IX.

Drug Study
Mechanism of Action Acts on blood vessels, GI, respiratory system by antagonizing the effects of histamine for H1-receptor site; decrease allergic response by blocking histamine; causes increased heart rate, vasodilatation, secretions; Significant CNS depressant and anticholinergic properties. Nursing Consideration Be alert for urinary retention, frequency, dysuria, especially elderly: drug should be discontinued if these occur. Assess type of involuntary movements and evaluate response to this medication. Assess movement disorder before and after administration. Assess sleep pattern. Assess nausea, vomiting, bowel sounds, and abdominal pain.

Drug Name Brand Name: Nebrecon Generic Name: Diphenhydramine Route: PO Dosage: 50mg Frequency: Stat Drug Classification: Antihistamine

Indication It is used for its antiemetic properties in the treatment of nausea and vomiting, particularly in the prevention and treatment of motion sickness when it should be given at least 30 mins before travelling.

Contraindication Hypersensitivity to antihistamines; history of sleep apnea; use in newborn or premature infants and in nursing women.

Adverse Reaction Dizziness: disturbed coordination; nausea; vomiting; diarrhea; constipation; change in bowel habits. Chest tightness; wheezing; Hypersensitivity reactions;

Drug Name Brand Name: Isoxilan Generic name: Isoxsuprine HCL Dosage: 10mg Route: PO Frequency: QID Drug Classification: Cerebral/Peripheral Vasodilators

Mechanism of Action Chemically similar to sympathomimetic amines and often described as beta adregenic agonist. However the drug appear to be a musculotropic vasodilator and its effects are not blocked by propanolol.

Indication Dizziness, confusion; numbness of limbs,.Raynauds disease.. Uterine hypermotility disorders, e.g., threatened abortion, premature labor, dysmenorrhea.

Contraindication Premature labor. Avoid parenteral administration to patients with hypotension, premature detachment of placenta or immediate postpartum.

Adverse Reaction Hypotension, Maternal pulmonary edema and fetal tachycardia. Dizziness.

Nursing Consideration Assess patients condition before therapy. Monitor for possible drug induce adverse reactions: hypotension, tachycardia, nausea, vomiting, and dizziness.

Drug Name Brand Name: Elin Magnesium Sulfate Generic Name: Magnesium Sulfate Dosage: 4grams Route: TIV Frequency: Q1 Drug Classification: Anticonvulsant

Mechanism of Action May decrease acetylcoline release by nerve impulses, but anticonvulsant mechanism is unknown.

Indication Used as an anticonvulsant. Prevention and control of seizures in toxemia (preeclampsia or eclampsia).Inhibits uterine contractions in tocolysis (preterm labor). Other uses: counteracts intense muscle stimulating effects of barium poisoning.

Contraindication Patients with heart block or myocardial damage.

Adverse Reaction Hypotension, muscular weakness, An excess of Mg ions in the body fluid causes direct depressant effect on skeletal muscles, decrease release of acetylcholine by motor nerve impulses and reduce sensitivity of the motor end plate acetylcholine.

Nursing Consideration Assess patients condition before therapy and reassess regularly thereafter to monitor drug effectiveness. Monitor respiration: RR 16/min. Monitor for possible drug induce adverse reactions: CNS: drowsiness, depressed reflexes, flaccid paralysis, hypothermia Monitor for signs of magnesium toxicity: disappearance of knee-jerk and patellar reflexes are signs of early magnesium toxicity. Assess patients and familys knowledge of drug therapy

Drug Name Brand Name: Nubain Generic Name: Nalbuphine Dosage: 10mg Route: TIV Frequency: PRN

Mechanism of Action Binds with opiate receptors in the CNS: ascending pain pathways in limbic system, thalamus, midbrain, hypothalamus, altering perception of and emotional response to pain. Relieves pain.

Indication Relief of moderate to severe pain; for preoperative analgesia

Contraindication Hypersensitivity. Pregnancy (category D if only used for prolong periods or in high doses at term).

Adverse Reaction Sedation, drowsiness, nausea, and dizziness, headache, vomiting.

Nursing Consideration Assess patients underlying condition before therapy obtains drug history. Assess pain characteristics (location, insensitive, type) before administration and after treatment. Monitor for respiratory depression Watch out for muscle rigidity. Monitor for possible drug reactions: CNS: sedation: drowsiness, dizziness, headache, hallucinations, euphoria, restlessness GI: vomiting EENT. Assess patients and familys knowledge of drug therapy.

Drug Classification: Opiates & Antagonists

Drug Name Brand Name: Phenergan Generic Name: Promethazin Hydrochloride Dosage: 25mg Route: IM Frequency: PRN Drug Classification: Antihistamine

Mechanism of Action Phenothiazine derivative that competes with histamine for H1receptor sites on effector cells. Prevents, but doesnt reverse, histamine mediated responses. At high doses, it also has local anesthetic effects.

Indication Motion sickness, nausea and vomiting..

Contraindication Contraindicated in patients hypersensitive to drug. Also contraindicated in new borns, premature neonates, breast feeding women.

Adverse Reaction CNS: confusion, sleepiness, dizziness, drowsiness. CV: hypotension and hypertension. EENT: GI: nausea, vomiting, GU: urine retention. Skin: photosensitivity.

Nursing Consideration Pronounce sedative effect limits used in many ambulatory patients. Prometazin is used as an adjunct to analgesics(usually to increase sedation); it has no analgesics activity. Reduce GI distress by giving drug with food or milk.

Drug Name Brand Name: Ampicillin Generic Name Ampicillin Dosage: 500mg Route: TIV Frequency: Q6 Drug Classification: Penicillins

Mechanism of Action Interferes with cell wall synthesis of susceptible organism, preventing bacterial multiplication, it also renders the cell wall osmotically unstable and burst due to osmotic pressure. Deactivated by beta-lactamase, an enzyme by resistant bacteria.

Indication Treatment of respiratory tract and soft tissue infections..

Contraindication Hypersensitivity to penicillins, cephalosporin or imipenem.

Adverse Reaction Dizziness, fatigue, insomnia, reversible hyperactivity, neurotoxicity, (irritability, hallucinations, convulsions, seizures)

Nursing Consideration Obtain patient history of infection before and during therapy to assess response. Assess patient for signs and symptoms of infections Assess history of previous sensitivity reaction to penicillin or other cephalosporins. Cross-sensitivity between penicillins and cephalosporins is common. Assess for allergic / hypersensitivity reactions: joint pain, Monitor renal function: urine output, urinalysis, protein and blood, BUN, creatinin (low urine output may indicate nephrotoxicity)

Drug Name Brand Name:

Mechanism of Action

Indication Respiratory diseases, myocardial involvement.

Contraindication Administration of live virus vaccines; topical monotherapy in primary bacterial infections.

Adverse Reaction Cardiac arrhythmias or ECG changes; syncopal episodes; hypertension; myocardial rupture. Convulsion; perineal irritation; secondary infections; striae; abdominal distention, nausea; vomiting; endocrine abnormalities(e.g., menstrual irregularities, hypersensitivity reactions); aggravation or masking of infection; malaise; fatigue; insomnia. Hypersensitivity.

Nursing Consideration Obtain patients history of underlying condition before therapy. GU: menstrual irregularitites. Monitor fatigue, nausea, vomiting, depression, polyuria, Monitor renal status and function: inputouput ratio, urinary output Assess patients and familys knowledge on drug therapy.

Synthetic glucocorticoid with marked anti Generic name: inflammatory effect Dexamethasome because o f its ability to inhibit Dosage: prostaglandin 24mg synthesis, inhibit migration of Route: macrophages, TIV leukocytes and fibroblast at sites of Frequency: inflammation, PRN phagocytosis and lysosomal enzymes Drug Classification: release. It can also adrenocorticosteroid cause the reversal of hormones increased capillary permeability.

Drug Name Brand Name: Senekot Generic Name: Sennosides Dosage: 25mg Route: PO Frequency: ODHS Drug Classification: Medicinal Plants

Mechanism of Action Causes local irritation in colon, which promotes persialsis and bowel evacuation. Softens feses by increasing water and electrolytes in large intestine.

Indication Acute constipation; preparation for bowel examination

Contraindication Hypersensitivity to drug its component. Inflammatory bowel disease.

Adverse Reaction GI: nausea, vomiting, cramp, loss of normal bowel function (with excessive use) GU: reddish-pink discoloration of alkaline urine, yellowish-brown discoloration of acidic urine. Metabolic: electrolytes imbalances (such as hypokalemia) Other laxative dependence (with long-term or excessive use)

Nursing Consideration Assess bowel movement to determine laxative efficacy. In long-term use, monitor fluid balance, nutritional status, and electrolyte levels and watch for laxative dependence

Drug Name Brand Name: Muskelax Generic Name: Paracetamol Dosage:

Route: PO Frequency: BID Drug Classification: Para-aminophenol Derivatives

Mechanism of Action Decreases fever by inhibiting the effect of pyrogens on the hypothalamic heat regulating centers and by a hypothalamic action leading to sweating and vasodilation. Relieves pain by inhibiting prostaglandin synthesis at the CNS but does not have anti inflammation action because of its minimal effect of peripheral prostaglandin synthesis.

Indication Relief of mild to moderate pain

Contraindication Hypersensitivity.

Adverse Reaction Stimulation, drowsiness, nausea, vomiting, hypersensitivity, convulsion.

Nursing Consideration Assess patient pain. Assess hepatotoxicity: dark urine, abdominal pain, diarrhea if patients are in longterm therapy. Monitor renal function. Check input and output ratio; decreasing output may indicate renal failure(long-term therapy) Assess for chronic poisoning.

Drug Name

Mechanism of Action

Indication Rheumatic pains, alcoholism, cardiac disorders, hyperemesis gravidarum(excessive vomiting) reserpine(lower blood pressure)

Contraindication

Adverse Reaction

Nursing Consideration 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.

Brand Name: Vitamins B1, B6 Vitamin B Complex and B12 (Polynerv) oral drops is Generic Name: valuable in Polynerv conditions where the requirements for Dosage: B vitamins are 1 tab ; 500mg increased as in growth, physiologic Route: stress, decreased PO resistance to infection and Frequency: chronic illnesses, OD x 7days metabolic disorders and in certain Drug Classification: diseases of the Vitamins and digestive tract and Minerals nervous system. It can also be given before and after surgical procedures. Vitamins B1, B6 and B12 (Polynerv) oral drops is indicated for the prevention and treatment of deficiency disorders arising from poor

Vitamin B complex Anaphylaxis, should not be used Pain. in hypersensitivity to any of the vitamins, containing in the preparation, as well as in patients with 2-nd or 3-rd degree arterial hypertension.

dietary intake, impaired B vitamin absorption as in prolonged diarrhea, excessive vomiting and antibiotic therapy, intake of drugs which interfere with the utilization of the B vitamins (i.e. isoniazid). As a nutritional supplement to promote appetite, weight gain and height increase.