Lactulose: (Enuluse, Kristalose, Duphalac, Chronulac Syrup)

GENERIC NAME CLASSIFICATION INDICATION ACTION SPECIAL CONTRANDICATION SIDE EFFECTS DOSAGE AND AVAILABILITY NURSING
PRECAUTION RESPONSIBILITIES
LACTULOSE Laxatives -Constipation The drug passes Patients with Hypersensitivity to -Nausea and Dosage Monitor
-To prevent and unchanged into Diabetes and lactulose and low Vomiting Oral: periodically for
treat hepatic the colon here Pregnant women galactose diet. -Abdominal Infants: electrolytes
(Enuluse, 2.5-10 mL/day divided into 3-4
encephalopathy, bacteria breaks -patients with -low-galactose diet cramps imbalance when
Kristalose, times/day; adjust dosage to
including hepatic it down into diabetes mellitus (patients) -Gas lactulose is used
Duphalac, produce 2-3 stools/day.
precoma and coma organic acids -pregnant -children with -Borborygmus Older Children:
>6 months or in
Chronulac in patients with that increase women chronic -Flatulence patients
Daily dose of 40-90mL divided to
Syrup) severe hepatic the osmotic -breastfeeding constipation -Abdominal 3-4 times/day; if initial dose predisposed to
disease. pressure in the women cramps, causes diarrhea then reduce it electrolyte
Duphalac, colon and -elderly patients belching, immediately; adjust dosage to abnormalities (eg,
Cephulac, -to induce bowel slightly acidify (more diarrhea, produce 2-3 stools/day. elderly); patients
Cholac, evacuation after a the colonic susceptible to distention, Constipation receiving lactulose
Chronulac, contents, stool hyponatremia) flatulence Oral and an oral anti-
barium meal Children:
Constulose, softening , and infective agent
examination 5g/day (7.5mL) after breakfast
Enulose, laxative actions. Adverse should be
Adult:
Generlac, -Relieves Reaction: monitored for
-to restore bowel 15-30 mL/day increased to 60
Kristalose constipation Nausea, mL/day in 1-2 divided doses if possible
movements after
vomiting necessary. inadequate
hemorrhoidectomy response to
- Decrease Acute PSE: Oral:
blood ammonia Adult: lactulose.
concentration 20-30g (30-45mL) every 1-2
hours to induce rapid laxation;
adjust dosage daily to produce 2-
3 soft stools; doses of 30-45mL
may be given hourly to cause
rapid laxation, then reduce to
recommended dose; usual daily
dose: 60-100g (90-150mL) daily.
Rectal Administration:
200g (300mL) diluted with
700mL to H2O or NS; administer
rectally via rectal balloon
catheter and retain 30-60
minutes every 4-6 hours.
Availability:
Medicine is available as crystals
and as liquids.
GENERIC NAME CLASSIFICATION INDICATION ACTION SPECIAL CONTRANDICATION SIDE EFFECTS DOSAGE AND NURSING
PRECAUTION AVAILABILITY RESPONSIBILITIES
RANITIDINE H2-receptor -Active duodenal Prevents the Porphyria, Contraindicated with Agitation, Dosage -Assess patient for
antagonists and gastric ulcer. secretion of acid Phenylketonuria, allergy to ranitidine, Nervousness, Adult: abdominal pain.
(Histamine -Gastroesophageal into the stomach. or kidney or liver lactation. Hallucinations, 150mg P.O. bid. -Note presence of
(Tritec, Zantac, blocker) reflux disease Inhibits action diseases before Constipation or blood in emesis,
Children:
Zantac75, Anti-ulcerative -pathologic of H2 at pregnancy or diarrhea, dark stool or gastric
(1mo-16 yrs.old))
Zantac hypersecretory receptor sites of lactation. yellow or Brown aspirate.
For duodenal and
EFFERdose, conditions (ZES) parietal cells, -patients with urine, dizziness, -Drug may be
gastric ulcers only; 2-
Zantac -Erosive decreasing hepatic headache, added to total
4mg/kg P.O. b.i.d.,up
Premixed, esophagitis gastric acid dysfunction nausea, vomiting, parenteral
to 300mg/day.
Zantac Syrup) -Heartburn dysfunction. -pregnant women redness, nutrition solutions.
-duodenal and -breastfeeding blistering,
gastric ulcer mother/women peeling or Availability;
loosening of the Tablet, an
-maintenance skin, including effervescent tablet,
therapy for the mouth, skin effervescent
duodenal rash, itching, sore granules, and syrup.
ulcer throat, fever,
stomach pain,
unusual
-gastroesophageal
weakness or
reflux dse.
tiredness,
-erosive unusual bleeding
esophagitis or bruising,
yellowing of the
-for occasional skin or eyes.
heartburn, acid
ingestion & sour
stomach
MANNITOL Diuretics, -Test dose for Increases the Should not be Hypersensitivity to CNS: Dosage Cardiovascular
Osmotic, market oliguria or osmotic pressure administered until mannitol or any headache, Adult: and children status should also
Sweetening suspected of glomerular adequacy of renal component or the convulsions, older than 12 years be evaluated; do
(Osmitrol) Agent inadequate renal filtrate, which function and urine formulation; severe headache, chills, old: not administer
function. inhibits tubular flow is renal disease dizziness 500-100g I.V. as 15%- electrolyte-free
-Oliguria reabsorption of established. (anuria); Dermatologic: 25% solution over 90 mannitol solutions
-To prevent oliguria water and dehydration, active Rash minutes to several with blood.
or acute renal electrolytes and intracranial bleeding, Endocrine & hours. -Asses patients
failure increases urinary severe pulmonary Metabolic: condition
-To reduce output. edema or congestion. Fluid and Availability before therapy
intracellular or Those with anuria, electrolyte Injection, Solution and
intracranial pulmonary edema, imbalance, water regularly
pressure. severe intoxication, thereafter to
-Diuresis in drug dehydration, dehydration, monitor the drugs
intoxication. progressive hypovolemia effectiveness.
heart failure or secondary to -Monitor vital
pulmonary rapid diuresis, signs, central
congestion after hyponatremia, venous pressure
mannitol Genitourinary: and fluid
therapy. Polyuria, Dysuria intake & output
Local: hourly.
Tissue necrosis -Insert urethral
Ocular: catheter in
Blurred Vision comatose or
Respiratory: incontinent
Pulmonary patient because
edema therapy is
Miscellaneous: based on strict
Allergic reaction evaluation
of fluid intake &
output.
DOPAMINE Adrenergies -To treat shock and Stimulates both Use with caution Hypersensitivity to CNS: Dosage Hypovolemia and
correct adrenergic and in patients with sulfites (commercial Headache, I.V. infusion electrolytes when
hemodynamic dopaminergic cardiovascular preparation contains anxiety (administration used in
(Intropin) imbalances. receptors, lower disease or cardiac sodium bisulfite); GI: requires the use of an hemodynamic
-To improve doses are mainly arrhythmias or pheochromocytoma; Nausea, infusion pump); support, use with
perfusion to vital dopaminergic patients with ventricular fibrillation vomiting, Neonates: caution in post-MI
organs. stimulating and occlusive vascular Metabolic: 1-20mcg/kg/min. patients.
-To increase produce renal and disease. Azolemia, continuous infusion, Obtain history of
cardiac output. mesenteric hyperglycemia titrate to desired patients
-To correct vasodilation, Respiratory: response. underlying
hypotension. higher doses also Asthmatic Children: condition before
are both episodes, 1-20mcg/kg/min, therapy.
dopaminergic and dyspnea maximum of 50 -During infusion,
betal-adrenergic Skin: mcg/kg/min frequently
stimulating and necrosis continuous infusion, monitor ECG,
produce cardiac titrates to desired blood
stimulation and response. pressure and
renal vasodilation; Adults: cardiac
large doses 1-5 mcg/kg/min up to output.
stimulate alpha- 20 mcg/kg/min, -Must be diluted
adrenergic desired response. before
receptors. Infusion may be use
increased by 1-4
mcg/kg/min at 10 to
30 minute intervals
until optimal response
is obtained. If dosage
>20-30 mcg/kg/minute
are needed, a more
direct-acting pressure
may be more
beneficial (ie,
epinephrine,
norepinephrine).
CLOPIDOGRIL Miscellaneous Prevention of Blocks the ADP Use with caution Hypersensitivity to Black, tarry Clopidogrel tablets, -Instruct patient to
cardiovascular vascular ischemic receptors, which in patients who clopidogrel or any stools, blood Clopidogrel Bisulfate notify prescriber if
drugs events in patients prevent fibrinogen may be at risk of component of the from vomiting, Oral tablets unusual bleeding
(Plavix) with symptomatic binding at that increased formulation; active blood in urine or Dosage: or bruising occurs.
atherosclerosis, site and thereby bleeding, pathological bleeding stools, Adults: -Inform patient
Acute coronary reduce the including patients such asPUD or nosebleed, red or 75 mg P.O. that drug may be
syndrome without possibility of with peptic ulcer intracranial purple spots on daily. taken without
ST- segment platelet adhesion disease, trauma, hemorrhage; the skin, skin Adults: regard to mass.
elevation and aggregation. or surgery. coagulation rash or itching, start therapy -Platelet
(NSTEMI), ST Consider disorders. stomach pain. with a single 300-mg aggregation wont
elevation MI discontinuing 5 PO loading dose, and return to normal
(STEMI). days before then continue at 75- for at least 5 days
- Reduce elective surgery. mg after drug has
atherosclerotic Use caution in PO daily. been stopped.
events in patients mixing with other
with antiplatelet drugs. Availability:
atherosclerosis Use with caution Tablets: 75 mg
documented by in patients with
recent stroke, MI, severe liver
or peripheral disease
arterial dse. (experience is
- Reduce limited). Cases of
atherosclerotic thrombotic
events in patients thrombocytopenic
with acute purpura (usually
coronary occurring within
syndrome, the first 2 weeks
including those of therapy) have
managed medically been reported.
and those who are
to be vention or
coronary artery
bypass graft.
EPINEPHRINE Antihistamine Treatment of Stimulates alpha-, Use cautiously in Hypersensitivity to Flushing, Dosage In patients with
bronchospasms, beta1-, and beta2- patients with epinephrine or any hypertension, Adult: Parkinsons
anaphylactic adrenergic long standing component of the pallor, chest pain, 0.1-0.5mL of 1:1,000 disease, drug
(Adrenalin, reactions, and receptors bronchial asthma formulation; cardiac increased solution IM or increases rigidity
Epifrin [DSC], cardiac arrest, resulting in or emphysema arrhythmias; angle- myocardial oxygen subcutaneous: 0.1- and tremor. Drug
EpiPen, EpiPen management of relaxation of who have closure glaucoma. consumption, 0.25mL of 1:1,000 interferes with test
Jr,Primatene open-angle smooth muscle of developed cardiac arrhythmia, solution IV slowly over for urinary
Mist [OTC]) (chronic simple) the bronchial tree, degenerative angina, 5-10 minutes cathecolamines.
glaucoma; added cardiac heart disease. vasoconstriction, Observe patient
to local anesthetics stimulation, and nervousness, Children: closely for adverse
to decrease dilation of skeletal anxiety, 0.01 ml of reaction.
systemic muscle restlessness, 1:1,000/kg Briskly massage
absorption, vasculature, small headache, subcutaneously; site o SC
increase duration doses can cause dizziness, repeat or IM injection to
of action, and vasodilation via lightheadedness, q 20 minutes to 4 hasten
decrease toxicity of beta2-vascular insomnia, nausea, hours, drug action.
the local receptors; large vomiting, prn. -Discard solution if
anesthetic. doses may xerostomia, dry reddish brown and
produce throat, acute Availability: after expiration
constriction of urinary retention in Aerosol inhaler: 220 date.
skeletal and patients with mcg/metered spray -Do not use topical
vascular smooth bladder outflow Injection: 0.01 mg/ml preparation in
muscle; decreases obstruction, Nebulizer inhaler:1% children
production of weakness, (1:100) under 6 years of
aqueous humor trembling, eye Parenteral: 5mg/m age.
and increase pain, allergic lid
aqueous outflow; reaction, ocular
dilates the pupil irritation,
by contracting the decreased renal
dilator muscle. and splanchnic
blood flow,
wheezing, dyspnea.
FUROSEMIDE Diuretics Management of Inhibits reabsorption Ototoxicity is Hypersensitivity to CNS: Dosage Adjust dose to
edema of sodium and associated with rapid furosemide, or any Vertigo, Adult: avoid
associated with chloride in the I.V. administration, components of headache, 40mg IV injected dehydration. In
(Lasix) congestive heart ascending loop of renal impairment, sulfonylureas; anuria; dizziness, fever slowly 1-2 cirrhosis, avoid
failure and Henle and distal renal excessive doses, and patients with hepatic GU: minutes : 40 mg electrolyte and
hepatic or renal tubule, interfering concurrent use of coma or in states of Nocturia, bid acid/base
disease, alone or with the chloride- other ototoxins. severe electrolyte polyuria, Children: imbalances that
in combination binding transport Hypersensitivity depletion until the frequent 0.5-2mg/kg PO might lead to
with anti- system, thus causing reactions can rarely condition improves urination once/twice daily hepatic
hypertensive in increased excretion of occur. Monitor fluid or is corrected. Musculoskeletal encephalopathy.
treatment of water, sodium, status and renal :
hypertension. chloride, magnesium, function in an Muscle spasm
and calcium. attempt to prevent
oliguria, azotemia,
and reversible
increases in BUN and
creatinine. Close
medical supervision
of aggressive diuresis
required. Monitor
closely for electrolyte
imbalances
particularly
hypokalemia.
Chemical similarities
are present among
sulfonamides,
sulfonylureas,
carbonic anhydrase
inhibitors, thiazides,
and loop diuretics
(except ethacrynic
acid).
CLONIDINE Antihypertensive Hypertension of any Stimulates alpha2- Diseases affecting Hypersensitivity to CNS: Dosage Gradual
etiology, the adrenoceptors in the rhythmic and AV clonidine Drowsiness, Tab, mild to withdrawal is
pheochromocytoma brain stem, thus conduction system hydrochloride or any sedation, moderate needed (over 1
(Catapres, Melzin) form. activating an of the heart; renal component of the weakness, hypertension: week for oral, 2-4
inhibitory neuron, failure. Impairment formulation, sick- fatigue, malaise 75-150g bid. days with
resulting in reduced of ability to drive or sinus syndrome. GI: Severe epidural) if drug
sympathetic outflow operate machinery. Constipation, hypertension: needs to be
from the CNS, Sudden dry mouth, Increase single stopped. Patients
producing a decrease discontinuance. anorexia dose to 300g should be
in peripheral GU: instructed about
resistance, heart Urine retention, the abrupt
rate, and blood impotence discontinuation
pressure; epidural Metabolic: (causes rapid
clonidine may Weight gain increase in BP and
produce pain relief at Others: symptoms of
spinal presynaptic Loss of libido sympathetic
and postjunctional overactivity).
alpha2-
adrenoceptors by
preventing pain
signal transmission;
pain relief occurs
only for the body
regions innervated by
the spinal segments
where analgesic
contraindications of
clonidine exist.
RIFAMPICIN Antituberculosis Pulmonary and Inhibits bacterial RNA Patients suffering Hypersensitivity, CNS: Dosage: Observe for
extrapulmonary synthesis by binding from convulsive jaundice Headache, Adults: hyperbilirubinemia;
TB; Neisseria to the beta subunit of disorders, chronic dizziness 10mg/kg Po or IV discontinue therapy
(Rifadin) meningitides DNA- dependent RNA alcoholism, Respiratory: daily in single if this, in
carrier, leprosy, polymerase, blocking impaired liver or Dyspnea, dos. conjunction with
infection caused RNA transcription. kidney function or wheezing Children age 5 clinical symptoms or
by gm+ve, gm-ve patients taking Skin: and up: signs of significant
bacteria other other potentially Pruritus, rash 10-20 mg/kg PO hepatocellular
sensitive hepatoxic agents. or in IV daily in damage develop.
microorganisms. single dose.
Availability:
Capsules:
150 mg, 300 mg
Ruder for
injection:
600 mg
ENALAPRIL Antihypertensive Hypertension in Competitive inhibitor Symptomatic Anuria, history of CNS: Dosage Monitor
patients for of angiotensin- hypotension; angioneuro Asthenia, 1 tab daily may periodically for
whom converting enzyme Vol-depleted or salt headache, be increased to 2 electrolytes
(Co-Renitec, combination (ACE); prevents depletion, ischemic dizziness, tabs daily. imbalance when
Vasotec) therapy is conversion of heart or fatigue Discontinue prior lactulose is used
appropriate. angiotensin 1 to cerebrovascular CV: diuretic therapy, >6 months or in
angiotensin 2, a disease, aortic Hypotension, if possible, for 2- patients
potent stenosis or chest pain, 3 days to predisposed to
vasoconstrictor; hypertrophic angina, pectoris minimize electrolyte
results in lower level cardiomyopathy, pre- GI: symptomatic abnormalities
of angiotensin 2 which existing renal Diarrhea, hypotension. (e.g., elderly);
causes an I increase in disease, renal nausea, patients receiving
plasma renin activity impairment, bilateral abdominal pain, lactulose and an
and a reduction in renal artery stenosis vomiting oral anti-infective
aldosterone secretion. of the artery to a GU: agent should be
solitary kidney. Decreased renal monitored for
function, possible
Hematologic: inadequate
Bone marrow response to
depression lactulose.
Skin:
Rash
LOSARTAN Antihypertensive Hypertension As a selective and Intravascular vol Anuria, Dizziness, dose Dosage Avoid use or use a
competitive, depletion. Cirrhosis hypersensitivity to related rioration Initial and smaller dose in
nonpeptide and hepatic other sulfonamide in renal function maintenance patients who are
(Cozaar, Hyzaar, angiotensin II receptor impairment. Bilateral derived drugs. can occur with dose: volume depleted;
Hyzaar DS) antagonist, losartan renal artery stenosis Intravascular vol initiation. Use 50 mg once daily, correct depletion
blocks the or stenosis of the depletion. Severe orthostatic may increase to first.
vasoconstrictor and artery to a solitary renal or hepatic effects, rashes, 100 mg once Deterioration in
aldosterone secreting kidney. impairment. angioedema, daily, renal function can
effects of angiotensin Pregnancy, lactation. hepatitis, liver occur with
II; angiotensin II Children. function initiation. Use
receptor antagonist abnormalities, with caution in
may induce a more myalgia, unilateral renal
complete inhibition of migraine, artery stenosis
the renin- angiotensin urticarial, and pre-existing
system than ACE pruritus, renal
inhibitors, they do not insufficiency;
affect the response to significant
bradykinin, and are aortic/mitral
less likely to be stenosis. Use
associated with caution with
nonrenin angiostenin hepatic
effects (eg; cough and dysfunction, dose
angioedema). adjustment may
Losartan increases beneeded.
urinary flow rate and
in addition to being
natriuretic and
kaliuretic, increases
excretion of chloride,
magnesium, uric acid,
calcium and
phosphate.
CHLORPHOMAZINE Antipsychotics Control of mania, Chlorphomazine is Use cautiously in Contraindicated in Contraindicated Dosage Use with caution
treatment of an alphatic elderly or debilitated patients in patients Adult: in Parkinsons
schizophrenia, phenothiazine patients with hepatic hypersensitive to hypersensitive For hospitalized disease. Caution
(Thorazine) control of nausea antipsychotic or renal disease, drugs; to those with to drugs; to patient with in patients
and vomiting, which blocks severe or disease, CNS depression, those with CNS acute disease, hemodynamic
relief of postsynaptic respiratory disorders, bone marrow depression, 25mg IM instability; bone
restlessness and mesolimbic hycalcema, glaucoma suppression or bone marrow Children ages 6 marrow
apprehension dopaminergic or prostatic subcorneal damage, suppression or months and suppression;
before surgery. receptors in the hyperplasia. and in those in come. subcorneal older: predisposition to
brain; exhibits a damage, and in 0.55mg/kg PO seizures,
strong alpha- those in come. q4-6h or IM q6- subcortical brain
adrenergic 8hhours. damage, severe
blocking effects cardiac, hepatic,
and depresses the renal or
release of respiratory
hypothalamic and disease.
hypophyseal Esophageal
hormones; dysmotility and
believed to aspiration have
depress the been associated
reticular activating with antipsychotic
system, thus use- use with
effecting basal caution in
metabolism, body patients at risk of
temperature, aspiration
wakefulness, pneumonia.
vasomotor tone
and emesis.
HALOPERIDOL Antipsychotics -Psychotic Haloperidol is a Hyperthyroidism, use Comatose condition, Extrapyramidal Dosage -Protect drug
disorders butyrophenone of lithium salts with severe CNS syndrome, 1->200mg/day from light.
-Chronic psychosis antipsychotic which high dose of depression, tardive depending on the -Dont withdraw
(Haldol, Serenace) requiring blocks postsynaptic haloperidol. Patients Parkinsons disease, dyskinesia, condition and drug abruptly
prolonged therapy mesolimbic receiving combined patients with lesions neuroleptic individuals unless required by
-Nonpsychotic dopaminergic D1and therapy must be of the basal ganglia, malignant responses. severe adverse
behavior disorder D2 receptors in the closely monitored, lactation. syndrome, other reaction
-Towette brain, depresses the epilepsy, CNS effects, CV -Tell patient to
syndrome release of thyrotoxicosis, effects. relieve dry mouth
-Delirium hypothalamic and pregnancy, elderly, with sugarless
hypophyseal debilitated gum or hard
hormones; believed to candy.
depress the reticular
activating system thus
affecting basal
metabolism, body
temperature,
wakefulness,
vasomotor tone,
emesis.
DIAZEPAM Anxiolytics Anxiety and Binds to stereospecific Pregnancy, lactation, Severe psychoses; 1st Mental Dosage -When using oral
tensions, benzodiazepine neonates, elderly, trimester of disturbance, Adults: solution, dilute
Agitation, receptors on the epileptics, pregnancy, acute drowsiness, Depending on dose just before
(Anxionil, LBS Tremor, postsynaptic GABA myasthenia gravis; narrow-angle amnesia the severity; 2- giving.
Diazepam, Halluconosis, neuron at several sites CV, hepatic, renal glaucoma. dependence, 1mg PO bid or -Monitor period
Nixtensyn, Muscle Spasm within the central disease; depression; blurred vision, qid hepatic, renal,
Trazepam, UL nervous system, blood dyscrasias urinary Children age 6 hematopoietic
Diazepam, Valium) including the limbic retention, months and up: function in
system, reticular hypotension, 1-2.5mg Po tid or patients receiving
formation. slurred speech, qid, increase repeated or
Enhancement of the rash. gradually as prolonged
inhibitory effect of needed and a therapy.
GABA in neural tolerated.
excitability results by
increased neural
membrane
permeability to
chloride ins result in
hyperpolarization (a
less excitable state)
and stabilization.
ASPIRIN Nonopioid Treatment of Inhibits prostaglandin Use cautiously in Hypersensitivity to EENT: Dosage -Use liquid form
analgesics and mild-to- synthesis, acts on the patients with GI salicylates other tinnitus, hearing Adult: for children and
antipyretics moderate pain, hypothalamus heat- lesions, impaired NSAIDs, or any loss Initially, 2.4-3.6g patients who have
(Bayer Aspirin inflammation regulating center to renal function, components of the GI: PO daily in difficulty in
Regimen Adult Low and fever, may reduce fever, blocks hypothrombinomia, formulation; asthma; Nausea, divided doses. swallowing.
Strength [OTC]; be used as prostaglandin Vitamin K deficiency rhinitis; nasal polyps; dyspepsia, Adults and -In children, do
Bayer Aspirin prophylaxis of synthetizes action and severe hepatic inherited or acquired Hepatic: Children older not exceed 5
Regimen Childrens myocardial which prevents impairment. bleeding disorders Hepatitis than 11 yrs. Old: doses in 24 hours.
[OTC]; Bayer infection, formation of the (including factor VII Skin: 325-650mg PO or -Advise parents
Aspirin Regimen prophylaxis of platelet-aggregating and Factor IX Rash, bruising, PR q4h, prn. that drug is only
Regular Strength; stroke and/or substance deficiency); do not urticarial for short-term
Bayer Extra transient thromboxane A2 use in children (<16 Other: use.
ischemic years old) for viral Angioedema,
Strength Arthritis
episodes, infections Reye syndrome
Pain Regimen;
management of (chickenpox or flu
Bayer Plus Extra rheumatoid symptoms), with or
Strength [OTC]; fever, without fever, due to
Bayer Womens osteoarthritis, a potential
Aspirin Plus Calcium and gout (high association with
[OTC]; Bufferin, dose), adjunctive Reyes syndrome;
Bufferin Extra therapy in pregnancy 93rd
Strength ; Buffinol revascularization trimester especially)
[OTC]; Buffinol procedures
Extra; Easprin; (coronary artery
bypass graft
Ecotrin [OTC];
[CABG],
Ecotrin Low
percutaneous
Strength [OTC]; transluminal
Ecotrin Maximum coronary
Strength [OTC]; angioplasty
Halfprin; St. Joseph [PTCA], carotid
Adult Aspirin; endarterectomy),
Sureprin 81TM [OTC]; stent
ZORprin implantation
GENERIC NAME CLASSIFICATION INDICATION ACTION SPECIAL PRECAUTION CONTRANDICATION SIDE EFFECTS DOSAGE AND NURSING
AVAILABILITY RESPONSIBILITIES
HEPARIN Anticoagulants Hypertropic and Accelerates Use cautiously with Hypersensitivity to Rarely local Dosage -Monitor renal
keloidal scars, formation of pregnant, women parabens skin reaction Adult: function periodically
movement amhthrombin II- older than 60 years Initially 5,000 units by and stop drug in
(Contractubex) restricting and thrombin comlex old are high risk for IV bolus; then 750- patients who
disfiguring scars, and deactivates hemorrhaging. 1500 units/hr. by IV develop unstable
contractures such tthrombin, infusion with pump. renal function or
as cicatrical preventing Children: severe renal
structures and conversion of Initially, 50 units/kg impairment while
Dupuytrens fibrinogen to fibrin. IV; then receiving therapy.
Syndrrome. 25units/kg/hr. or -Give the drug
20,000units/m2 daily subcutaneously in
by IV infusion pumps. fatty tissue, rotating
injection site.
METFORMIN Antidiabetics and Adjunct to diet to Exact mechanism is Use caution when Contraindicated in GI: Dosage -Dont mix drug in a
glucagons lower blood not understood; giving drug to patients Diarrhea, nausea, Adults age 17 and up: syringe with any
glucose with type possibly increases. elderly debilitated hypersensitivity to vomiting, Initially, 500-1,000mg other insulin except
2 diabetes or malnourished drug and in those abdominal PO with evening NPH.
mellitus. with hepatic bloating, anorexia, divided doses -Insulin
Hematologic: Children >10 years
Megaloblastic and adults:
Secondary
hyperuricemia
associated with
chemotherapy:
600-800mg/day in 2-3
divided doses for
prevention of acute
uric acid nephropathy
for 2-3 days starting 1-
2 days before
chemotherapy.
Gout: Mild:
200-300mg/day
Gout: Severe:
400-600mh/day; to
reduce the possibility
of acute gouty attacks,
initiate dose at
100mg/day and
increase weekly to
recommended
dosage.
Recurrent calcium
oxalate stones:
200-300mg/day in
single or divided
doses.
ALLOPURINOL Antigout drug Gout Chemical In pregnant and Contraindicated in Side effects: Dosage: - Assess patients
To prevent acute effect: Breast feeding patients Headache, Adults: history. Gout may
gouty Reduce uric women use hypersensitive to drowsiness. mild gout, be secondary
(Allorin, Apo- attacks. acid production cautiously. drug or any cataracts, 200 to 300 mg PO to dose. Such as
Allopurinol, Hyperuricemias by inhibiting of its components. retinopathy, daily; severe gout acute or chronic
Capurate, secondary the necessary nausea, vomiting, with large tophi, 400 leukemia,
Zyloprim) to malignancies. biochemical abdominal pain, to 600 mg PO daily. polycythemia Vera,
Recurrent calcium reaction diarrhea, uremia, Dosage varies with multiple myeloma,
oxalate Therapeutic anemia, Rash, severity of dose and and psoriasis.
calculi. effect: pruritus, urticarial can be given as - be alert for
Alleviates Gout and pulp uric single dose or in adverse reactions
symptoms. lesions, ichthyoids, divided doses, doses and drug
severe furunculosis larger than 300mg interactions.
of nose should be divided. - Give drug with or
Maximum dosage, immediately after
Adverse Reaction: 800 mg daily. meals to minimize
Renal adverse GI
failure, Availability: reactions.
agranulocytosis, Capsules: 100 mg, - have patients drink
aplastic 300 mg plenty of fluids
anemia, Tablets: 100 mg, while taking drug,
Thrombocytopenia. 2000, mg 300 mg unless
Hepatitis, Allopurinol contraindicated.
exfoliated lesions, sodium - Advise patient not
erythema Injection: 500m/30- to take alcohol
multiform, toxic ml vial while taking drug.
epidermal
necrosis
STREPTOMYCIN Antibiotic -Streptococcal Chemical Use cautiously in Use cautiously in Side Effects: Dosage: -Assess patients
endocarditis. effect: patients with patients with Ototoxicity, Adults: infection before
- Primary and Inhibits protein impaired kidney impaired kidney nausea, vomiting, 1g IM q 12 Hours for 1 starting therapy,
adjunct synthesis by function or function or eosinophilia, week, and regularly
treatment in binding neuromuscular neuromuscular exfoliated and then 500 mg q thereafter to
tuberculosis. directly to 30S dose. dose. dermatitis, 12 hours for 1 week, monitor the drugs
- Enterococcus ribosomal In breastfeeding In breastfeeding hypersensitivity given with penicillin. effectiveness.
endocarditis. subunit. women and women and elderly, reaction, - Obtain specimen
- Tularemia Therapeutic elderly, use cautiously. Availability: for culture and
effect: Kills use cautiously. Adverse effect: Injection: 400mg/ml, sensitivity test
Bacteria Neuromuscular 1 g/2.5-ml ampules before first dose
blockade, except when
nephrotoxicity treating
leukopenia. tuberculosis. Start
Thrombocytopenia, therapy pending
apnea, test result.
angioedema, - Be alert for
anaphylaxis. adverse reactions
and drug
interactions.
-protect hands
while preparing the
drug because drug
is irritating.
- instruct patient to
report hearing loss,
roaring noises, or
fullness in ears
and dizziness
immediately.
MORPHINE Narcotic -relief of Decreased -clients with -Heart failure N&V, Dosage: - List other agents
Analgesic moderate to permeability of known seizure secondary to constipation, Oral solution; prescribed,
SULFATE severe pain the cell disorders chronic lung disease somnolence, Tablets; Tablets, outcome.
-preoperatively membrane to -use with extreme -cardiac arrhythmias headache Soluble - Note any seizure
(Avinza, for sedation and sodium, which caution in aged or -brain tumor 530 mg (solution or disorder or head
Astramorph PF, to reduce results in debilitated clients -acute alcoholism tablets) on a trauma. Monitor
Duramorph, apprehension diminished -delirium tremens regularly scheduled VS and respiratory
Infumorph 200 -supplement to transmission of -convulsive states basis q 4 hr. at the status.
and 500, anesthesia pain impulses -cardiac arrhythmias lowest dosage level -Help client practice
Oramorph SR) -control and therefore -pregnancy category that will achieve cough and deep-
postoperative analgesia. C adequate analgesia breathing
pain exercises and
Availability: incentive
Capsules, Extended- spirometer to
Capsules, decrease risk of
Sustained-Release atelectasis.
Pellets: 20 mg, 30
mg, 50 mg, 60 mg,
100 mg
Injection: 0.5 mg/mL,
to 50 mg/mL Tablets,
Controlled-Release:
15 mg, 30 mg,
METHERGINE PC: Ergot Prevention and Stimulates uterine Sepsis. - contraindicated in Cardiovascular: Dosage: -Be alert for adverse
Alkaloid treatment of smooth muscles Obliterative patients hypertension, IV: reactions and drug
and Derivative postpartum and producing sustained vascular disorders. hypersensitive to temporary 0.2 mg after interactions.
(methylergonovine TC: oxytocic, post abortion contractions Hepatic or renal methylergonovine chest pain, delivery of -This drug should be
maleate) lactation hemorrhage thereby shortens disease. 2nd stage or any palpitation anterior used
stimulant caused by the third stage of of labor. Nursing component of the CNS: shoulder, after extremely carefully
uterine atony or labor mothers. formulation. Hallucinations, delivery of because of
sub involution -ergot alkaloids are dizziness, seizure, placenta, or its potent
contraindicated headache during puerperium; vasoconstrictor
with potent Gastrointestinal: may be action. I.V. use may
inhibitors of CYP3A4 Nausea, repeated as induce
(includes protease vomiting, required at sudden
inhibitors, diarrhea, foul intervals of 2-4 hypertension and
azole antifungals, taste hours cerebrovascular
and some Local: accidents. As a
macrolide Thrombophlebitis last resort, give I.V.
antibiotics); Optic: slowly
hypertension; Tinnitus over several
toxemia; Renal: minutes and
pregnancy Hematuria monitor blood
Respiratory: pressure closely.
Dyspnea,
nasal congestion
Miscellaneous:
Diaphoresis
PARACETAMOL Nonopioid -Mild pain or Chemical Use cautiously in Contraindicated in Side effects: Dosage: - assess patients
analgesic, fever. effect: patients with patients Hemolytic anemia Adult and children pain or temperature
ACETAMINOPHEN antipyretic May produce history of chronic hypersensitive to jaundice. Rash, older than age 12: before and during
- Osteoarthritis
analgesic effect alcohol abuse drug. urticaria 325 to 650 mg PO or therapy.
(Abenol, by blocking because PR q 4 hours prn or 1 - be alert for
Acephen, Aceta, pain impulses, by hepatoxicity may Adverse Reaction: g PO tid or qid, prn. adverse reactions
Aceta-Elixir, inhibiting occur after Thrombocytopenia, Alternatively, 2 and drug
Dymadon, prostaglandin therapeutic doses. neutropenia, extended release interactions
Panadol, Tempra, or pain receptor In pregnant and leukopenia, caplets Po q 8 hours. - Give liquid form to
Tylenol) sensitizers. breastfeeding pancytopenia, liver Maximum, 4 g daily. children and other
May relieve fever women, use damage, Dosage for long term patients who have
by acting in cautiously. hypoglycemia. therapy shouldnt trouble swallowing
hypothalamic exceed 2.6 g daily
heat-regulating unless monitored by
center. prescriber.
Therapeutic
effect: relieves Availability:
pain and reduces Infant drops:
fever. 80mg/0.8
ml
Capsules: 150 mg,
300 mg
Injection: 600mg
Solution:
80mg/1.66ml
Sprinkles:
80mg/capsules
Suppositories: 80 mg,
120 mg
Tablets: 160 mg, 325
mg, 500 mg
Tablets (chewable);
80
mg, 160 mg
LITHIUM Antimanic -control of mania A decrease in safety and efficacy -cardiovascular or Side effects: Dosage: -Monitor lithium
in cyclic have not been renal dose. Due to initial Acute mania. levels,
manic-depressive AMP levels established for -brain damage therapy: Capsules; Syrup; kidney and thyroid
(Lithobid, clients caused by children less than -lactation Fine hand tremor, Tablets; Tablets, function
Lithonate, - premenstrual lithium which 12years of age -pregnancy category polyuria, thirst, Extended-release studies; assess for
Lithotabs) tension decreases -use with caution D transient and mild (Adults)300600 mg decreased function.
- alcoholism sensitivity of in geriatric clients -dehydration nausea, general 3 times per day or -With arthritic
accompanied by hormonal- because lithium is - clients receiving discomfort 600900 mg twice per conditions,
depression sensitive more toxic to the diuretics day of slow-release document anti-
- tardive adenylcyclase CNS in these Adverse Reaction: form inflammatory
dyskinesia receptors clients peripheral (Elderly and agent(s)
- bulimia circulatory debilitated clients) used.
collapse, severe 0.61.2 grams/day in - Document mental
bradycardia three doses status,
causing Available forms: CV function, VS,
syncope, coma Lithium carbonate chemistry, thyroid
Capsules: 150 mg, function,
300 mg, 600 mg; urinalysis, weight,
Tablets: 300 mg; and ECG
Tablets,
Extended-Release:
300 mg, 450 mg.
Lithium citrate
Syrup: 300 mg/5 mL
METRONIDAZOLE Trichomonacide, -serious infections Inhibits growth -use with -blood dyscrasias Side effects: Dosage: -Reduce dose in
amebicide due to susceptible of trichomonae caution in -active organic Following Amebiasis: Acute those with hepatic
anaerobic bacteria and amoebae those with disease of systemic use: amebic dysentery or dose.
(Flagyl I.V., - peritonitis by binding to evidence the CNS Headache, amebic liver abscess - Do not use
Flagyl 375, - skin structure DNA, resulting or history of - trichomoniasis vaginitis, syringes with
Flagyl ER, infections due to in loss of helical blood during the nausea, Availability: Al needles or hubs.
MetroGel, Bacteroidesspecies structure, dyscrasias or in first trimester of metallic taste, Capsules: 375 mg - Document
MetroLotion, including B. fragilis strand those with pregnancy genital Cream: 0.75 %, 1% indications for
Vandazole) group, Clostridium breakage, impaired -lactation pruritus, Gel (Topical): 0.75%, therapy and
species and inhibition of hepatic bacterial 1% symptom
Peptococcus niger nucleic acid function infection, flu- Injection: 5 mg/ 1 mL characteristics.
synthesis, and like symptoms (ready-to-use) - Monitor CBC, LFTs,
cell death. Injection, Lyophi lized: and
Adverse 500 mg cultures
Reaction: Lotion: 0.75%
seizures, bone Tablets: 250 mg, 500
marrow mg
aplasia Tablets, Extended-
Release: 750 mg
Vaginal Gel/Jelly:
0.75%.
MEBENDAZOLE Anthelmintic -whipworm Blocks the --use with caution -hypersensitivity to Side effects: Dosage: -Note clinical
-pinworm glucose uptake in mebendazole Transient Whipworm, confirmation
-roundworm of the children under 2 -pregnancy category abdominal roundworm, and of organism, onset
(Vermox) -common and organisms, years old and C pain, diarrhea hookworm and
American thereby during Tablets, Chewable: characteristics of
hookworm reducing their lactation (Adults and children) 1 S&S, and
energy until tablet morning and any contributory
death results. evening on 3 factors.
consecutive days Identify all persons
Pinworm in
1 tablet, one time contact and
potentially
Availability: affected.
Tablets, Chewable -Tablets may be
100 mg chewed,
swallowed, or
crushed with
food.
-Teach client to
practice
personal hygiene
and
wash hands
regularly.
INSULIN Insulin Product -diabetic coma Increases -a pregnant hypersensitivity to Side effects: Dosage: -Note dose. Onset,
-diabetic acidosis synthesis of diabetic insulin Hypoglycemia, SC level of
(REGULAR) -clients suffering glycogen in the client inhibits milk hypokalemia, (Adults) 5-10 units control/
from labile liver. production. injection (Pediatric) 2-4 units. understanding of
(Humulin R, diabetes site reaction, Injection is given 15- dose. Previous
Novolin R, pruritus, 30 mi before meals agents trialed,
Velosulin BR) rash and at bedtime. outcome.
-Monitor VS, CBC,
Availability: HbA1c, and U/A:
Injection: 100 units/ml micro albumin, renal
and LFTs.
-Tell client to report
adverse effect or
lack or
sugar control.
Continue
diet, exercise and
weight
control.
ACETHYLCYSTINE Mucolytic -chronic Reduces the -lactation -sensitivity to drug Side effects: Dosage: -Use nonreactive
emphysema viscosity of -use with caution - Pregnancy Bronchial/tracheal Direct instillation into plastic,
-emphysema purulent and in category B irritation, N&V, tracheostomy glass, or stainless
(Acetadote, with no purulent elderly and clients rash, stomatitis 1-2 ml of 10% or 20% steel for
Mucomyst ) bronchitis pulmonary with asthma solution every 1-4 administration.
-tuberculosis secretions and hours -After prolonged
-chronic facilitates their Closed tent or nebulization, dilute
asthmatic removal by croquette the last
splitting Up to 300 ml of 10% fourth of the
disulfide bonds. or 20% solution per medication
treatment. with sterile water to
prevent drug
Availability: concentration.
Injection: 20% -Note pulmonary
Oral Solution (as findings:
sodium): 10%, 20% determine when
spasm
occur.
LANOXIN Pharmacologic -Heart failure, Chemical Electrolyte Hypersensitivity, CNS: (IV)Adult:Digitilizing -Monitor apical
Class: paroxysmal effect: abnormalities uncontrolled fatigue, headache, Dose I0.6-1 mg (10- pulse before
Cardiac glycoside supraventricular Inhibits sodium- ( hypokalemia, ventricular weakness 15 mcg/kg) given as administering.
(Digoxin, Therapeutic tachycardia, atrial potassium- hypercalcemia, arrhythmias, AV EENT: 50% of the dose -Monitor blood
Digitek, Class: fibrillation and activated and block, idiopathic blurred vision, initially pressure
Lanoxicaps) Inotropic, flutter. adenosine hypomagnesemia hypertrophic yellow vision and additional periodically in
antiarrythmic triphosphates, may predispose to subaortic stenosis, CV: fractions given at 4-8 patients receiving IV
thereby toxicity),Geriatric constrictive Arrhythmias, hr interval. dogoxin.
promoting patients, MI,Renal pericarditis, known bradycardia, ECG (PO)Adult: Digitalizing -Monitor intake and
movement of impairement, alcohol intolerance changes dose 0.75-1.25 mg output ratios and
calcium from Obese patients, (elixir only) GI: (10-15 mg/kg) given as daily weights.
extra cellular to Pregnancy, and anorexia, nausea, 50% of the dose -Observe patient for
intracellular Lactation, vomiting, diarrhea initially and additional signs and symptoms
cytoplasm and Endo: fractions given at 4-8 of toxicity.
strengthening gynecomastia hr intervals. -Oral preparations
myocardial Hemat: Maintenance dose can be administered
contraction. thrombocytopenia 0.063-0.5 mg/day as without regard to
Also acts on tablets or 0.350-0.5 meals.
CNS to mg/day as gelatin -Before
enhance vagal capsules, depending administering initial
tone, slowing on patients lean body loading dose,
conduction weight, renal function, determine whether
through SA and and serum level. patient has taken
AV nodes and any digitalis
providing preparations in the
Antiarrhythmic preceding 2-3 wk.
effect.
Therapeutic
effect:
strengthens
myocardial
tractions and
slows
conduction
through SA and
Av nodes.
CIPROILOXACIN Antibiotic, - acute sinusitis Interferes with -safety and -hypersensitivity to Side effects: Dosage: - Although food
fluoroquinolone due to DNA gyrase effectiveness of quinolones After systemic Pyelonephritis, delays
Haemophilus and ophthalmic, PO, or -use in children use: acute uncomplicated drug absorption, it
(Ciloxan influenzae, topoisomerase IV -lactation Headache, N&V, Adults: may be
Ophthalmic, Streptococcus IV. DNA gyrase use have not been -Pregnancy category diarrhea, 1,000 mg once daily of taken with/without
Cipro, Proquin pneumoniae,or is an enzyme determined in C restlessness, extended-release meals;
XR) Moraxella needed for children rash tablets for 714 days. recommended
catarrhalis replication, -possible After ophthalmic dosing time
- Chronic transcription, antibiotic use: Availability: is 2 hr. after a meal.
bacterial and repair of resistance when Irritation, burning, Injection: 200 mg, - Note reasons for
prostatitis due to bacterial DNA. used to treat stinging, itching, 400 mg therapy;
E. colior Proteus Pseudomonas inflammation Ophthalmic S&S and obtain
mirabilis aeruginosa Ointment: 3.33 mg/g cultures.
-UTI infections. Adverse Reaction: (equivalent to 3 mg - Store vials for IV
Intestinal base) use from
perforation, Tablets: 100 mg, 250 530C (4186F).
toxic epidermal mg, 500 mg, 750 mg Protect
necrolysis Tablets, Extended- from light, excessive
Release: 500 mg, heat,
1,000 mg and freezing
PHENYTOIN Antiarrhythmic, -Chronic epilepsy Acts in the -acute, -hypersensitivity to Side effects: Dosage: - List reasons for
Class IB - control sei zures motor cortex of intermittent hydantoins Ataxia, Oral suspension; therapy,
Anticonvulsant, during the brain to porphyria clients - exfoliative drowsiness, Tablets, Chewable onset,
(Dilantin hydantoin neurosurgery reduce the with dermatitis slurred speech, (Adults, initial) 100 mg characteristics of
Infatab, - Severe spread of a history of - sinus bradycardia confusion, N&V, (125 mg of the S&S, clinical
Dilantin-125) preeclampsia electrical asthma or - Lactation rash, suspension) 3 times presentation,
discharges from other allergies -Pregnancy category constipation/ per day; adjust dos blood levels, other
the rapidly firing - impaired renal or C diarrhea, age at 7- to 10-day agents
epileptic foci in hepatic function gingival intervals until seizures trialed, outcome.
this area. - heart disease hyperplasia are controlled - Note history and
(hypotension, (Pediatric, initial) 5 nature
severe Adverse Reaction: mg/kg/day in two to of seizures,
myocardial increased seizures, three divided doses addressing
insufficiency) toxic epidermal location, frequency,
necrolysis, toxic Availability: duration,
hepatitis Tablets, Chewable: causes/characteristi
50 mg cs,
Oral Suspension: triggers and EEG
125 mg/5 m findings.
- Do not substitute
products or
exchange
brands;
bioavailability of
phenytoin may vary.

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GENERIC NAME CLASSIFICATION INDICATION ACTION SPECIAL CONTRANDICATION SIDE EFFECTS DOSAGE AND AVAILABILITY NURSING

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