Generic Name



Amantadine Hydrochloride


Ranitidine Hydrochloride

Inluenza A virus prophylaxis: 200 mg/day PO or 100 bid PO for 10 days after exposure, for up to 90 days if vaccination is impossible and exposure is repeated. If used in conjunction with influenza vaccine, administer for 2 wks after vaccine has been given. Influenza A virus treatment: Same dose as above; start treatment as soon after exposure as possible, continuing for 2448 hr after symptoms are gone. Parkinsonism treatment: 100 mg bid (up to 400 mg/day) PO when used alone; reduce in patients receiving other antiparkinsonian drugs. Drug-induced extrapyramidal reactions: 100 mg bid PO, up to 300 mg/day in divided doses has been used. Active duodenal ulcer: 150 mg bid PO for 4-8 wk. Alternatively, 300 mg PO once daily hs or 50 mg IM or IV q 6-8 hr or by

Therapeutic Action May inhibit penetration of influenza A virus into the host cell; may increase dopamine release in the nigrostriatal pathway of patients with Parkinson’s disease, relieving their symptoms.

Classification Antiviral Antiparkinsonian

Contraindication Contraindicated with allergy to drug product, eczematoid rash, psychoses, lactation. Use cautiously with renal or hepatic disease, seizures, CHF, pregnancy.

• •

Side Effect CNS: Light headedness, dizziness, insomnia, confusion, irritability, psychosis, ataxia, depression, hallucination. CV: CHF, orthostatic hypotension, dyspnea. GI: Nausea, anorexia, constipation, dry mouth. GU: Urinary retention.

Nursing Responsibility • Do not discontinue abruptly when treating parkinsonism syndrome, parkinsonian crisis may occur.

Competitively inhibits the action of histamine at H2 receptors of the parietal cells of the stomach, inhibiting basal gastric acid secretion that stimulates by food,

Histamine2 (H2) antagonist

Contraindicated with allergy to ranitidine, lactation. Use cautiously with impaired renal or hepatic function,

CNS: Headache, malaise, dizziness, somnolence, insomia, vertigo CV: Tachycardia, bradycardia, PVCs (rapid IV

• • •

Administer oral drug meals and hs. Decrease doses in renal and liver failure. Provide concurrent antacid therapy to


Ampicillin Sodium

intermittent IV fusion, diluted to 100 ml and infused over 15-20 min. Do not exceed 400 mg/day. • Maintenance therapy. Duodenal ulcer: 150 mg PO hs. • Active gastric ulcer: 150 mg bid PO or 50 mg IM or IV q 6-8 hr. • Pathologic hypersecretory syndrome: 150 mg bid PO. Individualize dose with patient’s response. Do not exceed 6 g/day. • GERD, esophagitis, benign gastric ulcer: 150 mg bid PO. • Treatment of heartburn, acid indigestion: 75 mg PO as needed Adults: The usual adult dosage of ampicillin for the treatment of respiratory tract or skin and skin structure infections is 250–500 mg every 6 hours. For the treatment of GI or urinary tract infections, the usual adult dosage is 500 mg every 6 hours. For severe infections, larger doses may be required. The usual adult dosage of ampicillin for the treatment of septicemia or bacterial meningitis is 8–14 g or 150–200

insulin, histamine, cholinergic agonist, gastrin, and pentagastrin.

pregnancy. • •

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administration) Dermatologic: Rash, alopecia GI: Constipation, diarrhea, nausea, vomiting, abdominal pain, hepatitis, increase ALT levels GU: Gynecomastia, impotence or decreased libido Hematologic: Leukopenia, granulocytopenia, thrombocytopenia, pancytopenia Local: Pain at IM site, local burning or itching at IV site Other: Arthralgias

relieve pain. Administer IM dose undiluted, deep into large muscle group. Arrange for regular follow-up, including blood test, to evaluate effects.

Bactericidal action against sensitive organisms; inhibits synthesis of bacterial cell wall, causing cell death.

Antibiotic Penicillin

Contraindicated with allergies to penicillins, cephalosporins, or other allergens Use cautiously with renal disorder.

Adverse effects reported with ampicillin are similar to those reported with other aminopenicillins; however, diarrhea and rash have been reported more frequently with ampicillin than with other currently available aminopenicillins.

Culture infected area before treatment; reculture area if response is not as expected. Check IV site carefully for signs of thrombosis or drug reaction. Do not give IM injections in the same site; atrophy can occur. Monitor injection site. Administer oral drumg on an empty stomach, 1 hr before o 2 hrs after meals with a

mg/kg daily given parenterally in equally divided doses every 3–4 hours. For the initial treatment of septicemia or meningitis, ampicillin should be given IV for at least 3 days but may then be given IM.

full glass of water; do not give with fruit juice or soft drinks.


Nalbuphine HCL

The usual recommended adult dose is 10 mg for a 70 kg individual, administered subcutaneously, intramuscularly or intravenously; this dose may be repeated every 3 to 6 hours as necessary. Dosage should be adjusted according to the severity of the pain, physical status of the patient, and other medications which the patient may be receiving. In non-tolerant individuals, the recommended single maximum dose is 20 mg, with a maximum total daily dose of 160 mg.

Nalbuphine acts as an agonist at specific opioid receptors in the CNS to produce analgesia and sedation but also acts to cause hallucinations and its antagonist at mu receptors.

Opioid agonistantagonist analgesic

Hypersensitivity to nalbuphine or any component, including sulfites; pregnancy (prolonged use or high dosages at term)

CNS effects: Nervousness, depression, restlessness, crying, euphoria, floating, hostility, unusual dreams, confusion, faintness, hallucinations, dysphoria, feeling of heaviness, numbness, tingling, unreality. The incidence of psychotomimeti c effects, such as unreality, depersonalizati on, delusions, dysphoria and hallucinations has been shown to be less than that which occurs with pentazocine. Cardiovascular: Hypertension, hypotension, bradycardia, tachycardia,

Taper dosage when discontinuing after prolonged use to avoid withdrawal symptoms. Keep opioids antagonist and facilities for assisted or controlled respiration readily available in case of respiratory depression. Reassure patient about addiction liability; most patients who receive opiates for medical reasons do not develop dependence syndrome.

pulmonary edema. Gastrointestinal: Cramps, dyspepsia, bitter taste. Respiration: Depression, dyspnea, asthma. Dermatological: Itching, burning, urticaria. • • Monitor BP carefully during IV administration. Monitor for extrapyramidal reactions, and consult physician if they occur. Monitor diabetic patients, arrange for alteration in insulin dose or timing if diabetic control is compromised by alterations in timing of food absorption.



Gastroesophageal reflux: Oral: 10-15 mg/dose up to 4 times/day 30 minutes before meals or food and at bedtime; single doses of 20 mg are occasionally needed for provoking situations Gastrointestinal hypomotility (gastroparesis): Oral: 10 mg 30 minutes before each meal and at bedtime for 2-8 weeks I.V. (for severe symptoms): 10 mg over 1-2 minutes; 10 days of I.V. therapy may be necessary for best response Antiemetic (chemotherapy-induced emesis) (unlabeled): I.V.: 1-2 mg/kg 30 minutes before chemotherapy and every 2-4 hours, for a total of 5 doses (5-10 mg/kg) daily Postoperative nausea

Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions; appears to sensitize tissues to action of acetylcholine; relaxes pyloric sphincter, which when combined with effects on motility, accelerates gastric emptying and intestinal transit; little effect on gallbladder or colon motility; increases lower esophageal sphincter pressure; has sedative properties; induces release of prolactin.

GI Stimulant Antiemetic Dopaminergic blocker

Contraindicated with allergy to Metoclopramide; GI hemorrhage, mechanical obstruction or perforation; pheochromocytoma; epilepsy. Use cautiously with previously detected breast cancer; lactation, pregnancy.

CNS: restlessness, drowsiness, fatigue, lassitude, insomnia, extrapyramidal reactions, akathisia, dystonia, myoclonus, dizziness, anxiety. CV: Transient hypertension. GI: Nausea, diarrhea.

and vomiting (unlabeled): I.M., I.V.: 10 mg near end of surgery; 20 mg doses may be used Post-pyloric feeding tube placement (unlabeled): I.M., I.V.: 10 mg

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