DRUG STUDY

Drug Classification Proton pump inhibitors

Generic Name Omeprazole
Brand Name Prevacid, Prilosec
Prescribed Dosage 40mg
Route of Administration PO
Frequency of the Medication OD

Mechanism of Action:
It suppresses stomach acid secretion by specific inhibition of the H+/K+-ATPase system found at the secretory surface of gastric parietal cells.

Indication:
Omeprazole is used to treat certain conditions where there is too much acid in the stomach. It is used to treat gastric and duodenal ulcers, erosive esophagitis, and gastroesophageal
reflux disease (GERD). GERD is a condition where the acid in the stomach washes back up into the esophagus.

Contraindication:
Omeprazole is contraindicated in patients with a history of hypersensitivity to the drug or any excipients from the dosage form. Hypersensitivity reactions like anaphylactic shock,
angioedema, interstitial nephritis, anaphylaxis, urticaria, and bronchospasm may occur.

Adverse Reaction:
If you take omeprazole for more than 3 months, the levels of magnesium in your blood may fall. Low magnesium can make you feel tired, confused, dizzy and cause muscle
twitches, shakiness and an irregular heartbeat.

Nursing Responsibilities:
• Advise patient to avoid alcohol and foods that may cause an increase in GI irritation.
Report headache, onset of black, tarry stools, diarrhea, abdominal pain.
• Swallow capsules whole; do not chew, crush, dissolve, or divide.
• Take before eating
 Drug Classification Antihypertensives

Generic Name Losartan

Brand Name Cozaar

Prescribed Dosage 50mg (1tab)

Route of Administration PO

Frequency of the Medication OD

Mechanism of Action:
Inhibits vasoconstrictive and aldosterone secreting action of angiotensin II by blocking angiotensin II receptor on the surface of vascular smooth muscle and other tissue cells.

Indication:
• Losartan is indicated to treat hypertension.
• To reduce risk of stroke in patients with hypertension and left ventricular hypertrophy.

Contraindication:
Contraindicated in patient with hypersensitivity to drug.

Adverse Reaction:
CNS: Dizziness,headache, fatigue
CV: Edema, chest pain
EENT: Sinusitis, nasal congestion
GI: Abdominal Pain, nausea, diarrhea
Musculoskeletal: Muscle cramps, leg pain
Respiratory: Cough

Nursing Responsibilities:
• Monitor the patient’s blood pressure
• Instruct her or the S.O to notify a physician if she experiences prolonged diarrhea nausea or vomiting.
• Check blood pressure an hour or two after administrating the drug.
 Drug Classification HMG-CoA reductase inhibitors, or statins.
Generic Name Atorvastatin
Brand Name Lipitor
Prescribed Dosage 10mg (1tab)
Route of Administration PO
Frequency of the Medication OD

Mechanism of Action:
Atorvastatin competitively inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. [2] By preventing the conversion of HMG-CoA to mevalonate, statin
medications decrease cholesterol production in the liver.

Indication:
Atorvastatin is indicated for the treatment of several types of dyslipidemias, including primary hyperlipidemia and mixed dyslipidemia in adults, hypertriglyceridemia, primary
dysbetalipoproteinemia, homozygous familial hypercholesterolemia, and heterozygous familial hypercholesterolemia in adolescent patients with failed dietary modifications.

Contraindication:
• Hypersensitivity to atorvastatin.
• Active liver disease or unexplained transaminase elevation.

Adverse Reaction:
• Headache
• Hoarseness
• Lower back or side pain
• Pain or tenderness around the eyes and cheekbones
• Painful or difficult urination
• Stuffy or runny nose

Nursing Responsibilities:
• Do not crush, dissolve, or divide atorvastatin.
• Monitor serum lipid levels regularly.
• Evaluate the patient's response to atorvastatin.
• For muscle pain, administer pain medications as ordered.
 Drug Classification Calcium channel blockers

Generic Name Nicardipine

Brand Name Cardene

Prescribed Dosage 10 mg

Route of Administration IV

Frequency of the Medication

Mechanism of Action:
Like other calcium channel blockers, nicardipine acts by blocking the influx of calcium ions into vascular smooth muscle and cardiac cells during depolarization.

Indication:
Nicardipine hydrochloride injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or desirable.

Contraindication:
• Nicardipine is contraindicated in patients with hypersensitivity to the drug, in patients with advanced aortic stenosis.
• Adverse Reaction:
• Blurred vision
• Dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
• Sweating
• Unusual tiredness or weakness

Nursing Responsibilities:
In administering nicardipine, close monitoring of blood pressure and heart rate.
Nicardipine may occasionally produce symptomatic hypotension or tachycardia. Avoid systemic hypotension when administering the drug to patients who have sustained an acute
cerebral infarction or hemorrhage.
 Drug Classification cephalosporin antibiotics.
Generic Name Cefuroxime
Brand Name Zinacef
Prescribed Dosage 1.5 g
Route of Administration IVTT
Frequency of the medication q8h

Mechanism of Action:
Cefuroxime is a bactericidal agent that acts by inhibition of bacterial cell wall synthesis. Cefuroxime has activity in the presence of some beta-lactamases, both penicillinases and
cephalosporinases, of Gram-negative and Gram-positive bacteria.

Indication:
Cefuroxime is a cephalosporin indicated for the treatment of a variety of infections including acute bacterial otitis media, several upper respiratory tract infections, skin infections,
urinary tract infections, gonorrhea, early Lyme disease, and impetigo.

Contraindication:
Cefuroxime is contraindicated in patients with cephalosporin hypersensitivity or cephamycin hypersensitivity.

Adverse Reaction:
Nausea, vomiting, diarrhea, strange taste in the mouth, or stomach pain may occur. Diaper rash may occur in young children. Dizziness and drowsiness may occur less frequently,
especially with higher doses.

Nursing Responsibilities:
• Assess patient for allergy of Cefuroxime.
• Assess patient body temperature for chills and fever.
• Refer to the physician if any serious adverse reaction.
 Drug Classification NSAIDs
Generic Name Ketorolac
Brand Name IV
Prescribed Dosage 30 mg
Route of Administration IV
Frequency of the Medication q6h

Mechanism of Action:
Ketorolac is a non-selective NSAID and acts by inhibiting both COX-1 and COX-2 enzymes which are normally responsible for converting arachidonic acid to prostaglandins. The
COX-1 enzyme is constitutively active and can be found in platelets, gastric mucosa, and vascular endothelium.

Indication:
It is indicated for short term management of acute pain that requires the calibre of pain management offered by opioids.

Contraindication:
Ketorolac is contraindicated in patients with renal failure or patient's at risk for renal failure, dehydration ,pregnancy, labour, delivery or lactation.

Adverse Reaction:
• Headache.
• Dizziness.
• Drowsiness.
• Diarrhea.
• Constipation.

Nursing responsibilities:
• Monitor signs of GI bleeding, including abdominal pain.
• Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (laryngeal edema, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria).
 Drug Classification Analgesic

Generic Name Tramadol

Brand Name Ultram, ConZip

Prescribed Dosage 50 mg

Route of Administration IV

Frequency of the Medication q8

Mechanism of Action:
Binds to opioids receptors , inhibits re- uptake of norepinephrine and serotonin.

Indication:
Tramadol is approved for the management of moderate to severe pain.

Contraindications:
Hypersensitivity reaction to any opioid.

Adverse Reaction:
Headache, nervousness, heartburn, loss of strength and weakness, constipation.

Nursing Responsibilities:
• Monitor blood pressure and serum potassium.
• Report severe constipation , difficulty breathing, seizures, muscle weakness, palpitations.
• Reassess patients level of pain at least 30 minutes after administration.
 Drug Classification antibiotics

Generic Name Metronidazole

Brand Name Flagyl, Acea, Anabac

Prescribed Dosage 500 mg

Route of Administration IV

Frequency of the Medication q8

Mechanism of Action:
Metronidazole diffuses into the organism, inhibits protein synthesis by interacting with DNA, and causes a loss of helical DNA structure and strand breakage. Therefore, it causes
cell death in susceptible organisms.

Indication:
Metronidazole is one of the mainstay drugs for the treatment of anaerobic bacterial infections, protozoal infections, and microaerophilic bacterial infections.

Contraindication:
Metronidazole is contraindicated in patients with documented hypersensitivity to the drug or its components, and it should be avoided in first-trimester pregnancy.

Adverse Reaction:
confusion, peripheral neuropathy, metallic taste, nausea, vomiting, and diarrhea. Adverse events

Nursing Responsibilities:
• Be alert for confusion, agitation, headache, or other alterations in mental status. Notify the physician promptly if these symptoms develop.
• Monitor IV injection site for pain, swelling, and irritation.
 Drug Classification non-barbiturate sedative

Generic Name Propofol

Brand Name Diprivan

Prescribed Dosage 1 ampule, 20-40mg

Route of Administration IV

Frequency of the Medication 20-40mg every 10 seconds

Mechanism of Action:
The action of propofol involves a positive modulation of the inhibitory function of the neurotransmitter gama-aminobutyric acid (GABA) through GABA-A receptors. Rapid - time
to onset of unconsciousness is 15-30 seconds, due to rapid distribution from plasma to the CNS.

Indication:
Propofol is an intravenous anesthetic used for procedural sedation, during monitored anesthesia care, or as an induction agent for general anesthesia.

Contraindication:
Propofol is contraindicated in any patient that has any known hypersensitivity reaction to the drug.

Adverse Reaction:
•Chest pain or discomfort
• dark-colored urine
• dizziness
• Drowsiness
• lightheadedness
• muscle cramps

Nursing Responsibilities:
• Monitor hemodynamic status and assess for dose-related hypotension.
• Be alert to the potential for drug induced excitation (e.g., twitching, tremor, hyperclonus) and take appropriate safety measures.
• Provide comfort measures; pain at the injection site is quite common especially when small veins are used.

Drug Classification neuromuscular blocker

 Generic Name Suxamethonium
Brand Name Quelicin, Anectin
Prescribed Dosage 1 ampule
Route of Administration IV
Frequency of the Medication

Mechanism of Action:
Succinylcholine is an ultra-short-acting depolarizing muscle relaxant, which binds to motor endplate cholinergic receptors to produce depolarization. Since the depolarization is
sustained, the electrical activity of the motor endplate is lost, leading to paralysis.

Indication:
It is used in anaesthesia as a skeletal muscle relaxant to facilitate tracheal intubation and mechanical ventilation surgical procedures.

Contraindication:
Suxamethonium is contraindicated in patients with recent burns or spinal cord trauma causing paraplegia (can be given immediately after the injury, but should be avoided from
approximately day 10 to day 100 after the injury), raised potassium levels, severe muscle trauma, or a history of malignant hyperpyrexla.

Adverse Reaction:
• Prolonged resp depression or apnoea
• bradycardia
• tachycardia
• hypotension
• muscle fasciculation

Nursing Responsibilities:
• Be alert for a rapid rise in body temperature, especially if accompanied by muscle rigidity and stiffness.
• Assess any muscle pain, tenderness, or weakness, especially if accompanied by fever, malaise, and dark-colored urine.
• Assess blood pressure periodically and compare to normal values

Drug Classification Non-depolarizing neuromuscular blocking drug of the benzylisoquinolinium class.

 Generic Name Atracurium

Brand Name Tacrium

Prescribed Dosage 2 ampules

Route of Administration IV

Frequency of the Medication

Mechanism of Action:
Atracurium antagonizes the neurotransmitter action of acetylcholine by binding competitively with cholinergic receptor sites on the motor end-plate.

Indication:
Atracurium is indicated as an addition to general anesthesia to facilitate endotracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation.

Contraindication:
Atracurium besylate is contraindicated in patients known to have a hypersensitivity to it
Adverse Reaction:
skin flushing or redness. injection site reactions. hives.

Nursing Responsibilities:
• Observe the patient for residual muscle weakness and respiratory distress during the recovery period.
• Monitor infusion site frequently.
• If signs of tissue irritation or extravasation occur, discontinue and restart in another vein.