Drug(s) Indication Action Side Effect(s) and Adverse Effect(s)

Nursing Consideration(s)/ Health Teaching(s)

Dilantin

Generic Name: Phenytoin

Classification: Anticonvulsant

Dose: 100 mg/cap

Route: NGT

Frequency: q8H

Date Ordered:9/5 3pm

> Generalaized tonic clonic and complex partial (psychomotor, temporal lobe) seizures.

> status epilepticus

>To prevent seizures during neurosurgery

Thought to limit seizure activity by promoting sodium efflux from neurons in motor cortex and reducing activity in brainstem centers responsible for tonic phase of tonic-clonic seizures.

Head ache, fatigue, dizziness, drowsiness, weakness, depression, slurred speech, confusion, agitation, insomnia, twitching, tremors, chest pain, tachycardia, hypotension, nausea and vomiting, diarrhea.

- assess blood pressure, ECG and heart rate. WOF adverse reactions.

-Monitor phenytoin blood level, therapeutic range is 10-20 mcg/ml

-Evaluate CBC, kidney and liver function test.

-Closely monitor prothrombin time.

-monitor drug efficacy

Bactroban Ointment

Generic Name: Mupirocin

Classification: Antibacterial

-on affected left cheek

Frequency: TID

> infective traumatic skin lesion

>nasal colonization of methicillin resistant streptococcus aureus.

Inhibits bacterial protein and RNA synthesis by reversibly and specifically binding to bacterial cycle transfer RNA synthetase Bactericidal.

Dizziness, insomnia, head ache,fatigue, hypotension, nausea and vomiting, diarrhea, abdominal pain, hyperkalemia, joint pain, back pain, muscle cramps, dry cough

- WOF angio edema and other hypersensitive reactions

-monitor blood pressure to evaluate drug efficacy

-Assess liver and kidney function test and electrolyte levels.

-avoid potassium supplements and salt substitutes containing potassium unless directed by precaution

Cordarone

Generic Name: Amiodarone Hydrochloride

Classification:

> life threatening ventricular arrhythmias

Prolongs duration and refractory period of action potential. Slows electrical conduction, electrical impulse

Dizziness, fatigue, headache, insomnia, poor coordination, involuntary movements, tremor, sleep

- monitor patient closely. Drug may cause serious or life threatening adverse

Cardio Active drugs; antiarrhythmic drugs Class III

Dose: 200 mg/1 tab

Route: NGT

Frequency: TID x 7 days

Date Ordered:9/5 – 9/12

generation from sinoatrial node and conduction through accessory pathways also dilates blood vessels

disturbances, hypotension, bradycardia, cardiogenic shock

reactions.

-WOF slow onset of life threatening arrhythmias especially after giving loading dose

-monitor ECG continuously in loading dose and when the dosage is changed.

-check patient’s BP, pulse and heart rhythm regularly.

-assess for signs and symptoms of lung inflammation

-monitor baseline and subsequent chest x-rays as well as pulmonary, liver and thyroid function test.

Nimotop

Generic Name: Nimodipine

Classification: Calcium antagonist

Dose: 60 mg/1 tab

Route: NGT

Frequency: q6H

Subarachnoid hemorrhage

Inhibits calcium transport into vascular smooth muscle cells, suppressing contractions also dilates coronary and cerebral arteries.

Headache, depression, hypotension, peripheral edema, bradycardia, nausea, diarrhea, abdominal discomfort, muscle cramps, dyspnea, flushing, rash.

-monitor weight and fluid intake and output. Stay alert for fluid retention.

-assess neurologic status and mood. Watching for signs of depression.

Minnitol 20% solution for IV infusion

Generic Name: Mannitol

Classification: Diuretics

> test or marked oliguria or suspected inadequate renal function

> to reduce intracranial pressure

Increases osmotic pressure of plasma in glomerular filtrate inhibiting tubular reabsorption of water and electrolytes (including sodium and potassium).

Dizziness, headache, seizures, chest pain, hypotension, tachycardia, vascular overload, rhinitis, nausea and vomiting, diarrhea, dry mouth, polyuria, dehydration

> monitor IV site carefully to avoid extravasation and tissue necrosis

>monitor renal function test, urinary output.

Dose: 30-34 gtts/hr-defer for BP ≤ 110

Route: IV

Date Ordered:9/7

>to promote dieresis in drug toxicity

These actions enhance water flow from various tissues and ultimately decrease intracranial pressure; sodium level rises while potassium and blood urea falls, also protects kidney, preventing toxins from forming and blocking tubules.

Fluid and electrolyte imbalances

>WOF signs and symptoms of hypovolemic shock and dehydration.

Merop

Generic Name: Meropenem

Classification: Anti-infectives

Dose: 1 gram in 50cc PNSS

Route: IV via solucet

Frequency: q8H

Date Ordered:9/9

> intra abdominal infections,

> bacterial meningitis,

> skin structure infections

Inhibits bacterial cell-wall synthesis and penetrates gram-negative and gram-positive bacteria

Headache, , insomnia, weakness, drowsiness, hypotension, seizures,dizziness, nausea and vomiting, diarrhea, constipation, chest discomfort, hyperventilationa

- monitor patient for hypersensitivity reaction or anaphylaxis. If either stop infusion immediately

-monitor for CNS irritability and seizures

Ectrin

Generic Name: Erdosteine

Classification: Expectorant

Dose: 300 mg/1 cap

Route: NGT

Frequency: BID

Date Ordered:9/9

> respiratory disorders characterized by bronchial secretions

Contains 2 sulfhydryl groups, which are freed after metabolic transformation in the liver, the liberated sulfhydryl groups break the disulphide bonds which hold the glycoprotein fibers of mucus together. This makes the bronchial secretions more fluid and enhances elimination.

No gastro-intestinal or systemic side effects due to the drug have been observed. With over dosage sweating, vertigo and flushing have been observed.

- This drug can be taken with or without food

Pulmodual neb

Generic Name: Ipratropium, slbutamol

Classification:

To prevent and relieve broncho spasm in patients with reversible obstructive airway disease.

Relaxes smooth muscles by stimulating beta 2 –receptors, thereby causing broncho dilation and vasodilation.

Dizziness, headache, hyperactivity, hypertension, palpitations, tachycardia, chest pain, dry mouth,

-stay alert for hyper sensitivity reactions and bronchospasm. Stop immediately if

antcholinergics

Dose: 7gtts + 3cc NSS

Frequency: q4H, PRN

Date Ordered:9/8

dyspnea, excitement, muscle cramps

this occurs.

-perform back tapping after nebulisation for effective mobilization of secretions.