Drug Generic Name: Calcium Gluconate Brand Name: Kalcinate Classification: Calcium Salt

Indication

Adverse Reaction ● used to ● necessary ●constipation treat for many ●nausea/vomiting conditions normal ●loss of appetite arising from functions of ●unusual weight calcium the body, loss deficiencies especially ●mental/mood such as bone changes hypocalcem formation ●bone/muscle ic tetany, and pain ●headache hypocalcem maintenance ●increased ia related to can also thirst/urination hypoparathy bind to ●weakness rodism and other unusual tiredness hypocalcem minerals ●rash ia due to (such as ●itching rapid phosphate) ●swelling growth or and aid in ●severe dizziness pregnancy their ●trouble ●treatment removal breathing. of black from the widow body. spider bites to relieve muscle cramping and as an adjunct in the treatment of

Action

Contraindication ●contraindicated in patients with ventricular fibrillation ●is contraindicated when serum calcium levels are above normal.

Nursing Consideration ●the drug should be given slowly, e.g., approximately 1.5 mL over a period of one minute ●should be injected through a small needle into a large vein in order to avoid too rapid increase in serum calcium and extravasation of calcium solution into the surrounding tissue with resultant necrosis. ●rapid injection of calcium gluconate may cause vasodilation decreased blood

Patient Teaching ●before taking calcium, tell your doctor or pharmacist if you have any allergies. ●if you have any of the following health problems, consult your doctor or pharmacist before using this product: high calcium levels (hypercalcemia). kidney disease, kidney stones, little or no stomach acid (achlorhydria), heart disease, disease of the pancreas, a certain lung disease (sarcoidosis), difficulty absorbing nutrition from food ●some sugar-free formulations of calcium may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to restrict your intake of aspartame (or

rickets, osteomalaci a, lead colic and magnesium sulfate overdosage ●decrease capillary permeability in allergic conditions, nonthrombo cytopenic purpura and exudative dermatoses such as dermatitis herpetiformi s and for pruritus of eruptions caused by certain drugs.

pressure, bradycardia, cardiac arrhythmias, syncope and cardiac arrest.

phenylalanine) ●tell your doctor if you are pregnant before using this medication,this medication passes into breast milk. Consult your doctor before breast-feeding.

Drug Generic Name: Captopril Brand Name: Capoten Classification: ACE inhibitors

Indication ●used alone or in combination with other drugs for the treatment of high blood pressure and heart failure. ●improving survival and preventing heart failure and hospitalizations for heart failure after a heart attack. ●may slow the progression of kidney failure in patients with diabetes or high blood pressure.

Action ●angiotensin II is formed from angiotensin I in the blood by the enzyme angiotensin converting enzyme or ACE. ACE inhibitors are medications that slow (inhibit) the activity of the enzyme ACE and decrease the production of angiotensin II. As a result, blood vessels enlarge or dilate, and blood pressure is reduced. The lower blood pressure makes it easier for the heart to pump blood and can improve the

Adverse Reaction ●dry persistent cough ●abdominal pain, ●constipation, ●diarrhea ●rash ●dizziness ●fatigue ●headache ●loss of taste ●loss of appetite ●nausea vomiting ●fainting and numbness or tingling in the hands or feet

Contraindication Nursing Consideration ●hypersensitivity ●watch for to captopril or hypotensive any component of effect within 1-3 the formulation; hours of first ●angioedema dose or new related to higher dose previous ●should be treatment with an stored at room ACE inhibitor; temperature, 15 ● idiopathic or to 30 C (59 to 86 hereditary F) and away angioedema; from moisture. ●bilateral renal ●the artery stenosis; recommended pregnancy (2nd or dose of captopril 3rd trimester) is 25-150 mg two or three times daily. The maximum dose is 450 mg daily.

Patient Teaching ●can be harmful to the fetus and should not be taken by pregnant women. ●it should be taken on an empty stomach one hour before or two hours after meals since absorption of captopril is reduced when it is taken with food. ●do not use captopril without telling your doctor if you are pregnant or planning a pregnancy. This medicine could cause birth defects in the baby if you take the medication

function of a failing heart

during pregnancy. ●avoid drinking alcohol ●drink plenty of water each day while you are taking Captopril.

Drug Generic Name: Cefuroxime Brand Name: Ceftin Classification: Cephalosporin, Second Generation

Indication ● is a secondgeneration antibacterial used in the treatment of susceptible infections, bone and joint infections, bronchitis (and other lower respiratory-tract infections), gonorrhoea, meningitis, otitis media, peritonitis, pharyngitis, sinusitis, skin infections and urinary-tract infections. It is also used for surgical infection prophylaxis.

Action ●cefuroxime is bactericidal and has a similar spectrum of antimicrobial action and pattern of resistance to those of cefamandole. It is more resistant to hydrolysis by beta-lactamases than cefamandole, and therefore may be more active against beta-lactamaseproducing strains of, for example, Haemophilus influenzae and Neisseria gonorrhoeae..

Adverse Reaction ●hypersensiti vity reactions, gastrointestina l disturbances, rarely pain at injection site, candidiosis, eosinophilia, neutropenia, leucopenia, thrombocytop enia, transient rise in liver enzymes, and positive Combo’s test

Contraindication ●cefuroxime is contraindicated if there is a history of hypersensitivity to cephalexin or other cephalosporins

Nursing Consideration ●store cefuroxime tablets at room temperature away from moisture and heat. ●store cefuroxime oral suspension in the refrigerator. Do not allow it to freeze. ●shake the oral suspension well just before measure a dose ●give this medication for the entire length of time prescribed by your doctor ●can pass into breast milk and may harm a nursing baby. Do not give this medication without telling to the doctor.

Patient Teaching ●patients should be counseled that antibacterial drugs including ampicillin and sulbactam should only be used to treat bacterial infections. ●they do not treat viral infections (e.g., the common cold). ●the medication should be taken exactly as directed. ●kipping doses or not completing the full course of therapy may (1) decrease the effectiveness of the immediate treatment.

Drug Generic Name: Cinnarizine Brand Name: Stugeron Classification: Antihistamine drug

Indication ●for the treatment of vertigo/meniere's disease, nausea and vomiting, motion sickness and also useful for vestibular symptoms of other origins.

Action ●binds to the Histamine H1 receptor and to muscarinic acetylcholine receptors. Cinnarizine Stugeron also inhibits contractions of vascular smooth muscle cells by blocking L type calcium channels. Cinnarizine Stugeron has also been implicated in binding to dopamine D2 receptors.

Adverse Reaction ●diarrhea ●nausea ●constipation and other abdominal disturbances ●dry mouth ●sweating ●weight gain ●jaundice

Contraindication Nursing Consideration ●should not be ●any sign of used by children overdose must below five years be given the and by older proper medical people who have attention. decreased kidney ●taking greater and liver amounts of functions Cinnarizine than ●patients who what is have Parkinson’s prescribed can disease be fatal, ●pregnant and especially to lactating women children so you must really be quick at recognizing the warning signs.

Patient Teaching ●keep a close watch on your body ●have regular check-ups with your doctor to ensure that your progress with the medicine is closely monitored. ●should be taken with food.

Drug Generic Name: Clonidine

Indication

Action

●used to treat hypertension (high blood pressure). Brand Name: ●used to relieve Catapres alcohol withdrawal, as an aid in Classification:Anti methadone and hypertensive Drug opiate detoxification, as an aid in quitting smoking, to treat diabetic diarrhea, to treat Tourette's Syndrome. used to reduce menopausal flushing, to treat postherpetic neuralgia, to treat ulcerative colitis, and to diagnose pheochromocytoma.

Adverse Reaction ●unknown. ●anxiety Thought to ●nervousness stimulate ●dizziness or alpha2fainting spells adrenergic ●increased receptors sweating centrally ●irregular and inhibit heartbeat or the central palpitations vasomotor ●chest pain centers, ●pain or thereby difficulty passing decreasing urine sympathetic ●stomach pain outflow to ●weakness the heart, ●drowsiness kidneys, and ●lightheadedness peripheral ●dry mouth vasculature, ●constipation resulting in decreased peripheral vascular resistance, systolic and diastolic blood pressure, and heart

Contraindication Nursing Consideration ●cerebrovascular ●use cautiously disease or in patients with coronary severe coronary insufficiency or insufficiency, myocardial recent MI, infarction, recent cerebrovascular lowered blood disease, chronic pressure may renal failure, or decrease impaired perfusion and worsen ischemia ●drug may be ●mental given to rapidly depression, lower blood history of or pressure in Raynaud's some syndrome hypertensive ●renal function ●monitor blood impairment, pressure and chronic pulse rate ●sensitivity to frequently. clonidine ●dosage is Sinus node usually adjusted function to patient's impairment blood pressure and tolerance. ●elderly patients may be more sensitive

Patient Teaching ●instruct patient to take drug exactly as prescribed. ●advise patient that abrupt discontinuation of drug may cause severe rebound hypertension. ●tell him dosage must be reduced gradually over 2 to 4 days as instructed by doctor. ●tell patient to take the last dose immediately before retiring. ●reassure patient that the transdermal patch usually adheres despite

rate. than younger ones to drug's hypotensive effect ●observe patient for tolerance to drug's therapeutic effects, which may require increased showering and other routine daily activities. Instruct him on the use of the adhesive overlay to provide additional skin adherence if needed. ●caution patient that drug may cause drowsiness but that this adverse effect will usually diminish over 4 to 6 weeks. ●inform patient that orthostatic hypotension can be minimized by rising slowly and avoiding sudden position changes.

Drug Generic Name: Dexamethasone Brand Name: Decadron Classification: Anti inflammatory

Indication ●used to treat many inflammatory and autoimmune conditions, e.g., rheumatoid arthritis. ●useful to counteract allergic anaphylactic shock, if given in high doses ●used in transvenous screw-in cardiac pacing leads to minimize the inflammatory response of the myocardium

Action

Adverse Reaction ●decreases ●swelling inflammation ●rapid by weight gain suppression of ●feeling neutrophil short of migration, breath decreased ●severe production of depression inflammatory ●unusual mediators, thoughts or and reversal behavior of increased seizure capillary ●bloody or permeability; tarry stools suppresses ●coughing normal up blood immune ●severe response. headache Dexamethaso ●buzzing ne's in your ears mechanism of ●anxiety antiemetic ●confusion activity is ●chest unknown. pain, ●shortness of breath ●uneven

Contraindication Nursing Consideration ●Existing ●do not give gastrointestinal drug to nursing ulceration mothers ●Cushing's ●give daily syndrome doses before 9 am to mimic ●Severe forms of normal peak corticosteroid heart blood level. insufficiency ●Severe hypertension ●Uncontrolled diabetes mellitus ●Systemic tuberculosis ●Severe systemic viral, bacterial, and fungal infections ●Preexisting wide angle glaucoma ●Osteoporosis ●increase dosage when patient is subject to stress. ●taper doses when discontinuing high dose or long term therapy. ●do not give live virus vaccine with immunosuppres sive doses of corticosteroid

Patient Teaching ●should not use this medication if are allergic to dexamethasone, or if you have a fungal infection anywhere in your body. ●avoid being near people who are sick or have infections ●do not receive a "live" vaccine while you are taking dexamethasone. ●vaccines may not work as well while you are taking a steroid.

heartbeats Drug Generic Name: Diazepam Brand Name: Valium Classification: Antianxiety agents, anticonvulsants, sedative/hyptonics, skeletal muscle relaxants (centrally acting) Indication ●used to treat anxiety, insomnia, and symptoms of acute alcohol or opiate withdrawal ●used as a premedication for inducing sedation, anxiolysis or amnesia before certain medical procedures (e.g., endoscopy) ●rarely used for the longterm treatment of epilepsy because tolerance to the anticonvulsant Action ●benzodiazepine that binds to a specific subunit on the GABAA receptor at a site that is distinct from the binding site of the endogenous GABA molecule.[77][78] The GABAA receptor is an inhibitory channel which, when activated, decreases neuronal activity. Because of the role of diazepam as a positive allosteric modulator of GABA, when it binds to benzodiazepine Adverse Reaction ●dizziness ●drowsiness ●lethargy ●hangover ●headache ●depression: ●blurred vision ●respiratory depression ● hypotension ●constipation ●diarrhea ●nausea ●vomiting ●rashes Contraindication ●Ataxia Severe hypoventilation ●Acute narrow-angle glaucoma ●Severe hepatic deficiencies ●severe respiratory disorders ●Severe sleep apnea ●Severe depression, particularly when accompanied by suicidal tendencies ●Psychosis ●Pregnancy or breast feeding ●Caution required in elderly or debilitated patients Nursing Consideration ●monitor BP, PR,RR prior to periodically throughout therapy and frequently during IV therapy. ●assess IV site frequently during administration, diazepam may cause phlebitis and venous thrombosis. ●prolonged high-dose therapy may lead to psychological or physical dependence. ●restrict amount of drug available to patient. Patient Teaching ●inform patient he may take drug with or without food; recommend taking it with food if it causes stomach upset. ●teach caregiver how to administer rectal gel system, if prescribed. ●caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration

effects of diazepam usually develops within 6 to 12 months of treatment, effectively rendering it useless for this purpose

receptors it causes inhibitory effects. This arises from the hyperpolarization of the postsynaptic membrane, owing to the control exerted over negative chloride ions by GABAA receptors.[16][77]

●Coma or shock ●Abrupt discontinuation of therapy

●observe depressed patients closely for suicidal tendencies. ●observe and record intensity, duration and location of seizure activity. The initial dose of diazepam offers seizure control for 1520 min after administration. ●IM injections are painful and erratically absorbed. If IM route is used, inject deeply into deltoid muscle for maximum absorption.

and alertness. ●tell patient to notify prescriber immediately if easy bruising or bleeding occurs. ●instruct patient to move slowly when sitting up or standing, to avoid dizziness from blood pressure decrease. ●advise him to dangle legs briefly before getting out of bed. ●advise patient not to stop taking drug abruptly.

Drug Generic Name: Digoxin Brand Names: Digitek, Lanoxicaps, Lanoxin, Cardoxin Classification: Cardiac Glycoside

Indication ●used to treat congestive heart failure ●used to treat atrial fibrillation, a heart rhythm disorder of the atria (the upper chambers of the heart that allow blood to flow into the heart).

Action ●binds to a site on the extracellular aspect of the αsubunit of the Na+/K+ ATPase pump in the membranes of heart cells (myocytes) and decreases its function. This causes an increase in the level of sodium ions in the myocytes, which then leads to a rise in the level of calcium ions. The proposed mechanism is the following: inhibition of the Na+/K+ pump leads to increased intracellular Na+ levels, which in

Adverse Reaction ●loss of appetite ●nausea, vomiting, ●diarrhea ●blurred vision ●visual disturbances (yellow-green halos) ●confusion ●drowsiness ●dizziness ●nightmares

Contraindication Nursing Consideration ●hypertrophic ●take apex beat obstructive for one full cardiomyopathy; minute before dysrhytmias administration. caused via the ●document. accessory nerve Note rate, tracts rhythm and quality. Withhold digoxin and notify doctor immediately if changes are apparent and/or apex rate is <100/min in the preterm infant or <80/min in the term infant. For IV administration continuous cardiac monitoring is essential. ●monitor and assess patient response to

Patient Teaching ●instruct patient to take medication as directed, at the same time each day. ●teach parents or caregivers of infants and children how to accurately measure medication. ●take missed doses within 12 hr of scheduled dose or not taken at all. ●do not double doses. ●consult health care professional if doses for 2 or more days are missed. ●do not

turn slows down the extrusion of Ca2+ by the sodium-calcium exchanger that relies on the high Na+ gradient. This effect causes an increase in the length of Phase 4 and Phase 0 of the cardiac action potential, which when combined with the effects of digoxin on the parasympathetic nervous system, lead to a decrease in heart rate.

therapy. ●assess for signs of adverse effects and/or toxicity. ●monitor for dysrrhythmias, respiratory congestion and peripheral oedema. ●weigh daily. ●monitor fluid balance. ●monitor blood pressure.

discontinue medication without consulting health care professional ●teach patient to take pulse and to contact health care professional before taking medication if pulse rate is <60 or >100 ●advise patient that sharing of this medication can be dangerous

Drug

Indication

Action

Adverse

Contraindication

Nursing

Patient Teaching

Reaction Generic name: ●used for the ●works by ●sedation Dipenhydramine relief of nasal blocking the ●tiredness and non-nasal effect of ●sleepiness Brand Name: symptoms of histamine at H1 ●dizziness Benadryl various receptor sites. ●disturbed allergic This results in coordination Classification: conditions effects such as ●drying and Anti-motion such as the increase of thickening of sickness agent seasonal vascular smooth oral and Sedativeallergic rhinitis muscle other hypnotic ●used to contraction, thus respiratory Antiparkinsonian alleviate cold reducing the secretions Cough symptoms and redness, ●stomach suppressant chronic hyperthermia and distress Anti histamine urticaria edema that occurs ●low blood (hives) during an pressure ●used for inflammatory ●palpitations allergic reaction. In increased reactions addition, by heart rate involving the blocking the H1 ●confusion eyes (allergic receptor on ●nervousness conjunctivitis), peripheral ●irritability to prevent or nociceptors, ●blurred treat active diphenhydramine vision motion decreases their ●double sickness, and sensitization and vision for mild cases consequently ●tremor of reduces itching ●loss or Parkinsonism, that is associated appetite including with an allergic ●nausea

●Allergy to any antihistamines ●Asthmatic attack ●Not to be used in neonates

Consideration ●Administer with food if GI upset occurs. ●Administer syrup form if patient is unable to take tablets. ●Monitor patient response, and arrange for adjustment of dosage to lowest possible effective dose.

●take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. ●do not take a double dose of this medication unless otherwise directed by doctor. ●if over 60 years of age, may be more likely to experience side effects from diphenhydramine. may require a lower dose of this medication. ●use caution

drug-induced Parkinsonism ●used for treating insomnia.

reaction when driving, operating machinery, or performing other hazardous activities.. ●use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking diphenhydramine.

Drug Generic Name:

Indication

Action ●directly stimulates beta1 receptors of the heart to increase myocardial contractility and stroke volume, resulting in increased cardiac output.

●for inotropic support in the short- term Dobutamine treatment of Hydrochloride patients with cardiac Brand Name: decompensation due to depressed Dobutrex contractility resulting either Classification: Sympathomimetic from organic heart disease or Drug Acting from cardiac surgical procedures ●short-term treatment of cardiac failure secondary to acute MI or cardiac surgery.

Adverse Reaction ●increased heart rate ●hypotension ●nausea ●headache ●anginal pain ●chest pain, ●palpitations ●shortness of breath

Contraindication Nursing Consideration ●idiopathic ●observe IV site hypertrophic closely and avoid subaortic stenosis extravasation. and in patients Dobutamine can who have shown cause previous inflammatory manifestations of response and hypersensitivity tissue ischaemia. to dobutamine ●monitor for adverse reactions ●continuous blood pressure monitoring ●continuous cardiorespiratory monitoring ●document vital signs hourly and PRN

Patient Teaching ●when administered in emergencies, patient education should be appropriate to the situation. ●if patient is aware, instruct to promptly report chest pain, palpitations, rapid heartbeat, headache, nervousness, or restlessness, nausea or vomiting, or respiratory ●At room temperature <25° difficulty. Protect from light. ●breast-feeding precaution: Diluted solution stable for 48 hours ●consult prescriber if at room breast-feeding. temperature.

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