protein, insufficiency cc, infuse over 30
 Cholecystitis eosinophils,  Seizure min.
 Cholangitis granulocytes,  Bleeding  Assess neurologic
 scarlet fever Hgb, platelets disorder status especially for
 Otitis media  Uremia seizure.
 Sinusitis.  Hypokalemia  Monitor vital sign
 Cystic and i&O
fibrosis  Instruct client to
 Patient with report rash, hives,
sodium severe diarrhea, black
restriction tongue, sore throat,
 Pregnant or fever, or unusual
breastfeeding bleeding or bruising
patient  Tell patient to
instruct to monitor I
& O, annnd report
significant changes.
Kept patient monitored
[AMINOLEBA  A balance 500 cc @  Hepatic  For the treatment  Hypersensitivity  Patient with • Asses’ patient’s
N] and 20cc/hr q of Hepatic : rare skin abnormal condition before
encephalopathy
tolerable 24 hrs Encephalopathy eruptions amino acid starting the
is a therapy.
food in patient with  Gastrointestinal metabolism
supplement neuropsychiatric chronic liver : occasional (since the • Be alert to
to syndrome that disease. nausea and infuse amino adverse
nutritionall develops vomiting acids are not reaction.
y support secondary to  Others: adequately • Monitor patient
patients liver disease or to occasional chills, metabolized temperature.
with liver portal-systemic fever, headache  The patient If GI reaction occur
disease. clinical monitor patient
shunting of
condition may hydration
blood, or both. In
be worsened.)
such a patient,
plasma  Use with
concentrations of care in
aromatic amino patients
acids with severe
(phenylalanine, acidosis and
tyrosine, those with
tryptophan) is congestive
found to be heart
higher than failure.
normal while the
plasma
concentration of
BCAA (leucine,
isoleucine,
valine) is lower
than normal. It
was suggested
that a disturbance
of plasma amino
acid pattern may
cause a
disturbance in the
brain amino acid
concentration.
Brain
neurotransmissio
n is then
impaired by an
inhibition of
dopamine and
noradrenaline
synthesis, leading
to an increase of
false
neurotransmitters
including
octopamine and
phenylethanolam
ine. These toxic
substances are
suspected to
induce hepatic
encephalopathy.
BCAA is given
to normalize the
amino acid
imbalance in the
plasma in order
to compete with
AAA for an
uptake into the
brain.

In addition, after
the infusion of
high BCAA
solution, the
ammonia
concentration in
the blood is also
decreased mainly
due to the
detoxification of
ammonia to form
glutamine.

Another unique
quality of BCAA
is that they are
mostly
metabolized in
the skeletal
muscle, not in the
liver. They then
become good
sources in
providing
peripheral
energy. In
catabolic state,
BCAA play an
important role in
preventing the
muscle protein
breakdown and
in promoting
protein synthesis
to maintain
positive nitrogen
balance.