X. Medical Management
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X. MEDICAL MANAGEMENT
DRUG STUDY NAME OF DRUG WITH DOSAGE Sodium Bicarbonate 650 mg 2 tab TID
GENERIC NAME
ACTION/ CLASSIFICATION
MECHANISM OF ACTION
Sodium Bicarbonate
Antacid; Electrolyte
Increases plasma bicarbonate; buffers excess H+ concentrations; raises blood pH; reverses the clinical manisfestation of Acidosis; increases the excretion of free bases in the urine.
SIDE EFFECTS
INDICATIONS Treatment of metabolic acidosis with measures to control the cause of the acidosis; Symptomatic relief of upset stomach from hyperacidity associated with peptic ulcer. • Indicated for my pt. to treat her metabolic acidosis.
•
•
Gastric rupture following ingestion Systemic alkalosis, hypokalemi a secondary to intracellular shifting of potassium.
CONTRAINDICATIONS •
•
Contraindicated to patients allergy to components of preparations. Use cautiously with impaired renal function, heart failure, edematous or Na- retaining states; oilguria or anuria, potassium depletion, pregnancy and lactation.
NURSING RESPONSIBILITIES •
•
Have patient chew oral tablets thoroughly before swallowing, and follow them with a full glass of water. Do not give oral NaHCO3 with 12 hr of other oral drugs to reduce risk of drug interactions.
NAME OF DRUG WITH DOSAGE Heraclene Forte 3 mg OD
GENERIC NAME
ACTION/ CLASSIFICATION
Dibencozide
Appetite Stimulant
MECHANISM OF ACTION It facilitates optimum utilization of dietary protein intake; contributes to the formation and repair of body tissues and stimulates appetite
INDICATIONS Premature babies, low birth weight, retarded growth, poor appetite in infants, children and adults, adjuvant to treatment of tuberculosis and other chronic ailments, convalescence from acute infection or surgery, faulty nutrition in older people.
SIDE EFFECTS •
No side effects reported
CONTRAINDICATIONS •
No contraindications were noted.
NURSING RESPONSIBILITIES •
May administer drug with regards to meal.
NAME OF DRUG WITH DOSAGE Norvasc 5 mg
GENERIC NAME
ACTION/ CLASSIFICATION
Amlodipine
Antihypertensive; Angiotensin II Receptor Blocker
MECHANISM OF ACTION
INDICATIONS
Selectively blocks • the binding of Angiotensin II to specific tissue receptor, this action blocks the vasoconstriction effect of the reninangiotensin system as well as the release of aldosterone leading to decrease BP.
Treatment of Hypertensi on
SIDE EFFECTS •
Headache
•
Dizziness
•
Insomnia
•
Syncope
•
Rash
•
Urticaria
•
Pruritus
•
Alopecia
•
Dry skin
•
Diarrhea
•
Abdominal pain
CONTRAINDICATIONS
NURSING RESPONSIBILITIES
•
•
Administer drug without regards to meal
•
Ensure patient is nor pregnant Monitor patient closely in any situation that may lead to a decrease in BP secondary to reduction in fluid volumeexcessive perspiration, dehydration, vomiting, diarrheaexcessive hypotension can occur.
•
Contraindicated with hypersensitivity to Amlodipine; pregnancy and lactation Use cautiously with hepatic or renal impairment, hypovolemia.
•
NAME OF DRUG WITH DOSAGE
GENERIC NAME
Ciprofloxacin Ciprofloxacin 500mg 1 tab BID
ACTION/ MECHANISM INDICATIONS CLASSIFICATION OF ACTION Antibacterial; Fluoroquinolone
Bactericidal action against sensitive organisms, inhibits synthesis of bacterial cell wall, causing cell death.
Infections of the respiratory tract, middle ear, sinuses, eyes, kidneys and urinary tract, genital organs, abdomen, skin and soft tissues, bones and joints. • Indicated to treat my patient’s kidney infection.
SIDE EFFECTS •
Headache
•
Dizziness
•
Insomnia
• •
Blurred vision Fatigue
•
Ataxia
•
Arrhytmia s
•
Hypotensio n
•
Angina
• •
Abdomina l pain Fever
•
Rush
•
Nausea
CONTRAINDICATIONS •
•
Contraindicated with allergy to ciprofloxacin or other fluoroquinolones, pregnancy and lactation. Use cautiously with renal impairment, seizures, tendonitis or tendon rupture associated with fluroquinolones use.
NURSING RESPONSIBILITIES •
. Ensure that the patient is hydrated before administering this drug.
•
Do not administer ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice. May allow pt. to eat or drink dairy products or calcium-fortified juice with a regular meal, but do not use them alone when taking ciprofloxacin. They could make the medication less effective.
NAME OF DRUG WITH DOSAGE Furosenamide 60 mg IV
GENERIC NAME
ACTION/ CLASSIFICATIO N
MECHANIS M OF ACTION
Furosemide
Loop Diuretics
Furosemide works by blocking the absorption of sodium, chloride, and water from the filtered fluid in the kidney tubules, causing a profound increase in the output of urine (diuresis).
INDICATIONS
SIDE EFFECTS
Treatment of excessive accumulation of fluid and/or swelling (edema) of the body caused by heart failure,cirrhosis, chronic kidney failure, and the nephrotic syndrome.
•
low blood pressure
•
dehydration
•
electrolyte depleti on (for example, sodium, potassium)
•
jaundice
•
Tinnitus
•
•
sensitivity to light
•
rash
•
pancreatitis,
•
nausea,
•
diarrhea
•
abdominal pain
•
Dizziness
Indicated to treat my patient with renal dysfunction.
CONTRAINDICATIONS
NURSING RESPONSIBILITIES
•
•
•
Contraindicated with allergy to Furosemide and other diuretics Use cautiously with pregnancy and lactation
•
•
Observe patients receiving parenteral drug carefully; closely monitor B P and vital signs. Sudden death from cardiac arrest has been reported. Monitor BP during periods of diuresis and through period of dosage adjustment. Observe older adults closely during period of brisk diuresis. Sudden alteration in fluid and electrolyte balanc e may precipitate significant adverse reactions. Report symptoms to physician.
NAME OF DRUG WITH DOSAGE Prosec 20 mg 1 tab OD
GENERIC NAME Omeprazole
ACTION/ CLASSIFICATION MECHANISM INDICATIONS OF ACTION Anti-secretory drug; Proton Pump Inhibitor
Suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.
Duodenal ulcer, treatment of heartburn or symptoms of GERD, active benign gastric ulcer, GERD, sever erosive esophagitis. •
Indicated for my pt. since she is suffering from chest pain or heartburn.
SIDE EFFECTS
•
Headache
•
Dizziness
•
Diarrhea
•
Abdominal pain
• •
Nausea,vomitin g Constipation
•
Dry mouth
•
Tongue atrophy
•
URI symptoms
•
Cough
•
Epistaxis
•
Vertigo
CONTRAINDICATIONS
•
•
Contraindicated with hypersensitivity to omeprazole or its components Use cautiously with pregnancy and lactation.
NURSING RESPONSIBILITIES • •
•
•
Administer before meals. Caution pt. to swallow wholenot to open, chew or crush them. If using the oral suspension, empty packet into a small cup containing 2 tbsp. of water. Stir and have pt. drink immediately; fill cup with water and have this water. Do not use any other diluent. Administer antacid with, if necessary.
NAME OF DRUG WITH DOSAGE Cozaar 50 mg 1 tab OD
GENERIC NAME
ACTION/ CLASSIFICATION
MECHANISM OF ACTION
Losartan
Angiotensin II Receptor Antagonist; Antihypertensive
Angiotensin II receptor (type AT1) antagonist acts as a potent vasoconstrictor and primary vasoactive hormone of the renin– angiotensin– aldosterone system.
SIDE EFFECTS
INDICATIONS Hypertension
•
Headache
•
Dizziness
•
Insomnia
•
Syncope
•
Rash
•
Urticaria
•
Pruritus
•
Alopecia
•
Dry skin
•
Diarrhea
•
Abdominal pain
CONTRAINDICATIONS •
•
Contraindicated with hypersensitivity to Losartan; pregnancy and lactation Use cautiously with hepatic or renal impairment, hypovolemia.
NURSING RESPONSIBILITIES •
•
Monitor patient closely, BP alterations due to effect of drug Monitor any allergic reactions
NAME OF DRUG WITH DOSAGE
GENERIC NAME
ACTION/ CLASSIFICATION
MECHANISM OF ACTION
Rowatinex 2 caps QID
Natural Terpene
Antiurolithic
Promotes a diuresis and relaxes urinary tract spasm, thus assisting the passage of stones. The therapeutic effects of the balanced combination of terpenes reduces urinary tract inflammation, stimulating renal blood flow through the kidneys and increasing the output of less concentrated urine.
INDICATIONS
SIDE EFFECTS
Nephrolithiasis, • Urolithiasis,Cys tisis, Renal Colic, UTI, Post-op prophylaxis of calculi, treatment of urinary tract spasm and inflammation. •
Indicated for my pt. since she has dysfunction al kidney. To promote her diuresis.
No side effects have been reported
CONTRAINDICATION S
NURSING RESPONSIBILITIE S
•
•
No contraindications noted.
•
Liquid intake should be increased during therapy Store at temp. not exceeding 30oc.
NAME OF DRUG WITH DOSAGE
GENERIC NAME
ACTION/ CLASSIFICATION
Nervilan 1 tab OD
Vitamin B complex
Vitamin B
MECHANISM OF ACTION Vit.B acts as coenzyme in metabolic process; enzyme activatorinvolved in many oxidationreduction reactions.
INDICATIONS Neuritis, neulagia, polyneuritis, diabetic neuropathy, alcoholism, cervical and shoulder-arm syndrome and encephalopathy.
SIDE EFFECTS •
No side effects reported.
CONTRAINDICATIONS •
Use cautiously to pt. with liver dysfunction
NURSING RESPONSIBILITIES •
May be taken with meals to reduce GI discomfort.
NAME OF DRUG WITH DOSAGE Iterax 25 mg 1 tab
GENERIC NAME Hydroxyzine
ACTION/ CLASSIFICATION
Antiemetic; Antihistamine; Antixiolytic
MECHANISM OF ACTION Competes with histamine for H1-receptor sites on effector cells in the gastrointestinal tract, blood vessels, and respiratory tract. Possesses skeletal muscle relaxing, bronchodilator, antihistamine, antiemetic, and analgesic properties.
INDICATIONS
SIDE EFFECTS
CONTRAINDICATIONS
Treatment of anxiety; preoperative sedative; antipruritic Allergy
•
Drowsiness
•
•
Headache
•
Fatigue
•
Nervousness
•
Dizziness
Hypersensitivity to hydroxyzine or any component of the formulation
NURSING RESPONSIBILITIES •
Extravasation can result in sterile abscess and marked tissue induration; provide safety measures (ie, side rails, night light, and call button); remove smoking materials from area; supervise ambulation
DRUG STUDY NAME OF DRUG WITH DOSAGE Sodium Bicarbonate 650 mg 2 tab TID
GENERIC NAME
ACTION/ CLASSIFICATION
MECHANISM OF ACTION
Sodium Bicarbonate
Antacid; Electrolyte
Increases plasma bicarbonate; buffers excess H+ concentrations; raises blood pH; reverses the clinical manisfestation of Acidosis; increases the excretion of free bases in the urine.
SIDE EFFECTS
INDICATIONS Treatment of metabolic acidosis with measures to control the cause of the acidosis; Symptomatic relief of upset stomach from hyperacidity associated with peptic ulcer. • Indicated for my pt. to treat her metabolic acidosis.
•
•
Gastric rupture following ingestion Systemic alkalosis, hypokalemi a secondary to intracellular shifting of potassium.
CONTRAINDICATIONS •
•
Contraindicated to patients allergy to components of preparations. Use cautiously with impaired renal function, heart failure, edematous or Na- retaining states; oilguria or anuria, potassium depletion, pregnancy and lactation.
NURSING RESPONSIBILITIES •
•
Have patient chew oral tablets thoroughly before swallowing, and follow them with a full glass of water. Do not give oral NaHCO3 with 12 hr of other oral drugs to reduce risk of drug interactions.
NAME OF DRUG WITH DOSAGE Heraclene Forte 3 mg OD
GENERIC NAME
ACTION/ CLASSIFICATION
Dibencozide
Appetite Stimulant
MECHANISM OF ACTION It facilitates optimum utilization of dietary protein intake; contributes to the formation and repair of body tissues and stimulates appetite
INDICATIONS Premature babies, low birth weight, retarded growth, poor appetite in infants, children and adults, adjuvant to treatment of tuberculosis and other chronic ailments, convalescence from acute infection or surgery, faulty nutrition in older people.
SIDE EFFECTS •
No side effects reported
CONTRAINDICATIONS •
No contraindications were noted.
NURSING RESPONSIBILITIES •
May administer drug with regards to meal.
NAME OF DRUG WITH DOSAGE Norvasc 5 mg
GENERIC NAME
ACTION/ CLASSIFICATION
Amlodipine
Antihypertensive; Angiotensin II Receptor Blocker
MECHANISM OF ACTION
INDICATIONS
Selectively blocks • the binding of Angiotensin II to specific tissue receptor, this action blocks the vasoconstriction effect of the reninangiotensin system as well as the release of aldosterone leading to decrease BP.
Treatment of Hypertensi on
SIDE EFFECTS •
Headache
•
Dizziness
•
Insomnia
•
Syncope
•
Rash
•
Urticaria
•
Pruritus
•
Alopecia
•
Dry skin
•
Diarrhea
•
Abdominal pain
CONTRAINDICATIONS
NURSING RESPONSIBILITIES
•
•
Administer drug without regards to meal
•
Ensure patient is nor pregnant Monitor patient closely in any situation that may lead to a decrease in BP secondary to reduction in fluid volumeexcessive perspiration, dehydration, vomiting, diarrheaexcessive hypotension can occur.
•
Contraindicated with hypersensitivity to Amlodipine; pregnancy and lactation Use cautiously with hepatic or renal impairment, hypovolemia.
•
NAME OF DRUG WITH DOSAGE
GENERIC NAME
Ciprofloxacin Ciprofloxacin 500mg 1 tab BID
ACTION/ MECHANISM INDICATIONS CLASSIFICATION OF ACTION Antibacterial; Fluoroquinolone
Bactericidal action against sensitive organisms, inhibits synthesis of bacterial cell wall, causing cell death.
Infections of the respiratory tract, middle ear, sinuses, eyes, kidneys and urinary tract, genital organs, abdomen, skin and soft tissues, bones and joints. • Indicated to treat my patient’s kidney infection.
SIDE EFFECTS •
Headache
•
Dizziness
•
Insomnia
• •
Blurred vision Fatigue
•
Ataxia
•
Arrhytmia s
•
Hypotensio n
•
Angina
• •
Abdomina l pain Fever
•
Rush
•
Nausea
CONTRAINDICATIONS •
•
Contraindicated with allergy to ciprofloxacin or other fluoroquinolones, pregnancy and lactation. Use cautiously with renal impairment, seizures, tendonitis or tendon rupture associated with fluroquinolones use.
NURSING RESPONSIBILITIES •
. Ensure that the patient is hydrated before administering this drug.
•
Do not administer ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice. May allow pt. to eat or drink dairy products or calcium-fortified juice with a regular meal, but do not use them alone when taking ciprofloxacin. They could make the medication less effective.
NAME OF DRUG WITH DOSAGE Furosenamide 60 mg IV
GENERIC NAME
ACTION/ CLASSIFICATIO N
MECHANIS M OF ACTION
Furosemide
Loop Diuretics
Furosemide works by blocking the absorption of sodium, chloride, and water from the filtered fluid in the kidney tubules, causing a profound increase in the output of urine (diuresis).
INDICATIONS
SIDE EFFECTS
Treatment of excessive accumulation of fluid and/or swelling (edema) of the body caused by heart failure,cirrhosis, chronic kidney failure, and the nephrotic syndrome.
•
low blood pressure
•
dehydration
•
electrolyte depleti on (for example, sodium, potassium)
•
jaundice
•
Tinnitus
•
•
sensitivity to light
•
rash
•
pancreatitis,
•
nausea,
•
diarrhea
•
abdominal pain
•
Dizziness
Indicated to treat my patient with renal dysfunction.
CONTRAINDICATIONS
NURSING RESPONSIBILITIES
•
•
•
Contraindicated with allergy to Furosemide and other diuretics Use cautiously with pregnancy and lactation
•
•
Observe patients receiving parenteral drug carefully; closely monitor B P and vital signs. Sudden death from cardiac arrest has been reported. Monitor BP during periods of diuresis and through period of dosage adjustment. Observe older adults closely during period of brisk diuresis. Sudden alteration in fluid and electrolyte balanc e may precipitate significant adverse reactions. Report symptoms to physician.
NAME OF DRUG WITH DOSAGE Prosec 20 mg 1 tab OD
GENERIC NAME Omeprazole
ACTION/ CLASSIFICATION MECHANISM INDICATIONS OF ACTION Anti-secretory drug; Proton Pump Inhibitor
Suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.
Duodenal ulcer, treatment of heartburn or symptoms of GERD, active benign gastric ulcer, GERD, sever erosive esophagitis. •
Indicated for my pt. since she is suffering from chest pain or heartburn.
SIDE EFFECTS
•
Headache
•
Dizziness
•
Diarrhea
•
Abdominal pain
• •
Nausea,vomitin g Constipation
•
Dry mouth
•
Tongue atrophy
•
URI symptoms
•
Cough
•
Epistaxis
•
Vertigo
CONTRAINDICATIONS
•
•
Contraindicated with hypersensitivity to omeprazole or its components Use cautiously with pregnancy and lactation.
NURSING RESPONSIBILITIES • •
•
•
Administer before meals. Caution pt. to swallow wholenot to open, chew or crush them. If using the oral suspension, empty packet into a small cup containing 2 tbsp. of water. Stir and have pt. drink immediately; fill cup with water and have this water. Do not use any other diluent. Administer antacid with, if necessary.
NAME OF DRUG WITH DOSAGE Cozaar 50 mg 1 tab OD
GENERIC NAME
ACTION/ CLASSIFICATION
MECHANISM OF ACTION
Losartan
Angiotensin II Receptor Antagonist; Antihypertensive
Angiotensin II receptor (type AT1) antagonist acts as a potent vasoconstrictor and primary vasoactive hormone of the renin– angiotensin– aldosterone system.
SIDE EFFECTS
INDICATIONS Hypertension
•
Headache
•
Dizziness
•
Insomnia
•
Syncope
•
Rash
•
Urticaria
•
Pruritus
•
Alopecia
•
Dry skin
•
Diarrhea
•
Abdominal pain
CONTRAINDICATIONS •
•
Contraindicated with hypersensitivity to Losartan; pregnancy and lactation Use cautiously with hepatic or renal impairment, hypovolemia.
NURSING RESPONSIBILITIES •
•
Monitor patient closely, BP alterations due to effect of drug Monitor any allergic reactions
NAME OF DRUG WITH DOSAGE
GENERIC NAME
ACTION/ CLASSIFICATION
MECHANISM OF ACTION
Rowatinex 2 caps QID
Natural Terpene
Antiurolithic
Promotes a diuresis and relaxes urinary tract spasm, thus assisting the passage of stones. The therapeutic effects of the balanced combination of terpenes reduces urinary tract inflammation, stimulating renal blood flow through the kidneys and increasing the output of less concentrated urine.
INDICATIONS
SIDE EFFECTS
Nephrolithiasis, • Urolithiasis,Cys tisis, Renal Colic, UTI, Post-op prophylaxis of calculi, treatment of urinary tract spasm and inflammation. •
Indicated for my pt. since she has dysfunction al kidney. To promote her diuresis.
No side effects have been reported
CONTRAINDICATION S
NURSING RESPONSIBILITIE S
•
•
No contraindications noted.
•
Liquid intake should be increased during therapy Store at temp. not exceeding 30oc.
NAME OF DRUG WITH DOSAGE
GENERIC NAME
ACTION/ CLASSIFICATION
Nervilan 1 tab OD
Vitamin B complex
Vitamin B
MECHANISM OF ACTION Vit.B acts as coenzyme in metabolic process; enzyme activatorinvolved in many oxidationreduction reactions.
INDICATIONS Neuritis, neulagia, polyneuritis, diabetic neuropathy, alcoholism, cervical and shoulder-arm syndrome and encephalopathy.
SIDE EFFECTS •
No side effects reported.
CONTRAINDICATIONS •
Use cautiously to pt. with liver dysfunction
NURSING RESPONSIBILITIES •
May be taken with meals to reduce GI discomfort.
NAME OF DRUG WITH DOSAGE Iterax 25 mg 1 tab
GENERIC NAME Hydroxyzine
ACTION/ CLASSIFICATION
Antiemetic; Antihistamine; Antixiolytic
MECHANISM OF ACTION Competes with histamine for H1-receptor sites on effector cells in the gastrointestinal tract, blood vessels, and respiratory tract. Possesses skeletal muscle relaxing, bronchodilator, antihistamine, antiemetic, and analgesic properties.
INDICATIONS
SIDE EFFECTS
CONTRAINDICATIONS
Treatment of anxiety; preoperative sedative; antipruritic Allergy
•
Drowsiness
•
•
Headache
•
Fatigue
•
Nervousness
•
Dizziness
Hypersensitivity to hydroxyzine or any component of the formulation
NURSING RESPONSIBILITIES •
Extravasation can result in sterile abscess and marked tissue induration; provide safety measures (ie, side rails, night light, and call button); remove smoking materials from area; supervise ambulation
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