Drug Study

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Drugs Name RANITIDINE (Zantac)

Classification Histamine Blocker

Indication Treatment and prevention of heartburn, acid indigestion, and sour stomach.

Action Potent anti-ulcer drug that competitively and reversibly inhibits histamine action at H2-receptor sites on parietal cells, thus blocking gastric acid secretion. Indirectly reduces pepsin secretion but appears to have minimal effect on fasting and postprandial serum gastrin concentrations or secretion of gastric intrinsic factor or mucus.

Contraindications/ Precautions Contraindicated with allergy to ranitidine, lactation. Use cautiously with impaired renal or hepatic function and pregnancy.

Adverse Reaction

Patient/ Family Teaching CNS: Take drug Confusion, with meals and dizziness, at bedtime. drowsiness, Therapy may hallucinations, continue for 4headache 6 weeks or CV: longer. Arrhythmias If you are GI: also using an Altered taste, antacid, take it black tongue, exactly as constipation, dark prescribed, stools, diarrhea, being careful of nausea the times of GU: administration. Decreased sperm Have regular count, impotence medical follow HEMATOLOGY: up care to Agranulocytosis, evaluate your neutropenia, response. thrombocytopenia Report sore MISC: throat, fever, Hypersensitivity unusual reactions, bruising or vasculitis bleeding, tarry stools, severe headache, muscle or joint pain.

Drugs Name Phospho-soda (sodium biphosphate and sodium phosphate)

Classification Laxatives, Purgatives

Indication Relief of occasional constipation. For bowel cleansing prior to medical procedures e.g. surgery, x-ray or endoscopic exam.

Action Saline laxative; osmotically mediated water retention which stimulates peristalsis.

Contraindications/ Adverse Reaction Precautions Impaired renal Transient function, hyperphosphatemia. preexisting electrolyte imbalances, and debilitated patients. Rectal bleeding or no bowel movement after use.

Patient/ Family Teaching Should be taken on an empty stomach (Take on an empty stomach 1 hr before or 2 hr after meals. Dilute recommended dose w/ glass of water, drink & follow w/ 1 full glass of water.).

Drugs Name

Classification

Indication

Action

Contraindications/ Precautions Severe renal impairment; pregnancy, lactation; hypersensitivity to penicillins. Hypersensitivity to cephalosporins.

Adverse Reaction

Darcef (cefuroxime)

Second Uncomplicated generation urinary tract cephalosporins infections Respiratory tract infections Uncomplicated gonorrhoea Otitis media Meningitis Renal impairment

Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death. Absorption: Absorbed from the GI tract with peak plasma concentrations after 23 hr (oral); may be enhanced by the presence of food. Distribution: Pleural and synovial fluid, sputum, bone and aqueous fluids; CSF (therapeutic concentrations). Crosses the placenta and enters breast milk. Protein-binding: Up to 50%. Metabolism: Rapidly hydrolysed (intestinal mucosa and blood).

Patient/ Family Teaching Large doses Advise patient can cause to cerebral immediately irritation and report rash or convulsions; bleeding nausea, tendency. vomiting, Instruct diarrhea, GI patient to take disturbances; drug with food erythema every 12 multiform, hours as Stevensprescribed. Johnson Teach syndrome, patient how to epidermal recognize necrolysis. signs and Potentially symptoms of Fatal: Anaphyl super axis, infection. nephrotoxicity Instruct him to , report these pseudomembr right away. anous colitis. Advise patient to report CNS changes. As appropriate, review all other significant and lifethreatening

Excretion: Via the urine by glomerular filtration and renal tubular secretion (as unchanged); via bile (small amounts); 70 min (elimination halflife); prolonged in neonates and renal impairment.

adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

Drugs Name Hemostan

Classification

Indication

Action

Contraindications/ Precautions Forms a reversible complex that displaces plasminogen from fibrin resultin g in inhibition of fibrinolysis Forms a reversible complex that displaces plasminogen from fibrin resultin g in inhibition of fibrinolysis, Not advisable to use for prolonged periods in patients predisposed to thrombosis. Not recommended for prophylaxis during pregnancy and before delivery. Opthalmic exam before and during therapy required if patient is treated beyond several days; caution in patients with cardiovascular, renal and cerebrovascular disease.

Adverse Reaction

Antihemophilic agent

Antihemorrhagic and antifibrinolytic for effective hemostasis in various surgical and clinical cases.

Gastrointestina l disorders: Nausea, Vomiting Central Nervous System: Anorexia, Headache, impaired renal insufficiency, hypotension occurs when iv injection is too rapid

Patient/ Family Teaching Dosage modificati on required in patients with renal impairme nt. Watch out for any signs of bleeding.

Drugs Name Furosemide

Classification Electrolytic and water balance agent; loop diuretic.

Indication For the treatmen t of edema associat ed with congesti ve heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrom e. Also for the treatmen t of hyperten sion alone or in combinat ion with other antihyper tensive agents.

Action Furosemide inhibits reabsorptio n of Na and chloride mainly in the medullary portion of the ascending Loop of Henle. Excretion of potassium and ammonia is also increased while uric acid excretion is reduced. It increases plasmarenin levels and secondary hyperaldost eronism may result. Furosemide reduces BP

Contraindications/ Adverse Precautions Reaction Severe sodium and water depletion, hypersens itivity to sulphona mides and furosemid e, hypokalae mia, hyponatra emia, precomato se states associate d with liver cirrhosis, anuria or renal failure. Addison's disease. Monitor fluid and electrolyte balance and renal function. It also lowers serum levels of Rashe s, photos ensitivi ty, nause a, diarrh oea, blurre d vision, dizzin ess, heada che, hypote nsion. Hypok alaemi a and magne sium depleti on can cause cardia c arrhyt hmias. Fluid and electro lyte

Patient/ Family Teaching Instruct patient to take furosemide as directed. Take missed doses as soon as possible; do not double doses Caution patient to change positions slowly to minimize orthostatic hypotension. Instruct patient to consult health care professional regarding a diet high in potassium Advise patient to contact health care professional immediately if muscle weakness, cramps, nausea, dizziness, numbness, or tingling of extremities occurs. Emphasize the importance of routine follow-up examinations Advise patients on antihypertensive

in hypertensiv es as well as in normotensiv es. It also reduces pulmonary oedema before diuresis has set in.

calcium and magnesiu m, thus serum levels should be monitored. Pregnanc y and lactation.

imbala nce.

regimen to continue taking medication even if feeling better. Furosemide controls but does not cure hypertension.

Drugs Name Metronidazo le

Classificati on Antimicrobi al

Indication

Action

Contraindications/ Precautions History of hypersensit ivity to metronidaz ole or other nitroimidaz ole derivatives. Patients with Central Nervous System diseases; discontinue iv therapy if abnormal neurologic symptoms occur. History of seizure disorder. Evidence or a history of blood dyscrasias; perform total and differential leukocyte counts

Adverse Reaction

Treatment of serious abdominal infections due to susceptible anaerobic bacteria. Treatment of protozoal infections. e.g. Amebiasis, giardiasis, trichomonia sis

selectively absorbed by anaerobic bacteria and sensitive prot ozoa. Once taken up by anaerobes, it is nonenzymaticall y reduced by reacting with reduced ferre doxin, which is generated by pyruvate oxidoreductase.

GIdisturbances e.g. Nausea, unpleasant metallic taste, vomiting, diarrhoea or constipation. Furred tongue, glossitis, and stomatitis due to overgrowth of candida. Rarely, antibioticassociated colitis. Weakness, dizziness, ataxia, headache, drowsiness, insomnia, changes in mood or mental state. Numbness or tingling in the extremities, epileptiform seizures (high doses or prolonged

Patient/ Family Teaching Advise patient to take drug with food if it causes GI upset. Howev er, instruct him to take extend edrelease tablets 1 hour before or 2 hours after meals. Advise patient to report fever, sore

before and after treatment. Severe hepatic impairment; monitor plasma levels. Prolonged use may result in fungal or bacterial superinfecti on.

treatment). Transient leucopenia and thrombocytopen ia. Hypersensitivity reactions. Urethral discomfort and darkening of urine. Raised liver enzyme values, cholestatic hepatitis, and jaundice. Thrombophlebiti s.

throat, bleedin g, or bruisin g. Infor m patie nt that drug may caus e metal lic taste and may discol or urine to brow nishred.

Drugs Name Salbutamol

Classification Bronchodilator (therapeutic); adrenergics (pharmacologic)

Indication For symptomatic relief and prevention of bronchospasm due to bronchial asthma, chronic bronchitis, and other chronic bronchopulmon ary disorders such as COPD.

Action It relieves nasal congestion and reversible bronchospasm by relaxing the sm