Medication Aminoleban Dose/route: 1 sachet 50 g

action Given to normalize the amino acid, carbohydrate s, fats, vitamins and minerals in the plasma

Indication For the treatment of Hepatic Encephalopathy in patient with chronic liver disease.

Contraindication Patient with abnormal amino acid metabolism (since the infuse amino acids are not adequately metabolized, the patient clinical condition may be worsened.)

Freq/timing: q12 (6-6)

classification: A balance and tolerable food supplement to nutritionally support patients with liver disease.

Side effects Nursing responsibilities Hypersensit Asses ivity: rare patients skin condition eruptions before Gastrointes starting tinal: the occasional therapy. nausea and Be alert vomiting to Others: adverse occasional reaction. chills, fever, Monitor headache patient temperat ure. If GI reaction occur monitor patient hydration .

Medication Metronidazole Brand ne0e: Flagyl Dose/route: 500 mg 1 tab

action An antibiotic effective against anaerobic bacteria and certain parasites. Selectively blocks some of the functions within the bacterial cells and the parasites resulting in their death.

indication For bacterial infection caused by anaerobic microorganism.

Contraindicati on Contraindicat ed to patient hypersensitiv e to drug or other nitroimidazole derivatives.

Side effects Nausea, diarrhea, and/or metallic taste in the mouth. Hypersensitivit y reactions (rash, itch, flushing, fever), headache, dizziness, vomiting, dark urine

Nursing responsibilities Asses patients condition before starting the therapy. Be alert to adverse reaction. Give drugs with meal to minimize GI distress. Inform patient metallic taste dark or red brown urine may occur. Advice patient to stand slowly to prevent dizziness.

Freq/timing: Tid (8-1-6)

Classification: Antibiotic

Name of Drug Generic Name:

Dosage/ Time/ Route 125 mg/mL 1-2 inj/day. 250 mg/mL 1 inj/day

Indications Cerebrovascular Diseases, accelerates the recovery of consciousness and overcoming motor deficit.

citicholineBrand Name:

ZynapseClassification:

CNS stimulantReference: Daviss Drug Guide for Nurses Fifth Edition pp. 237-238

Mechanism of Actions Citicoline activates the biosynthesis of structural phospholipids in the neuronal membrane, increases cerebral metabolism and increases the level of various neurotransmitters, including acetylcholine and dopamine. Citicoline has shown neuroprotective effects in situations of hypoxia and ischemia.

Contraindicatio n Hypersensitivity to drugs

Side Effects citicoline may exert a stimulating action of the parasympathetic, as well as a fleeting and discrete hypotension effect

Nursing Responsibilities Watch out for hypotensive effects Somazine must not be administered along with medicaments containing meclophenoxate Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places.

y

y y y

Drug Name isosorbide-5- dinitrate Imdur Oral 40mg OD

Mechanism of Action Increases supply of oxygen to the heart by dilating both the arteries and veins which supply the heart itself.

Indication Preventive and longterm treatment of angina pectoris/post myocardial infarction angina. Treatment of severe congestive heart failure in combination with cardiac glycosides, diuretics, angiotensinconverting enzyme inhibitors, arterial vasodilators, pulmonary hypertension

Side Effects Adverse reactions: transient hypoxemia, headache, fall in BP, reflex rise in PR, dizziness. Nausea, vomiting, transient skin disorders and allergic skin reactions may sometimes occur.

Contraindications Acute MI with low filling pressures, except in ICU with continuous hemodynamic monitoring; left heart failure with low filling pressures; shock; very low blood pressure; circulatory collapse; hypertrophic

Nsg. Considerations -assess for pain; duration, time started, activity being performed, character, intensity -monitor BP, pulse at baseline and during treatment

Cardiovascular drug: Osmotic Diuretic

Generic (Trade Name) Ipratropium Br, Salbutamol/ albuterol sulfate (Combivent )

Dosage Frequency Neb q 4 hours (12 am-4am8am-12pm4pm-8pm)

Classification

Indication

Contraindication

Adverse Reaction

Nursing Responsibilities

Antiasthmatic & COPD Preparations

Management of reversible bronchospasm associated with obstructive airway diseases in patients who require more than a single bronchodilator

Fine tremor of Skeletal Muscle; Palpitations; Headache, 2.) Patients with dizziness, Hypertropic nervousness; obstructive Dryness of the cardiomyopath mouth, throat y irritation; urinary 3.) Patients retention. having tachyarrythmia .

1.) Patients who is allergic to the Drugs.

1.) Use Cautiously to patients with known sensitivity to atropine, soybeans, soya lecithin, and peanuts. 2.) Assess Vital Signs Before drug administration 3.) Observe for paradoxical bronchospasm (Wheezing). If Condition occurs, withhold Medication and notify physician or other health care professional immediately. 4.) Instruct patient to contact health care professional immediately if shortness of breath is not relieved by medication or is accompanied by diaphoresis, dizziness, palpitations, or chest pain. 5.) Advise the patient to rinse mouth with water after using

the nebulizer to minimize dry mouth.

Generic/ Trade NameMontelukast (Kastair)

Dosage Frequency10 mg (8pm)

ClassificationAntiasthmatic & COPD Preparations

IndicationTreatment of bronchial asthma, allergic rhinitis, concomitant to bronchial asthma.

Contraindication1.) Do not use for treatment of acute asthma attacks.

Adverse ReactionRash, angioedema, pruritus, & urticaria. Dizziness, headache, dream abnormalities, hallucinations, paresthesia, drowsiness, infectious gastroenteritis, diarrhea, nausea & vomiting.

Nursing Responsibilities1.) Assess eosinophil count 2.) Monitor temperature . Watch for fever and symptoms of infection. 3.) Inform patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.

DRUGSGeneric Name Isosorbide Dinitrate / Mononitrate Brand Name ISOKET ISORDIL Classification CV Drugs (Anti-anginal DrugsOrganic Nitrates) Dosage tab 5mg amp 5mg/2ml

ACTIONIncrease supply of oxygen to the heart by dilating both the arteries & veins which supply the heart itself.

INDICATIONPreventive & long-term treatment of angina pectoris/post MI angina. Treatment of severe CHF in combination w/ cardiac glycosides, diuretics, ACEinhibitors, arterial vasodilators, pulmonary hypertension.

CONTRAINDICATION Acute MI w/ low-filling pressures (except in ICU w/ continuous hemodynamic monitoring) Left heart failure w/ lowfilling pressures Shock Very low BP

ADVERSE EFFECTS Transient Hypoxemia Headache Decrease BP Rise in PR Dizziness Weakness Nausea Vomiting Transient skin disorders Allergic reactions

NURSING RESPONSIBILITY Assess for pain: location, type, character, intensity. Monitor BP, PR during treatment. Caution pt. to make position changes slowly to prevent Orthostatic Hypotension. Warn pt. to avoid alcohol & OTC medications unless approved by the doctor. Inform pt. that the drug may be taken before stressful activity. Advise pt. to avoid hazardous activities if dizziness occurs & sudden position changes to prevent Orthostatic Hypotension.

DRUGS

ACTION

INDICATIONAnxiety & tension states; Depressive mood; Nervous tension; Agitation & Insomnia. Functional disturbances of the CV & Respiratory systems, GIT, GUT. Adjuvant to psychotherapy in psychoneurosis.

CONTRAINDICATION Pregnancy (Category D) Lactation Myasthenia Gravis Hypersensitivity

ADVERSE EFFECTS Acute Anxiety Insomnia Excitation (Discontinue) Hallucinations

NURSING RESPONSIBILITY Assess degree of anxiety & level of sedation. Monitor VS, adverse effects, laboratory examination, doses for elderly, malnourished pt. with liver or renal function, & w/ CV diseases. Caution pt. to avoid taking alcohol or other CNS depressants concurrently with this medication. Advise pt. that drug may impair ability to drive vehicles & to operate machinery. Teach pt. that during course of therapy, tolerance to sedative effects usually develops.

Generic Name Depress the Bromazepam CNS, probably by potentiating Brand Name GABA, an inhibitory LEXOTAN neurotransmitter. Classification Produces skeletal muscle relaxation CNS Drugs (Benzodiazepines) by inhibiting spinal polysynaptic afferent Dosage pathways. tab 1.5mg

Generic Name

Ampicillin Sodium

Brand Name

Ampisan

Functional Classification

Systemic Anti-infectives

Chemical Classification

Penicillins

Indication

Treatment of UTI, otitis media, sinusitis, bronchitis, uncomplicated community-acquired pneumonia, Haemophilusinfluenzae infections and invasive salmonellosis.

Contraindication

Hypersensitivity to penicillins. Infectious mononucleosis. Use cautiously with renal disorders.

Mode of Action

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Ideal Dosage Preparation and Supply Form

IVAdult Usual Dose: 1-2 gramsevery 4-6 hours in slow intravenous injection over 10-15 minutes. 1 gram vial will be diluted in 7.4ml of distilled or bacteriostatic water to have a 135/ml concentration and 2 gram vial with 14.8ml distilled water for 135/ml concentration. Route Onset Peak Duration

I.V.

Immediate

5 min

6-8 hr

Adverse Effect

Skin rashes including urticaria or maculopapular

rash. Diarrhea, nausea and vomiting, and pseudomembranous colitis. Simultaneous use with oral contraceptives may Drug Interaction lead to increased risk of breakthrough bleeding and reduced efficacy of the contraceptive. Skin rash increased with allopurinol. Probenecidincreases blood levels. Synergism with -lactamase inhibitors, clavulanic acid or sulbactam, penicillinase-stable drugs eg, cloxacillin or flucloxacillin and aminoglycosides. Potentially Fatal: Increases disulfiram and anticoagulant effects. Ampicillin is a broad spectrum antibiotic which is Rationale for Giving the Medication active against Gram-positive and Gram-negative bacteria. It is given to kill a wide range of bacteria since no culture was done to identify the specific bacteria causing the infection. Thus, treating the underlying cause of the disease (UTI) will alleviate its symptoms including dysuria and lumbar pain. A. Assessment Nursing Responsibilities - History: Allergies to penicillins, cephalosporins, or other allergens; renal disorders - Physical: Culture infected area; skin color,

lesion; Respiratory, adventitious sounds; bowel sounds; liver and renal function tests, serum electrolytes, hematocrit, urinalysis. B. Interventions 1. Observe patients 10 rights in drug administration. 2. Monitor patients vital signs to serve as baseline data and to determine the effectiveness of the drug. 3. Check IV site carefully for signs of thrombosis or drug reaction. 4. For direct I.V. injection, give over 10 - 15 minutes. Dont exceed 200 mg/minute.More rapid administration may result in convulsive seizures. 5. Change I.V. site every 48 hours. 6. Watch for signs and symptoms of hypersensitivity reaction. 7. Monitor for bleeding tendency or hemorrhage.

Name of Drug Generic Name: Cefuroxime Trade Name: Ceftin

Classification of Drug Therapeutic: Anti-infectives

Content:

Mechanism of Action Bind to bacterial cell wall Pharmacologic: membrane, Second causing cell generation death Cephalosporins Therapeutic Pregnancy Effects: Catergory B Bactericidal action

Indication Treatment of It is effective for the treatment of penicillinaseproducingNeisseria gonorrhoea(PPNG). Effectively treats bone and joint infections, bronchitis, meningitis, gonorrhea, otitis media, pharyngitis/tonsilliti s, sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used for surgical prophylaxis, reducing or eliminating infection.

Contraindications Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation.

Side Effects GI: Diarrhea, nausea, antibioticassociated colitis. Skin: Ra sh , pruritus, urticaria. Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance. Hemat: Hemolytic anemia MISC: Anaphylaxis

Nursing Responsibilities Before:

Determine history of hypersensitivity reacti ons to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated.

Maximum Dose:

Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results. Monitor periodically BUN and creatinine clearance.

Minimum Dose:

Availability: Tablets: 125mg, 250mg, 500mg Powder for injection: 750mg, 1.5g, 7.5g Premixed

containers: 750 mg/50ml, 1.5g/50ml

During:

Inspect IM and IV injection sites frequently for signs of phlebitis.

Source: Davis Drug Guide for Nurses 10th Edition

Monitor for manifestations of hypersensitivity (see Appendix F). Discontinue drug and report their appearance promptly.

Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

Report onset of loose stools or diarrhea. Although pseudomembranous colitis (see Signs &

Symptoms, Appendix F) rarely occurs, this potentially lifethreatening complication should be ruled out as the cause of diarrhea during and after antibiotic therapy. After: y Instruct patient to take medication around the clock at evenly spaced times and to finish the medication completely, even if feeling better y Advise patient to report signs of superinfection and allergy y Instruct patient to notify health professional if fever and diarrhea develop