DRUG NAME

Generic Name: furosemi de Brand Name:

DOSE
Initially, 20 80 mg/day PO as a single dose. If needed, a second dose may be given in 68 hr.

ACTION
Furosemide inhibits reabsorption of Na and chloride mainly in the medullary portion of the ascending Loop of Henle. Excretion of potassium and ammonia is also increased while uric acid excretion is reduced. It increases plasma-renin levels and secondary hyperaldosteronism may result. Furosemide reduces BP in hypertensives as well as in normotensives. It also reduces pulmonary oedema before diuresis has set in.

INDICATION CONTRAINDICATIO N

ADVERSE EFFECT

NURSING CONSIDERATION

Oral, IV: Edema associated with CHF, cirrhosis, renal disease

Severe sodium and water depletion, hypersensitivity to sulphonamides and furosemide, hypokalaemia, hyponatraemia, precomatose states associated with liver cirrhosis, anuria or renal failure.

Fluid and electrolyte imbalance.

History: Allergy to furosemide, sulfonamides, tartrazine; electrolyte depletion anuria, severe renal failure; hepatic coma; SLE; gout; diabetes mellitus; lactation, pregnancy

Lasix

Rashes, photosensitivity, nausea, diarrhoea, blurred vision, dizziness, headache, hypotension. Bone marrow depression (rare), hepatic dysfunction.

IV: Acute pulmonary edema

Oral: Hypertension

Physical: Skin color, lesions, edema; orientation, reflexes, hearing; pulses, baseline ECG, BP, orthostatic BP, perfusion; R, pattern, adventitious sounds; liver evaluation, bowel sounds; urinary output patterns; CBC, serum electrolytes

Addisons disease.

Hyperglycaemia, glycosuria, ototoxicity.

Potentially Fatal: Rarely, sudden death and cardiac arrest. Hypokalaemia and

magnesium depletion can cause cardiac arrhythmias.

(including calcium), blood sugar, LFTs, renal function tests, uric acid, urinalysis, weight

Generic Name: Acetylcysteine Brand Name: Acetadote, Mucomyst

Adults and children: 1 to 2 ml 10% or 20% solution by direct instillation into trachea as often asq hour. Or, 1 to 10 ml of 20% solution or 2 to 20 ml of 10% solution by nebulization q 2 to 6hours, prn

Mucolytic that reduces the viscosity of pulmonary secretions by splitting disulfide linkages between mucoprotein molecular complexes. Also, restores liver stores of glutathione to treat acetaminophen toxicity.

Adjunct therapy for abnormal viscid or thickened mucous secretions in patients with pneumonia, bronchitis, bronchiectasis, primary amyloidosis of the lung, tuberculosis, cystic fibrosis, emphysema, atelectasis, pulmonary complications of thoracic surgery, or CV surgery

Contraindicated in patients hypersensitive to drug. Use cautiously in elderly or debilitated patients with severe respiratory insufficiency. Use I.V.formulation cautiously in patients with asthma or a history of bronchospasm.

CNS: fever, drowsiness, abnormal thinking, gait disturbances CV: tachycardia, hypotension, hypertension, flushing, chest tightness EENT: rhinorrhea, ear pain, eye pain, pharyngitis, throat tightness GI: stomatitis, nausea, vomiting Respiratory: rhonchi, bronchospasm, cough, dyspnea Skin: rash, clamminess, diaphoresis, pruritus, urticaria Other: angioedema, chills, anaphylactoid reaction

Observe 10 rights in drug administration. Use plastic, glass, stainless steel, or another nonreactive metal when giving by nebulization. Handbulb nebulizers arent recommended because output is too small and particle size too large. Drug is physically or chemically incompatible with tetracyclines, erythromycin lactobionate,amphot ericin B, and ampicillin sodium. If given by aerosol inhalation, nebulize these drug

Generic Name:

PO (Adults

It relieves nasal

1. To control

1. Hypersensitivity to

1. Nervousness

1. Assess lung sounds,

Albuterol Brand Name: Salbutamol

and Children more than 12 years): 24 mg 3-4 times a day or 4-8 mg of extended dose tablets twice a day.

congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following mechanism that takes place when Salbutamol is administered.

and prevent adrenergic amines reversible 2. Hypersensitivity to airway fluorocarbons obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD) 2. Quick relief for bronchospas m 3. For the prevention of exerciseinduced bronchospas m 4. Long-term control agent for patients with chronic or persistent bronchospas m

2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Restlessness Tremor Headache Insomnia Chest pain Palpitations Angina Arrhythmias Hypertension Nausea and vomiting 12. Hyperglycemia 13. Hypokalemia

2.

3.

4.

5.

6.

PR and BP before drug administration and during peak of medication. Observe fore paradoxical spasm and withhold medication and notify physician if condition occurs. Administer PO medications with meals to minimize gastric irritation. Extended-release tablet should be swallowed-whole. It should not be crushed or chewed. If administering medication through inhalation, allow at least 1 minute between inhalation of aerosol medication. Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth.

7. Inform the patient that Albuterol may cause an unusual or bad taste. Generic Name: Doxofylline Brand Name: Ansimar 400 mg (8am-8pm) Bronchial asthma & pulmonary disease with spastic bronchial component Patient allergic to the drug. Patient with acute myocardial linfarction. Hypotension lactation Nausea, vomiting, epigastric pain cephalalgia ,irritability, insomnia, tachycardia extrasystole, tachypnea, hyperglycemia, albuminuria Use Cautiouslywith patients having Liver Disease Chronic Heart Failure Chronic obstructive lung disease, concominant infection and Pregnancy

Generic Name: Hydrocortisone Brand Name: Hydrocortone

20-240 mg/day insingle dose or divided doses

Enters target cells and binds to cytoplasmic receptor; initiates many complex reactions that are responsible for its anti-inflammatory, immune suppressive (glucocorticoid), and salt-retaining (mineralocorticoid) actions. Some actions maybe undesirable, depending on drug use.

Replacement therapy in adrenal corticalin sufficiency -Allergic states severe or incapacitating allergic conditions Hematologic disordersUlcerative colitis

Allergy to any component of the drug Fungal infections Amebiasis Hepatitis B Vaccinia or varicella Antibioticresistant infections Immuno suppression

CNS:Vertigo, headache, paresthesias, insomnia, seizures, psychosis CV: Hypotension, shock, H PN and heart failure secondary to fluid retention, thrombo embolism,thrombo phlebitis, fat embolism, cardiac arrhythmias Dermatologic: Thin, fragile skin, petechiae,

Before - Assess for contraindications. - Assess body weight, skin color, V/S, urinalysis, serum electrolytes, X-rays, CBC. - Arrange for increased dosage when patient is subject to unusual stress. - Do not give live vaccines with immunosuppressive doses of hydrocortisone. - Observe the 15 rights of druga dministration.

ecchymoses, purpura, striae, subcutaneousfat atrophy EENT: Cataracts, glaucoma, increased IOP

During - Give daily before 9am to mimic normal peak diurnal corticosteroid levels - Space multiple doses evenly throughout the day. - Use minimal doses for minimal duration to minimize adverse effects. - Do not give IM injections if patient has thrombocytopenic purpura. - Taper doses when discontinuing high -dose or long-term therapy. After - Monitor client for at least 30minutes. - Educate client on the side effects of the medication and what to expect. - Instruct client to report pain at injection site. - Instruct client to take drug exactly as prescribed. - Dispose of used

materials properly.Document that drug has been given