DRUG

   
 DIAZEPAM > Apo-diazepam > Diastal > Diazemuls > Novo-Dipam 

INDICATION AND DOSAGE
Anxiety. Adults: Depending on severity, 2 to 10 mg P.O. b.i.d. Or 2 to 10 mg I.M. or I.V. q 3 to 4 hours, if needed. Elderly Patients: 2 to 2.5 mg P.O once or twice daily; increase gradually, as needed and tolerated. Acute alcohol withdrawal. Adults: 10 mg P.O. t.i.d or q.i.d., p.r.n. Or, initially, 10 mg I.M. or I.V.; then 5 to 10 mg I.M or I.V. in 3 to 4 hours, if needed. Before endoscopic procedures. Adults: Titrate I.V. dose to desired sedative response (up to 20 mg). Or 5 to 10 mg I.M. 30 minutes before procedure. Muscle spasm: Adults: 2 to 10 mg P.O. b.i.d to q.i.d daily. Or 5 to 10 mg I.M. or I.V. initially; then 5 to 10 I.M. or I.V in 3 to 4 hours p.r.n. For tetanus, larger doses may be required. Elderly patients: 2 to 2.5 mg I.M. or I.V. once or twice daily; increase p.r.n. Children age 5 and older: 5 to 10 mg I.M. or I.V .q 3 to 4 hours, p.r.n. Infants older than age 30 days and younger than age 5 : 1 to 2 mg I.M. or I.V. slowly repeated q 3 to 4 hours, p.r.n. Preoperative Sedation: Adults: 10 mg I.M. (preferred) or I.V. before surgery. Cardioversion: Adults: 5 to 15 mg I.V. 5 to 10 minutes before procedure. Adjunct in seizure disorders: Adults: 2 to 10 mg P.O. b.i.d to q.i.d. Elderly Patients: 2 to 2.5 P.O. once or twice daily; increase p.r.n. Children and infants age 6 months and older: 1 to 2.5 mg P.O. t.i.d or q.i.d initially; increase as tolerated and needed. Status epilepticus: Adults: 5 to 10 mg I.V. (preferred) or I.M. initially. Repeat q 10 to 15 minutes, p.r.n., to maximum, 30 mg. Repeat in 2 to 4 hours p.r.n. Children age 5 and older: 1 mg I.V. q 2 to 5 minutes maximum, 10 mg. Repeat in 2 to 4 hours p.r.n. Infants older than age 30 days and younger than age 5 : 0.2 to 0.5 mg I.V. slowly q 2 to 5 minutes t o maximum, 5

ACTION
Chemical Effects: May depress CNS at limbic and subcortical levels of brain; suppresses spread of seizure activity produced by epiloleptogenis foci in cortex, thalamus, and limbic system. Therapeutic Effects: Relieves anxiety, muscle spasm, seizures (parenteral form); promotes calmness and sleep.

DRUG INTERACTION
Drug-drug. Crinetidine: May increase sedation. Monitor patients carefully. CNS Depressants: May increase CNS depression. Avoid using together. Diltiazem: May increase CNS depression and may prolong effects of diazepam. Use lower dose of diazepam. Fluconazole, ketoconazole, itraconazole, miconazole: May increase and prolong diazepam level, CNS depression, psychomotor impairment. Don’t use together. Digoxin: May increase level of digoxin, increasing toxicity. Monitor dogoxin level. Phenobarbital: May increase effects of both drugs. Use together cautiously. Phenytion: May increase level of phenytion. Monitor patient for toxicity. Ranitidine: May increase

ADVERSE REACTION
CNS: pain, drowsiness, lethargy, hangover, ataxia, fainting, depression, anterograde, amnesia, psychosis, slurred speech, tremors, headache, insomnia. CV: transient hypotension, bradycardia, CV collapse. EENT: diplopia, blurred vision, nystagmus,. GI: nausea, vomiting, abdominal discomfort, constipation. Respiratory: respiratory depression Skin: rash, uticaria, desquamation Other: physical or psychological dependence, acute withdrawal syndrome after sudden discontinuation in physically dependent people, phlebitis at injection site.

CONTRAINDICATION
> Contraindicated in patients hypertensive to drug or any of its components and in those with angle-closure glaucoma, shock, coma, or acute alcohol intoxication (parenteral form). > Use cautiously in patients with hepatic or renal impairment, depression or chronic open angle glaucoma.

NURSING CONSIDERATION
>Obtain history of patient’s underlying condition before therapy, and reassess regularly thereafter. >Periodically monitor liver, kidney and hepatopoetic function studies in patient receiving repeated or prolonged therapy. >Look for adverse reactions and drug interactions. >Assess patient’s and family’s knowledge of drug therapy.

Pharmacologic class: benzodiazepine


  

Kava. A second dose may be given 4 to 12 hours after the first dose.r. A second dose may be given 4 to 12 hours after the first dose.R. if needed. Adults and Children age 12 and older: 0. if needed.n. Children age 6 to 11: 0.5 mg/kg P. A second dose may be given 4 to 12 hours after the first dose. valerian: Sedative effects may be enhanced.R. Monitor patient for decreased effect. if needed. To control acute repetitive seizure activity in patients already taking anticonvulsants. using applicator. mg. sassafras. Repeat in 2 to 4 hours p. Children ages 2 to 5: 0. Discourage using together. absorption. . using applicator. using applicator.3 mg/kg P.R. Drug-herb.2 mg/kg P.

EENT: changes in accommodation. Drugs that may produce hyperglycemia. Insulin: May increase potential for hypoglycemia. based on patient’s response >Adjust to metformin therapy in patients with type 2 ( noninsulin-dependent) diabetes mellitus whose hyperglycemia can’t be managed by diet exercise. Aloe. pancytopenia. urticaria and morbilliform or maculopapular eruptions). Maximum.O. May require dosage adjustment. Hepatic: cholestatic jaundice. Adults: 8 mg P. garlic. increase sensitivity of peripheral tissues to insulin. erythema. or renal insufficiency. 8 mg daily. other diuretics: May lead to loss of glucose control. agranulocytosis. NURSING CONSIDERATION >Monitor fasting glucose periodically to determine therapeutic response.. low-dose insulin. Beta blockers:May mask symptoms of hypoglycemia. > Therapeutic effect: Lowers glucose levels. . usually every 3 to 6 months. and in those with allergies to sulfonamides or thiazide diuretics. headache. bilberry leaf. hepatic.O. once daily with first meal of day. such as glimeperide. based on patients response. hemolytic anemia. Skin: allergic skin reactions ( pruritis. Also monitor glycosylated hemoglobin level. other highly protien –bound drugs: May increase hypoglycemic action of sulfonylureas. Usual maintenance dosage to 4 mg. May cause disulfiram like reaction. and gliperemide or metformin alone. >Assess patient’s and family’s knowledge of drug therapy. thrombocytopenia. DRUG INTERACTION >Drug-drug. asthenia. P. pituitary. Monitor patient carefully. which may allow reduction of oral hypoglycemic. dandelion. bitter melon. Adults: Initially. to more precisely assess longterm glycemic control. NSAIDs: . ginseng: May improve glucose control. 1 to 2 mg P.n. >Hematologic : leucopenia.DRUG GLIPEREMIDE >Amaryl Pharmacologic class: sulfonylurea INDICATION AND DOSAGE >Type 2 (non insulin dependent) diabetes mellitus who’s hyperglycemia can’t be managed by diet and exercise alone. >Adjustment to insulin therapy in patients with type 2 ( non-insulin dependent) diabetes mellitus whose hyperglycemia can’t be managed by diet and exercise with oral hypoglycemic. Adults: 8 mg P.r. most commonly hypoglycemia. >Use cautiously in debilitated or malnourished patients and in those with adrenal. in combination with metformin. GI: nausea.Alcohol use: May alter glycemic control. apastic anemia. >Metabolic: hypoglycemia. Monitor glucose levels carefully.O. Adjust dosages based on patient’s blood glucose response to determine minimum effective ACTION >Chemical effect: Stimulates release of insulin from pancreatic beta cells. increase dosage in increments not exceeding 2 mg q 1 to 2weeks. burdock. Adjust insulin upward weekly p. fenugreek. once daily with first main meal of the day. CONTRAINDICATION >Contraindicated in patients hypersensitive to the drug or any of its components. After reaching 2 mg. Monitor glucose level closely. ADVERSE REACTION >CNS: Dizzines. once daily. >Drug lifestyle. Tell patient to discuss herbs with prescriber before use. once daily with first meal of the day.O. in those with diabetic ketoacidosis. >Drug herb.

. Sex Exposure: May cause photosensitivity. Discouraging using together.dosage of each drug. Discourage prolonged or unprotected exposure to the sun.

glaucoma. >Monitor patient for stress. Fever.M. Give together cautiously. thromboembolism. Discourages using together. ACTION >Chemical effect: Not clearly defined. >Skin: hirsutism. Monitor potassium level. other NSAIDs: May increase risk of GI distress and bleeding. >CNS: euphoria.V. diabetes mellitus. GI irritation. >Be alert for adverse reactions and drug interactions.M. decreases inflammation. >Metabolic: hypokalemia. >Drug lifestyle: Alcohol use: May increase risk of GI effects. or I. >CV: heart failure.DRUG HYDROCORTISONE >Cortel >Cortenema >Hydrocortone Pharmacologic class: Adrenocortical steroids INDICATION AND DOSAGE >Severe Inflammation. Or 15 to 240 mg phosphate I.r. trauma.C. Barbiturates. diverticulitis. .R. or S. . ADVERSE REACTION Most adverse reactions are dose or duration dependent. >EENT: cataracts.rifampin: May decrease corticosteroid effect. Live-attenuated virus vaccines. >Other: susceptibility to infections. Give once q 2 to 3 weeks. cirrhosis. delayed wound healing. >Periodically measure growth and development during high dose and prolonged therapy in child.acute adrenal insufficiencywith increased stress (infection. divided into 12. hypertension. psychotic behavior. or succinate I. and influences nutrient metabolism.i. initially. hypothyroidism. and electrolyte levels. or I. Adults: Initially. daily.phyenytoin. and psychotic tendencies NURSING CONSIDERATION >Assess patients condition before starting therapy and regularly thereafter. carbohydrate intolerance. growth suppression in children. >Musculoskeletal: muscle weakness. stimulates bone marrow. pancreatitis.. >Monitor patient’s weight. mainly by stabilizing leukocyte lysosomal membranes. daily or b. Skin-test antigens :May decrease skin response. edema. . Or 5 to 75 mg acetate injected into joints to soft tissue. 100 to 500 mg succinate I. or I. Defer testing until therapy is completed. adrenal insufficiency: Adults: 20 to 240 mg hydrocortisone or crypionate P. nightly for 21 days. surgery.O. Monitor PT and INR closely. Dosage varies with degree of inflammation and size and location of the joint of soft tissues.hour intervals. pseudomotor cerebri.M. Or. DRUG INTERACTION >Drug-drug: Aspirin. and emotional problems may increase adrenal insufficiency. >Use cautiously in patients with recent MI and in those with GI ulcer. hypertension. nonspecific ulcerative colitis. may require increased dosage.n. acne. easy brusing. Children: 0.d.V. or trauma) or abrupt withdrawal after long-term therapy. Potassium depleting drugs (such as thiazide diuretics): May enhance potassium-wasting effects of hydrocortisone.16 to 1 mg/kg or 6 to 30 mg/m2 phosphate I. insomnia. osteoporosis. >Therapeutic effect: Reduces inflammation. recent instability. hyerglycemia. repeated in 4 hours or q 24 hours. blood pressure. >Shock. CONTRAINDICATION >Contraindicated in patients hypertensive to drug or any of its components. increased appetite.n.r. various skin eruptions. other toxoids and vaccines: May decrease antibody response and increase risk of neurologic complications.V. suppresses immune function and raises adrenocorticoid hormonal levels. >GI: peptic ulceration. >Assess patient’s and family’s knowledge of drug therapy. Oral anticoagulants: May alter dosage requirements.V. although some conditions may require weekly injections. Adults: 1 enema (100 mg) hydrocortisone or acetate P.M. seizures. p. may repeat q 2 to 6 hours p. suppresses immune response. and in those with systemic fungal infections. 50 mg/kg succinate I. indomethacin. renal disease. daily. Avoid using all together. osteoporosis. surgery. arythmias. >Adjuct for ulcerative colitis and proctitis. Hydrocortisone sodium succinateis contraindicated in premature infants.

Monraxella catarrhalis. constipation. Adults: 500 mg P. and sulfamethoxazole. dizziness. or S. parainfluenzae. . Give antacid at least 6 hours before or 2 hours after levofloxacin. pnenumoniae.DRUG LEVOFLOXACIN >Levaquin Pharmacologic class: fluorinated carboxyquinolone INDICATION AND DOSAGE >Acute Maxillary Sinusitis caused by susceptible strains of Stertococcus penumoniae. magnesium hydroxide: May decrease effects of levofloxacin. Theophyline: May decrease theophyline clearance with some fluoroquinolones. Iron salts: May decrease absorption of levofloxacin reducing anti -infective response.O. Chlamydia pneumoniae. M.O.O. abdominal pain. or daily for 10-14 days. or other fluoroquinolones. or H.V. flatulence. Sucralfate. >Therapeutic effect: Kills susceptible bacteria. Adults: 250 mg. hydroxide. catarrhalis. pnenumoniae resistant to two or more of the following antibiotics: penicillin. hepatic. hemolytic anemia. calcium carbonate. aureus or Stretococcus pyogenes. Monitor PT and INR closely.V. insomnia. influenza. Other: hypersensitivity reactions. paresthesia. >Acute bacterial exascerbation of chronic bronchitis caused by Streptococcus aureus. daily for 7 to 10 days. M. multisystem organ failure. >GU: vaginitis >Hematologic : eosinophilia. DRUG INTERACTION >Drug-drug. Legionella pneumophilia. transcription. daily for 7 to 14 days. Or.O. Wafarin: May enhance anticoagulant effects. P. lymphocytopenia. trimethoprim. ADVERSE REACTION >CNS: headache. dyspepsia. Antidiabetics: May alter glucose levels. Monitor them closely. Pneumoniae or Straphylococcus saprophyticus. seizures. Pseudomembranous colitis. >Obtain history of seizure disorders or other CNS diseases. Aluminum. Adults: 500 mg P.Adults: 500 mg P. pneumoniae). vasodilation. >GI: nausea. before starting therapy. encephalopathy.O. Skin: Rash. or by S. Give at least 2 hours apart. and recombination in susceptible bacteria. Give at least 2 hours apart. or I. daily for 3 days. macrolides. CONTRAINDICATION >Contraindicated in patients hypersensitive to the drug or any of its components. photosensitivity reactions. pain. tendon rupture. 750 mg P. daily for 7 days. anaphylaxis. second-generation cephalos[orins. Mycoplasma pnuemoniae. >Mild to moderate uncomplicated UTI causd by Escherichia coli. or Haemophilus Influenzae. or I. or I. or I. such as cerebral arteriosclerosis. Monitor theophylline levels. Therapy may begin pending results.V. abnormal ECG. >Drug-lifestyle. Sun exposure: May cause photosensitivity reactions. >Monitor glucose level and renal. influenza. pnuemoniae.O. palpitations. NSAIDs: May increase CNS stimulation. Respiratory: allergic pneumonitis. >Assess patient’s and family’s knowledge of drug therapy. Stevensjohnson syndrome. >Mild moderate skin and skin – structure infections caused by S. >CV: Chest pain. >Mild and Moderate UTI caused ACTION >Chemical effect: Inhibits bacterial DNA gyrase and prevents DNA replication. diarrhea. H. or parainfluenzae. and hematopoetic blood studies. products containing zinc: May interfere with GI absorption of levofloxacin. NURSING CONSIDERATION >Obtain specimen for culture and sensitivity tests before starting therapy and as needed to detect bacterial resistance. tetracyclines. repair. catarrhalis. S. >Community –acquired pneumonia caused by S.V. Klebsiella pnuemoniae. Adults: 500 mg P. K. vomiting. Monitor patient for seizures. erythema multiforme. once daily for 5 days ( not for multidrug-resistant S. pruritis. >Metabolic: Hypoglycemia Muscoskeletal: back pain. H. aureus.

faecalis. Urge patient to avoid unprotected or prolonged exposure to sunlight. E. nosocomial pneumonia caused by methicillin susceptible S. pyogenes. or I. or Pseudomonas aeruginosa. Enterobacter cloacae. daily for 10 days. E. Adults: 250 mg. >Chronic bacterial prostatitis caused by E.V. infusion over 90 minutes daily for 7 to 14 days.by Enterococcus faecalis. E. P. influenza. daily for 28 days. Pneumoniae. H. or Straphylococcus epidermidis. P. mirabilis.O. aureus . Pneumoniae. K.O or I.V. >Mild moderate acute pyelonephritis caused by E coli. Adults: 250 mg P.O. coli. Serratia marcescens. P. Adullts: 500 mg P.V. . faecalis. or S. daily for 10 days.O. E. S. coli. aeuginosa. or I. pneumoniae. or I. Adults: 750 mg P.V. K. coli. > Complicated skin to skin structure infections causedby methicillin-sensitive S aureus.

or ulcerative colitis. Or 3 mg/kg ferrous sulfate daily in three or for divided doses.d to q. tetracyclines: May decrease GI absortion. >Therapeutic effect: Relives iron deficiency. Watch patient carefully. b. t. . peptic ulcer disease. Or 300 mg ferrous sulfate P. yogurt.. ADVERSE REACTION >GI: nausea. L-Thyroxine: May decrease Lthyroxine absortion. fluoroquinolones. possibly decreasing levels and effectiveness. increase to 650 mg q. Or 325 mg and iron supplement ferrous gluconate P.i.i. >Iron deficiency. May impair oral iron absorption. >Drug-food: Cereals .milk. Children: 4 to 6 mg/kg ferrous fumerate P. levodopa. Suggest patient take vitamin C with drug. eggs. hemolytic anemia (unless iron deficiency anemia is also present). hematocrit.d.i. >Other: suspension and drops may temporarily stain teeth.d.. constipation. Vitamin C: May increase iron absorption. CONTRAINDICATION >Contraindicated in patients with primary hemochromatosis. q. Children age 2 and older: 3 mg/kg ferrous gluconate P. vomiting. penivillamine. . diarrhea. daily. anorexia. Separate doses by 2 to 4 hours. >Use cautiously on long term basis.i. Monitor thyroid function. Chloramphenicol: May increase iron response. penicillamine. Or I extendedreleasecapsule ( 160 to 525mg ) ferrous sulfate P. >Be alert for adverse reactions and drug interactions. Levodopa. hemosiderosis. Antacids. daily in three to four divided doses.i.DRUG FERROUS SULFATE >ferosol INDICATION AND DOSAGE ACTION >Chemical effect: provides elemental iron. epigastric pain. cholestyramine resin. Monitor patient for decreased effects of these drugs. tea.O. Flouroquinolones. daily to b.d. regional enteritis. divided into three doses. >Assess patient’s and family’s knowledge of drug therapy.cheese coffee. an essential component in formation of hemoglobin.O. Separate doses by 2 to 4 hours. black stools.O.O. NURSING CONSIDERATION >Obatin baseline assessment of patient’s iron deficiency before starting therapy. and in those receiving repeated blood transfusions.d. whole-grain breads. DRUG INTERACTION >Drug-drug. Advise against using together. >Evaluate hemoglobin. if needed and tolerated. and reticulocyte count during therapy. methyldopa: May decrease absorption and effectiveness of levodopa and methyldopa. vitamin E.O.O.: May decrease iron absorption. Adults: 50 to 100 mg ferrous fumerate elementa iron Pharmacologic class: oral P. tetracycline.d.i. Separate doses by at least 2 hours.

Sign up to vote on this title
UsefulNot useful