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Brand Name >Neut
Classificat ion Alkalinizing agent, Electrolyte, Antacid
Mechanism of Action >A systemic and urinary alkalinizer by increasing plasma & urinary bicarbonate. >The antacid action is due to neutralization of hydrochloric acid by forming NaCl & CO2. Provides temporary relief of peptic ulcer pain & of discomfort associated with indigestion.
Indication >Acute to mild metabolic acidosis >severe dehydration >excreta corporeal circulation of blood.
Contraindica tion >Metabolic & Respiratory Alkalosis. >CHF >convulsions >hypocalcemi a
Side Effects >milk- alkali syndrome >dizziness >cramps >thirst >anorexia >N&V >tetany >diminish breathing >rebound hypracidity
Nursing Responsibilities >Norepinephrine & Dobutamine are incompatible with Sodium bicarbonate. >Assess for edema, which may indicate inability to utilize Sodium bicarbonate. >Record I & O. >Observe for dry skin & mucous membranes, polydipsia, polyuria, & air hunger; may indicate a reversal metabolic acidosis. >Monitor electrolytes & ABGs. >Chew tablets thoroughly, follow with a full glass of water. Do not take with milk/ yogurt. >Continuous, routine ingestion of Sodium bicarbonate may cause formation of phosphate crystals in the kidney, kidney stones & fluid retention. >Avoid OTC preparations
that contain Sodium bicarbonate. such as Alka/Bromo-Seltzer. Generic Name Dopamin e Brand Name Revimin e Classificat ion Vasopresso r Mechanism of Action Stimulates beta-1 receptors in the heart. Solution is stable for 24 h after dilution. >Store the medication at 20° to 25°C. >Dilute just prior to administration. Protect from freezing. causing more complete and forceful contractions (inotropy). Avoid excessive heat. >Open heart surgery >Renal failure >Chronic Side Effects >Anxiety >Headache >Nausea >Vomiting >Azotemia >Dyspnea Nursing Responsibilities > Monitor vital signs and ECG closely throughout therapy. >Administer by IV infusion only. note decreases in urine output. Gaviscon or Fizrin. preferably into a large vein. Metering device . >Monitor I&O regularly. Also acts on alpha receptors (dose dependent) and has dopaminergic effects Indication Contraindica tion >Correction >Pheochromo of cy-toma hemodynami >uncorrected c imbalances tachycardia present in >ventricular shock fibrillation syndrome >arrhythmias after MI >Pediatric Clients >Trauma >Endotoxic septicemia.
Dilute before use if not prediluted. >Dopamine is potent drug. the rate of infusion should be decreased . increase blood volume with whole blood or plasma.cardiac decompensa tion is essential for controlling rate of flow. including sodium bicarbonate or other alkaline IV solutions (dopamine is inactivated). >Chemically incompatible with alkaline solutions. >Do not use if solution is discolored. >If a marked decrease in pulse pressure and disproportionate increase in diastolic BP are observed. >When appropriate.
>If an increased number of ectopic beats are observed. nausea and vomiting Nursing Responsibilities >arrange for regular follow-up. abdominal pain. constipation. as well as foodand pentagastrin- Indication Active duodenal ulcer Gird Heart burn Acid indigestion Contraindica tion >impaired renal or hepatic function >pregnancy Side Effects Headache. Both daytime and nocturnal basal gastric acid secretion. diarrhea. the dose should be reduced if possible. Generic Name Ranitidin e HCl Brand Name Neuranic Classificat ion Histamine H2 receptor blocking drug Mechanism of Action Competitively inhibits gastric secretion by blocking the effect of Histamine H2 receptors.. including blood test to evaluate >instruct the patient to avoid beverages that contain caffeine that increase stomach acid >instruct client not to drive or operate machine because of the side effects of Ranitidine (dizziness and drowsiness .
changes in rate or rhythm may indicate toxicity. >Note any drugs prescribed . Weak inhibitor of cytochrome. thus.stimulated gastric acid are inhibited. at which cardiac glycosides are to be held. >Protect from light. drug interactions involving inhibition of hepatic metabolism are not expected to occur Generic Name Digoxin Brand Name Lanoxin General Action >cardiac glycoside Mechanism of Action >Increases the force & velocity of myocardial contraction (positive inotropic effect) by increasing the refractory period of the Indication >edema >dyspnea >orthopnea >cardiac arrhythmia >slow heart rate in sinus tachycardia Contraindica tion >ventricular fibrillation/ tachycardia >hypersensiti ve carotid sinus syndrome Side Effects >tachycardia >headache >dizziness >mental disturbances >N&V >diarrhea >anorexia >blurred/ yellow Nursing Responsibilities >Obtain written parameters for high / low pulse rates.
>Monitor weights And I&O. note rhythm & rate. use antacid. >Assess for hypo/hyperthyroidism. . serum electrolytes. >Do not take with grapefruit juice. Mg. >Observe elderly clients for early S&S of toxicity. >Maintain a Na restricted diet. Inhibiting Na/K –ATPase results in increased calcium influx & increased release of free Calcium-ions within the myocardial cells. & renal >Obtain ECG. vision that would adversely interact with digoxin & monitor.AV node & increasing total peripheral resistance. This effect is due to inhibition of Sodum/ Potassium – ATPase in the sarcolemmal membrane. diuretics may increase toxicity. Ca. >Monitor CBC. which alters excitationcontraction coupling. which then potentiate the contractility of cardiac muscle fibers. hypothyroid clients are sensitive to glycosides while hyperthyroid clients may require a higher dose. >Document HR below 50 bpm. >If gastric distress experienced.
potassium replacement therapy Nausea and vomiting Diarrhea -Nurses should consider reminding the patient of the following: .Generic Name Potassiu m Chloride Brand name Kalium Durule General Classification Electrolyte Mechanism of Action Potassium is readily and rapidly absorbed from Indication Contraindica tion Severe renal function impairment with azotemia Side effects Nursing Responsibilities.
cantaloupe. beans. or. ham. broccoli. and molasses. treat hypokalemia diabetic acidosis diarrhea and vomiting certain cases of uremia hyperaldren alism corticosteroi d or diuretic therapy hypokalemia with or without metabolic acidosis or oliguria Flatulence Addison’s disease Hyperkalemia from any cause Anuria Heat cramps Acute dehydration Clients receiving potassium sparing diuretics or aldosteroneinhibiting drugs.This is especially important if the patient is also taking diuretics and/or digitalis preparations. -monitor plasma potassium Abdomi-nal discomfort GI bleeding -To take each dose with meals mixed in water or other suitable liquid. which may change stool consistency. watermelon. -To inform patients that this product contains as a dispersing agent the stool softener. Though a number of salts can be used to supply the potassium cation. banana. produce diarrhea or cramps. -To take this medicine following the frequency and amount prescribed by the physician. docusate sodium.the GI tract. rarely. apricots. Potassium richfoods include most meats (beef. turkey) fish. potassium chloride is the agent of choice since hypochloremia frequently accompanies potassium deficiency. -To check with the physician at once if tarry stools or other evidence of gastrointestinal bleeding is noticed. brussels. chicken. .
levels in patients with cardiac disease. renal impairment. and ECG is recommended . or acidosis: monitoring of acid-base balance. potassium levels. -mix IV infusion solution thoroughly after adding potassium chloride to prevent bolus administration .
adverse effect or loss of effectiveness may result. Dizziness CV:Arrhytmias. anorexia GU: Constriction of renal blood vessel and decreased urine formation. tachycardia. Effects on beta receptors include positive chronotropic effect and inotropic effects on the heart(beta receptors). light headedness.Generic Name Epinephri ne Brand Name Adrenali ne Chloride Classificat ion Sympatho mimetic Cardiac stimulant bronchodil ator Mechanism of Action Naturally occurring neurotransmitt er. normalm urine output. Teaching points > do not exceed recommended dosage.reflexes. GI: Nausea. Effects on alpha receptors include vasoconstrictio n. dysuria Nursing Responsibilities Assess >allergy or hypersensitivity to epinephrine >Asses skin. orientation. prostate palpation. color Temperature. vasodilation and uterine Indication > treatment and prophylaxis of cardiac arrest >relief from respiratory distress of bronchial asthma Contraindica tion > hypersensitivi ty to epinephrine or components of preparation >hypertensio n >Use cautiously with prostatic hypertrophy( may cause bladder sphincter spasm. anxiety. contraction of dilator muscles of iris. the effects of which are mediated by alpha or beta receptors in target organs. restlessness Headache. vomiting. palpitations. hypertension. . may cause fetal Side Effects CNS:fear.d ifficult and painful urination)labo r and delivery(may delay second stage of labor:can accelerate fetal heart beat. bronchodilation . renal function tests.
CV: palpitation GI: Excessive bowel activity. reflexes. temperature. If this occurs discontinue drug and consult your health care provider. therapy abdominal > IM or IV: pain.relaxation(beta 2 receptors). attracts and retains water in the intestinal lumen and distends the bowel to Indication and maternal hypoglycaemi a) Contraindica tion > acute > nephritis.to Contraindicat control ed with hypertension allergy to > magnesium IV:hypomag products. BP. fainting. . Generic Name Magnesiu m Sulfate Brand Name Epsom salt Classificat ion Electrolyte Antiepilepti c Laxative Mechanism of Action Cofactor of many enzyme systems involved in neurochemichal transmission and muscular excitability. or a.myocardial replacement damage. perianal irritation.Do not take if abdominal pain. rhythm strip. affect. Teaching points: > use onlu as a temporary measure to relieve constipation. . nausea or vomiting occurs. peripheral sensation. PHYSICAL: Skin color. nausea. preeclampsi vomiting. sweating. orientation. > you may experience diarrhea with oral use. prevents or controls seizures by blocking neuromascular transmission. dizziness. >Do not give during 2 hr preceding delivery because of Side Effects CNS:weakness. nesemia heart block . eclampsia other symptoms of appendicitis. muscle tone. decreased production of aqueous humor. texture. METABOLIC: Magnesium intoxication Nursing Responsibilities Assesment: Allergy to magnesium products.
chronic alcoholism. pregnancy. Generic Name Acetaminop hen Brand Name Atasol Classificat ion Analgesic Antipyretic Mechanism of Action Antipyretic: -reduces fever by acting directly on hypothalamic heat center that causes vasodilation and sweating Analgesic: -mechanism is unclear Nursing Responsibilities >do not exceed the recommended dosage >Avoid using multiple preparations with acetaminophen and check all OTC drugs >Given with food if with upset GI >Discontinue drug if hypersensitivity occur >Instruct to report rash. tremors. Indication >Fever >Common cold with flu >Pain Contraindica tion >impaired hepatic function. Flushing. lactation Side Effects CNS: headache CV: chest pain. changes in voiding pattern . unusual bleeding or bruising. or twitching. >Use cautiously with renal imsufficiency. yellowing of the skin and eyes. inabiolity to move extremities.promote mass movement and relieve constipation the risk of magnesium toxicity in the neonate. dyspnea GI:jaundice Rashes > report sweating.
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