NCM118RLE

Care of Clients with Life-threatening Conditions, Acutely Ill/Multi-organ Problems, High Acuity and Emergency Situation
S.Y. 2022-2023 | 1st Semester
DRUG STUDY
MEDICATION CLASSIFICATION (Specific USE OF MEDICATION DOSAGE CONTRAINDICATIONS AND NURSING
NAME Action) (Book based & (Book based SIDE EFFECTS RESPONSIBILITIES
(Generic and Patient Centered) & Patient (Patient & Family
Brand) Centered) Teachings)
Acts via specific receptor Treatment of type 1 100 units/mL Contraindications Baseline assessment
to regulate metabolism of diabetes (insulin vial, 3-mL DRUG: Alcohol may increase Obtain serum glucose level,
carbohydrates, protein, dependent) and type 2 cartridge. risk of hypoglycemia. Beta Hgb A1c. Discuss lifestyle to
Insulin and fats. Acts on liver, diabetes (non– blockers (e.g., determine extent of
Glusiline skeletal muscle, and insulin dependent) to carvedilol, metoprolol) may learning, emotional needs. If
(Apidra) adipose tissue. Liver: improve glycemic alter effects; may mask given IV, obtain serum
Stimulates hepatic control. signs, prolong periods of chemistries (esp. serum
glycogen synthesis, hypoglycemia. potassium).
synthesis of fatty acids. Glucocorticoids, thiazide
Muscle: Increases protein, diuretics may increase Intervention/evaluation
glycogen synthesis. serum glucose. -Assess for hypoglycemia
Adipose tissue: Stimulates HERBAL: Garlic, ginger, -Check for hyperglycemia
lipoproteins to provide ginseng may increase risk of -Be alert to conditions
free fatty acids, hypoglycemia. FOOD: altering glucose
triglyceride synthesis. None known. LAB VALUES: requirements
Therapeutic Effect: May decrease serum
Controls serum glucose magnesium, phosphate, Patient/family teaching
levels. potassium. • Instruct on proper
technique for drug
Side effects administration, testing of
Occasional: Localized glucose,
redness, swelling, itching signs/symptoms of
(due to improper insulin hypoglycemia and
hyperglycemia.
1
 injection technique), allergy • Diet and exercise are
to insulin cleansing solution. essential parts of treatment;
Infrequent: Somogyi do not skip/delay meals.
effect (rebound • Carry candy, sugar
hyperglycemia) with packets, other sugar
chronically excessive insulin supplements for immediate
dosages. response to
Systemic allergic reaction hypoglycemia.
(rash, angioedema,
anaphylaxis), lipodystrophy
(Depression at injection site
due to breakdown of
adipose tissue),
lipohypertrophy
(accumulation of
subcutaneous tissue at
injection site due to
inadequate site rotation).
Rare: Insulin resistance.
Piperacillin + Piperacillin inhibits cell Treatment of severe Per 2 g/250 Contraindications Baseline assessment
Tazobactam wall synthesis by binding gm -ve infection & mg History of allergic reactions Question for history of
(Vigocid) to bacterial cell other susceptible Piperacillin to penicillins, allergies, esp. to penicillins,
membranes. Tazobactam bacteria; neutropenic Na 2 g, cephalosporins, β- cephalosporins. Obtain
inactivates bacterial beta- patients; cystic tazobactam lactamase inhibitors. baseline CBC with
lactamase. Therapeutic fibrosis; otitis media; Na 250 mg. differential, BMP, LFT;
Effect: Piperacillin is skin infection; surgical Side effects urinalysis; PT, aPTT (if on
bactericidal in susceptible infection prophylaxis; Per 4 g/500 Frequent: Diarrhea, anticoagulants or history of
organisms. UTI; bone & joint mg headache, constipation, coagulopathy).
infections; Piperacillin nausea, insomnia, rash.
gynecological Na 4 g, Occasional: Vomiting, Intervention/evaluation
infection including tazobactam dyspepsia, pruritus, fever, Monitor daily pattern of
postpartum Na 500 mg agitation, candidiasis, bowel activity, stool
endometritis & pelvic consistency; mild GI effects
inflammatory disease may

2

Ketoanalogues Ketosteril Tablet belongs
+ Essential to a class of drugs called
Amino Acids nutritional supplements.
(Ketosteril) It follows same catabolic
pathways as amino acids
and works by improving
the metabolism of protein
in the body, thereby
improving the renal
function.
Cyklokapron Tranexamic acid is a
(Tranexamic synthetic derivative of the
Acid) amino acid lysine and
binds the 5 lysine binding
sites on plasminogen. This
inhibits plasmin formation
and displaces
(PID); peritonitis; dizziness, abdominal pain, be tolerable, but increasing
septicemia. edema, anxiety, dyspnea, severity may indicate onset
rhinitis. of antibiotic-associated
colitis. Be alert for
superinfection: fever,
vomiting, diarrhea,
anal/genital
pruritus, oral mucosal
changes (ulceration, pain,
erythema). Monitor I&O,
urinalysis. Monitor serum
electrolytes, esp. potassium,
renal function tests.
Prevention and 1 Tab 600 mg Contraindications Nursing Considerations of
therapy of damages (film-coated) Hypercalcemia disturbed Ketosteril
due to faulty or x 100's. amino acid metabolism. • Evaluate for any
deficient protein contraindications
metabolism in chronic Side Effects • Take drug as
renal insufficiency in Hypercalcemia. Regularly prescribed
connection with monitor the serum calcium • Warn the patient
limited protein in food level. Ensure the sufficient about possible side
of 40 g/day (for adults) supply with calories. effects and how to
and less, ie, generally recognize them
in patients with a • Give with food if GI
glomerular filtration upset occurs
rate (GFR) < 25 • Frequently assess for
mL/min. hypercalcemia
Tranexamic acid is 100mg/mL Contraindications Before:
used to treat heavy Hypersensitivity. Active
bleeding during the thromboembolic disease, Monitor blood pressure,
menstrual cycle history or risk of pulse, and respiratory status
(monthly periods) in thromboembolism; as indicated by severity of
women. Tranexamic fibrinolytic conditions after bleeding.
acid is in a class of consumption coagulopathy,
3
plasminogen from the
fibrin surface. It may also
directly inhibit plasmin
and partially inhibit
fibrinogenolysis at higher
concentrations.
Tranexamic acid is also
thought to exert an anti-
inflammatory effect and
may improve platelet
function in certain
circumstances
medications called history of convulsions; Monitor for overt bleeding
antifibrinolytics. It acquired disturbances of every 15–30 min.
works to improve color vision. Severe renal Monitor neurologic status
blood clotting. impairment. Concomitant (pupils, level of
use with combined consciousness, motor
hormonal contraceptives. activity) in patients with
subarachnoid hemorrhage.
Side Effects Assess for thromboembolic
Headache, tiredness, sinus complications. (Especially in
pain, back pain, stomach patients with history).
pain, and bone, joint, or Notify physician of positive
muscle pain Homans’ sign, leg pain
hemorrhage, edema,
hemoptysis, dyspnea, or
chest pain.
Monitor platelet count and
clotting factors prior to and
periodically throughout
therapy in patients with
systemic fibrinolysis.
During:
Stabilize IV catheter to
minimize thrombophlebitis.
Monitor site closely.
After:
Instruct patient to notify the
nurse immediately if
bleeding recurs or if
thromboembolic symptoms
develop.
4
 Caution patient to make
position changes slowly to
avoid orthostatic
hypotension.
Entocort EC, Inhibits accumulation of Nasal: (Rx): Oral Contraindications Baseline assessment
Pulmicort inflammatory cells, Management of Inhalation DRUG: CYP3A4 inhibitors Question for
Flexhaler, controls rate of protein seasonal or perennial Powder (e.g., itraconazole, hypersensitivity to any
Pulmicort, synthesis. allergic rhinitis in (Pulmicort ketoconazole) may increase corticosteroids,
Rhinocort decreases migration of adults and Flexhaler): 90 concentration. HERBAL: components. Auscultate
Allergy polymorphonuclear children 6 yrs and mcg per Echinacea may decrease lung sounds.
Rhinocort, leukocytes (reverses older. (OTC): Relief of inhalation; effects. FOOD: Grapefruit
Aqua, capillary hay fever, other 180 products may increase Intervention/evaluation
Uceris permeability and upper respiratory mcg per systemic exposure. LAB Monitor for relief of
(Budesonide) lysosomal stabilization at allergies. inhalation. VALUES: May decrease symptoms. Auscultate lung
cellular level). Therapeutic Nebulization, Oral serum sounds. Observe proper use
Effect: Inhalation: Inhalation potassium. of
Relieves symptoms of Maintenance or Suspension medication delivery device
allergic rhinitis, asthma, prophylaxis therapy for Side effects to ensure correct technique.
Crohn’s disease. for asthma. Nebulization Frequent (greater than 3%):
PO:(Entocort EC): (Pulmicort): Nasal: Mild nasopharyngeal Patient/family teaching
Treatment of mild to 0.25 irritation, burning, • Improvement noted in 24
moderate active mg/2 mL; 0.5 stinging, dryness; headache, hrs, but full effect may take
Crohn’s mg/2 mL; 1 cough. Inhalation: Flu-like 3–7 days.
disease. Maintenance mg/2 mL. symptoms, headache, • Report if no improvement
of clinical remission of pharyngitis. Occasional in symptoms or if sneezing,
mild to moderate Nasal Spray (3%–1%): Nasal: Dry mouth, nasal irritation occurs.
Crohn’s disease. (Rhinocort dyspepsia, rebound
(Uceris): Induction of Allergy, congestion, rhinorrhea, loss
remission in active, Rhinocort of taste. Inhalation: Back
mild to moderate Aqua): 32 pain, vomiting, altered
ulcerative mcg/spray. taste, voice changes,
colitis. OFF-LABEL: Capsules, abdominal pain, nausea,
Treatment of Enteric dyspepsia.
vasomotor rhinitis. Coated

5
(Entocort EC):
3 mg. Tablets,

Extended-
Release:
(Uceris): 9
mg.