IX.

MEDICAL MANAGEMENT

PHARMACOLOGIC MANAGEMENT

DRUG STUDY Drug name Dosage Classification Mechanism of Action Generic Dosage: name: 20g Omeprazole Frequency: Brand name: OD Losec (CAN) Route: oral -Antisecretory drug Proton pump inhibitor -Gastric acid-pump inhibitor: Suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal -Short-term treatment of activeduodenal ulcer; -First-line therapy intreatment of heartburn orsymptoms of gastroesophageal reflux disease (GERD); -Short-term treatment of active benign gastric ulcer; - GERD, -severe erosiveesophagitis, poorlyresponsive symptomaticGERD; -Long-term therapy:Treatment of pathologichypersecretory conditions(Zollinger-CNS: Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities Dermatologic: Rash, inflammation, urticaria, pruritus, alopecia, dry skin -Contraindicated withhypersensitivity toomeprazole or itscomponents;Use cautiously withpregnancy,lactation. Indication Side effect Contraindication Nursing Consideration C: Antisecretory drug; Proton pump inhibitor H: IVTT E: decrease gastric acid secretion C: Take the drug before meals. Report severe headache, worsening of symptoms, fever, chills. K: Swallow the capsules whole; do not

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cells; blocks the final step of acid production

Ellisonsyndrome, multipleadenomas, systemicmastocytosis) -Eradication of H. pyloriwith amoxicillin ormetronidazole andclarithromycin

-GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy -Respiratory: URI symptoms, cough, epistaxis -Other: Cancer in preclinical studies, back pain, fever .

chew, open, or crush them.

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Drug name

Dosage

Classification

Mechanism of Action

Indication

Side effect

Contraindication

Nursing Consideration

Generic: q4 PRN Acetaminophen (Paracetamol) Brand: Tylenol

-Analgesics ( Non-opioid) Antipyretics

Cause analgesia by inhibiting CNS prostaglandin synthesis.

Temporary relief of pain and discomfort from headache, fever, cold, flu, minor muscular aches.

-Hematologic: hemolyticanemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia. -Hepatic: liver damage, jaundice -Metabolic: hypoglycemia Skin: rash, urticuria

-Contraindicated with allergy to acetaminophen. -Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation.

-Advise caregivers to check concentration of liquid preparation. -Assess fever, note associated signs (diaphoresis, tachycardia,malaise) -Advise caregiver not to take medication longer than 5 days in children -Advise caregiver to take medication exactly as directed.

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Drug name

Dosage

Classification

Mechanism of Action

Indication

Side effect

Contraindication

Nursing Consideration

Generic Name: Isoniazid Brand Name: Norvit

200 mg / 1 tsp. OD AC

Anti-infective Anti Tuberculosis Drug

Inhibits RNA synthesis, decreases tubercle bacilli replication.

Pulmonary and extrapulmonary tuberculosis (TB).

Various skin eruptions, fever, lymphadenopathy, and vasculitis, hypersensitivity, N/V, GI disturbances, and liver dysfunction.

Should not be given to patients with drug induced liver disease.

-Assess laboratory examinations. -Monitor liver/renal function. -Instruct patient that compliance with dosage schedule for duration is necessary to gain benefits. -Caution patient in alcohol while in therapy may increase risk of liver damage. -Tell patient to report peripheral neuritis.

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Drug name

Dosage

Classification

Mechanism of Action

Indication

Side effect

Contraindication

Nursing Consideration

Generic Name: Ethambutol Brand Name: Odetol

400 mg / tab / OD ORAL

-Anti-infective

-Tuberculostatic, it suppresses the growth of tubercle bacilli however the specific mechanism of action is unknown.

-Ethambutol is used with other antituberculous drugs in the primary treatment of pulmonary and extra pulmonary tuberculosis to suppress emergence of resistance to the other drugs used in the regimens.

Retrobulbarneurirtis with a reduction in visual acuity, constriction of visual field, central or peripheral scotoma, and greenred color blindness. One or both eyes may be affected. Retinal hemorrhage, skin rashes, pruritus, leucopenia, fever and joint pains

-Patients with optic neuritis. Should generally not be used in children below 6 yrs. of age.

- Perform visual acuity and color discrimination tests before and during therapy. -Assess liver and renal status and function before and during therapy. -Assess patient for visual disturbance that may indicate optic neuritis. -Advise patient that compliance with dosage schedule and duration is necessary to eradicate disease.
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-Remind patient to come for follow up consultations including opthalmic appointments.

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Mechanism of Drug name Generic Name: Dosage Classification Antiinfectives Tuberculosis drug Action Mechanism unknown, highly specific and bactericidal for Mycobacterium tuberculosis hominis. Indication Treatment of active tuberculosis in adults and selected children Side effect Dose-related hepatoxicity, N/V, anorexia, thrombocytopenia, increased serum iron concentration and adverse effects on blood clotting mechanisms Contraindication Acute-liver disease porphyria peripheral neuritis acute gout hypersensitivity pregnancy

Nursing Consideration Assess patients condition before therapy and regularly thereafter to monitor drug effectiveness. Monitor serum uric acid which may be elevated and cause gout symptoms. Regularly assess for hepatoxicity. Regularly assess renal status. Instruct patient to take drug continuously
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500 mg / 5 ml/ 1 tsp. OD / Pyrazinamide oral

Brand Name: Mycobak

as prescribed. Remind patient to comply with follow-up schedule

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Drug name

Dosage

Classification

Mechanism of Action

Indication

Side effect

Contraindication

Nursing Consideration

Vitamin B complex

1 tsp. / OD / oral

Vitamins and Minerals

A coenzyme Pernicious that stimulate anemia metabolic function and is needed for cell replication, hematopoiesis, and nucleoprotein and myelin synthesis

CV: peripheral hypersen-sitive to vascular vitamin B12 or thrombosis, heart cobalt. failure. GI: transient diarrhea. Respi: pulmonary edema. Skin: itching, transitory exanthema, urticaria. Other: anaphylaxis, anaphylactoid reactions with parenteral administration, pain or burning at injection site

BEFORE: Determine reticulocyte count, hct, Vit. B12, iron, folate levels before beginning therapy. Obtain a sensitivity test history before administration Avoid I.V. administration bec. faster systemic elimination will reduce effectiveness of vitamin. DURING: Dont give large doses of vitamin B12 routinely; drug is lost through excretion. Dont mix parenteral preparation in same syringe with other drugs. AFTER: Protect Vit. B12 from light.

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Dont refrigerate or freeze. Monitor patient for hypokalemia for first 48 hours, as anemia correct itself. Give potassium supplements, as needed.

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