Drug

Mechanism of action

Contraindicatio ns
()ith

Indications

Side effect

Nursing responsibilities 5. note indications -or therap#% onset% characteristics osigns and s#mptoms. 2. monitor "6s 7. document disease onset% subt#pe% other agents trialed and outcome. 8. ta*e e!tra precaution on the patients 'ith -ollo'ing conditions3 01 diseases/ h#perth#roidism/ &M/ $ar*inson9s disease/ elderl#/ pregnanc#% lactation.

Brand Name: Hizon epinephrine Generic Name: Epinephrine Classification Beta2 Adrenergic Agonists Dosage: 0.5 mL IM

Stimulates beta receptors in lung. ela!es bronchial smooth muscle. Increases "ital capacit# Increases B$% H %$ &ecreases air'a# resistance.

angle( closure glaucoma% shoc* +other than anaph#lactic shoc*,% organic brain damage% cardiac dilation% arrh#thmias% coronar# insu--icienc#% or cerebral arteriosclerosis (In con.unction 'ith local anesthesia% epinephrine is contraindicated -or use in -inger% toes% ears% nose% and genitalia. (In pregnant 'oman% drug is contraindicated. (In breast -eeding do not use the drug or stop breast -eeding.

Ad"anced cardiac li-e support% anaph#lactic shoc*% ocular h#pertension% open(angle glaucoma% asthmatic attac*s

epigastric pain/ 01 disorders/ di--icult# in micturition 'ith urinar# retention/ d#spnoea/ h#pergl#caemia/ s'eating/ h#persali"ation/ 'ea*ness% tremors/ coldness oe!tremities/ h#po*alaemia. 2angrene% tissue necrosis and sloughing +e!tra"asation, 'hen used in addition to local anaesthetics. E#e drops3 Se"ere smarting% blurred "ision% photophobia/ naso(lachr#mal ducts obstruction. 4edema% h#peraemia and in-lammation o- the e#es 'ith repeated administration.

Drug

Mechanism of Action :he analgesic e--ect is onl# partiall# antagonized b# the antagonist nalo!one. 0auses signi-icantl# less respirator# depression than morphine. In contrast to morphine% tramadol does not cause release ohistamine. $roduces dependence o- the mu(opioid t#pe ho' e"er there is little e"idence oabuse. :olerance occurs but is relati"el# mild/ the 'ithdra'al s#ndrome is not as se"ere as 'ith other opiates

Contraindications

Indications

Side Effects

Nursing responsibilities

Brand name: &olcet Generic Name: :ramadol h#drochloride Route of administration : 4ral Classification 3 Analgesic Dosage: 50(500mg ; 8(< hrs. prn

H#persensiti"it# to tramadol% in acute into!ication 'ith alcohol% h#pnotics% centrall# acting analgesics% opiates or ps#chotropic drugs. =se in cleitns 'ith past r resent addictin or opiate dependence or in those 'ith a prior histor# oallerg# to codeine or opiates. =se -or obstetric preoperati"e medicatin opostdeli"er# analgesia In nursing mothers.

Moderate to moderatel# se"ere pain.

&izziness% headache% 5.do not con-use 0>S stimulation% =ltram 'ith =ltrase ata!ia% sedation% 2. List reasons -or "ertigo% itching% therap#% location% constipation% nausea% onset% triggers% seizures% characteristics o- S paresthesia% and S. use a pin( cogniti"e rating scale to rate d#s-unction% pain. hallucinations% 7. Assess -or histor# tremor% amnesia% o- drug addiction% concentration allerg# to opiates or di--icult#% abnormal codeine% seizures/ gait% migraine% drug ma# increase nausea% constipation% the ris* o"omiting% d#spepsia% con"ulsions dr# mouth% diarrhea% anore!ia

Drug

Brand Name: 0alcibloc Generic Name: >i-edipine Classification: 0alcium channel bloc*er Route of administration : 4ral Dosage: 0apsules3 50(20 mg 7! a da# :ablets3 70(<0 mg per da#

Mechanism of action . It bloc*s the calcium or ?slo'? channels and inhibits entr# ocalcium ions into "ascular smooth muscles particularl# oresistance "essels and coronar# arteries. &ilates coronar# and peripheral arteries% as 'ell as "eins. 0oronar# arterial "asodilation increases coronar# blood -lo' in the ischemic post( stenotic areas% 'hile dilation o- the peripheral arteries lo'ers arterial blood pressure and reduces le-t "entricular a-terload. Some renal arter# dilatation ma# stimulate mild diuresis.

Contraindicatio ns 0ardio"ascular shoc*% se"ere aortic stenosis or in patients *no'n to be h#persensiti"e to ni-edipine. 0are is needed in patients 'ith "er# lo' blood pressure +se"ere h#potension 'ith s#stolic pressure @A0 mmHg, or decompensated heart -ailure.

Indications :reatment o"asospastic angina% chronic stable angina% h#pertension.

Side Effects Blushing% nausea% dizziness% headache% tiredness% sedation% leg edema and other mani-estations operipheral "asodilation.

Nursing Responsibilities 5. dot not con-use ni-edipine 'ith nicardipine 2. do not e!ceed a single dose 7. be-ore increasing dose% care-ull# monitor B$ 8. use onl# the sustained release tablets to treat h#pertension 5. concomitant therap# 'ith beta renergic bloc*ing agents ma# be used <. clients 'ithdra'n -rom beta bloc*ers ma# mani-est s#mptoms oincreased angina 'hich cannot be pre"ented b# ni-edipine/ in -act ni-edipine ma# increase the se"erit# o- angina situation

Drug Data Brand Name Solu(0orteGeneric Name H#drocortisone Dosage 20(280 mg6da# in single dose or di"ided doses Classification : Adrenal cortical steroid 0orticosteroid 2lucocorticoid

Mechanism of Action Enters target cells and binds to c#toplasmic receptor/ initiates man# comple! reactions that are responsible -or its anti( in-lammator#% immunosuppressi"e +glucocorticoid,% and salt(retaining +mineralocorticoid, actions..

Indication ( eplacement therap# in adrenal cortical insu--icienc# ( Allergic states C se"ere or incapacitating allergic conditions ( Hematologic disorders ( =lcerati"e colitis

Contraindications Hepatitis B%1accinia or "aricella%Antibiotic( resistant in-ections%Immunosu ppression Special recaution ! Didne# disease ( Li"er disease ( 0irrhosis ( H#poth#roidism ( =lcerati"e colitis 'ith ( H#pertension ( Heart -ailure ( :hromboembolic tendencies ( 4steoporosis ( 0on"ulsi"e disorders ( Metastatic carcinoma

Side Effects CNS: 1ertigo% headache% paresthesias% insomnia% seizures% ps#chosis% EEN": 0ataracts% glaucoma% increased I4$ Endocrine: Amenorrhea% irregular mens% gro'th retardation% decreased GI: $eptic or esophageal ulcer% pancreatitis% #ematologic: >a and -luid retention% h#pocalcemia% increased blood sugar% Musculos$eletal: Muscle 'ea*ness% steroid m#opath# and loss o- muscle mass% osteoporosis.

Nursing Responsibilities ( Assess -or contraindications. ( Assess bod# 'eight% s*in color% 16S% urinal#sis% serum electrol#tes% E(ra#s% 0B0. ( Arrange -or increased dosage 'hen patient is sub.ect to unusual stress. ( &o not gi"e li"e "accines 'ith immunosuppressi"e doses oh#drocortisone. ( 4bser"e the 55 rights o- drug administration. .( Space multiple doses e"enl# throughout the da#. ( =se minimal doses -or minimal duration to minimize ad"erse e--ects. ( &o not gi"e IM in.ections ipatient has thromboc#topenic purpura.

Drug Brand Name: Fantac Generic Name: anitidine Classification : Anti(ulcer agents Dosage: 550 C 700 mg

Mechanism of action . G Inhibits the action ohistamine at the H2 receptor site located primaril# in gastric parietal cells% resulting in inhibition o- gastric acid secretion. G In addition% ranitidine bismuth citrate has some antibacterial action against H. p#lori.

Contraindicatio ns GH#persensiti"it#% 0ross(sensiti"it# ma# occur/ some oral li;uids contain alcohol and should be a"oided in patients 'ith *no'n intolerance. Special recaution33 G enal impair( ment G 2eriatric patients +more susceptible to ad"erse 0>S reactions, G $regnanc# or Lactation

Indications =sed in management o- "arious gastro intestinal disorders such as d#spepsia% gastroesophageal re-lu! disease%peptic ulcer and Follinger( Ellison s#ndrome.

Side Effects G 0>S3 0on-usion% dizziness% dro'siness% hallucinations% headacheG 013 Arrh#thmiasG 2I3 Altered taste% blac* tongue% constipation% dar* stools% diarrhea% drug(induced hepatitis% nauseaG 2=3 &ecreased sperm count% impotenceG E>&43 2#necomastiaG HEMA:3 Agranuloc#tosis% Aplastic Anemia% neutropenia% thromboc#topeniaG L40AL3 $ain at IM siteG MIS03 H#persensiti"it# reactions% "asculitis .

Nursing Responsibilities 5. =se caution in presence o- renal or hepatic impairment 2. Assess potential interactions 'ith other pharmacologi cal agents patient ma#be ta*ing. 7. Monitor AS:%AL:%ser um creatinine%'h en used to pre"ent stress(related 2I bleeding

Drug Brand Name: $h#llocontin Generic Name: Aminoph#lline Classification : Bronchodilator Route of administration : I1%4ral Dosage: :abletsH500% 200 mg/ li;uid H505 mg65 mL/ in.ectionH 250 mg650 mL/ suppositoriesH 250% 500 mg

Mechanism of Contraindicatio Indications action ns (0ontraindicated . ela!es bronchial (S#mptomatic relie'ith smooth muscle% causing or pre"ention oh#persensiti"it# bronchodilation and bronchial asthma to an# !anthine increasing "ital and re"ersible or to capacit#% 'hich has bronchospasm eth#lenediamin been impaired b# associated 'ith e% peptic ulcer% bronchospasm and air chronic acti"e gastritis/ trapping/ in higher bronchitis and rectal or colonic concentrations% it also emph#sema irritation or inhibits the release o(=nlabeled uses3 in-ection +use slo'(reacting substance espirator# rectal preparations,. o- anaph#la!is +S S( stimulant in (=se cautiousl# A, and histamine. 0he#ne(Sto*es 'ith cardiac respiration/ arrh#thmias% treatment oacute apnea and m#ocardial brad#cardia in in.ur#% 0HB% premature babies cor pulmonale%
se"ere h#pertension% se"ere h#po!emia% renal or hepatic disease% h#perth#roidis m% alcoholism% labor% lactation.

Side Effects !CNS: Irritabilit# +especiall# children,/ restlessness% dizziness% se"ere depression !C%: $alpitations% sinus tach#cardia% "entricular tach#cardia% li-e %circulator# -ailure !GI: Loss oappetite% hematemesis% epigastric pain% gastroesophageal re-lu! during sleep! G&: B0s/urinar# retention in men 'ith prostate enlargement !Respirator': :ach#pnea% respirator# arrest

Nursing Responsibilities (Administer to pregnant patients onl# 'hen clearl# needed. (0aution patient not to che' or crush enteric(coated timed(release -orms. (2i"e immediate( release% li;uid dosage -orms 'ith -ood i- 2I e--ects occur. (Maintain ade;uate h#dration. (Monitor -or clinical signs o- ad"erse e--ects (Ensure that diazepam is readil# a"ailable to treat seizures.

Drug . Brand Name: 1oltaren Generic Name: &iclo-enac sodium Classification : Anti( in-lammator# Route of administration : oral Dosage: 50 mg

Mechanism of action

Inhibits prostaglandin s#nthesis to cause antip#retic and anti( in-lammator# e--ects/ the e!act mechanism is un*no'n.

Contraindicatio ns 0ontraindicated 'ith allerg# to >SAI&s% signi-icant renal impairment% pregnanc#% lactation. =se cautiousl# 'ith impaired hearing% allergies% hepatic% cardio"ascular% and 2I conditions

Indications . Acute or long( term treatment omild to moderate pain% including d#smenorrhea heumatoid arthritis 4steoarthritis An*#losing spond#litis :reatment oactinic *eratosis in con.unction 'ith sun a"oidance 4phthalmic3 $ostoperati"e in-lammation -rom cataract e!traction

Side Effects . CNS: Headache, dizziness, somnolence% insomnia% -atigue% tiredness% tinnitus% ophthalmologic e--ects Dermatologic: ash% pruritus% s'eating% dr# mucous membranes% stomatitisGI: Nausea, dyspepsia, GI pain, diarrhea, "omiting% constipation, -latulence G&: &#suria% renal impairment #ematologic: Bleeding% platelet inhibition 'ith higher doses

Nursing Responsibilities 5.:a*e drug 'ith -ood or meals i2I upset occurs. 2.:a*e onl# the prescribed dosage. :hese side e--ects ma# occur3 &izziness% dro'siness +a"oid dri"ing or using dangerous machiner# 'hile using this drug,. 7. eport sore throat% -e"er% rash% itching% 'eight gain% s'elling in an*les or -ingers% changes in "ision/ blac*% tarr# stools.

Drug

Mechanism of action &epresses the 0>S% probabl# b# potentiating gamma( aminobut#ric acid% an inhibitor# neurotransmitter% produces s*eletal muscle rela!ation b# inhibiting spinal pol#s#naptic a--erent path'a#s% has anticon"ulsant properties due to enhanced pres#naptic inhibition. It also relie"es an!iet#. It is used also as sedati"e% s*eletal muscle rela!ation% cessation o- seizure acti"it#.

Contraindicatio ns &ependence on other substances including alcohol e!cept in management oacute 'ithdra'al reactions. Se"ere chronic h#percapnia.

Indications Management oan!iet#% $reoperati"e sedation% light anesthesia% amnesia% treatment ostatus epilepticus% s*eletal muscle rela!ant Management othe s#mptoms oalcohol 'ithdra'al. Special recaution3 0ardiorespi. insu--icienc#/ pregnanc#% lactation/ m#asthenia gra"is

Side effect 0>S3 dizziness% dro'siness% letharg#% hango"er% parado!ical e!citation% mental depression% headache EE>:3 blurred "ision esp3 respirator# depression 013 h#potension +I1 onl#, 2I3 nausea% "omiting% diarrhea% constipation &erm3 rashes Local3 "enous thrombosis% phlebitis +I1, Misc3 tolerance% ps#chological dependence% ph#sical dependence

Nursing responsibilities 5.&on9t mi! in.ectable diazepam 'ith other drugs% and don9t store parenteral solution in plastic s#ringes. 2. A"oid mi!ing 'ith an# other drugs or solutions% and a"oid in-usion sets or containers made -rom pol#"in#l chloride.

Brand Name: &iazepam Generic Name: 1alium Classification Anti(con"ulsant Dosage: Tab Adult 5(20 mg dail#

Drug

Mechanism of action Ihibits sodium and chloride reabsorption at the pro!imal tubules% distal tubules and ascending loop oHenle# leading to e!cretion o- 'ater% together 'ith sodium% chloride and potassium.

Contraindicatio ns . H#persensiti"it# to sul-on#ureas/ Anuria

Special Precaution: Elderly patients, diabetes mellitus severe hepatic disease, pregnant or breastfeeding patients, neonates

Indications Bor acute pulmonar# edema% Edema caused b# heart -ailure% hepatic cirrhosis and renal disorder

Side effect 0>S3dizziness%headac he%"ertigo%'ea*ness%le tharg#%paresthesia 013 h#potension%light( headedness%necrotizin g angiitis%thrombolebitis% arr#thmias EE>:3 blurred "ision%hearing loss%tinittus 2I3 acute pancreatitis 2=3 oliguria%intestinal nephritis HEMA:4L42I03 Leucopenia%thromboc# topenia%hemol#tic anemia HE$A:I03 .aundice M=04SDELE:AL3 muscle pain%muscle cramps SDI>3 er#thema multi-orme 4:HE 3 -e"er%trancient pain

Nursing responsibilities 5.A"oid dri"ing and other hazardous acti"ities until he *no's ho' drug e--ects concentration and alertness. 2.0aution the patient to stop to a"oid alcohol and herbs 'hile ta*ing this drug. 7. In-orm patient that he 'ill regularl# undergo blood testing therap#.

Brand Name: Lasi! Generic Name: Burosemide Classification &iuretic% Antih#pertensi"e Dosage: In.ection C 50 mg6dl 4ral Solution( 50 mg6ml :ablet( 20 mg

Drug

Mechanism of action $aracetamol produces analgesia b# raising threshold o- the pain center o- the brain and b# obstructing imulpses at the pain(mediating chemoreceptors. :he drug produces antip#resia b# an action oh#pothalamus / heat dissipation%is increased as a result o"asodilation and K peripheral blood -lo'

Contraindicatio ns >ephropath# .

Indications

Side effect

Nursing responsibilities

Brand Name: Ae*nil Generic Name: $aracetamol Classification Analgesic % Antip#retic Dosage: I50 #ears old 5(2 ml Adult and children J 50#r. 2(7 ml

Bor s#mpmtomatic relie- o- -e"er and pain Special associated 'ith Precaution: enal and hepatic common childhood -ailure disorders%tonsillit is%= :I%post immunization reactions

HEMA:4L42I03 lue*openia%thromboc#t 5. Instruct patient to openia ta*e 'ith meals. SDI> s*in eruption 2. Ha"e plent# o'ater 'hen ta*ing this drug.

Drug

Mechanism of action 0ompetes 'ith histamine -or H 5( receptor site on e--ector cells/ decreases allergic response b# bloc*ing histamine.

Contraindicatio ns
. Newborn or premature infants, hyperthyroidism, hypertension. acute asthma attack, active peptic ulcer, tuberculosis Special Precaution: Liver disease,epilepsy,c hronic respiratory disorders, hepatic disease,pregnant or breastfeeding pts.

Indications :reatment -or allergic disorders o- allergic rhinitis% bronchial asthma% -ood and drug allerg#% measles% asthma % pains% headaches% common cold% anaph#lactic shoc*.

Side effect &r# mouth% constipation% blurred "ision% delirium % agitation% .aundice% "entricular tach#cardia% dro'siness% nasal stu--iness% cardiac arrh#thmias% cardiac -ailure% s*in rashes.

Nursing responsibilities 5Assess patientLs condition be-ore a-ter therap# and regularl# a-ter. 2. Assess -or h#persensiti"it# reaction3 -e"er% s*in rash. 7. :ell patient to report ad"erse e--ect. 8. Ad"ise patient that drug ma# cause photosensiti"it#. 5. A"oid dri"ing and other hazardous acti"ities because dro'siness ma# occur% obser"e until drugLs e--ect are *no'n.

Brand Name: 0hlorphenamine Generic Name: Antamin Classification Antihistamines% Antiallergies Dosage: Adult3 5 tab6 7! a da#

Drug

Mechanism of action .Inhibits brea*do'n o-ibrin clots.It acts primaril# b# bloc*ing the binding oplasminogen and plasmin to -ibrin/ direct inhibition oplasmin occurs onl# to a limited degree.

Contraindicatio ns H#persensiti"it# to drugs% patients 'ith intra"ascular clotting because o- the ris* othrombosis. Se"ere renal insu--ienc# % patients 'ith microscopic hematuria.
Special Precaution: Patients with pre disposition to thrombosis, hematuria, renal impairment,pregna nt or breastfeeding pts.

Indications :reatment and proph#la!is ohemorrhage associated 'ith e!cessi"e -ibrinol#sis.

Side effect .2astrointestinal disturbances% h#potension% disturbance color "ision% thrombotic complication.

Nursing responsibilities 5. $er-orm blood tests% li"er -unction tests% e#e e!amination% and obtain prothrombine time. 2. educed dosage -or patients 'ith renal impairment. 7. Ad"ice patient to report "isual abnormalities to the ph#sician.

Brand Name: Hemostan Generic Name: :rane!amic acid Classification Haemostatics Dosage: 4ral( +55 to 25 mg, 2 to 8 ! a da#

Drug

Mechanism of action 0auses an in-lu! o-luid in the intestinal tract b# increasing the osmotic pressure 'ithin the intestinal lumen.Bacterial metabolism o- the drug to lactate and other acids 'hich are onl# partiall# ab"sorbed in the distal ileum and colon augments the osmotic e--ect olactulose.

Contraindicatio ns .$atients 'ho re;uire to lo' lactose diet% galactosaemia or disaccharide de-icienc# % intestinal obstruction.
Special Precaution: Diabetes mellitus elderly,pregnant or breastfeeding pts. , do not use if presence of adominal pain , nausea,vomiting, fever,.

Indications 0onstipation% salmonellosis% treatment -or hepatic encephalopath#.

Side effect Abdominal discom-ort associated 'ith -latulence and intestinal cramps% nausea% "omiting% diarrhea on prolonged use.

Nursing responsibilities 5..Bor patient 'ith hepatic encephalopath#% regularl# assess mental condition and ammonia le"el. 2. Monitor -or possible 2I reactions3 nausea% "omiting% abdominal cramps% blenching% diarrhea % -latulence% and distention. 7. Monitor -or increased glucose le"els -or diabetic patient.

Brand Name: Buscopan plus Generic Name: H#oscine6 $aracetamol Classification Antispasmodic Dosage: In-ants3 5 mL % initial dose :I& 0hildren3 5(< #rs. 5(50 mL % initial dose :I& 0hildren3 M( 58 #rs. 55 mL% Initial dose :I& Adult3 55(85 mL :I&

Drug

Mechanism of action &opamine agonist that acts b# increasing receptor sensiti"it# and response o- upper 2I tissues to acet#choline. :his causes the contraction ogastric smooth muscles% rela!ation o- p#loric sphincter and duodenal bulb and increased peristalsis 'ithout stimulating gastric%biliar# and pancreatic secretions.It also produces sedation and induces releases oprolactin.

Contraindicatio ns .$atients in 'hom increased 2I might be dangerous %h#persensiti"it# to drugs% children% lactation% patients 'ith breast cancer% epileptic patients.
Special Precaution: Patients with Parkinsonism and history of mental illness,epileptics,el derly ,pregnant or breastfeeding pts.

Indications 2astrointestinal motilit# disturbances.>au sea and "omitingocentral and peripheral origin associated 'ith surger# % metabolic diseases% in-ectious diseases% and drug induced.

Side effect Sedation% restlessness% -atigue diarrhea% insomnia% headache% dizziness% ner"ousness% menstrual disorders% dro'siness% bo'el upsets.

Nursing responsibilities 5..Bre;uentl# monitor blood pressure o- patients ta*ing I1 -orm odrug. 2. Assess mental status during treatment 3 depression%an!iet#% irritabilit#. 7. Assess patientLs and -amil#Ls *no'ledge o- drug therap#.

Brand Name: $lasil Generic Name: Metoclopera mide Classification Antiemetic% 2I regulator% anti( in-lammator#% anti-latulents Route: IM% slo' I1 in.ection o"er 5( 2 mins. Dosage: $edia3 5 (50 mg :I& Adult3 50 mg :I&

Drug

Mechanism of action

Contraindicatio ns Acute m#ocardial in-arction / 'ith lo' -illing pressures % e!cept in the intensi"e care unit 'ith continuous haemod#namic monitoring/ le-t heart -ailure 'ith lo' -illing pressures / shoc*/ "er# lo' blood pressure . .
Special Precaution: Pregnant or breastfeeding patients, acute myocardial infarction, constrictive pericarditis.

Indications .$re"enti"e and long term treatment oangina pectoris% congesti"e heart -ailure% arterial "asodilators% pulmonar# h#pertension.

Side effect :ransient h#po!emia%headache% N blood pressure% K pulse rate% dizziness and 'ea*ness% nausea%"omiting% allergic s*in reactions.

Nursing responsibilities 5.Assess -or pain3 duration% time started% acti"it# being per-ormed% character% intensit#. 2. Monitor B6.$% pulse at baseline and during treatment. 7. 0aution pt. to ma*e position changes slo'l# to pre"ent orthostatic h#potension. 8. Instruct pt. to s'allo' sustained released tablet 'hole% do not che'/ SL tablet should be dissol"ed under the tongue %do not s'allo' che'able tablet should be che'ed thoroughl#.

Brand Name: Isordil

Increases suppl# oo!#gen to the heart b# dilating both the Generic Name: arteries and "eins Isosorbide 'hich suppl# the dinitrate6mononit heart itsel-. rate Classification Anti( anginal Route: 4ral Dosage: 80 mg 4&

EME 2E>0O & =2S

Submitted b#3 Mar# Anne E. ElepaPo BS> C Q 0 Submitted to3 Ms. Silgrid 1illanue"a 0linical Instructor