Drug Study (Cp)

7/30/2019 Drug Study (Cp)

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DRUG STUDY

BRAND NAME GENERIC

NAME CLASSIFICATION

Prescribed and

Recommended dosage,

frequency, route of

administration

Mechanism

Of

Action Indication Contraindication Adverse Reaction Nursing Responsi

G: Paracetamol,

Acetaminophen

B: Biogesic, Panadol,

Tylenol

C: Non-narcotic

analgesic, Antipyretic

300 mg IVTT then q 4 hrs

PRN for T= 38 degreescelsius

Inhibits the synthesis of

prostaglandin that servesas mediators of pain and

fever, primarily in the

CNS. Analgesia

Mild pain and fever. Hypersensitivity, renal

insufficiency, anemia.

GI: hepatic failure,

hepatotoxicity (overdose)

GU: renal failure

Hemat: neutropenia,

pancytopenia, leucopenia

Derm: rash, urticaria

Assess overall h

status and alcobefore administ

Assess amount,

frequency, and

of drugs taken

patients self-

medicating, esp

with OTC drugs

Pain: Assess typ

location, intens

prior to and 30-

min following

administration

Fever: Assess fe

note presence o

associated sign

(diaphoresis,

tachycardia, an

malaise).

Report nausea

vomiting, cyano

SOB, and abdom

pain as these ar

of toxicity.


2/15

DRUG STUDY

BRAND NAME GENERIC

NAME CLASSIFICATION

Prescribed and

Recommended dosage,

frequency, route of

administration

Mechanism

Of


G:Piperacillin /

Tazobactam

B: Zosyn

C: Anti-infective

4.5 gm IVTT q 8 hrs ANST

(-)

Piperacillin

: Binds to bacterial cell

wall membrane, causing

cell death. Spectrum is

extended compared with

other penicillins

Tazobactam

: Inhibits beta-lactamase,

an enzyme that can

destroy penicillins

Treatment of moderate to

severe appendicitis,

uncomplicated and

complicated skin and skin

structure infections.

Hypersensitivity to

penicillins,cephalosphorins, or other

drugs. Safety in childrenamebic hepatic abscess

>intestinal amebiasis

>trichomoniasis

>retractory

trichomoniasis

>bacterial infection

caused by anaerobic

microorganisms

>to prevent postoperative infection

incontaminated

colorectal surgery

>pelvic inflammatory

disease

Breast-feeding,

hypersensitivity tometronidazole or its

components,

trichomoniasis during first

trimester of pregnancy.

CNS: Ataxia, dizziness,

encephalopathy, fever,headache, light-

headedness, peripheral

neuropathy, seizures

(highdoses)

EENT: Dry mouth,

lacrimation (topical

form),metallic taste,

pharyngitis

GI: Abdominal cramps or

pain, anorexia, diarrhea,

nausea, pancreatitis,vomiting

GU: Darkened urine,

vaginal candidiasis (oral,

parenteral, and topical

forms); burning or

irritation of sexual

partners, dysuria, urinary

frequency,

If pt has advers

reactions, suchseizures or peri

neuropathy, te

prescriber and

drug immediate

Monitor pt

severe liver

disease bec

slowed

metronida

metabolism

cause drug

accumulate

body and inthe risk of

adverse eff

If skin irrita

occurs, app

topical gel

frequently

discontinue

ordered.

Monitor CB

culture and

sensitivity t

therapy las

longer than

days or if s

course of

treatment

needed

Give IV dru


6/15

slow infusio

1 hr; dont

direct IN

injection.


7/15

DRUG STUDY

BRAND NAME GENERIC

NAME CLASSIFICATION

Prescribed and

Recommended dosage,

frequency, route of

administration

Mechanism

Of

Action Indication Contraindication Adverse Reaction Nursing Responsib

G: Bisacodyl

B: Dulcolax

C: Gastrointestinal agent /

Laxative

2 suppository Expands

intestinal fluid

volume by

increasing

epithelial

permeability.

Induces

peristaltic

contractions by

direct

stimulation of

sensory nerve

endings in the

colonic wall.

Temporary relief of acute

constipation and for

evacuation of colon

before surgery,

proctoscopic,

sigmoidoscopic, and

radiologic examinations.

Also used tocleanse

colonbeforedeliveryand

torelieve constipationin

patients withspinal cord

damage.

Ileus, intestinal

obstruction, acute

surgical abdominal

conditions;

severedehydration.

Appendicitis & acute

inflammatory bowel

diseases.

Rarely, abdominal

discomfort & diarrhoea.

Evaluate

periodicall

patients nfor continu

of drug;

bisacodyl u

produces 1

soft forme

stools daily

Monitor pa

receiving

concomita

anticoagul

Indiscriminuse of laxa

results in

decreased

ption of vit

K.

Add high-fi

foods slow

regular die

avoid gas a

diarrhea.

Adequate f

intakeinclu

least 68

glasses/d.


8/15

DRUG STUDY

BRAND NAME GENERIC

NAME CLASSIFICATION

Prescribed and

Recommended dosage,

frequency, route of

administration

Mechanism

Of


G: Methylprednisolone

B: Medrol

C: Corticosteroid (Anti-

inflammatory)

Glucocorticoid

Hormone

8 mg 1 tab Enters target cells and

binds to intracellularcorticosteroid receptors,

initiating many complex

reactions that are

responsible for its anti-

inflammatory and

immunosuppressive

effects.

Hypercalcemia

associated with cancer

Short-term

management of various

inflammatory and

allergic disorders, such

as rheumatoid arthritis,

collagen diseases (eg,

SLE), dermatologic

diseases and

autoimmune disorders.

Contraindicated with

infections, especially

tuberculosis, fungal

infections:lactation;

allergy to tartrazine

Use cautiously with

kidney or liver disease,

hypothyroidism,

ulcerative colitisr,

inflammatory bowel

disease, CHF,

hypertension,

osteoporosis, seizure

disorders, diabetes

mellitus, pregnancy.

CNS: Vertigo, headache,

paresthesias, insomnia,seizures,

CV:Hypot ension, shock,

hypertension and CHF

secondary to fluid

retention,

thrombophlebitis,

Electrolyte imbalance: Na+

and fluid retention,

hypokalemia,hypocalcemia

Endocrine: Amenorrhea,

irregular menses, growth

retardation, decreased

carbohydrate tolerance,

diabetes mellitus,

GI: Peptic or esophageal

ulcer, pancreatitis,

abdominal distention,

nausea, vomiting,

increased appetite, weight

gain

Musculoskeletal: Muscle

weakness, steroid, loss of

muscle mass, osteoporosis

Other:

Immunosuppression;

History: Infections;

or liver disease,

hypothyroidism,

ulcerative colitis,diverticulitis, active

latent peptic ulcer,

inflammatory bowe

disease, CHF,

hypertension,

thromboembolic

disorders, osteopor

seizure disorders,

diabetes mellitus;

pregnancy; lactatio

Physical: Weight, T,

reflexes and grip staffect and orientat

BP, peripheral perf

prominence of supe

veins, R and advent

sounds, serum

electrolytes, blood

glucose.

Give daily dose bef

AM to mimic norm

corticosteroid bloo

levels.

Increase dosage wh

patient is subject to

stress.


9/15

DRUG STUDY

BRAND NAME GENERIC

NAME CLASSIFICATION

Prescribed and

Recommended dosage,

frequency, route of

administration

Mechanism

Of


G: Tramadol

B: Ultram

C: Analgesic

50 mg IV q 8 hrs PRN for

pain

Binds to mu-opioid

receptors.

Inhibits reuptake of

serotonin and

norepinephrine in the

CNS.

Decreased pain.

Moderate to moderately

severe pain.

Hypersensitivity;

pregnancy and lactation;renal impairment; history

of epilepsy because they

are at risk of seizure.

CNS: Seizure, dizziness,

headache

EENT: Visual

disturbances

CV: Vasodilation

GI: Constipation, nausea,

abdominal pain

GU: urinary frequency

Germ: Pruritus, swelling

Misc: physicaldependence, tolerance.

Assess type, location

intensity of pain befo2-3 hr (peak) after

administration.

Assess BP & RR befo

periodically during

administration. Resp

depression has not

occurred with

recommended doses

Assess bowel functio

routinely. Preventionconstipation should

instituted with incre

intake of fluids and b

and with laxatives to

minimize constipatin

effects.

Assess previous anal

history. Tramadol is

recommended for pa

dependent on opioid

who have previouslyreceived opioids for

than 1 wk; may caus

opioid withdrawal

symptoms.


10/15

Prolonged use may l

physical and psychol

dependence and tole

Tramadol is consider

provide more analge

than codeine 60 mg

than combined aspir

650mg/codeine 60 m

acute postoperative

Monitor patient for

seizures. May occur

recommended dose

Risk increased with h

doses and inpatients

antidepressants (SSR

tricyclics, or Mao

inhibitors), opioid

analgesics, or other d

that decrese the seiz

threshold.

Overdose may cause

respiratory depressio

seizures. Naloxone (

may reverse some, b

all, of the symptoms

overdose. Treatment

should be symptoma

supportive. Maintain

adequate respiratory

exchange.

Encourage patient to

and breathe deeply e

hr to prevent atelact

and pneumonia.


11/15

DRUG STUDY

BRAND NAME GENERIC

NAME CLASSIFICATION

Prescribed and

Recommended dosage,

frequency, route of

administration

Mechanism

Of


G: NaHCO3 (Sodium

Bicarbonate)

B: Sodium Bicarbonate

C: Antacid

1 tab BID Acts as an alkalinizing

agent by releasingbicarbonate ions.

Neutralization of gastric

acid.

Treatment of metabolic

acidosis, promotion ofgastric, systemic and

urine alkalinization in the

case of intoxication with

weak organic acids.

Metabolic or

respiratory alkalosis;hypocalcemia; CHF; renal

insufficiency.

CNS: tetany

CV: edema

GI: gastric distention,

flatulence

Metabolic: hypokalemia,

hyponatremia

Obtain patie

history includrug history

hypersensit

Assess respiratory a

pulse rate, rhythm, d

lung sounds and not

physician.

Assess for carbon d

in GI tract, may lead

perforation if ulcer is

severe.

Test and monitor upH, urinary output, d

beginning treatment

If patient has edem

tendency, notify phy

If patient is vomitin

hold medication and

immediately inform

physician.

If the patient exhib

shortness of breath a

hyper apnea, immedinform the physician

Inform physician if

not obtained or if the

patient demonstrate

symptom suggest ble


12/15

such as black tarry st

coffee ground emesi

Caution patient to

immediately report t

physician if symptom

as nausea, vomiting

anorexia occurs.

Advise the patient t

notify the physician

indigestion occurs.


13/15

DRUG STUDY

BRAND NAME GENERIC

NAME CLASSIFICATION

Prescribed and

Recommended dosage,

frequency, route of

administration

Mechanism

Of


G: Colchicine

B: Colcrys

C: Antigout agent

0.5 mg 1 tab Interferes with the

functions of WBCsinitiating and

perpetuating the

inflammatory response

to monosodium urate

crystals.

Decrease pain and

inflammation in acute

attacks of gout.

Acute attacks of gouty

arthritis.

Treatment of hepatic

cirrhosis and familial.

Serious GI, renal,

hepatic, or cardiac

disorders; blood

dyscrasias;

hypersensitivity to the

drug.

GI: Diarrhea, nausea and

vomiting, abdominal pain.

GU: Anuria, hematuria

Hemat: Aggranulocytosis,

anemia

Assess patie

toxicity (we

abdominal

discomfort,nausea, vom

difficulty

swallowing)

withhold dr

report symp

immediately

Assess invo

joints for pa

mobility, an

edema thro

therapy.

Monitor int

and output

Fluids shoul

encouraged

promote ur

output of at

2000 mL/da

Check CBC

periodically

patients

undergoing

term therap

Administer

great cautio

debilitated

patients andthose with e

manifestati

GI or cardia

disorders.


14/15

SUMMARY OF MEDICATION

DATE MEDICATIONS- dosage, frequency, route Remarks

November 22, 2012

November 23, 2012

November 25, 2012

November 26, 2012

Paracetamol 300 mg IVTT then q 4 hrs PRN for T=

38 degrees Celsius Piperacillin, Tazobactam 4.5 gm IVTT q 8 hrs ANST (-)

Omeprazole 40 mg IV OD

Metronidazole 500 mg IV q 8 hrs ANST (-)

Dulcolax 2 suppositories

Colchicine 0.5 mg 1 tab

Medrol 8 mg 1 tab

Tramadol 50 mg IV q 8 hrs PRN for pain

NaHCO3 (Sodium Bicarbonate) 1 tab BID

Given, tolerated and recorded

Given, tolerated and recordedGiven, tolerated and recorded



Given, taken, tolerated and recorde





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Drug Study (Cp)