Drug Paracetamol

Drug Class Analgesic Antipyretic

Mechanism of Action Decreases fever by inhibiting the effects of pyrogens on the hypothalamus heat regulating centers & by a hypothalamic action leading to sweating & vasodilatation. Relieves pain by inhibiting prostaglandin synthesis at the CNS but does not have antiinflammatory action because of its minimal effect on peripheral prostaglandin synthesis.

Indication Relief of mild-tomoderate pain; treatment of fever.

Contraindication Hypersensitivity Intolerance to tartrazine (yellow dye #5), alcohol, table sugar, saccharin Allergy to acetaminophen Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation

Adverse Effects CNS: Headache CV: Chest pain, dyspnea, myocardial damage when doses of 5-8g/day are ingested daily for several weeks or when doses of 4g/day are ingested for 1 year GI: Hepatic toxicity and failure, jaundice GU: Acute renal failure, renal tubular necrosis Hematologic: Methemoglobinemiacyanosis, hemolytic anemia- hematuria, anuria, neutropenia, leucopenia, pancytopenia, thrombocytopenia, hypoglycemia Hypersensitivity: Rash, fever

Nursing Responsibilities
Assess patients fever or pain: typeof pain, location, intensity, duration, temperature, and diaphoresis Do not exceed recommended dosage Give drug with food if GI upset occurs Discontinue drug if hypersensitivity reaction Teach patient to recognize signs of chronic overdose: bleeding, bruising, malaise, fever, sore throat. Trearment of overdose: Monitor serum level regularly, Nacetylcystein should be available as a specific antidote, basic life support measures may be necessary Chew the chewable tablets, otherwise do not cut, crush or chew Take the drug only for complaints indicated, it is not an antiinflammatory agent Do not take for longer than 10 days unless prescribed Avoid use of OTC or prescription preparation containing acetaminophen. Serious overdose can occur. Consult with health care provider. Report rash, unusual bleeding or bruising, yellowing of skin or eyes, changes in voiding patterns.

Drug Fluimucil (Nacetylcystein e)

Drug Class Mucolytic Antidote

Mechanism of Action Mucolytic activity: Splits links in the mucoproteins contained in respiratory mucus secretions, decreasing viscosity of the mucus Antidote to acetaminophen hepatotoxicity: Protects liver cells by maintaining cell function and detoxifying acetaminophen metbolites

Indication

Contraindication

Adverse Effects

Nursing Responsibilities

Treatment of Mycolytic use: respiratory Hypersensitivity affections to acetylcysteine characterized Use caution and by thick and discontinue viscous immediately if hypersecreti bronchospasm ons: acute occurs bronchitis, chronic Antidotal use: bronchitis No and its contraindication; exacerbation use caution with s; pulmonary esophageal emphysema, varices, peptic mucoviscidos ulcer is and bronchieacta sis.

Mucolytic use: Dilute the 20% acetylcysteine GI: Nausea, solution with either normal stomatitis saline or sterile water for Hypersensitivity: injection Urticaria Administer the following Respiratory: drugs separately because Bronchospasm they are incompatible with especially in patients acetylcysteine solutions: with asthma Tetracyclines, erythromycin Antidotal use: lactobionate, amphotericin B, Dermatologic: Rash iodized oil chymotrypsin, GI: Nausea, trypsin, hydrogen peroxide. vomiting, other GI Report difficulty of breathing symptoms or nausea Other: Anaphylactoid reaction

Drug
Aspirin (acetylsalicylic acid)

Drug Class
Analgesic Antipyretic Antiinflammatory Antiplatelet Antirheumatic NSAID Salicylate

Mechanism of Action
Analgesic and antirheumatic effects are attributable to aspirins ability to inhibit synthesis of prostaglandins, important mediators of inflammation. Antipyretic effects are not fully understood, but aspirin probably acts in the thermoregulatory center of the hypothalamus to block effects of the endogenous pyrogen by inhibiting synthesis of prostaglandin intermediary. Inhibition of platelet aggregation is attributable to the inhibition of platelet synthesis of thrimboxane A2 , a potent vasoconstrictor and inducer of platelet aggregation. This effect occurs in low doses and lasts for the life of the platelet (8days). Higher doses inhibit the synthesis of prostacyclin, a potent vasodilator and inhibitor of platelet aggregation.

Indication
Mild to moderate pain Fever Inflammatory conditions Reduction of risk of recurrent TIA or CVA in patients with history of TIA due to fibrin platelet emboli or ischemic stroke Reduction of risk of death or nonfatal MI in patients with history of infarction or unstable angina pectoris or suspected acute MI

Contraindication Adverse Effects

Allergy to salicylates or NSAIDS, allergy to tartrazine, hemophilia, bleeding, ulcers, hemorrhagic states, blood coagulation defects, hypoprothrom binemia, vitamin K deficiency Use cautiously with impairmed renal function, chickenpox Acute aspirin toxicity: Respiratory alkalosis, hyperpnea, tachypnea, hemorrhage, excitement, confusion, asterixis, pulmonary edema, seizures, tetany, metabolic acidosis, fever, coma, CV collapse, renal and respiratory failure Aspirin Intolerance: exacerbation of bronchospasm, rhinitis GI: Nausea, dyspepsia, heartburn, epigastric discomfort, anorexia, hepatotoxicity, Hematologic: Occult blood loss, hemostatic defects Hypersensitivity: Anaphylactoid reaction to anaphylactic shock Salicylism: Dizziness, tinnitus, difficulty of hearing, nausea, vomiting, diarrhea, mental confusion, lassitude (dose related)

Nursing Responsibilities
Take extra precaution to keep this drug out of the reach of children; this drug can be very dangerous for children Use the drug only as suggested, avoid over dose. Avoid the use of OTC drugs while taking this drug. Many of these drugs contain aspirin, and serious overdose can occur. Take this drug with food or meals if GI upset occurs Do not cut, crush, chew sustained release products OTC aspirins are equivalent. Prices do not affect their effectiveness Report ringing in ears, dizziness, confusion, abdominal pain, rapid or difficulty breathing, nausea, vomiting, bloody stools.