drugstudy_ grand cp

7/29/2019 Drugstudy_ Grand Cp

1/16

NAME OF PATIENT: DRUGSTUDY DIAGNOSIS:

Name of Drug DateOrdered

Classification

Recommended Dose& Frequency

Why given to patientin relation to the

mechanism of action

Contraindication SideEffects/Toxic

effects/Drug-druginteraction

Stability of theDrug

Nursing Consider

Generic (Brand)

Acetylcysteine

( Flumucil )

Dose/FrequencyPrescribed

60mg in glass

H2O OD

November19, 2012

Mucolytic

PO loading dose:

140mg/kg;

Maintenance dose:70mg/kg 4hr after the

loading dose andevery 4hr thereafter

for a total of 17doses.

Reduces the

viscosity of purulentand non purulent

pulmonarysecretions and

facilitates theirremoval by splitting

disulfide bonds.

Therapeutic action:

Mucolytic activity,splits links in the

mucoproteinscontained in

respiratory mucussecretions,

decreasing the

viscosity of themucus.

Contraindicated

withhypersensitivity

to acetylcisteine;use caution and

discontinueimmediately if

bronchospasmoccurs.

Most common:

bronchial/tracheal

irritation nausea &

vomiting rash stomatitis.

Closed bottles

of solutionremain stable

for 2 yearswhen stored at

20 degreeCelsius. Open

bottle shouldbe stored at 2-8

degree Celsiusand should be

used within96hr. once a

bottle has beenopened, record

the time anddate of opening

so that the drug

will not beused beyond

the 96hrperiod.

Use non-reactplastic glass ostainless steel

administration Note pulmona

findings, detewhen spasm o

Document conthat likely cau

congestion &wheezing.

Use as directenot exceed pre

dosage. report sputum

consistency,characteristic,

set fever.

report lack of response adve

effects, or woof symptoms.


2/16



Classification RecommendedDose &

Frequency


mechanism of action

Contraindication Side Effects/Toxiceffects/Drug-drug

interaction

Stability ofthe Drug

Nursing Consid

Generic (Brand)

Ipratropium

Bromide andAlbuterol

Sulfate(Combivent)


1 neb TID

November19, 2012

Antiasthmatic

One 3ml vialgiven 4 times per

day vianebulization with

up to 2additional 3ml

doses daily, ifneeded.

Treatment of COPD(including

bronchospasm) inthose who are on

regular aerosolbronchodilator

therapy and whorequire a second

bronchodilator.

History ofhypersensitivity to

lecithin or relatedfood products such

as soy bean andpeanuts.

Most common:

bronchitis URTI headache pain dyspnea coughing nausea pharyngitis sinusitis

Store between15-30 degree

Celsius (59-86 degree

Fahrenheit)avoid

excessivehumidity.

discard canlabeled num

inhalations use as direc

not increasdoe/freque

administratspecifically

avoid eye creport any

disturbanceirritation.


3/16



Classification RecommendedDose & Frequency

Why given topatient in relation

to the mechanismof action


interaction


Nursing Consi

Generic (Brand)

Potassium Chloride

(Kalium Durule)


2 tab OD

November

15, 2012

Electrolyte

Highly

individualized.Oral

administration ispreferred because

the slowabsorption from

the GI tractprevents sudden

large increases inplasma potassium

levels. Dosage isusually expressed

as mEq/L ofpotassium.

The usual adult

daily requirement

of potassium is 40-80mg.

It is given to

client to treathypokalemia due

to digitalisintoxication,

diabetic acidosis,diarrhea and

vomiting, familialperiodic paralysis,

certain cases ofuremia, starvation

and debilitation,and corticosteroid

and diuretictherapy.

severe renalfunctionimpairment with

azotemia oroliguria,postopera

tively beforeurine flow has

beenreestablished.

Crush syndrome Addisons disease Hyperkalemia

from any cause

Anuria Heat cramps acute dehydration severe hemolytic

reaction

adynamia clients receiving

potassium -sparing diureticsor aldosteroneinhibiting drugs.

CNS:

dizziness mental

confusionCV:

arrhythmia weak irregular

pulse

hypotension

heart blockGI:

abdominaldistention

anorexia nausea &

vomitingNEUROMUSCULAR

weakness paresthesia

of

extremities

flaccidparalysis.

Store between

15-30 degreeCelsius (59-

86 degreeFahrenheit)

avoidexcessive

humidity

instruct cswallow coated ta

extendedcapsules

tablets andissolve

the mout salt subs

should nused

concomiwith pota

preparati if GI ups

occurs, pcan be ta

meals or

food withglass of w

give oral times dailHypokaleshould beslowly ov

period of to minimi

developmhyperkale


4/16


Name of Drug Date

Ordered

Classification Recommended Dose

& Frequency

Why given to patient

in relation to themechanism of action

Contraindication Side

Effects/Toxiceffects/Drug-

drug interaction

Stability of

the Drug

Nursing Consider

Generic (Brand)

Fluconazole

( Diflucan)

Dose/Frequency

Prescribed

200mg 1cap OD

November

26, 2012

Antifungalagent

Adults:First day: 200mg

then, 100mg oncedaily for a minimum

of 14 days.

It is given to clientto treat

oropharyngeal andesophageal

candidiasis. serioussystemis candidal

infection (includingUTI, peritonitis, and

pneumonia).

Therapeutic action:

Binds to sterols inthe fungal cell

membrane, changingmembrane

permeability,fungicidal or

fungistaticdepending on

concentration and

organism.

Contraindicated with

hypersensitivity to

fluconazole, lactation.

usecautiously

with renal

or hepaticimpairment

Side effects aremore frequently

reported in HIVinfected clients

than in nonHIVclients.

GI:

nausea vomiting abdomina

l pain diarrhea

Miscellaneous:

headache skin rash hepatotox

icity

exfoliative skin

disorders.

Store between

15-30 degreeCelsius (59-


avoidexcessive

humidity

Take a througnursing and d

Determine if cHIV infected

possible) becamay place clie

increased riskpossible side e

Due to a long once daily dos

(either IV or P

possible. Obtain baseline

function studiewho develop abliver function tshould be closemonitored for tdevelopment oserious liver to

Observeimmunocomprclients closely evidence of a r

lesions progresdrug should bediscontimued.


5/16


Name of Drug Date

Ordered


& Frequency




Effects/Toxiceffects/Drug-drug

interaction

Stability of

the Drug

Nursing Consider

Generic (Brand)

Azithromycin(Zithromax)

Dose/Frequency

Prescribed

500 mg/tab 1 tabOD

November

15, 2012

Macrolide

antibiotic

Adults:500 mg PO single

dose on first day,followed by 250 mg

PO daily on days 2-5for a total dose of

1.5g or 500 mg/dayPO for 3 days.

Treatment of lowerrespiratory

infections: acutebacterial

exacerbations ofCOPD.

Therapeutic action:

Bacteriostatic or

bactericidal insusceptible bacteria.

Contraindicatedwith

hypersensitivityto azithromycin,

erythromycin, orany macrolide

antibiotic.

CNS:

Dizziness, headache,

vertigo,

Somnolence, fatigue

GI:

Diarrhea, abdominal

pain,

Nausea,dyspepsia

Flatulence, vomiting,

mmelena

other:

superinfections,

angioedema,

rash, vaginitis.

DRUG-DRUG

INTERACTIO:

Decreased serum

levels and

effectiveness of

azithromycin with

aluminum and

magnesium-

containing antacids.

Possible increased

effects of

theophylline.

Possible increased

anticoagulant effectsof warfarin.

Storebetween 15-

30 degreeCelsius (59-


avoidexcessive

humidity

Culture site ofinfection befo

therapy. Administer on

stomach 1hr b2-3hr after me

Food affects tabsorption of

drug. Take the full c

prescribed. Do

take with antaTablets and orsuspension ca

taken with or food.

You may expethese side effe

stomach cramdiscomfort, di

fatigue,headache;add

infections in t

mouth or vagi


6/16


Name of Drug Date

Ordered

Classification Recommended

Dose & Frequency

Why given to

patient in relation tothe mechanism of

action

Contraindicat

ion

Side Effects/Toxic


Stability of

the Drug

Nursing Consider

Generic (Brand)

CefipimeHydrochloride

(Axera)

Dose/Frequency

Prescribed

1g in 100cc D5Win soluset of 8hrs

infusion no ANST

November

17, 2012

Antibiotic

Cephalosporins(third

generation)

Adults:2-8g/day IM or IV

equally divideddoses every 6-8hr.

Do not exceed12g/day.

It is given to pt. to

treat infection.The pt. manifested

pneumonia.

Therapeutic action:Bactericidal:

Inhibits synthesis ofbacterial cell wall,

causing cell death.

Contraindicated with

allergy tocephalospori

ns andpenicillins.

CNS:Headache, dizziness,lethargy, paresthesias.GI:N & V, diarrhea, anorexia,abdominalpain,pseudomembraneous

colitis.GU: Nephrotoxicity

HEMATOLOGICBone marrow epression-decreased WBC count,

platelets and Hct.

DRUG-DRUGINTERACTION:

Increased nephrotoxicitywith aminoglycosides,monitor renal function test.Increased bleeding effectswith oral anticoagulants,reduced dosage may beneeded.Increased toxicity ifcombined with alcohol,

avoid this combinationduring and for 3 days aftercompleting therapy.

Storebetween 15-

30 degreeCelsius (59-


avoidexcessive

humidity

Do not drink awhile taking t

and for 3 daysdrug has been

severe reactiooccur.


stomach upseappetite, naus

diarrhea, head

dizziness. Report severediarrhea, diffi

breathing, unutiredness or fa

pain at injecti Have vitamin

available in ca

hypoprothromoccurs.

Culture infectand arrange fo

sensitivity tesgiving therapy


7/16



Classification Recommended Dose& Frequency


mechanism of action




Nursing Consider

Generic (Brand)

Clopidoreglbisulfate


75mg/tab 1 tabOD

November26, 201

Antiplatelet

Adults:

300mg PO loadingdose, then 75mg/day

PO with aspirin,given at a dose from

75-325mg oncedaily.

Treatment to pt. at

risk for ischemicevents.

Therapeutic action:

Inhibits plateletaggregation byblocking ADP

receptors onplatelets, preventing

clamping ofplatelets.

Contraindicated

with allergy toclopidogrel,

activepathological

bleedeing such aspeptic ulcer or

intracranialhemorrhage,

lactation.

Use cautiouslywith bleedingdisorders, recent

surgery, hepaticimpairment.

CNS:

Headache,dizziness,

weakness, syncope,flushing.CV:Hypertension,edema.

DERMATOLOGIC:Rash, pruritus.

GI:Nausea. GI distress,constipation,diarrhea, GI bleed.

DRUG-DRUGINTERACTION:Increased risk of GIbleding withNSAID, monitor

patient carefully.Increased risk ofbleeding with

warfarin; monitorcarefully.

Store

between 15-30 degree


Fahrenheit)avoid

excessivehumidity

Provide frequentmeals if GI upset

not a s common Provide comfort

and arrange for aheadache occurs

Monitor patient fincreased bleedininvasive procedu

Take daily as premay be taken wit

report rash, chestfainting, severe habnormal bleedin

bruising.

You may experieside effects: dizz

lightheadedness,pass as you adjusdrug), headache

in a cool environrest; over the cou

preparations maynausa, gastric disfrequent small m

prolonged bleedidentist and healthprovider of this d


8/16





mechanism of action




Nursing Consider

Generic (Brand)

Furosemide( Lasix )


20 mg IV now

November26, 2012

Loop diuretic

Adults:

4o mg IV over 1-2min. May be

increased to 80mg IVgiven over 1-2min if

responseunsatisfactory after

1hr.

It is given to patient

to treat acutepulmonary edema.

Therapeutic actions:

Inhibits reabsorptionof sodium andchloride from the

proximal and distaltubules and

ascending limb atthe loop of Henle,

leading to a sodium-rich diuretics.

Contraindicated

with allergy offurosemide,

sulfonamides;allergy to

tartazine ( in oralsolution); anuria;

severe renalfailure; hepatic

coma.

Use cautiouslywith SLE, gout,Diabetes mellitus.

CNS:

Dizziness, vertigo,

xanthopsia,

weakness, headache,

irreversible hearing

loss.

CV:

Orthostatic

hypotension, volume

depletion,

thrombophlebitis.

DERMATOLOGIC:

Rash, pruritus,urticaria, purpura,

dermatitis.

GI:

Nausea, anotexia,

vomiting, jaundice,

acute pancreatitis.

DRUG-DRUG

INTERACTION:

Increased risk of

cardiac arrhythmias

with catdiac

glycosides. increased

risk of ototoxicitywith aminoglycosides

antibiotics.

Store



Fahrenheit)avoid

excessivehumidity

Administer wior ,milk to pre

upset. Reduce dosage

with otherantihypertensi

readjust dosag

gradually as B

responds. Give early in t

that increased will not disturb

Avoid IV use iuse as it is pos

Do not exposewhich may dis

tablet or oral sdo not use disc

drug or solutio Report loss or

more than 1.5kday, swelling i

ankles or finge


9/16




Why given topatient in relation to

the mechanism ofaction


interaction


Nursing Conside

Generic (Brand)

Hydrocortisonesodium succinate

(solu-cortef)


100mg every 8hrs

Novenber17, 2012

Corticosteroidhormones

100-500 mg initiallyand every 2, 4, or 6

hour based oncondition and

response.


preventinflammation of the

lungs that will leadthe pt. in difficulty

of breathing.

Contraindicated

with allergy toany component of

the drug, fungalinfections,

amebiasis,hepatitis b,

vacinia, orvaricella,and

antibiotic

resistantinfections,immunosuppressi

on.

CNS:Vertigo, headache,

insomnia, psychosis.

CV:

Hypotension, shock,

hypertension and heart

failure secondary to

fluid retention.

EENT:

Cataracts, glaucoma.

GI:

Peptic or esophageal

ulcer, pancreatitis.MUSCULOSKELET

AL:

Muscle weakness,

osteoporosis,

spontaneous fracture.

DRUG-DRUG

INTERACTION:

Increased steroid

blood levels with

hormonal

contraceptives,

troleandomycin,

ketoconazole,

estrogen.

Decreased serum level

of salicylates.

Store



Fahrenheit)avoid

excessivehumidity

Check label of hydrocortisoneroute that can ba particular prebecause IM andare not necessainterchangeabl

No part of hydacetate intrarecaerosol containbe inserted into

When corticostgiven chronicasmallest dose pthat will achievdesired effect.

At frequent intdose of medicashould be gradudecreased to desymptoms of dbe effectively cby the smaller drug.


10/16





mechanism of action




Nursing Consider

Generic (Brand)

Lactulose

Dose/Frequency

Prescribed

10cc every HS

Hold for BM 2xdose

November29,2012

Laxative

Adults:

15-30ml/day (10-20g/day) as a single

dose after breakfast(up to 60ml/day may

be required).

It is given to patient

for the treatment ofconstipation.

Therapeutic action:

The drug passesunchanged into the

colon where the

bacteria break itdown into organicacids that increase

the osmotic pressurein the colon and

slightly acidify thecolonic contents,

resulting in anincrease in stool

softening, laxativeaction.

Contraindicated

with allergy tolactulose, low

galactose diet.Use cautiously

with diabetes,pregnancy and

lactation.

GI:

Transientflatulence,

distention,intestinal cramps,

belching,diarrhea, nausea.

OTHER:Acid-base

imbalances,

electrolyteimbalance.

Store below

30 DegreeCelsius.

Avoidfreezing.

Report any pt. of GI distress. problem may sthe therapy conthe dose of memay need to be

The medicationcarbohydrate. Tobserve pt. for dry skin, compdry mouth and

thirst, a fruity obreath, abdomiand low BP. Thsymptoms ofhyperglycemiamore likely to oclients with dia

Keep th client cdry. Assess skicondition frequbecause skin brmay occur rapi

To minimize swdilute with watjuice or add to


11/16





mechanism of action




Nursing Consider

Generic (Brand)

Meropenenem(Merrem)


1g IV every 8

hrs. ANST

November20, 2012

Antibiotic Adults:

Meningitis, intra-

abdominal

infections:

1g IV every hr.

Skin and skin

structure infection:500mg IV every 8hr.

Therapeutic action:

Bactericidal: Inhibitssynthesis of bacterialcell wall and causes

cell death insusceptible cells.

Contraindicated

with allergy tocephalosporins,

penicillins, beta-lactams, lctstion.

Use cautiously

with CNSdisorders,

seizures, renal or

hepaticimpairment.

CNS:

Headache,dizziness,

lethargy, seizures,insomnia.

GI:N & V, diarrhea,

anorexia,abdominal pain,

flatulence,

pseudomembraneous colitis, livertoxicity.

DRUG-DRUG

INTERACTION:Possible toxic

levels ifcombined with

probenecid; avoidthis combination.

Store



Fahrenheit)avoid

excessivehumidity

This drug can given IV.


stomach upsetappetite, nause

drug with food

diarrhea(stay n

bathroom),headizziness.

Report severe difficulty breat

unusual tirednat injection sit

Monitor forsuperinfection

arrange treatm

appropriate. Discontinue dr

sign of colitis

arrange for app

supportive trea


12/16





mechanism of action

Contraindication

Side Effects/Toxiceffects/Drug-drug

interaction


Nursing Consid

Generic (Brand)

Omeprazole

(Omestop)

Dose/Frequency

Prescribed

40mg/tab

November

14, 2012

Proton pump

inhibitor20mg PO daily for

2-8wk. should not beused for

maintenancetherapy.


prevent fromirritation of the inner

lining of thestomach.

Contraindicat

ed withhypersensitiv

ity toomeprazole

or itscomponents.

CNS:

Headache, dizziness,asthenia, vertigo,

insomnia, apathy, anxiety.DERMATOLOGIC:rash,

inflammation, urticaria,pruritus, alopecia, dry

skin.GI:

Iarrhea, abdominal pain,

constipation, dry mouth,tongue atrophy.RESPIRATORY:

URI symptoms, cough,epistaxis.

DRUG-DRUGINTERACTION:

Increased serum levelsand potential increase in

toxicity ofbenzodiazepines,

phenytoin, warfarin,; if

these combinations areused, monitor pt. closely.

Store

between15-30

degreeCelsius

(59-86degree

Fahrenheit)avoid

excessive

humidity

Administer bmeals. Cautiswallow caps

whole-not tochew, or crus

using oral suempty packe

cup containinwater. Stir an

to drink imm

fill cup with have pt. drinkwater. Do no

other diluent Administer a

with, if neede Review the l

effects assocdrug therapy

instruct clienpersistent sym

Report any curinary elimipain and discassociated w


13/16





mechanism of action




Nursing Consider

Generic (Brand)

Dose/Frequency

Prescribed


14/16

Name of Drug Date

Ordered


& Frequency





interaction

Stability of

the Drug

Nursing Consider


15/16


Generic (Brand)


Name of Drug Date

Ordered


& Frequency





interaction

Stability of

the Drug

Nursing Consider


16/16


Generic (Brand)


drugstudy_ grand cp

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