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Nursing Resposibilty:
• Seizure: assess location, duration, frequency and characteristics of
seizure activity.
• Arrythmias: Monitor ECG contiously during treatment of arrythmias
• Assess patient for phenytoin hypersensitivity syndrome( fever, skin
rash, lymphopathy). Rash usually occurs within the first 2 weeks of
therapy.
• Assess oral hygiene. Vigorous oral cleaning beginning within 10 days of
initiation of phenytoin therapy may help control gingival hyperplasia.
• May cause increase serum alkaline phosphates,GTT and glucose level.
Dosage:
Nursing Resposibilty:
• Assess for epigastric pain or abdominal pain and frank or occult blood
in the stool, emesis or gastric aspirate.
• Antagonize effects of pentagstrin and histamine during gastric acid
secretion testing
• May cause uncrease in serum transaminase and serum creatinine
• Ranitidine may cause false positive results for urine protein, test with
sulfosalicylic acid.
• Instruct the patient to take the medication as directed for the full
course of therapy, even if feeling better.
• Inform the patient that smoking interferes with the action of histamine
antagonist.
• Advise the patient to avoid alcohol products containing to avoid aspirin
or NSAIDS, and foods that may cause increase in GI irritation.
• Inform the patient that increase fluid and fiber intake and exercise may
minimize constipation.
I.V.: Initial dose: 0.5 mg/kg, followed by 0.25-1 mg/kg every 6 hours for up to
48 hours (maximum daily dose: 90 mg) Oral: 0.25 mg/kg every 6 hours
Nursing Resposibilty:
• Monitor response (pain, range of motion, grip strength, mobility, ADL
function),
• Should be used cautiously in patients receiving anticoagulant therapy
and patients with hemophilia.
• Haematological effects : Ketorolac inhibits thrombocyte aggregation
and prolong bleeding time. Because of that ketorolac should not be
used before surgery and use with caution if there is hemostasis
disturbances.
• Should be used with caution in patients with cardiac decompensation,
acute renal failure, hypertension or other conditions associated with
fluid retention.
• Ketorolac tromethamine should be used with caution in patients with
impaired hepatic function or patients with history of hepatic desease.
• Hepatic effects : Ketorolac therapy increases hepatic enzymes and in
hepatic disease patients, severe hepatic risk reaction may occur.
Administration of ketorolac should be discontinued if abnormality of
hepatic function test occurs after ketorolac administration.
• Ketorolac tromethamine is not recommended for children under 16
years (Safety and efficacy have not been established).
Generic name: Co amoxiclav
Brand name: amoxcil
Classification: Antibiotics
Mode of Action:
• Abdominal infections
• Animal bites
• Infections of the organs associated with breathing, including nasal
passages, sinuses, windpipe and lungs (respiratory tract)
• Infections of the sex organs and organs associated with urination
(genito-urinary infections)
• Inflammation of connective tissue, commonly the skin (cellulitis)
Contraindication:
Side Effect:
• Diarrhea, Vomiting, Jaundice, Fever, Pseudomembranous colitis,
Angina, Bradycardia, Flushing, Nausea, Gingival hyperplasia
Dosage;
• Standard adult dosages for respiratory tract, urinary, abdominal and
dental infections as well as cellulitis and animal bites is co-amoxiclav
250/125 (one tablet Augmentin 250) taken every 8 hours, which may
be doubled in severe infections (as a single tablet of co-amoxiclav
500/125 Augmentin 500, but not as two co-amoxiclav 250/125 tablets
which would double the maximum recommended dose of clavulanic
acid
Nursing Resposibilty:
• Assess for infection
• Obtain specimens for culture and sensitivity prior to therapy. First dose
may be given before receiving the result
• Monitor bow function
• Instruct the patient to take the medication around the cock and to
finish the drug completely as directed.
• Review use and preparation of tablets for oral suspension
• Instruct female patients taking oral contraceptives to use an alternate
or additional non-hormonal method contraception during therapy with
amoxicillin and until next menstrual period.
• Advise the patient to report signs of superinfection ( furry overgrowth
on the tongue, vagina itching or discharge, foul-smelling stools.and
allergy.
Contraindication:
Indication:
Prevention and correction of potassium deficiency; when associated with
alkalosis, use potassium chloride; when associated with acidosis, use
potassium acetate, bicarbonate, citrate, or gluconate. IV: Treatment of
cardiac arrhythmias due to cardiac glycosides
Contraindication:
Drug Interaction:
Drug-drug
Dermatologic: Rash
• Arrange for serial serum potassium levels before and during therapy.
• Administer liquid form to any patient with delayed GI emptying.
• Administer oral drug after meals or with food and a full glass of water
to decrease GI upset.
• Caution patient not to chew or crush tablets; have patient swallow
tablet whole.
• Mix or dissolve oral liquids, soluble powders, and effervescent tablets
completely in 3–8 oz of cold water, juice, or other suitable beverage,
and have patient drink it slowly.
• Arrange for further dilution or dose reduction if GI effects are severe.
• Agitate prepared IV solution to prevent "layering" of potassium; do not
add potassium to an IV bottle in the hanging position.
• Monitor IV injection sites regularly for necrosis, tissue sloughing,
phlebitis.
• Monitor cardiac rhythm carefully during IV administration.
• Caution patient that expended wax matrix capsules will be found in the
stool.
• Caution patient not to use salt substitutes.
• Take drug after meals or with food and a full glass of water to decrease
GI upset. Do not chew or crush tablets, swallow tablets whole. Mix or
dissolve oral liquids, soluble powders, and effervescent tablets
completely in 3–8 ounces of cold water, juice, or other suitable
beverage, and drink it slowly. Take the drug as prescribed; do not take
more than prescribed.
• Do not use salt substitutes.
• You may find wax matrix capsules in the stool. The wax matrix is not
absorbed in the GI tract.
• Have periodic blood tests and medical evaluation.
• You may experience these side effects: Nausea, vomiting, diarrhea
(taking the drugs with meals, diluting them further may help).
• Report tingling of the hands or feet, unusual tiredness or weakness,
feeling of heaviness in the legs, severe nausea, vomiting, abdominal
pain, black or tarry stools, pain at IV injection site.
Dosage:
Ordered dose: 1 grm. IV q 12 hrs. / 5 ml TID
Contraindication:
Patients with parasympathetic hypertonia.
Caution:
Somazine must not be administered along with medicaments containing
meclophenoxate.
Interaction:
Somazine potentiates the effects of L-dopa. Incompatibilities: Somazine must
not be administered with products containing meclofenoxate (clophenoxate)
Side Effects:
Indication:
Contraindication:
• Well established anuria due to severe renal disease.
• Severe pulmonary congestion or frank pulmonary edema.
• Active intracranial bleeding except during craniotomy.
• Severe dehydration.
• Progressive renal damage or dysfunction after institution of mannitol
therapy, including increasing oliguria and azotemia.
• Progressive heart failure or pulmonary congestion after institution of
mannitol therapy. Do not administer to patients with a known
hypersensitivity to mannitol
Indication:
Contraindication:
Magnesium sulfate should not be administered parenterally in patients
with heart block or myocardial damage.
Adverse Effect/side effect:
Flushing, sweating, sharply lowered blood pressure, hypothermia, stupor and
ultimately, respiratory depression.
Nursing Responsibility: