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by blocking pain impulses by inhibiting synthesis of prostaglandin in the CNS or of other substances that sensitive pain receptors to stimulation. The drug may relieve fever through central action in the hypothalamic heat regulating center. INDICATION Mild pain or fever CONTRAINDICATION Contraindicated in patient hypersensitivity to drug ADVERSE EFFECT GU : acute renal failure, renal tubular necrosis NURSING RESPONSIBILITY Assess type of pain and assess fever. Assess hepatic, hematologic, and renal function periodically during prolonged therapy. Advice patient to take medication exactly as desired. Advice patient to read labels and avoid taking more than one product. Advice patient to consult health care provider if discomfort or fever is not relieved by routine doses.
DRUG CLASSIFICATION Pharmacologic Class : natural penicillin Therapeutic Class : rapid- acting antibiotics
CONTRAINDICATION Contraindicated in patients hypersensitive to drug or other penicillins. Use cautiously in patients with other drug allergies, especially to cephalosporins, and cephamycins.
ADVERSE EFFECT CNS : neuropathy, seizures CV : thrombophlebitis HEMATOLOGIC : hemolytic anemia, leucopenia, thrombocytopenia MUSCULOSKELETAL: arthralgia
NURSING RESPONSIBILITY Assess patients infection before starting therapy, and regularly thereafter to monitor the drugs effectiveness. Observe patient closely.
ACTION Inhibits cell wall synthesis, promoting osmotic instability; usually bactericidal
CONTRAINDICATION Contraindicated in patients hypersensitive to drug or history other cephalosporins. Use cautiously in patients with sensitivity to penicillin and in patients with renal impairment.
ADVERSE EFFECT CNS: dizziness, headache, malaise, paresthesia. GI: abdominal cramps, anal pruritus, anorexia, diarrhea, dyspepsia, glossitis, nausea GU: genital pruritus and candidiasis. HEMATOLOGIC: eosinophilia, hemolytic anemia. RESPIRATORY: dyspnea SKIN: maculopapular and erythematous rashes, urticaria
NURSING RESPONSIBILITY Assess patients infection before therapy and regularly thereafter. Assess patient about previous reactions to cephalosporins or penicillin. Be alert for adverse reaction and drug interaction.
DRUG CLASSIFICATION Pharmacologic Class: cardiac glycoside Therapeutic Class: antiarrhythmic, inotropic
ACTION Strengthens myocardial contractions and slows conduction through SA and AV nodes.
INDICATION Heart failure, paroxysmal supraventricular tachycardia, atrial fibrillation and flutter
CONTRAINDICATION Contraindicated in patients hypersensitive to the drug or any of its components and in those with digitalisinduce toxicity, ventricular fibrillation or ventricular tachycardia unless cause by heart failure. Use in patients with acute MI, incomplete AV block, sinus bradycardia, PVCs, chronic constrictive pericarditis, hypertrophic cardiomyopathy, renal insufficiency, severe pulmonary disease, or hypothyroidism.
ADVERSE EFFECT CNS: agitation, dizziness, fatigue, generalized muscle weakness, hallucinations, headache, malaise, paresthesia, stupor, vertigo. CV: arrhythmias, heart failure, hypotension EENT: blurred vision, diplopia, light flashes, photophobia, yellow- green halos around visual images. GI: anorexia, diarrhea, nausea, vomiting
NURSING RESPONSIBILITY Monitor effectiveness by taking apical pulse for one full minute before giving a dose. Evaluate ECG, and regularly assess patient cardiopulmonary condition for signs of improvement. Assess for adverse reaction and drug interactions.
ADVERSE EFFECT CNS: headache, dizziness, vertigo, malaise, paresthesia, fever CV: palpitations, flushing EENT: tinnitus, orbital edema
NURSING RESPONSIBILITY Assess patients and familys knowledge of drug therapy. Assess patients GI disorder before starting therapy and reassess regularly. Be alert for adverse reaction.
GI: diarrhea, constipation, anorexia, taste disorder, dry mouth MUSCULOSKELETAL: musculoskeletal pain SKIN: acne, dry skin
DRUG CLASSIFICATION Pharmacologic Class: proton pump inhibitor Therapeutic Class: antisecretory
ACTION Suppress gastric secretion through proton pump inhibition Decreases gastric acid
ADVERSE EFFECT CNS: headache GI: diarrhea, abdominal pain, nausea, flatulence, dry mouth, vomiting, constipation
NURSING RESPONSIBILITY Assess patients condition before and during drug therapy. Monitor liver function test result.
DRUG CLASSIFICATION Pharmacologic Class: synthetic analog of vitamin K Therapeutic Class: blood coagulation modifier
ADVERSE EFFECT CNS: dizziness, seizurelike movements CV: flushing, transient hypotension after IV administration, rapid and weak pulse, cardiac irregularities SKIN: diaphoresis, erythema
NURSING RESPONSIBILITY Assess patients condition before starting therapy and regularly thereafter to monitor the drugs effectiveness. Be alert for adverse reactions and drug interactions.
DRUG CLASSIFICATION Pharmacologic Class: benzodiazepine Therapeutic Class: anxiolytic, skeletal muscle relaxant, anticonvulsant, sedative- hypnotic
ACTION Relieves anxiety, muscle spasms, and seizures; promotes calmness and sleep
CONTRAINDICATION Contraindicated in patients hypersensitive to drug or any of its components and in those with angleclosure glaucoma, shock, coma. Use cautiously in patients with hepatic or renal impairment, depression, or chronic open angle glaucoma.
ADVERSE EFFECT CNS: anterograde amnesia, ataxia, depression, drowsinees, fainting, hangover, headache,insomnia, lethargy, pain, psychosis, restlessness, slurred speech, tremors CV: bradycardia, CV collapse, transient hypotension EENT: blurred vision, diplopia, nystagmus GI: abdominal discomfort, constipation, nausea, vomiting GU: incontinence, urine retention
NURSING RESPONSIBILITY
ACTION Actions may be due to suppression of subcortical areas of the CNS; has clinically demonstrated antihistaminic, analgesic, antispasmodic, antiemetic, mild antisecretory, and bronchodilator activity.
INDICATION Control of nausea and vomiting and as adjunct to analgesia preoperatively and postoperatively to allow decreased opioid dosage.
CONTRAINDICATION Contraindicated with allergy to hydroxyzine or cetirizine. Use cautiously with uncomplicated vomiting in children.
ADVERSE EFFECT CNS: drowsiness, involuntary motor activity, including tremor and seizures GI: dry mouth, reflux, constipation GU: urinary retention HYPERSENSITIVITY: wheezing, dyspnea, chest tightness
NURSING RESPONSIBILITY Assess patients condition before therapy and regularly thereafter. Be alert for adverse reactions and drug interactions. Assess patients and familys knowledge of drug therapy.
ACTION Anticholinergic, chemically related to atropine, which blocks vagally mediated reflexes by antagonizing the action of acetylcholine. Causes bronchodilation and inhibits secretion from serious and seromucous glands lining the nasal mucosa.
ADVERSE EFFECT CNS: nervousness, dizziness, headache, fatigue, insomnia, blurred vision GI: nausea, GI distress, dry mouth RESPIRATORY: dyspnea, bronchitis, bronchospasms, URI, cough
NURSING RESPONSIBILITY Assess patients condition before and after therapy. Be alert for adverse reactions and drug interactions.
ACTION Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions; appears to sensitize tissues to actions of acetylcholine; relaxes pyloric sphincter which, when combined with effect on motility, accelerate gastric emptying and intestinal trasit, little effect on gallbladder or colon motility, increases lower esophageal sphincter pressure, has sedative properties.
CONTRAINDICATION Contraindicated with allergy to metoclopramide; GI hemorrhage, mechanical obstruction or perforation, epilepsy.
ADVERSE EFFECT CNS: restlessness, drowsiness, fatigue, lassitude, insomnia, extrapyramidal reactions, Parkinson-like reactions, akathisia, dystonia, myoclonus, dizziness, anxiety. CV: transient hypertension GI: nausea and diarrhea
NURSING RESPONSIBILITY Assess patients condition before therapy and regularly thereafter to monitor the drugs effectiveness. Frequently monitor blood pressure in patient taking IV form of drug Be alert for adverse reaction and drug interactions