XII.

DRUG STUDY

Name

Mechanism of Action

Indication
Adjunctive treatment to decrease the number of adenomatous colorectal polyps in familial adenomatous polyposis

Contraindication
hypersensitivity to drug, sulfonamides, or other NSAIDs Severe hepatic impairment History of asthma or urticaria Advanced renal disease

Adverse Effect
dizziness, drowsiness, headache, insomnia, fatigue, peripheral edema, ophthalmic effects, tinnitus, pharyngitis, rhinitis, sinusitis, nausea, diarrhea,

Nursing Consideration
- Instruct patient to take drug with food or milk. - Teach patient to avoid aspirin and other NSAIDs (such as ibuprofen and naproxen) during therapy. - Advise patient to immediately report

Exhibits anti1. Celecoxib inflammatory, analgesic, and antipyretic 200 action due to mg/cap 1 cap BID inhibition of the enzyme x Pain COX-2 Nonsteroi dal antiinflammat ory drug (NSAID)

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
or signs or symptoms of liver damage

Name

Mechanism of Action

Indication
Replacement Therapy in adrenocortica l insufficiency

Contraindication
Viral/fungal infections, tubercular or syphilitic lesions, bacterial infections unless used in conjunction with appropriate chemotherapy.

Adverse Effect
CNS: headache, nervousnes s, depression, euphoria EENT: cataracts, increased intraocular pressure, GI: nausea, vomiting, ulcer, abdominal distention

Nursing Consideration
- Do not confuse hydrocortiso ne with hydrocodone . - Check label of parenteral hydrocortiso ne because IM and IV preparations are not necessarily interchangea ble. - Assess blood glucose levels in

Suppresses 2. Hydrocor inflammatory tisone and immune responses, 100 mg IV mainly by Q4 x 3 inhibiting doses migration of Corticost leukocytes and eroids phagocytes and decreasing inflammatory mediators.

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
Expect to increase insulin or oral hypoglycemi c dosage - Urge patient to immediately report unusual weight gain, face or leg swelling, vomiting of blood, prolonged sore throat, epigastric burning

Name

Mechanism of Action

Indication

Contraindication
GI hemorrhage, epileptics, hypersensitivity , lactation, pts. With breast cancer

Adverse Effect
Restlessnes s, drowsiness, fatigue, insomnia, headache, dizziness, nausea

Nursing Consideration
- give 30 mins before meals and at bed time - assess mental status during treatment - tell pt. To avoid driving & other hazardous activities for at least 2 hrs.

Dopamine Gastrointesti 3. Metoclop antagonist that nal motility, ramide acts by nausea, increasing vomiting of 10 mg IV receptor central and initial sensitivity and peripheral dose response of origin assoc. then 1 with surgery amp Q8 upper GIT tissues to Antiacetylcholine emetics

Name
4. Mannitol

Mechanism of Action

Indication
Raised intracranial pressure; Raised intraocular pressure; Cerebral edema

Contraindication
Pulmonary congestion or edema; intracranial bleeding; CHF; metabolic edema with abnormal capillary fragility; anuria due to severe renal disease; severe dehydration.

Adverse Effect
Fluid and electrolyte imbalance; acidosis (with high doses). Nausea, vomiting, thirst; headache, dizziness, convulsions , chills, fever; tachycardia, chest pain; blurred vision;

Nursing Consideration
Monitor the following: 1. Vital signs 2. Intake and output 3. Central venous pressure Pulmonary artery pressure Signs and symptoms of dehydration (e.g. poor skin turgor, dry skin, fever, thirst) Signs of electrolyte

Mannitol increases urinary output 100cc IV by inhibiting Q8 tubular Diuretics reabsorption of water and electrolytes. It raises the osmotic pressure of the plasma allowing water to be drawn out of body tissues.

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect
urticaria and hypotensio n or hypertensio n; acute renal failure; skin necrosis; thrombophl ebitis

Nursing Consideration
imbalance/de ficit (e.g. muscular weakness, paresthesia, numbness, confusion, tingling sensation of extremity and excessive thirst) (for increase ICP) Neurologic status and intracranial pressure readings.

Name

Mechanism of Action

Indication
Treatment of infections of the lower respiratory tract, acute bacterial otitis media, skin & skin structure infection, UTI, uncomplicate d gonorrhea, pelvic inflammatory disease, bacterial septicemia.

Contraindication
Hypersensitivity to cephalosporins. Hypersensitivity to lidocaine (IM inj)

Adverse Effect
Pain Induration Phlebitis Rash Diarrhea Thrombocyt osis Leucopenia Glossitis Respiratory super infections

Nursing Consideration
- Assess patients previous sensitivity reaction to penicillin or other cephalospho rins. - Assess patient for signs and symptoms of infection before and during the treatment - Obtain C&S before beginning

Inhibiting the 5. Ceftriaxo mucopeptide ne synthesis in the bacterial cell 1gm IV wall. The betaQ12 lactam moiety ANST of Ceftriaxone Cephalos binds to porins carboxypeptida ses, endopeptidases , and transpeptidases in the bacterial cytoplasmic membrane

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
drug therapy to identify if correct treatment has been initiated. - Monitor hematologic, electrolytes, renal and hepatic function. - Assess for possible super infection: itching fever, malaise, redness, diarrhea

Name
6. Diazepa m

Mechanism of Action

Indication
Tablet: Symptomatic relief of anxiety, agitation, tension due to psychoneurot ic states and transient situational disturbances, adjunct in major mental and organic disorders; relief of reflex muscle,

Contraindication
Hypersensitivity, Dependence in other substance including alcohol, except in management of acute withdrawal reactions, Severe hypercapnia

Adverse Effect
Blurred vision, Paradoxical reactions, Dependenc e, Withdrawal symptoms

Nursing Consideration
- Obtain history of patients underlying condition before therapy and reassess regularly thereafter. - Monitor signs of anxiety. - Monitor vital signs: BP, CR, and RR. Hold drug if BP drops 20mmHg and

Facilitates/pote ntiates the inhibitory activity of 1 tab OD GABA at limbic HS system and Anxiolyti reticular formation to c reduce anxiety, promote calmness and sleep

Name

Mechanism of Action

Indication
spasm due to spinal and supraspinal interneurons.

Contraindication

Adverse Effect

Nursing Consideration
respirations every 5-15 minutes if drug is given IV.

Name

Mechanism of Action

Indication
Used for treating inflammation and pain in the operation site.

Contraindication
Hypersensitivity to ketorolac, aspirin, other NSAIDs, or any component of the formulation

Adverse Effect
Rash Ringing in the ears Headaches Dizziness Drowsiness Abdominal pain Nausea Diarrhea Constipatio n Heartburn Fluid retention

Nursing Consideration
- Instruct client to avoid alcohol and maintain adequate hydration (23 L/day of fluids) unless instructed to restrict fluid intake. - Monitor for signs of pain relief, such as an increased appetite and activity

Inhibits 7. Ketorolac prostaglandin synthesis by 30 mg IV decreasing the Q6 x 24h activity of the Nonsteroi enzyme, dal Anti- cyclooxygenas Inflamma e, which results tory in decreased Drugs formation of (NSAIDs) prostaglandin precursors, chemicals that cells of the immune system make that cause the redness,

Name

Mechanism of Action
fever, and pain of inflammation and that also are believed to be important in the production of noninflammatory pain.

Indication

Contraindication

Adverse Effect

Nursing Consideration

Name

Mechanism of Action

Indication

Contraindication
Nephropathy

Adverse Effect
Hematologi cal, skin and other allergic reactions

Nursing Consideration
- instruct patient to take with meals - have a plenty of water when taking this drug

8. Through the Fever and Paracetamo produce pain l analgesia by blocking pain 300mg IV impulse by Q4 x 24h inhibiting synthesis of Analgesics prostaglandin and in cns that Antipyretics synthesize pain receptor to stimulation

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
- Instruct patient that the drug should be taken with food. - Patients with Phaeochrom ocytoma. Porphyria or bronchial asthma should be treated with extra care.

9. Betahistine Meniere's Betahistin improves the disease e microcirculatio n in the 16 mg/tab labyrinth which PO reduces 1 tab TID endolymphatic pressure. Antivertig o

Phaeochromocyt Rash, oma. Porphyria. pruritus, urticaria, dyspepsia, nausea, peptic ulcer disease, headache, dizziness, insomnia.

Name

Mechanism of Action

Indication
Used to prevent ulcer while patient is on NPO.

Contraindication
Hypersensitivity to ranitidine or any component of the formulation.

Adverse Effect
Constipatio n Diarrhea Fatigue Headache Insomnia Muscle pain Nausea Vomiting Agitation Anemia Confusion Depression Easy bruising or bleeding

Nursing Consideration
- Inform patient that the medication may cause drowsiness, dizziness, or fatigue (use caution when driving or engaging in tasks requiring alertness). - Instruct patient to avoid taking any new medication during

Competitive 10. Ranitidin inhibition of e histamine at H2-receptors of 50 mg IV the gastric Q6 while parietal cells, NPO which inhibits Gastroint gastric acid estinal secretion, agent; gastric volume, Antisecre and hydrogen tory (H2ion receptor antagoni concentration are reduced. st)

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
without consulting prescriber. - Instruct patient to avoid alcohol and follow diet as prescriber recommends .

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect
Dizziness Headache Paresthesis Drowsiness Peripheral edema Palpitations Tachycardia Nausea Dry mouth Abdominal discomfort Rash Flushing

Nursing Consideration
Patients with hepatic impairment should receive lower dose Monitor blood pressure. Allow at least 3 days between dosage adjustment to achieve steady plasma levels. Advise patient to report immediately if

Inhibits calcium Chronic Patient who are 11. Nicardipi ion influx stable angina hypersensitive ne across cardiac to nicardipine and smooth 0.5 mg IV muscle cells, now thus decreasing myocardial AntiAnginal contractility Drug and oxygen demand and coronary arteries and arterioles.

Name
12. Tranexa mic Acid

Mechanism of Action

Indication
Used for the prompt and effective control of hemorrhage in various surgical and clinical areas

Contraindication
Hypersensitivity Presence of blood clots (e.g. in the leg, lung, eye, brain), have a history of blood clots, or are at risk for blood clots Current administration of factor IX complex concentrates or anti-inhibitor coagulant concentrates

Adverse Effect
Calf pain, swelling or tenderness Chest pain Confusion Coughing up blood Decreased urination Severe or persistent headache Severe or persistent body malaise Shortness of breath

Nursing Consideration
Unusual change in bleeding pattern should be immediately reported to the physician.

It exerts its antifibrinolytic effect through the reversible 1000 mg blockade of TIVT then lysine-binding 500 mg sites on Q8 plasminogen Antihemo molecules. Antirhagic fibrinolytic drug inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of blood clots.

Name

Mechanism of Action

Indication
Acute & chronic respiratory tract affections w/ abundant mucus secretions.

Contraindication
MAO inhibitor therapy within 14 days initiating therapy; severe hypertension.

Adverse Effect
Hypersensit ivity reactions have been reported in patients receiving acetylcystei ne, including bronchospa sm, rashes and pruritus may occur.

Nursing Consideration
- Monitor effectiveness of therapy and advent of adverse/allerg ic effects. - Instruct patient in appropriate use and adverse effects to report

Exerts 13. Acetylcys mucolytic teine action through its free 100 mg sulfhydryl Q6 x 2 group which doses opens up the Mucolytic disulfide bonds s in the mucoproteins thus lowering mucous viscosity

Name
14. Ampicilli n+ Sulbacta m

Mechanism of Action

Indication
Treatment of respiratory infections

Contraindication
Allergy to penicillin, infectious mononucleosis.

Adverse Effect
Pain at Injection site Thrombophl ebitis Diarrhea Itching Nausea Vomiting Flatulence Candidiasis Fatigue Malaise Headache Chest pain

Nursing Consideration
- Assess patient for infection (vital signs, wound appearance, sputum, urine, stool, and WBCs) at beginning and throughout therapy. - Observe patients for signs and symptoms of anaphylaxis (pruritus, laryngeal

Ampicillin exerts bactericidal action on both gram-positive and gramnegative organisms. Its 750 mg TIVT Q8 spectrum includes gramAntibiotic positive organisms. s Sulbactam inhibits lactamases and extends the spectrum of ampicillin to include lactamase producing pathogens.

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
- Discontinue the drug and notify the physician immediately if these occur. - Keep epinephrine, an antihistamin e, and resuscitation equipment close by in the event of an anaphylactic reaction.

Name
15. Ipratropiu m Bromide + Salbutam ol Sulfate Q6 x 4 doses Antiasth matic

Mechanism of Action
Ipratropium bromide is a quaternary ammonium derivative of atropine and is an anticholinergic drug which has bronchodilator properties. Salbutamol produces bronchodilation through stimulation of beta2adrenergic

Indication
For the management of bronchospas m in patients suffering from chronic obstructive pulmonary disease (COPD) who requires regular treatment with both ipratropium and salbutamol

Contraindicatio n
Patients with cardiac tachyarrhythmi a, hypertrophic obstructive cardiomyopath y and patients with a history of hypersensitivit y to any of its components or to atropine or its derivatives

Adverse Effect
Fatigue, abdominal pain, hypertension , dyspepsia, tachycardia, sinusitis, dysuria, and urinary retention blurred vision, taste perversion, dry mouth.

Nursing Consideration
- Monitor respiratory status; auscultate lungs before and after inhalation - Report treatment failure (exacerbatio n of respiratory symptoms) to physician

Name

Mechanism of Action
receptors in bronchial smooth muscle, thereby causing relaxation of muscle fibers.

Indication

Contraindication

Adverse Effect

Nursing Consideration

Name

Mechanism of Action

Indication
Infections of upper & lower respiratory tract, prophylaxis against infections associated w/ major surgical procedure (for IV presentations ).

Contraindication
Hypersensitivity to penicillin & cephalosporins or other allergen, possible cross sensitivity w/ other -lactams. History of penicillinassociated cholestatic jaundice/hepati c dysfunction.

Adverse Effect
Diarrhea, indigestion, nausea, vomiting, candidiasis, rash.

Nursing Consideration
History of hypersensitivit y Renal impairment Hepatic impairment may cause cholestatic jaundice up to 6 weeks after cessation May cause maculopapular rashes almost always in presence of glandular fever

Inhibits 16. Coamoxicla enzymes v involved in formation of 625 peptidoglycan mg/tab 1 tab x 7 layer of bacterial cell days wall No effect on human cell walls Bactericidal; only works on dividing bacteria Well absorbed enterally Clavulanic acid

Name
17. Chlorhexi dine Oral Solution .2%

Mechanism of Action

Indication
It is often used as an active ingredient in mouthwash designed to kill dental plaque and other oral bacteria. Chlorhexidine can thus be used to improve bad breath.

Contraindication
Brain, meninges, middle ear or sensitive tissues. Hypersensitivity to ciprofloxacin.

Adverse Effect
Skin sensitivity; irritation of conjunctiva, mucosal irritation; reversible brown staining of the teeth; tongue discoloratio n; parotid gland swelling.

Nursing Consideration
Avoid contact with eyes except when dilute solutions are used.

Chlorhexidine reacts with the microbial cell surface, destroys the integrity of the 10 ml TID cell membrane, penetrates the for 7 days cell and precipitates the Antisepti cytoplasm c/Antibac leading to cell terial death.

Name

Mechanism of Action

Indication
Chlorhexidine based products are usually utilized to combat or prevent gum diseases such as gingivitis.

Contraindication

Adverse Effect

Nursing Consideration

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
Instruct patient not to take ciprofloxacin with dairy products such as milk or yogurt, or with calciumfortified juice. May eat or drink dairy products or calciumfortified juice with a regular meal, but do not use them alone when taking

Interferes with 18. Ciproflox DNA replication acin in susceptible bacteria 500mg/ca preventing cell p reproduction 1 Cap Q12 x7days AntiInfectives

Alternative to Hypersensitivity Nausea, aminoglycosi to ciprofloxacin. vomiting, de for chronic diarrhea, otitis media dyspepsia, w/ perforation flatulence, of the constipatio tympanic n, membrane. heartburn, abdominal discomfort, headache, restlessnes s, malaise, dizziness, tremor, insomnia, nightmares, depression.

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
They could make the medication less effective. Inform that Ciprofloxacin may cause swelling or tearing of a tendon especially in the Achilles' tendon of the heel.

Name
19. Ofloxacin Otic Drops

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
Determine history of hypersensiti vity reactions to quinolones or other drugs before therapy is started. Withhold ofloxacin and notify physician at first sign of a skin rash or other allergic reaction.

A fluoroquinolone antibiotic with a broad spectrum of activity against gram-positive and 2 Drops negative aerobic to right ear 3x a and anaerobic bacteria. Inhibits day DNA gyrase, an Antienzyme Infectives necessary for bacterial DNA replication and some aspects of its transcription, repair, recombination, and transposition.

Otitis Hypersensitivity Headache, externa, to quinolones dizziness, otitis media insomnia, with hallucination perforated s. Nausea, tympanic vomiting, membrane diarrhea, GI s. discomfort. Urogenital: Pruritus, pain, irritation, burning, dysuria, urinary frequency. Pruritus, rash.

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
Monitor for seizures, especially in patients with known or suspected CNS disorders. Discontinue ofloxacin and notify physician immediately if seizure occurs. Assess for signs and symptoms of super infection

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect

Nursing Consideration
- Assess patients pain(location , type, character) before therapy & regularly thereafter to monitor effectiveness of the drug(give before pain becomes extreme)

Binds to muModerate to 20. Tramadol opioid moderately receptors. severe pain 100 mg IV Inhibits initially reuptake of then 50 mg IV Q6 serotonin and norepinephrine Analgesi in the CNS c

Hypersensitivity Nausea, vomiting, sweating and constipatio n. Drowsiness is reported, although it is less of an issue than for nonsynthetic opioids. Patients prescribed tramadol for general pain

Name

Mechanism of Action

Indication

Contraindication

Adverse Effect
without other agents have reported withdrawal symptoms including uncontrolla ble nervous tremors, muscle contracture, and 'thrashing' in bed (similar to restless leg syndrome.

Nursing Consideration
- Assess hypersensiti vity reactions; monitor CNS, I&O, bowel pattern