RANITIDINE

DRUG
CLASSIFICATION
INDICATION CONTRAINDICATION SIDE EFFECTS ADVERSE EFFECT NURSING CONSIDERATIONS
ROUTE
DOSAGE
Zantac, Potent anti-ulcer Hypersensitivity to Blocks CNS: Headache, Assessment & Drug Effects
Zantac drug that ranitidine; acute daytime and malaise,
EFFERdose, competitively and porphyria; OTC nocturnal dizziness, Potential toxicity

Zantac reversibly inhibits administration in basal gastric somnolence, results from

GELdose, histamine action at children <12 y. acid secretion insomnia, decreased clearance
Zantac-75 H2-receptor sites stimulated by vertigo, mental (elimination) and
on parietal cells, histamine and confusion, therefore prolonged
Classifications thus blocking reduces agitation, action; greatest in the
: gastric acid gastric acid depression, older adult patients or
GASTROINTES secretion. release in hallucinations in those with hepatic or
TINAL AGENT; Indirectly reduces response to older renal dysfunction.
ANTISECRETO pepsin secretion food, adults. CV: Brady Lab tests: Periodic

RY (H2- but appears to pentagastrin, cardia (with rapid liver functions.

RECEPTOR have minimal and insulin. IV Monitor creatinine
ANTAGONIST effect on fasting Shown to push). GI: Constip clearance if renal
) Prototype: and postprandial inhibit 50% of ation, nausea, dysfunction is present
Cimetidine serum gastrin the stimulated abdominal pain, or suspected. When
Pregnancy concentrations or gastric acid diarrhea. Skin: Ra clearance is <50
Category: B secretion of gastric secretion. sh. Hematologic: mL/min,
intrinsic factor or Reversible manufacturer
mucus. decrease in WBC recommends
count, reduction of the dose
thrombocytopeni to 150 mg once q24h
a. Body as a with cautious and
Whole: Hypersen gradual reduction of
sitivity the interval to q12h or
reactions, anaphy less, if necessary.
laxis (rare). Be alert for early signs
of hepatotoxicity
(though low and
thought to be a
hypersensitivity
reaction): jaundice
(dark urine, pruritus,
yellow sclera and
skin), elevated
transaminases
(especially ALT) and
LDH.
Long-term therapy
may lead to vitamin
B12 deficiency.

Patient & Family Education

Note: Long duration

of action provides
ulcer pain relief that is
maintained through
 the night as well as
the day.
Be aware that even if
symptomatic relief is
provided by
ranitidine, this should
not be interpreted as
absence of gastric
malignancy. Follow-up
examinations will be
scheduled after
therapy is
discontinued.
Adhere to scheduled
periodic laboratory
checkups during
ranitidine treatment.
Do not supplement
therapy with OTC
remedies for gastric
distress or pain
without physician's
advice (e.g., Mylanta II
reduces ranitidine
absorption).
Do not smoke;
research shows
 smoking decreases
ranitidine efficacy and
adversely affects ulcer
healing.
Do not breast feed
while taking this drug
without consulting
physician.
 PARACETAMOL
DRUG
CLASSIFICATION
INDICATION CONTRAINDICATION SIDE EFFECTS ADVERSE EFFECT NURSING CONSIDERATIONS
ROUTE
DOSAGE
Classifications: Adrenal Body as a
CENTRAL insufficiency Whole: Negligible Assessment & Drug Effects
NERVOUS concomitantly with with Monitor for S&S of:
SYSTEM AGENT; a recommended
hepatotoxicity, even
NONNARCOTIC mineralocorticoid; It provides dosage; with moderate
ANALGESIC, inflammatory temporary rash. Acute acetaminophen doses,
ANTIPYRETIC conditions, allergic analgesia for poisoning: Anore
especially in
Pregnancy states, collagen mild to xia, nausea, individuals with poor
Category: B diseases, moderate vomiting,
nutrition or who have
hematologic Hypersensitivity to pain. In dizziness, ingested alcohol over
Mild to disorders, cerebral acetaminophen or addition, lethargy, prolonged periods;
Moderate Pain, edema, and phenacetin; use with acetaminophe diaphoresis, poisoning, usually
Fever Adult: PO addisonian shock. alcohol. n lowers body chills, epigastric from accidental
325650 mg q4 Also palliative temperature or abdominal
ingestion or suicide
6h (max: 4 g/d) treatment of in individuals pain, diarrhea; attempts; potential
PR 650 mg q4 neoplastic disease, with a fever. onset
abuse from
6h (max: 4 g/d) as adjunctive of hepatotoxicity psychological
Child: PO 1015 short-term therapy elevation of dependence
mg/kg q46h PR in acute rheumatic serum
(withdrawal has been
25 y, 120 mg disorders and GI transaminases associated with
q46h (max: 720 diseases, and as a (ALT, AST) and
restless and excited
mg/d); 612 y, diagnostic test for bilirubin;
 325 mg q46h Cushing's hypoglycemia, he responses).
(max: 2.6 g/d) syndrome and for patic coma, acute
Neonate: PO 10 differential renal Patient & Family Education
15 mg/kg q68h diagnosis of failure (rare). Chr
Do not take other
adrenal onic
hyperplasia and ingestion: Neutro medications (e.g., cold
adrenal adenoma.. penia, preparations)
pancytopenia, containing
leukopenia, acetaminophen
thrombocytopeni without medical
c advice; overdosing
purpura, hepatot and chronic use can
oxicity in cause liver damage
alcoholics, renal and other toxic
damage. effects.
Do not self-medicate
adults for pain more
than 10 d (5 d in
children) without
consulting a physician.
Do not use this
medication without
medical direction for:
fever persisting longer
than 3 d, fever over
39.5 C (103 F), or
recurrent fever.
 Do not give children
more than 5 doses in
24 h unless prescribed
by physician.
Do not breast feed
while taking this drug
without consulting
physician.
 DEXAMETHASONE
DRUG
CLASSIFICATION
INDICATION CONTRAINDICATION SIDE EFFECTS ADVERSE EFFECT NURSING CONSIDERATIONS
ROUTE
DOSAGE
Classifications: Adrenal Systemic fungal Aerosol Assessment & Drug Effects
HORMONES AND insufficiency infection, acute therapy: Nasal
SYNTHETIC concomitantly with infections, active or irritation, dryness Monitor and report
SUBSTITUTES, a resting tuberculosis, , epistaxis, S&S of Cushing's
ADRENAL mineralocorticoid; vaccinia, varicella, rebound syndrome (see
CORTICOSTEROI inflammatory administration of live congestion, Appendix F) or other
D; conditions, allergic virus vaccines (to bronchial systemic adverse
GLUCOCORTICOI states, collagen patient, family asthma, effects.
D; STEROID diseases, members), latent or Drug has anosomia, Monitor neonates
Prototype: hematologic active antiinflammat perforation of born to a mother who
Prednisone disorders, cerebral amebiasis. Ophthalm ory and nasal has been receiving a
Pregnancy edema, and ic use:Primary open- immunosuppr septum. Systemic corticosteroid during
Category: C addisonian shock. angle glaucoma, eye ession Absorption pregnancy for
Also palliative infections, superficial properties. CNS: Euphoria, symptoms of
Allergies, treatment of ocular herpes insomnia, hypoadrenocorticism.
Inflammation, neoplastic disease, simplex, keratitis and convulsions, Monitor for S&S of a
Neoplasias as adjunctive tuberculosis of eye. increased ICP, hypersensitivity
Adult: PO 0.254 short-term therapy Safe use during vertigo, reaction (see
mg b.i.d. to q.i.d. in acute rheumatic pregnancy (category headache, Appendix F). The
IM 816 mg q1 disorders and GI C), lactation, or in psychic acetate and sodium
3 wk or 0.81.6 diseases, and as a children is not disturbances. CV: phosphate
mg intralesional diagnostic test for established. CHF, formulations may
 q13 wk Child: Cushing's hypertension, ed contain bisulfites,
PO/IV/IM 0.08 syndrome and for ema. Endocrine: parabens, or both;
0.3 mg/kg/d differential Menstrual these inactive
divided q612h diagnosis of irregularities, hyp ingredients are
Cerebral Edema adrenal erglycemia; cushi allergenic to some
Adult: IV 10 mg hyperplasia and ngoid state; individuals.
followed by 4 mg adrenal adenoma. growth
q4h, reduce suppression in Patient & Family Education
dose after 24 d children;
Take drug exactly as
then taper over hirsutism. Special
57 d Child: Senses: Posterior prescribed.
Report lack of
PO/IV/IM 12 subcapsular
mg/kg loading cataract, increase response to
dose, then 11.5 d IOP, glaucoma, medication or
mg/kg/d divided exophthalmos. GI malaise, orthostatic
q46h (max: 16 : Peptic ulcer hypotension,
mg/d) Shock with possible muscular weakness
Adult: IV 16 perforation, and pain, nausea,
mg/kg as a single abdominal vomiting, anorexia,
dose or 40 mg distension, hypoglycemic
repeated q26h nausea, reactions (see
if needed increased Appendix F), or
Dexamethasone appetite, mental depression to
Suppression Test heartburn, physician. These
Adult: PO 0.5 mg dyspepsia, symptoms may signal
q6h for 48 h pancreatitis, bow hypoadrenocorticism.
Report changes in
Inflammation el
 Adult/Child: perforation, oral appearance and easy
Ophthalmic/Topi candidiasis. Musc bruising to physician.
cal/Inhalation/In uloskeletal: Musc These symptoms may
tranasal See le weakness, loss signal
Appendix A. of muscle hyperadrenocorticism
mass, vertebral .
compression Note: Hiccups that
fracture, occur for several
pathologic hours following each
fracture of long dose may be a
bones, tendon complication of high-
rupture. Skin: Ac dose oral
ne, impaired dexamethasone.
wound Keep appointments
healing, petechia for checkups; make
e, ecchymoses, sure electrolytes and
diaphoresis, BP are evaluated
allergic during therapy at
dermatitis, hypo- regular intervals.
or Add potassium-rich
hyperpigmentati foods to diet; report
on, SC and signs of hypokalemia
cutaneous (see Appendix F).
atrophy, burning Concomitant
and tingling in potassium-depleting
perineal area diuretic can enhance
(following IV dexamethasone-
injection). induced potassium
loss.
Note: Dexamethasone
dose regimen may
need to be altered
during stress (e.g.,
surgery, infections,
emotional stress,
illness, acute
bronchial attacks,
trauma). Consult
physician if change in
living or working
environment is
anticipated.
Discontinue drug
gradually under the
guidance of the
physician.
Note: It is important
to prevent exposure
to infection, trauma,
and sudden changes
in environmental
factors, as much as
possible, because
drug is an
 immunosuppressor.
Do not breast feed
while taking this drug
without consulting
physician.