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Jazmine Andrea L.

Caritos Drug Study Drug Generic name: Methylprednisolone Brand name: Solu-Medrol Functional Class: Corticosteroid hormone Chemical Class: Anti-inflammatory steroid Dosage 125mg/2 ml vial Indication and Contraindication Unbound glucocorticoids Indication cross cell membranes and Arthritis bind with high affinity to Blood disorders specific cytoplasmic Severe allergic receptors, modifying reactions transcription and protein Certain cancers synthesis. By this Immune system mechanism, glucocorticoids disorders can inhibit leukocyte Shock infiltration at the site of inflammation, interfere Contraindication with mediators of Hypersensitivity inflammatory response, Hypokalemia/ and suppress humoral hypocalcemia immune responses. The Systemic fungal antiinflammatory actions of infections corticosteroids are thought Latent or active TB to involve phospholipase Herpes simplex A2 inhibitory proteins, infection lipocortins, which control Latent or active the biosynthesis of potent peptic ulcer mediators of inflammation Osteoporosis such as prostaglandins and Hypertension leukotrienes. Avoid live virus vaccines Mechanism of action Side effect and Adverse effect Side effect Nausea/vomiting/ stomach upset Heartburn Headache Dizziness Appetite changes Pain/redness/ swelling at the injection site Adverse effect Hypertension Mental disorders Ulcer disease Exacerbation, pancreatitis; Glucose tolerance disorders Glucose serum level elevation Cushing-like syndrome, Amenorrhoea, Rash, contact

4NU02 Group 1

Nursing Considerations Assessment Hypersensitivity Assess for potassium depletion (fatigue, nausea, vomiting, depression, polyuria, dysrhythmia and weakness). Assess for hypertension, oedema and cardiac symptoms. Assess for mental status. Rotate sites in IM injection. Patient teaching Increase potassium, calcium and protein intake. Do not discontinue suddenly (can precipitate adrenal crisis). Avoid OTC products unless cleared with prescriber. Methylprednisolone can pass into breast milk and may harm a nursing baby. Educate on symptoms of

Jazmine Andrea L. Caritos dermatitis, Steroidal acne Moon-like face Edemas Increased potassium excretion Muscular weakness, Osteoporosis

4NU02 Group 1 adrenal insufficiency (anorexia, dizziness, dyspnoea, fatigue, joint pain, nausea and weakness).

Potentially Fatal: Bleeding from the stomach or intestine

Drug Generic name: Midazolam Brand name: Versed Functional Class: Sedative Chemical Class:

Dosage 125mg/2 ml vial

Mechanism of action Midazolam is a short-acting benzodiazepine. It potentiates gammaaminobutyric acid (GABA) inhibitory action in the CNS by binding to benzodiazepine-specific receptors on the GABA benzodiazepine receptor complex. Binding of this

Indication and Contraindication Indication Preprocedural sedation Aids in induction of anesthesia Contraindication Hypersensitivity to benzodiazepines Severe respiratory

Side effect and Adverse effect Side effect Nausea/vomiting/ rash Agitation Restlessness Uncontrollable shaking of a part of the body Slow/irregular heartbeat

Nursing Considerations Assessment Hypersensitivity Assess level of sedation and level of consciousness throughout and for 2-6 hr following administration. Monitor BP, pulse and respiration continuously during IV administration. Oxygen and resuscitative

Jazmine Andrea L. Caritos Benzodiazepine complex potentiates GABAmediated chloride influx, thus exerting sedative and hypnotic, muscle relaxant, anxiolytic and anticonvulsant actions. failure or acute respiratory depression

4NU02 Group 1 equipment should be immediately available. If overdose occurs: confusion, sedation, diminished reflexes, coma, and untoward effects on vital signs.

Adverse effect Potentially Fatal: Life-threatening breathing problems (shallow, slowed, or temporarily stopped breathing)

*The effects of midazolam can be reversed with flumazenil (Romazicon).

Drug Generic name: Nicardipine hydrochloride Brand name: Cardene Functional Class: Vasodilator, antihypertensive, anti-

Dosage 2mg/2ml amp

Mechanism of action Inhibits calcium ion from entering the slow channels or select voltagesensitive areas of vascular smooth muscle and myocardium during depolarization, producing a relaxation of coronary vascular smooth muscle and coronary vasodilation;

Indication and Contraindication Indication Chronic stable angina/angina pectoris Management of hypertension Contraindication Suspected

Side effect and Adverse effect Side effect Flushing Hypotension Ventricular tachycardia Headache Dizziness Adverse effect

Nursing Considerations Assessment Hypersensitivity Edema Peripheral perfusion Liver and renal function test Urinalysis Provide small, frequent meals if GI upset occurs.

Jazmine Andrea L. Caritos anginal agent Chemical Class: Calcium Channel Blocker increases myocardial oxygen delivery in patients with vasospastic angina intracranial hemorrhage; elevated intracranial pressure at the acute stage of cerebral stroke. Hepatic or renal dysfunction Aortic stenosis. *Discontinue treatment if the following occurs: Paralytic ileus, hypoxemia, pulmonary edema, dyspnea, anginal pain. Pregnancy & lactation. Thrombocytopenia Hepatic dysfunction associated w/ elevated AST (GOT), ALT (GPT) or -GPT & jaundice. Tachycardia, ECG changes, hypotension, Increase in BUN & creatinine.

4NU02 Group 1 Patient teaching Monitor fluid intake and output. Assess for signs and symptoms of heart failure. Decreases its potency if taken with food. Serum concentrations/ toxicity of nicardipine may be increased by grapefruit juice; avoid concurrent use. Advise patient to immediately report chest pain or blood pressure drop. *Nicardipine crosses the placenta; changes in fetal heart rate, neonatal hypotension and neonatal acidosis have been observed following maternal use (rare based on limited data).

Potentially Fatal: Dropped blood pressure