Medication Aminoleban Dose/route: 1 sachet 50 g
action Given to normalize the amino acid, carbohydrate s, fats,
vitamins and minerals in the plasma
Indication For the treatment of Hepatic Encephalopathy in
patient with chronic liver disease.
Contraindication Patient with abnormal amino acid metabolism
(since the infuse amino acids are not adequately metabolized, the
patient clinical condition may be worsened.)
Freq/timing: q12 (6-6)
classification: A balance and tolerable food supplement to
nutritionally support patients with liver disease.
Side effects Nursing responsibilities Hypersensit Asses ivity:
rare patients skin condition eruptions before Gastrointes starting
tinal: the occasional therapy. nausea and Be alert vomiting to
Others: adverse occasional reaction. chills, fever, Monitor
headache patient temperat ure. If GI reaction occur monitor patient
hydration .
Medication Metronidazole Brand ne0e: Flagyl Dose/route: 500 mg 1
tab
action An antibiotic effective against anaerobic bacteria and
certain parasites. Selectively blocks some of the functions within
the bacterial cells and the parasites resulting in their death.
indication For bacterial infection caused by anaerobic
microorganism.
Contraindicati on Contraindicat ed to patient hypersensitiv e to
drug or other nitroimidazole derivatives.
Side effects Nausea, diarrhea, and/or metallic taste in the
mouth. Hypersensitivit y reactions (rash, itch, flushing, fever),
headache, dizziness, vomiting, dark urine
Nursing responsibilities Asses patients condition before
starting the therapy. Be alert to adverse reaction. Give drugs with
meal to minimize GI distress. Inform patient metallic taste dark or
red brown urine may occur. Advice patient to stand slowly to
prevent dizziness.
Freq/timing: Tid (8-1-6)
Classification: Antibiotic
Name of Drug Generic Name:
Dosage/ Time/ Route 125 mg/mL 1-2 inj/day. 250 mg/mL 1
inj/day
Indications Cerebrovascular Diseases, accelerates the recovery
of consciousness and overcoming motor deficit.
citicholineBrand Name:
ZynapseClassification:
CNS stimulantReference: Daviss Drug Guide for Nurses Fifth
Edition pp. 237-238
Mechanism of Actions Citicoline activates the biosynthesis of
structural phospholipids in the neuronal membrane, increases
cerebral metabolism and increases the level of various
neurotransmitters, including acetylcholine and dopamine. Citicoline
has shown neuroprotective effects in situations of hypoxia and
ischemia.
Contraindicatio n Hypersensitivity to drugs
Side Effects citicoline may exert a stimulating action of the
parasympathetic, as well as a fleeting and discrete hypotension
effect
Nursing Responsibilities Watch out for hypotensive effects
Somazine must not be administered along with medicaments containing
meclophenoxate Keep all medicine locked up and away from children.
Store medicine away from heat and direct light. Do not store your
medicine in the bathroom, near the kitchen sink, or in other damp
places.
y
y y y
Drug Name isosorbide-5- dinitrate Imdur Oral 40mg OD
Mechanism of Action Increases supply of oxygen to the heart by
dilating both the arteries and veins which supply the heart
itself.
Indication Preventive and longterm treatment of angina
pectoris/post myocardial infarction angina. Treatment of severe
congestive heart failure in combination with cardiac glycosides,
diuretics, angiotensinconverting enzyme inhibitors, arterial
vasodilators, pulmonary hypertension
Side Effects Adverse reactions: transient hypoxemia, headache,
fall in BP, reflex rise in PR, dizziness. Nausea, vomiting,
transient skin disorders and allergic skin reactions may sometimes
occur.
Contraindications Acute MI with low filling pressures, except in
ICU with continuous hemodynamic monitoring; left heart failure with
low filling pressures; shock; very low blood pressure; circulatory
collapse; hypertrophic
Nsg. Considerations -assess for pain; duration, time started,
activity being performed, character, intensity -monitor BP, pulse
at baseline and during treatment
Cardiovascular drug: Osmotic Diuretic
Generic (Trade Name) Ipratropium Br, Salbutamol/ albuterol
sulfate (Combivent )
Dosage Frequency Neb q 4 hours (12 am-4am8am-12pm4pm-8pm)
Classification
Indication
Contraindication
Adverse Reaction
Nursing Responsibilities
Antiasthmatic & COPD Preparations
Management of reversible bronchospasm associated with
obstructive airway diseases in patients who require more than a
single bronchodilator
Fine tremor of Skeletal Muscle; Palpitations; Headache, 2.)
Patients with dizziness, Hypertropic nervousness; obstructive
Dryness of the cardiomyopath mouth, throat y irritation; urinary
3.) Patients retention. having tachyarrythmia .
1.) Patients who is allergic to the Drugs.
1.) Use Cautiously to patients with known sensitivity to
atropine, soybeans, soya lecithin, and peanuts. 2.) Assess Vital
Signs Before drug administration 3.) Observe for paradoxical
bronchospasm (Wheezing). If Condition occurs, withhold Medication
and notify physician or other health care professional immediately.
4.) Instruct patient to contact health care professional
immediately if shortness of breath is not relieved by medication or
is accompanied by diaphoresis, dizziness, palpitations, or chest
pain. 5.) Advise the patient to rinse mouth with water after
using
the nebulizer to minimize dry mouth.
Generic/ Trade NameMontelukast (Kastair)
Dosage Frequency10 mg (8pm)
ClassificationAntiasthmatic & COPD Preparations
IndicationTreatment of bronchial asthma, allergic rhinitis,
concomitant to bronchial asthma.
Contraindication1.) Do not use for treatment of acute asthma
attacks.
Adverse ReactionRash, angioedema, pruritus, & urticaria.
Dizziness, headache, dream abnormalities, hallucinations,
paresthesia, drowsiness, infectious gastroenteritis, diarrhea,
nausea & vomiting.
Nursing Responsibilities1.) Assess eosinophil count 2.) Monitor
temperature . Watch for fever and symptoms of infection. 3.) Inform
patient to minimize GI upset by eating small, frequent servings of
food and drinking plenty of fluids.
DRUGSGeneric Name Isosorbide Dinitrate / Mononitrate Brand Name
ISOKET ISORDIL Classification CV Drugs (Anti-anginal DrugsOrganic
Nitrates) Dosage tab 5mg amp 5mg/2ml
ACTIONIncrease supply of oxygen to the heart by dilating both
the arteries & veins which supply the heart itself.
INDICATIONPreventive & long-term treatment of angina
pectoris/post MI angina. Treatment of severe CHF in combination w/
cardiac glycosides, diuretics, ACEinhibitors, arterial
vasodilators, pulmonary hypertension.
CONTRAINDICATION Acute MI w/ low-filling pressures (except in
ICU w/ continuous hemodynamic monitoring) Left heart failure w/
lowfilling pressures Shock Very low BP
ADVERSE EFFECTS Transient Hypoxemia Headache Decrease BP Rise in
PR Dizziness Weakness Nausea Vomiting Transient skin disorders
Allergic reactions
NURSING RESPONSIBILITY Assess for pain: location, type,
character, intensity. Monitor BP, PR during treatment. Caution pt.
to make position changes slowly to prevent Orthostatic Hypotension.
Warn pt. to avoid alcohol & OTC medications unless approved by
the doctor. Inform pt. that the drug may be taken before stressful
activity. Advise pt. to avoid hazardous activities if dizziness
occurs & sudden position changes to prevent Orthostatic
Hypotension.
DRUGS
ACTION
INDICATIONAnxiety & tension states; Depressive mood; Nervous
tension; Agitation & Insomnia. Functional disturbances of the
CV & Respiratory systems, GIT, GUT. Adjuvant to psychotherapy
in psychoneurosis.
CONTRAINDICATION Pregnancy (Category D) Lactation Myasthenia
Gravis Hypersensitivity
ADVERSE EFFECTS Acute Anxiety Insomnia Excitation (Discontinue)
Hallucinations
NURSING RESPONSIBILITY Assess degree of anxiety & level of
sedation. Monitor VS, adverse effects, laboratory examination,
doses for elderly, malnourished pt. with liver or renal function,
& w/ CV diseases. Caution pt. to avoid taking alcohol or other
CNS depressants concurrently with this medication. Advise pt. that
drug may impair ability to drive vehicles & to operate
machinery. Teach pt. that during course of therapy, tolerance to
sedative effects usually develops.
Generic Name Depress the Bromazepam CNS, probably by
potentiating Brand Name GABA, an inhibitory LEXOTAN
neurotransmitter. Classification Produces skeletal muscle
relaxation CNS Drugs (Benzodiazepines) by inhibiting spinal
polysynaptic afferent Dosage pathways. tab 1.5mg
Generic Name
Ampicillin Sodium
Brand Name
Ampisan
Functional Classification
Systemic Anti-infectives
Chemical Classification
Penicillins
Indication
Treatment of UTI, otitis media, sinusitis, bronchitis,
uncomplicated community-acquired pneumonia, Haemophilusinfluenzae
infections and invasive salmonellosis.
Contraindication
Hypersensitivity to penicillins. Infectious mononucleosis. Use
cautiously with renal disorders.
Mode of Action
Inhibits bacterial cell wall synthesis by binding to one or more
of the penicillin binding proteins (PBPs); which in turn inhibits
the final transpeptidation step of peptidoglycan synthesis in
bacterial cell walls, thus inhibiting cell wall biosynthesis.
Bacteria eventually lyse due to ongoing activity of cell wall
autolytic enzymes (autolysins and murein hydrolases) while cell
wall assembly is arrested.
Ideal Dosage Preparation and Supply Form
IVAdult Usual Dose: 1-2 gramsevery 4-6 hours in slow intravenous
injection over 10-15 minutes. 1 gram vial will be diluted in 7.4ml
of distilled or bacteriostatic water to have a 135/ml concentration
and 2 gram vial with 14.8ml distilled water for 135/ml
concentration. Route Onset Peak Duration
I.V.
Immediate
5 min
6-8 hr
Adverse Effect
Skin rashes including urticaria or maculopapular
rash. Diarrhea, nausea and vomiting, and pseudomembranous
colitis. Simultaneous use with oral contraceptives may Drug
Interaction lead to increased risk of breakthrough bleeding and
reduced efficacy of the contraceptive. Skin rash increased with
allopurinol. Probenecidincreases blood levels. Synergism with
-lactamase inhibitors, clavulanic acid or sulbactam,
penicillinase-stable drugs eg, cloxacillin or flucloxacillin and
aminoglycosides. Potentially Fatal: Increases disulfiram and
anticoagulant effects. Ampicillin is a broad spectrum antibiotic
which is Rationale for Giving the Medication active against
Gram-positive and Gram-negative bacteria. It is given to kill a
wide range of bacteria since no culture was done to identify the
specific bacteria causing the infection. Thus, treating the
underlying cause of the disease (UTI) will alleviate its symptoms
including dysuria and lumbar pain. A. Assessment Nursing
Responsibilities - History: Allergies to penicillins,
cephalosporins, or other allergens; renal disorders - Physical:
Culture infected area; skin color,
lesion; Respiratory, adventitious sounds; bowel sounds; liver
and renal function tests, serum electrolytes, hematocrit,
urinalysis. B. Interventions 1. Observe patients 10 rights in drug
administration. 2. Monitor patients vital signs to serve as
baseline data and to determine the effectiveness of the drug. 3.
Check IV site carefully for signs of thrombosis or drug reaction.
4. For direct I.V. injection, give over 10 - 15 minutes. Dont
exceed 200 mg/minute.More rapid administration may result in
convulsive seizures. 5. Change I.V. site every 48 hours. 6. Watch
for signs and symptoms of hypersensitivity reaction. 7. Monitor for
bleeding tendency or hemorrhage.
Name of Drug Generic Name: Cefuroxime Trade Name: Ceftin
Classification of Drug Therapeutic: Anti-infectives
Content:
Mechanism of Action Bind to bacterial cell wall Pharmacologic:
membrane, Second causing cell generation death Cephalosporins
Therapeutic Pregnancy Effects: Catergory B Bactericidal action
Indication Treatment of It is effective for the treatment of
penicillinaseproducingNeisseria gonorrhoea(PPNG). Effectively
treats bone and joint infections, bronchitis, meningitis,
gonorrhea, otitis media, pharyngitis/tonsilliti s, sinusitis, lower
respiratory tract infections, skin and soft tissue infections,
urinary tract infections, and is used for surgical prophylaxis,
reducing or eliminating infection.
Contraindications Hypersensitivity to cephalosporins and related
antibiotics; pregnancy (category B), lactation.
Side Effects GI: Diarrhea, nausea, antibioticassociated colitis.
Skin: Ra sh , pruritus, urticaria. Urogenital: Increased serum
creatinine and BUN, decreased creatinine clearance. Hemat:
Hemolytic anemia MISC: Anaphylaxis
Nursing Responsibilities Before:
Determine history of hypersensitivity reacti ons to
cephalosporins, penicillins, and history of allergies, particularly
to drugs, before therapy is initiated.
Maximum Dose:
Lab tests: Perform culture and sensitivity tests before
initiation of therapy and periodically during therapy if indicated.
Therapy may be instituted pending test results. Monitor
periodically BUN and creatinine clearance.
Minimum Dose:
Availability: Tablets: 125mg, 250mg, 500mg Powder for injection:
750mg, 1.5g, 7.5g Premixed
containers: 750 mg/50ml, 1.5g/50ml
During:
Inspect IM and IV injection sites frequently for signs of
phlebitis.
Source: Davis Drug Guide for Nurses 10th Edition
Monitor for manifestations of hypersensitivity (see Appendix F).
Discontinue drug and report their appearance promptly.
Monitor I&O rates and pattern: Especially important in
severely ill patients receiving high doses. Report any significant
changes.
Report onset of loose stools or diarrhea. Although
pseudomembranous colitis (see Signs &
Symptoms, Appendix F) rarely occurs, this potentially
lifethreatening complication should be ruled out as the cause of
diarrhea during and after antibiotic therapy. After: y Instruct
patient to take medication around the clock at evenly spaced times
and to finish the medication completely, even if feeling better y
Advise patient to report signs of superinfection and allergy y
Instruct patient to notify health professional if fever and
diarrhea develop