Name of Drug

Indication

Action

Furosem ide

Brand Name: Lasix

Acute pulmo nary edema Edema Hypert ension

A potent drug that inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle

Dosage, Frequenc y and Route 200 mg TID

Contraindication

Adverse effect

Drug Interaction

Nursing Responsibilities To prevent nocturia, give P.O and I.M preparations in the morning. Give second dose in early afternoon. Monitor weight, blood pressure and pulse rate routinely with long term use during diuresis. Use can lead to profound water and electrolyte depletion. Monitor fluid intake and output and electrolyte Watch for signs of hypokalemi

Contraindicated in patients hypersensitive to drug and in those with anuria. Use cautiously with patients with hepatic cirrhosis and in those allergic to sulfonamides

CNS: vertigo, headache, dizziness, paresthesia, weakness, restlessness, fever. CV: orthostatic hypotension, thrombophlebitis with IV administration EENT: transient deafness, blurred or yellowed vision, tinnitus Hepatic: hepatic dysfunction, jaundice GI: abdominal discomfort, diarrhea, anorexia, nausea, vomiting, constipation, pancreatitis Metabolic: volume depletion and dehydration Musculoskeletal: muscle spasm

Aminoglyc oside antibiotics cisplatin: May increase ototoxicity. Amphoteri cin B, corticoster oids, corticotropi n, May increase risk of hypokalem ia

a such as muscle weakness and cramps. Monitor for CNS, GI, Cardiovasc ular, Neurologic, Integument ary manifestatio ns of Hypocalce mia. Monitor for CNS, Neuromusc ular, GI, Cardiac manifestatio ns of Hypomagne semia. Monitor for CV, GI, Neurologic manifestatio ns of Hyponatre mia. Monitor for neurologic, respiratory manifestatio ns of hyperchlore mia.

Assess patient for tinnitus, hearing loss, ear pain, periodic testing of hearing is needed when high doses of this drug are given by IV route. Assess patients and familys knowledge of drug therapy.

Name of Drug

Indication

Action

Folic Acid Brand Name: FOLATE

Treatment of megaloblastic anemias, nutritional deficiency

Required for nucleoprotein synthesis and maintenance of normal erythropoiesis

Dosage, Frequency and Route 1g 1tab Oral Drug, Once a day

Contraindication

Adverse effect

Drug Interaction Decreased serum phenytoin and increase in seizure activity with folic acid preparations Decreased absorption with sulfasalazine, aminosalicylic acid

Nursing Responsibilities Assess Allergy to folic acid preparations Physical: Skin lesions, hemoglobin serum folate levels Assess patients folic acid deficiency before starting therapy. Assess patient for (megaloblastic anemia), weakness, fatigue, dyspnea, shortness of breath and activity intolerance. Assess nutritional status: determine if high folic acid foods are missing from diet. Identify drugs currently taken: alcohol, oral contraceptive, glucocorticoids, estrogens, hydantoins and carbamazepine, These drugs may cause increased folic acid use by the body and contribute to the deficiency. Monitor folate levels (6-15 mcg/ml) Hgb, Hct and reticulocyte count before and throughout therapy.

Contraindicated with allergy to folic acid, pernicious, aplastic, normocytic anemias

Hypersensitivity: allergic reactions

Monitor for possible drug induced reactions: CNS: general malaise GI: bitter taste, anorexia, flatulence. Respiratory: bronchospasm Assess patients and familys knowledge on drug therapy.