Name of Drug

Classification

Adverse effect

Indication

Contraindication

Nursing Considerations

Cefuroxime IV 50mg q6

ANTIINFECTIVE; ANTIBIOTIC; SECONDGENERATION CEPHALOSPORIN

Body as a Whole: Thrombophlebitis (IV site); pain, burning, cellulitis (IM site); superinfections, positive Coombs' test. GI: Diarrhea, nausea, antibioticassociated colitis. Skin: Rash, pruritus, urticaria. Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance.

It is effective for the treatment of penicillinaseproducing Neisseria gonorrhoea (PPNG). Effectively treats bone and joint infections, bronchitis, meningitis, gonorrhea, otitis media, pharyngitis/tonsillitis , sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used for surgical prophylaxis, reducing or eliminating infection.

Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation.

y

y

y

y

Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Inspect IM and IV injection sites frequently for signs of phlebitis. Report onset of loose stools or diarrhea. Although pseudomembranous colitis. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

Classification Name of Drug

Adverse effect

Indication

Contraindication

Nursing Consideration

Ambroxol 0.5m tid

Mucolytic

Occasional gastrointestinal side effects may occur but these are almost invariably mild.

Adjuvant therapy in patients with abnormal, viscid, or inspissated mucous secretions in acute and chronic bronchopulmonary diseases, and in pulmonary complications of cystic fibrosis and surgery, tracheostomy, and atelectasis. Also used in diagnostic bronchial studies and as an antidote for acute acetaminophen poisoning.

There are no absolute contraindication but in patients with gastric ulceration relative caution should be observed.

Assessment & Drug Effects y Monitor for S&S of aspiration of excess secretions, and for bronchospasm (unpredictable); withhold drug and notify physician immediately if either occur. y Lab tests: Monitor ABGs, pulmonary functions and pulse oximetry as indicated. y Have suction apparatus immediately available. Increased volume of respiratory tract fluid may be liberated; suction or endotracheal aspiration may be necessary to establish and maintain an open airway. Patient & Family Education

DRUGNAME: Classification Mechanism of Action INDICATION/CONT RAINDICATION ROUTES/ DOSAGE ADVERSE EFFECTS OF THE DRUG Side Effects NURSING RESPONSIBILITIES /PRECAUTIONS .y Report difficulty with clearing the airway or any other respiratory distress.

Causes bronchodilation and inhibits secretion from serous and seromucous glands lining the nasal mucosa. sympathomim etic. allergictype reactions Headache. *Ensure adequate hydration. tachyarrythmias. dryness of mouth.Provide proper nutrition. exacerbation of symptoms. nausea. tremors. weakness. dizziness. hypersensitivity to atropine Dosage:1 nebule 2. irregular heartbeat. bronchodilato r Ipraprotium bromide:Anticholin ergic. Salbutamol:Stimul ates beta-2 receptors of bronchioles to produce bronchodilation INDICATIONS COMBIVENT Inhalation Aerosol is indicated for use in patients with chronic obstructive pulmonary disease (COPD) on a regular aerosol bronchodilator who continue to have evidence of bronchospasm and who require a second bronchodilator.5 mgRoute:Neb ulizationFrequ ency:Q8H Fine tremor of skeletal muscles. *Report rash. dyspnea. provide ventilation to prevent hyperpyrexia. urinary retention.Perform chest physiotherapy after nebulization. DRUGNAME: Classification Mechanism of Action INDICATION/CONT RAINDICATION ROUTES/ DOSAGE ADVERSE EFFECTS OF THE DRUG Side Effects NURSING RESPONSIBILITIES . GI upset *Assess cardiorespiratory function: heart rate and rhythm. throat irritation. which blocks vagally mediated reflexes by antagonizing the action of acetylcholine.Generic Name: Ipraprotium SalbutamolBran d Name:Combive nt Functional:Pa rasympatholyt icBronchodilat orAnticholiner gicChemical: Adrenergic beta2agonist. palpitations. vomiting. Drug should be given exactly as prescribed. eye pain. nervousness. and breath sounds. *Do not double doses or increase the frequency of doses. respiration rate and breathing pattern. Contraindication Hypersensitivity to the drug.Note adventitious sounds. palpitations. hypertrophic obstructive cardiomyopathies. chemically related to atropine. Give small frequent feedings for GI upset/nausea/vomitin g.

these effects may be minimized by using a bronchodilator inhaler. for example. for example. Oral candidiasis or thrush (a fungal infection of the throat) may occur in 1 in 25 persons who use budesonide without a spacer device on the inhaler The most commonly noted side effects associated with inhaled budesonide are mild cough or wheezing. prolonged treatment. albuterol (Ventolin). Pulmicort Respules glucocorticoi d steroid Budesonide is a man-made glucocorticoid steroid related to the naturallyoccurring hormone. these effects may be minimized by using a bronchodilator inhaler. albuterol ( Ventolin) or those with asthmatic episodes at night. prior to the budesonide. Such patients may include those with frequent asthmatic episodes requiring bronchodilators. cortisol or hydrocortisone which is produced in the adrenal glands. for example./PRECAUTIONS GENERIC NAME: budesonide BRAND NAME: Pulmicort Turbuhaler. inhaler The most commonly noted side effects associated with inhaled budesonide are mild cough or wheezing. Oral candidiasis or thrush (a fungal infection of the throat) may occur in 1 in 25 persons who use budesonide without a spacer device on the inhaler . It is used for treating asthma by inhalation The budesonide inhaler is used for the control of asthma in persons requiring continuous. albuterol (Ventolin). prior to the budesonide.

and character of sputum produced. . Adrenergic bronchodilators and phosphodiesterase inhibitors both work by increasing intracellular level of cyclic-3¶. pulse and blood pressure before administration and during peak of medication. adrenergics by increasing production and phosphodiesterase inhibitors by decreasing breakdown. If conditions occur. Not amount. Anticholinergics (ipratropium) produce brondhodilation by decreasing intracellular levels of cyclic guanosine monophosphate (cGMP). Increased levels of cAMP produce bronchodilation. Doxofylline has a prolonged bronchodilator effects and unlike theophylline it has least adenosine interactions.Name of Drug Classification Adverse effect Indication Contraindication Nursing Considerations Brand name: Ansimar Antiasthmatic & COPD Generic name: Preparations Doxofylline No CNS and CVS side effects.5¶adenosine monophosphate (cAMP). Monitor pulmonary function tests before initiating therapy and periodically during therapy to determine effectiveness of medication. There is no sleep disturbances and no effects on gastric secretions with doxofylline. Leukotriene receptor antagonists and mast cell stabilizers decrease the release of substances that can contribute to bronchospasm. It is highly safe in smokers. withhold medication and notify physician of other health care professional immediately. Bronchial asthma & pulmonary disease w/ spastic bronchial component. Observe for paradoxical bronchospasm (wheezing). Assess lung sounds. color. Corticosteroids act by decreasing airway inflammation.

Assess nutritional status through 24 h diet recall.Name of Drug Classification Adverse effect Indication Contraindication Nursing Considerations Brand name: Moriamin Forte multivitamins and Generic name: minerals Calcium pantothenic hypervitaminosis (large doses) may color urine yellow contraindicated for patient¶s with malabsorption syndrome Assess patient for signs of vitamin deficiency before and periodically throughout therapy. Determine frequency of consumption of vit rich foods .

5 mg Base).73 mg (entspr. 0.Name of Drug Classification Adverse effect Indication Contraindication Nursing Considerations Appetitmangel.: Pizotifenhydrogenmalat 0. enth. c . Einzelstoffe Generic: Mosegor 1 Drg.

dizziness. and bone pain). and alkaline phosphatase. Elevations in serum concentrations of alanine transaminase. Rifampicin Anti-infectives/ Antituberculosis/Antilep ros Rifampicin: "flulike" syndrome (such as.isoniazid. shock. cutaneous. thrombocytopenia. Each drug induced neutropenia individually on rechallenge. bilirubin. Gastrointestinal and hepatic reactions. Hypersensitivity. and acute renal failure.Name of Drug Classification Adverse effect Indication Contraindication Nursing Considerations Generic Name: Ethambutol. aspartate transaminase. asymptomatic jaundice. chills. and rifampicin. hematopoietic reactions (such as. Pre-existing optic neuritis . fever. Isoniazid. sometimes with headache. Neutropenia has been reported in a patient on ethambutol. dyspnea. and acute hemolytic anemia). leukopenia. Jaundice or severe liver disease. and For the continuation phase treatment of all forms of pulmonary and extrapulmonary tuberculosis. wheezing. .

hepatitis. Name of Drug Classification Adverse effect Indication Contraindication Nursing Considerations .

LOOP DIURETIC CV: Postural hypotension. Furomide . pregnancy (category C). y Lab tests: Obtain frequent blood count. circulatory . anorexia. particularly in meningitis. cirrhosis of liver. hypocalcemia (tetany). increasing oliguria. closely monitor BP and vital signs. Has been used concomitantly with mannitol for treatment of severe cerebral edema. GI: Nausea. serum and urine electrolytes. BUN. circulatory collapse. and for treatment of hypercalcemia. glycosuria. Luramide ELECTROLYTIC AND WATER BALANCE AGENT. and kidney disease. Urogenital: Allergic interstitial nephritis. Excessive diuresis can result in dehydration and hypovolemia. alone or in combination with other antihypertensive agents. hypomagnesemia. urinary Treatment of edema associated with CHF.FUROSEMIDE (fur-oh'se-mide) Fumide . hepatic coma. y Observe older adults closely during period of brisk diuresis. irreversible renal failure. hypochloremia metabolic alkalosis. and uric acid values during first few months of therapy and periodically thereafter. Metabolic: Hypovolemia. Assessment & Drug Effects y Observe patients receiving parenteral drug carefully. acute pancreatitis. oral and gastric burning. Sudden alteration in fluid and electrolyte balance may precipitate significant adverse reactions. including nephrotic syndrome. acute hypotensive episodes. Sudden death from cardiac arrest has been reported. vomiting. jaundice. Report decrease or unusual increase in output. hyponatremia hypokalemia. elevated BUN. CO2. anuria. dizziness with excessive diuresis. hyperuricemia. constipation. blood sugar. diarrhea. y Monitor I&O ratio and pattern. y Monitor for S&S of hypokalemia. fluid and electrolyte depletion states. lactation. Lasix. abdominal cramping. hyperglycemia. y Monitor BP during periods of diuresis and through period of dosage adjustment. Report symptoms to physician. History of hypersensitivity to furosemide or sulfonamides. May be used for management of hypertension. dehydration.

weakness. y Monitor urine and blood glucose & HbA1C closely in diabetics and patients with decompensated hepatic cirrhosis. porphyria cutanea tarde.frequency. exfoliative dermatitis. photosensitivity. Drug may cause hyperglycemia. . Skin: Pruritus. and hypotension. vertigo. muscle spasms. feeling of fullness in ears. necrotizing angiitis (vasculitis). thrombocytopenic purpura. leukopenia. Weigh patient daily under standard conditions. agranulocytosis (rare). activation of SLE. Special Senses: Tinnitus. blurred vision. urticaria. hearing loss (rarely permanent). thrombophlebitis. purpura. aplastic anemia. paresthesias. Hematologic: Anemia. pain at IM injection site. collapse. Body as a Whole: Increased perspiration.

25mg 1tab OD INDICATION -atrial fibrillation ACTION -(+) inotrophic effect more available calcium promotes increase forces to increase cardiac output CONTRAINDICATION -hypersensitivity -intermittent complete heart block -2nd heart block SIDE EFFECTS -anorexia -GI disturbance -atrial tachycardia -gynecomastia -CNS effect NURSING CONSIDERATIONS -monitor v/s -should be administered with food or after eating -watch out for the adverse reaction of drug DRUG INDICATION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATIONS .DRUG Drug name: -digoxin Brand name: -lanoxin Doctor¶s order: -0.

hypertension. taste disturbance. ischemic cardiac events. nervousness. elderly. vertigo. chest pain. lactation. Children and adolescent < 16 yr hypersensitivity reactions. headache. coagulation defects. appetite and wt changes. insomnia. Rheumatoid arthritis 90 mg once daily. history of cardiac failure. photosensitivity. dry mouth. fatigue. active peptic ulceration.Arcoxia etoricoxib GI disorders. blood disorders. severe congestive heart failure. depression. Acute gout 120 mg once daily. dizziness. Adult: PO Osteoarthritis 60 mg once daily. paraesthesia. left ventricular dysfunction. myalgia. tinnitus. fluid retention. Renal toxicity Allergic disorders. drowsiness. cerebrovascular disease. mouth ulcers. cardiac or hepatic impairment . influenza-like syndrome. Max duration: 8 days. hypertension. Inflammatory bowel disease. CrCL <30 ml/min. renal. or in patients with oedema due to other reasons.

‡ Assess bowel function routinely. Tramadol is not recommended for patients dependent on opioids or who have previously received opioids for more than 1 wk.Generic /Brand name TRAMADOL (9/20/10) Classification Analgesics Dosage. ‡ Assess Contraindication the CNS previous analgesic history. or Mao inhibitors). although it is less of an issue than for nonsynthetic opioids. . Drowsiness is reported. Nursing responsibilities ‡ Assess type. tricyclics. Risk increased with higher doses and inpatients taking antidepressants (SSRIs. ‡ Inhibits reuptake of serotonin and norepinephrine in Adverse reaction nausea. vomiting. although it may be used when other treatments have failed (under the supervision of a psychiatrist). may cause opioid withdrawal symptoms. location. Patients prescribed tramadol for general pain relief with or without other agents have reported withdrawal symptoms including uncontrollable nervous tremors. or other durgs that decrese the seizure Health professionals have not yet fully endorsed of its use on a large scale for these disorders. opioid analgesics. and intensity of pain before and 2-3 hr (peak) after administration. ‡ ‡ Monitor patient for seizures. Route 50mg IVTT q 8hrs Indication Moderate to moderately severe pain Mechanism of Action ‡ Binds to mu-opioid receptors. May occur within recommended dose range. and 'thrashing' in bed (similar to restless leg syndrome. sweating and constipation. muscle contracture. Timing.

IM/IV/Intermittent IV 50 Completely inhibits action of histamine on the H2 at receptor sites of Contraindicated in patients hypersensitive to drug and those with CNS: headache. .d. GENERIC NAME INDICATION AND DOSAGE ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION Ranitidine HCL Active Duodenal Ulcer Adults: PO 150mg b. Maintenance dose is 150 mg at bedtime. vertigo Instruct patient on proper use of OTC preparation as indicated. malaise.i. ‡ Overdose may cause respiratory depression and seizures. ‡ Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and pneumonia.threshold. or 300 mg at bedtime.

Contraindicated in patients hypersensitive to drug Use cautiously in patients with history of drug abuse and in those with emotional instability. Hepatic: jaundice Other: anaphylaxis. q. Watch . GERD and Erosive Esophagitis Adults: PO 150mg b.i.O. increased ICP. unusual Reassess patient s level of pain at least 15 and 30 minutes after parenteral administration Nalbuphine acts as an opioid antagonist and may cause withdrawal syndrome. floating feeling. nervousness. Erosive Esophagitis: Maintenance dosage is 150mg P. Children 1 mon -16 y/o: PO 2 to 4 mg/kg twice daily (max. faintness. and hepatic or renal CNS: Sedation. numbness. stool. MI accompanied by N/V.O. heaviness feeling. up to 150mg daily. give 25% of the usual dose initially. impaired ventilation. dysphoria. as symptoms occur. confusion. depression.d. unreality. GENERIC NAME INDICATION AND DOSAGE parietal cells. crying. headache. For patients who have received log-term opioids. 300 mg/day).d. altering perception of and emotional response to pain. not to exceed 2 weeks of continuous treatment. angioedema. dizziness.i. or gastric aspirate Ranitidine may be added to total parenteral nutrition solution Remind patient to take once daily prescription drug at bedtime for best results Instruct patient to take without regard to meals because absorption isn t affected by food Remind patient not to confuse ranitidine with rimantadine: don t confuse Zantac with Xanax or Zyrtec ACTION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION Nalbuphine HCL Management of moderate to severe pain preoperative and postoperative analgesia supplement to balanced anesthesia obstetrical analgesia during labor and delivery DOSAGE Adults Subcutaneous / IM / IV Binds with opiate receptors in the CNS. Individualize.O at bedtime Children 1 mon -16 y/o: PO 2 to 4 mg/kg daily up to 150mg daily Pathologic Hypersecretory Conditions Adults: PO 150 mg twice daily. Heartburn Adults and Children 1 mon -12 y/o and older: 75mg of Zantac 75 P. head injury. hallucinations. burning ad itching at injection site Assess patient for abdominal pain. Note presence of blood in emesis. Maintenance therapy for Duodenal and Gastric Ulcers Adults: 150mg P. hostility. upcoming biliary surgery. decreasing gastric acid secretions porphyria Use cautiously in patients with hepatic dysfunction. Adjust dose in patients with impaired renal function EENT: Blurred vision. tingling. seizures.mg every 6 to 8 h. Children 1 mon -16 y/o: PO 5 to 10 mg/kg daily usually given in 2 divided doses. euphoria. vertigo. agitation. restlessness.

Psychological and physical dependence may occur with prolonged use. Remind patient not to confuse Nubain with Navane. withhold dose and notify prescriber Constipation is often severe with maintenance therapy. Alert: Drug causes respiratory depression. If respirations are shallow or rate is below 12 breaths/minute. pulmonary edema Skin: Burning. vomiting. biliary tract spasms. which at 10mg is equal to respiratory depression produced by 10 mg of morphine Monitor circulatory and respiratory status. hypotension.10 mg per 70 kg q 3 to 6 h as needed. dyspepsia GU: Urinary urgency Respiratory: Respiratory depression. pruritus. do not exceed 20 mg/dose or 160 mg/day disease dreams CV: Bradycardia. dry mouth GI: Nausea. uticaria for sings of withdrawal. In nontolerant patients. clamminess. bladder and bowel function. hypertension. diaphoresis. constipation cramps. Name of Drug Classification & Indication Contraindication & Adverse Reaction Drug to Drug Interaction Nursing Responsibilities . Make sure stool softener or other laxative is ordered. asthma. tachycardia EENT: Blurred vision. dyspnea. Individualize dosage.

discard if ampule is discolored. Contraindication: y Pregnancy y Toxemia y Hypertension y Ergot hypersensitivity y To include labor and spontaneous abortions. massage to check for relaxation or severe cramping.Methergine (Methylergonovine Maleate) Dosage: 0. Report any severe cramping. y Use with CYP3A4 inhibitors. do not use together. 4. Assess fundal tone and nonphasic contractures. Indication: y Headache y Dizziness y Sweating y Nasal Congestion y Leg cramps Antifungals like: y Azole (litraconazole. Take only directed and do not exceed dosage 7. Monitor Vital Signs. Ensure placenta completely passed or removed. y Protease inhibitors ± increase risk of vasospasm leading to cerebral ischemia or ischemia of extremities. y Administration before delivery of placenta. do not use together. 1. give only if the solution is clear and colorless.6 mg/3 ml Preparation: Intramascular Classification: PC: Ergot Alkaloid and Derivative TC: oxytoxic. 2. color. do not use together. Note reason for therapy. ketoconazole. headaches. vericonazole) ± Increase risk of vasospasm leading to cerebral ischemia or ischemia of extremities. 6. amount. any associated S&S. Report frequency. 5. and calcium. do not use together. y Erythomycins ± Increase risk of vasospasm leading to cerebral ischemia and ischemia of extremities. lactation stimulant Indication: Management and prevention of postpartum and postabortal hemorrhage by producing firm uterine contractions and decreasing uterine bleeding. List drug prescribe to ensure none interact. or increase . Correct if low to improve drug effectiveness and assess for decrease milk production. CBC. Before administering the methergine. y Clarithomycin ± Increase risk of vasospasm leading to cerebral ischemia or ischemia of extremities. 3.

severe toxemia. tetanic contraction.Infuse via constant infusion pump to ensure accurate control of rate. spasm. hypertonic uterine patterns. management of inevitable or incomplete abortion.Ensure fetal position and size and absence of complications. uterine inertia. unfavorable fetal positions or presentations. second trimester abortion .Drug Data Generic Name Oxytocin Trade Name Pitocin Content Synthetic oxytocin Classification Pharmacologic Class Hormone Therapeutic Class Oxytocic Pregnancy category X Indication . begin with 1-2mL/min and increase at 16. rupture of the uterus with excessive dosage. afibrinogemia. . neonatal jaundice. uterine inertia. maternal death Nursing Responsibilities Before .lactation deficiency . uterine tone . low Apgar scores GI: nausea. unfavorable fetal positions or presentations.Assess fetal heart rate. pregnancy (nasal) Use cautiously with renal impairment.Assess for significant cephalopelvic disproportion. vomiting GU: postpartum hemorrhage. or hypersensitivity Hypersensitivity: Anaphylactic reactions Other: Maternal and fetal deaths when used to induce labor or in 1st or 2nd stages of labor.Postpartum: To produce uterine contractions during the third stage of labor and to control postpartum bleeding or hemorrhage.Educate client on the side effects of the medication and what to expect. hypertonic uterine patterns. Adverse Reaction CV: Cardiac arryhtsmias. During . treatment off breast engorgement Contraindications . .Monitor neonate for jaundice .Monitor maternal BP . stimulation or reinforcement of labor in selected cases of uterine inertia. prolonged use in severe toxemia.Antepatum: to initiate or improve uterine contractions to achieve early vaginal delivery. HPN.Document that drug has been given. previous cesarean section.Do not combine in solution with fibrinolysin or heparin . rate determined by uterine response. To evaluate fetal distress (oxytocin challenge test). uterine rupture.significant cephalopelvic disproportion. severe water intoxication with seizures and coma.Unlabeled use. pelvic hematoma.Discontinue drug and notify physician at any sign of hypertensive emergency After . . subarachnoid hemorrhage Fetal effects: Fetal bradycaria. induction or ougmentation of labor when vaginal delivery is contraindicated. uterine hypertonicity. previous cesarean section .to 60-min intervals . PVCs. obstetric emergencies that favor surgical intervention.

hydrochlorothiazide Brand name: -micardis plus Doctor¶s order: -40mg 1tab OD INDICATION -essential hypertension ACTION -blocks the vasoconstrictive and aldosterone-secreting effects of angotensin II by binding angiotensin II to the AT I receptor in many tissue.DRUG Drug name: -telmisartan. CONTRAINDICATION -hypersensitivity to the drug -2nd and 3rd trimester of pregnancy -lactation SIDE EFFECTS -diarrhea -anorexia -loss of appetite -gastric irritation -constipation NURSING CONSIDERATIONS -special precaution in patients with impaired hepatic and renal impairment -special precaution with volume and/or Nadepleted patients -may impair ability to drive or operate machineries DRUG INDICATION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATIONS .

active intravascular clotting. colour vision disorders. N/V > disturbances in color vision > giddiness > hypotension (after rapid IV injection) NURSING CONSIDERATIONS > Incompatible with benzylpenicillin > may be taken with or without food > monitor eye examination regularly during long term use > discontinue if changes in color vision occurs > avoid IV injection rate of more than 1 ml/minute due to risk of hypotension > monitor bleeding . subarachnoid bleeding SIDE EFFECTS > diarrhea. dilates peripheral arteries. thromboembolic disease.Drug name: -diltiazem Brand name: -cordazem Doctor¶s order: -90mg 1tab BID -angina pectoris ACTION -inhibits calcium ion influx across cell membrane during cardiac depolarization. slows SA/AV node conduction times. produces relaxation of coronary arteries. -sick-sinus syndrome -2nd and 3rd AV block -severe hypotension -pregnancy -nausea -swelling/edema -arrhythmia -headache -rash -fatigue -monitor v/s especially the BP -should be administered with food or after eating DRUG Tranexamic acid INDICATION short term management of hemorrhage CONTRAINDICATION severe renal failure.

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