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DRUG STUDY Drug Date Ordered: 2/2/11 Generic Name: Scopolamine butylbromide (hyoscine butylbromide) Brand Name: Buscopan Classification: Belladonna alkaloid, antimuscarinic Dosage: 1 amp q4 Indicatio n Action Side Effects & Adverse Reactions Nursing Considerations -Raise side rails as a precaution because some patients become temporarily excited or disoriented and some develop amnesia or become drowsy. Reorient patient, as needed. -Tolerance may develop when therapy is prolonged. -Atropine-like toxicity may cause dose-related adverse reactions. Individual tolerance varies greatly. -Alert: overdose may cause curare-like effects such as respiratory paralysis. Keep emergency equipment available. -Warn patient to avoid activities that require alertness until CNS effects of drug are known Patient Teachings

CNS: disorientation, restlessness, irritability, dizziness, drowsiness, >Inhibits headache, confusion, muscarinic hallucinations, delirium, actions of impaired memory acetylcholine on CV: paradoxical autonomic bradycardia, palpitations, effectors tachycardia, flushing > innervated by EENT: constipation, dry Delerium, postganglionic mouth, epigastric preanesth cholinergic distress, nausea, vomiting etic neurons. RESPI: bronchial sedation, plussing, depressed and >May affect respirations obstetric neural pathways SKIN: rash, dryness, amnesia originating in the contact dermatitis with with inner ear to transdermal patch analgesic inhibit nausea OTHER: heat s and vomiting intolerance

impeding COX2. nausea METABOLIC: hyperchloremia MUSCULOSKEL: back pain RESPI: upper respi tract infection SKIN: erythema multiforme. watch for signs and symptoms of liver toxicity -before drug therapy. dizziness. or black. flatulence. unexplained weight gain. and perforation of the stomach or intestines which can be fatal. aspirin. urine. and antipyretic effects. the combination may increase risk of GI bleeding. -Drug can cause fluid retention -Assess pt for CV risk factors before therapy -Drug may be hepatotoxic. rash -Alert: Pts allergic to or with a history of anaphylactic reactions to sulfonamides. -Although drug may be used with low aspirin dosages. Advise pt to stop therapy and notify prescriber immediately if he experiences signe . -Monitor pt’s renal functions -Tell pt to report history of allergic reactions to sulfonamides. dyspepsia. ulceration. CNS: headache. including bleeding.Date Ordered: 2/8/11 Generic Name: celecoxib Brand Name: Celebrex Classification: Cyclooxygenase2 (COX-2) inhibitor Dosage: 1 tab TID >Acute pain and primary dysmenor rhea >Thought to inhibit prostaglandin synthesis. or swelling -Tel woman to notify prescriber if she becomes pregnant during drug therapy -Instruct pt to take drugs with food if stomach upset occurs -Tell pt that drug may harm the liver. or stool. peripheral edema EENT: pharyngitis. rhinitis. -Instruct pt to promptly report signs of GI bleeding such as blood in vomit. or other NSAIDs before therapy. sinusitis GI: abdominal pain. CV: hypertension. exfoliative dermatitis. diarrhea. rehydrate dehydtrated pt. aspirin. or other NSAIDs may be allergic to this drug -NSAIDS cause an increased risk of serious GI adverse events. to produce antiinflammatory. insomnia. toxic epidermal necrolysis. tarry stools -Alert: advise pt to immediately report rash. analgesic. StevensJohnson syndrome.

nausea. pulmonary edema -Constipation is commonly SKIN: burning. tachycardia produced by 10mg of EENT: blurred vision. equal to respiratory depression known. asthma. withdrawal syndrome. confusion. fatigue. walking. right upper quadrant tenderness. -Monitor circulatory and adverse effects such constipation. RESPI: respiratory withhold dose and notify depression. and bowel function. and flulike symptoms. respiratory status and bladder as constipation. depression. unusual that require mental dreams -Alert: Drug causes respiratory alertness until drug’s CV: bradycardia. restlessness. lethargy. which at 10mg is CNS effects are hypertension. CNS: dizziness. Binds with opioid receptors in the CNS. severe with maintenance Date Ordered: 2/8/11 Generic Name: nalbuphine hydrochloride Brand Name: nalbuphine hydrochloride Classification: Opioid agonistantagonist. opioid partial agonist Dosage: 10mg q6 >Modera te to severe pain >Adjunct to balanced anesthesi a >Unknown. including nausea. Warn depression. dyspepsia. alerting perception of and emotional response to pain .and symptoms of liver toxicity. itching. hypotension. If vomiting respirations are shallow or rate GU: urinary urgenc is below 12 breaths/min. -Drug acts as an opioid outpatient to avoid hallucinations. delusions. hostility. -Teach pt how to dry mouth manage troublesome GI: biliary tract spasms. cramps. hazardous activities speech disorders. least 15-30 min after parenteral ambulatory pt about vertigo. yellowing or skin or eyes. sedation. dyspnea. -Inform pt that it may take several days before he feels consistent pain relief. morphine. prescriber. euphoria. -Reassess pt’s level o pain at -Caution headache. admin getting out of bed or crying. antagonist and may cause driving and other nervousness.

Make sure stool softener or other stimulant laxative is ordered. urticaria -Psychological and physical dependence may occur with prolonged use. pruritis. . clamminess.therapy. diaphoresis.