17113104-dr-drug-study
TRANSCRIPT
Generic Name(Brand Name)
Drug Classification & Indication
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction Contraindication Nursing Responsibility
Methergine(methylergonovine maleate)
PC: Ergot Alkaloid and Derivative
TC: oxytocic, lactation stimulant
Indication:Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution
IV:0.2 mg after delivery of anterior shoulder, after delivery of placenta, or during puerperium; may be repeated as required at intervals of 2-4 hours
Methergin↓
Stimulates uterine smooth muscles
↓producing sustained
contractions↓
thereby shortens the third stage of
labor
Cardiovascular: hypertension, temporary chest pain, palpitation
CNSHallucinations, dizziness, seizure, headache
Gastrointestinal: Nausea, vomiting, diarrhea, foul taste
Local: Thrombophlebitis
Otic: Tinnitus
Renal: Hematuria
Respiratory: Dyspnea, nasal congestion
Miscellaneous: Diaphoresis
> contraindicated in patients hypersensitive to methylergonovine or any component of the formulation.
>ergot alkaloids are contraindicated with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics); hypertension; toxemia; pregnancy
>Be alert for adverse reactions and drug interactions.
>This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely.
HERRERA, Perry Lee B.BSN III – A3a
Generic Name(Brand Name)
Drug Classification & Indication
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction Contraindication Nursing Responsibility
Oxytocin PC: Exogenous Agent
TC: oxytocic, lactation stimulant
Indication:Induction of labor at term; control of postpartum bleeding; adjunctive therapy in management of abortion
I.V.: 10-40 units by I.V. infusion in 1000 mL of intravenous
fluid at a rate
sufficient to control uterine atony
Oxytocin↓
Causes potent and selective
stimulation of uterine and
mammary gland smooth muscles
↓producing sustained
contractions↓
Induces labor and milk ejection and
reduces post partum bleeding
Cardiovascular: hypertension; increased heart rate, systemic venous return, and cardiac output, and arrhytmias
CNS: seizures, coma from water intoxication
Gastrointestinal: Nausea, vomiting,
GU: titanic uterine contractions, abruption placentae, impaired uterine blood flow, pelvic hematoma
Hematologic: afibrinogenemia
Respiratory: anoxia, asphyxia
> Contraindicated in patients hypersensitive to the drug or any of its component.
> Also contraindicated in cephalopelvic disproportion or delivery that requires conversion, as in tranverse lie; in fetal distress when delivery isn’t imminent; in prematurity and in severe toxemia, hypertonic uterine patterns, total placenta previa or vasa previa.
> Also contraindicated in fetal distress.
> Monitor and record uterine contractions, heart rate, BP, intrauterine pressure, fetal heart rate, and blood loss q15.
>Be alert for adverse reaction
>Monitor I/O. Antidiuretic effect may lead to fluid overload, seizures, and coma
>never give oxytocin simultaneously by more than one route.
>have 20% solution magnesium sulfate available for relaxation of the myometrium.
>If contractions are less than 2 minutes apart, if they’re above 50mm Hg ,or if they last 90seconds or longer, stop infusion, and turn patient on her side, and notify prescriber
HERRERA, Perry Lee B.BSN III – A3a
Generic Name(Brand Name)
Drug Classification & Indication
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction Contraindication Nursing Responsibility
Cefazolin Sodium
PC: first-generation cephalosporin
TC: antibiotic
Indication:Perioperative prophylaxis in contaminated surgery.
IV:250 mg to 2 g every 6-12 (usually 8) hours, depending on severity of infection; maximum dose: 12 g/day
Cefazolin ↓
Inhibits cell-wall synthesis
↓Promoting osmotic
instability↓
Hinders/kills susceptible bacteria
CNS: dizziness, headache, malaise
GI: nausea, vomiting, diarrhea, glossitis, dyspepsia,
Respi: Dyspnea
Skin: Erythematous rashes
> contraindicated in patients hypersensitive to cephalosporins
>use cautiously in patients with history of sensitivity to penicillin because of cross-allergic reaction
>use cautiously in pregnant and lactating women
>ask patient about previous reaction to cephalosporin or penicillin before starting the therapy
>If GI reaction occurs, monitor hydration
HERRERA, Perry Lee B.BSN III – A3a
Generic Name(Brand Name)
Drug Classification & Indication
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction Contraindication Nursing Responsibility
Hyoscine Butylbromide
PC: anticholinergic
TC: antimuscarinic, antiemetic, antivertigo drug, antiparkinsonism
Indication:To reduce secretions perioperatively.
IV:1 mg/ml
HBB↓
Inhibits muscarinic actions of
acetylcholine in the ANS
↓Affecting neural
pathway↓
Relieves spasticity, nausea and
vomittin; reduces secretions; and blocks cardiac vagal reflexes.
↓
Promotes cervical effacement
CNS: dizziness, headache, restlessness, disorientation, irritability, fever
GI: constipation, dry mouth, nausea, vomiting
CV: palpitations, tachycardia, flushing
EENT: dilated pupils, blurred vision, photophobia, dysphagia
GU: urinary hesitancy, urinary retention
Skin: rash, dryness
Contraindicated in patients with angle-closure glaucoma, obstructive uropathy, asthma, COPD, myasthenia gravis, paralytic ileus, intestinal atony, & unstable CV.
>Be alert for adverse reactions and drug interactions.
>Encourage pt. to void
>Monitor BP for possible hypotension.
>Monitor cervical effacement and dilatation.
HERRERA, Perry Lee B.BSN III – A3a
Generic Name(Brand Name)
Drug Classification & Indication
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction Contraindication Nursing Responsibility
Hydralazine PC: peripheral vasodilator
TC: anti-hypertensive
Indication:Pre-eclampsia /eclampsia
5 mg/dose then 5-10 mg every 20-30 minutes as needed.
Hydralazine ↓
Directly relaxes arteriolar smooth
muscle↓
Vasodilaion↓
Lowers Blood Pressure
CNS: peripheral neuritis, headache, dizziness
CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations.
GI: n/v, diarrhea, anorexia
Hematologic: neutropenia, leukopenia, agranulocytopenia
Metabolic: weight gain, sodium retention
Skin: rash
Contraindicated to pt.s hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease.
Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.
Assess blood pressure before starting therapy and regularly thereafter.
Instruct client to take oral form with meals.
Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly.
Tell pt. not to abruptly stop taking drug, but to call prescriber if adverse reaction occurs.
Tell client to limit sodium intake.
HERRERA, Perry Lee B.BSN III – A3a
Generic Name(Brand Name)
Drug Classification & Indication
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction Contraindication Nursing Responsibility
Magnesium Sulfate
PC: Magnesium Salt
TC: Anti-convulsant, Mineral
Indication: 1. Control seizures in preeclampsia and eclampsia
2. To manage preterm labor
I.M.: 1-4 g every 4 hours I.V.: Initial: 4 g, then switch to I.M. or 1-4 g/hour by continuous infusion
Magnesium Sulfate ↓
may decrease acetylcholine
released by nerve impulses
↓but anticonvulsant
mechanism is unknown.
↓Control seizures
CNS: drowsiness, depressed reflexes, flaccid paralysis and hypothermia.
CV: hypotension, flushing, circulatory collapsed, decreased cardiac function and heat block.
Metabolic: hypoglycemia
Respiratory:Respiratory paralysis
Skin: diaphoresis
Parenteral administration contraindicated in patients with heart block or myocardial damage.
Use cautiously in patients with impaired kidney function.
> Assess pt.’s condition before therapy and regularly thereafter to monitor the drug’s effectiveness.
> BP monitoring, and hold if BP is <80/60
>withhold if urine output is <30 cc/hour
>withhold if respiration <12 cpm
> Keep I.V. calcium gluconate at all times to reverse magnesium intoxication.
(↓ RR, ↓ BP, ↓ UO)
HERRERA, Perry Lee B.BSN III – A3a