August 13, 2009

DRUG STUDY

August 13, 2009

1. HERACLENE capsule OD incorporated to milkfeeding

ACTION PHARMACO-

INDICATION

>Increases the

KINETICS Absorption:

-premature

protein

-oral

babies

efficiency

administration

-low birth

CONTRAINDICATION

coefficient, i.e.,

weight

the percentage

-retarded

of bound

growth

nitrogen for

-poor appetite

protein build

in infants,

up in the body

children and

compared to

adults

ingested

-adjuvant to

nitrogen with

treatment of

food intake.

tuberculosis

PRECAUTION

ADVERSE REACTION

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

The initial sign

and other

is manifested

chronic

by

ailments -convalescence ACTION PHARMACO-

INDICATION

KINETICS

CONTRA-

PRECAUTION

INDICATION

a marked

from acute

increased in

infection or

appetite.

surgery

ADVERSE

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

REACTION

-faulty nutrition in older people

September 9, 2009

2. NALBUPHINE 0.06mL q6o TIVT

ACTION

PHARMACO-

>Binds with

KINETICS Absorption:

opiate receptors in

INDICATION

CONTRA-

-relief of

INDICATION *Hypersensitivit

-Well (SC/IM)

moderate to

y *Pregnancy

-Complete

severe pain

PRECAUTION

ADVERSE

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

*Misuse may

REACTION -sedation

1. Assess

1. Discuss in

cause

-drowsiness

patient’s

detail all aspects

psychological

-sweating

underlying

of the drug

the CNS

(IV)

-pre-op

and physical

-nausea

condition

therapy: reason

altering

Distribution:

analgesia

dependence

-dry mouth

before

for taking drug

perception

-Crosses

-supplement

and tolerance

-dizziness

therapy.

and expected

to ACTION

PHARMACO-

and

KINETICS placenta

emotional

INDICATION

CONTRAINDICATION

PRECAUTION

ADVERSE

results. NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

balanced

REACTION -headache

2. Monitor VS

2. Discuss with

Metabolism:

anesthesia

-vomiting

after

patient that

response to

-Liver

-surgical

parenteral

dizziness,

pain.

Excretion:

anesthesia

route. Monitor

drowsiness, and

>Relieves

-Feces,

-obstetrical

for respiratory

confusion are

pain

kidneys,

anesthesia

distress,

common. Instruct

Unchanged

assess

patient to change

(small

respiratory

position slowly to

amounts)

rate, character

prevent

and rhythm.

orthostatic

Report

hypotension and

respiratory

avoid getting up

rate <10/min.

without

Watch out for

assistance.

muscle

3. Advice patient

rigidity.

to refrain from

3. Monitor for

taking CNS

ACTION

PHARMACOKINETICS

INDICATION

CONTRA-

PRECAUTION

INDICATION

ADVERSE

possible

depressants

adverse

(alcohol,

reactions.

sedative/hypnotic

4. Monitor

s)

allergic

for at least 24 hrs

reactions.

after taking this

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

REACTION 5. Assess

drug.

patient’s and

4. Instruct patient

family’s

to report signs

knowledge of

and symptoms of

drug therapy.

adverse drug reaction. 5. Teach patient to turn, cough, and breathe deeply after surgery to prevent atelectasis.

3. CALMOSEPTINE ointment over a cellophane at the peri-ileostomy area BID

ACTION >zinc oxide

PHARMACOKINETICS Absorption:

particularly the

ACTION

PHARMACO-

INDICATION

CONTRA-

PRECAUTION

ADVERSE

-protects,

INDICATION *Pregnancy

*Avoid contact

REACTION *no data

soothes and

and lactation

w/ mouth or

INDICATION

CONTRA-

fine particles of

helps promote

INDICATION *Deep skin

the oxide have

healing in

deodorizing

those with

and

KINETICS

PRECAUTION

ADVERSE

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION 1. Assess for

1. Discuss in

history of

detail all

allergy aspects NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

REACTION Allergic

to zinc,

of the drug

wounds and

reaction:

dimethicone,

therapy:

severe burns

-hives

lanolin, cod

reason for

impaired skin

-difficulty

liver oil,

taking drug

antibacterial

integrity

breathing

petroleum

and expected

actions.

related to

-swelling of

jelly, parabens,

results.

feeding tube

face, lips,

mineral oil, or

2. Practice

site leakage,

tongue, or

wax.

thorough

wound

throat

eyes

sanitary

drainage, fetal

hygiene.

and urinary

2. Notify the

incontinence,

physician if

bedsores, etc.

signs of infection such

as redness and warmth or

4. ELICA CREAM at periumbilical area OD

ACTION

PHARMACO-

>Mometasone

KINETICS Absorption:

furoate, a

INDICATION

CONTRA-

-Relief of

INDICATION *Hypersensitivit

-undetected in

inflammatory

synthetic

plasma

corticosteroid,

PRECAUTION

ADVERSE

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

*Pregnancy

REACTION Rare:

1. Document

1. Instruct

y to

*Pediatric

-paresthesia

onset, duration

patient to use

& pruritic

mometasone

patients

-pruritus

and character

regularly as

although

manifestations

furoate

*Systemic

-burning

of symptoms.

directed.

exhibits anti-

some may be

of

absorption

-

2. Attempt to

2. Advise

inflammatory,

swallowed

corticosteroid-

may be

tingling/stinging

identify

patient to

antipruritic and

Distribution:

responsive

increased if

-signs of skin

triggers.

identify

vasoconstrictiv

-98-99%

dermatoses.

extensive

atrophy

3. Monitor for

triggers and

e properties.

bound to

-May be

body surface

systemic

practice

plasma

applied to

are treated.

absorption:feve

avoidance.

protein

scalp lesions.

Long-term use

r.

3. Instruct to

Metabolism:

in infant &

4. Monitor for

report failure

-liver

childn. *Avoid

possible drug

to improve

Excretion:

contact w/

induced

condition after

-liver and

eyes.

adverse

3-5 days of

kidney

*Pregnancy

reactions.

therapy.

and lactation.

5. Assess for

4. Teach

patient’s and

patient to limit

family’s knowledge on

ACTION

PHARMACOKINETICS

INDICATION

CONTRAINDICATION

PRECAUTION

ADVERSE REACTION

drug therapy. NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION treatment for 14 days. 5. Instruct patient to monitor for and report

drug induced adverse reactions.

September 12, 2009

5. CEFTRIAXONE 250 mg IV OD for 30 mins.

ACTION

PHARMACO-

INDICATION

CONTRA-

>Inhibits

KINETICS Absorption:

-treatment for

INDICATION *Hypersensitivit

bacterial

-IM, IV

susceptible

cell wall

administratio

PRECAUTION

ADVERSE

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

*Pregnancy

REACTION -pain,

1. Assess

1. Instruct patient

y to

and lactation

induration,

patient’s

to take medication

cephalosporins,

*with history of

phlebitis after

previous

as prescribed for

n ACTION

PHARMACO-

INDICATION

CONTRA-

NURSING CONSIDERATION ASSESSMENT HEALTH

PRECAUTION

ADVERSE

gastrointestina

REACTION IV

sensitivity

the length of time

EDUCATION

synthesis,

KINETICS Distribution:

infections

INDICATION penicillins,

rendering

-wide, good

such as

lidocaine or any

l disease

administration

reaction to

ordered even if he

cell wall

CSF

chancroid,

other local

*Nephrotoxicit

, rash,

penicillin or

feels better.

osmotically

penetration

gastroenteritis

anesthetic

y concomitant

diarrhea,

other

2. Teach patient to

unstable,

Metabolism:

, Lyme

product of the

administration

eosinophilia

cephalosphorin

report sore throat,

leading to

-Liver,

disease, etc.

amide type

w/

-elevation of

s.

bruising, bleeding

cell death

partially

-treatment of

*Neonates and

aminoglycosid

AST, ALT, BUN

2. Assess

and joint pain

metabolized

LRTI, skin and

premature

es

and

patient for

indicative of blood

Excretion:

soft tissue

infants with

*Rare: PT

creatinine.

signs and

dyscrasia (rare).

-Kidneys

infections,

bilirubin

alterations esp.

-GI

symptoms of

3. Advise patient

primarily,

complicated

encephalopathy

to patients

disturbances

infection before

to watch out for

liver

and

*Peristalsis-

with impaired

-hematologic

and during

perineal itching,

minimally

uncomplicated

inhibiting

Vit. K synthesis

changes

treatment.

fever, malaise,

UTI

preparations

or low Vit. K

-skin reactions

3. Obtain C&S

redness, pain,

-pre-operative

*Prophyria,

stores

-vaginitis due

before

swelling, drainage,

prophylaxis to

unapplianced

*Anaphylactic

to C. albicans

beginning drug

etc. indicative of

reduce chance

auricular-

shock esp. to

proliferation

therapy to

superinfection.

of post-

ventricular

premature

identify if

operative

block;

neonates

correct

4. Advise patient to report bloody,

surgical

cardiogenic

*Severe renal

treatment has

or hepatic

been initiated.

infections

insufficiency ACTION

PHARMACOKINETICS

INDICATION

CONTRAINDICATION shock

PRECAUTION

ADVERSE

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

REACTION IV

4. Assess for

mucoid diarrhea

administration

allergic and

which may indicate

, rash,

anaphylactic

pseudomembrano

diarrhea,

reactions.

us colitis.

eosinophilia

5. Assess renal

-elevation of

function before

AST, ALT, BUN

and during

and

therapy.

creatinine.

6. Monitor

-GI

hematologic,

disturbances

electrolyte and

-hematologic

hepatic status

changes

if patient is on

-skin reactions

long term

-vaginitis due

therapy.

to C. albicans

7. Assess for

proliferation

possible superinfection.

September 13, 2009

6. OMEPRON 20 mg IV OD

ACTION

PHARMACO-

>Suppresses

KINETICS Absorption:

gastric

-rapidly

INDICATION

CONTRA-

-short-term

INDICATION *Hypersensitivit

treatment of

y

PRECAUTION

ADVERSE

NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

*Pregnancy,

REACTION -angina

1. Assess other

1. Take before

lactation and

-tachycardia

medications

meals.

secretion by

absorbed

active

*Lactation and

children

-bradycardia

patient may be

2. Do not crush

inhibiting

Distribution:

duodenal

children

*Possible

-palpitation

taking for

or chew

hydrogen/

-protein

ulcer, benign

*Combination

gastric ulcer

-headache

effectiveness

capsules.

potassium

binding (95%)

gastric ulcer,

therapy with

*Hepatic

-dizziness

and

3. Delayed

ATPase

-gastric

GERD

clarithromycin

impairment

-rash

interactions.

release

enzyme

parietal cells

-long-term

for patient w/

-diarrhea

2. Monitor

capsule may

system in the

Metabolism:

treatment of

hepatic

-abdominal

therapeutic

be opened and

gastric parietal

-Liver

pathologic

impairment

pain

effectiveness

contents

cell:

extensively

hypersecretory

-acid

and

added to apple

characterized

-by CYP450

conditions

regurgitation

interactions.

sauce.

as a gastric

enzyme sytem

(e.g. Zollinger-

-nausea

3. Assess GI

acid pump

Excretion:

Ellison

-vomiting

system: bowel

inhibitor, since

-Kidneys

syndrome,

-cough

sounds 8 hrly,

it blocks the

-feces

multiple

-back pain

abdomen for

4. Caution patient to avoid alcohol, salicylates, ibuprofen: may cause GI

final step of

endocrine

pain and

acid

adenomas)

swelling, loss of

production ACTION

PHARMACOKINETICS Half-life:

INDICATION

CONTRAINDICATION

PRECAUTION

ADVERSE

appetite. NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION

REACTION 4. Monitor

irritation.

-30 mins-1 hr

hepatic

5. Small

-increase in

enzymes.

frequent meals

elderly

5. Assess

may help to

-hepatic

knowledge/teac

maintain

diseases

h appropriate

nutrition.

use of

6. Report

medication,

severe

interventions to

headache,

reduce side

unresolved

effects and

diarrhea or

report adverse

changes in

symptoms.

respiratory status. 7. Inform physician if patient is or intends to become pregnant. Breastfeeding

ACTION

PHARMACOKINETICS

INDICATION

CONTRAINDICATION

PRECAUTION

ADVERSE REACTION

is NURSING CONSIDERATION ASSESSMENT HEALTH EDUCATION not recommended.

*The patient was prescribed with 30 medications from July 20 until September 13, 2009. However, only the six (6) drugs indicated above were discussed and given prior significance for this case study.