Salbutamol Drug Study Generic Name: Albuterol Brand Name: Salbutamol, Proventil, Ventolin, Accuneb, airet, Novo-Salbutamol,Proventil HFA,

Gensalbutamol, Ventodisk, Ventolin HFA, Volmax, VoSpira ER Classification: Bronchodilator (therapeutic); adrenergics (pharmacologic) Indications 1. To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD)2. Quick relief for bronchospasm3. For the prevention of exerciseinduced bronchospasm4. Longterm control agent for patients with chronic or persistentbronchospasm Mechanism of Action It relieves nasal congestion and reversible bronchospasm by relaxing the smoothmuscles of the bronchioles. The relief from nasal congestion and bronchospasmis made possible by the following mechanism that takes place when Salbutamolis administered.1. First, it binds to the beta2-adrenergic receptors in the airway of the smoothmuscle which then leads to the activation of the adenyl cyclase andincreased levels of cyclic- 35-adenosine monophosphate (cAMP).2. When cAMP increases, kinases are activated.3. Kinases inhibit the phosphor ylation of myosin and decrease intracellular calcium.4. Decreased in intracellular calcium will result to the relaxation of the smoothmuscle airways. Contraindications 1. Hypersensitivity to adrenergic amines2. Hypersensitivity to fluorocarbons Precaution 1. Cardiac disease including coronary insufficiency, a history of stroke, coronary artery diseaseand cardiac arrhythmias2. Hypertension3. Hyperthyroidism4. Diabetes5. Glaucoma6. Geriatric patients older individuals are at higher risk for adverse reactionsand may require lower dosage7. Pregnancy especially near term8. Lactation9. Children less than 2 years of age because safety of its use has not beenestablished10. Excess inhaler use which may lead to tolerance and paradoxicalbronchospasm Side Effects and Adverse Reactions 1. Nervousness2. Restlessness3. Tremor 4. Headache5. Insomnia6. Chest pain7. Palpitations8. Angina9. Arrhythmias10. Hypertension11. Nausea and vomiting12. Hyperglycemia13. Hypokalemia Route and Dosage PO (Adults and Children more than 12 years): 2-4 mg 3-4 times a day or 4-8 mgof extended dose tablets twice a day.PO (Geriatric Patients): initial dose should not exceed 2 mg 3-4 times a day andmay be increased carefully up to 32 mg/dayPO (Children 6-12 years old): 2 mg 3-4 times a day or 4 mg as extended-releasetablets twice a day; may be carefully increased as needed but not to exceed 24mg/dayPO (Children 2-6 years old): 0.1 mg/kg 3 times a dayInhalation (Adults and children more

than 4 years of age): 2 inhalations every 4-6hoursInhalation (Children 2-12 years old): 0.1-0.15 mg/kg/dose 3-4 times a day D r u g N a m e A c t i o n I n d i c a t i o n C o n t r a i n d i c a t i onAdverseEffectNursing Considerations GenericName: amikacinsulfate Brand Name: Amikin Classification: Aminoglycoside Availableforms: *Infection:pediatric:50mg/ml,250mg/mlNSS:5mg/ml(500mInhibits proteinsynthesis bybindingdirectly to the30S ribosomalsub unit;bactericidal*Route: IVOnset:immediatePeak: 30mins.Duration: 812hrs.*Route: I.MOnset:unknownPeak: 1hr.Duration: 8-12hrs. Seriousinfectioncause bysensitiverestrainsof Pseudomonasaeruginusa, E.coli,Proteus,Klebsiella,staphylococcus Uncomplicated UTIcaused byorganismsusceptible to lesstoxicdrugs. Activetuberculosis, withotherantituberculotics Mycobacterium Contraindicatedinpatientshypersensitive todrug orotheraminogycosides. Usecautiously inpatientswithimpairedrenalfunctionorneuromusculardisorders, inneonatesandinfantsand inelderlypatients.CNS:neuromuscularblockadeEENT:-ototoxicity Obtain specimen for culture andsensitivity test before giving firstdose. Therapy may begin whileawaiting the results. Evaluate patients hearing beforeand during therapy if he will bereceiving drug for longer than 2weeks. Notify prescriber if patienthas tinnitus, vertigo, or hearing loss. Weigh patient and review renalfunction studies before therapybegins. Correct dehydration before therapybecause of increase risk of toxicity. Obtain blood for peak level 1 hourI.M injection and 30 mins. to 1 hourafter IV infusion ends; for troughlevels draw blood just before thenext dose. Dont

collect blood in aheparinized tube; heparin isincompatible with aminoglycosides. Peak drug levels more than 35mcg/ml and trough levels more than10 mcg/ml may linked to a higherrisk of toxicity Watch for signs and symptoms of super infection (especially URT),such as continued fever, chills, andincreased pulse rate. Name of drug General Action SpecificActionAdverse Effects Indication Contraindication NursingResponsibilitiesGenericName:Kalium duruleBrand Name: PotassiumChloride Classifications: electrolyticand water balance agent; replacementsolution Principalintracellular cation;essential for maintenanceof intracellular isotonicity,transmissionof nerveimpulses,contraction of cardiac,skeletal, andsmoothmuscles,maintenanceof normalkidneyfunction, andfor enzymeactivity.Plays aprominentrole in bothformationandcorrection of imbalancesin acid basemetabolism. GI: Nausea, vomiting,diarrhea, abdominaldistension. BodyWhole: Pain, mentalconfusion, irritability,listlessness, paresthesias of extremities,muscleweaknessand heaviness of limbs, difficulty inswallowing, flaccid paralysis. Urogenital: Oliguria, anuria. Hematologic: Hyperkalemia. Respiratory: Respiratorydistress. CV: Hypotension,bradycardia; cardiacdepression, arrhythmias, or arrest; altered sensitivity todigitalis glycosides. ECGchanges in hyperkalemia:Tenting (peaking) of T wave(especially in right precordialleads), lowering of R withdeepening of S waves anddepression of RST;prolonged P-R interval,widened QRS complex,decreased amplitude anddisappearance of P waves,prolonged Q-T interval,To preventand treatpotassiumdeficitsecondary todiuretic or corticosteroidtherapy. Alsoindicatedwhenpotassium isdepleted byseverevomiting,diarrhea;intestinaldrainage,fistulas,

or malabsorption;prolongeddiuresis,diabeticacidosis.Effective in thetreatment of hypokalemicalkalosis(chloride, notthegluconate). . Severe renalimpairment;severehemolyticreactions;untreated Addisons disease; crushsyndrome;earlypostoperativeoliguria (exceptduring GIdrainage);adynamicileus; acutedehydration;heat cramps,hyperkalemia,patientsreceivingpotassiumsparingdiuretics,digitalisintoxicationwith AVconductiondisturbance.Monitor I&Oratio and patternin patientsreceiving theparenteral drug.If oliguriaoccurs, stopinfusionpromptly andnotifyphysician.Lab test:Frequent serumelectrolytes arewarranted.

Monitor for andreport signs of GI ulceration(esophageal or epigastric painor hematemesis).

Monitor patientsreceivingparenteralpotassiumclosely