Professional Documents
Culture Documents
DOSAG E 40mg PO
INDICATION This drug is used to treat hypertension, either alone or in combination with other drugs.
CONTRAINDICATION Biliary obstructive disorders, severe hepatic impairment. Fructose intolerance. Pregnancy (2nd & 3rd trimesters) & lactation.
SIDE EFFECTS CNS: dizziness, headache, fatigue CV: chest pain, peripheral edema, hypertension EENT: sinusitis, pharyngitis GI: nausea, vomiting, diarrhea, dyspepsia, abdominal pain GU: urinary tract infection Musculoskeleta l: myalgia, back and leg pain Respiratory: cough, upper respiratory infection Other: pain, flu or flulike symptoms
NURSING RESPONSIBILITIES Drugs that react on the renin angiotensin system can cause fetal and n e o n a t a l morbidity and death when given to pregnant women. These problems havent been detected when exposure has been limited to the first trimester. Use cautiously in patients with biliary obstruction disorders or Renal and hepatic insufficiency and in those with and activated Renin angiotensin system such as volume or salt depleted patients Monitor patient for hypotension after starting drug. Place patient supine
i f hypotension occurs, and give I.V. normal saline is needed. Most of the antihypertensive effect occurs within 2 weeks. Maximal blood pressure reduction is usually reached after 4 weeks. Diuretics may be added if blood pressure isnt controlled by drug alone. For patients whose renal function may depend on the activity of the r e n i n - angiotensinaldosterone system (such those with severe heart failure), treatment with A C E inhibitors and angiotensin receptor antagonists has cause oliguria o r progressive
azotemia and (rarely) acute renal failure. Drug isnt removed by hemodialysis. Patients undergoing dialysis may develop orthostatic hypotension. Closely monitor blood pressure. Assess condition before therapy and reassess regularly thereafter to monitor drugs effectiveness Monitor for any adverse GI reactions, nausea, vomiting, diarrhea Assess for adverse reactions For patient with hepatic encelopathy, regularly assess mental condition Monitor I & O
Lactulose
Patient who require a low lactose diet. Constipation, Galactosemia salmonellosis. Tre deficiency .Intestinal atment of hepatic obstruction encephalopathy
Abdominal discomfort associated with flatulence and intestinal cramps. Nausea, vomiting, diarrhea on prolonged use.
monitor for Increase glucose level in diabetic patients Relief of pain including muscular, rheumatic, traumatic, dental, post-op and postpartum pain, headache, migraine, fever, dysmenorrheal Pregnancy &lactation, hypersensitivity, active ulceration or chronic inflammation of either upper or lower GIT, blood disorders, poor platelet function, kidney or liver impairment, children < 14 yrs GI discomfort, diarrhea or constipation, gas pain, nausea, vomiting, drowsiness
Assess patients pain before therapy Monitor for possible drug induced adverse reactions Advice patient not to take drug for more than 7 days
Gastrointestinal motility, nausea, vomiting of central and peripheral origin associated with surgery
Advice patient to report immediately persistence or failure to relieve pain Give 30 minutes before meals and at bed time Assess mental status during treatment Tell patient to avoid driving and other hazardous activities
Nutritionally complete and well-balanced to provide the total dietary needs of most tube-fed patients. High calorie nutrition with less sodium content, suitable for people with sodium restrictions.
for at least 2 hrs Aspiration pneumonitis may occur with enteral tube feedings, and is more common in the elderly. Advice patient to avoid alcohol and other CNS depressant that enhance sedating properties of this drug
Celecoxib
Celecoxib is used for the relief of signs and symptoms of Arthritis Celecoxib should not (Osteoarthritis be given to patients and Rheumatoid Arthritis) in adults. who have
Particular attention should be given to water supply for comatose and Gastrointestinal unconscious patients disturbances m and others who ay also be a cannot express the complication of usual sensations of feeding tube thirst. use, with or without Additional water is pneumonitis. important also when renal concentrating ability is impaired, when there is extensive breakdown of tissue protein, or when water requirements are high, Diarrhea, as in fever. Dyspepsia, Headache, Upper respiratory tract infections, Assess patients
It is also used for the treatment of acute pain and menstrual pain. Celecoxib is also used to reduce the number of adenomatous colorectal polyps in familial adenomatous polyposis.
demonstrated allergictype reactions to sulfonamides. Celecoxib should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients Celecoxib is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surger
Abdominal pain, Flatulence, Nausea, Back pain, Peripheral edema, Dizziness, Rash
range of motion, degree of swelling, and pain in affected joints before and periodically throughout therapy. Assess patient for allergy to sulfonamides, aspirin, or NSAIDS. Patients with these allergies should not receive celecoxib. May be administered without regard to meals. Instruct patient to take celecoxib exactly as directed. Do not take more than prescribed dose. Increasing doses does not appear to increase effectiveness.
Advise patient to notify health care professional promptly if signs or symptoms of GI toxicity (abdominal pain, black stools), skin rash, unexplained weight gain, edema occurs. Patient should discontinue celecoxib and notify health care professional if signs and symptoms of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice, upper right quadrant tenderness, flu-like symptoms) occur. Shock. Gynecomastia, galactorrhea, hysterorrhea; anorexia, catharsis,
AntiInflammatories
Dompenyl
Symptomatic relief of acute nausea & v omiting. Treatment of nausea & vomiting caused by levodopa or
Watch out for the signs and symptoms of the side effects
Inhibitor of Prevention of adenosine vascular ischemic diphosphate (ADP) events in patients with symptomatic athe rosclerosis Clopidrogel Acute coronary
In patients with hypersensitivity to drug or its components and in those with pathologic bleeding (peptic ulcer or intracranial hemorrhage)
The tolerability of clopidogrel is similar to that of aspirin. Platelet aggregation Diarrhea, rash, wont return to normal or itching occur for at least 5 days
75mg 1tab Od
To reduce risk of death from disease and CV events in patients at high-risk for coronary events
s in approximately 1 in 20 persons taking clopidogrel. Abdominal pain also occurs in about 1 in 20 persons, but it is less frequent than with aspirin. Abdominal pain, diarrhea, indigestion, and a general feeling of weakness. Rare side effects include joint pain, memory loss, and muscle cramps. Cholestatic hepatitis, hepatic cirrhosis, rhabdomyolysis and myositis have been
after the drug has been stopped Watch out for: drug can cause fatal thrombotic thrombocytopenic purpura May be taken without regard to meals. Instruct the patient to notify prescriber if unusual bleeding will occur Assess nutrition. Fat, protein, carbohydrates Monitor bowel pattern daily Monitor triglycerides, cholesterol baseline throughout treatment Past liver disease, alcoholism, severe acute infections, trauma, severe metabolic disorders, electrolyte imbalances,
reported in patients receiving the drug chronically Antivertigo Drugs Betahistine (HCl) is primarily indicated in conditions like Hearing loss, Menieres disease, Tinnitus, Vertigo. 16mg PO TID Betahistine is contraindicated for people with peptic ulcers or tumours of the adrenal gland, such as pheochromocytoma People with bronchial asthma should be closely monitored. Headache. Low level of gastric side effects. Nausea can be a side effect, but the patient is generally already experiencing nausea due to the vertigo so it goes largely unnoticed. Decreased appetite, leading to weight loss Dizziness, headache, swelling of the ankles, feet or
Betahistine
Avoid contact of oral solution or injection with skin Raise bed rails, institute safety measures, supervise ambulation
Patients w/ sick sinus syndrome or 2nd/3rd degree AV block except in the presence of a functioning ventricular pacemaker.
Monitor blood
hand
pressure and heart rate when starting therapy and during dosage adjustments If systolic blood pressure is below 90mmHg or heart rate is below 60 bpm, withhold the medication and notify the physician. Advise patient to do hazardous activity