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Drug-MEC

Drug-MEC

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Published by Camille Calangi

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Published by: Camille Calangi on Mar 01, 2012
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01/14/2013

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Drug Oxytoxin

Classification Oxytocic

Pharmakokinetics Absorption: Well absorbed from the nasal mucosa Distribution: Widely distributed in extracellular fluid. Small amounts reach fetal circulation. Metabolism and Excretion: Rapidly metabolized by liver and kidneys Half-life: 3±9min. TIME/ACTION PROFILE (IV = uterine contractions; intranasal = milk letdown)

Indication y To stimulate uterine contraction and improve uterine tonus in induction of labour y Treatment of postpartum hemorrhage y Termination of pregnancy during the second trimester y Treatment of uterine atony following abortion

Side Effects y Anaphylactic reaction y Postpartum hemorrh age y Cardiac arrhythmia y Fatal y Afibrinogenemia y Hypertensive episod e y Nausea y Vomiting y Premature ventricula r contractions y Pelvic hematoma y Subarachnoid hemorrhage y Hypertensive episodes y Rupture of the uterus y y y y y y y y Constipation Dizziness Drowsiness Headache mild nervousness nausea trouble sleeping vomiting.

Nursing Responsibilities y Monitor the duration and intensity of contractions y Monitor blood pressure and pulse, fetal heart rate y Advise the prescriber if nausea and vomiting happens.

Phenytoin

Anticonvulsantantiarrhythmic diphenyl hydantoin

Absorption: Well absorbed following IM administration. Distribution: Unknown. Metabolism and Excretion: 10% excreted unchanged by kidneys Half-life: Unknown.

y Treatment of status epilepticus, and control /prevention of seizures y Treatment of ventricular arrhythmias due to digoxin in persons refractory or hypersensitive to conventional therapy

y Patient should avoid activities requiring mental alertness or coordination until drug effects are realized, as drug may cause dizziness, drowsiness, or confusion. y This drug may decrease effectiveness of oral contraceptives with concurrent use. Recommend additional form of birth

hepatotoxicity. y This drug may cause constipation. nephrotoxicity. as this may affect the blood level of phenytoin. or systematic lupus erythamatosus. or skin/mucous membrane blistering) or toxic epidermal necrolysis (widespread peeling/blistering of skin) y Patient should not drink alcohol while taking this drug. atxia. y Patient should report signs and symptoms of a severe skin reaction such as Stevens-Johnson syndrome (flu-like symptoms. slurred speech and nervousness.control. Phenobarbital Anticonvulsant. and febrile y Somnolence y Syncope y Erythroderma y Patient should avoid activities requiring mental alertness or . Sedative/ Hypnotics Absorption: Absorption is slow but relatively complete (70±90%). spreading red rash. gingival hyperplasia. partial. y Anticonvulsant in tonicclonic (grandmal). y Tell patient to report signs and symptoms of pancytopenia. Vomiting. choreoathetosis. nausea.

sedative/hypnot ics. y Instruct patient to report sign and symptoms of withdrawal upon dose reduction or discontinuation y Patients should not increase phenobarbital dose unless instructed by health care professional y Advise patient against sudden discontinuation of drug. Half-life: Neonates: 1. y Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. or somnolence. anticonvulsant. y Patients should not Diazepam Antianxiety agents. Metabolism and Excretion: 75% metablized by the liver. Absorption from IM sites may be slow and unpredictable. incoordination Euphoria Respiratory depression Fatigue Neutropenia . Skeletal muscle relaxant. Adults: 2±6 days. Anxiety relief prior to cardioversion (injection). as drug may cause dizziness.3 days.5± 3 days. Management of the symptoms of alcohol y y y y y y y y y Hypotension Rash Diarrhea Muscle weakness Ataxia. Preoperative sedative and in other situations in which sedation may be required. y Elderly and debilitated patients are especially sensitive to adverse effects.5 days. 25% excreted unchanged by the kidneys. Crosses the blood-brain barrier. enters breast milk.8± 8. Conscious sedation (provides light anesthesia and anterograde amnesia). Treatment of status epilepticus/uncontrolled seizures (injection). Unlabeled uses: Prevention/treatment of hyperbilirubinemia in neonates. Athetosis.8± 5. Stiffman Syndrome. Children: 1. Well absorbed (90%) from rectal mucosa Distribution: Widely distributed. skeletal muscle relaxants (centrally acting) Absorption: Rapidly absorbed from the GI tract. y Patients receiving extended diazepam therapy should avoid abrupt discontinuation of drug in order to prevent withdrawal symptoms. seizures in children. Infants: 0. Crosses the placenta. light² headedness. Metabolism and Excretion: Highly y Adjunct in the management of: Anxiety Disorder. y Megaloblastic anemia y Liver damage y Immune hypersensitivity reaction y Hallucinations y Barbiturate withdrawal coordination until drug effects are realized. Hypnotic (short term). Preoperative sedation.Distribution: Unknown.

Aids in the induction of anesthesia and as part of balanced anesthesia. insomnia drink alcohol while taking this drug. as transient amnestic effects may occur even if patient seems alert. and 2 other inactive withdrawal. Half-life: Neonates: 50± 95 hr. y PO: Preprocedural sedation and anxiolysis in pediatric patients.metabolized by the liver. IV administration results in complete bioavailability. Infants 1 month± 2 yr: 40±50 hr. Adults: 20±50 hr (up to 100 hr for metabolites). y Excessive somnolence y Headache y Hiccoughs y Cardiac arrest y Involuntary movement y Agitation y Apnea y Advise patient not to drive for 24 to 48 hours after receiving this drug. y IM. y IV: Provides sedation/anxiolysis/amn esia during therapeutic. undergoes substantial intestinal and first-pass hepatic metabolism. provides sedation of mechanically ventilated patients during anesthesia or in a critical care setting. Status epilepticus. Metabolism and Excretion: Almost exclusively metabolized by the liver. y Review postprocedure instructions with patient¶s family and give a copy in writing. Children 2±12 yr: 15-21 hr. Children 12±16 yr: 18± 20 hr. . IV: Preoperative sedation/anxiolysis/amn esia. diagnostic. or radiographic procedures (conscious sedation). resulting in conversion to hydroxymidazolam. Some products of metabolism are active as CNS depressants. As a continuous infusion. Midazolam antianxiety agents. Protein Binding: 97%. as there may be residual sedative and amnestic effects. sedative/hypnot ics Absorption: Rapidly absorbed following oral and nasal administration. Well absorbed following IM administration. Unlabeled uses: Anxiety associated with acute myocardial infarction. y Instruct patient to avoid alcohol or other CNS depressants until at least 24 hours after drug therapy. an active metabolite. as concomitant use increase risk of sedation or respiratory depression. Distribution: Crosses the blood-brain barrier and placenta.

Adults: 2±6 hr (increased in renal impairment.metabolites(metabolized by cytochrome P450 3A4 enzyme system). Severe pain. CHF. . More reliably absorbed from rectal. excessive sedation. constipation. Children: 3±7 hr. or urinary retention. Morphine Opioid analgesics Absorption: Variably absorbed (about 30%) following oral administration. Pulmonary edema. y Tell patient to report signs and symptoms of respiratory depression. Crosses the placenta. Neonates: 4±12 hr. ineffective pain control. systemic absorption and absorption into the intrathecal space via the meninges occurs. hypotension. Metabolism and Excretion: Mostly metabolized by the liver. Distribution: Widely distributed. y Advise patient using morphine for long periods of time against sudden discontinuation of drug.7 hr. Half-life: Pretermneonates: 2. Adults: 35%. Following epidural administration.6± 17. metabolites are excreted in urine. Pain associated with MI. and IM sites. or cirrhosis). subcut. y Patient should not use additional CNS depressants while taking this drug. y y y y y y y y y y y y y y y y y y Peripheral edema Pruritus Sweating Abdominal pain Constipation Loss of appetite Nausea and vomiting Xerostomia Liver function test abnormal Backache Dizziness Insomnia Paresthesia Somnolence Anxiety Urinary retention Fever Hiccoughs y Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. Protein Binding: Premature infants: <20%. enters breast milk in small amounts.

6 hr. y IM: Self-injected or when IV unavailable (during y CNS: SEIZURES.3 hr. teach patient proper technique and placement of injections. y Advise patient to rotate injection sites y Patient should not use alcohol or other CNS depressants s y Instruct patient to take extra care to avoid injury of body areas that are numbed by Lidocaine Polyampule Anesthetics² topical/local. Supplement to balanced anesthesia.2 hr. y Patient should report depression y Advise patient against sudden discontinuation of drug. y Diaphoresis y Nausea and vomiting y Xerostomia y Dizziness y Headache y Vertigo y Immune hypersensitivity reaction y Loss of consciousness y Seizure y Pulmonary edema y Respiratory depression y Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. y IV: Ventricular arrhythmias. Infants 1±3 mo: 6. Adults: 2±4 hr. confusion. Children 6mo±2. dizziness. Metabolism and Excretion: Mostly metabolized by the liver and eliminated in the feces via biliary excretion. Minimal amounts excreted unchanged by the kidneys. blurred vision.Active metabolites excreted renally Half-life: Premature neonates: 10±20 hr. . drowsiness. Distribution: Probably crosses the placenta and enters breast milk. anti arrhythmics Absorption: Well absorbed after administration into the deltoid muscle. Children 6±19 yr with sickle cell disease: 1. Children 3±6 yr: 1±2 hr.9 hr. as drug may cause dizziness or sedation. Also provides: Analgesia during labor. Neonates: 7. Sedation before surgery. y If self-administered.5 yr: 2. Nalbuphine Opioid analgesics Absorption: Well absorbed after IM and subcut administration. y Moderate to severe pain. Half-life: 5 hr.

EENT: mucosal use² decreased or absent gag reflex. arrhythmias. coma. erythema. y Instruct patients to report signs/symptoms of lidocaine or prilocaine toxicity. y Patch: Pain due to posther-petic neuralgia. bradycardia. including AN PHYLAXIS. Concentrates in adipose tissue. burning. lidocaine. <10% excreted in urine as unchanged drugs. Crosses the blood-brain barrier and placenta. contact dermatitis. heart block. or cardiac dysrhythmia . slurred speech tremor. y Local: Infiltration/mucosal/topic al anesthetic. Local: stinging. Distribution: Widely distributed. CV: CARDIAC ARREST. Misc: allergic reactions. Half-life: Biphasic² initial phase. seizures. Resp: bronchospasm. enters breast milk Metabolism and Excretion: Mostly metabolized by the liver. transport to hospital facilities). difficulty breathing. terminal phase. hypotension GI: nausea. or applying extreme temperatures until body area sensation returns. increased in CHF and liver impairment. rubbing. vomiting.some absorption follows local use. 7±30min. 90±120 min. y y y y y nervousness. Patient should avoid scratching.

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