Case Pres Eamc-surgery Drug Study

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Domperidone

Motilium film-coated tab Motilium susp

GIT Regulators, Antiflatulents &

Anti-inflammatories,

Antiemetics

Domperidone is a peripheral dopamine-

receptor blocker. It increases oesophageal

peristalsis, lower oesophageal sphincter

pressure, gastric motility and peristalsis, thus facilitating gastric

emptying and decreasing small bowel

transit time.

OralNausea and vomiting

OralNon ulcer dyspepsia

Migraine

Nausea and vomiting

Drowsiness, extrapyramidal

reactions, galactorrhoea, gynaecomastia; constipation or

diarrhoea, lassitude, decreased libido, skin

rash, itch.Potentially Fatal:

Convulsions, arrhythmias and cardiac arrest,

dysrrhythmias in patients with CV

disease or hypokalaemia,

patients on cancer chemotherapy.

Seizures; hypertensive crisis in patients with phaeochromocytoma.

Hypersensitivity. GI haemorrhage,

obstruction and perforation, patients

with prolactin releasing pituitary hormone, chronic admin or routine

prophylaxis of postoperative

nausea and vomiting.

Phaeochromocytoma; children<2 yr, elderly;

renal or hepatic impairment. Risk of cardiac arrhythmias and hypokalaemia if

administered IV. Pregnancy and

lactation.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Ciprofloxacin

Baxolyn tab

Quinolones, Eye Anti-infectives & Antiseptics,

Ear Anti-infectives & Antiseptics

Baxolyn tab

Ciprofloxacin promotes breakage of double-

stranded DNA in susceptible organisms

and inhibits DNA gyrase, which is essential in

reproduction of bacterial DNA.

For the treatment of infections caused by susceptible gram-negative bacteria, including E. coli, P. mirabilis, K. pneumoniae, Enterobacter cloacae, P. vulgaris, P. rettgeri, M. morganii, P. aeruginosa, Citrobacter freundii, S. aureus, S. epidermidis, group D streptococci

Otic: Treatment of acute otitis externa

Treatment of chronic bacterial prostatitis

IV: Treatment of nosocomial pneumonia caused by Haemophilus influenzae, K. pneumoniae

GI disturbances; headache, tremor,

confusion, convulsions; rashes;

joint pain; phototoxicity.

Transient increases in serum creatinine. Haematological,

hepatic and renal disturbances.

Vasculitis, pseudomembranous

colitis and tachycardia.

Phototoxicity.Potentially Fatal:

Anaphylactoid reaction;

cardiopulmonary arrest

Hypersensitivity. Not to be used

concurrently with tizanidine. Avoid

exposure to strong sunlight or sun lamps during treatment.

Epilepsy, history of CNS disorders; severe renal or hepatic dysfunction;

G6PD deficiency; maintain adequate

hydration; myasthaenia gravis. Caution when used in patients with

QT prolongation or risk factors e.g.

bradycardia, pre-existing cardiac disease

or uncorrected electrolyte

disturbances. Discontinue treatment if patients experience

tendon pain, inflammation or

rupture. Avoid usage in methicillin-resistant

staphylococcus aureus (MRSA) infections due

to high level of resistance. May impair

ability to drive or operate machinery.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

Oral: Typhoid feverOral: Sexually

transmitted diseases caused by N. gonorrheae

Prevention of anthrax following exposure to anthrax bacilla (prophylactic use in regions suspected of using germ warfare)

Unlabeled use: Effective in patients with cystic fibrosis who have pulmonary exacerbations

Safety and efficacy have not been

established in pregnant and lactating women.

Not to be used in children <18 yr; except where benefit clearly

exceeds risk.

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

Metoclopramide

Biclomet amp

Plasil tab

GIT Regulators, Antiflatulents &

Anti-inflammatories,

Antiemetics

Biclomet amp

Plasil tab

Metoclopramide enhances the motility of the upper GI tract and increases gastric

emptying without affecting gastric, biliary

or pancreatic secretions. It increases

duodenal peristalsis which decreases

intestinal transit time, and increases lower

oesophageal sphincter tone. It is also a potent

central dopamine-receptor antagonist and may also have

serotonin-receptor (5-HT3) antagonist

properties.

Diabetic gastric stasis

Nausea and vomiting associated with

cancer chemotherapy or

radiotherapy

Gastro-oesophageal reflux disease

Prevent delayed emesis following chemotherapy

Premedication in diagnostic

procedures

Nausea and vomiting associated with

cancer chemotherapy

Premedication for radiologic

examination of the upper

gastrointestinal tract

Intubation of the

Extrapyramidal symptoms, restlessness,

drowsiness, anxiety, diarrhoea, hypotension,

hypertension, headache, depression, blood disorders (e.g.

aganulocytosis, methaemoglobinaemia),

hypersensitivity reactions (e.g.

bronchospasm, rash), galactorrhoea or related

disorders, transient increase in plasma aldosterone levels.Potentially Fatal:

Neuroleptic malignant syndrome; cardiac

conduction disorders may occur with IV

dosage form.

GI haemorrhage, mechanical

obstruction and perforation;

phaeochromocytoma; history of seizures.

Children, elderly. Renal or hepatic

impairment, porphyria, epilepsy, Parkinson's disease,

history of depression. Ability to drive or

operate machineries may be impaired.

Pregnancy and lactation. Monitor

patients on prolonged therapy. Increased

risk of tardive dyskinesia in patients on prolonged or high-

dose treatment.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

small intestine

Postoperative nausea and vomiting

Diabetic gastric stasis

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

Ensure With Fiber® [powd]

Enteral/Nutritional Products

Supplementary or sole source of complete & balanced nutrition in

conditions w/c preclude normal food

intake eg convalescence,

early/uncomplicated carcinoma, coma, pre-op prep, post-op care,

bowel prep, psychological

problems (anorexia nervosa, severe

depression), malnutrition;

chronically ill or elderly patients.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Salbutamol + Ipatropine

Combivent® [Unit dose vial]

Antiasthmatic & COPD

Preparations

Ipratropium and albuterol combination reduces bronchospasm

through both anticholinergic and sympathomimetic

mechanisms. Simultaneous

administration of both drugs produces a

greater bronchodilator effect than when either

drug is used alone at recommended dosages.

Albuterol—Albuterol is a sympathomimetic agent that has a relatively high degree of selectivity for

beta 2-adrenergic receptors. Activation of

these receptors on airway smooth muscle leads to the activation of the enzyme adenylyl

cyclase and to an

Management of reversible

bronchospasm associated w/

obstructive airway diseases in patients who require more

than a single bronchodilator.

Angioedema (swelling of the face, lips, or

eyelids)

bronchospasm, paradoxical or

hypersensitivity-induced (shortness of

breath; wheezing)

chest discomfort or pain

irregular heartbeat

oropharyngeal edema (swelling of the mouth

or throat)

skin rash

tachycardia (fast heartbeat)

urticaria

Hypertrophic obstructive

cardiomyopathy or tachyarrhythmia.

History of hypersensitivity to

soya lecithin or related food

products (for MDI only).

Insufficiently controlled diabetes mellitus, recent MI, severe organic heart or

vascular disorders, hyperthyroidism,

pheochromocytoma, risk of narrow-angle glaucoma, prostatic

hypertrophy or bladder-neck

obstruction; cystic fibrosis. Pregnancy,

lactation.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

increase in the intracellular

concentration of cyclic-3, 5-adenosine

monophosphate (cAMP). Increased cAMP

concentrations indirectly lower

intracellular ionic calcium, which results in airway smooth muscle

relaxation.

Ipratropium—Ipratropium is an

anticholinergic agent that produces a local,

site-specific effect rather than a systemic

effect. It appears to produce

bronchodilation by inhibition of cholinergic receptors on bronchial

smooth muscle.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Ceftriaxone

Rocephin

IV Vial

Third-generation cephalosporins.

Ceftriaxone binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Indications:

Sepsis, meningitis; abdominal, biliary tract, GIT, bone,

joints, soft tissue, renal, resp tract, ENT,

genital & skin & wound infections.

Perioperative prophylaxis of

infections.

Shock, hypersensitivity, blood

abnormality. Liver & kidney failure, GI & resp disturbances, superinfection, vit

deficiency.

-History of shock, hypersensitivity to

cephalosporins, penicillins, anilide local anesthesia.

-Instruct patient to take medication as prescribed for the length of time ordered even if he feels better.

-Teach patient to report sore throat, bruising, bleeding and joint pain.

-Advise patient to watch out for perineal itching, fever, malaise, redness, pain, swelling,

rash, and diarrhea.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Lactulose

Chronulac

Laxative

Produces an osmotic effect in the colon with

resultant distention promoting peristalsis

To treat constipation. May cause gas, belching or stomach

cramps, diarrhea, nausea, vomiting.

It is contraindicated in patients who

require a low galactose diet.

-Assess usual bowel patterns, use other methods to relieve constipation where possible.

-Do not give if client has abdominal pain, discourage chronic use.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Omeprazole

Prilosec

Belongs to the class of proton

pump inhibitors.

Mechanism of Action:

Prevent the movement of hydrogen ions from the parietal cell into the stomach, which results to the blocking of all gastric acid secretion.

Short-term treatment of duodenal ulcer, gastric ulcer & erosive esophagitis. Long-term treatment of Zollinger-Ellison syndrome. Treatment of heartburn & other symptoms associated with GERD.

Headache, diarrhea & skin rashes. Pruritus, dizziness, fatigue, constipation, nausea & vomiting, flatulence, abdominal pain, arthralgia & myalgia, urticaria & dry mouth.

Contraindicated in patients with known hypersensitivity to any component of the formulation.

-Assess for allergies and history of liver disease.

-Instruct the patient taking omeprazole:

>It should be taken before meals.>The capsule should be swallowed whole, not crushed, opened, or chewed.>It may be given with antacids.>Emphasize that the treatment will be short term.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Tramadol

Dolmal

Amp

Analgesics (Opioid)

Mechanism of Action:

Binds to -opiate receptors in the CNS causing inhibition of ascending pain pathways, altering the perception of and response to pain; also inhibits the reuptake of norepinephrine and serotonin, which also modifies the ascending pain pathway

Cap Acute & chronic pain. Amp Moderate to severe pain due to mild illness, pain after diagnosis or post-op pain.

Constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; nausea; trouble sleeping; vomiting; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; chest pain; difficult or painful urination; disorientation; fainting; hallucinations; irregular heartbeat; loss of coordination;

-Acute alcohol intoxication;

-Patients under intoxication w/ hypnotic analgesics or psychotropic drugs

-Severe respiratory depression

-Patients w/ a risk of stupor due to head injuries or lesions; concomitant administration w/ MAOIs.

Assess for level of pain relief and administer prn dose as needed but not to exceed the recommended total daily dose.

Monitor vital signs and assess for orthostatic hypotension or signs of CNS depression.

Discontinue drug and notify physician if S&S of hypersensitivity occur.

Assess bowel and bladder function; report urinary frequency or retention.

Use seizure precautions for patients who have a history of seizures or who are concurrently

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

mood or mental changes (eg, depression); red, blistered, swollen, or peeling skin; seizures; severe dizziness or lightheadedness.

using drugs that lower the seizure threshold.

Monitor ambulation and take appropriate safety precautions.

DRUG

ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

HNBB

Buscopan® [tab]

Antispasmodics

Relieve cramps or spasms of the

stomach,intestines, and bladder

Paroxysmal pain in diseases of the

stomach or intestine, spastic pain &

functional disorders in the biliary & urinary

tracts & female uterine organs (eg

dysmenorrhea).

Rubefaction, allergic reactions w/ exanthema,

thrombocytopenia, leucopenia;

agranulocytosis (in isolated case associated w/ paracetamol), pancytopenia.

Bronchospasm (in predisposed patient).

Myasthenia gravis, megacolon. Should

not be given to patients who have prior sensitivity to

HNBB or paracetamol or any

component of buscopan plus.

Hepatic & renal dysfunction, Gilbert's syndrome. Pregnancy

esp during 1st trimester.

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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INDICATION

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NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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INDICATION

ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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ADVERSE REACTION

CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

DRUG

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CONTRAINDICATION

NURSING RESPONSIBILITY

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

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Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery

Galang, Patrick Albert C 3nu05 Drug Study EAMMC - Surgery