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C.

DRUG STUDY
DRUG STUDY
Age: 57 yrs.old
Sex: Male
Date of
Admission:
November 21,
2013
Indication
Contraindication

Patient’s Name: Mr. NC
Diagnosis: Chronic Renal Failure secondary to DM Nephropathy
Doctor: Dr. Augustine Aguhob

Drug Data
Generic
Name:
Isosorbide
Mononitrate

Classificat
ion
Pharmacol
ogic Class:
Nitrates

Trade Name:
IMDUr,
Monoket

Therapeut
ic Class:
antianginal
s

Patient’s
Dose:
20mg tab OD
@ 8AM

Pregnancy
Risk
Category:
C

Maximum
Dose:
60 mg OD
Minimum
Dose:
5mg BID
Availability:
Tablets (ISMO,
Monoket): 10
mg, 20 mg.
Extendedrelease tablets
(Imdur): 30
mg, 60 mg,
120 mg.
Route:
PO

Mechanism of
Action
Produce
vasodilation
(venous greater
than arterial).
Decrease left
ventricular end–
diastolic pressure
and left ventricular
end–diastolic
volume (preload).
Net effect is
reduced myocardial
oxygen
consumption.
Increase coronary
blood flow by
dilating coronary
arteries and
improving collateral
flow to ischemic
regions.
Absorption:has
100% bioavailability
(does not un- dergo
first-pass
metabolism).
Distribution:Unkno
wn.
Metabolism &
Excretion:
primarily
meteabolized by the
liver to inactive
metabolites;
primarily excreted
in urine as

General:
Acute treatment of
anginal attacks (SL
only). Prophylactic
management of
angina pectoris.
Treatment of
chronic CHF
(unlabeled).
Patient’s
Indication:
Prophylaxis for
heart attack.

Contraindicated to:
Hypersensitivity;
Concur- rent use of
sildenafil, vardenafil
or tadalafil.
Precaution:
Volume
depleted
patients;
Right
ventricular infarction;
Hypertrophic
cardiomyopathy;
Geri:
Older patients may
be more sensitive to
hypotension
(start
with lower doses);
OB: Pregnancy (may
compromise
maternal/fetal
circulation)
or
lactation; Pedi: Children
(safety
not
established).
Interactions
Drug-drug
Concurrent use of
sildenafil, ta- dalafil,
or vardenafil may
result in significant
and potentially fatal
hypotension (do not
use
these
drugs
within
24
hr
of
isosorbidedinitrate or
mononitrate).
Additive hypotension
with
antihypertensives,
acute ingestion of

Height: 5’2ft.
Weight: 50kg.
Body Build: Asthenic

Adverse
Effect/Reaction
CNS: dizziness,
headache.
CV: hypotension,
tachycardia,
paradoxicbradyca
rdia, syncope.
GI: nausea,
vomiting.
Misc: flushing,
tolerance.

Nursing Responsibilities
Before:
 Verify patient’s identity
 Assess for allergy
 Assess level of consciousness
 Make sure that the dose is right for
the patient
 Refer if patient refuses to take the
medication.
 Assess location, duration, intensity,
and pre- cipitating factors of
anginal pain.
 Monitor blood pressure and pulse
routinely during period of dosage
adjustment.
During:
 Administer initial dose at bedtime to
minimize adverse reactions.
 Avoid eating, drinking, or smoking
until tablet is dissolved. Replace
tablet if inadvertently swallowed.
 PO: Extended-release tablets should
be swallowed whole. Do not crush,
break, or chew.
 Caution patient to make position
changes slowly to minimize
orthostatic hypotension.
After:
 Document after administration.
 Instruct patient to take medication
as directed, even if feeling better.
Take missed doses as soon as
remembered. Caution not to stop
abruptly.
 Caution against double dosing.
 Avoid hazardous activities until
drug’s CNS effects are known

2013 Contraindicatio Adverse n Effect/Reac tion Body Build: Asthenic Hypersensitivity. After: Inform pt of what to expect on adverse effects that may occur to modify activities and be guided. 65 Date of Admission: November 21. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr. Advise pt. calcium channel blockers. and renal function periodically . 500mg Injection: vials Therapeutic: Antipyretics. leukopenia.old Sex: Male Height: 5’2ft. and malaise. For fever. note presence of associated signs ( diaphoresis. to avoid taking more than one acetaminophen containing product at a time to prevent toxicity Precaution . During: Check IV patency Use aseptic technique in administering the drug to avoid introduction of microorganisms. tylenol Patient’s Dosage: 300mg IVTT q4 PRN Maximum Dose: Don’t exceed 2. renal disease. to take the medication exactly as directed and not to take more than the recommended dose. hepatotoxicit  y  Derm: rash. malnutrition Interactions: Drug-Drug Barbiturates.Life: 5hr Patient’s Name: Mr. pancytopenia Hepatic: Jaundice  GI: liver failure. Advise pt. carbamazepine. sulfinpyrazone: high doe or long term use of these drugs may their therapeutic ffects and enhance hepatotoxic effects Hematologic: Hemolytitopc anemia. alcohol. especially OTCs. Assess amount.  neutropenia. non-opioid analgesics Pregnancy Risk Category: B Absorption 75% absorbed after oral administration Distribution Crosses the placenta. Weight: 50kg.or tartrazine should be avoided in patients who have hypersensitivity pr intolerance to these compounds Before: Assess type .enter s the breastmilk in low concentrations Metabolism Mostly metabolized by the liver Excretion Metabolites excreted by Mild pain and Fever Patient’s indication: Relief for fever DRUG STUDY Age: 57 yrs.metabolites. rifampin. Advise pt. aspartate. Augustine Aguhob Drug Data Classification Mechanism of Action Indication Generic Name: Acetaminophen Pharmacologi c Class: Paraaminophenol derivative Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever primarily in the CNS. Assess overall status and alcohol usage before administering to avoid risk of developing hepatotoxicity. May be administered without regard to meals since GI integrity is maintained. 500 mg Capsules: 325 mg. Keep a dose of acetylcysteine readily available at time when overdose occurs. Drug Half.Use cautiouslyin hepatic disease. location and intensity of pain prior to and 3060 minutes following administration. General Indication: Trade Name: tempra. hematologic.  urticaria      Nursing Responsibilities . and phenothiazines. assess fever. sugar. and type of drug the patient was self.6 g daily Minimum Dose: 325-650 mg PO q4 to 6 hrs Availability: Caplets: 160 mg. products containing alcohol. saccharin. chronic alcohol abuse. frequency. to avoid alcohol if taking more than an occasional 1-2 doses and to avoid taking concurrently with salicylates or NSAIDs for more than a few days. tachycardia.medicating. Evaluate hepatic. beta blockers.

bruising.  DRUG STUDY Age: 57 yrs. Height: 5’2ft. fever. Weight: 50kg. 66 Body Build: Asthenic Adverse Effect/Reaction Nursing Responsibilities .the kidneys Route of Administratio n IV Patient’s Name: Mr. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr. malaise. Avoid using together.old Sex: Male Date of Admission: November 21. Augustine Aguhob Drug Data Classification Mechanism of Action of acetaminophen. 2013 Indication Contraindicatio n Teach pt to recognize signs of chronic overdose: bleeding. sore throat.

nervousness. drowsiness. fatigue.  confusion. kidneys and peripheral vasculature thus lowering blood pressure and decreases neurogenic pain.Generic Name: Clonidine Trade Name: Catapres Therapeutic: Antihypertensive Pharmacologic: Centrally Acting Sympatholytic Patient’s Dose: 75mcg BID Minimum Dose: 0. UTI Metabolic: transient glucose intolerance SKIN: pruritus.15mg PO Maximum Dose 1. somnolence  CV: bradycardia. Hepatic Impairment Adjunctive therapy for nicotine Diabetic Diarrhea Dysmenorrhea  Patient’s Actual Indication: Treatment for  hypertension  Interaction: Drug-Drug: Beta blockers – may cause severe rebound hypertension CNS depressants – enhances CNS depression MAO Inhibitors – Decrease Antihypersensit ive effects CNS: anxiety. CVD.’s order Prepare drug aseptically Assess for any allergic reaction to drug  Prepare right dosage GI: constipation. nausea.  Explain rationale on giving drug impotence.malignant hypertension Contraindicate d in: Hypersensitivity and to those patients receiving anticoagulation therapy Sever pain Prophylaxis for Vascular headache Precaution: Severe coronary insufficiency. 20% in feces Time Reaction Profile Onset: 15-30mins Peak: 1.5 hours Duration: 6-8 hours General Indication: Essential. dry mouth.  Urge pt to rise slowly & avoid sudden position changes DRUG STUDY 67 . renal.5-2.2mg PO Contents: not known Availability: Injectable Tablets Transdermal Route/s for Administratio n: PO Transdermal Pregnancy Category Risk: C Pharmacodynamics : May inhibit central vasomotor centers decreasing sympathetic outflow to heart. During: vomiting  Verify identity GU: urine retention.  sedation.  headache. orthostatic hypertension Before: Assess blood pressure Verify Dr. dizziness. that drug can cause drowsiness  Monitor blood pressure of client carefully. dermatitis  Drug may be given rapidly in emergency situations  Administer drug aseptically  Advise not to stop drug abruptly After:  Document drug administration. hypotension.  Advise client to report to healthcare facility for complications. recent MI. Half-Life: 6-20 hours  Caution pt. Pharmacokinetics Absorption: Good Distribution: Nearly 50% is transform to inactive metabolites Metabolism & Excretion: 65% in urine.

Geriatric patients Diabetes mellitus. During: Administer around the clock. avoid in patients with alcohol intolerance. Pharmacolo gic: loop diuretics Pregnancy Category Risk: C Therapeutic Effects: Diuresis and subsequent mobilization of excess fluid. some nonhepatic metabolism. headache. enters breast milk. 80mg Oral solution: 8mg/ml. Body Build: Asthenic Adverse Effect/Reac tion CNS: blurred vision. hyperuricem ia  F&E: dehydration. IV Classificatio n Mechanism of Action Therapeutic: diuretics Pharmacodynamics: Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Assess client for electrolyte status. rash Endo: hyperglycem ia.old Sex: Male Date of Admission: November 21. Height: 5’2ft. Children. potassium. 10mg/ml Solution for injection: 10mg/ml Route/s for Administratio n: PO. Do not give drug if patient has low blood pressure.   Half-Life: Contraindicated in: Hypersensitivity. Advise client to report to healthcare facility for complications. May cause lithium toxicity.  pruritus. metabolic alkalosis Nursing Responsibilities Before: Assess client for history of hypersensitivity of drug components. hypomagnes emia. diarrhea. some renal excretion as unchanged drug.  hypovolemia . tinnitus  CV: hypotension GI: anorexia. 30 min 2 hr. vertigo  EENT: hearing loss. magnesium. Check for input and output of client. Durati on 6-8 hr. After: Document drug administration. Some liquid products may contain alcohol. Decreases blood pressure. also absorbed from IM sites. Hepatic come and anuria. sodium. Pharmacokinetics Absorption: 60-67% absorbed after oral administration. nitrates or acute ingestion of alcohol Increses risk of hypokalemia with other diuretics. Promote bed rest for client. Explain to patient the use and side effects of the drug. unkno wn 4-8 hr. constipation. dyspepsia  GU: excessive urination Derm:  photosensiti vity.  Time Reaction Profile Rout e PO IM IV Ons et 3060mi n 1030 min 5min Peak 1-2 hr. Increases renal excretion of water. Hypertension. and calcium. hypochlore  mia. dizziness. 68 . Interaction: Drug-Drug: Increased hypotension with antihypertension. Patient’s Actual Indication: Edema and hypertension prevention due to renal failure. Increasing azotemia. Effectiveness persists in impaired renal function. amphotericin B. 2013 Indication Contraindication General Indication: Edema due to heart failure. IM. Age: 57 yrs. Pregnancy and lactation. 40mg. Distribution: Crosses the placenta. 20mg. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr. Augustine Aguhob Drug Data Generic Name: Furosemide Trade Name: Lasix. Electrolyte depression. dry mouth. stimulant laxatives and digoxin and increase risk or arrhythmias. Weight: 50kg. Cross sensitivity with thiazides and sulfonamides may occur. Assess client for alcohol intolerance.Patient’s Name: Mr. hyponatremi a. hepatic impairment or renal disease. Metabolism & Excretion: Minimally metabolized by the liver. Precaution: Severe live disease. Observe proper route of administration. hypokalemia . Novosemide Patient’s Dose: 40mg IVTT every 12 hours Minimum Dose: 20mg IVTT STAT Maximum Dose: 40mg IVTT STAT Contents: not known Availability: Tablets. Check patient for signs for anaphylactic reactions. chloride.

 Avoid clopidogrel in patients who . as CV: Chest pain. edema. administration. hypotension. Weight: 50kg. Augustine Aguhob Drug Data Generic Name: Clopidogrel Trade Name: Plavix Classificatio n Therapeutic: Platelet Aggregation Inhibitor Pharmacolo Mechanism of Action Pharmacodyna mics: Binds to adenosine diphosphate receptors on the DRUG STUDY Age: 57 yrs. Height: 5’2ft. headache  Obtain blood cell count. Before: dizziness. hypertension.  Monitor blood pressure of client carefully. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr. stroke and MI including peptic  Monitor renal function of client by input and output.old Sex: Male Date of Admission: November 21. depression. hallucinations. 2013 Indication Contraindicatio n General Contraindicate Indication: d in: To reduce Active atherosclerotic pathological events such as bleeding.30-60 min. Body Build: Asthenic Adverse Effect/Reaction Nursing Responsibilities CNS: Confusion. ordered before hypercholesterolemia.  Monitor for recurrent symptoms of anemia and advise to client to rest. Hemat: aplastic anemia Patient’s Name: Mr. fatigue.

Verify doctor’s order Assess for any allergies of drug Assess over-all condition During: Verify Pt’s identity Explain rationale on giving drug Clean site of administration Administer drug aseptically Note that clopidogrel prolongs bleeding time After: Inform of the possible side effects of drug Monitor for signs of bleeding Caution that bleeding may continue longer than usual. Without fibrinogen. This action blocks ADP. angioedema. noninfectious hepatitis. interference with warfarin metabolism vasculitis EENT: Altered taste. StevensJohnson syndrome. rhinitis. elevated liver function test results. bronchospasm. serum sickness have a genetic variation or receiving CYP2c19 inhibitors. dyspnea. back pain. diarrhea. Availability: Tablets Pharmacokineti cs Route/s for Administrati on: PO Route: PO Onset: 2hr Peak: 3-7 days Duration: 5 days To reduce rate of death.  gastric. conjunctival. upper respiratory tract infection SKIN: Erythema multiforme. Instruct to report unusual bleeding or bruising. or peptic ulcer. nausea. colitis. prolonged bleeding time. thrombotic thrombocytopenic purpura. hypersensitivity to drug and its components Patient’s Actual Indication: To prevent clot formation Interaction: Drug-Drug: Aspirin – Increased risk of bleeding NSAIDS: increased risk of GI bleeding. interference with NSAID metabolisim Warfarin: Prolonged bleeding time. platelets cant aggregate and form thrombi. purpura. pruritus. pancytopenia. pancreatitis GU: Elevated serum creatinine level. glomerulopathy. or retinal bleeding. indigestion. gastritis. unusual bleeding or bruising MS: Arthralgia. interstitial pneumonitis.Patient’s Dose: 75mg pc lunch gic: Thienopyridin e derivative Minimum Dose: 75mg Pregnancy Category Risk: Maximum Dose 300mg (loading dose) B surface of activated platelets. duodenal. aplastic anemia. neutropenia. epistaxis.  taste disorders GI: Abdominal pain. ocular. UTI HEME: Agranulocytosis. cough. toxic epidermal necrolysis Other: Anaphylaxis. thrombocytopenic purpura. myalgia RESP: Bronchitis. flulike symptoms. reinfarction or stroke ulcer and intracranial hemorrhage. which deactivates nearby glycoprotein IIB/IIIA receptors and prevents fibrinogen from attaching to receptors. acute liver  failure. rash. Monitor condition Evaluate knowledge of drug 69 DRUG STUDY . lichen planus.

 Explain rationale on giving medication  Verify patient’s identity  Caution patient that this medication may increase sensitivity to cold. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr. Cardiogenic shock. nightmares EENT: blurred vision. mental depression. hypoglycemia MS: arthralgia. Augustine Aguhob Drug Data Generic Name: Metropolol Trade Name: Inderal Classification Therapeutic: Antianginals. if < 50 bpm or if arrhythmia occurs. After:  Advised patient to change position slowly to minimize orthostatic hypotension  Advise patient to notify health care professional if slow pulse. potassium. at the same time each day. muscle cramps Nursing Responsibilities Before:  Check lab test for blood levels of BUN. nausea GU: erectile dysfunction. pheochromocytoma. decreased libido Derm: itching. Additive bradycardia may occur with digoxin.Patient’s Name: Mr. IV phenytoin and verapamil may cause additive myocardial depression. nervousness. bradycardia.  Caution patient to avoid activities that require alertness  Inform patient that abrupt withdrawal can cause life- .pregnant women. enters breast milk. unusual bleeding occurs. dry eyes. alcohol or nitrates. peripheral vasoconstriction GI: constipation.old Sex: Male Date of Admission: November 21. Time Reaction Profile Onset: PO: 30 mins IV: immediate Peak: PO: 60 – 90 mins IV: 1 min Duration: PO: 6-12 hr IV: 4-6 hr Half-Life: 3.  Check Blood Glucose level  Assess patient’s over-all condition. mental status changes. dizziness. geriatric clients.  Take baseline vital sign  Take apical pulse. antiarrhythmic s. and the prevention of vascular headaches Patient’s Actual Indication: Management of hypertension Contraindication: Uncompensated CHF. anxiety. thyrotoxicosis. arrhythmias. weakness. Height: 5’2ft. triglyceride and uric acid levels. Drug Interaction: General anesthesia. essentials tremors. serum lipoprotein. lactating women. Bradycardia or heart block Precaution: Renal or hepatic impairment. Metabolism & Excretion: Almost completely metabolized by the liver. rashes Endo: hyperglycemia. diarrhea. Body Build: Asthenic Adverse Effect/Reaction CNS: fatigue. pulmonary disease. nasal stuffiness Resp: bronchospasm. During:  Instruct patient to take medication as directed. 2013 Indication Contraindication General Indication: Management of hypertension. vascular headache suppressants Patient’s Dose: 50mg OD Minimum Dose: 80 mg / daily Pharmacologi c: Beta blockers Maximum Dose: 240 mg / daily Availability : Oral Solution Tablets Sustainedrelease capsules Extendedrelease capsules Injection Route/s for Administra tion: PO IV Pregnancy Category: C Mechanism of Action Blocks stimulation of beta and adrenergic receptor sites thus decreasing heart rate and blood pressure.  Reinforce the need to continue additional therapies for hypertension. angina.  Evaluate patient’s knowledge of drug. withhold medication and notify physician. Prevention and management of MI. diabetes mellitus. crosses placenta.4 – 6 hr Age: 57 yrs. wheezing CV: arrhythmias. drowsiness. Distribution: Moderate CNS penetration. thyrotoxicosis. hypertrophic cardiomyopathy. CHF. Additive hypotension may occure with other hypertensives. insomnia. Pulmonary Edema. dizziness. memory loss. antihypertensiv e. Pharmacokinetics Absorption: Well absorbed but undergoes extensive first-pass hepatic metabolism. pulmonary edema. orthostatic hypotension. backpain. Weight: 50kg.

lactation o children. Precaution: Liver disease. Healing of duodenal ulcers. triazolam. flurazepam. flatulence. Body Build: Asthenic Adverse Effect/Rea ction CNS:  dizziness. fatigue.old Sex: Male Date of Admission: November 21. Weight: 50kg.  nausea and vomiting  Derm: itching.  weakness CV: chest  pain GI: abdominal pain. Zegerid Patient’s Dose: A: 4g IVTT q 24 B: 40mg PO OD Pharmacolo gic: proton-pump inhibitors Minimum Dose: 20mg PO OD Maximum Dose: 120mg 3x daily Pregnancy Category Risk: C Contents: not known Availability: Delayed-release capsules: 10mg. Administer doses before meals early in the morning Check patient for signs for anaphylactic reactions. headache. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr. Patient’s Name: Mr.disulfer am. Metabolic alkalosis and hypocalcemia. Duodenal ulcers. 40mg Immediatepowder for oral suspension: 20mg packet. Interaction: Drug-Drug: Decreases metabolism of antifungal agents. Pathologic hypersecretory conditions. Assess client for electrolyte status. Bartter’s syndrome. Therapeutic Effects: Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux. Time Reaction Profile DRUG STUDY Age: 57 yrs. atazanavir. digoxin. diarrhea. Pregnancy. Distribution: Good distribution into gastric parietal cells. Observe proper route of administration. constipatio n. Mechanism of Action Pharmacodynamics: Binds to enzyme on gastric parietal cells in the presence of acidic gastric pH. Metabolism & Excretion: Extensively metabolized by the liver. Reduction of risk of GI bleeding in  critically ill patients. including Zollinger-Ellison syndrome. Assess client metabolic alkalosis. Geriatric patients. immediate-release formulation contains bicarbonate to prevent acid degradation. 2013 Indication Contraindicatio n General Indication: GERD/ maintenance of healing in erosive esophagitis. acid  regurgitatio  n. During: Administer around the clock. diazepam. Short-term treatment of active benign gastric ulcer. After: 70 . 20mg. rash  Misc: allergic  reactions  Nursing Responsibilities Before: Assess client for history of hypersensitivity of drug components. Explain to patient the use and side effects of the drug.threatening conditions. preventing the final transport oh hydrogen ions into the gastric lumen. Check clients vital signs prior to administration. Assess client for abdominal pain. Patient’s Actual Indication: Prevention of gastric ulcers in NPO status Contraindicated in: Hypersensitivity. hypokalemia and respiratory alkalosis. Augustine Aguhob Drug Data Classificati on Generic Name: Omeprazole Therapeuti c: antiulcer agents Trade Name: Losec. cyclosporine. Absorption: Rapidly absorbed following oral administration. phenytoin and Height: 5’2ft.

NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr.old Sex: Male Patient’s Actual Indication: Prevention of further liver damage Document drug administration. and that the post-absorptive kinetics seems to be distributed very early in the development of the disease.  Duration of Use: Ketolog tablets are given as long as the GFR is between 5 and about 15 mL/min. swallowed whole. food should contain ≤40 g/day of protein ie.. Classification Generic Name: Ketoanalogues+ essential amino acids Therapeutic: Supplements Trade Name: Ketolog -Amino Acid Solution Patient’s Dose: 60g PO Pregnancy Category Risk: Minimum Dose: Adults (70kg/body weight): 4 tablets 3 times daily during meals Maximum Dose: Adults (70kg/body Pharmacologic : B  My increase risk of bleeding with warfarin. In case of hereditary phenylketonuria.  Take supplements regularly as prescribed. . 24 hr.  Advise client to report to healthcare facility for complications. on 72-96 hr. Body Build: Asthenic Adverse Effect/React ion Nursing Responsibilities 71  Administration: Hypercalcemi  For oral use. generally in patients with glomerular filtration rate (GFR) between 5 and about 15 mL/min. Precaution: Ketolog should be taken during meals to allow proper absorption and metabolism into the corresponding amino acids. 2013 Indication Contraindicatio n General Indication: Prevention and therapy of damages due to faulty or deficient protein metabolism in chronic renal insufficiency in connection with limited protein food of ≤40 g/day (for adults). Date of Admission: November 21.  Contraindicated in: Hypercalcemia. Mechanism of Action Pharmacodynamics: Pharmacokinetics: The plasma kinetics of amino acids and their integration in metabolic pathways are well established.  Store at temperatures not exceeding 30°C. there is an increase in the plasma level of ketoanalogues. Keep in a cool and dry place. Peak levels are reached within 20-60 min and normal levels are reached again DRUG STUDY Age: 57 yrs. 10 min after oral ingestion.  Monitor vital signs of client carefully. disturbed amino acid metabolism. in uremic patients. These levels reach values that are approximately 5 times higher than the initial level.40mg packet Route/s for Administration : PO Rou te PODR Ons et w/in 1hr.  Inform client on next administration of drug. It should nevertheless be noted that. 30 min . should be develop. Patient’s Name: Mr.  Advise client to limit ambulation and moving on bed. POIR rapi d Pe ak w/i n 2hr. Duratiand underlying condition. the plasma disturbances do not seem to depend on digested amino acid intake.  Simultaneously for adults. Height: 5’2ft. it has to be taken into account that Ketolog contains phenylalanine. The serum calcium levels should be monitored regularly.  Inform health care professional if toxicity occurs. Tablets may be taken a may during meals. In normal individuals. Augustine Aguhob Drug Data warfarin. Weight: 50kg.

Pregnancy Category Risk: C Pharmacokinetics Absorption: Rapidly absorbed Distribution: Widely distributed into extracellular fluid Metabolism & Excretion: Metabolized in the Shelf-Life: 24 months. Hypocalcemia. Gastrointestinal absorption is thus very rapid. DRUG STUDY Age: 57 yrs. Weight: 50kg. it is probable that exogenous intakes are very rapidly integrated into metabolic cycles. acetolyte) may lead to pathological increases of the serum calcium level or intensification. Interaction: Drug-Drug: Simultaneous administration of medicaments containing calcium (eg. and excessive chloride loss Alkalinize urine and promote excretion Antacid Precaution: Use cautiously in CHF. corticosteroids therapy Patient’s Actual Indication: Alkalinize urine and promote excretion  Interaction: Drug-Drug: May decrease absoption of ketoconazole Body Build: Asthenic Adverse Nursing Effect/Reactio Responsibilities 72 n Before: CV: edem  Assess fluid balance all throughout the therapy GI: Flatulence. Contents: Ketoanalogues and essential amino acids Availability: Tablets Route/s for Administratio n: PO Patient’s Name: Mr. In the plasma a simultaneous increase in levels of the ketoanalogue and the corresponding amino acid show that transamination of the ketoanalogues are very rapid. hypokalemia.old Sex: Male Height: 5’2ft. hypernatremia.  sodium and water retention  Neuro: Tetany Observe proper dosage of medication Monitor serum electrolyte Assess urine PH During: Verify Pt’s identity Medication may cause premature dissolution of . Gastric  Assess for signs of distention acidosis F&E: metabolic  alkalosis. Date of Admission: November 21. Augustine Aguhob Drug Data Classification Mechanism of Action Generic Name: Sodium Bicarbonate Trade Name: Bell-ans Therapeutic: Anti ulcer Pharmacologic: Alkalanizing agent Patient’s Dose: 1 tab TID PO Minimum Dose: 12 meQ Maximum Dose 48 meQ Availability: Oral powder Tablets Solution for Pharmacodynami cs: Acts as an alkalinizing agent by releasing bicarbonate ions which is capable of neutralizing gastric acid. Due to natural pathways of disposal of αketonic acids in the organism. hypocalcemia. 2013 Indication Contraindicatio n General Indication: Management of metabolic acidosis Contraindicated in: Metabolic and respiratory alkalosis. renal insufficiency.weight): 8tablets 3 times daily during meals after 90 min. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr.

Excreted in the kidneys in the form of urine enteric-coated tablets May negate the protectiveness effects of enteric-coated products Explain rationale on giving drug Administer with full glass of water Keep emergency treatment in case of toxicity occurs  After: Instruct to take meds as directed  Inform of the possible side effects of drug  Review symptoms of electrolyte imbalance  Monitor serum electrolyte level  Evaluate knowledge of drug 73 DRUG STUDY .injection Route/s for Administration: PO  liver.

erythro heart failure. dizziness. chloramphenicol fluid retention. especially one metoclopramide effects HEME: with heart failure or cirrhosis. Give drug over 1 to 2 e. 2013 Contraindication Adverse Nursing Responsibilities Effect/Reaction Contraindicated in: CNS: Agitation.  Verify doctor’s order Precaution: irritability. sodium. supraventricular minutes. hypersensitivity to dyskinesia). and CNS components. Agranulocytosis for possible fluid retention or SKIN: Rash volume overload due to transient increase in plasma aldosterone level. Don’t administer lassitude.V. methotrexate. Augustine Aguhob Drug Data Generic Name: Metocloprami de Trade Name: Reglan Patient’s Dose: 10g IVTT q8 Classificati on Therapeuti c: Antiemetic Upper GI stimulant Pharmacol ogic: Benzamide Minimum Dose: 10mg Pregnancy Category Risk: Maximum Dose 2mg/kg B Availability: Oral solution Tablets Injectables Route/s for Administrati on: PO IM IV Mechanism of Action Pharmacodynamics: Antagonizes the inhibitory effect of dopamine on GI smooth muscles. such as abnormal or other drugs that may drowsiness. Excreted in the kidneys in the form of urine Rout e PO IV IM Onse t 3060 mins 1-3 mins 1015mi ns Peak Duration N/A 1-2 hr N/A 1-2 hr N/A 1-2 hr Indication General Indication: Diabetic Gastroparesis Gastroesophag eal Reflux Disease Prevention of Therapyinduced Vomiting Prevention of postoperative nausea and vomiting Patient’s Actual Indication: Prevention of therapyinduced vomiting Age: 57 yrs. 74 .  For I.  Assess patient for signs of butyrophenones. gluconate.DRUG STUDY Patient’s Name: Mr.V. doses of lactobionate.cisplatin. or sodium EENT: Dry mouth bicarbonate. diarrhea. Date of Admission: Body Build: Asthenic November 21. ENDO:  Administer drug aseptically Galactorrhea.cephalothin restlessness  Explain rationale on giving drug sodium. nausea drug analgesics: Possibly GU: Menstrual decreased irregularities Monitor patient. preventing nausea and vomiting.mechanica restlessness. Metoclopramide also blocks dopaminergic receptors in the chemoreceptor trigger zone. opioid diarrhea. nausea.old Height: 5’2ft. use. Sex: Male Weight: 50kg. headache. CV: AV block. This causes gastric contraction. Pharmacokinetics Absorption: Rapidly absorbed Distribution: Unknown Metabolism & Excretion: Metabolized in the liver. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr. tardive catecholamine levels. depressants while taking drug insomnia. bowel cause extrapyramidal sounds. in patients with hypertension l obstruction. penicillin G tachycardia  Clean site of administration potassium. panic  Verify Pt’s identity calcium reaction. obstruction. Before: Concurrent use of anxiety.furosemid hypotension. Inform of the possible side effects of Anticholinergics. GI (motor  Use metoclopramide cautiously Hemorrhage. thus reducing gastroesophageal reflux. intestinal hiazines. because it may increase perforation.  Urge patient to avoid alcohol metoclopramide or its fatigue. or parkinsonism.phenot depression. and extrapyramidal reactions vomiting. line as syndrome. Interaction: gynecomastia After: Drug-Drug: GI: Constipation. reactions. you need not dilute mycin hypertension. which promotes gastric emptying and peristalsis.  Assess for any allergies of drug metoclopramide neuroleptic through malignant During: same I. 10 mg or less.

renal calculi Interaction: Drug-Drug: Aluminumcontaining antacids: enhance aluminum absorption with use of calcium citrate Atenolol: decreased blood atenolol level and beta blockade Calcitonin: possibly antagonized Height: 5’2ft.  irregular heartbeat GI: Nausea or  vomiting SKIN: Diaphoresis. Weight: 50kg.old Sex: Male Date of Admission: November 21. Advise against activities that require alertness for about 2 hours after each dose Evaluate knowledge of drug Patient’s Name: Mr.  Give with full glass of water  Administer drug aseptically  After: Inform of the possible side effects of drug . Neutralize or buffer stomach acid to relieve discomfort caused by hyperacidity. which is needed to maintain homeostasis. injection site burning. hypersensitivity to calcium salts or their components. NC Diagnosis: Chronic Renal Failure secondary to DM Nephropathy Doctor: Dr. or sensation of  warmth Other:  Hypercalcemia. hypophosphatemia . or redness  Before: Obtain serum values Verify doctor’s order electrolyte Assess for any allergies of drug Assess over-all condition Assess for signs of hypocalcemia During: Verify Pt’s identity Explain rationale on giving drug  Instruct to take calcium carbonate tablets 1 – 2 hours after meals. Body Build: Asthenic Adverse Effect/Reaction Nursing Responsibilities CNS: Paresthesia CV: Hypotension. especially in the nervous and musculoskeletal systems. Augustine Aguhob Drug Data Generic Name: Calcium Carbonate Trade Name: Apo-Cal Patient’s Dose: 1 tab TID Minimum Dose: 2 tablets Maximum Dose 3-4 tablets Classification Mechanism of Action Therapeutic: Antacid Antihypermagnese mic. discard if discolored or contains particulate.  flushing. Antihyperphosphat emic Antihypocalcemic Calcium replacement Cardiotonic Pharmacodyna mics: Increases levels of intracellular and extracellular calcium. and Contraindicated in: Hypercalcemia. 2013 Indication Contraindication General Indication: To treat hyperphospha temia Prevention of hypocalcemia Provide antacid effects Replace calcium in hypocalcemia Patient’s Actual Indication: To bind dietary phosphorus. rash. reduce phosphorus retention.Store drug in a light-resistant container. pain. Pharmacologic: Elemental cation Pregnancy Category Risk: C Availability: Tablets Capsules Oral suspension Syrup IV injection Pharmacokinet ics Route: PO Onset: unknown Peak: unknown Duration: unknown DRUG STUDY Age: 57 yrs.

Route/s for Administrati on: PO IM IV prevent negative calcium balance. effects of calcitonin in hypercalcemia treatment Calcium / magnesiumcontaining preparations: increased serum calcium or magnesium level     Regularly monitor serum calcium level Instruct to avoid taking calcium within 2 hours of another oral drug because of risk of interactions Monitor condition Evaluate knowledge of drug 75 .