EMERGENCY DRUGS

DUQUE, JENNIFER A.
BSN402 / GROUP 5
Name of Drug

Mechanism of Action

Generic Name:
Furosemide

Furosemide, a loop
diuretic, inhibits water
reabsorption in the
nephron by blocking the
sodium-potassiumchloride cotransporter
(NKCC2) in the thick
ascending limb of the
loop of Henle.
It works by helping the
kidneys to remove fluid
from the body.

Brand Name:
Apo-Furosemide (C
AN),
Furosemide Special
(CAN),
Lasix
Classification:
Loop diuretic
Pregnancy Category
C
Dosage and Route:
Available forms :Tablets
20, 40, 80 mg; oral
solution10 mg/mL,
40 mg/5 mL; injection
10 mg/mL

SUBMITTED
TO:
DRUG
STUDY
PROF. JOCELYN
P. LAURO
Indication
Contraindication
Edema
LASIX is indicated in
adults and pediatric
patients
for
the
treatment of edema
associated
with congestive
heart
failure, cirrhosis of the
liver, and renal disease,
including the nephrotic
syndrome. LASIX is
particularly useful when
an
agent
with
greater diuretic potential
is desired.
Hypertension
Oral LASIX may be
used in adults for the
treatment
of hypertension alone or
in combination with
other antihypertensive a
gents. Hypertensive pati
ents who cannot be
adequately controlled
with
thiazides
will
probably also not be
adequately controlled
with LASIX alone.

Absence
of
Urine
Formation,
Low
Amount of Protein in
the Blood, Pancreatitis,
Hearing Problem, Heart
Attack, Blood Pressure
Drop Upon Standing,
Abnormally Low Blood
Pressure, Blockage of
Urinary
Bladder,
Enlarged
Prostate,
Systemic
Lupus
Erythematosus, Blood
Circulation Failure due
to
Serious
Heart
Condition,
High
Amount of Uric Acid in
the Blood, Azotemia,
Decreased
Blood
Volume, Acid Base
Imbalance of the Blood
Toward the Basic Side,
Diabetes, Gout, Low
Amount of Magnesium
in the Blood, Low
Amount of Calcium in
the Blood, Low Amount
of Sodium in the Blood,
Low
Amount
of
Potassium in the Blood,
Low
Amount
of
Chloride in the Blood

PROF. JOCELYN P. LAURO

HOMEWORK
Side Effects

low blood pressure,

dehydration
and
electrolyte depletion
(for
example,
sodium, potassium).
jaundice,
ringing in the ears
(tinnitus),
sensitivity to light
(photophobia),
rash,
pancreatitis,
nausea,
diarrhea,
abdominal pain, and
dizziness.
Increased
blood sugar and uric
acid levels

Nursing
Responsibilities
Reduce dosage if
given with other
antihypertensive;
readjust
dosage
gradually as BP
responds.
Administer
with
food or milk to
prevent GI upset.
Give early in the
day
so
that
increased urination
will not disturb
sleep.
Avoid IV use if oral
use is at all possible.
WARNING: Do not
mix
parenteral
solution with highly
acidic solutions with
pH below 3.5.
Do not expose to
light, may discolor
tablets or solution;
do
not
use
discolored drug or
solutions.
Discard
diluted
solution after 24 hr.
Refrigerate
oral
solution.
Measure and record
weight to monitor
fluid changes.

Allergies:
furosemide
diuretics

loop

Arrange to monitor
serum electrolytes,
hydration, liver and
renal function.
Arrange
for
potassium-rich diet
or
supplemental
potassium
as
needed.

DUQUE, JENNIFER A.
BSN402 / GROUP 5

PROF. JOCELYN P. LAURO

HOMEWORK
DRUG STUDY

Name of Drug

Mechanism of Action

Indication

Generic Name:
Hydrocortisone

Hydrocortisone binds to
the
cytosolic
glucocorticoid receptor.
After
binding
the
receptor the newly
formed receptor-ligand
complex
translocates
itself into the cell
nucleus, where it binds
to many glucocorticoid
response
elements
(GRE) in the promoter
region of the target
genes. The DNA bound
receptor then interacts
with basic transcription
factors, causing the
increase in expression
of specific target genes.
The anti-inflammatory
actions
of
corticosteroids
are
thought
to
involve
lipocortins,
phospholipase
A2
inhibitory
proteins
which,
through
inhibition arachidonic
acid,
control
the
biosynthesis
of

For the relief of the

inflammatory
and
pruritic manifestations
of
corticosteroidresponsive dermatoses.
Also used to treat
endocrine (hormonal)
disorders
(adrenal
insufficiency, Addisons
disease). It is also used
to treat many immune
and allergic disorders,
such as arthritis, lupus,
severe psoriasis, severe
asthma,
ulcerative
colitis, and Crohn's
disease.

Brand Name:
Cortef, Solu-Cortef, Cor
tenema, Cortifoam
Classification:
Glucocorticoids
Dosage and Route:
Usual Adult Dose for
Adrenocortical
Insufficiency
Acute Adrenal Gland
Failure:
100 mg IV bolus, then
300 mg/day in divided
doses every 8 hours or
as a continuous infusion
for 48 hours. When
patient stable, change to
oral, 50 mg every 8
hours for 6 doses, then
taper to 30 - 50 mg/day.

Contraindication
Topical corticos
teroids
are
contraindicated
in
those patients with a
history
of
hypersensitivity
to
any
of
the
components of the
preparation.

Side Effects

Nursing
Responsibilities

Hives;
difficulty
breathing; swelling of Assessment & Drug
your face, lips, tongue, Effects
or throat.
Establish baseline
Stop
using
and continuing data
hydrocortisone topical
on BP, weight, fluid
and call your doctor at
and
electrolyte
once if you have any of
balance, and blood
these
serious
side
glucose.
effects:
Lab tests: Periodic

blurred vision,
serum electrolytes
or seeing halos around
blood glucose, Hct
lights;
and Hgb, platelet
count, and WBC

uneven
with differential.
heartbeats;

sleep problems
(insomnia);

weight
gain,
puffiness in your face;
or

feeling tired.
Less serious side effects
may include:

skin
redness,
burning, itching, or

Monitor for adverse

effects. Older adults
and patients with
low serum albumin
are
especially
susceptible
to
adverse effects.

Be alert to signs of
hypocalcemia (see

Usual Adult Dose for

Anti-inflammatory
Oral, Intramuscular or
Intravenous: 15 to 240
mg/day.
Usual Adult Dose for
Shock
200 mg per day by
continuous intravenous
infusion

prostaglandins
and
leukotrienes.
Specifically
glucocorticoids induce
lipocortin-1 (annexin-1)
synthesis, which then
binds to cell membranes
preventing
the
phospholipase A2 from
coming into contact
with
its
substrate
arachidonic acid. This
leads to diminished
eicosanoid production.
The
cyclooxygenase
(both COX-1 and COX2) expression is also
suppressed, potentiating
the effect. In other
words, the two main
products
in
inflammation
Prostaglandins
and
Leukotrienes
are
inhibited by the action
of
Glucocorticoids.
Glucocorticoids
also
stimulate the lipocortin1 escaping to the
extracellular
space,
where it binds to the
leukocyte
membrane
receptors and inhibits
various
inflammatory
events:
epithelial
adhesion,
emigration,
chemotaxis,
phagocytosis,
respiratory burst and the

peeling;

Appendix F).

thinning of your
skin;

blistering skin;

Ophthalmoscopic
examinations
are
recommended every
23 mo, especially
if
patient
is
receiving
ophthalmic steroid
therapy.

Monitor
for
persistent backache
or
chest
pain;
compression
and
spontaneous
fractures of long
bones and vertebrae
present hazards.

Monitor for and

report changes in
mood and behavior,
emotional
instability,
or
psychomotor
activity, especially
with
long-term
therapy.

Be
alert
to
possibility
of
masked
infection
and delayed healing
(antiinflammatory
and
immunosuppressive

or

stretch marks.

release
of
various
inflammatory mediators
(lysosomal
enzymes,
cytokines,
tissue
plasminogen activator,
chemokines etc.) from
neutrophils,
macrophages
and
mastocytes.
Additionally
the
immune
system
is
suppressed
by
corticosteroids due to a
decrease in the function
of the lymphatic system,
a
reduction
in
immunoglobulin
and
complement
concentrations,
the
precipitation
of
lymphocytopenia, and
interference
with
antigen-antibody
binding.

actions).

Note:
Dose
adjustment may be
required if patient is
subjected to severe
stress
(serious
infection, surgery,
or injury).

Note: Single doses

of corticosteroids or
use for a short
period (<1 wk) do
not
produce
withdrawal
symptoms
when
discontinued, even
with
moderately
large doses.

Patient
&
Education

Family

Expect a slight
weight
gain
with improved
appetite. After
dosage
is
stabilized,
notify physician
of a sudden
slow but steady
weight increase
[2 kg (5 lb)/wk].

Avoid alcohol
and
caffeine;

may contribute
to steroid-ulcer
development in
long-term
therapy.

Do not ignore
dyspepsia with
hyperacidity.
Report
symptoms
to
physician and
do NOT selfmedicate to find
relief.

Do NOT use
aspirin or other
OTC
drugs
unless
prescribed
specifically by
the physician.

Note: A high
protein,
calcium,
and
vitamin D diet
is advisable to
reduce risk of
corticosteroidinduced
osteoporosis.

Notify
physician
of
slow
healing,
any
vague

feeling of being
sick, or return to
pretreatment
symptoms.

Do not abruptly
discontinue
drug; doses are
gradually
reduced
to
prevent
withdrawal
symptoms.

Report
exacerbation of
disease during
drug
withdrawal.

Carry medical
identification at
all times. It
needs
to
indicate medical
diagnosis, drug
therapy,
and
name
of
physician.

Apply topical
preparations
sparingly
in
small children.
The hazard of
systemic
toxicity
is
higher because

of the greater
ratio of skin
surface area to
body weight.

Check shelf-life
date on topical
corticosterone
during
longterm use.

Do not breast
feed
while
taking/using this
drug
without
consulting
physician.