Name of Drug Generic (Brand)

Classification

Dose Frequency Route

Mechanism of Action

Specific Indication

Side Effects

Nursing Implications

Vitamin B complex

Vitamins and Minerals

A coenzyme that stimulate metabolic function and is needed for cell replication, hematopoiesis, and nucleoprotein and myelin synthesis.

Pernicious anemia CONTRA: ~ hypersensitive to vitamin B12 or cobalt. ~ early Lebers disease

CV: peripheral vascular thrombosis, heart failure. GI: transient diarrhea. Respi: pulmonary edema. Skin: itching, transitory exanthema, urticaria. Other: anaphylaxis, anaphylactoid reactions with parenteral administration , pain or burning at injection site.

BEFORE: ~ Determine reticulocyte count, hct, Vit. B12, iron, folate levels before beginning therapy. ~ Obtain a sensitivity test history before administration ~ Avoid I.V. administration bec. faster systemic elimination will reduce effectiveness of vitamin. DURING: ~ Dont give large doses of vitamin B12 routinely; drug is lost through excretion. ~ Dont mix parenteral preparation in same syringe with other drugs. AFTER: ~ Protect Vit. B12 from light. Dont refrigerate or freeze. ~ Monitor patient for hypokalemia for first 48 hours, as anemia correct itself. Give potassium supplements, as needed.

Name of Drug Generic (Brand) Acetaminophen (Paracetamol)

Classification

Dose Frequency Route 1.2 mL q 4 hr PRN od

Mechanism of Action Inhibits the synthesis of prostaglandin s that may serve as mediators of pain and fever, primarily in the CNS

Specific Indication Mild pain Fever

Side Effects

Nursing Implications

antipyretics, nonopioid analgesics

Hema: hemolytic anemia, neutropen ia, leukopeni a, pancytope nia. Hepa: jaundice Metabolic: hypoG GI: HEPATIC FAILURE, HEPATOT OXICITY (overdose) GU: renal failure (high doses/chro nic use). Derm: rash, urticaria.

BEFORE: ~ Advise parents or caregivers to check concentrations of liquid preparations. Errors have resulted in serious liver damage. ~ Assess fever; note presence of associated signs (diaphoresis, tachycardia, and malaise). DURING: ~ Adults should not take acetaminophen longer than 10 days and children not longer than 5 days unless directed by health care professional. ~ Advise mother or caregiver to take medication exactly as directed and not to take more than the recommended amount. AFTER: ~ Advise patient to consult health care professional if discomfort or fever is not relieved by routine doses of this drug or if fever is greater than 39.5C (103F) or lasts longer than 3 days.

DRUG ORDER

TRAD E/ BRAN D NAME Omep ron

PHARMAC OLOGIC ACTION OF DRUG

INDICATIONS AND CONTRAINDICATIONS

ADVERSE EFFECTS OF THE DRUG

DESIRED ACTION ON THE CLIENT

Nursing Implications

Omepra zole 20mg tab OD

Gastric acid-pump inhibitor: Suppresse s gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.

INDICATIONS: Short-term treatment of active duodenal ulcer; First-line therapy in treatment of heartburn or symptoms of gastroesophageal reflux disease (GERD); Short-term treatment of active benign gastric ulcer; GERD, severe erosive esophagitis, poorly responsive symptomatic GERD; Long-term therapy: Treatment of pathologic hypersecretory conditions (Zollinger-Ellison syndrome, multiple adenomas, systemic mastocytosis); Eradication of H. pylori with amoxicillin or metronidazole and clarithromycin; Prilosec OTC: Treatment of frequent heartburn (2 or more days per wk); Unlabeled use: Posterior laryngitis; enhance efficacy of pancreatin for the treatment of steatorrhea in cystic fibrosis CONTRAINDICATIONS: Contraindicated with hypersensitivity to omeprazole or its components; Use cautiously with pregnancy, lactation.

CNS: Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities Dermatologic: Rash, inflammation, urticaria, pruritus, alopecia, dry skin GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy Respiratory: URI symptoms, cough, epistaxis Other: Cancer in preclinical studies, back pain, fever

Treatment of active benign gastric ulcer

Assessment History: Hypersensitivity to omeprazole or any of its components; pregnancy, lactation Physical: Skin lesions; T; reflexes, affect; urinary output, abdominal exam; respiratory auscultation Interventions Administer before meals. Caution patient to swallow capsules wholenot to open, chew, or crush them. Arrange for further evaluation of patient after 8 wk of therapy for gastroreflux disorders; not intended for maintenance therapy. Symptomatic improvement does not rule out gastric cancer, which did occur in preclinical studies. Administer antacids with omeprazole, if needed. Teaching points Take the drug before meals. Swallow the capsules whole; do not chew, open, or crush them. This drug will need to be taken for up to 8 wk (short-term therapy) or for a prolonged period (> 5 yr in some cases). Have regular medical follow-up visits. These side effects may occur: Dizziness (avoid driving or performing hazardous tasks); headache (request medications); nausea, vomiting, diarrhea (maintain proper nutrition); symptoms of upper respiratory tract infection, cough (do not selfmedicate; consult with your health care provider if uncomfortable). Report severe headache, worsening of symptoms, fever, chills.