NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: furosemide Brand Name:

Lasix Classification: Loop Diuretic Dosage: 10mg Route: IVTT Frequency: q12 Rapid-acting potent sulfonamide loop diuretic and antihypertensive with pharmachologic efffects and uses almost identical to those of ethacrynic acid. Exact mode of action not clearly defined; decreases renal vascular resistance and ay increase renal blood flow. Treatment of edema associated with CHF, cirrhosis of liver, and kidney disease, including nephritic syndrome. May be used for management of hypertension, alone or in combination with other antihypertensive agents, and for treatment of hypercalcemia. Has been used concomitantly with mannitol for treatment of severe cerebral edema, particularly in meningitis. History of hypersensitivity to furosemide or sulfonamides; increasing oliguria, anuria, fluid and electrolyte depletion states; hepatic coma; pregnancy (category C), lactation. CV: palpitations, flushing tachycardia, bradycardia, dizziness with escessive diuresis, acute hypotensive episodes, circulatory collapse. Metabolic: hypovolemia, dehydration, hyponatremia, hypokalemia, hypochloremia metabolic alkalosis, hypomagnesemia GI: abdominal cramp, nausea, anorexia, constipation, dyspepsia, acute pancreatitis. Urogenital: allergic interstitial nephritis, irreversible renal failure, urinary frequency. HEMA: anemia, leukopenia, thrombocytopenic purpura; aplastic anemia. SKIN: pruritus, urticaria. Monitor BP during periods of diuresis and through period of dosage adjustment. Monitor for S&S of hypokalemia. Monitor I &O ratio and pattern. Report decrease or unusual increase in output. Excessive diuresis can result in dehydration and hypovolemia, circulatory collapse, and hypotension. Weigh patient daily under standard conditions. ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: omeprazole Brand Name: Omepron Classification: Gastric acid-pump inhibitor. Suppresses gastric acid secretion by specific inhit=bition of the hydrogen-potassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks final step of acid production.  Short term treatment for duodenal ulcer.  Treatment of heartburn or symptoms of GERD.  Short term treatment of active benign gastric ulcer.  GERD, severe erosive esophagitis, poorly responsive symptomatic GERD. Hypersensitivity Use cautiously with pregnancy and lactation. CNS: headache, asthenia, vertigo, insomia,anxiety, apathy DERM: rash, inflammation, pruritus, dry skin GI: diarrhea, abdominal pain, RESP: URI symptoms, sough, eistaxis CV: chest pain Monitor BP during periods of diuresis and through period of dosage adjustment. Administer before meals. Caution patient to swallow whole not to open, chew, or crush them. Administer antacids if needed. Advise patient to avoid alcohol, products containing aspirin or NSAIDs, and foods that may cause an increase in GI irritation. ADVERSE EFFECTS RESPONSIBILITIES/

Proton pump inhibitors

Dosage: 20mg Route: PO Frequency: OD

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: acetylcysteine Brand name: Fluimucil Classification: mucolytic agent Dosage: 600mg + 70cc H2O Route: PO Frequency: BID Acetylcysteine probably acts by disrupting disulfide linkages of mucoproteins in purulent and nonpurulent secretions. Adjuvant therapy in Hypersensitivity to patients with abnormal, acetylcysteine; patients at viscid, or inspisated risk of gastric hemorrhage. mucous secretions in acute and chronic bronchopulmonary diseases, and in pulmonary complications of cystic fibrosis and surgery, tracheostomy, and atelectasis. CNS: dizziness, drowsiness GI: nausea, vomiting stomatitis, hepatotoxicity RESPIRATORY: bronchospasm, rhinorrhea, burning sensation in upper respiratory passages, epistaxis. - assess airway obstruction - monitor for S&S of aspiration of excess secretions. - advise to report occurence of nausea. - monitor for effectiveness of therapy. - monitor vital sign and cardiac status. ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS THE DRUG PRECAUTIONS Generic Name:
domperidone

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Brand name: Motilium Classification: antiemetics and anti-vertigo Dosage: 10mg i tab Route: PO Frequency: TID

Its action on the dopamine-receptors in the chemo-emetic trigger zone produces an anti-emetic effect. Does not cross the blood-brain barrier to any appreciable degree and so exerts relatively little on cerebral dopaminergic receptors.

Dyspeptic symptom complex associated w/ delayed gastric emptying, GERD, esophagitis eg epigastric sense of fullness, early satiety, feeling of abdominal distension, upper abdominal pain; bloating, eructation, flatulence; heartburn w/ or w/o regurgitations of gastric contents in the mouth. Nausea & vomiti ng of functional, organic, infectious or dietetic origin or induced by radio- or drug therapy.

Hypersensitivity

Allergic reaction, such as rash or urticaria, have been reported. Abdominal cramps Dystonic reaction hypertension

- Monitor vital sign. - should be taken on an empty stomach. Take 15-30 mins before meals. - monitor for effictiveness of the therapy.

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS THE DRUG PRECAUTIONS Generic Name:
potassium chloride

ADVERSE EFFECTS OF RESPONSIBILITIES/

Replcement of potassium and maintain potassium level.

To prevent hypokalemia, prophylaxis during treatment with diuretics.

Brand name: Kalium Durule Classification: electrolytes Dosage: i tab Route: PO Frequency: TID

Contraindicated in patient with oliguria, anuria,; patient with untreated Addisons disease or with acute dehydration ,heat cramps, Use cautiously with patient with cardiac disease and renal impairment

Arrhythmias, Heart block, Hypotension Cardiac arrest Hyperkalemia Respiratory paralysis Nausea and vomiting , abdominal pain

- Monitor vital sign. - check potassium level after repeated doses. - inform patient of short-term need drug and answer questions and address concern. - review potential adverse reactions and instruct patient promptly reprt any occurences.

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS THE DRUG PRECAUTIONS Generic Name:
sodium chloride

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Brand name: Classification: electrolytes Dosage: i tab Route: PO Frequency: TID

Sodium is the major cation of the bodys extracellular fluid. It plasys a crucial role in maintaining the fluid electrolyte balance. Excess sodium results in over hydration (edema, Hypervolemia), which is often treated with diuretics. Abnormally low level of sodium result to dehydration.

Prophylaxis of heat prostration or muscle cramps; chloride deficiency due to diuresis or restriction; prevention or treatment of extracellular volume depletion.

Congestive heart failure, severely impaired renal function, hypernatremia, retention,

Hypernatremia, hypopotassemia, acidosis. Fluid solute overload leading to dilution serum electrolyte level, CHF, overhydration, acute pulmonary edema

- monitor electrolytes, ECG, liver and renal function studies. - note level of consciousness - assess the heart and lung sounds - observe signs and symptoms of hypernatremia, flushed skin, elevated temperature, rough dry tongue, edema - monitor vital signs and monitor intake and output. - assess urine specific gravity and serum soudium levels.

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS THE DRUG PRECAUTIONS Generic Name:
ketoanalogues and essential amino acids

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Brand name: Ketosteril Classification: Urologicals Dosage: 600mg i tab Route: PO Frequency: TID

Normalizes metabolic process, promotes recycling product exchange. Reduces ion Concentration of potassium, magnesium, and phosphate.

Prevention and treatment of conditions caused by modified or insufficient protein metabolism in chronic renal falure.

Allergy and hypersensitivity

Hypercalcemia

- evaluate for any contraindications. - take drugs as prescribed. - warn the patient about possible side effects - give with food if GI upset occurs. - frequently assess for hypercalcemia.

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS THE DRUG PRECAUTIONS Generic Name: propranolol HCL Brand name: Parvilox Classification: Non-selective betablocking agents Dosage: 400mg i tab Route: PO Frequency: OD The sympathetic nervous stimulates the pace of the heart beat by blocking the action of these nerves thus reducing the heart rate and becomes useful in treating abnormally rapid heart rhythms, reduces the force of the heart muscle contraction and lowers blood pressure. By reducing the heart reate and the force of muscle contraction, propranolol redces heart muscle oxygen demand.
Management of HTN, angina pectoris, MI & cardiac arrhythmias.

ADVERSE EFFECTS OF RESPONSIBILITIES/

Heart failure, bradycardia, heart block of any degree, bronchospasm eg asthma & obstructive airway disease, metabolic acidosis, diabetic ketoacidosis, after prolonged fasting, concurrent use of verapamil IV.

GI disturbances eg nausea & vomiting, fatigue, dizziness. CV effects eg bradycardia, hypotension, paradoxical HTN, cold extremities, Raynauds phenomenon, CHF or heart block.

- evaluate for any contraindications. - take drugs as prescribed. - warn the patient about possible side effects - give with food if GI upset occurs. - frequently assess for hypercalcemia.

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS THE DRUG PRECAUTIONS Generic Name: pregabalin Brand name: Lyrica Classification: Anticonvulsants or Antiepileptics Dosage: 50mg i cap Route: PO Frequency: q12 In vitro studies show that Treatment of pregabalin binds to an neuropathic pain in auxiliary subunit ( 2adults. protein) of voltage-gated calcium channels in the central nervous system, potently displacing [3H]gabapentin. Two lines of evidence indicate that binding pregabalin to the 2- site is required for analgesic and anticonvulsant activity in animal models: (1) Studies with the inactive Renantiomer and other structural derivatives of pregabalin and (2) Studies of pregabalin in mutant mice with defective drug binding to the 2- protein. In addition, pregabalin reduces the release of several neurotransmitters, including glutamate, noradrenaline and substance P. The significance of these effects for the clinical pharmacology of pregabalin is not known. Hypersensitivity to pregabalin or to any of the excipients of Lyrica. GI disturbances eg nausea & vomiting, fatigue, dizziness. EYE:Blurred vision, diplopia. Visual disturbance, dry eye, eye swelling, reduced visual acuity, eye pain, asthenopia, increased lacrimation.Photopsia, eye irritation, mydriasis, oscillopsia, altered visual depth perception, peripheral vision loss, strabismus, visual brightness. EAR: Vertigo, Hyperacusis. CARDIO:Tachycardia, First-degree atrioventricular block, sinus tachycardia, sinus arrhythmia, sinus bradycardia. -advice the patient not to immediately stand up may cause dizziness. - monitor vital signs continously and cardiac status. - may be taken with or without food. ADVERSE EFFECTS OF RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS THE DRUG PRECAUTIONS Generic Name: budesonide Brand name: Asmavent Classification: Antiasthmatic Dosage: i neb Route: nasal Frequency: q12 Budesonide is an antiinflammatory corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity. The precise mechanism of action on inflammation is not known. Corticosteroids have been shown to have a wide range of inhibitory activities against multiple cell types (eg, mast cells, eosinophils, neutrophils, macrophages and lymphocytes) and mediators (eg, histamine eicosanoids, leukotrienes and cytokines) involved in allergic and non-allergicmediated inflammation. These anti-inflammatory actions may contribute to their efficacy in asthma. Chronic control of signs and symptoms of bronchial asthma. Maintenance treatment of asthma as prophylactic therapy in adult and pediatric patients. Primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. Hypersensitivity to budesonide. Body as a Whole: Neck pain. Respiratory: Cough, respiratory infection, rhinitis, sinusitis, stridor. Gastrointestinal Tract: Gastroenteritis, oral candidiasis, abdominal pain, dry mouth, nausea, vomiting, dyspepsia. Metabolic: Weight gain. Musculoskeletal: Fracture, myalgia, arthralgia. Central Nervous System: Hypertonia, migraine, asthenia, dystonia, hyperkinesia. Hematologic: Ecchymosis, epistaxis, purpura. Psychiatric: Insomnia, anorexia, emotional lability. Dermatologic: Contact dermatitis, rash. Special Senses: Taste perversion. - monitor vital signs. - chest tapping after nebulization. - assess airway obstruction. ADVERSE EFFECTS OF RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: hyrocortisone Na succinate Brand name: Solu-cortef Classification: Corticosteroid hormones Dosage: 100mg Route: IV Frequency: q12 Decrease inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. Management of adrenocortical insufficiency, relief inflammation of corticosteroidresponsive dermatoses, adjunctive treatment of ulcerative colitis. Systemic fungal infection. Lactation. Administration of live or live attenuated vaccines. Fluid & electrolyte disturbances; decreased carbohydrate tolerance; impaired wound healing, thin fragile skin; muscle weakness, steroid myopathy, osteoporosis, aseptic necrosis; peptic ulceration w/ possible perforation; cataracts, increased intraocular & intracranial pressure; growth retardation; Cushingoid state; protein catabolism; psychic derangements, exophthalmos, masking of infections, gasping syndrome, seizures, menstrual irregularities. - monitor vital signs. - monitor any sign of anaphylactic reaction. - assess clients muscle weakness and wasting, weight. ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: celecoxib Brand name: Celebrex Classification: NSAID, analgesic and cox-2 enzyme blocker Dosage: 200 mg Route: P.O Frequency: OD Analgesic and antiinflammatory activities related to inhibition of the cox-2 enzyme which is activated in inflammation to cause the sign and symptoms associated with inflammation does not affect cox-1 enzyme, which protects the lining if the GI-tract and has blood clotting and renal functions Acute and long term treatment of sign and symptoms of rheumatoid arthritis and osteoarthritis Contradicted with allergies to sulfonamides, celecoxib, NSAIDS and aspirin Headache, dizziness, fatigue, MI, CVA, Nauseam abdominal pain and GI bleed - Administer drug with food or after meals if GI upset occurs. - Establish safety measures if CNS or visual disturbances occur. - Provide comfort measures. - Report rash, fever, swelling in ankles and fingers ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: salbutamol Brand name: It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles it binds to the beta 2 adrenergic receptors in the airway if the smooth muscle which leads to the activation of the adenyl cyclase and increased level of cyclic adenosine monophosphate To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder Quick relief of bronchospasm Hypersensitivity ti adrenergics amins Hypersensitivity to flusrocarbons Nervousness, restlessness, tremors, headache, insomnia, chest pain, palpitations, angina, arrhythmias, hypertension, hyperkalemia and hypokalemia Assess lung sounds PR and BP before drug administration and during peak of medication Observe for paradoxical spasm and with hold medication and notify physician Administering medication through inhalation allow at least 1 minute bet inhalation of the aerosol meds. Advise the patient to rinse mouth with water after inhalation to minimize dry mouth Inform the patient that it may cause unusual bad taste ADVERSE EFFECTS RESPONSIBILITIES/

Classification: Bronchodilator, adrenergic Dosage:i neb Route: Frequency: q6

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: fluconazole Brand Name: Diflucan Classification: antifungal Dosage: 50 mg Route: P.O Frequency:OD Take drug with food if GI upset occur It prevents the growth of fungi by preventing production of the membranes that surrounds fungal cells It may also be effective Contraindicated with in treating urinary tract hypersensitivity to infection and pneumonia and disseminated infection caused by candida Headache, nausea, abdominal pain, diarrhea, rash, dizziness, and taste disturbances Monitor patient before and after giving the medication Monitor vital signs Report any unusual condition if occur ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: oxycodone Brand Name: Oxynorm Classification: Narcotic Dosage: 5mg Route: PO Frequency: PRN Instruct patient to report any unusual discomfort Pain reliever and cough suppressant similar to morphine the precise mechanism action is not known but may involve stimulation of opiod receptors in the brain Pain reliever Contraindicated high risk for abuse and severe, possibly fatal breathing problems Lightheadedness, dizziness, sedation, nausea, vomiting, headache, rash, constipation, dry mouth and sweating You may take the drug with food or without food Assess level of pain Monitor for signs and symptoms of hypersensitivity Monitor effectiveness of therapy ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: Brand Name: Iberet-Folic Acid Classification: Vitamins and minerals/antianemics Dosage: i tab Route: PO Frequency: OD It is a hematinic containing iron in a sustained-release system, vitamin C for enhancement of iron absorption and vitamin B complex including folic acid Treatment and prevention of Fedeficiency and concomitant folic acid deficiency with associated deficient intake or increased need for Vitamin B complex in non pregnant adults Thalassemia, sideroblastic anemia, hemochromatosis and hemosiderosis Nausea, Vomiting, constipation or diarrhea, gastric pain at high dose Take with meal if GI upset occurs Instruct the patient to avoid taking vitamins together it can result to overdose Instruct patient to report difficulty in swallowing Report allergies and unusual conditions. ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: Piperacilin+tazobactam Brand Name: Tazocin Classification: Penicillins Dosage: 2.25mg Route: IV Frequency: q8 Rapid-acting potent sulfonamide loop diuretic and antihypertensive with pharmachologic efffects and uses almost identical to those of ethacrynic acid. Exact mode of action not clearly defined; decreases renal vascular resistance and ay increase renal blood flow. Treatment of systemic &/or local bacterial infections caused by susceptible organisms; UTI, lower resp tract, intraabdominal; skin & skin structure infections; bone & joint; gynecologic; bacterial infections in neutropenic patients; bacterial septicemia; polymicrobic infections. Hypersensitivity to penicillins, cephalosporins or -lactamase inhibitors. Diarrhea, nausea, vomiting, rash, leukopenia, neutropenia, thrombocytopenia, hypersensitivity reaction, headache, insomnia, hypotension, phlebitis, thrombophlebitis, constipation, dyspepsia, jaundice, stomatitis, increased blood creatinine, pruritus, urticaria, fever, inj site reaction. Monitor BP during periods of diuresis and through period of dosage adjustment. Monitor for S&S of hypokalemia. Monitor I &O ratio and pattern. Report decrease or unusual increase in output. ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: multivitamins Brand Name: AminoVita Classification: Vitamins and or Minerals Dosage: i cap Route:PO Frequency: TID In cases where there are considerable nutrient losses (febrile illnesses, infectious diseases, strenuous physical activities). As adjuvant in the therapy of malnutrition, chronic illnesses. Conditions associated w/ protein loss &/or increased nutritional requirements (burns, wounds, bone fracture, convalescence, stress, postsurgical operations). Nutritional supplement in protein & vit deficiencies associated w/ restrictive or deficient diet (anorexia, starvation). - May be taken with or without food (May be taken w/ meals for better absorption or if GI discomfort occurs.). ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: human albumin Brand Name: Albuminar Classification: Albumin Dosage: 25% Route: IVTT Frequency: q12 This extra fluid reduces hemoconcentration and blood viscosity. The degree of volume expansion is dependent on the initial blood volume. When the circulating blood volume has been depleted, hemodilution following albumin administration persists for many hours. In individuals with normal blood volume, it usually lasts only a few hours. For emergency treatment of shock and in other similar conditions where the restoration of blood volume is urgent. If there has been considerable loss of red blood cells, transfusion with packed red blood cells is indicated. Patients with severe anemia or cardiac failure and in patients with a history of allergic reactions to human albumin. The incidence of untoward reactions to Albuminar is low. Reports have been received of anaphylaxis, which may be severe and hypersensitivity reactions (including urticaria, skin rash, pruritus, edema, erythema, hypotension and bronchospasm). Nausea, vomiting, increased salivation, chills and febrile reactions Monitor BP during periods of diuresis and through period of dosage adjustment. Monitor for S&S of hypokalemia. Monitor I &O ratio and pattern. Report decrease or unusual increase in output ADVERSE EFFECTS RESPONSIBILITIES/

NURSING MECHANISM OF DRUG ORDER ACTION INDICATIONS CONTRAINDICATIONS OF THE DRUG PRECAUTIONS Generic Name: fentanyl Brand Name: Durogenic Classification: Opioid agonist analgesic Dosage: 25mg Route: patch Frequency: OD Acts at specific opioid receptors, causing analgesia, respiratory depression, physical depression, euphoria. Management of chronic pain & intractable pain requiring opioid analgesia particularly cancer pain. Hypersensitivity to opioids, diarrhea caused by poisoning, acute bronchial asthma, upper airway obstruction, pregnancy. Hypoventilation, nausea, vomiting, constipation, hypotension, bradycardia, headache, somnolence, confusion, hallucination, euphoria, pruritus, sweating & urinary retention, skin reactions, opioid w/drawal symptoms (transfer from previous opioid analgesic to fentanyl). Monitor BP during periods of diuresis and through period of dosage adjustment. Monitor I &O ratio and pattern. Report decrease or unusual increase in output. Do not drink grapefruit juice while using this drug. Report severe nausea, vomiting, palpitations, shortness of breath, or difficulty breathing. ADVERSE EFFECTS RESPONSIBILITIES/