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Drug name Brand Name: Ketosteril Generic Name: Essential Amino Acid Classification: Ketoanalogs Essential amino acids

Dosage : 3 tablet Frequency: Q feeding Route : NGT

Action Normalizes metabolic process, promotes recycling product exchange. Reduces ion concentration of potassium, magnesium and phosphate.

Indication Protein energy malnutriti on Preventio n and treatment of condition s caused by modified or insufficie nt protein metabolis m in chronic renal failure

Contraindication

Side effects

Nursing responsibilities Evaluate for any contraindications Take drug as prescribed Warn the patient about possible side effects and how to recognize them Give with food if GI upset occurs Frequently assess for hypercalcemia

Allergy and Hypercalce hypersensiti mia may vity to any develop content of this drug Hypercalce mia Disturbed amino acid metabolism Caution use for patiet with phenylketo nuria

Drug name Brand Name: Mestinon Generic Name: PYRIDOSTIGMI NE Classification: anticholinesterase Dosage : tablet 60mg Frequency: Every 6hrs. Route : NGT

Action It works by preventing the breakdown of a certain natural substance (acetylcholin e) in your body. Acetylcholin e is needed for normal muscle function.

Indication To improve muscle strength in patients with a certain muscle disease (myasthe nia gravis).

Contraindication Allergy and hypersensit ivity to any content of this drug Lung disease kidney disease, slow/irregu lar heartbeat

Side effects Nausea, vomiting, diarrhea, abdominal cramps, increased saliva/mucus, decreased pupil size, increased urination, or increased sweating

Nursing responsibilities BEFORE: Ask patient if she is allergic to it; or too the corticosteroids (e.g.,prednisone); or ifshe has any other allergies. This medication may contain inactive ingredients, which can cause allergic reactions or other problems. DURING: Inform patient that it can cause dizziness and to avoid sudden change of movements. Side rails up to ensure safety. AFTER: Monitor patient for any signs of allergic reactions

Drug name Brand Name: DUAVENT Generic Name:

Action Treatment of obstructive airway diseases

Indication Management of reversible bronchospasm associated with obstructive

Contraindication -Hypertrophic obstructive cardiomyopathy or tachyarrhythmia

Side effects -Headache -pain, -influenza -chest pain -Nausea

Nursing responsibilities Position patient on high back rest position. Do back tapping after you nebulize

IPRATROPIU M SALBUTAMO L Classification: adrenergic inhalants, selective beta2adrenoreceptor agonists Dosage : 50mg Frequency: Q8 And PRN Route : NEB

airway diseases Bronchodil ator

-Hypersensitivity to atropine and its derivatives

- Bronchitis -dyspnea -coughing -pneumonia bronchospasm - pharyngitis -sinusitis -rhinitis -edema -fatigue -hypertension -dizziness -nervousness -tremor -dyspepsia -vomiting -arrhythmia -palpitation -tachycardia -arthralgia -angina -increased sputum, taste perversion and -UTI/dysuria -allergic-type reactions

the patient do not give a food immediately it can cause vomiting

Drug name Brand Name: Ultram Generic Name: tramadol hydrochloride Classification: Analgesic Centrally acting Dosage : 50mg Frequency: PRN Route : IV

Action Tramadol inhibits reuptake of norepineph rine, serotonin and enhances serotonin release. It alters perception and response to pain by binding to mu-opiate receptors in the CNS.

Indication Relief of moderat e to moderat ely severe pain

Contraindication Suicidal patients Acute alcoholism head injuries raised intracranial pressure severe renal impairment lactation

Side effects -Sweating -Dizziness -Nausea -vomiting -dry mouth -Fatigue -Asthenia -somnolence -confusion -constipation -flushing -headache -Vertigo -tachycardia -palpitations -insomnia - orthostatic -hypotension -seizures -CNS stimulation e.g. hallucination s.

Nursing responsibilities Assessment History: Hypersensitivity to tramadol; pregnancy; acute intoxication with alcohol, opioids, psychotropic drugs or other centrally acting analgesics; lactation; seizures; concomitant use of CNS depressants or MAOIs; renal or hepatic impairment; past or present history of opioid addiction Physical: Skin color, texture, lesions; orientation, reflexes, bilateral grip strength, affect; P, auscultation, BP; bowel sounds, normal output; LFTs, renal function tests Interventions Control environment (temperature, lighting) if sweating or CNS effects occur. Teaching points You may experience these side effects: Dizziness, sedation, drowsiness, impaired visual acuity (avoid driving or performing tasks that require alertness); nausea, loss of appetite (lie quietly, eat frequent small meals). Report severe nausea, dizziness, severe constipation.

Drug name Brand Name: Domperidone Generic Name: Motilium Classification: Anti-emetic and antivertigo Dosage : 10mg 1 tab Frequency: Q8 Route : NGT prefeeding Drug name Brand Name: Reglan Generic Name: Metoclopramid e Classification: Anti-emetic and antivertigo Dosage : 10 mg Frequency: Q8 Route : IV for N&V

Action Domperidon e is a dopaminereceptor blocking agent. Its action on the dopaminereceptors in the chemoemetic trigger zone produces an anti-emetic effect.

Indication primarily indicated in conditions like Acute nausea and vomiting, Dyspepsia, Gastric distension pain due to pressure on the stomach, Gastrooesophageal reflux disease

Contraindication Suicidal patients Acute alcoholism head injuries raised intracranial pressure severe renal impairment lactation

Side effects Allergic reactions, Abdominal cramps Dystonic reactions Reversible raised serum prolactin levels Hypertensive crises

Nursing responsibilities Assess for extrapyramidal effects such as jerking and tongue protrusion.2. Check for hypotension.

Action Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions, appears to sensitize tissues to action of acetylcholine . Relaxes pyloric sphincter which when combined with effects on motility, accelerates gastric emptying and intestinal transit.

Indication Relief symptoms of acute and recurrent diabetic gastro paresis. Short term therapy (412weeks) for adults with symptomatic gastroesophageal reflux who fail to respond to conventional therapy

Contraindication Contraindicated with allergy to metaclopramide, GI hemorrhage, mechanical obstruction or perforation.

Side effects Restlessness Drowsiness Fatigue Insomnia Transient hypertension Nausea Diarrhea

Nursing responsibilities Asses if the patient has history of allergies to metoclopramide. Monitor BP carefully during IV administration. Monitor extrapyramidal reactions, and consult physician if they occur. Monitor patients with diabetes, arrange for alteration in insulin dose or timing if diabetic control is comprised by alterations in timing of food absorption

Drug name Brand Name: NaHCO3 Generic Name: Sodium bicarbonate Classification: Acidifiers and alkalinizing Anti-ulcer Dosage: 1 tab Frequency: TID Route: NGT

Action Restores buffering capacity of the body and utilizes excess acid

Indication cardiac arrest Metabolic acidosis Urinary alkalinizatio n antacid

Contraindication Contraindicated to patient w/ metabolic or respiratory alkalosis & in those with hypocalcaemia in w/c alkalosis may produce tetanus, hypertension, seizures or heart failure Also contraindicated in patient losing chlorides because of vomiting or continuous GI suction & receiving diuretics that produce hypochloremic alkalosis

Side effects CNS: tetany CV: edema GI: gastric distention, flatulence Metabolic: hypokalemia, hypernatremia

Nursing responsibilities Monitor patient closely for toxicity and effectiveness Avoid using NaHCO3 andenteric-coated drugs together.

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