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GENE RIC NAME / TRAD E NAME

MEDICAL INTERVENTI ON
Proton pump inhibitor

CLASSIFI CA-TION

INDICATIO NS

PHARMACOLOGY
Inhibits activity of acid (proton) pump and binds to hydrogenpotassium adenosine triphosphatase at secretory surface of gastric parietal cells to block formation of MECHANISM gastric acid. 40 mg IV OD

MECHANISM OF ACTION

ROUTE/ FREQUENCY/ DOSAGE

ADVERSE REACTIONS/ SIDE EFFECTS

DRUG-DRUG, FOODDRUG INTERACTION

NURSING CONSIDERA-TION

OMEP RAZOLE

-short-term treatment for duodenal ulcer -treatment of heartburn or symptoms of GERD. INDICATIO

GENER

CLASSIF

ROUTE/

CNS: -Ampicillin esters, iron -Dosage adjustment may be necessary in dizziness, derivatives, asians and patient with hepatic headache ketoconazole: may impairment. GI: abdominal cause poor -Drugs increases its own biovailability pain, bioavailability of these with repeated doses. Drug is unstable in constipation, drugs because they gastric acid; less drug is lost to hydrolysis diarrhea, need a low gastric pH because drug inreases gastric pH. nausea, for optimal absorption. -Gastrin level rises in most patients vomiting Avoid using together. during the first 2 weeks of therapy. MUSCULOSKE -diazepam, phenytoin, -monitor drug levels. LETAL: back warfarin: may -tell patient to swallow tablets. pain decrease hepatic -caution patient to avoid hazardous RESP: cough, DRUG-DRUG, clearance, possibly activities ADVERSE NURSING if gets dizzy. upper leading to increased respiratory levels of drugs. tract infection Skin: rash

IC NAME/ TRADE NAME TRAM ADOL

ICATION

NS

OF ACTION

FREQUENC Y/ DOSAGE 50mg IV every 8hrs IVTT.

REACTIONS/ SIDE EFFECTS CNS: dizziness, headache, confusion, CV: vasodilation EENT: visual disturbances GI: constipation, nausea, vomiting, abdominal pain, diarrhea, anorexia

FOOD-DRUG INTERACTION

CONSIDERA-TION

Synthetic , centrally active analgesic

Moderate to moderately severe pain.

-binds to receptors in the brain that are important for transmitting the sensation of pain from throughout the body. -inhibit reuptake of norepinephrine and serotonin.

SSSRIs: may increase risk of serotonin syndrome. Carbamazipine: may increase tramadol metabolism.

-reassess patients level of pain at least 30minutes after administration. -monitor CV and respiratory status. -monitor bowel and bladder function. Anticipate need for laxative. -for better analgesic effect, give drug before onset of intense pain. -monitor patients at risk for seizures. Drug may reduce seizure threshold. -do not stop the medication abruptly.withdrawal symptoms may occur if drug is stopped abruptly. Reduce dosage. -monitor patient for drug dependence.

GENERIC NAME/ TRADE NAME MEROPENE M

CLASSIFIC A-TION

INDICATI ONS

MECHA NISM OF ACTION Inhibits cell-wall synthesis in bacteria. Readily penetrat es cell wall of most grampositive and negative bacteria to reach penicillin -binding protein targets.

ROUTE/ FREQU ENCY/ DOSAG E 500 mg IV q 12 hrs ANST (-),

ADVERSE REACTIO NS/ SIDE EFFECTS CNS: headache, pain, seizures CV: phlebitis, thromboph lebitis GU: RBCs in urine SKIN: pruritus GI: constipatio n, diarrhea, glossitis, nausea Resp.: apnea, dyspnea

DRUG-DRUG, FOOD-DRUG INTERACTION

NURSING CONSIDERATION

Antibiotic

Complicat ed skin and skin structure infections from staphyloc occus aureus(be talactamas e or nonbetalactamas e producing , methicilli nsusceptibl e isolates only)

Adrenergic drugs, dopamine, epinephrine: may cause hypertension. Serotoninergic drugs: may cause serotonin syndrome Food and beverages high in tyramine: may increase BP

-obtain specimen for culture and sensitivity tests before giving. Begin therapy awaiting test results. -monitor patient for signs and symptoms of super infection. -monitor patients fluid balance and weight carefully. -periodic assessment of organ system functions is recommended during prolonged therapy. -in patient with CNS disorders, bacterial meningitis, and compromised renal function, drug may cause seizures and other CNS adverse reactions. - if seizure occur during therapy, stop infusion and notify prescriber. Dosage adjustment may be needed. -monitor patients fluid balance and weigh carefully.

GENERIC NAME/ TRADE NAME RISPERID ONE

CLASSIFIC A-TION

INDICATIO NS

MECHA NISM OF ACTION

ROUTE/ FREQUEN CY/ DOSAGE

ADVERSE REACTIO NS/ SIDE EFFECTS CNS: akathisia, heahache, agitation, anxiety, pain, dizziness, fever, impaired concentrat ion, fatigue CV: tachycardi a, chest pain, orthostatic hypotensio n, peripheral edema EENT:

DRUG-DRUG, FOOD-DRUG INTERACTION

NURSING CONSIDERA-TION

Benzisoxaz ole derivative

-short-term treatment of schizophre nia and acute manic or mixed episodes from bipolar 1 disorder.

Blocks 2mg tab dopamin e and 5Ht2 receptor s in the brain.

Antihypertensi ve: may enhance hypotensive effects. Carbamazepin e: may increase risperidone clearance, and decrease effectiveness. Alcohol use: may cause additive CNS depression. CNS depressants: may cause addtive

-obtain baseline BP before the therapy. -monitor patient for tardive dyskinesia. -life-threatening hyperglycemia may occur in patients taking atypical antipsychotic. -monitor pt. For tardive dyskinesia, which may occur after prolonged use. It may not apper until months or year later and may disappear spontaneously or persist for life, despite stopping drugs, -life-threatening hyperglycemia may occur in pts taking atypical antipsychotics. Monitor pt. With diabetes regularly. -monitor pt. For wight gain -periodically reevaluate drugs risk and benefits, especially during prolonged use.

rhinitis, sinusitis, pharyngiti s, abnormal vision GI: constipatio n, nausea, vomiting, dyspepsia, abdominal pain GU: urinary incontinen ce, increase urination Musculosk eletal: back pain, leg pain Skin: rash, dry skin

GENERIC NAME/ TRADE NAME

CLASSIFI CA-TION

INDICATI ONS

MECHANIS M OF ACTION

ROUTE/ FREQUEN CY/ DOSAGE

ADVERSE REACTIO NS/ SIDE EFFECTS

DRUGDRUG, FOODDRUG INTERACTI ON Antacids, cholestyra mine, colestipol: may decrease atorvastati n level. Digoxin: may increase digoxin level. FOOD: Grapefruit

NURSING CONSIDERA-TION

ATORVAS TATIN (LIPITOR)

Antilipemi cs

Increased LDL, triglycerid es

-Lowers the 80mg level of tab OD blood cholesterol -prevent production of cholesterol in the liver by blocking HMG-CoA reductase.

CNS: headache, insomnia CV: peripheral edema EENT: rhinitis, sinusitis GI: abdominal pain, constipatio n, diarrhea,

-teach patient about proper diet management, weight control and exercise. -warn patient to avoid alcohol. -obtain baseline lipid profile. -can be taken with or without meal. - use only after diet and other nondrug therapies prove ineffective. Pt. Should follow a standard low-cholesterol diet before and during therapy. -drug may be given as a single dose at any time of day, with or without food. -Wacth for signs of myositis. -before treatment, assess pt. For underlying causes for

flatulence GU: UTI Skin: rash

juice: may increase drug levels, increasing risk of adverse reactions.

hypercholesterolemia an obtain a baseline lipid profile. Obtain periodic liver function test results and lipid levels before starting treatment and at 6-12 weeks after initiation, or after an increase in dosage and periodically thereafter.

GENERIC NAME/ TRADE NAME

CLASSI FICATION

INDICATIO NS

MECHANIS M OF ACTION

ROUTE/ FREQUE NCY/ DOSAGE

ADVERSE REACTIO NS/ SIDE EFFECTS CNS: tetany CV: edema GI: gastric distention, belching, flatulence Metabolic:

DRUGDRUG, FOODDRUG INTERACTI ON Anorexiant s, flecainide, mecamyla mine: may decrease renal clearance

NURSING CONSIDERA-TION

SODIUM BICARBONA TE

Alkaliniz er

-metabolic acidosis -systemic or urinary alkalinizatio n -antacid

Restores 10cc/hr buffering IV capacity of the body and neutralizes excess acid.

-obtain ABG. -tell patient not to take drug with milk because doing so may cause high levels of calcium in the blood, abnormally high alkalinity in tissues and fluids or kidney stones. - to avoid risk of alkalosis, obtain blood pH, partail pressure of arterial

hypokalem ia, metabolic alkalosis, hypernatre mia Skin: pain and irritation at injection site

of these drugs and increase risk of toxicity. Lithium, tetracyclin e: may increase urine alkalinizatio n, increase renal clearance of these drugs and decrease their effect.

oxygen, partial pressure of arterial carbon dioxide, and electrolyte levels. Tell prescriber laboratory results. -oral products may contain 27% sodium

GENERIC NAME/ TRADE NAME

CLASSIF ICATION

INDICATIO NS

MECHANIS M OF ACTION

ROUTE/ FREQUEN CY/ DOSAGE

ADVERSE REACTIO NS/ SIDE EFFECTS

DRUGDRUG, FOODDRUG INTERACTI ON

NURSING CONSIDERA-TION

Vit. K /

Fat

Prevention

Cofactor for IVTT

1 GI: gastric

-monitor

for

frank

and

occult

Phytome nadione

soluble vitamins

& treatment of hypoprothr ombinemia which may be associated with excessive doses of oral anticoagula nts, salicytates

an enzyme amp. that (1mg) catalyzes the carboxylati on of the amino acid, glutamic acid, resulting in its conversion to gammacarboxyglut amic acid.

upset, unusual taste Derm: flushing, rash, urticaria Hema: hemolytic anemia

bleeding. -monitor pulse & BP frequently. -caution pt. to avoid IM injections and activities leading to injuries. -use a soft toothbrush, do not floss and shave w/ an electric razor until coagulation defect is corrected.

GENERIC NAME/ TRADE NAME

CLASS IFICATION

INDICATIO NS

MECHANIS M OF ACTION

ROUTE/ FREQUEN CY/ DOSAGE

ADVERSE REACTIO NS/ SIDE EFFECTS NONE

DRUGDRUG, FOODDRUG INTERACTI ON

NURSING CONSIDERA-TION

NEPHROST ERIL

Parente ral nutritio nal product s

Supply of protein elements in acute and chronic renal failure, peritoneal & hemodialys is

0.5g amino acids/kg body wt/day

-monitor serum electrolytes, fluid and acid-base balance, serum urea. -dont use if the solution is cloudy or if with container is damaged.

treatment.

GENERIC NAME/ TRADE NAME

CLASSIF ICATION

INDICATIO NS

MECHANIS M OF ACTION

ROUTE/ FREQUEN CY/ DOSAGE

ADVERSE REACTIO NS/ SIDE EFFECTS CNS: dizziness, muscle weakness GI: abdominal cramps, burning sensation in rectum with suppositori es, nausea and vomiting Metabolic: alkalosis, fluid and electrolyte s imbalance s, hypokalem ia. Musculosk

DRUGDRUG, FOODDRUG INTERACTI ON Antacids: may cause gastric irritation of dyspepsia from premature dissolution of enteric coating. Separate doses by at least 1 or 2hrs. Milk: may cause gastric irritation of dyspepsia from premature dissolution of enteric coating. Dont use

NURSING CONSIDERA-TION

BISACOD YL(dulcol ax)

Diphenyl methane derivativ e

Chronic constipatio n

Stimulate laxative that increases peristalsis, probably by direct effect on smooth muscle of the intestine, by irritating the muscle or stimulating the colonic intramural plexus.

Suppositor y 10mg.

-give drugs at times that dont interfere with scheduled activities or sleep. Soft, formed stools are usually form 15-60 minutes after rectal use. -insert suppository as high as possible into the rectum and try to position suppository against the rectal wall. -teach patient about the dietary sources of bulk, including bran and other cereals. Fresh fruits and vegetables.

eletal: tetany

within 1 or 2 hrs of drinking milk.

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