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INDICATION
CONTRAINDICATIO N
Pregnancy especially during the last trimester. Use in clients with the aspirin triad(bronchial asthma, rhinitis, aspirin intolerance)
SIDE EFFECTS
NURSING RESPONSIBILITIE S
Review history for any conditions that may preclude drug therapy(e.g. PUD, Lupus, asa intolerance, heavy alcohol intake.) Obtain/monitor CBC, liver and renal function studies, x-rays and eye exam prior to initiating long-term therapy. Take with meals or milk to decrease GI upset. Report any nausea and vomiting , diarrhea and constipation. Take the dosage prescribed for the best results. May cause dizziness and drowsiness.Do not perform activities that require mental alertness until drug effects realized. Individualize dosage based on tolerance and effectiveness. Give with meals starting at a low dose
*Generic Name: Ibuprofen Brand Name: Mortin, Advil 400mg P.O. tid Classification: Non-Steroidal AntiInflammatory Drugs(NSAIDs)
Analgesic for mild to moderate pain. Fever and minor aches and pain due to colds, flu, sorethroat, headaches and toothaches. Pain of migraine headaches.
Dermatitis, rashes.Hypersensitivity reaction consisting of abdominal pain, fever, headache,nausea and vomiting.
Decreases hepatic glucose production, decreases intestinal absorption of glucose and increases
Alone as adjunct to diet to lower blood glucose in clients having NIDDM whose
Renal disease or dysfunction (serum creatinine levels > 1.5mg/dL in males and >14 md/dL in females.In
Lactic acidosis (fatal), Diarrhea, nausea and vomiting, abdominal bloating, flatulence, anorexia, unpleasant and
Infections due to penicillinaseproducing staphylococci; may be used to initiate treatment when a staphylococci is
Contraindicated with allergies to penicillin, cephalosporin, or other allergens. Use cautiously with renal disorders, pregnancy and lactation.
Make sure that client has no allergies to penicillin, cephalosporin or other allergens. Finish entire course of therapy as prescribed.
Amoebiasis
Gastric acid pump inhibitor:Suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the
Short-term management of pain(up to 5 days) ophthalmic:Relie f of ocular itching due to seasonal conjunctivitis and relief of postoperative inflammation after cataract surgery. Short-term treatment of active duodenal ulcer. First-line therapy treatment of heartburn or
Contraindicated with significant renal impairment, during labor and delivery, lactation;patients wearing soft contact lenses(ophthalmic); aspirin allergy; concurrent use of NSAIDs; active peptic ulcer disease, recent GI bleed or perforation . Contraindicated with hypersensitivity to omeprazole and its components. Use cautiously with pregnancy and lactation.
Headache, dizziness, somnolence, insomnia, fatigue, tinnitus, ophthalmologic effects.Rash, pruritus, sweating, dry mucous membranes.Nausea, dyspepsia, GI Pain, diarrhea, vomiting, constipation, flatulence,gastric or duodenal ulcers. Headache,dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, rash, inflammation, urticaria, pruritis,alopecia, dry skin.Diarrhea, abdominal
Do not use ophthalmic drops with contact lenses. Report sore throat , fever, rash, itching, weight gain, swelling in ankles or fingers, changes in vision, black tarry stool, bruising.
Take the drug before meals. Report severe headache, worsening of symptoms, fever, chills. Have regular medical
DRUGS
MECHANISM OF ACTION
Acts to suppress gastric acid secretion by specifically inhibiting the hydrogen-potassium ATPase enzyme system at the secretory surface of gastric parietal cells;blocks the final step of acid production. The antiinflammatory effect is likely due to inhibition of the enzyme cyclooxygenase (cox). These are 2 cox isoenzymes-cox1 and cox 2. Depending on NSAID, either cox1 and cox2 both enzymes may be inhibited. Inhibition of cyclooxygenase results in decreased prostaglandin synthesis. Effective in reducing joint swelling pain and
INDICATION
CONTRAINDICATIO N
Lactation
SIDE EFFECTS
NURSING RESPONSIBILITIE S
Take with meals Antacids maybe used with proton pump inhibitors Record abdominal assessments, Xray(UGI,US,Barium,En ema) Endoscopic findings and H.Pyloric results.
*Generic Name: Omeprazole Brand Name: Prilosec, Losec 40mg IV O.D. Classification: Proton Pump Inhibitor
Short term treatment of active duodenal ulcer & active benign gastric ulcer.
Generic Name: Ketorolac Tromethamine Brand Name: Toradol 30mg IV q8 Classification: Non Steroidal Anti Inflammatory Drugs
Use with morphine and meperdine shows an opioidsharing effect,combinati on can be used for breakthrough pain. Mild to moderate pain.
Adjunct dosage age for 65 y/o and older for clients less than 50 kg. and for those with moderately elevated serum creatinine. Do not exceed IV/IM doses of 60mg/day in these clients.
If given on PRN basis base the size of a repeat dose on the duration of pain relief from previous dose if pain returns within 3-5 hr. the next dose can be increased by up to 50 % (as long as the total daily dose is not exceeded. If the pain does not return for 812 hour the next dose can be decrease by as much as 50% or the dosing interval may be increased to every 8-12 hours. Do not mix IV/IM
Slows intestinal motility by acting on the nerve endings and or intramural ganglia embedded in the intestinal wall. The prolonged retention of the feces in the intestine results in reducing the volume of the stools, increasing viscosity and decreasing fluid and electrolyte loss.
Symptomatic relief of acute non-specific diarrhea and of chronic diarrhea associated with inflammatory bowel disease
Abdominal pain, distention or discomfort, dry mouth, nausea and vomiting, epigastric distress.
Brand Name: Metformin HCL Generic Name: Glucophage 500mg PO TID Classification: Anti-diabetic agents
Non insulin dependent diabetes mellitus (TYPE II) that does not respond to diet management and exercise alone. Impaired glucose intolerance
To decrease the incidence of gastric upset take P.O. drugs with food. For clients receiving 20-40 units of insulin daily, initiate oral hypoglycemic therapy and reduce insulin dose by 25-50%. Discontinue insulin gradually using the absence of glucose in the urine as guide with glyburide insulin maybe discontinued abruptly. Monitor v/s, ecg, cholesterol panel, electrolytes, CBC and urine for microalbuminuria. Strive for control. Record blood sugar at diff. times during day
DRUGS
MECHANISM OF ACTION
Following a combination with insulin receptors on cell plasma membranes , insulin facilitates the transport of glucose into cardiac and skeletal muscles and adipose tissue. It also increases synthesis of glycogen in the liver. Insulin stimulates protein synthesis and lipogenesis and inhibits lypolysis and release of free fatty acids from cells. Insulin also causes intracellular shifts in Mg and K+ Since insulin is a protein. It is destroyed in the GI tract. Thus it must be administered SC, so
INDICATION
CONTRAINDICATIO N
IV or IM use due to possible inadvertment overdosage
SIDE EFFECTS
NURSING RESPONSIBILITIE S
Rotation of injection sites may lead to differences in blood levels of insulin . the abdomen is considered the best site due to constant insulin peak times with better gradual absorption. Apply gentle pressure after injection but do not massage since this may alter rate of absorption. Weigh to determine amount of agent needed Monitor electrolytes, lipid profile, thyroid studies, BS phosphate, Mg, CBC, HBA 1c & urinalysis. Assess injection sites, monitor VS plot growth & weight every 3-4 months.
*Generic Name: Rapid Acting Insulin (RAI) Brand Name: Humulin R Regular u 500 ( concentrated) 25 "u" SC Classification: Insulin Products
Generic Name: Domperidone Brand Name: Domphenyl Classification: Non Steroidal Anti-Flatulence Brand Name: Isophane Insulin Suspension (Nph) Generic Name: Humulin N Classification: Insulin Product
Following a combination with insulin receptors on cell plasma membranes , insulin facilitates the transport of glucose into cardiac and skeletal muscles and adipose tissue. It also increases synthesis of glycogen in the liver. Insulin stimulates protein synthesis and lipogenesis and inhibits lypolysis and release of free fatty
Treatment of diabetes mellitus for control of hyperglycemia. Not recommended for emergency use. Not suitable for IV administration. For SC only.
Rotation of injection sites may lead to differences in blood levels of insulin . the abdomen is considered the best site due to constant insulin peak times with better gradual absorption. Apply gentle pressure after injection but do not massage since this may alter rate of absorption. Weigh to determine amount of agent needed Monitor electrolytes,
Brand Name: Ciprofloxacin HCL Generic Name: Ciloxan Classification: Antibiotic, Fluoroquinolone
For the treatment of infections caused by susceptible gram negative bacteria including E.coli, Pseudomonas Aeruginosa, Staphylococcus Aureus
With allergy to ciprofloxacin, norfloxacin,or other fluoroquinolones, pregnancy lactation. Use cautiously with renal impairment , seizures, tendonitis.
Nausea, Vomiting Dry mouth, diarrhea, abdominal pain, constipation, blurring of vision, dizziness (use caution if driving)
Ensure that patient is well hydrated. Monitor clinical response. Give anatacids 2 hours before or after dose