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DRUG STUDY NAME OF DRUG Paracetamol DRUG CLASSIFICATION Antipyretics Non Opioid Analgesic ACTION Thought to produce analgesia

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.

SKIN : rash and urticaria

CV : chest pain and dyspnea

HEMATOLOGIC : hemolytic anemia, leucopenia, pancytopenia

NAME OF DRUG Penicillin G Sodium

DRUG CLASSIFICATION Pharmacologic Class : natural penicillin Therapeutic Class : rapid- acting antibiotics

ACTION Inhibits cell wall synthesis during microorganism multiplication

INDICATION Moderate to severe systemic infection

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.

NAME OF DRUG Cefuroxime

DRUG CLASSIFICATION Pharmacologic Class: secondgeneration cephalosporin Therapeutic Class: antibiotic

ACTION Inhibits cell wall synthesis, promoting osmotic instability; usually bactericidal

INDICATION Secondary bacterial infection

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.

NAME OF DRUG Lanoxin

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.

NAME OF DRUG Famotidine

DRUG CLASSIFICATION Pharmacologic Class: H2receptor antagonist Therapeutic Class: antisecretory

ACTION Decrease gastric acid level and prevents heart burn

INDICATION Peptic Ulcer in children

CONTRAINDICATION Contraindicated in patients hypersensitive to drug or any of its components.

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

NAME OF DRUG Nexium

DRUG CLASSIFICATION Pharmacologic Class: proton pump inhibitor Therapeutic Class: antisecretory

ACTION Suppress gastric secretion through proton pump inhibition Decreases gastric acid

INDICATION Reduce risk of gastric ulcers in patient on continuous NSAID therapy

CONTRAINDICATION Contraindicated in patients hypersensitive to any component of esomeprazole or omeprazole.

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.

Use cautiously in patients with severe hepatic insufficiency.

NAME OF DRUG Vitamin K

DRUG CLASSIFICATION Pharmacologic Class: synthetic analog of vitamin K Therapeutic Class: blood coagulation modifier

ACTION An antihemorrhagic factor that promotes hepatic formation of active prothrombin

INDICATION Hemorrhagic disease hypoprothrombinemia

CONTRAINDICATION Contraindicated in patients hypersensitive to the drug or any of its components

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.

NAME OF DRUG Diazepam

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

INDICATION Muscle spasm Adjunct in seizure disorders

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

NAME OF DRUG Hydroxyzine ( iterax )

DRUG CLASSIFICATION Antiemetic Antihistamine

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.

NAME OF DRUG Ipratropium

DRUG CLASSIFICATION Pharmacologic Class: anticholinergic Therapeutic Class: bronchodilator

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.

INDICATION Bronchodilator for maintenance treatment of bronchospasm

CONTRAINDICATION Contraindicated with hypersensitivity to atropine of its derivatives

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.

NAME OF DRUG Metoclopramide Plasil

DRUG CLASSIFICATION Antiemetic

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.

INDICATION Delayed gastric emptying caused by diabetic gastroparesis

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

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