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Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

DIAZEPAM
(dye-az'e-pam)
Apo-Diazepam, Diastat,
Diazemuls , E-am ,
!eval , Novodipam ,
"alium, "alrelease, "ivol
Classifications# CENTRAL
NERVOUS SYSTEM
AGENT;
BENZODIAZEPINE
ANTICONVULSANT;
ANXIOLYTIC
Status Epilepticus
Adult: IV/IM 510 mg,
repeat if needed at 1015
min intervals up to 30 mg,
then repeat if needed !"h
Child: IV/IM <5 y, 0#!0#5
mg slo$ly !5min up to 5
mg; %5 y, 1 mg slo$ly !
5min up to 10 mg, repeat if
needed !" h
Anxiety, Muscle Spasm,
Convulsions, Alcohol
Withda!al
Adult: P" !10 mg &#i#d# to
#i#d# or 1530 mg'd
sustained release IV/IM !
10 mg, repeat if needed in
3" h
Geriatric: P" 1! mg 1!
times'd (ma() 10 mg'd)
Child: P" %6 mo, 1!#5 mg
&#i#d# or t#i#d#
*sy+hotherapeuti+ agent
related to +hlordiazepo(ide;
reportedly superior in
antian(iety and
anti+onvulsant a+tivity, $ith
some$hat shorter duration
of a+tion# ,i-e
+hlordiazepo(ide, it appears
to a+t at &oth lim&i+ and
su&+orti+al levels of ./0#
1rug of +hoi+e for status
epilepti+us# 2anagement of
an(iety disorders, for short-
term relief of an(iety
symptoms, to allay an(iety
and tension prior to surgery,
+ardioversion and
endos+opi+ pro+edures, as
an amnesi+, and treatment
for restless legs# 3lso used
to alleviate a+ute
$ithdra$al symptoms of
al+oholism, voiding
pro&lems in older adults,
and ad4un+tively for relief
of s-eletal mus+le spasm
asso+iated $ith +ere&ral
palsy, paraplegia, athetosis,
stiff-man syndrome, tetanus#
#ody as a Whole$ 5hroat
and +hest pain# C%S$
Drowsiness, fatigue, ata(ia,
+onfusion, parado(i+ rage,
dizziness, vertigo, amnesia,
vivid dreams, heada+he,
slurred spee+h, tremor; 667
+hanges, tardive dys-inesia#
CV$ 8ypotension,
ta+hy+ardia, edema,
+ardiovas+ular +ollapse#
Special Senses$ 9lurred
vision, diplopia, nystagmus#
&I$ :erostomia, nausea,
+onstipation, hepati+
dysfun+tion# 'o(enital$
;n+ontinen+e, urinary
retention, gyne+omastia
(prolonged use), menstrual
irregularities, ovulation
failure# )espiatoy$
8i++ups, +oughing,
laryngospasm# "the$ *ain,
venous throm&osis,
phle&itis at in4e+tion site#
Injectable form: 0ho+-,
+oma, a+ute al+ohol
into(i+ation, depressed vital
signs, o&stetri+al patients,
infants <30 d of age# Tablet
form: ;nfants <= mo of age,
a+ute narro$-angle
glau+oma, untreated open-
angle glau+oma; during or
$ithin 1" d of 23>
inhi&itor therapy# 0afe use
during pregnan+y (+ategory
1) and la+tation is not
esta&lished#
Assessment & Drug Effects
2onitor for adverse rea+tions# 2ost
are dose related# *hysi+ian $ill rely on
a++urate o&servation and reports of
patient response to the drug to
determine lo$est effe+tive maintenan+e
dose#
2onitor for therapeuti+
effe+tiveness# 2a(imum effe+t may
reuire 1! $-; patient toleran+e to
therapeuti+ effe+ts may develop after "
$- of treatment#
>&serve ne+essary preventive
pre+autions for sui+idal tenden+ies that
may &e present in an(iety states
a++ompanied &y depression#
>&serve patient +losely and monitor
vital signs $hen diazepam is given
parenterally; hypotension, mus+ular
$ea-ness, ta+hy+ardia, and respiratory
depression may o++ur#
,a& tests) *eriodi+ .9. and liver
fun+tion tests during prolonged therapy#
0upervise am&ulation# 3dverse
rea+tions su+h as dro$siness and ata(ia
are more li-ely to o++ur in older adults
and de&ilitated or those re+eiving larger
doses# 1osage ad4ustment may &e
ne+essary#
2onitor ;?> ratio, in+luding
urinary and &o$el elimination#
6ri+ 6vangelista
1rug name 1osage admin 3+tion ;ndi+ations .ont 3dverse effe+ts /ursing responsi&ility
$odium
%icarbonate
%rand Name#
9a-in 0oda,
9ell-3ns,
.itro+ar&onate,
/eut, 0oda
2int
Classification#
antiul+er
agents,
al-alinizing
agent
;ntravenous
or ta-en orally
Action
0odium 9i+ar&onate
a+ts as an al-alinizing
agent &y releasing
&i+ar&onate ions#
@ollo$ing oral
administration of this
medi+ation, it releases
&i+ar&onate $hi+h is
+apa&le of neutralizing
gastri+ a+id#
Indications
1# 2anagement
of meta&oli+
a+idosis
!# Ased to
al-alinize
urine and
promote
e(+retion of
+ertain drugs
in over
dosage
situations
3# Ased as an
anta+id
Contraindication
1# 2eta&oli+ or
respiratory
al-alosis
!# 8ypo+al+emia
3# 6(+essive +hloride
loss
"# ;t is not
re+ommended as
an antidote
follo$ing ingestion
of strong mineral
a+ids
5# *atients on sodium
restri+ted diet
=# Benal failure
C# 0evere a&dominal
pain of un-no$n
+ause espe+ially if
asso+iated $ith
fever
&sed cautiously in patients
'it(#
1# .ongenital heart
failure
!# .on+urrent
+orti+osteroid
therapy
3# .hildren $ith
dia&eti+
-etoa+idosis
&e+ause ta-ing
sodium &i+ar&onate
may in+rease the
ris- of +ere&ral
edema
"# .hronis use as an
anta+id &e+ause it
1# 6dema
!# @latulen+e
3# 7astri+
distention
"# 2eta&oli+
al-alosis
5# 8ypernatremia
=# 8ypo+al+emia
C# 8ypo-alemia
D# 0odium and
$ater retention
E# ;rritation at ;F
site
10# 5etany
1# 3ssess the +lientGs fluid &alan+e
throughout the therapy# 5his
assessment in+ludes inta-e and
output, daily $eight, edema and
lung sounds#
!# 0ymptoms of fluid overload
should &e reported su+h as
hypertension, edema, diffi+ulty
&reathing or dyspnea, rales or
+ra+-les and frothy sputum#
3# 0igs of a+idosis should &e
assessed su+h as disorientation,
heada+he, $ea-ness, dyspnea
and hyperventilation#
"# 3ssess for al-alosis &y
monitoring the +lient for
+onfusion, irrita&ility,
paresthesia, tetany and altered
&reathing pattern#
5# 8ypernatremia +lini+al
manifestations should &e
assessed and monitored $hi+h
in+ludes) edema, $eight gain,
hypertension, ta+hy+ardia,
fever, flushed s-in and mental
irrita&ility#
=# 8ypo-alemia should also &e
assessed &y monitoring signs
and symptoms su+h as)
$ea-ness, fatigue, A $ave on
6.7, arrhythmias, polyuria and
polydipsia#
C# ;F sites should &e o&served
+losely# 6(travasation should &e
avoided as tissue irritation or
+ellulitis may o++ur $hen
ta-ing sodium &i+ar&onate#
D# ;f infiltration o++urs, the
may result to
meta&oli+ al-alosis
and possi&le
sodium overload
physi+ian should &e notified
immediately# .onfer $ith the
do+tor or other health +are staff
regarding $arm +ompresses and
infiltration site $ith lido+aine or
hyaluronidase#
E# 2onitor the +lientGs serum
+al+ium, sodium, potassium,
&i+ar&onate +on+entrations,
serum osmolarity, a+id-&ase
&alan+e and renal fun+tion
&efore and throughout the
therapy#
10# 5a&lets must &e ta-en $ith a
full glass of $ater#
11# @or +lients ta-ing the
medi+ation as a treatment for
pepti+ ul+ers it may &e
administered 1 and 3 hours after
meals and at &edtime#
1rug name 1osage 3+tion .ontraindi+ation 3dverse effe+ts 1rug intera+tion /ursing
responsi&ility
)eneric Name#
+efuro(ime
%rand Name#
:orimi(
(armalogical
H A5; prevention
H C50 mg 1 ta&
9;1
;nhi&its +ell $all
synthesis
promoting osmoti+
insta&ility usually
&a+teri+ida
.ontraindi+ated in
patients
hypersensitive to
drug or other
+ephalosporin#
Ase +autiously in
patients
hypersensitive to
.F) phle&itis,
throm&ophle&itis
7;) diarrhea,
anore(ia, vomiting
8ematologi+)
hemolyti+ anemia,
throm&o+ytopenia,
transient
3minogly+osides)
2ay +ause
synergisti+ a+tivity
against some
organisms#2ay
in+rease
nephroto(i+ity#
2onitor patientGs
renal fun+tion
+losely#
H 9efore giving
dug# as- patient if
she is allegi+ to
peni+illin or
+ephalosporin#
>&tain spe+imen
for +ulture and
sensitivity tests
&efore giving first
Class#
!
nd
generation
+ephalosporin
*(erapeutic
Class#
.ephalosporin
peni+illin &e+ause
of possi&ility of
+ross-sensitivity
$ith other &eta
la+tam anti&ioti+s
neutropenia,
eosinophilia
dose# a&sorption
of oral drug is
indu+ed#