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DRUG__EDITED__MAJH.print

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for the nursing students, medical team

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									   NAME OF        MECHANISM                                                            ADVERSE
                                      INDICATION         CONTRAINDICATION                                             NURSING CONSIDERATIONS
     DRUG          OF ACTION                                                           EFFECTS
Generic name:    Inhibits the        Essential, renal,   >Contraindicated with   CNS: drowsiness,
Clonidine        central vasomotor   and hypertension    hypersensitivity to     dizziness, fatigue,       >Monitor BP and pulse rate frequently
Hydrochloride    centers, thereby                        clonidine               sedation, nervousness
                 decreasing                                                      headache                  > Maybe given to rapidly lower BP in some
Brand Name:      sympathetic                             > Renal failure                                   hypertensive emergency situation
Catapres         outflow                                                         CV: orthostatic
                                                                                 hypotension,              > Discontinuing clonidine for surgery is not
Classification                                                                   bradycardia, severe       recommended.
Anti-                                                                            rebound hypertension
hypertensive                                                                                               >In patient s receiving both clonidine and a beta blocker,
                                                                                 EENT: dry mouth           the beta blocker should be gradually withdrawn before
Dosage,                                                                                                    clonidine to minimize adverse effects.
frequency,                                                                       GI: constipation
interval                                                                                                   >Instruct patient to check with doctor or pharmacist
                                                                                 GU: urine retention,      before taking OTC medications.
150mcg Tablet                                                                    impotence
                                                                                                           >Observe for tolerance to the drug’s therapeutic effects
                                                                                 METABOLIC;                that may require an increased dosage.
                                                                                 transient glucose
                                                                                 intolerance after large   >Inform patient that orthostatic hypertension can be
                                                                                 doses                     minimized by rising slowly and avoiding sudden position
                                                                                                           changes.
                                                                                 SKIN: pruritus
                                                                                                           >Elderly patients may be more sensitive to hypotensive
                                                                                                           effects.

                                                                                                           >Last dose should be taken immediately before retiring.
                         MECHANISM OF                                                                         ADVERSE
   NAME OF DRUG                                          INDICATION               CONTRAINDICATION                              NURSING CONSIDERATIONS
                             ACTIONS                                                                          EFFECTS
                     Selectively blocks the         >Treatment of                 >Contraindicated with   >CNS: Headache, >Warning: Alert surgeon and mark
Generic Name:        binding of angiotensin II      hypertension, alone or in     hypersensitivity to     dizziness, syncope, the patient’s chart with notice
Losartan             to specific tissue receptors   combination with other        Iosartan,               insomnia            theIosartan is being taken. The
                     found in the vascular          antihypertensives.                                                        blockage of the rennin-angiotensin
                     smooth muscle and                                            >Use cautiously with    >Dermatologic:      system following surgery can
Brand Name:          adrenal gland; this action     >Treatment of diabetic        renal impairment        Rash, , pruritus,   produce problems. Hypertension may
Lifezar              blocks the                     nephropathy with an                                   dry skin            be reversed with volume expansion.
                     vasoconstriction effect of     elevated serum creatinine
Dosage, Frequency,   the renin-angiotensin as       and proteinuria in patients                           >GI: dry mouth     >Monitor patient closely in any
interval:            well as the release of         with type 2 (non-insulin                                                 situation that may lead to decrease in
50mg tablet          aldosterone leading to         dependent) diabetes and a                             >Respiratory:      BP secondary to reduction in fluid
                     decreased BP.                  history of hypertension.                              cough,             volume-excessive perspiration,
                                                                                                                             dehydration, vomiting, diarrhea-
                                                    >Reduction of the risk of                             >Other: muscle     excessive hypotension can occur.
                                                    CVA in patients with                                  weakness.
                                                    hypertension and left                                                    >Take the drug without regard to
                                                    ventricular hypertrophy.                                                 meals. Do not stop taking this drug
                                                                                                                             without consulting your health care
                                                                                                                             provider.
                       MECHANISM OF
 NAME OF DRUG                                   INDICATION          CONTRAINDICATION              ADVERSE EFFECTS                     NURSING CONSIDERATIONS
                            ACTIONS
                     >Mechanism of of           >Symptomatic        >Contraindicated with       >CNS: Drowsiness,             >contraindicated in shock or comatose states.
Generic Name:        Action not understood;     relief of anxiety   allergy to hydroxyzine or   involuntary motor activity,
Hydroxyzine          actions may be due to      and tension         cetirizine                  including tremor and          >dosage should be reduced in elderly or debilitated
hydrochloride        suppression of             associated with                                 seizures                      patients.
                     subcortal areas of the     psychoneurosis;     >Use cautiously with
Brand Name:          CNS; has clinically        adjunct is          uncomplicated vomiting      >GI: dry mouth,               >Warn patient to avoid activities that require
Atarax               demonstrated               organic disease     (may contribute to Reye’s                                 alertness and good psychomotor coordination until
                     antihistaminic,            states in which     syndrome or unfavorably     >GU: Urinary retention        CNS effects of the drug are known.
Dosage, Frequency,   analgesic,                 anxiety is          influence its outcome;
interval:            antispasmodic,             manifested.         extrapyramidal effects      >Hypersensitivity:            >Warn patient not to combine drug with alcohol or
25mg tablet          antiemetic, mild                               may obscure diagnosis of    Wheezing, dyspnea, chest      other depressants.
                     antisecretory, and                             Reye’s syndrome)            tightness.
                     bronchodilator activity.                                                                                 >Observe for excessive sedation due to
                                                                                                                              potentiation with other CNS drugs.

                                                                                                                              >Used perioperatively as anti-emetic and
                                                                                                                              anxiolytic. Its sedative and antihistamine
                                                                                                                              properties make it especially useful to treat
                                                                                                                              pruritus that prevents sleep.

                                                                                                                              >Used in psychogenically induced allergic
                                                                                                                              conditions, such as chronic uticaria and pruritus.
                          MECHANISM OF
 NAME OF DRUG                                      INDICATION         CONTRAINDICATION              ADVERSE EFFECTS                         NURSING CONSIDERATIONS
                               ACTIONS
                        Inhibits reabsorption of   Edema              >Contraindicated with       >CNS: dizziness, vertigo,      >Potent loop diuretic; can lead to profound water and electrolyte
                                                                                                                                 depletion. Monitor BP and pulse rate during rapid dieresis
Generic Name:           sodium and chloride        associated with    allergy to furosemide,      weakness, headache,
Furosemide              from the proximal and      renal disease      sulfonamides; allergy to    drowsiness, fatigue, blurred   >Sulfonamide sensitive patient may have allergic reactions to
                        distal tubules and         and hypertension   tartrazine (in oral         vision,                        furosemide
                                                                                                                                 >If oliguria or azolemia develops or increases, may require
Brand Name:             ascending limb of the                         solution); anuria, severe                                  stopping drug
Uritol                  loop of henle, leading                        renal failure; lactation.   >GI: nausea and vomiting,      >Monitor serum electrolyte, BUN, and CO2 frequently
                        to a sodium-rich                                                          constipation                   >Monitor serum potassium level. Watch for sign of hypokalemia
                                                                                                                                 (for ex:muscle weakness and cramps). Patient also and digitalis
Classification: loop    diuretics                                     >Use cautiously with                                       have an increased risk of digitalis toxicity from the potassium
diuretics                                                             diabetes mellitus.          >GU; polyuria, nocturia,       depleting effect
                                                                                                  glycosuria, urinary bladder
                                                                                                                                 >Consult with doctor and dietitian to provide
Dosage and intervals:                                                                             spasm                          High potassium diet
20mg OD
                                                                                                  >HEMATOLOGIC:                  >Food rich in potassium include citrus fruits, tomatoes, bananas,
                                                                                                                                 dates, and apricots
                                                                                                  leucopenia, anemia,
                                                                                                  thrombocytopenia,              >Monitor blood sugar in patient with diabetes. May treat severe
                                                                                                  hyperuricemia.                 hyperglycemia with oral diabetic agents

                                                                                                                                 >Give P.O and I.M. preparation in a.m.to prevent nocturia. Give
                                                                                                  OTHER>:muscle cramps           second doses in early afternoon
                                                                                                  and muscle spasm
                                                                                                                                 >Store tablets in light – resistant container to prevent discoloration
                                                                                                                                 (doesn’t affect potency). Don’t use discolored (yellow) injectable
                                                                                                                                 preparation. Oral furosemide solution should be stored in the
                                                                                                                                 refrigerator to ensure instability of drugs.

                                                                                                                                 >Promotes calcium excretion. IV furosemide often used to treat
                                                                                                                                 hypercalcemia

                                                                                                                                 >Advise patient to report immediately ringing in ears severe
                                                                                                                                 abdominal pain or sore throat and fever may indicate furosemide in
                                                                                                                                 toxicity
                                                                                                                                 >Discourage patients receiving furosemide therapy at home from
                                                                                                                                 storing different types of medication in the same container. This
                                                                                                                                 increases the risk of drug errors, especially for patients taking both
                                                                                                                                 furosmide and digoxin, since the most popular strengths of these
                                                                                                                                 drugs pills are while tablets approximately equal in size.
                        MECHANISM OF                                                                              ADVERSE
  NAME OF DRUG                                         INDICATION                CONTRAINDICATION                                   NURSING CONSIDERATIONS
                             ACTIONS                                                                               EFFECTS
                     Selectively blocks the       >Treatment of                >Contraindicated with           >CNS: Headache,     >Warning: Alert surgeon and mark
Generic Name:        binding of angiotensin II    hypertension, alone or in    hypersensitivity to Iosartan,   dizziness,          the patient’s chart with notice
Losartan             to specific tissue           combination with other                                       syncope, insomnia   theIosartan is being taken. The
                     receptors found in the       antihypertensives.           >Use cautiously with renal                          blockage of the rennin-angiotensin
                     vascular smooth muscle                                    impairment                      >Dermatologic:      system following surgery can
Brand Name:          and adrenal gland; this      >Treatment of diabetic                                       Rash, , pruritus,   produce problems. Hypertension
Lacidipine           action blocks the            nephropathy with an                                          dry skin            may be reversed with volume
                     vasoconstriction effect of   elevated serum creatinine                                                        expansion.
Dosage, Frequency,   the renin-angiotensin as     and proteinuria in                                           >GI: dry mouth
interval:            well as the release of       patients with type 2 (non-                                                       >Monitor patient closely in any
20mg tablet          aldosterone leading to       insulin dependent)                                           >Respiratory:       situation that may lead to decrease
                     decreased BP.                diabetes and a history of                                    cough,              in BP secondary to reduction in fluid
                                                  hypertension.                                                                    volume-excessive perspiration,
                                                                                                               >Other: muscle      dehydration, vomiting, diarrhea-
                                                  >Reduction of the risk of                                    weakness.           excessive hypotension can occur.
                                                  CVA in patients with
                                                  hypertension and left                                                            >Take the drug without regard to
                                                  ventricular hypertrophy.                                                         meals. Do not stop taking this drug
                                                                                                                                   without consulting your health care
                                                                                                                                   provider.
 NAME OF DRUG          MECHANISM OF             INDICATION         CONTRAINDICATION    ADVERSE                  NURSING
                            ACTIONS                                                     EFFECTS            CONSIDERATIONS
                      Co- enzyme for         Vit. B12 deficiency   Hypersensitivity   SKIN: itching   >use cautiously in anemic
                      various metabolic                                                               patients with co-existing
Generic Name:         functions necessary                                                             cardiac, pulmonary or
                      for cell replication                                                            hypertensive disease, and in
Dibencozide           and hematopoiesis.                                                              severe Vit. B12 deficiencies.

Bramd Name:                                                                                           >protect from light and heat.
heraclene forte
                                                                                                      >closely monitor serum
Classification:                                                                                       potassium for first 48 hours.
Vit. B12 supplement
                                                                                                      >physically incompatible with
Dosage and                                                                                            dextrose solutions, alkaline or
Frequency:                                                                                            strongly acidic solution,
3 mg capsule                                                                                          oxidizing and reducing agents,
                                                                                                      and many other drugs.
Name of Drug        Mechanism of           Indication            Contraindication        Adverse Effect          Nursing Consideration
                    Action
Generic Name:       Insulin is a           Treatment of type     Contraindicated with                            >: Dosage is always expessed in USP units.
Insulin             hormone secreted       2 diabetes mellitus   allergy to pork         LOCAL: itching :        >:Lente semilente, and ultra lente insulin may be mixd in any
Brand Name:         by beta cells of the   that cannot be        products (varies with   usually resolves in a   proportion.
                    pancreas that by       controlled by diet    preparation; human      few days to a few
                                                                                                                 >:Regular insulin should not be mixed with globin insulin
Classification:     receptor-mediated      or oral drugs         with insulin not        weeks a changes in
Anti diabetic       effects promotes                             contraindicated with    type or speci8es        >: Note that switching from separate injection to a prepared mixture
Hormone             the storage of the                           pork allergy );         source of insulin       may alter patients response.
                    bodies fuels,                                history of smoking      may be tried;           >: Store insulin in cool area. Refrigeration desirable but not
Dosage, frequency   facilitating the                             or lung disease         lipodystropy;           essentials, except with regular insulin concentrated.
and intervals:      transport of                                 (inhaled insulin)       pruritus
                                                                                                                 >: Don’t use insulin that has changed color or becomes clumped or
                    metabolites and                                                                              granular in appearance.
                    ions (potassium)                                                     METABOLIC :
                    through cell                                                         hypoglycemia; keto      >: Check expiration date on vial before using contents.
                    membranes and                                                        acidosis                >: Administration route is S.C because absorption rate and pain are
                    stimulating the                                                                              less than with i.m. injection
                    synthesis of
                                                                                                                 >: press but do not rub site after injection. Rotate injection sites and
                    glycogen from                                                                                chart to avoid overuse of one area.
                    glucose, of fats
                    from lipids, and                                                                             >: Be sure the patient knows that therapy relieves symptoms but
                                                                                                                 doesn’t cure the disease.
                    proteins from
                    amino acids.                                                                                 >: Advise patient to wear medical identification alert at all times; to
                                                                                                                 carry ample insulin supply and syringes on trips; to have
                                                                                                                 carbohydrates (lump of sugar or candy) on hand for emergency ; to
                                                                                                                 take note of time zone changes for dose schedule when traveling.

                                                                                                                 >: Cigarette smoking decreases the amount of absorption of insulin
                                                                                                                 administered subcutaneously. Advise patient not to smoke within
                                                                                                                 30 minutes after insulin injection.
                     MECHANISM OF                                                        ADVERSE                 NURSING
NAME OF DRUG                                  INDICATION       CONTRAINDICATION
                          ACTIONS                                                         EFFECTS          CONSIDERATIONS
                     The drug works by      type II diabetes   Hypoglycemia, type 1   METABOLIC:           >make sure patient
                     inhibiting ATP-                           DM,                    hypoglycemia         understand that
Generic Name:        sensitive potassium                                                                   therapy relieves
Glyburide            channels in                                                      SKIN: rash, pruritus symptoms but doesn’t
                     pancreatic beta                                                                       cure the disease
                     cells. This inhibition
Bramd Name:          causes cell                                                                          >monitor patient
Glibenclamide        membrane                                                                             closely for
                     depolarization,                                                                      hypoglycemia
Classification:      which causes
anti-diabetic drug   voltage-dependent                                                                    >advise patient to
                     calcium channels to                                                                  avoid large intake of
Dosage and           open, which causes                                                                   alcohol. It may inhibit
Frequency:           an increase in                                                                       the absorption.
5 mg tab             intracellular calcium
                     in the beta cell,
                     which stimulates
                     insulin release.

								
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