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September 4, 2009

GENERIC BRAN DOSAGE INDICATIO MECHANISM CONTRAINDICATI ADVERSE NURSING


NAME D N OF ACTION ON EFFECT RESPONSIBILITI
NAME ES
citicholine Zynaps 500mg IV Cerebrovascu Citicoline hypertonia of the citicoline may • Watch out for
e q8 lar Diseases, activates the parasympathetic exert a hypotensive
Discontinu accelerates biosynthesis of stimulating effects
ed on the recovery structural action of the • Somazine
September of phospholipids parasympathetic, must not be
9, 2009 consciousness in the neuronal as well as a administered
and membrane, fleeting and along with
overcoming increases discrete medicaments
motor deficit. cerebral hypotensor effect containing
metabolism
and increases
the level of
various
neurotransmitt
ers, including
acetylcholine
and dopamine.
Citicoline has
shown
neuroprotectiv
e effects in
situations of
hypoxia and
ischemia.
lactulose Lilac 80cc HS Constipation . metabolism of Low galactose diet & Abdominal • Do not
lactulose by intestinal obstruction discomfort administer if
bacteria results associated w/ patient has
in reduced flatulence or already pass
colonic pH cramps. out stool
which Prolonged use or especially if
stimulates large doses may stool is liquid
peristalsis and result in diarrhea
decreases stool w/ excessive loss
transit time. In of water &
turn, decreased electrolytes
water
reabsorption
from the feces
further
facilitates the
passage of soft
well-formed
stools. And
increased
osmotic
pressure of
fecal material
secondary to
an increase in
colonic organic
acids results in
accumulation
of fluid from
surrounding
tissues, helping
to soften stool
mass.
Mannitol 100cc IV Raised It raises the Pulmonary Fluid and • Take care to
intracranial osmotic congestion or electrolyte avoid
pressure pressure of the oedema; intracranial imbalance; extravasation.
plasma bleeding; CHF; acidosis (with Observe
allowing water metabolic oedema high doses). injection site
to be drawn out with abnormal Nausea, for signs of
of body tissues. capillary fragility; vomiting, thirst; inflammation
anuria due to severe headache, or edema
renal disease; severe dizziness, • check for signs
dehydration. convulsions, of fluid and
chills, fever; electrolyte
tachycardia, imbalance
chest pain; • measure I&O
blurred vision; accurately and
urticaria and record to
hypotension or achieve proper
hypertension; fluid balance
acute renal • monitor vital
failure; skin signs closely.
necrosis; Report
thrombophloebiti significant
s. changes in BP
and signs of
CHF
Nimodipine Nimoto 30 mg / tab Prophylaxis Calcium None Severe BP • Take apical
p 2 tabs q 6 and treatment channel lowering, GI pulse prior to
of ischemic blocking agent disturbances, administering
neurological that is deterioration of drug and hold
deficits due to relatively renal function, it if pulse is
cerebral selective for disturbances of below 60.
vasospasms cerebral heart rhythm, notify the
after arteries phlebitis, physician.
subarachnoid compared with increase of liver • Establish
hemorrhage arteries enzymes. baseline data
elsewhere in before
the body. This treatment is
may be started.BP,
attributed to pulse and
the drug’s high laboratory
lipid solubility evaluations of
and specific liver and
binding to kidney
cerebral tissue. function.
• Monitor
frequently for
adverse drug
effects,
including
hypotension,
peripheral
edema,
tachycardia, or
skin rash.
• Monitor
frequently for
dizziness or
lightheadednes
s in older
adult, risk of
hypotension is
increased.

Phenobarbi 60 mg/tab Used as a It depresses the Severe renal and Bradycardia, • Observe
tal 1 tab HS sedative in sensory cortex, hepatic disorders. hypotension, patients
anxiety or reduces motor Severe respiratory syncope; receiving large
tension states. activity, depression, dyspnoea drowsiness, doses closely
changes or airway lethargy, CNS for at least 30
cerebellar obstruction; excitation or mins to endure
function, and porphyria. depression, that sedation is
produces Pregnancy. impaired not excessive.
drowsiness, judgment, • Keep patient
sedation and confusion, under constant
hypnosis. Its nervousness, observation
anticonvulsant headache, when drug is
property is insomnia, administered
exhibited at nightmares, every hour or
high doses. hallucinations, more often if
anxiety, indicated
dizziness; rash, • Monitor serum
thrombocytopeni drug levels.
a, megaloblastic Serum
anaemia; concentrations
respiratory >50 mcg/ml
depression, may cause
apnoea coma.
(especially with Therapeutic
rapid IV admin), serum
concentrations
of 15-40
mcg/ml
produce
anticonvulsant
activity in
most patients.
• Expect
barbiturates to
produce
restlessness
when given to
patients in pain
because these
drugs do not
have analgesic
action
• Be prepared
for paradoxical
responses
• Monitor for
drug
interactions.
Barbiturates
increase the
metabolism of
many drugs,
leading to
decreased
pharmacologic
al effects of
those drugs.
• Avoid
administering
with beta-
blockers,
calcium
channel
blockers,
warfarin, oral
contraceptives
Ranitidine Zantac 50 mg IV q Prophylaxis Potent anti- Safe use during Headache, • Potential
8 shifted to of stress ulcer drug that pregnancy or malaise, toxicity results
September ulceration competitively lactation is not dizziness, mental from decreased
7, 2009 and recurrent and reversibly established confusion, clearance
hemorrhage inhibits agitation, (elimination)
from peptic histamine depression, and therefore
ulcer action at H2- hallucinations in prolonged
receptor sites older adult. action; greatest
on parietal Constipation, in the older
cells, thus nausea, adult patients
blocking abdominal pain or those with
gastric acid hepatic or
secretion. renal
dysfunction.
• Be alert for
early signs of
hepatotoxicity;
jaundice (dark
urine, pruritus,
yellow slera
and skin)
• Long term
therapy may
lead to vitamin
B12
deficiency.
Tramadol Tramal 50 mg / Moderate to Centrally Hypersensitivity to Drowsiness, • Assess for
cap 1 cap q severe acute acting opiate tamadol or other dizziness, level of pain
8 or chronic receptor opioid analgesics; vertigo, fatigue, relief and
RTC pain and in agonist that patients on MAOI, headache, administer
shifted to painful inhibits the patients acutely restlessness, dose as needed
September diagnostic or uptake of intoxicated with euphoria, but not to
10, 2009 therapeutic norepinephrine alcohol, hypnotics, confusion, exceed the
measures and serotonin, centrally acting anxiety, recommended
suggesting analgesics, opioids, palpitations, total daily
both opiod and or psychotropic vasodilation, dose.
nonopioid drugs; patients on nausea, • Monitor vital
mechanisms of obstetric constipation, signs and
pain relief. preoperative urinary assess for
May produce medication, lactation. retention/frequen orthostatic
opioid-like cy. hypotension or
effects, but signs of CNS
causes less depression.
respiratory • Discontinue
depression than drug and
morphine notify the
physician if
s/sx of
hypersensitivit
y occur.
• Assess bowel
and bladder
function,
report urinary
frequency or
retention.\
• Take
appropriate
safety
precautions.

September 6, 2009

GENERI BRAN DOSAG INDICATIO MECHANIS CONTRAINDICATIO ADVERSE NURSING


C NAME D E N M OF N EFFECT RESPONSIBILITIE
NAME ACTION S
Potassium Kalium 1 tab TID hypokalemia Provides a Renal insufficiency, Diarrhea, • Watch out for
chloride durule * 6 doses direct hyperkalemia, untreated nausea, levels of
replacement of Addison’s disease, stomach potassium
potassium in constriction of the pain, electrolyte level
the body esophagus and or discomfort or to prevent
obstructive changes in gas vomiting. hyperkalemia.
the alimentary tract. • Observe 10 rights
of giving
medication.
• Watch out for
possible adverse
reaction of the
patient.
Ranitidine Zantac 150 mg / Prophylaxis Potent anti- Safe use during Headache, • Potential toxicity
tab q 12 of stress ulcer drug that pregnancy or lactation is malaise, results from
ulceration and competitively not established dizziness, decreased
recurrent and reversibly mental clearance
hemorrhage inhibits confusion, (elimination) and
from peptic histamine agitation, therefore
ulcer action at H2- depression, prolonged action;
receptor sites hallucination greatest in the
on parietal s in older older adult
cells, thus adult. patients or those
blocking Constipation, with hepatic or
gastric acid nausea, renal
secretion. abdominal dysfunction.
pain • Be alert for early
signs of
hepatotoxicity;
jaundice (dark
urine, pruritus,
yellow slera and
skin)
• Long term
therapy may lead
to vitamin B12
deficiency.

September 8, 2009

GENERI BRAN DOSAGE INDICATIO MECHANIS CONTRAINDICATIO ADVERSE NURSING


C NAME D N M OF N EFFECT RESPONSIBILITI
NAME ACTION ES
Mannitol 50 cc q 8 Raised It raises the Pulmonary congestion Fluid and • Take care to
discontinue intracranial osmotic or oedema; intracranial electrolyte avoid
d on pressure pressure of bleeding; CHF; imbalance; extravasation.
September the plasma metabolic oedema acidosis (with Observe
10, 2009 allowing with abnormal high doses). injection site for
water to be capillary fragility; Nausea, signs of
drawn out of anuria due to severe vomiting, thirst; inflammation or
body tissues. renal disease; severe headache, edema
dehydration. dizziness, • check for signs
convulsions, of fluid and
chills, fever; electrolyte
tachycardia, imbalance
chest pain; • measure I&O
blurred vision; accurately and
urticaria and record to
hypotension or achieve proper
hypertension; fluid balance
acute renal • monitor vital
failure; skin signs closely.
necrosis; Report
thrombophloebiti significant
s. changes in BP
and signs of
CHF

September 10, 2009

GENERIC BRAN DOSAG INDICATIO MECHANIS CONTRAINDICATIO ADVERSE NURSING


NAME D E N M OF N EFFECT RESPONSIBILITIE
NAME ACTION S
Tramadol Dolcet 1 tab TID Moderate to Analgesic Acute intoxication with CNS and GI • Assess for level
HCl 37.5 severe pain alcohol, hypnotics, disturbances of pain relief and
mg, narcotics, centrally- . Nausea, administer dose
paracetamo acting analgesics, dizziness. as needed but not
l 325 mg opioids or psychotropic Fatigue, to exceed the
drugs. Hypersensitivity. constipation, recommended
dry mouth. total daily dose
• Discontinue drug
and notify the
physician if s/sx
of
hypersensitivity
occur
• Take appropriate
safety
precautions.
• To be taken with
food to avoid GI
upset.
Potassium Kalium 1 tab TID hypokalemia Provides a Renal insufficiency, Diarrhea, • Watch out for
chloride durule direct hyperkalemia, untreated nausea, levels of
replacement of Addison’s disease, stomach potassium
potassium in constriction of the pain, electrolyte level
the body esophagus and or discomfort to prevent
obstructive changes in or gas hyperkalemia.
the alimentary tract. vomiting. • Observe 10 rights
of giving
medication.
• Watch out for
possible adverse
reaction of the
patient.

September 11, 2009

GENERI BRAN DOSAG INDICATIO MECHANIS CONTRAINDICATI ADVERSE EFFECT NURSING


C NAME D E N M OF ON RESPONSIBILITI
NAME ACTION ES
metoprol 50 Hypertensio Metoprolol 2nd or 3rd degree AV Bradycardia, • Take apical
ol mg/tab n selectively block; decompensated hypotension, arterial pulse and BP
BID inhibits β- heart failure; insufficiency, chest before
adrenergic clinically relevant pain, CHF, , administering
receptors but sinus bradycardia. palpitation, syncope, drug. Report to
has little or Severe peripheral dizziness, fatigue, physician
no effect on arterial circulatory depression, significant
β2-receptors disorders. Cardiogenic confusion, headache, changes in rate,
except in shock. Asthma. insomnia, short-term rhythm, or
high doses. Phaeochromocytoma memory loss, rash, quality of pulse
(without α-blockade), sexual or variations in
systolic BP <100 dysfunction/impotenc BP prior to
mmHg. Metabolic e,; diarrhea, administration.
acidosis. Pregnancy constipation, • Monitor BP,
(2nd and 3rd flatulence, GI pain, HR, and ECG
trimesters). heartburn, nausea, carefully during
Heart failure, heart administration
block, bronchospasm. • Expect maximal
effect on BP
after 1 week of
therapy
• Observe
hypertensive
patients with
CHF closely for
impending heart
failure.
Dyspnea on
exertion,
orthopnea,
night cough,
edema,
distended neck
veins.
• Monitor I&O,
daily weight,
auscultate daily
for pulmonary
rales.