Prescribed drugs (dosage, route, frequency, timing) Prednisone 200 mg/tab Oral I tab BID

Classification and mechanism of action Classification: Corticosteroid (intermediate acting) Glucocorticoid hormone

Indication and contraindication Indication: y

Side effects or adverse reactions

Special precautions

Nursing responsibilities

Replaceme nt therapy in adrenal cortical insufficien cy. Mechanism of y Short term action: manageme nt of Enters target cells various and binds to inflammato intracellular ry and corticosteroid allergic receptors, disorders initiating many such as, complex reactions rheumatoid that are arthritis, responsible for its collagen anti-inflammatory diseases, and dermatolog immunosuppressi ic diseases ve effects. status asthmaticu s and autoimmun e disorders. Contraindication: y Contraindi

CNS: vertigo, head ache, paresthesias, cataracts, increased IOD glaucoma. CV: hypotension, shock, cardiac arrhythmias ELECTROLYTE: Na+ and fluid retension, hypokalemia hypocalcemia. GI: nausea and vomiting increased appetite, weight gain anaphylactic reaction. MUSCUSKELETAL: muscle weakness, steroid myopathy loss of muscle mass, osteoporosis, spontaneous fractures. OTHER: immunosuppression aggravation or masking of infections, impaired wound healing, thin, fragile skin.

Use cautiously with renal or liver disease, hypothyroidism, ulcerative colitis with impending perforation, diverculitis active or laten peptic ulcer, inflammatoru bowel disease, CHF, hypertension.

y y

Check doctors order. Observe 10 rights. Administer once a day doses before 9 am to mimic normal peak corticostero id blood levels. Increased dosage when patient is subject to stress. Taper doses when discontinui ng highdose or long term therapy to avoid

cated with infection especially tuberculosi s fungal infections, ameobiasis vaccinia and varicella and antibiotic resistant infections.

adrenal insufficienc y Do not give live viruses vaccines with immunosup pressive doses of corticostero ids.

Prescribed drugs (dosage, route, frequency, timing) Hydrocortisone 100mg IVTT Q 8H

Classification and mechanism of action

Indication and contraindication

Side effects or adverse reactions

Special precautions

Nursing responsibilities

CNS: vertigo, headache paresthesias, insomnia, Corticosteroid, short y Replacement psychosis, seizures. acting CV: hypotension, therapy in glucocorticosteroid, shock and CHF adrenal adrenal cortical secondary to fluid cortical steroid, and hormone. insufficiency retention. DERMATOLOGIC: . Mechanism of action: thin, fragile skin, y Allergic states, severe petichae, ecchymosis Enters target cells and purpura, striae, or bind as to cystoplastic incapacitatin subcutaneous fat receptors initiates atrophy. g allergic many complex GI: peptic or conditions. reactions that are y Dermatologi esophageal ulcer, responsible for its pancreatitis, nausea c anti-inflammatory, vomiting increased preparation. immunosuppressive appetite, weight gain To relieve and salt retaining inflammator HEMATOLOGIC: actions. Some actions y and pruritic Na+ and fluid may be undesirable, manifestatio retension, hypotension. depending on dose. MUSCUSKELETAL: ns of muscle weakness, dermatoses steroid myopathy and that are loss of muscle mass, steroid osteoporosis responsive. OTHER: Contraindications: immunosuppression, aggravation or Classification: Indication:

Use cautiously with kidney disease; liver disease cirrhosis, hypothyroidism ulcerative colitis, with impending perforation, diverculitis, recent GI surgery, active or latent peptic ulcer, inflammatory bowel disease hypetension, CHF, thrombo embolic tendencies, thrombophlebitis , osteoporosis convulsive disorders, metastatic carcinoma, diabetes mellitus; TB; lactation.

Check physicians order Observe 10 rights.

Contraindica ted w/ fungal infections, ameobiasis, Hepa B vaccinia or varicella and anti-bioticresistant infections.

masking.

Prescribed drugs (dosage, route, frequency, timing) Ibuprofen (advil) 200mg/ gel cap Oral 1gel cap Q 6H

Classification and mechanism of action Classification: NSAIDs,Analgesic (non-opoid) Propionic acid derivative Mechanism of action: Anti- inflammatory analgesic and antipyretic activities largely related to inhibition of prostaglandin synthesis; exact mechanisms of action are known. Inhibits both cyclooxygenas (cox) 1 and 2 ibuprofen is slightly more selective for cox-1

Indication and contraindication Indication: y Relief of signs and symptoms of rheumatoid arthritis and osteoarthritis Relief of mild to moderate pain Treatment of primary dysmenorrhea Fever reduction Unlabeled uses; prophylactic for migraine; abortive treatment for migraine

Side effects or adverse reactions CNS: headache, dizinness, somnolence, insomnia, fatigue, tiredness, tinnitus, ophthalmologic effects. CV: hypertension, palpitations, arrhythmias. DERMATOLOGI C: rash, pruritus, sweating, dry mucous membranes. GI: nausea, dyspepsin, diarrhea, vomiting, GI bleeding. GU: dysuria, renal impairement, menorrhagia. HEMATOLOGIC: bleeding, platelet inhibition with higher doses RESPIRATORY: dyspnea, pharyngitis, bronchospasm, rhinitis

Special precautions Use cautiously with CV dysfunction, hypertension peptic ulceration, GI bleeding, impaired hepatic or renal function

Nursing responsibilities y Check physicians order Observe 10 rughts Administe r drug with food or after meals if GI upset occurs Arrange for periodic ophthalmo logic examinati on during long term therapy Use drug as suggested; avoid overdose Avoid over the counter drugs

y y

y y

Contraindication: y Contraindicated with allergy to ibuprofen, salicylate or other NSAIDs, more common in patients with

rhinitis, asthma, chronic uticaria, nasal polyps.

OTHER: anaphylactoid reactions.

Report some throat, fever, rash, itching, and weight gain, selling in ankles, changes in vision, black or tarry stools.

Prescribed drugs (dosage, route, frequency, timing) Acetylcysteine 600mg/tab Oral 1tab HS x 5 days

Classification and mechanism of action Classification Mucolytic Antidote

Indication and contraindication Indication:

Side effects or adverse reactions GI: nausea, stomatitis, Hypersensitivity: urticaria RESPIRATORY: bronchospasm especially in patients with asthma. OTHER: rhinorrhea.

Special precautions Use cautiously and discontinue immediately if bronchospasm occurs.

Nursing responsibilities y Check doctors order Observe 10 rights Observe for adverse reactions.

Mucolytic adjuvant therapy for abnormal viscid or Mechanism of action: inspissated mucus secretions in acute and chronic y Mucolytic activity; splits bronchopulmonary complications of links in the cystic fibrosis and mucoproteins in tracheostomy contained in care. respiratory mucus Contraindications: secretions, decreasing the viscosity of the Contraindicated with mucus. hypersensitivity to y Antidote to acetaminophen acetylcysteine. hepa toxicity; protects liver cells by maintaining cell function and detoxifying acetaminophen metabolites.

y y

Prescribed drugs (dosage, route, frequency, timing) Cefuroxime 5oomg Oral BID 86

Classification and mechanism of action

Indication and contraindication

Side effects or adverse reactions

Special precautions

Nursing responsibilities

Classification: 2nd generation cephalosporins Action: Inhibits cell wall synthesis promoting osmotic instability usually bactericidal.

Indication: y Uncomplicated skin or skin structure infection. Bone or joint infection. Serious lower respiratory tract infection.

y y

Contraindication: y Contraindicated in patients hypersensitive to drug or other cephalosporins.

GI: pseudomonas colitis, vomiting, nausea, anorexia HEMATOLOGIC: Thrombocytopenia, transient neutropenia. SKIN: maculopapular and erythematous rashes, urticaria, OTHER: anaphylaxis.

Skin testing before giving drug. Ask if patient is allergic to other penicillins and cephalosporins

Tell patient to take drug as prescribed even after he feels better. Instruct patient to notify about rashes, loose stools, diarrhea or evidence of super infection. Check doctors order Observe 10 rights.