Generic Name

Brand Name

Classification

Dosage

Mechanism of

ActionIndication Contraindications S.E/ A.R

Nursing Implications/Respo

nsibilities

paracetamol

tylenol Paraminophenol derivatives

300mg TIV q4

Thought to produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in the CNS/ other subs. that sensitize pain receptors to stimulation. The drug may relieve fever through central action in the hypothala

Mild pain or fever

• Hypersensitive to drug

• Use cautiously in patients with long term alcohol use because therapeutic doses cause hepatotoxicity in these patients

Hematologic: hemolytic anemiaHepatic: jaundiceMetabolic: hypoglycemiaSkin:rashes, urticaria

• Alert: many OTC prescriptions contain acetaminophen, be aware of this when calculating total daily dose

• Warn patients that high-dose can cause liver damage. excessive alcohol intake increase risk of liver disease.

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Generic Name

Brand Name

Classification

Dosage

Mechanism of

ActionIndication Contraindications S.E/ A.R

Nursing Implications/Respo

nsibilities

Nimodipine

Nimotop

Calcium channel blocking agent

30 mg/tab 2tabs Q°4

Has a greater effect on cerebral arteries than arteries elsewhere in the body (probably due to its highly lipophilic properties). Mechanism to reduce neurologic deficits following subarachnoid hemorrhage not known.

prevention of cerebral vasospasm and resultant ischemia

contraindicated in unstable angina or an episode of myocardial infarction more recently than one month

CV: Hypotension, peripheral edema, CHF, ECG abnormalities, tachycardia, bradycardia, palpitations, rebound vasospasm, hypertension, hematoma, DIC, DVT. GI: Nausea, dyspepsia, diarrhea, abdominal discomfort, cramps, GI hemorrhag

Take the history of the client if he has unstable angina or an episode of myocardial infarction.

The client may experience side effects

May cause reductions in blood pressure. Use caution in hepatic impairment. Intestinal pseudo-obstruction and ileus have been reported during the use of nimodipine. Use caution in patients with decreased GI

e vomiting. CNS: Headache, depression, lightheadedness, dizziness. Hepatic: Abnormal LFT, hepatitis, jaundice. Hematologic: Thrombocytopenia, anemia, purpura, ecchymosis

motility of a history of bowel obstruction. Use caution when treating patients with increased intracranial pressure.

Generic Name

Brand Name

Classification

Dosage

Mechanism of

ActionIndication Contraindications S.E/ A.R

Nursing Implications/Respo

nsibilities

phenytoin Dilantin anticonvulsant

100 mg IV Q8

The mechanism of action is not definitely known, but extensive research strongly suggests that its main mechanism is to block frequency-, use- and voltage-dependent neuronal sodium channels, and therefore limit repetitive firing of action

Dilantin is indicated for the control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

• Phenytoin is contraindicated in those patients who are hypersensitive to phenytoin or other hydantoins.

CNS: nystagmus, ataxia, slurred speech, decreased coordination, and mental confusion. Dizziness, insomnia, transient nervousness, motor twitchings, and headaches

• Phenytoin should not be given at the same time as a "tube feeding," since this may decrease the level of the medicine in your blood.

• The medication should be taken at the same times each day to maintain even levels of phenytoin in your blood.

potentials. At usual levels, there is little or no change in normal patterns of firing. At high or toxic levels, however, phenytoin can impair the function of healthy neurons.

 

• For the medication to work properly, it must be taken as prescribed. Phenytoin will not work if you stop taking it.

 

Generic Name

Brand Name

Classification

Dosage

Mechanism of

ActionIndication Contraindications S.E/ A.R

Nursing Implications/Respo

nsibilities

Lactulose Cephulac

Laxative

30 cc ODHS

Produces increased osmotic pressure within colon and acidifies its contents, resulting in increased stool water content and stool softening. Causes migration of ammonia from blood into colon, where it is converted to ammonium ion and expelled through laxative

Treatment of constipation; prevention and treatment of portal-systemic encephalopathy, including stages of hepatic precoma and coma.

Use in patients who require low-galactose diet.

•

Gaseous distention with flatulence or belching, abdominal discomfort and cramping; diarrhea; nausea; vomiting.

• Advise patient that drug can be mixed with fruit juice, water, or milk to make it more palatable.

• Inform patient that drug may cause belching, flatulence, or abdominal cramps. Instruct patient to notify health care provider if these symptoms become bothersome or if diarrhea occurs.

• Instruct patient not to take other laxatives while receiving lactulose therapy.

• Encourage patient to

action. increase dietary fiber and fluid intake and participate in regular exercise.

•

Generic Name

Brand Name

Classification

Dosage

Mechanism of

ActionIndication Contraindications S.E/ A.R

Nursing Implications/Respo

nsibilities

Celecoxib Celcoxx NSAID 200mg/tab Q8

Celecoxib is a highly selective COX-2 inhibitor and primarily inhibits this isoform of cyclooxygenase (inhibition of prostaglandin production), whereas traditional NSAIDs inhibit both COX-1 and COX-2.[citation needed] Celecoxib is approximately 7.6 times more selective for

osteoarthritis, rheumatoid arthritis, acute pain, painful menstruation and menstrual symptoms, and to reduce the number of colon and rectal polyps in patients with familial adenomatous polyposis.

• Allergy to celecoxib or any of its ingredients; allergy to sulfonamides; aspirin triad (eg, asthma, nasal polyps, allergy to aspirin); previous allergic reactions following aspirin or other NSAID use (eg, asthma, hives, rash).

CNS: Dizziness; headache; sleeplessness.

GI: Stomach pain; diarrhea; indigestion; gas; nausea.

RESP: Sinus infection; congested or runn

• Assess for signs and symptoms of hypersensitivity.

• Take a complete drug history and monitor potential drug/drug interactions and contraindications that should be reported to the primary care provider.

• Monitor for signs of GI bleeding, adverse CNS symptoms, and any other adverse events.

• Monitor for signs of skin rash.

• Monitor for

COX-2 inhibition over COX-1.[citation needed] In theory, this selectivity allows celecoxib and other COX-2 inhibitors to reduce inflammation (and pain) while minimizing gastrointestinal adverse drug reactions (e.g. stomach ulcers) that are common with non-selective NSAIDs.

Celecoxib inhibits COX-2

y nose; upper respiratory tract infection; sore throat.

OTHER: Back pain; swelling of arms or legs; accidental injury; rash.

signs and symptoms of decreased renal function: Serum creatinine, BUN, unexpected weight gain, edema.

• Monitor for signs of hypophosphatemia and hyperchloremia.

• Monitor hepatic function, as decreased hepatic function may require a reduced dose.

•

without affecting COX-1. COX-1 is involved in synthesis of prostaglandins and thromboxane, but COX-2 is only involved in the synthesis of prostaglandin. Therefore, inhibition of COX-2 inhibits only prostaglandin synthesis without affecting thromboxane and thus has no effect on platelet aggregation or blood

clotting.

Generic Name

Brand Name

Classification

Dosage

Mechanism of

ActionIndication Contraindications S.E/ A.R

Nursing Implications/Respo

nsibilities

MannitolOsmitrol

Paraminophenol derivatives

300mg TIV q4

Thought to produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in the CNS/ other subs. that sensitize pain receptors to stimulation. The drug may relieve fever through central action in the hypothala

Promotion of diuresis, in promotion or treatment of oliguric phase

Reduction of ICP and treatment of cerebral edema by reducing brain mass

Reduction of intraocular pressure when it cannot be lowered by any means

• Well-established anuria due to severe renal disease. Severe pulmonary congestion or frank pulmonary edema. Active intracranial bleeding except during craniotomy. Severe dehydration. Progressive renal damage or dysfunction after institution of Mannitol therapy, including

Metabolic: fluid and electrolyte imbalance, acidosis, dehydration.Gastrointestinal: dryness of mouth, nausea, vomiting, diarrhea.Genitourinary: osmotic nephrosis, urinary retention.Central Nervous System: headache, convulsions, dizziness.

• This medication can only be given by infusion. Report immediately any muscle weakness, numbness, tingling, acute headache, nausea, dizziness, blurred vision, eye pain, respiratory difficulty, chest pain, or pain at infusion site.

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increasing oliguria and azotemia.

Special Senses: Blurred vision, rhinitis.Cardiovascular: pulmonary edema, hypotension, hypertension, tachycardia, angina-like chest pains.Dermatologic: skin necrosis, thrombophlebitis.Hypersensitivity: urticaria.Miscellaneous: thirst, arm pain, chills, fever.

Generic Name

Brand Name

Classification

Dosage

Mechanism of

ActionIndication Contraindications S.E/ A.R

Nursing Implications/Respo

nsibilities

Nicardipine

Cardene

Calcium channel blockers

Drip titrated

Inhibits calcium ion from entering the "slow channels" or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization, producing a relaxation of coronary vascular smooth muscle and coronary vasodilation; increases myocardial oxygen delivery in patients with

hypertension

Nicardipine hydrochloride is contraindicated in patients with hypersensitivity to the drug.

•

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Generic Name

Brand Name

Classification

Dosage

Mechanism of

ActionIndication Contraindications S.E/ A.R

Nursing Implications/Respo

nsibilities

Esomeprazole

Nexium Proton pump inhibitor

10mg IV OD

Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of H+/K+-ATPase in the gastric parietal cell. By acting specifically on the proton pump, esomeprazole blocks the final step in acid production,

H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence

Treatment of Gastroesophageal Reflux Disease (GERD) (1.1)•Risk Reduction of NSAID-Associated Gastric Ulcer

• NEXIUM is contraindicated in patients with known hypersensitivity to any component of the formulation or to substituted benzimidazoles. (

• Alert: many OTC prescriptions contain acetaminophen, be aware of this when calculating total daily dose

• Warn patients that high-dose can cause liver damage. excessive alcohol intake increase risk of liver disease.

thus reducing gastric acidity. This effect is dose-related up to a daily dose of 20 to 40 mg and leads to inhibition of gastric acid secretion.