Drugs Study

ST. PAUL UNIVERSITY DUMAGUETE(St. Paul University System)

P.O. Box 126200 Dumaguete City

Philippines

As Partial Fulfillment for the Degree of

Master of Arts in Nursing

Submitted to:

Dr. Richard Pascua M.A.NProfessor

Submitted by:

Ms. Joralyn A. Pacres, RN

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ST. PAUL UNIVERSITY DUMAGUETE(St. Paul University System)

P.O. Box 126200 Dumaguete City

PhilippinesDrug Order

(Generic Name, Brand Name, Classification,

Dosage, Route, Frequency)

Mechanism Of Action Indication contraindication Adverse Effects Nursing Considerations

Generic Name: Furosemide

Brand Name: Lasix

Classification: Loop Diuretic

Dosage:Tablet – 20, 40, 80 mg;Oral Solution – 10mg/ml; injection 10mg/ml

Inhibits reabsorption of sodium and water in the ascending limb of the loop of henle by interfering with the chloride binding site. Loop diuretics increase the rate of delivery of tubular fluid and electrolytes to the distal sites of hydrogen and potassium ion secretion, while plasma volume contraction increases aldosterone production. The increased delivery and high aldosterone levels promote sodium reabsorption at the distal tubules, thus increasing the loss of potassium and hydrogen ions.

Indicated to patient’s with edema associated with CHF, cirrhosis, renal disease

Hypertension

Severe Sodium and water depletion

Hypersensitivity to sulphonamides and furosemide, hypokalemia, hyponatremia, precomatose states associated with liver cirrhosis, anuria or renal failure

Addison’s Disease

Low blood pressure Fluid and Electrolyte

Imbalance Rashes,

photosensitivity, nausea, diarrhea, blurred vision, dizziness, headache, hypotension

Hyperglycemia, glycosuria, ototoxicity

Assess patient’s underlying condition before starting therapy.

Monitor for renal, cardiac, neurologic, GI manifestation

Assess fluid volume status

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Drug Order(Generic Name, Brand Name,

Classification, Dosage, Route, Frequency)


Generic Name:Mannitol

Brand Name:Osmitrol

Classification:Osmotic diuretic

Dosage:15% to 25% solution IV infusion

Increases osmotic pressure of plasma in glomerular filtrate, inhibiting tubular reabsorption of water and electrolytes (including sodium and potassium). These actions enhance water flow from various tissues and ultimately decrease intracranial and intraocular pressures.

It raises the osmotic pressure of the plasma allowing water to be drawn out of body tissues.

Active intracranial bleeding, anuria secondary to severe renal disease, progressive heart failure, pulmonary congestion, renal damage, severe dehydration

CNS: dizziness, headache, seizures

CV: chest pain, hypotension, tachycardia

GI: nausea and omitting, diarrhea

GU: polyuria, urinary retention

METABOLIC: dehydration, water intoxication, hypernatremia, hyponatremia, hypokalemia, metabolic acidosis

Assess skin turgor, mucous membranes and mental status before administering the drug

Assess signs of electrolyte imbalance

Monitor iv site carefully to avoid extravasations and tissue necrosis

Do not add to other IV solutions or mix with other medications.

Watch for excessive fluid loss and signs and symptoms of hypovolemia and dehydration

Assess for evidence of circulatory overload, including pulmonary edema and heart failure.

Drug Order(Generic Name, Brand


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Name, Classification, Dosage, Route, )

Generic Name:Hydralazine hcl

Brand Name:apresoline

Classification:vasodilator

Dosage: 5 or 10mg by iv infusion

Routeintravenous

Acts directly on vascular smooth muscle to cause vasodilation, primarily anteriolar, decreasing peripheral resistance; maintains or increase renal and cerebral flow

Hypertension Manage

hypertensive emergencies related to pregnancy

Manage severe heart failure

Contraindicated in patients hypersensitive to the drug and its components and those with coronary artery disease or mitral valvular rheumatic heart disease.

CNS: headache, dizziness, tremors

CV: palpitations, tachycardia, hypotension

GI: nausea and vomiting, diarrhea, constipation

Urticarial, pruritus

Check blood pressure before administering the drug

Inform patient that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly.

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Drug Order(Generic Name, Brand Name, Classification,

Dosage, Route)


Generic Name:hydrocortisone

Brand Name:Solu-cortef

Classification:steroid

Dosage:20-240mg

Route:IV, oral

Enters target cells and binds to cytoplasmic receptor; initiates many complex reactions that are responsible for its anti- inflammatory, immunosuppressive, and salt retaining actions.

Replacement therapy in adrenal cortical insufficiency.

Allergic states – severe or incapacitating allergic conditions.

Hematologic disorders

Allergy to any components of the drug

CNS: vertigo, headache, insomnia, siezures

CV: hypotensions, shock, heart failure secondary to fluid retention

GI: peptic ulcer, nausea and vomiting, abdominal distention

Assess for contraindications

Monitor vital signs

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Dosage, Route)


Generic Name:digoxin

Brand Name:Lanoxin

Classification:Inotropic, antiarrhythmic cardiac glycoside

Dosage:0.75-1.25mg PO0.125mg-0.25mg IV

Route:Oral, IV

Inhibits sodium-potassium activated adenosine triphosphatase, promoting movement of calcium from extracellular to intracellular cytoplasm and strengthening myocardial contraction. Also acts to CNS to enhance vagal tone, slowing conduction through the SA and AV nodes.

Heart failure, paroxysmal supraventricular tachycardia, atrial fibrillation and flutter.

Contraindicated in patients hypersensitive to drugs and in those with digitalis- induced toxicity, ventricular fibrillation, or ventricular tachycardia unless caused by heart failure.

CNS: fatigue, generalized muscle weakness, agitation, hallucinations.

CV: arrhythmias, heart block

EENT: yellow green halos around visual images, blurred vision, light flashes, photophobia

GI: anorexia, nausea

Before giving loading dose, obtain baseline data and ask patient about use of cardiac glycosides within the previous 2 to 3 weeks.

Before giving drug, take apical-radial pulse for 1minute. Record and notif prescriber of significant changes (sudden increase or decrease in pulse rate, irregular beats). If these occur, check blood pressure and obtain a 12 leads ECG.

Monitor potassium level carefully. Take corrective action before hypokalemia occurs. Hyperkalemia may results from digoxin toxicity.

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Dosage, Route)


Generic Name:diphenhydramine

Brand Name:benadryl

Classification:antihistamine

Dosage:25-50mg PO

Route: PO, Im, IV

Action on blood vessel, GI, respiratory tract by antagonizing the effects of histamine for H1 receptors site decrease allergic response by blocking histamine caused increased heart rate, vasodilation secretions.

Histamine H1 receptor antagonist of effector cells in respiratory tract, blood vessels, and GI smooth muscle.

It is used for symptomatic relief of allergic conditions including urticarial and angioedema. It is used for abtimiscarinic properties in the control of parkinsonism and drug-induced extrapyramidal disorders.

Hypersensitivity to drugs and its components.

CNS: sedation, confusion, nervousness, restlessness, convulsion

CV: tachycardia, hypotension, palpitation,

Euphoria Anorexia Urinary retention Tinnitus Diplopia Orthostatic

hypotension Palpitations Drowsiness Sedation

Assess respiratory status, rate, rhythm and increase In bronchial secretions, wheezing and chest tightness.

Instruct patients not to take Benadryl when driving.

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Dosage, Route)


Generic Name:Epinephrine hydrochloride

Brand Name:adrenaline

Classification:Beta2 adrenergic agonists

Dosage:1mg IV,

Route: IM, IV

Stimulates alpha and beta receptors in sympathetic nervous system

Relaxes bronchial smooth muscles, causes cardiac stimulation, relieves allergic signs and symptoms, helps stop local bleeding, and decreases pain sensation.

Bronchospasm, hypersensitivity reactions, anaphylaxis

Hemostasis Prolonging local

anesthetic effect Restoring cardiac

rhythm in cardiac arrest.

Asthma

Cardiac dysrhythmias, angle-closure glaucoma, local anesthetic of fingers and toes

General anesthesia with halocarbons or cyclopropane, organic brain damage, labor coronary insufficiency.

CNS: anxiety, dizziness, fear, headache, hemiplegia, subarachnoid hemorrhage, tremors, weakness, restlessness

CV: angina pain, dysrhythmias, palpitations

GI: nausea and vomiting

Urinary retention Respiratory diffiulty

Monitor vital signs and check for cardiac dysrhythmias.

Avoid IM use of parenteral suspensions into buttocks. Gas gangrene may occur.

Massage site after IM injection to counteract possible vasoconstriction.

If blood pressure increases sharply, rapid-actiong vasodilators such as nitrates or alpha blockers can be given to counteract.

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Dosage, Route)


Generic Name:Adenosine

Brand Name:Adenocard

Classification:Antidysrhythmics

Dosage and route: 3mg/ml140mcg/kg IV infusion6mg IVP

PSVT: slow conduction through AV node and interrupts AV reentry pathways, which restore normal sinus symptoms.

Stress testing: A2A adenosine receptor agonist; activation of the A2A adenosine receptor produces coronary vasodilation and increases coronary blood flow.

Indicated as adjunct to thallium-201 myocardial perfusion scintigraphy in patients unable to exercise adequately.

Sustained ventricular tachycardia

Hypersensitivity to drugs

Broncho constrictive or bronchospastic lung disease (eg. Asthma)

Dyspnea Chest pain Headache Lightheadedness Dizziness Numbness Nausea Hypotension Palpitations Blurred vision Bradycardia Seizure

Monitor vital signs

Check for hypersensitivity reactions

Do not refrigerate; possible crystal formation

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Dosage, Route)


Generic Name:aminophylline

Brand Name:paladron

Classification:bronchodilator

Dosage:6mg over 3ominutes

Route: IV

Directly relaxes smooth muscles of respiratory tract.

To prevent and relieve symptoms of acute bronchial asthma and treatment of bronchospasm associated with chronic bronchitis and emphysema

Hypersensitivity to xanthine deratives.

CNS: nervousness, restlessness, depression, insomnia, headache,

CV: cardiac arrhythmias, tachycardia

GI: nausea and vomiting, anorexia, diarrhea, epigastric pain

Monitor vital signs and I&O, a sudden, sharp unexplained rise in heart rate may indicate toxicity.

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Dosage, Route)


Generic Name:Amiodarone

Brand Name:Cordarone

Classification:Antidysrhythmics

Dosage:50mg/ml100mg-400mg/tab

Route:IV, oral

Class III antiarrhythmic agent, which inhibits adrenergic stimulation; affect sodium, potassium, and calcium channels; markedly prolongs action potential and repolarization; decreases AV conduction and sinus node function.

Indicated only for life threatening arrhythmias because of risk for substantial toxicity;

Hypersensitivity to the drugs.

Severe sinus node dysfunction

Cardiogenic shock Avoid during

breastfeeding

Hypotension Dizziness Headache Malaise Ataxia Fatigue Impaired memory Involuntary

movement Sleep disturbance Photosensitivity Hypothyroidism Constipation Anorexia Bradycardia GI: hepatitis,

cirrhosis, pancreatitis, dry mouth

Nephrology: renal impairment, acute renal failure

Avoid excessive exposure to sunlight, may cause photosensitivity

Check for blood pressure: hypotension is the most common adverse reaction in some cases.

Assess for electrolyte imbalance

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Dosage, Route)


Generic Name:Atropine sulfate

Brand Name:AtroPen, Saltropine

Classification:Anticholinergic, antimuscarinic, parasympatholytic, antiparkinsonian

Dosage:Bradycardia: 0.5mg IVCardiac arrest: 1mg

Route:

Chemical effect: inhibits acetylcholine at parasympathetic neuroeffector junction, blocking vagal effects on SA node, enhancing conduction through AV node

Therapeutic effect: increases heart rate, decreases secretions and slow GI motility. Antidote for anticholinesterase insecticide poisoning.

Sympatomatic bradycardia, bradyarrhythmia

Anticholinesterase insecticide poisoning

Preoperatively for decreasing secretions and blocking cardiac vagal reflexes

Adjunct in peptic ulcer disease; functional GI disorders such as irritable bowel syndrome.

Contraindicated in patients with hypersensitivity to the drug and its components

Those with acute angle closure glaucoma, obstructive uropathy, obstructive disease of GI tract, paralytic ileus, asthma, myasthenia gravis

CNS: agitation, ataxia, coma, confusion, disorientation, dizziness, hallucination, headache, insomnia, restlessness

CV: angina, arrhythmias, palpitations, tachycardia


Ensure adequate hydration

Have patient void before taking medication if urinary retention is the problem

Monitor vital signs

Instruct to take 30 minutes before meals

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Dosage, Route)


Generic Name:Calcium Gluconate

Brand Name:gluconate

Classification:Antidote, calcium salts

Dosage:100mg/ml IV50-650mg tablet500mg capsule

Route:Oral, IV

Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways

Treatment for hypocalcemia

Cardiac arrest Hyperkalemia Hypermagnesemia

Contraindicated to hypersensitivity to drugs

Hypercalcemia

Bradycardia Hypotension Headache Constipation Diarrhea Flatulence Nausea Vomiting Hypomagnesemia Hypophosphatemia

Monitor vital signs

Assess for electrolyte imbalance

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Dosage, Route)


Generic Name:Dexamethasone

Brand Name:Decadron, solurex

Classification:Corticosteroids, anti-inflammatory agents

Dosage and route:Tablet: 0.5 mg – 6mgInjectables: 4mg/ml10mg/ml

Decreases inflammation by sippressing migration of polymorphonuclear leukocytes (PMNs) and reducing capillary permeability; stabilizes cell and lysosomal membranes, increases surfactant synthesis, increases serum vitamin A concentration, and inhibits prostaglandin and proinflammatory cytokines; suppresses lymphocytes proliferation through direct cytolysis, inhibits mitosis, breaks down granulocytes aggregates, and improves pulmonary microcirculation.

Inflammation Cerebral edema Shock Allergic

condition

Hypersensitivity to drug

Systemic fungal infection

Cerebral malaria

Bradycardia Depression Diaphoresis Euphoria Insomnia Rash Seizure Vertigo Weight gain Urticarial Moon face

Monitor vital signs Check for

hypersensitivity reaction

Drug Order(Generic Name, Brand


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Name, Classification, Dosage, Route)

Generic Name:Diazepam

Brand Name:Valium

Classification:Anticonvulsants, skeletal muscle relaxant

Dosage and Route:Tablet: 2mg, 5mg, 10mgIV: 5mg/mlIM: 5mg/ml

Modulates postsynaptic effects of GABA-A transmission, resulting in an increase in presynaptic inhibition. Appears to act on part of the limbic system, as well as on the thalamus and hypothalamus, to induce a calming effect.

Anxiety Alcohol

withdrawal Muscle spasm Seizure disorder Status epilepticus

Contraindicated in patient with hypersensitivity to drugs

Sleep apnea Breastfeeding Children below

6months Severe respiratory

depression

Hypotension Fatigue Muscle weakness Respiratory

depression Urinary retention Depression Blurred vision Headache Skin rash

Monitor vital signs Check for respiration

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Dosage, Route)


Generic Name:Dopamine hcl

Brand Name:decocard

Classification:Sympathomimetic

Dosage:2.5mcg

Route:Iv infusion

Sympathomimetic chemical precursor to norepinephrine. It has differing effects on the vascular and cardiac systems.

Correction of hemodynamic imbalances present in shock after myocardial infarction, trauma, surgery and renal failure or imbalance in condition or chronic refractory cardiac decompensation.

Should not be used in patient with phaechromocytoma or hyperthyroidism, nor the presence of uncorrected tachyarrhythmias or ventricular fibrillation.

CNS: headache, anxiety

CV: ectopic beats, tachycardia, angina pain, palpitations, hypotension, dyspnea, bradycardia


Monitor vital signs, cardiac output, and urinary output. Report significant changes.

Assess for containdication

Advise patient to inform NOD immediately if chest pain, dyspnea, numbness, tingling or burning of extremities occurs.

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Dosage, Route)


Generic Name:Nicardipine

Brand Name:cardene

Classification:Calcium channel blockers

Dosage and route:Capsule: 20mg, 30mg, 60mgInfusion: 20mg/200mlInjectable: 2.5mg/ml

Calcium channel blocker; inhibits transmembrane influx of extracellular calcium ions across membranes of myocardial cells and vascular smooth muscle cells without changing serum calcium concentration; this inhibits cardiac and vascular smooth muscle contraction, thereby dilating main coronary and systemic arteries.

Hypertension Chronic stable

angina


Advanced aortic stenosis

Headache Peripheral edema Hypotension Nausea Dizziness Polyuria Facial edema Tachycardia

Monitor blood pressure

Check for peripheral edema; it may occur

Check for hypersensitivity reaction.

Monitor vital signs

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Dosage, Route)


Generic Name:Norepinephrine

Brand Name:Levophed

Classification:Alpha/beta adrenergic agonists

Dosage and route: Injectables: 1mg/ml

Strong beta1 and alpha adrenergic effects and moderate beta2 effects, which increase cardiac output and heart rate, decrease renal perfusion and PVR, and cause variable BP effects.

Acute hypotension Cardiac arrest Sepsis/septic shock


Hypotension due to blood volume deficit

Peripheral vascular thrombosis

Bradycardia Hypertension Arrhythmias Confusion Anxiety Dyspnea Headache Nausea and vomiting Sweating Tremors Restlessness Urinary retention gangrene

monitor blood pressure and heart rate

monitor intake and output

check cause of hypotension

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Dosage, Route)


Generic Name:Phenobarbital

Brand Name:No brand

Classification:Anticonvulsants, barbiturates

Dosage and route:Tablet: 15mg-100mgIV: 20mg/5ml

Depresses sensory and motor cortex, cerebellum.

Anti-seizures activity occurs primarily where GABA mediates neurotransmission

Hypnotic effect of barbiturates result from activity of GABA receptor in the polysynaptic midbrain reticular formation ( control CNS arousal)

Status epilepticus Seizures Sedation Insomnia

Hypersensitivity Porphyria COPD Dyspnea Pregnancy

Respiratory depression

Ataxia Dizziness Drowsiness Fatigue Headache Irritability Vertigo Constipation Diarrhea Nausea Vomiting

Monitor vital signs

Let patient lie down, do not take when driving

Check for hypersensitivity

Monitor heart rate

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Dosage, Route)


Generic Name:Phenytoin sodium

Brand Name:dilantin

Classification:anticonvulsant

Dosage:

Route:

Produces a voltage and frequency dependent blockage of sodium channels in rapidly discharging nerve cells. Thus, it stops sustained repetitive firing such as that occurring during a seizure.

Control of generalized tonic-clonic (grand-mal)and complex partial seizures

Preventin and treatment of seizures occurring during or following neurosurgery

Status epelipticus

Contraindicated in patients who are hypersensitive to phenytoin or other hydantoins

SA block adams-stroke syndrome

CNS: ataxia, confusion, dizziness, headache, slurred speech, twitching

CV: hypotension GI: nausea and

vomiting HEMATOLOGIC:

anemia, lecopenia METABOLIC:

hyperglycemia

Patients taking phenytoin should be advised of the importance of adhering strictly to the prescribed dosage regimen, and of informing the physician of any clinical condition in which it is not possible to take the drug orally as prescribed.

The importance of good dental hygiene should be stressed in order to minimize the development of gingival hyperplasia and its complications.

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Dosage, Route)


Generic Name:Isosorbide Dinitrate

Brand Name:Isoket

Classification:Nitrates, angina

Dosage and route:PO: 5mg-40mg

Vasodilating agent; relaxes smooth muscle via dose-dependent dilation of arterial and venous beds to reduce bot preload and afterload, as well as myocardial oxygen demand; also improves coronary collateral circulation, lowering blood pressure, increasing heart rate, and causing occasional paradoxical bradycardia.

Angina pectoris Hypersensitivity Severe anemia Recent use (within

several days) of PDE-5 inhibitors (eg. Avanafil, sildenafil, tadalafil, or vardenafil) may cause dangerously low hypotension; the time courses of the interaction appear to be related to the PDE-5 inhibitor half-life.

Cardiovascular: rebound hypertension, syncope, unstable angina flushing, hypotension/ orthostatic hypotension, lightheadedness, palpitation

CNS: dizziness, headache, restlessness, weakness

GI: nausea HEMATOLOGIC:

methemoglobinemia

Monitor vital signs (blood pressure)

Check for hypersensitivity reaction

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Dosage, Route)


Generic Name:Magnesium sulfate

Brand Name:

Classification:Antidysrhythmics, electrolytes

Dosage and route:Injectables: 40mg/ml

Depresses CNS, blocks peripheral neuromuscular transmission produces anticonvulsants effects; decreases amount of acetylcholine released at end-plate by motor nerve impulses.

Hypomagnesemia Indicated to prevent

seizures associated with pre-eclampsia, and for control of seizures with eclampsia

Torsades de pointes


Hypothermia Hypotension Drowsiness Diaphoresis Hypocalcemia Hyperkalemia Visual changes

Monitor vital signs

Check for electrolytes imbalance

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Dosage, Route)


Generic Name:Midazolam

Brand Name:Versed

Classification:Antianxiety, anxiolytics, benzodiazepines

Dosage and route:Oral: 2mg/mlIM: 70-80mcg/kgIV: 0.5-1mg

Binds receptors at several sites within the CNS, including the limbic system and reticular formation; effects may be mediated through GABA receptor system; increase in neuronal membrane permeability to chloride ions enhances the inhibitory effects of GABA; the shift in chloride ions causes hyperpolarization (less excitability) and stabilization of neuronal membrane.


Drowsiness Nausea and

vomiting Cough Headache Sedation Delirium Euphoria Hypotension Seizures activity apnea

Monitor vital signs

Do not administer by rapid IV injection in neonates (hypotension and seizures reported, especially when used concomitantly with fentanyl)

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Dosage, Route)


Generic Name:Morphine sulfate

Brand Name:

Classification:Opioid agonists analgesic

Dosage:Oral: 10-30mg q4SC and IM: 10mgIV: 2.5-15mg

Route:

Acts as agonists at specific opioid receptors in the CNS to produce analgesia, euphoria, sedation.

Relief of moderate to severe acute and chronic pain

Preoperative medications

Analgesic adjunct during anesthesia

Intraspinal use with microinfusion devices for the relief of intractable pain

Hypersensitivity to opioid

Diarrhea caused by poisoning until toxins are eliminated

During labor or delivery of premature infant

Pregnancy

CNS: light-headedness, dizziness, sedation, euphoria, insomnia, agitation, anxiety, fear

CV: facial flushing, tachycardia, bradycardia, palpitations, hypertension, hypotension

GI: dry mouth, nausea and vomiting constipation

SKIN: tissue irritation and induration

OTHER: sweating, physical tolerance, psychological dependence.

Dilute and administer slowly

Tell patient to lie down during IV administration

Keep opioid antagonists and facilities for assisted or controlled respiration readily available during IV administration

Use caution when injections SC or IM onto chilled areas in patients with hypotension or in shock

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Dosage, Route)


Generic Name:Esomeprazole

Brand Name:Nexium

Classification:Proton pump inhibitor

Dosage and route:PO: 20mg -40mg

S-isomer of omeprazole; PPI: binds to H+/K+ - xchanging ATPase (proton pump) in gastric parietal cells, resulting in blockage of acid secretion.

GERD without erosive esophagitis

NSAID-induced gastric Ulcer

Zollinger-Ellison Syndrome

Gastric and Duodenal Ulcer

Frequent heartburn

Hypersensitivity to esomeprazole or other proton pump inhibitor

Headache Flatulence Nausea Abdominal pain Diarrhea Dizziness Constipation Stomatitis Hypomagnesimia Muscle weakness bronchospasm

Monitor vital signs

Let patient take the drug before meals

Check for electrolyte imbalance: hypomagnesemia may occur with prolonged use.

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Dosage, Route)


Generic Name:Methotrexate

Brand Name:trexall

Classification:Immunosuppressants, antineoplastics, antimetabolites

Dosage and route:25mg/mlSC: 10mg/0.4mlPO: 2.5mg

Inhibits dihydrofolic acid reductase; inhibits purine and thymidylic acid synthesis; which in turn interferes with DNA synthesis, repair, and cellular replication; cell cycle specific for S phase of cycle.

Osteosarcoma Rheumatoid

arthritis Psoriasis Treatment of

myasthenia gravis


Pregnancy: do not use due to potential for fetal death and teratogenic effects.

Immunodeficiency syndromes

Reddening of skin Hyperurecemia Nausea and

vomiting Diarrhea Anorexia Leukopenia Renal failure Alopecia Rash Fatigue Chills, fever

Monitor vital signs

Monitor closely elderly patient for early signs of hepatic and bone marrow.

Monitor intake and output; may cause renal damage leading to acute renal failure.

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Dosage, Route)


Generic Name:streptokinase

Brand Name:Streptase

Classification:Thrombolytic agent

Converts endogenous plasminogen to plasmin which breaks down fibrin clots, fibrinogen, and other plasma proteins; lysis thrombi and emboli

Coronary artery thrombosis; management of acute evoving transmural MI; lysis of pulmonary embolic; treatment of DVT arterial thrombosis, and embolism; opening of occluded arteriovenous cannula


Headache Angioneurotic Edema Hypotension Skin rash Bleeding Pain Fever Anaphylactic shock

Monitor vital signs

Check for bleeding

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Dosage, Route)


Generic Name:Ranitidine

Brand Name:Zantac

Classification:Histamine H2 Antagonist

Dosage and route:25mg/ml

H2-receptors antagonist; blocks H2 receptors of gastric parietal cells, leading to inhibition of gastric secreation.

Gastroesophageal reflux disease

Gastric ulcer, Benign Erosive Esophagitis Hypersecretory

Conditions

Hypersensitivity to ranitidine or components of the formulation

Abdominal pain Diarrhea Constipation Dizziness Hypersensitivity

reaction Nausea Vomiting

Use caution in hepatic impairment

Monitor for adverse effects.

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Dosage, Route)


Generic Name:Tranexamic acid

Brand Name:hemostan

Classification:Antihemophilic agent

Dosage:250-500mg

Route: IV, oral

Forms a reversible complex that displaces plasminogen from fibrin resulting in inhibition of fibrinolysis, it also inhibits the proteolytic activity of plasmin.

Antihemorrhagic and antifibrinolytic for effective hemostasis in various surgical and clinical cases, in traumatic injuries.

Treating heavy menstrual bleeding

Allergy reaction to drug

Presents of blood clots, have history of blood clots or are at risk for blood clots

Renal function impairment

Hematuria of upper urinary tract

Unsual changes in bleeding pattern should be immediately reported to the physician.

It can be taken with or without meals

Inform the patients to notify physician immediately if the following severe side effects occur.

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Dosage, Route)


Generic Name:Metoclopramide

Brand Name:Reglan

Classification:Antiemetic agents, Prokinetic agents

Dosage and route:5mg/ml injectable solution

Blocks dopamine receptors (at high dose) and serotonin receptors in chemoreceptor trigger zone of CNS; and sensitizes tissues to acetylcholine; increases lower GI motility but not secretions; increases lower esophageal sphincter tone

Chemotherapy-Induced Nausea and Vomiting

Diabetic Gastroparesis

Small bowel intubation/Radiologic examination of Upper GI Tract

Gastroesophageal reflux disease

Post-operative Nausea and Vomiting

Hypersensitivity to metoclopramide or procainamide

Patient with GI hemorrhage, mechanical obstruction, perforation, history of seizures, pheochromocytoma.

Fatigue Restlessness Sedation Headache Dizziness

Discontinue with signs and symptoms of tardive dyskinesia

Use caution in patient with hypertension, CHF, renal impairment, cirrhosis

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Dosage, Route)


Generic Name:Dobutamine

Brand Name:

Classification:Inotropic Agents

Dosage and route:200ng/100ml

Strong beta 1 and weak beta2 effects, resulting in increased cardiac output, blood pressure, and heart rate, as well as decreased peripheral vascular resistance

Cardiac decompensation

Low cardiac output

Hypersensitivity Idiopathic

hypertrophic subaortic stenosis

Hypertension Premature

ventricular beats Dyspnea Headache Nausea

Monitor vital signs

Caution in patient with Myocardial Infarction

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Dosage, Route)


Generic Name:Hetastarch

Brand Name:Hespan

Classification:Volume expanders

Dosage and route:500-1000ml injectable solution

Ethoxylated amylopectins; colloidally expands plasma volume

Hypovolemia Leukapheresis Renal impairment

Hypersensitivity Severe bleeding

disorders, severe CHF, severe renal failure

Hypertension Premature

ventricular beats Dyspnea Headache Nausea

Discontinue use at first sign of renal injury

Do not use in critically ill adult including those with sepsis, and those admitted to the ICU

Cautions to patient with allergy to corn, liver disease, renal impairment, thrombocytopenia

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Classification, Dosage, Route)


Generic Name:Sodium bicarbonate

Brand Name:No brands

Classification:Alkalinizing agents

Dosage and route:Injectable: 4.2%5%Tablet: 325mg, 650mgIV: 50 mEq

Bicarbonate reacts with H+ ions to form water and carbon dioxide. It acts as a buffer against acidosis by raising blood pH.

Metabolic acidosis Cardiac arrest


Hypercarbic acidosis Metabolic or

respiratory alkalosis hypocalcemia

aggravated CHF edema hypernatremia hypokalemia tetany metabolic alkalosis

monitor vital signs

check for extravasation

check for electrolyte imbalance

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Generic Name:enoxaparine

Brand Name:Lovenox

Classification:Anticoagulants

Dosage and route:Prefilled syringe: 30mg/0.3mL150mg/mL

Antithrombotic that inhibits factor Xa by increasing inhibition rate of clotting proteases that are activated by antithrombin III.

Prevent occurrence of pulmonary embolism in patients at risk for thromboembolic complications who are undergoing abdominal surgery or hip or knee replacement surgery.

Acute STEMI Renal impairement

Active major bleeding, thrombocytopenia with antiplatelet antibody in presence of enoxaparin or heparin.

Hypersensitivity to enoxaparin, heparin, pork products

Thrombocytopenia Nausea Anemia Heart failure Pneumonia Pulmonary edema Hyperkalemia Headache

Monitor vital signs

Check for signs and symptoms of neurologic impairment.

Monitor patents for bleeding

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Generic Name:fondaparinux

Brand Name:arixtra

Classification:Anticoagulants

Antithrombotic agent; inhibits factor Xa, which interrupts blood coagulation cascade and inhibits thrombin formation and thrombus development; generally does not increases prothrombin time (PT) or partial thromboplastin time (PTT).

Deep vein thrombosis

Acute pulmonary embolism treatment

Severe renal impairment

Active major bleeding

Bacterial endocarditis


Anemia Fever Nausea Dizziness Confusion Diarrhea Edema Headache Hypokalemia Hypotension Insomnia Thrombocytopenia Urinary retention vomiting

monitor vital signs

check for bleeding

monitor inatake and output

check for electrolyte imbalance

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Drugs Study

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