Professional Documents
Culture Documents
1. Ondansetron
• Action: these block serotonin receptors in
the central nervous system and
gastrointestinal tract. As such, they can be
used to treat post-operative and cytotoxic
drug nausea & vomiting.
Routes: Oral.
Dosage: 10mg
Side effects: Headache, dizziness, dry mouth,
nervousness, flushing, or irritability
3.Metoclopramide
•Action: is a potent dopamine receptor
antagonist used for its antiemetic properties.
Thus it is primarily used to treat nausea and
vomiting, and to facilitate gastric emptying in
patients with gastroparesis.
•Routes: Oral, IV.
•Dosage: 10mg – 20mg
NURSING INTERVENTION:
•Monitor fluid intake and output. Note signs and
symptoms of fluid and electrolyte imbalances that
may result from watery stools.
2.Lisinopril
Action: is an angiotensin converting enzyme
(ACE) inhibitor.
Route of administration: Orally,
Dosage: 2.5, 5, 10, 20, and 40 mg oral
tablets.
Side effects: First doses of lisinopril can cause
dizziness due to a drop in blood pressure.
Lisinopril can cause nausea, headaches,
anxiety, insomnia, drowsiness, and nasal
congestion.
NURSING INTERVENTIONS
Monitor laboratory tests related to renal function
(BUN, creatinine, protein) and blood glucose
levels. Watch for hypoglycemic reaction in clients
with diabetes mellitus.
Report to the health care provider occurrences of
bruising, petechiae, and/ or bleeding. These may
indicate a severe reaction to the Angiotensin
• NURSING INTERVENTIONS
• Monitor laboratory tests related to renal
function (BUN, creatinine, protein) and blood
glucose levels. Watch for hypoglycemic
reaction in clients with diabetes mellitus.
• Report to the health care provider occurrences
of bruising, petechiae, and/ or bleeding. These
may indicate a severe reaction to the
Angiotensin Antagonist Inhibitors such as
captopril.
Client Teaching
•Instruct the client not to abruptly discontinue
use of captopril without notifying the health
care provider.
•Inform the client to avoid over the counter
drugs.
•Teach the client how to take and record
his/her own blood pressure. A blood pressure
chart should be established, and blood
pressure changes should be reported.
•Explain to the client that dizziness may occur
during the first week of captopril therapy. If
dizziness persist, inform the health care
provider.
Instruct the client to take captopril 20minutes to
1 hour before a meal. Food decreases captopril
absorption.
D. Alpha-1 blocker
1.Prazosin (Minipress)
Inhibits conversion of
Fibrinogen to Fibrin
Step IV
Clot prevented.
2.Warfarin (Coumadin)
Action: Coumadin is an oral anticoagulant that
inhibits the synthesis of clotting factors, thus
preventing blood clot formation.
Route of administration: Orally
Dosage: tablets (1mg, 2mg, 2.5mg, 5mg, 7.5mg,
10mg)
Side effects: The two most serious side effects
are bleeding and necrosis of the skin.
Bleeding around the brain can cause severe
headache and paralysis, joints can cause joint
pain and swelling, stomach or intestines can
cause weakness, fainting spells, black tarry
stools, vomiting of blood, or coffee ground
material, kidneys can cause back pain and blood
in urine.
• Signs of overdose include bleeding gums,
bruising, nosebleeds, heavy menstrual
bleeding, and prolonged bleeding from cuts.
NURSING INTERVENTIONS
•Monitor vital signs. an increased pulse rate
followed by a decrease systolic
•Pressure can indicate a fluid volume deficit
resulting from external or internal bleeding.
•Check for bleeding from the mouth, nose
(epistaxis), urine (hematuria), and skin
(petechiae, purpura).
•Check stools periodically for occult blood.
•Monitor older adults closely for bleeding.
•Keep anticoagulant antagonists ( protamine for
heparin and vitamin K for warfarin) available
when drug dose is increased or there are
indications of frank bleeding.
• Client Teaching
• Instruct the client to inform the dentist when
taking an anticoagulant.
• Instruct the client to use a soft toothbrush to
prevent the gums from bleeding.
3. Ibuprofen
Action: Inhibition of prostaglandin synthesis,
thus relieving pain and inflammation.
Route of administration: Oral, Topical
Available Dosage: 200mg, 400mg
Side effects: anorexia, nausea, vomiting,
diarrhea, edema, rash, purpura,tinnitus, fatigue,
dizziness, anxiety, confusion.
NURSING INTERVENTION
•Observe the client for bleeding gums,
petechiae, ecchymoses, or black stools.
bleeding time can be prolonged when NSAIDs
are taken, especially anticoagulant.
•Administer the NSAIDs at mealtime or with
food to prevent GI upset.
•Monitor vital signs and check peripheral
edema, especially in the morning.
• Client teaching
• Instruct the client not to take asprin and
paracetamol with NSAIDs. Taking an NSAIDs
with asprin could cause GI upset and possible
GI bleeding.
• Instruct the client to avoid alcohol when taking
NSAIDs. GI upset or gastric ulcer may result.
•Advise the client to inform the dentist or
surgeon before a procedure when taking
Ibuprofen or other NSAIDs for a
continuous period.
•Advise women not to take NSAIDs 1 to 2 days
before menstruation to avoid heavy menstrual
flow.
•Instruct the client to take NSAIDs with meals
or food to reduce GI upset.
ANTIPYRETIC
Paracetamol
Action: Analgesic and Antipyretic. Inhibition of
prostaglandin synthesis, inhibition of
hypothalamic heat regulating center.
Route of administration: Oral, Rectal, IM
Dosage: 500mg.
Side effects: anorexia, nausea, vomiting, rash.
Hemorrhage, Hepatotoxicity,thrombocytopenia,
ANTIDIABETICS
• 1. Metformin
• Action: Inhibits hepatic glucose production and
increases sensitivity of peripheral tissue to
insulin.
• Route of administration: oral
• Available dose: 500mg
• Side effects: headache, weakness, lactic
acidosis, diarrhea, nausea, vomiting,
thrombocytopenia
• NURSING INTERVENTIONS
• Assess hypoglycemic reaction (sweating,
weakness, dizziness, anxiety, tremors, and
hunger)
• Assess for lactic acidosis (malaise,
myalgia, abdominal distress, chills)
• Administer PO, do not break or crush
tablet
• Evaluate therapeutic response
• Client teaching
– Teach client lactic acidosis symptoms; to
notify doctor immediately if occur
– Instruct client to use regular self monitoring
of blood glucose using blood glucose meter
– Teach client about symptom of hypo/
hyperglycemia, what to do about each
– Instruct client that drug must be continued
on daily basis and not to stop drug abruptly.
2. Insulin
INSULINS
INTERMEDIATE
RAPID ACTING LONG ACTING MIXTURES
ACTING
• Action: decreases blood glucose; by transport of
glucose into cells and conversion of glucose to
glycogen.
• Route: subcutaneous
• Side effects: blurred vision, dry mouth, rash,
urticaria, lipodystrophy, swelling, redness,
hypoglycemia
• NURSING INTERVENTIONS
• Assess fasting blood glucose
• Assess for hypoglycemic reaction that can occur
during peak time (sweating, weakness, dizziness,
chills, confusion, headache, nausea, rapid weak
pulse, slurred speech, anxiety, tremors and hunger)
•Assess for hyperglycemia: acetone breath,
polyuria, polydipsia, dry skin, lethargy
• Administer oral antidiabetic 30 min before
meals
• Administer insulin after warming to room
temperature by rotating in palms to prevent
lipodystrophy from injecting cold insulin.
• Administer subcutaneous route, rotate site of
injection
• Store insulin at room temperature
• Keep food ready before administering insulin or
antidiabetic agents
• Client teaching
– Instruct client to keep insulin,
equipment available at all times;
carry candy or lump sugar to treat
hypoglycemia
– Inform client that the drug does not
cure diabetes but control symptoms
– Instruct client to carry emergency ID
as diabetic
– Teach client to recognize
hypoglycemia reaction: headache,
tremors, fatigue, and weakness
– Teach client to recognize
hyperglycemia reaction: frequent
urination, thirst, fatigue, hunger
– Instruct patient about blood glucose
testing; make sure patient is able to
determine glucose level
– Instruct client about dosage, route, if
any diet restrictions
– Obtain yearly eye examination
ANTICONVULSANT
• Phenytoin (Dilantin)
– Action: Inhibits spread of seizure activity in
motor cortex by altering ion transport.
– Route of administration: oral/ IV
– Dosage: 200mg – 600mg
– Side effects: drowsiness, dizziness,
insomnia, depression, headache, confusion,
slurred speech, ventricular fibrillation,
blurred vision, nausea, vomiting,
constipation, hepatitis, leucopenia.
• NURSING INTERVENTIONS:
• Assess for phenytoin hypersensitivity syndrome
• Assess drug level; toxic level 30-50 mcg/ml
• Assess for seizures: duration, type, intensity,
precipitating factors
• Assess for mental status: mood, sensorium,
memory
• Assess for respiratory depression
• Administer after diluting with diluent provided
• Client teaching:
– Instruct client that if diabetic, urine glucose
should be monitored
– Inform client that urine may turn pink
– Teach client not to discontinue drug abruptly;
seizures may occur
– Instruct client proper brushing of teeth using
a soft toothbrush to prevent gingival
hyperplasia; need to see dentist frequently
– Instruct client to avoid hazardous activities
until stabilized on drug
– To carry emergency ID stating drug use.
Narcotic analgesic
Morphine
• Action: acts directly on the central nervous system (CNS); depression of
pain impulses by binding with opiate receptor in the CNS, to relieve pain.
• Route of administration: Oral, subcutaneous, IV, IM
• Dosage:
• Side effects: anorexia, nausea, vomiting, constipation, drowsiness,
dizziness, sedation, urinary retention, flushing.
NURSING INTERVENTIONS:
Administer the narcotic before pain reaches its peak.
NURSING INTERVENTIONS:
•Administer the narcotic before pain reaches its
peak.
CLASSIFICATIONS OF BACTERIA
• Gram-positive
• Gram-negative
• Aerobic: depend on oxygen for survival
• Anaerobic: do not use oxygen
Aminoglycosides
Generic Name Common Uses Side Effects Mechanism of
action
•Amikacin Infections •Hearing loss Inhibition of
•Gentamicin caused by •Vertigo, bacterial
Gram-negative •rash protein
•Streptomycin bacteria, such synthesis;
as Escherichia •Nausea, bactericidal
coli and •Vomiting effect
Klebsiella. •Anorexia
Effective against •Tremors
Aerobic bacteria.
•Tinnitus
•Muscle cramps
•Nephrotoxicity
NURSING INTERVENTIONS:
AMINOGLYCOSIDES.
•Monitor intake and output. Inform immediately if
urine output is decreased.
•Check hearing loss. aminoglycosides can
cause ototoxicity.
•Monitor vital signs. Note if body temperature
has decreased.
•For IV use, dilute the aminoglycosides in 50 –
200ml of normal saline or D5w solution and
administer in 30 to 60 minutes.
•Monitor for signs and symptoms of
superinfection such as stomatitis, genital
discharge.
• Client teaching
• Unless fluids are restricted, encourage the
client to increase fluid intake.
• Instruct the client never to take leftover
antibiotics.
• Instruct client to report side effects including
hearing loss,
• nausea, vomiting, anorexia, tremors, tinnitus,
muscle cramps.
Cephalosporins (First generation)
Generic Common Uses Possible Mechanism of
Name Side Effects action
•Cefazolin Bactericidal for •diarrhea Interfere with
•Cefalexin both Gram- •stomach cell wall-
positive and pain building ability of
Gram-negative •upset bacteria when
organisms and they divide.
stomach
therefore useful
for broad- •vomiting
spectrum •rash
antibacterial
coverage
Cephalosporins (Second generation)
Penicillin
• Action: disrupt the synthesis of the peptidoglycan
layer of bacterial cell walls.
• Route of administration:oral
• Available dosage:250 mg,q 4-8 h.
• Side effects: diarrhea, hypersensitivity,
nausea, rash, neurotoxicity urticaria, and/or
superinfection (including candidiasis).
NURSING INTERVENTIONS: PENICILLIN
•Test dose should be given to the client before
administering IV penicillin.
•Check the client for allergic reaction to the
penicillin product,especially after the first and
second dose.
•Have epinephrine available to counteract a
severe allergic reaction.
•Do not mix aminoglycoside with a high doses of
penicillin because this combination may
inactivate the aminoglycoside.
•Monitor body temperature
•Dilute the antibiotic for IV use.
Client teaching
•Instruct the client to take all the prescribed
penicillin product such as amoxicillin until the
bottle is empty.
•Advise the client who is allergic to penicillin to
carry a card that indicates the allergy. The client
should notify the health care provider of any
allergy to penicillin when recording the health
history.
•Encourage the client to increase fluid intake;
fluids aids in
•excreting the drug.
•Advise the client to take oral penicillin 1 hour
before or 2 hours after meals to avoid in delay
in drug absorption.
Macrolides
Erythromycin
Action: inhibition of the steps of protein
synthesis; bacteriostatic or bactericidal effect
Route of administration:oral , parentral.
Available dosage: 250 mg.
• Side effects: anorexia, nausea, vomiting,
diarrhea, tinnitus, abdominal cramps, pruritus,
rash.
Quinolones
Ciprofloxacin
Action: interference with the enzyme DNA
gyrase, which is needed for bacterial DNA
synthesis; bactericidal effects
Route of administration:
Available dosage: oral tablets (250, 500, 750,
and 1000 mg), infusion bottles (200 and 400 mg).
Side effects: nausea, vomiting, diarrhea,
tinnitus, abdominal cramps, headache, fatigue,
dizziness ,insomnia, restlessness.
.
NURSING INTERVENTIONS:
•Obtain specimen from infected site before
drug therapy.
•Monitor intake and output.
•Monitor vital signs.
•Administer ciprofloxacin 1 hour before or 2
hours after meals.
•Dilute IV ciprofloxacin in an appropriate
amount of solution as indicated in the drug
circular. Infuse over 60 minutes.
•Check for signs and symptoms of
superinfection
Sulfonamides
Co-trimoxazole (Bactrim)
• Action: inhibition of protein synthesis of
nucleic acids; bactericidal effect
• Available dosage:400 mg.
• Routes: oral , parenteral
• Side effects: Anorexia, nausea, vomiting, and
diarrhea Allergy (including skin rashes),
Crystals in urine, stomatitis, headache,
photosensitivity.
NURSING INTERVENTIONS:
•Administer sulfonamides with a full glass of
water. extra fluid intake can prevent kidney
stone formation.
•Monitor the client’s intake and output. urine
output should be atleast 1200ml/day.
•Monitor vital signs. Note if the client’s
temperature has decreased.
•Observe the client for hematologic reaction
that may lead to life- threatening anemias.
•Check for signs and symptoms of
superinfection.
• Client teaching
• Instruct the client to drink several glasses of
fluid daily while taking sulfonamides to avoid
the complication of kidney stone formation.
• Instruct the client not to take antacids with
sulfonamides because antacids decrease the
absorption rate. instruct the client to take the
1 hour before or 2 hours after meals with a full
glass of water.
Antihistamine
Cetirizine
• Action: Antihistamines block the effects of histamines.
Histamines cause symptoms of allergy when released by
allergic reactions in the body. Antihistamines block the
ability of histamine to promote the allergy symptoms.
• Route of administration: oral
• Available dosage: 5- 10mg
• Side effects: drowsiness, headache, excessive
tiredness, Sleepiness, dry mouth, nausea, diarrhea,
vomiting
Piriton
•Action: it is an antihistamine that blocks allergic
reactions.
•Route of administration: oral, IV, IM
•Available dosage: 4mg
•Side effects: drowsiness, difficulty
concentrating; blurred vision; loss of appetite,
indigestion or upset stomach.
NURSING INTERVENTION:
•Administer the medication with food to
decrease gastric distress.
•Administer intramuscularly in large muscle.
• Client Teaching
• Instruct client to avoid driving and performing
other dangerous activities if drowsiness
occurs..
• Avoid alcohol and other CNS depressants.
• For temporary relief of mouth dryness, suggest
Hypnotic
using gum or ice chips.
Benzodiazepine
1.Nitrazepam
Action: induce sleep , used in the treatment of
insomnia and in surgical anesthesia
Route of administration: oral
Dosage: 2.5mg to 10mg, taken at bedtime
• Side effects: dizziness, depressed mood,
violence, fatigue, headache, impairment of
memory, hangover feeling in the morning,
slurred speech, reduced alertness, muscle
weakness.
• 2.Flurazepam
• Action: Depression of the CNS,
Neurotransmitter inhibition
• Dosage: 15 to 30 mg
• Route of administration: oral
Side effects: drowsiness, lethargy, hangover,
dizziness, lightheadedness, confusion, nausea,
vomiting, diarrhea.
.NURSING INTERVENTIONS:
•Monitor vital signs. check for signs of
respiratory distress, such as slow, irregular
breathing patterns.
•Raise bedside rails, confusion may occur,
and injury may result.
•Observe the client for side effects, such
hangover, dizziness,
•lightheadedness, confusion.
• Client teaching
• Instruct the client to avoid alcohol and
antidepressant while taking these drugs
• Advise client to take the medication
before bedtime.
• Suggest the client urinate before taking
the medication, to prevent sleep
disruption.
• Instruct the client to report adverse
reactions to the health care provider.
Sedative-hypnotic (tranquilizers)
Barbiturate
Pentobarbital sodium
• Action: depresses the central nervous system resulting
in calmness, relaxation, reduction of anxiety,
sleepiness, and slowed breathing, and possibly - at
higher doses - slurred speech, staggering gait, poor
judgment, and slow, uncertain reflexes.
• Route of administration: oral, IV, IM
• Dosage: 20mg – 100mg.
• Side effects: drowsiness, hangover, dizziness,
nystagmus and ataxia.
NURSING INTERVENTION:
•Monitor vital signs, especially respirations and
blood pressure.
•Raised bedside rails.
•Observe skin rashes.
•Administer IV at the rate of less than
50mg/min.
•IM injection should be given in large muscle
such as the gluteus muscle.