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BSN III-3 CLASSIFICATION Antigout Drug DRUG STUDY INDICATION CONTRAINDICATION Management of the Contraindicated with signs and symptoms allergy to of primary and allopurinol, blood secondary gout, dyscrasias. Use leukemia, lymphoma cautiously with liver and malignancies disease, renal that result in failure, lactation and elevations of serum pregnancy. and urinary uric acids. ADVERSE EFFECT Headache, drowsiness, peripheral neurophaty, neuritis, paresthesias. Rashesmaculopapular, scaly or exfoliativesometimes fatal. NURSING CONSIDERATION Take drug after meals. Avoid over the counter medication. Many of this preparation contain vitamin C or other agents that might increase the likelihood of kidney stone formation. Encourage patient to drink 2.5-3L/day to decrease the risk of renal stones. Report rash; unusual bleeding or bruising; fever, chills; gout attack; numbness or tingling; flank pain, skin rash.

NAME Ketosteril

CLASSIFICATION INDICATION Ketoanalogs; Essential amino Protein energy acids malnutrition. Prevention and treatment of conditions caused by modified or insufficient protein metabolism in chronic renal failure

CONTRAINDICATION ADVERSE EFFECT Allergy and Hypercalcemia hypersensitivity to any content of this drug, hypercalcemia, disturbed amino acid metabolism. Caution use for patietn with phenylketonuria

NURSING CONSIDERATION Evaluate for any contraindications Take drug as prescribed Warn the patient about possible side effects and how to recognize them Give with food if GI upset occurs Frequently assess for hypercalcemia

NAME Sodium Bicarbonate

CLASSIFICATION Antiulcer agents, Alkalinizing agent

INDICATION Management of metabolic acidosis Used to alkalinize urine and promote excretion of certain drugs in over dosage situations Used as an antacid

CONTRAINDICATION Metabolic or respiratory alkalosis Hypocalcemia Excessive chloride loss It is not recommended as an antidote following ingestion of strong mineral acids Patients on sodium restricted diet Renal failure Severe abdominal pain of unknown cause especially if associated with fever Use cautiosly to client with:Congenital heart failure, concurrent corticosteroid therapy, children with diabetic ketoacidosis because taking sodium bicarbonate may increase the risk of cerebral edema and chronis use as an antacid because it may result to metabolic alkalosis and possible sodium overload

ADVERSE EFFECT Edema Flatulence Gastric distention Metabolic alkalosis Hypernatremia Hypocalcemia Hypokalemia Sodium and water retention Irritation at IV site Tetany

NURSING CONSIDERATION Assess the client s fluid balance throughout the therapy. This assessment includes intake and output, daily weight, edema and lung sounds. Symptoms of fluid overload should be reported such as hypertension, edema, difficulty breathing or dyspnea, rales or crackles and frothy sputum. For clients taking the medication as a treatment for peptic ulcers it may be administered 1 and 3 hours after meals and at bedtime.

NAME Nifedipine (ADALAT)

CLASSIFICATION cardiovascular agent; calcium channel blocker; antiarrhythmic (class iv); nonnitrate vasodilator

INDICATION Treatment of angina due to coronary artery spasm (Prinzmetal s variant angina), chronic stable angina (Effortassociated angina). It is also used in the treatment of essential hypertension. Nifedipine can also be used in the treatment of Raynaud s phenomena.

CONTRAINDICATION Contraindicated with allergy to nifedipine. Use cautiously with lactation, pregnancy. HF and aortic stenosis.

ADVERSE EFFECT Nausea Drowsiness Confusion Slurred speech

NURSING CONSIDERATION Do not crush or break filmcoated tablets and sustainedrelease capsules. Give without regards to meals Grapefruit juice may alter absorption. Concurrent therapy of sublingual nitroglycerin may be used for relief of anginal pain. Record onset, type, radiation, location, intensity, and duration of anginal pain or precipitating factors. Check blood pressure for hypotension immediately prior to giving medication. Assist with ambulation if client is lightheaded or dizziness occurs. Assess for peripheral edema behind medial malleolus. Assess skin for flushing. Monitor liver enzyme tests. Rise slowly from lying to sitting position, dangle legs from bed before standing to reduce hypotensive effect. Contact physician or nurse if irregular heartbeat, shortness of breath, pronounced dizziness, or nausea occurs. Avoid alcohol and grapefruit juice use.

NAME Co-amoxiclav (ADDEX)


INDICATION Lower respiratory tract infections, otitis media, sinusitis, skin & soft tissue infections, UTI, pre& postsurgical procedures, bone & joint, O & G infections, dental infections

CONTRAINDICATION History of penicillin hypersensitivity. Superinfections involving Pseudomonas or candida. Pregnancy & lactation


NURSING CONSIDERATION Allergic reactions Assess bowel pattern - itching, rashes, fever before and during -angioneuroticoedema treatment as - anaphylaxis pseudomembranous (1 in 50,000to colitis may occur. 100,000) -Report hematuria or Cross-allergy with oliguria as high doses other penicillins can be nephrotoxic. Partial cross-allergy Assess respiratory with cephalosporins status. (10%) Observe for anaphylaxis. Hepatitis, cholestatic Ensure that the jaundice Erythema patient has adequate multiforme (including fluid intake during any Stevens-Johnson) diarrhea attack. If the patient develops Toxic epidermal a rash, wheezing, necrolysis; itching, fever or Exfoliative dermatitis swelling in the joints, this could indicate an Diarrhea, vomiting allergy and should be Rashes reported. Neutropenia The medicine must be Anaemia taken in equal doses around the clock to maintain level in the blood. Report diarrhea, cramping and blood in stools as pseudomembranous colitis may occur.

NAME Paracetamol (Biogesic)

CLASSIFICATION Analgesia, Antipyretic

INDICATION Fever, Relief of mild to moderate pain like headaches, muscular aches and pain, toothache, colds, earache, fever due to tonsillectomy, inoculations, and vaccinations.


ADVERSE EFFECT Cramping, heartburn, abdominal distention can be experienced. On a rarity, hypersensitivity reactions.

NURSING CONSIDERATION Can be given without regards to meals. -Tablets can be crushed. -Assess temperature directly before and 1 hour after giving medication. -If respirations are <12/min (<20/min in children), withhold the medication and contact the physician. -Evaluate for therapeutic response: relief of pain, stiffness, swelling; increasing in joint mobility; reduced joint tenderness; improve grip strength.

NAME Vitamin B Complex (Surbex) thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folic acid or folate (B9), cobalamin (B12


INDICATION Vitamin B1 (thiamin) and vitamin B2 (riboflavin) help the body produce energy and affect enzymes that influence the muscles, nerves, and heart. Vitamin B3 (niacin) has a role in energy production in cells and helps keep the skin, nervous system, and digestive system healthy. Vitamin B5 (pantothenic acid) influences normal growth and development. Vitamin B6 (pyridoxine) helps the body break down protein and helps maintain the health of red blood cells, the nervous system, and parts of the immune system. Vitamin B7 (biotin) helps break down protein and carbohydrates and helps the body make hormones. Vitamin B9 (folic acid) helps the cells in the body make and maintain DNA and is important in the production of red blood cells. Vitamin B12 (cobalamin) plays a role in the body's growth and development. It also has a part in producing blood cells, nervous system function, and how the body uses folic acid and carbohydrates.

CONTRAINDICATION Sensitivity to the ingredients listed.

ADVERSE EFFECT Possible side effects include gout, high blood sugar levels, and skin problems. Overdoses can lead to heart and liver problems. Rarely, large doses of vitamin B3 (niacin) supplements can cause blurred vision, nausea, vomiting, and can make stomach ulcers worse.

NURSING CONSIDERATION Assess history of allergies to any of the components of Vit. B Complex. -Watch out for possible side effects.

NAME Amlodipine Besylate (Norvasc)

CLASSIFICATION Anti-Anginal Drugs / Calcium Antagonists / Other Antihypertensives

INDICATION Management of HTN & angina pectoris

CONTRAINDICATION Hypersensitivity. Pregnancy & lactation. Childn.

ADVERSE EFFECT Swelling of the ankles, feet, face or hands. Headache, tiredness, dizziness, drowsiness, flushing, tacchycardia, nausea, stomach pain, indigestion.

NURSING CONSIDERATION Monitor BP for therapeutic effectiveness. BP reduction is greatest after peak levels of amlodipine are achieved 6 9 h following oral doses. Monitor for S&S of doserelated peripheral or facial edema that may not be accompanied by weight gain; rarely, severe edema may cause discontinuation of drug. Monitor BP with postural changes. Report postural hypotension. Monitor more frequently when additional antihypertensives or diuretics are added. Monitor heart rate; doserelated palpitations (more common in women) may occur.

NAME Isoniazid (Niazid)

CLASSIFICATION Antituberculotic

INDICATION Tuberculosis of all forms Prophylaxis in specific patients who are tuberculin reactors (positive Mantoux test)) or who are considered to be high risk for TB.

CONTRAINDICATION isoniazid is contraindicated in patients who develop severe hypersensitivity reactions, including drug -induced hepatitis; previous isoniazid-associated hepatic injury; severe adverse reactions to isoniazid such as drug fever, chills, arthritis; and acute liver disease of any etiology.

ADVERSE EFFECT Peripheral neuropathy Nausea and vomitting Thrombocytopenia Local irritation at IM site Epigastric distress Elevated AST

NURSING CONSIDERATION Give in an empty stomach 1 hr before or 2 after meals; may be given with food if GI UPSET OCCURS. Give in a single daily dose. Reverse parenteral dose for pt unable to take oral meds. Dec. foods containing tyramine or histamine in pt diet. Consult doctor and arrange for daily pyridoxine in diabetic, alcoholic or malnourished pt also for pt that develops peripheral neuritis, and those with HIV. Family health teachings: Take this drug in single daily dose. Take drug on an empty stomach, 1 hour before or 2 hours after meals. If GI distress occurs, may be taken with food. Take this drug regularly, avoid missing doses, do not discontinue without first consulting your health careprovider. Do not drink alcohol or drink as little as possible. There is an inc. risk of heap if these two drugs are combined. Avoid foods containing tyramine, consult a dietitian to obtain a list of foods containing tyramine or histamine. Have periodic medical check-ups, including an eye examination and blood test, to evaluate the drug effects. Report for weakness, fatigue, loss of appetite, n/v, yellowing of skin or eyes, darkening of the urine, numbness or tingling in hands or feet,

NAME Furosemide (Lasix)


INDICATION Treatment of edema associated with congestive heart failure, chronic renal failure, hepatic cirrhosis, and acute pulmonary edema. It is also used for treatment of hypertension, alone or in combination with other hypertensives. Can also be used for treatment of hypercalcemia.

CONTRAINDICATION Hypersensitivity. Pregnancy & lactation

ADVERSE EFFECT Excessive diuresis may lead to increased water loss and electrolyte depletion resulting to hypokalemia, hyponatremia, and dehydration. Sudden volume depletion may result in increased risk f thrombosis, circulatory collapse, or sudden death. Acute hypotensive episodes may occur, sometimes several days after beginning of therapy. Ototoxicity manifested as deafness, vertigo, and tinnitus may occur especially in patients with severe renal impairment. It can exacerbate diabetes mellitus, systemic lupus erthematosus, gout, and pancreatitis. Blood dyscrasias have been reported.

NURSING CONSIDERATION Give with food to avoid gastroinestinal upset, preferably with breakfast (to prevent nocturia). If given IM, temporary pain at injection site may be noted. Check vital signs especially blood pressure for hypotension prior to administration. Assess baseline electrolyte, particularly check for low potassium. Assess edema, skin turgor, and mucous membranes for hydration status. Assess muscle strength and mental status. Obtain baseline weight. Initiate Input and Output monitoring. Note extent of diuresis.