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Drug study

Generic Name: Bisacodyl Brand Name: Dulcolax Classification: Laxative Action: Stimulant laxative that increases peristalsis by that directly affects smooth muscle of the intestine stimulating the intramural plexus. It also promotes fluid accumulation in colon and small intestine. Indication:

Bisacodyl is used to treat chronic constipation. It may also be used to clean out the intestines before a bowel examination, childbirth and or surgery. It is known as a stimulant laxative. It works by increasing the movement of the intestines, helping the stool to come out.

Dosage, Route and Frequency :

Adults and children age 12 and older: 5-10 mg per orem in the evening or before breakfast. Up to 30 mg per orem as needed or, 10 mg per rectum for evacuation before examination or sugery. Children ages 6 to 11: 5 mg per orem or per rectum at bedtime or before breakfast. Oral dose isnt recommended I child cant swallow whole tablet.

Side effects: dizziness, faintness, muscle weakness with excessive use, abdominal cramps, nausea, vomiting, diarrhea with high doses. Contraindications: Contraindicated in patients hypersensitive to drug or its components and in those with rectal bleeding, gastroenteritis, intestinal obstruction, abdominal pain, nausea, vomiting or other symptoms of appendicitis or acute surgical abdomen. Nursing Implications:

Drug should be given at times that dont interfere with sleep. Soft, formed stools are usually produced 15-60 minutes after rectal use. Before giving for constipation, determine whether patient has adequate fluid intake exercise and diet. Tablet and suppositories are used together to clean the colon before and after surgery and before barium enema. Insert suppository as high as possible into the rectum and position it against the rectal wall. Avoid embedding within fecal material because doing so may delay onset of action.

Advise patient to swallow enteric coated tablet to avoid GI irritation. Instruct him not to take milk or antacid within 1 hour. Tell patient that drug is for 1 week treatment only. Excessive use should be discouraged. Advise patient to report adverse effects immediately. Teach patient about dietary resources of bulk, including bran and other cereals, fresh fruits and vegetables. Drug should be taken with a full glass of water.

Generic Name: Tolterodine tartrate Brand Name: Detrol, Detrol LA Classification: Antispasmodic / Anticholinergic Action: Competitively antagonizes muscarinic receptors. Both urinary bladder contraction and salivation are medicated via cholinergic muscarinic receptors. Indication: Overactive bladder in patients with symptoms of urinary frequency, urgency, or urge incontinence Dosage, Route and Frequency :

Adults: 2 mg tablet per orem b.i.d. or 4mg extended release capsule, per orem, daily. Dose may be reduced to 1 mg tablet per orem b.i.d. or 2mg extended release capsule per orem. Adjust- a-dose: For patients with significantly reduced hepatic or renal function or those taking a potent CYP3A4 inhibitor, 1mg tablet per orem b.i.d. or 2mg extended release capsule per orem daily.

Side effects: headache, fatigue paresthesia, vertigo, dizziness, nervousness, somnolence, hypertension, chest pain, sinusitis, dry mouth, nausea, vomiting, weight gain, rash, dry skin. Contraindications: Contraindicated in patients hypersensitive to drug or its components and in those with uncontrolled angle-closure glaucoma or urine or gastric retention. In patients with significant bladder outflow obstruction, GI obstructive disorders such as pyloric stenosis, hepatic or renal impairment. Nursing Implications:

Assess baseline bladder function and monitor therapeutic effects. Sugarless gum, hard candy, or saliva substitute may help relieve dry mouth. Advise patient to avoid driving or other potentially hazardous activities until visual effects of drugs are known. Instruct patient to stop breast feeding during therapy. Instruct patient to immediately report any signs of infection, urine retention, or GI problems.

Generic Name: Prochlorperazine Brand Name: Compazine Classification: Antiemetic/ Antipsychotic / Tranquilizer/ Anxiolytic/ Phenothiazine Action: Block postsynaptic dopamine receptors in the brain; depresses the RAS, including the parts of the brain involved with wakefulness and emesis. Indication: Management of manifestations of psychotic disorders; control of severe nausea and vomting; short term treatment of nonpsychotic anxiety (not drug of choice). Dosage, Route and Frequency : Adults: Psychotic disturbances: Initially, 5-10 PO tid or qid. Gradually increase dosage every 2-3 days as needed up to 50-75mg/ day for mild or moderate disturbances, 100-150mg/ day for more severe disturbances. Antiemetic: For control of severe nausea and vomiting, 5-10 mg PO tid-qid; 15mg (SR) on arising; 10mg (SR) every 12hrs, 25mg rectally bid; or 5-10mg IM initially, repeated every 3-4 hr up to 40mg/ day. Nausea, vomiting related to surgery: 5-10mg IM 1-2hr before anesthesia or during and after surgery (may repeat once in 30mins); 510mg IV 15 min before anesthesia or during and after surgery (may repeat once); or as IV infusion, 20mg/L of isotonic solution added to infusion 15-30 min before anesthesia. Nonpsychotic anxiety: 5mg PO tid or qid. For spanules, one 15-mg spansule on arising or one 10-mg spansule every 12hrs. Do not give more than 20mg/day or for longer than 12wk. Pediatric patients Do not use in pediatric surgery. Less than 9kg or younger than 2 yr: Generally not recommended. Psychotic disturbances: 2-12yr: 2.5mg PO rectally bid-tid. Do not give more than 10mg on first day. Increase dosage according to patient response; total daily dose usually does not exceed 20mg (2-5yr ) or 25mg (6-12yr). Younger than 12yr: 0.132mg/kg by deep IM injection. Switch to oral dosage as soon as possible. (usually after one dose). Antiemetic for control of severe nausea and vomiting. Oral or rectal: more than 20lb or older than 2yr:

9.1-13.2kg: 2.5mg daily-bid not to exceed 7.5mg/ day 13.6-17.7kg: 2.5mg daily bid-tid, not to exceed 10mg/day 18.2-38.6kg: 2.5mg tid or 5mg bidm not to exceed 15mg/ day Side effects: dizziness, drowsiness, anxiety; sleep problems (insomnia), strange dreams; dry mouth, stuffy nose; blurred vision, constipation, breast swelling or discharge, a missed menstrual period, weight gain, swelling in your hands or feet, impotence, trouble having an orgasm, mild itching or skin rash, headache Contraindications: Contraindicated in patients hypersensitive to drug or its components and in those with glaucoma, heart disease or high blood pressure, liver or kidney disease, severe asthma or breathing problems, a history of seizures, adrenal gland tumor, Parkinson's disease, enlarged prostate or urination problems, an infectious disease (such as chickenpox, measles, flu, or central nervous system infection), past or present breast cancer, low levels of calcium in blood, or if a patient had a serious side effect while using prochlorperazine or similar medicines. Nursing Implications: Do not allow patient to crush or to chew capsules. Do not administer subcutaneously because of local irritation. Give IM injections deeply into the upper outer quadrant of the buttock. Avoid skin contact with oral solution; contact dermatitis may occur. Discontinue drug if serum creatinine or BUN become abnormal or if WBC count is depressed. Elderly patients may be more sensitive to antidopaminergic and anticholinergic effects; monitor accordingly. Monitor elderly patients for dehydration, and institute remedial measures promptly; sedation and decreased sensation of thirst related to CNS effects of drug can lead to severe dehydration. Consult physician regarding appropriate warning of patient or patients guardian about tardive dyskinesias. Take drug exactly as prescribed. Avoid contacting skin with drug solutions. Maintain fluid intake, and use precautions against heatstroke in hot weather. Avoid exposure to ultraviolet or sunlight to prevent photosensitivity. Use sunscreen and protective clothing. Avoid driving or engaging in other dangerous activities if dizziness, drowsiness, or vision changes occur. Report sore throat fever, unusual bleeding or bruising, rash, weakness, tremors, impaired vision, dark urine (expect pink or reddish-brown urine), pale stools, yellowing of the skin or eyes.

Prepared by: Clarisse Mae T. Manaloto, RN