eent drug study2

8/6/2019 Eent Drug Study2

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Drug DrugClass.

TherapeuticActions

Indications Contraindications Adverse Effect

Ranitidine

Brand name:Taladine, Zantac

Histamine-stimulatesthestomach

cells to produce

acid.

Anti -ulcer agents

Treatment and prevention of heartburn, acidindigestion,

and sour stomach

•Hypersensitivity,

Cross-sensitivity may

occur; some oral

liquids contain alcohol

and should be avoided

in patients with known

intolerance.

Use Cautiously in:

• Renal impair- ment

• Geriatric patients

(more

susceptible to adverse

CNS reactions)

• Pregnancy or

Lactation

• CNSConfusion, dizziness, drowsiness,hallucinations,headache

• CV:Arrhythmias

• GI:

Altered taste, black tongue,

constipation, dark stools,

diarrhea, drug-induced hepatitis, nausea

• GU:Decreased sperm count, impotence• ENDO:Gynecomastia

• HEMAT:

Agranulocytosis, Aplastic Anemia,

neutropenia,

thrombocytopenia

• LOCAL:Pain at IM site

• MISC:

Hypersensitivity reactions, vasculitis



Tramadol

Brand name:

Rybix ODT, Ryzolt,Ultram

Analgesics(centrallyacting)

PhysiologicMechanism

• Decreased pain.

PharmacologicMechanism

• Binds to mu-opioidreceptors.

• Inhibitsreuptake of

serotonin and

norepinephrinein the CNS.

Moderate tomoderately severe

pain• where opioids

are

contraindicated,

including acute

intoxication with

any of the

following: alcohol,

hypnotics,

narcotics, centrally

acting analgesics,

opioids or

psychotropic

drugs.

• worsen central

nervous systemand respiratory

depression in these

patients.

Body as a Whole – Asthenia, fatigue,hot flushes

Central and Peripheral NervousSystem – Dizziness, headache, tremor

Gastrointestinal System – Abdominal pain, constipation, diarrhea, dyspepsia,flatulence, dry mouth, nausea, vomiting

Psychiatric Disorders – Anorexia,anxiety, confusion, euphoria, insomnia,nervousness, somnolence

Skin and Appendages – Pruritus, rash,increased sweating.

Selected Adverse events occurring atless than 1%: the following lists

clinically relevant adverse reactions thatoccurred with an incidence of less than

1% in ULTRACET® clinical trials.

Body as a Whole – Chest pain, rigors,syncope, withdrawal syndrome

Cardiovascular Disorders–

Hypertension, aggravated hypertension,hypotension

Central and Peripheral Nervous

System – Ataxia, convulsions,hypertonia, migraine, aggravatedmigraine, involuntary muscle



contractions, paresthesias, stupor,vertigo

Gastrointestinal System– Dysphagia,melena, tongue edema

Hearing and Vestibular Disorders –

Tinnitus

Heart Rate and Rhythm Disorders –

Arrhythmia, palpitation, tachycardia

Liver and Biliary System– Hepaticfunction abnormal

Metabolic and Nutritional Disorders

– Weight decrease

Psychiatric Disorders – Amnesia,depersonalization, depression, drugabuse, emotional lability, hallucination,impotence, paroniria, abnormal thinking

Red Blood Cell Disorders – Anemia

Respiratory System – Dyspnea

Urinary System – Albuminuria,micturition disorder, oliguria, urinaryretention

Vision Disorders – Abnormal vision



Ciprofloxacin brandname: Cipro

Antibacterial

Fluoroquinolone Bactericidal;

interferes withDNAreplication insusceptible

bacteria preventing cell

reproduction.

For the treatment of infections caused bysusceptible gram-negative bacteria,including E. coli, P.

mirabilis, K. pneumoniae,Enterobacter cloacae,P. vulgaris, P.rettgeri, M. morganii,P. aeruginosa,Citrobacter freundii,

S. aureus, S.epidermidis, group D

streptococci

Contraindicated withallergy tociprofloxacin,norfloxacin or other fluoroquinolones,

pregnancy, lactation.

Use cautiously withrenal dysfunction,seizures, tendinitis or tendon ruptureassociated withfluoroquinolone use.

CNS: Headache, dizziness, insomnia,

fatigue, somnolence, depression, blurred vision

CV: Arrhythmias, hypotension, angina

EENT: Dry eye, eye pain, keratopathy

GI: Nausea, vomiting, dry mouth,diarrhea, abdominal pain

Hematologic: Elevated BUN, AST,

ALT, serum creatinine and alkaline phosphatase; decreased WBC,neutrophil count, Hct

Other: Fever, rash



Calciumcarbonate

Brand name: Alka-Mints, Alkets,

Alkums, Amilac-antacids

- Calcium

carbonate isused to prevent

and to treatcalcium

deficiencies.

- As a dietarysupplement wherecalcium intake may

be inadequate:childhood,

adolescence,adulthood, pregnancy, lactation, perimenopausal and postmenopausalwomen and in theaged.

- Hypercalcemia andhypercalciuria (e.g.hyperparathyroidism,vitamin D overdosage,decalcifying tumorssuch as

plasmocytoma, bonemetastases); severerenal disease; and incalcium loss due toimmobilization.Hypersensitivity toany of thecomponents.

-

• upset stomach• vomiting

• stomach pain• belching• constipation

• dry mouth• increased urination• loss of appetite

• metallic taste

-

http://www.revolutionhealth.com/drugs-treatments/alka-mints


http://www.revolutionhealth.com/drugs-treatments/alkets

http://www.revolutionhealth.com/drugs-treatments/alkums

http://www.revolutionhealth.com/drugs-treatments/amilac

http://www.drugs.com/drug-class/antacids.html






http://www.drugs.com/drug-class/antacids.html



Vitamin bcomplex

- thiamine(B1),

riboflavin(B2),niacin(B3),

pantothenicacid (B5),

pyridoxine(B6), biotin(B7), folicacid or folate (B9),

cobalamin(B12)

- essential for growth,development,and a variety of other bodilyfunctions. They

play a major role in the

activities of enzymes,

proteins thatregulate

chemicalreactions in the

body, whichare importantin turning foodinto energy andother neededsubstances.

-patients with chronicobstructive

pulmonary disease

(COPD) on a regular aerosol bronchodilator whocontinue to haveevidence of

bronchospasm andwho require a second

bronchodilator

-history of hypersensitivity tosoya lecithin or relatedfood products such assoybean and peanut.

-cardiac

-allergic reactions (Rash, Oropharyngealedema, angioedema, bronchospasm)



CombiventBrand name:Combivent, DuoNeb

bronchospasms

(combination of

ipratropiumand

albuterolinhaler )

-prevent airwayspasms

-osteoarthritis,

rheumatoid arthritis, acute pain, painfulmenstruation and

menstrual symptoms,ankylosingspondylitis and toreduce the number of colon and rectal

polyps in patientswith familialadenomatous

polyposis. It wasoriginally intended torelieve pain whileminimizing thegastrointestinaladverse effectsusually seen withconventional

NSAIDs.

-with allergies tosulfonamides,

celecoxib, NSAIDS,or aspirin, significantrenal empairment;

pregnancy (third tri),lactation

-headache, abdominal pain, dyspepsia,diarrhea, nausea, flatulence, andinsomnia.

http://lungs.emedtv.com/ipratropium-and-albuterol-inhaler/ipratropium-and-albuterol-inhaler.html




http://www.ask.com/wiki/Osteoarthritis?qsrc=3044

http://www.ask.com/wiki/Rheumatoid_arthritis?qsrc=3044

http://www.ask.com/wiki/Acute_pain?qsrc=3044

http://www.ask.com/wiki/Menstruation?qsrc=3044

http://www.ask.com/wiki/Ankylosing_spondylitis?qsrc=3044


http://www.ask.com/wiki/Familial_adenomatous_polyposis?qsrc=3044



http://www.ask.com/wiki/Non-steroidal_anti-inflammatory_drug?qsrc=3044

http://www.medicinenet.com/script/main/art.asp?articlekey=20628






























CelecoxibBrandname:celebrex

-analgesics

-nonsteroidalantiinflammatory drug(NSAID) thatis used to treatarthritis, pain,menstrualcramps, and

colonic polyps.Prostaglandinsare chemicalsthat are

importantcontributors to

theinflammation

of arthritis thatcauses pain,

fever , swelling

and tenderness.

- lower respiratory

tract infections,skinand skin structureinfections, urinary

tract infections, bacterial septicemia, bone and jointinfections,gynecologicinfections, intraabdominal infections(including

peritonitis), andcentral nervoussystem infections(includingmeningitis).

- hypersensitivity toceftazidime or thecephalosporin groupof antibiotics.

- Diarrhea; headache; nausea; numbnessor tingling of skin; stomach pain;vomiting.




















CeftazidimeBrand name: Fortazand Tazicef

-antibiotics

-Treating bacterialinfections.

DRUG DRUG CLASS THERAPEUTICACTIONS

INDICATIONS CONTRAINDICATIONS ADVERSE AFFECT

9.CeftazidimeBrand name: Fortaz

and Tazicef

-antibiotics -Treating bacterialinfections.

- lower respiratorytract infections,skin

and skin structureinfections, urinarytract infections,

bacterial septicemia, bone and jointinfections,gynecologicinfections, intra

- hypersensitivity toceftazidime or the

cephalosporin group of antibiotics.

- Diarrhea; headache;nausea; numbness or

tingling of skin;stomach pain;vomiting.



10.CelecoxibBrandname: celebrex

-analgesicsnonsteroidalantiinflammatorydrug (NSAID) that isused to treat arthritis,

pain, menstrualcramps, and colonic

polyps.Prostaglandins arechemicals that areimportantcontributors to theinflammation of arthritis that causes

pain, fever , swellingand tenderness.

abdominal infections(including

peritonitis), andcentral nervous

system infections(including

meningitis).

-osteoarthritis ,rheumatoid arthritis,acute pain, painfulmenstruation andmenstrual

symptoms,ankylosing

spondylitis and toreduce the number

of colon and rectal polyps in patients

with familialadenomatous

polyposis. It wasoriginally intendedto relieve pain whileminimizing thegastrointestinaladverse effectsusually seen withconventional

-with allergies tosulfonamides, celecoxib,

NSAIDS, or aspirin,significant renalempairment; pregnancy

(third tri), lactation

--headache,abdominal pain,dyspepsia, diarrhea, nausea, flatulence, and insomnia.
























































11.CombiventBrand name:Combivent, DuoNeb

-bronchospasms(combination of ipratropium andalbuterol inhaler )

-prevent airwayspasms

NSAIDs.

-patients withchronic obstructive

pulmonary disease(COPD) on a regular aerosol

bronchodilator whocontinue to haveevidence of

bronchospasm andwho require asecond

bronchodilator -history of hypersensitivity to soyalecithin or related food

products such as soybeanand peanut.

-cardiac

-allergic reactions(Rash, Oropharyngealedema, angioedema,

bronchospasm)









12.Vitamin bcomplex

- thiamine (B1),riboflavin (B2),niacin (B3),

pantothenic acid(B5), pyridoxine(B6), biotin (B7),folic acid or folate(B9), cobalamin(B12)

- essential for growth,

development, and avariety of other

bodily functions.

They play a major role in the activities

of enzymes, proteinsthat regulate

chemical reactions inthe body, which are

important in turningfood into energy and

other neededsubstances.

- As a dietarysupplement wherecalcium intake may

be inadequate:childhood,

adolescence,adulthood,

pregnancy, lactation, perimenopausal and

postmenopausal

women and in theaged.

- Hypercalcemia andhypercalciuria (e.g.

hyperparathyroidism,vitamin D overdosage,

decalcifying tumors suchas plasmocytoma, bone

metastases); severe renaldisease; and in calciumloss due toimmobilization.Hypersensitivity to any of the components.

• upset

stomach•

vomiting• stomach pain• belching

• constipation• dry mouth• increased

urination• loss of

appetite• metallic taste



13.Calciumcarbonate

Brand name: Alka-Mints, Alkets,Alkums, Amilac

-antacids

-Calcium carbonateis used to prevent

and to treat calciumdeficiencies.

- For the treatment

of infections caused by susceptible gram-negative bacteria,

including E. coli, P.mirabilis, K.

pneumoniae,Enterobacter cloacae, P. vulgaris,P. rettgeri, M.morganii, P.aeruginosa,

Citrobacter freundii,S. aureus, S.epidermidis, groupD streptococci

- Moderate to

moderately severe

pain

- Contraindicated withallergy to ciprofloxacin,norfloxacin or other fluoroquinolones,

pregnancy, lactation.

Use cautiously with renaldysfunction, seizures,tendinitis or tendonrupture associated withfluoroquinolone use.

•

CNS: Headache,

dizziness, insomnia,fatigue, somnolence,

depression, blurredvision

CV: Arrhythmias,

hypotension, angina

EENT: Dry eye, eye pain, keratopathy

GI: Nausea,vomiting, dry mouth,diarrhea, abdominal

pain













15.Tramadol

Brand name:

Rybix ODT, Ryzolt,Ultram

Analgesicsnonsteroidalantiinflammatorydrug (NSAID) that isused to treat arthritis,

pain, menstrualcramps, and colonic

polyps.Prostaglandins are

chemicals that areimportant

contributors to theinflammation of

arthritis that causes pain, fever , swelling

and tenderness.

Disorders –

Anorexia, anxiety,confusion, euphoria,insomnia,nervousness,somnolence

Skin and

Appendages –

Pruritus, rash,increased sweating.

Selected Adverse

events occurring atless than 1%: the

following listsclinically relevant

adverse reactions thatoccurred with anincidence of less than1% in ULTRACET®

clinical trials.

Body as a Whole –

Chest pain, rigors,syncope, withdrawal
























syndrome

Cardiovascular

Disorders–

Hypertension,aggravatedhypertension,hypotension

Central and

Peripheral Nervous

System – Ataxia,convulsions,hypertonia, migraine,aggravated migraine,involuntary muscle

contractions, paresthesias, stupor,vertigo

Gastrointestinal

System– Dysphagia,melena, tongueedema

Hearing and

Vestibular

Disorders – Tinnitus

Heart Rate and

Rhythm Disorders –

Arrhythmia, palpitation,

tachycardia

Liver and Biliary



Treatment and

System– Hepaticfunction abnormal

Metabolic and

Nutritional

Disorders – Weightdecrease

Psychiatric

Disorders –

Amnesia,depersonalization,depression, drugabuse, emotionallability, hallucination,impotence, paroniria,

abnormal thinking

Red Blood Cell

Disorders – Anemia

Respiratory System

– Dyspnea

Urinary System –

Albuminuria,micturition disorder,

oliguria, urinaryretention

Vision Disorders –

Abnormal vision



16.RanitidineBrand name:Taladine, Zantac

Histamine-stimulates the

stomach cells to produce acid.

Anti -ulcer agents prevention of heartburn, acidindigestion,and sour stomach

•Hypersensitivity, Cross-

sensitivity may occur;

some oral liquids containalcohol and should be

avoided in patients with

known intolerance.

Use Cautiously in:

• Renal impair- ment

• Geriatric patients (more

susceptible to adverse

CNS reactions)• Pregnancy or Lactation

• CNSConfusion, dizziness,

drowsiness,hallucinations,headache• CV:Arrhythmias

• GI:

Altered taste, black

tongue, constipation,



dark stools,

diarrhea, drug-

induced hepatitis,

nausea

• GU:Decreased spermcount, impotence• ENDO:Gynecomastia

• HEMAT:

Agranulocytosis,

Aplastic Anemia,

neutropenia,

thrombocytopenia

• LOCAL:Pain at IM site• MISC:

Hypersensitivityreactions, vasculitis



ASSESSMENT NURSINGDIAGNOSIS

INFERENCE OBJECTIVES INTERVENTION/IMPELEMTATION

RATIONALE EVALUATION

S: “nahihirapan po siyang

magsalita” asverbalized by the

patients relative.

O:

Impaired verbalcommunication

related to Physical barrier

( tracheostomy,nasogastric tube)

Upper airwayobstruction

Tracheostomy,

nasogastric tubeinserted

Difficultyvocalizing words

After 4 hours of nursing

intervention the patient will be

able to:- use a form of

communication to

get needs met andto relateeffectively with

persons and his or her environment.

- Provide alternativemethods of

communication, like pictures or visual

cues,gestures or

demonstration.

- Place importantobjects withinreach.

-Anticipate and provide for patient’s needs

- Providecommunication

needsor desires based

onindividual

situation or

underlying deficit.

- This maximizes

patient’s sense of independence.- Helpful indecreasingfrustration whendependent onothers

After 4 hours of nursing

intervention the patient able to:

- use a form of communication to

get needs met and

to relateeffectively with persons and his or

her environment.



- Talk directly to

patient.

Speaking slowlyanddirectly. Use yes or

noquestion to begin

with.

- Speak in normaltones

and avoid talkingtoo fast.Give patient ampletimeto respond.

- Encourage familymembers andvisitors to

persist efforts to

communicate withthe

patient.

and unable tocommunicatedesires.- It reduces

confusionor anxiety and

having

to process andrespond to largeamount of

information at onetime.

- Patient is notnecessary hearingimpaired andraisingvoice may irritateor

anger the patient.- It is importantfor family memberstocontinue talkingtothe patient toreduce

patients isolation, promote

establishment of effectivecommunicationandmaintain sense of

connectedness or bonding with the

family.






S: “di po xamasyadonagkikilos” as

verbalized by the patients relative.

O:

Activityintolerance relatedto Imposed

activity restriction

Insufficient physiological or psychological

energy to endureor completerequired or desired dailyactivities

After 5 hours of nursingintervention the

patient will beable to:- maintainsactivity levelwithincapabilities, asevidenced bynormal heart rateand blood

pressure duringactivity, as well as

absence of shortness of

breath, weakness,and fatigue.

- Establishguidelines and goalsof activity with the

patient andcaregiver.

- Assess the level of mobility and the

physical conditionof the patient

-Assess thenutritional status of the patient

- Support patient in

doing ROMexercises at least 3

times a day.

- Note changes in

balance/ gaitdisturbance, muscle

weakness.

- Motivation isenhanced if the

patient

participates ingoal setting.

- Helps inknowing thecapability of

patientwhich is neededin settinggoals.- Adequate energy

isneeded for activities to bedone.

- Exercise sustain

muscle strengthand ROM.

- May indicateneurological

changesassociated

with vitamin B12deficiency,

affecting patient safety or

risk of injury.

- Promotes


patient able to:- maintainsactivity levelwithincapabilities, asevidenced bynormal heart rateand blood

pressure duringactivity, as well asabsence of

shortness of breath, weakness,and fatigue.



s:

O:- t/c malignant

Risk for infectionrelated toInadequateacquired

immunity

At increased risk for being invaded

by pathogenicorganisms


patient will:

- Identifyinterventions

techniques to

prevent/ reducerisk factors-Demonstrate

techniques,lifestyle changes

to promote safeenvironment

- Teach patient towash handsoften,especially

beforetoileting,

before meals

and before andafter administering

self-care

-Discuss to patientsthefollowing signsof infection-redness,swelling,increased pain,

or purulentdrainage on thesite and fever

- Note risk factorsfor occurrence of infection.

- observed for localized sign of infection at

insertion sites of invasive lines,surgical incisions or wounds.- Review

environmentalfactors.

- Hand washingreduces therisks for infection

- To impart to

the patientwhen thewound

becomeinfected andwhen to

soughtmedicalcare- to evaluate

presence/character of infection.- to evaluate

presence/character of infection.

- to assess if thereis

a need of avoidance

or modification of environment to


patient will now:

- Identifyinterventions

techniques to

prevent/ reducerisk factors-Demonstrate

techniques,lifestyle changes

to promote safeenvironment



- Monitor clientsvisitors/ caregivers

for respiratory

illnesses. Offer masks and tissues toclient/ visitors who

are coughing/sneezing.

- Instruct client intechniques to

protect the integrityof skin, care of lesions and

prevention of spreadof infection.

reduce incidenceof infection.- To limit

exposures, thisreduce cross

contamination

- Instruct client

in techniques to protect theintegrity of skin,care of lesionsand prevention of spread of

infection.




S: “ Risk for aspiration relatedto Presence of tracheostomy andtube feedings

At risk for entryof gastrointestinalsecretions,oropharyngealsecretions, or solids or fluids


patient will beable to:- Patient’s risk of

- Assess pulmonarystatus for clinicalevidence of aspiration.Auscultate breathsounds for

-Aspiration of small amounts canoccur withoutcoughing or sudden onset of respiratory


patient risk of aspiration isdecreased as a



intotracheobronchial

passages

aspiration isdecreased as aresult of ongoingassessment and

early intervention.

development of crackles and/or rhonchi.

- In patients with

endotracheal or tracheostomy tubes,monitor the

effectiveness of thecuff. Collaborate

with the respiratorytherapist, as needed,to determine cuff

pressure.- Keep suction setupavailable (in both

hospital and homesettings) and use asneeded.- Notify the

physician or other health care provider immediately of noted decrease incough and/or gagreflexes or difficultyin swallowing.

- Provide oral careafter meals.

-

distress,especially in

patients withdecreased levels

of consciousness.- An ineffective

cuff can increase

the risk of aspiration.

- This is necessaryto maintain a

patent airway.

- Earlyintervention

protects the patient’s airwayand preventsaspiration.

- This removesresiduals and

reduces pocketingof food that can

be later aspirated.-

result of ongoingassessment andearly intervention.

eent drug study2

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