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Name of the Mechanism of Dosage Indications Contraindication Adverse reaction Nursing Consideration/
Drug Action Responsibilities
Phenytoin May stabilize Oral To control Contraindicated in CNS: ataxia, decreased Therapeutic dose usually
(diphethydant neuronal suspension: tonic-clonic pts hypersensitive coordination, mental increases during
oin) membranes and 125mg/5m (grand mal) to hydantoin, in confusion, slurred pregnancy.
If rash appears, stop drug.
limit seizure L and complex those taking speech, dizziness,
If rash is scarlatiniform or
activity either by Tablets partial delavirdine, and in headache, insomnia,
morbilliform, resume drug
increasing efflux (chewable): (temporal those with sinus nervousness, twitching, after drug clears.
or decreasing 50mg lobe) bradycardia, SA peripheral neuropathy. Dont stop drug suddenly
influx of sodium seizures block, second or CV: bradycardia, because this may worsen
ions across cell For patients third degree AV periarteritis nodosa, seizures.
membranes in requiring a block, Adams-Stoke hypotension. Monitor drug level.
the motor cortex loading dose Syndrome EENT: diplopia, Therapeutic level of total
phenytoin is 10 to 20
during To prevent Use cautiously in nystagmus, blurred
mcg/mL.
generation of and treat pts in patients with vision, thickening of Monitor CBC and calcium
nerve impulses. seizures hepatic dysfunction, facial features. every 6 mos, and
occurring hypotension, GI: gingival hyperplasia, periodically monitor
during myocardial nausea, vomiting, hepatic function. If
neurosurgery insufficiency, constipation. megaloblastic anemia is
. diabetes, Hematologic: evident, prescriber may
Status respiratory agranulocytosis, order folic acid and Vit.
B12.
epilleptus depression; in leukopenia,
Maintain seizure
elderly or pancytopenia, precautions, as needed.
debilitated pts; and thrombocytopenia, Mononucleosis may
in those receiving macrocythemia, decrease level. Watch for
other hydantoin megaloblastic anemia. increased seizures.
derivatives. Watch for gingival
Elderly patients hyperplasia, especially in
tend to metabolize children.
If seizure control is
drug slowly and
established with divided
may need reduced doses, once-daily dosing
dosages. may be considered.
Avoid use during Because of the risks of
pregnancy due to cardiac and local toxicity
fetal risk. Breast with parenteral phenytoin,
feeding isnt use oral form when
recommended. possible.
Name of Mechanism
the Drug of Action Dosage Indications Contraindication Adverse reaction Nursing
Consideration/
Responsibilities
Losartan Inhibits Tablets: Hypertension Patients Patients with HPN or left Drug can be used
vasoconstrictiv 25mg, Neuropathy hypersensitive to ventricular hypertrophy. alone or with other
e and 50mg, in pts with drug. Breast- CNS: dizziness, asthenia, antihypertensive.
aldosterone 100mg type 2 feeding isnt fatigue, headache, insomnia If hypertensive
secreting diabetes recommended CV: edema, chest pain effect is
action of To reduce during losartan EENT: nasal congestion inadequate using
angiotensin II therapy. sinusitis, pharyngitis, sinus
risk of stroke once-daily doses,
disorder.
by blocking in patients twice-daily
GI: abdominal pain, nausea,
angiotensin II with regimen using the
diarrhea, dyspepsia
receptor on the hypertension same or increased
Musculoskeletal: muscle
surface of and left total daily dose
cramps, myalgia, back or leg
vascular ventricular pain may give a more
smooth muscle hypertrophy Respiratory: cough, upper satisfactory
and other respiratory tract infection response.
tissue. Other: angioedema Monitor pts BP
closely to evaluate
Patients with neuropathy effectiveness of
CNS: asthenia, fatigue, fever, the therapy.
hypoesthesia Monitor pts who
CV: chest pain, hypotension, are also taking
orthostatic hypotension. diuretics for
EENT: sinusitis, cataract symptomatic
GI: diarrhea, dyspepsia, hypotension.
gastritis, nausea. Regularly assess
GU: UTI the pts renal
Hematologic: anemia function (via
Metabolic: hyperkalemia, creatinine and BUN
hypoglycemia, hyponatremia,
levels).
weight gain
Musculoskeletal: back pain,
leg or knee pain, muscle
weakness.
Respiratory: cough,
bronchitis.
Skin: cellulitis
Other: flulike syndrome,
diabetic vascular, disease,
angioedema, infection,
trauma, diabetic neuropathy.