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BS CI: Ma’am Valencia Brand Name
• Adult & childn ≥10 yr 2-3 mL, ≤10 yr 1-2 mL. Depending on severity of case, dose may be repeated 4 hrly. In severe cases, dose may be administered by IV very slowly. Form: IV
Mechanism of Action
Pharmacology: Paracetamol p roduces analgesia by raising the threshold of the pain center in the brain and by obstructing impulses at the pain-mediating chemoreceptors. The drug produces antipyresis by an action on the hypothalamus; heat dissipation is increased as a result of vasodilation and increased peripheral blood flow. Pharmacokinetics: Paracetam ol is rapidly and almost completely absorbed from the gastrointestinal tract. Following oral administration, peak plasma levels are attained in 10 min to 1 hr and the half-life is 75 min to 3 hrs. Distribution of paracetamol to most body tissues and fluids is both rapid and uniform. Paracetamol is excreted in the urine primarily as the glucuronide and smaller amounts as the sulfate, mercapturate and unchanged drug. Approximately 85% of a dose of paracetamol is excreted in the urine within 24 hrs after administration.
• Pyrexia of unknown origin. Fever & pai n associated w/ common childhood disorders, tonsilliti s, upper resp tract infections postimmunization reactions, after tonsillectomy & other conditions. Prevention of febrile convulsion.Heada che, cold, sinusitis, mus cle pain, arthritis & too thache.
• A paracetamol overdose is particularly dangerous because the liver damage may not be obvious for four to six days after the drug has been taken. Even if someone who has taken a paracetamol overdose seems fine and doesn't have any symptoms, it's essential that they are taken to hospital urgently. An overdose of paracetamol can be fatal. • When taken at the recommended dose, side-effects of paracetamol are rare. Skin rashes, blood disorders and a swollen pancreas have occasionally happened in people taking the drug on a regular basis for a long time.
• Use liquid form for children and patients who have difficulty swallowing. • In children, don’t exceed five doses in 24 hours. • Advise patient that drug is only for short term use and to consult the physician if giving to children for longer than 5 days or adults for longer than 10 days. • Advise patient or caregiver that many over the counter products contain acetaminophen; be aware of this when calculating total dailydose. • Warn patient that high doses or unsupervised long term use can cause liver damage.
• Analgecsic (Opioid)
Childn 5-14 yr 2. galactorrhea. Indications • Disturbances of GI motility including GERD & diabetic gastroparesis. Renal Impairment (CrCl <40 mL/min) ½ the recommended dose. Its mode of action is unclear. migraine headache or drugs including cancer chemotherapy. Max: 0. insomnia. <1 yr 1 mg bid. fatigue & lassitude. bowel disturbances.5 mg/kg/day. Nursing Considerations • Give 30 mins before meals and at bed time • Assess mental status during treatment • Tell patient to avoid driving & other hazardous activities for at least 2 hrs • Advice pt. rash including urticaria. infectious diseases. gastroparesis. It seems to sensitize tissues to the action of acetylcholine. resulting in accelerated gastric emptying and intestinal transit. Pharmacokinetics: Peak plasma levels are reached 3060 min following an oral dose. stimulates motility of the upper gastrointestinal tract without stimulating gastric. nausea.DRUG STUDY: Metoclopramide (Plasil) dsds BSN III B CI: Ma’am Valencia Brand Name • Plasil Dosage • Tab Adult 1 tab tid. Metoclopramide increases the tone and amplitude of gastric (especially antral) contractions. Its safe use has been described in patients with advanced liver disease whose renal function was normal. a dopamine antagonist. Extrapyramidal symptoms. dizziness. Form: IV TAB Mechanism of Action Pharmacology: Metoclopramid e. metabolic diseases. drowsiness. Syr Ad ult 10 mL tid. Nau sea &vomiting of central & peripheral origin associated w/ surgery. AmpIM/IV Adul t 1 amp 8 hrly. Excretion is primarily in the urine. Antiflatulents. headache. 1-3 yr 1 mg bid-tid. biliary or pancreatic secretions. It increases the resting tone of the lower esophageal sphincter. Antiinfammatories . gynecomastia. Metoclopramide undergoes minimal hepatic metabolism. to avoid alcohol and other CNS depressant that enhance sedating properties of this drug Generic Name: • Metoclopramide Classification: • GIT Regulators. The plasma half-life is about 3 hrs.5-5 mg tid. Facilitate small bowel intubation & radiological procedures of GIT. Radiological exam of GIT 1-2 amp IM or IV 10 min before procedure. Adverse Reaction • Restlessness. except for simple conjugation. Increased prolactin levels. relaxes the pyloric sphincter and the duodenum and jejunum. 3-5 yr 2 mg bid-tid. The effect of metoclopramide on motility is not dependent on intact vagal innervation but it can be abolished by anticholinergic drugs.
obtain C&S before starting therapy • Assess blood dyscrasias Precautions: Pregnancy C. G6PD deficiency. elevated serum transaminase and bilirubin. possible folate deficiency. coli.combination blocks two consecutive steps in bacterial synthesis of essential nucleic acids. nausea. megaloblastic anemia. (Macromed) dsdsdsds BSN III B CI: Ma’am Valencia Brand Name • Macromed Generic Name: • Cotrimoxazole Classification: • Antibacterial Combinations Dosage • Cap Adult 1-2 cap bid for 10-14 days. Susp Childn 6-12 yr 1-2 tsp. exfoliative dermatitis GI: Epigastric distress. Proteus mirabilis. Klebsiella pneumoniae. Form: SUSP CAP Mechanism of Action • Blocks synthesis of tetrahydrofolic acid. pruritus. protein Indications • Uncomplicated UTIs caused by susceptible strains of E.DRUG STUDY: Cotrimoxazole susp. severe allergy. influenza in children Adverse Reaction Dermatologic: Rash. including Staphylococcus saprophyticus • Treatment of acute otitis media due to susceptible strains of S. and coagulasenegative Staphylococcus species. Enterobacter species. impaired hepatic/renal disease. methemoglobinemia. bronchial asthma . leukopenia. glossitis Hematologic: Thrombocytopenia. vomiting. eldery. neutropenia. increased BUN and serum creatinine levels Other: Fever Nursing Considerations • Assess allergic reactions • Monitor I&O ratio • Monitor kidney function • Assess type of infection. renal disease. 25 yr ½-1 tsp bid. pneumoniae and H.
per pack. 10. Calories 23. Intestinal obstruction or perforated bowel. fruit Form: punch. hot & humid environment. prolonged sun exposure. potassium ≥1yr: Give every 4. 32–64oz/day. • Note for the drugs.6Eq. intake: 8. Nursing Considerations • Assess allergic reactions. . Adynamic ileus.7mEq. Indications • To supplement fluid & electrolyte loss due to active play. • Note the side effects of the drugs. chloride 1–4hrs. Intractable vomiting. contains acesulfame. 1L • Electrolytes Singles—8oz • A07CA . time. dosage. or Liq (falvored)— strawberry flavor. rehydration salt 8 formulations . • Monitor I&O ratio. or impaired homeostatic mechanism.Oral Pwd (packets)—4. Used in Pops—16 the treatment of diarrhea. apple. grape. Adverse Reaction • As sole therapy in severe continuing diarrhea. <1yr: • Dextrose 5.r oute. client.DRUG STUDY: Pedialyte sdsds BSN III B CI: Ma’am Valencia Brand Name • Pedialyte Dosage Mechanism of Action • Pedialyte and Gatorade are advocated for the treatment of dehydration in viral gastroenteritis.3mEq. Anuria.7g. but there is limited evidence to support their use. • Mix one pack with 8oz of water Generic Name: and drink. oliguria. 1L Liq (unflavored)— Classification: 2oz. sodium not recommended.
abdominal pain. bilirubin. nephrotoxicity. headache. bleeding. stomach cramps.Drug Study : Cefuroxime DRUG ORDER (Generic name. flatulence. fever. renal failure. loose stools. rendering cell wall osmotically unstable.) Cefuroxime 500mg/tab 1 tab BID (p. alkaline phosphatase. etc. fever. leading to cell death by binding to cell wall membrane INDICATIONS AND CONTRAINDICATIONS Indications: • Urinary tract infections. nausea. pruritus. dysuria. glossitis. LDH. paresthesia. heartburn.) for 7 days PHARMACOLOGIC ACTION OF DRUG Inhibits bacterial wall synthesis. dyspnea • Identify urine output • Assess bowel pattern daily • Monitor for bleeding . vomiting. Otitis media. candidiasis. Frequency. jaundice GU: vaginitis. increased BUN.o. confusion GI: Diarrhea. increased AST. • Severe infections Contraindications: • Sensitivity to cephalosporins ADVERSE EFFECTS OF THE DRUG CNS: Dizziness. Dosage. pyuria. chills. anorexia. urticaria. colitis. Route. chills. ALT. fatigue. reversible interstitial nephritis NURSING RESPONSIBILITIES /PRECAUTIONS • Assess patient for signs and symptoms of infection • Assess for anaohylaxis: rash.
Route.DRUG STUDY : NORXIFLOXACIN DRUG ORDER (Generic name. vomiting.) PHARMACOLOGIC ACTION OF DRUG INDICATIONS AND CONTRAINDICATIONS ADVERSE EFFECTS OF THE DRUG NURSING RESPONSIBILITIES /PRECAUTIONS Norxifloxacin 400mg/tab 1 tab BID (p. uncomplicated gonorrhea Contraindications: • Hypersensitivity to quinolones CNS: headache. insomnia EENT: visual disturbances GI: nausea. allergic reactions Monitor blood studies Assess bowel pattern daily . Frequency. dizziness. AST. decreased ALT. somnolence.o. constipation. depression. dry mouth INTEG: rash Assess patient for previous sensitivity reaction Assess patient for signs and symptoms of infection. flatulence. Dosage. heartburn. diarrhea. fatigue. etc.) Interferes with conversion of intermediate DNA fragments into high-molecular weight DNA in bacteria • Indications: UTI.
) Inhibits HMG-CoA reductase. dyspepsia. and CV events. abdominal pain. carbohydrates Monitor bowel pattern daily Monitor triglycerides. renal disease • CNS: Headache. Frequency. asthenia. constipation. liver failure Respiratory: Sinusitis. serum LDLs. nausea. Indications Adjunct to diet in the treatment of elevated total cholestrol and LDL cholesterol with primary hypercholesterolemia (types IIa and IIb) in those unresponsive to dietary restriction of saturated fat and cholesterol and other nonpharmacologic measures To reduce the risk of coronary disease. the enzyme that catalyzes the first step in the cholesterol synthesis pathway. sleep disturbances GI: Flatulence. MI and reduction in need for bypass surgery and angionplasty in patients with coronary heart disease and hypercholesterolemia Treatment of patients with isolated hypertriglyceridemia ADVERSE EFFECTS OF THE DRUG NURSING RESPONSIBILITIES /PRECAUTIONS • • • Assess nutrition: fat.) PHARMACOLOGIC ACTION OF DRUG INDICATIONS AND CONTRAINDICATIONS • Simvastatin 40mg/tab 1 tab OD at hs (p. electrolyte imbalances. severe acute infections. arthralgia. resulting in a decrease in serum cholesterol. cholesterol baseline throughout treatment Precautions: Past liver disease. acute renal failure. TIA. elderly.DRUG STUDY : SIMVASTATIN DRUG ORDER (Generic name. protein. myalgia • • DRUG STUDY : CELECOXIB .o. severe metabolic disorders. cramps. diarrhea. pharyngitis Other: Rhabdomyolysis. and either an increase or no change in serum HDLs. mortality. including stroke. alcoholism. etc. Dosage. heartburn. Route. trauma.
Route. sweating. environmental control). • If overdose occurs. fatigue. 200 mg NURSING RESPONSIBILITIES /PRECAUTIONS • Administer drug with food or after meals if GI upset occurs. ankylosing spondylitis and to reduce the number of colon and rectal polyps in patients with familial adenomatous polyposis. eosinophilia. GI bleed Hematologic: Neutropenia. acute pain. bone marrow depression.DRUG ORDER (Generic name. supportive therapy. tiredness. • • Brand Name: Celebrex Celebra Available forms Capsules—100. stomatitis GI: Nausea. NSAIDs. aplastic anemia. induction of emesis. celecoxib. positioning. insomnia. dry mucous membranes. Use cautiously with impaired hearing. does not affect the COX-1 enzyme. flatulence. • Provide further comfort measures to reduce pain (eg positioning. institute emergency procedures—gastric lavage.dyspepsia. hepatic and cardiovascular conditions ADVERSE EFFECTS OF THE DRUG Adverse effects CNS: Headache. somnolence. tinnitus. which protects the lining of the GI tract and has blood clotting and renal functions. which is activated in inflammation to cause the signs and symptoms associated with inflammation. rheumatoid arthritis. agranulocytosis. INDICATIONS AND CONTRAINDICATIONS Indications: Celecoxib is licensed for use in osteoarthritis. etc. visual disturbances occur. pregnancy. • Establish safety measures if CNS. pruritus. or aspirin. dizziness. granulocytopenia. rest . thrombocytopenia.) Generic: Celecoxib PHARMACOLOGIC ACTION OF DRUG Analgesic and antiinflammatory activities related to inhibition of the COX-2 enzyme. Dosage. leukopenia. significant renal impairment. Frequency. dizziness. lactation. painful menstruation and menstrual symptoms. • Arrange for periodic ophthalmologic examination during long-term therapy. ophthamologic effects Dermatologic:Rash. Contraindications: Contraindicated with allergies to sulfonamides. and to reduce inflammation (eg warmth. abdominal pain. decreased hemoglobin or hematocrit. It was originally intended to relieve pain while minimizing the gastrointestinal adverse effects usually seen with conventional NSAIDs. pancytopenia.
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