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Drugs Name

Drug Classificatio n

Mechanis Indication m of action

Contraindication

Nursing consideration

Generic Name Magnesium Sulfate

Brand name Martham

Pharmacol ogic Class Mineral ,Electrolyte Therapeuti c Class Antiepileptic ,Laxative; Mineral, electrolyte replacemen t Pregnancy Risk Facto r AB (Laxative)

Dosage: Minimum Dose 1-2 g qH by IVinfusion MaximumDo se 4-6 g qH by IVinfusio

Cofactor of many enzyme systems involved in neuroche mical transmissi on and muscular excitability ; prevents or controls seizures by locking the neuromus cular transmissi on attracts and retains the water in the intestinal lumen and distends the bowel to promote mass movement and relieve constipatio n. Pharma cokineti csA: Following administra tion, 3050% of the dose is absorbe d from the small intestine. D: Crosses the placenta and small amounts enter the breast milk. M: Unknown E: Via urine and feces

Constipatio n- Torsades depointesMuscle stimulatinge ffects of bariumpoiso ningReduction of cerebral oedema.Hypomagne saemiaSeizures associated with epilepsy, glomerulone phritisor hypothyroidi sm.Toxemias of pregnanc y- Boils and carbuncles

-Allergy to magnesium productsAbdominal painNausea- VomitingAcute surgical abdomen- Fecal impaction- Intestinal and biliary tract obstruction- HepatitisMyocardial damageHeart blocks- 2 hr preceding delivery

Adverse effects: CNS: Weakness,drowsiness, dizziness,fainting, sweating Respiratory: Decreasedrespiratory rate CV: Palpitations GI: Excessive bowelactivity, perianal irritation Metabolic: Magnesiumintoxicatio n,hypocalcemia with tetany

Before - Assess for contraindicatedconditi ons.- Monitor kneejerk reflex beforerepeated parenteral administration.- Give as laxative as temporarymeasure.Reserve IV use in eclampsia forlifethreatening situations.- Observe the 15 rights in drugadministration. During - Give IM route by deep IM injection.Monitor serum magnesium levels.Do not give oral MgSO 4 withabdominal pain, nausea, orvomiting.Do not administer if knee-jerkreflexes are suppressed- Monitor bowel function. After - Arrange to discontinueadministra tion as soon as levels arewithin normal limits and desiredclinical response is obtained.Discontinue if diarrhea orcramping occurs.- Arrange for dietary measures, exercise and environmental control to return to normal bowel activity.- Report sweating, flushing, muscle tremors or twitching, inability to move extremities.Maintain urine output at a level of 100 mL every 4 hr during parenteral administration.

Safest drug to use when cause respiratory depression is uncertain. Monitor respiratory depth and rate.

Generic name: Verapamil hydrochloride Brand name: Verelan

-Antianginal -Antiarrhytmic -Antihypertensive -Calcium Channel Blocker

Inhibits the movement of calcium ions across the membranes Dosage: of cardiac Individualized. Adults, and arterial initial: 80-120 mg t.i.d. muscle (40 mg t.i.d. if client is Cells results sensitive to verapamil); then, increase in the dose to total of 240-480 depression mg/day. Covera HS is of impulse given once daily at bedtime in doses of either formation 180 or 240 mg. in specialized pacemaker cells.

-Agina pectoris duty to coronary artery spasm -effortassociated agina -chronic stable agina -essential hypertension

Severe hypotension, second- or thirddegree AV block, cardiogenic shock, severe CHF, sick sinus syndrome (unless client has artificial pacemaker), severe LV dysfunction. Cardiogenic shock and severe CHF unless secondary to SVT that can be treated with verapamil. Lactation. Use of verapamil, IV, with beta-adrenergic blocking agents (as both depress myocardial contractility and AV conduction). Ventricular tachycardia. Adverse effect: Dizziness, Vertigo Sleepiness, headache, peripheral edema, hypotension, nausea, constipation, muscle fatigue

-Monitor BP very carefully -Monitor cardiac rhythm regularly -Protect IV solution from light -Advice patient to take this drug in the morning with food -Advise patient to report irregular heart beat, shortness of breath, swelling of hands and feet, dizziness, nausea and constipation

Generic name: Vasopressin Brand name: Pitressin

Pituitary (posterior) hormone antidiuretic (central diabetes insipidus) diagnostic aid (diabetes insipidus) Dosage:
IV Initial control of variceal bleeding As argipressin: 20 u. IM/SC Cranial diabetes insipidus As argipressin: 5-20 u 4 hrly.

Vasopressin is a posterior pituitary hormone which may be synthetically prepared or extracted from animals. It exerts direct antidiuretic action on the kidneys by increasing tubular reabsorption of water. Vasopressin also acts by constricting the peripheral blood vessels and causes the smooth muscle of the intestine, gall bladder and urinary bladder to contract. Vasopressin is given parenterally or intranasally in the form of argipressin or lypressin. Argipressin is a synthetic type of vasopressin derived from most mammals (including man but excluding pig) while lypressin is vasopressin from pig.

Diabetes insipidus, central (treatment) Vasopressin is indicated in the control or prevention of symptoms of central diabetes insipidus caused by insufficient antidiuretic hormone . It controls the polydipsia, polyuria, and dehydration associated with central diabetes insipidus {03} {0 4} {18} . Vasopressin injection may be used initially when diabetes insipidus is transient or due to surgery or head injury, or in unconscious patients receiving intravenous fluids {16}. However, desmopressin is generally preferred for

Hypersensitivi ty. Vascular disease especially coronary artery disease; chronic nephritis (until reasonable bloodnitrogen conc attained). Adverse effect :
Pallor, vomiting, nausea, belching, abdominal cramps, tremour, pounding headache, vertigo, fluid retention, hyponatraemia, hypersensitivity reaction, sweating, urticaria, gangrene, desire to defecate, arrhythmias, bradycardia, angina, MI and bronchoconstric tion. Potentially Fatal: Anaphyla xis; cardiac arrest or shock.

Risk-benefit should be considered when the following medical problems exist Allergy to vasopressin Asthma or Epilepsy or Heart failure or Migraine (rapid addition of extracellular water may be hazardous)

Coronary artery disease (vasopressin may precipitate anginal pain,large doses may precipitate a myocardial infarction) Hypertensive cardiovascular disease (vasopressin may increase blood pressure)

Renal failure, chronic, with nitrogen retention

chronic therapy, since it lacks many of the effects on gastrointestin al and vascular smooth muscle vasopressin possesses {03}
{17} {19} {20} {21} {22}{23} {26}

[Diabetes insipidus (diagnosis)]1 Vasopressin injection is used to differentially diagnose central and nephrogenic diabetes insipidus and psychogenic polydipsia