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Salbutamol 1 neb q8 Accuneb, Novosalmol , Proventil, Proventil HFA, Proventil Repetabs, Salbutamol, Ventolin, Ventolin Rotocaps, Volmax

Classifications:autonomic nervous system agent; beta-adrenergic agonist (sympathomimetic); bronchodilator (respiratory smooth muscle relaxant)

-Synthetic sympathomimetic amine and moderately selective beta2-adrenergic agonist with comparatively long action. Acts more prominently on beta2 receptors (particularly smooth muscles of bronchi, uterus, and vascular supply to skeletal muscles) than on beta1 (heart) receptors. Minimal or no effect on alpha-adrenergic receptors. Inhibits histamine release by mast cells.

-To relieve bronchospasm -Pregnancy (category C), associated with acute or lactation. Use of oral syrup chronic asthma, bronchitis, in children <2 y or other reversible obstructive airway diseases. Also used to prevent exercise-induced bronchospasm.

-Hypersensitivity reaction. -CNS: Tremor, anxiety, nervousness, restlessness, convulsions, weakness, headache, hallucinations. -CV: Palpitation, hypertension, hypotension, bradycardia, reflex tachycardia. Special Senses: Blurred vision, dilated pupils. -GI: Nausea, vomiting. Other: Muscle cramps, hoarseness

-Inhaler may be used 15 minutes before exercise to prevent exercise-induced bronchospasm. -Patient may use tablets and inhaler at the same time. Monitor for toxicity. -Warn the patient about the risk of paradoxical bronchospasm and if it occurs, stop drug immediately. -Teach patient to use the inhaler correctly: Shake it, clear the throat, expel as much air as possible from the lungs, inhale deeply while releasing the drug from the inhaler, hold breath for several seconds.

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Dexamethasone 8 mg IV -Dexamethasone q8 suppresses inflammation and the normal immune Classification: Long- acting response. It prevents the corticosteroid release of substances in the body that causes inflammation.

-Management of cerebral edema -Diagnostic agent in adrenal disorders -Relieves inflammation -Allergic disorders -Asthma -Arthritis

-Hypersensitivity -Active untreated infection -Lactation -Systemic fungal infection

-Acne, Decreased wound healing, Depression, Vomiting, Easy bruising, Headache, Increased hair growth, Insomnia, Restlessness, Stomach irritation, Irregular or absent menstruation, Dizziness

-Monitor intake and output of patient. -Observe the patient for peripheral edema, steady weight gain, rales or crackles or dyspnea. Notify the physician immediately if these clinical manifestations are noted. -Administer with meals to minimize GI irritation. -For patients with difficulty swallowing, tablets can be crushed and administered with fluids or food. However, capsules should be swallowed whole. -Educate the patient to take missed doses as soon as remembered, unless almost time for the next dose skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

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Tramadol 50 mg IV q8 PRN Classification: Analgesic, centrally acting Pregnancy Category C

-Tramadol inhibits -Relief of moderate to -Sweating, dizziness, -Suicidal patients, acute reuptake of moderately severe pain nausea, vomiting, dry alcoholism; head injuries; norepinephrine, serotonin mouth, fatigue, asthenia, raised intracranial and enhances serotonin somnolence, confusion, pressure; severe renal release. It alters perception constipation, flushing, impairment; lactation. and response to pain by headache, vertigo, binding to mu-opiate tachycardia, palpitations, receptors in the CNS. miosis, insomnia, orthostatic hypotension, seizures, CNS stimulation e.g. hallucinations.

-Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration. -Assess BP & RR before and periodically during administration. -Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk and with laxatives to minimize constipating effects. -Monitor patient for seizures. May occur within recommended dose range. -Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and pneumonia.

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Clindamycin 300 mg IV q6

-Inhibits protein synthesis -Systemic administration: in susceptible bacteria, Serious infections caused causing cell death. by susceptible strains of anaerobes, streptococci, staphylococci, pneumococci -Parenteral: Treatment of septicemia caused by staphylococci, streptococci; acute hematogenous osteo myelitis; adjunct to surgical treatment of chronic bone and joint infections due to susceptible organisms; do not use to treat meningitis; does not cross the blood brain barrier. -Vaginal preparation: Treatment of bacterial vaginosis

-Contraindicated with allergy to clindamycin, history of asthma or other allergies, tartrazine (in 75and 150-mg capsules); hepatic or renal dysfunction; lactation. -Use cautiously in newborns and infants due to benzyl alcohol content; associated with gasping syndrome.

-Hypotension, cardiac arrest (with rapid IV infusion) -GI: Severe colitis, including pseudomembra nous colitis, nausea, vomiting, diarrhea, abdominal pain, esophagitis, anorexia, jaundice, liver function changes Hematologic: Neutropeni a, leukopenia, agranulocyt osis, eosinophilia Hypersensitivity: Rashes, urticaria to anaphylactoid reactions Local: Pain following injection, induration and sterile abscess after IM injection, thrombophlebiti s after IV use

-Administer oral drug with a full glass of water or with food to prevent esophageal irritation. -Do not give IM injections of more than 600 mg; inject deep into large muscle to avoid serious problems. -Do not use for minor bacterial or viral infections. -Monitor renal and liver function tests, and blood counts with prolonged therapy. -Take oral drug with a full glass of water or with food. -Take full prescribed course of oral drug. Do not stop taking without notifying health care provider. -Report severe or watery diarrhea, abdominal pain, inflamed mouth or vagina, skin rash or lesions.

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Ambroxol 30 mg 1 tab -It stimulates serous cells of TID gland of bronchi mucous membranes, increasing mucous secretion content, due to which serous-tomucous expectoration components relation is changed. It changes the structure of bronchial secretion by reducing and fragmenting mucopolysaccharide fibers, resulting in reduction of expectoration viscosity. Also it intensifies motion of ciliated epithelium cilia, increasing expectoration transport. Ambroxol stimulate s synthesis of phospholipids by alveolar cells and formation of surfactant lipids.

-All forms of tracheobronchitis, emphy sema with bronchitis pneumoconiosis, chronic inflammatory pulmonary conditions, bronchiectasis, and bronchitis with bronchospasm asthma. Given to the client, so that the client can easily expectorate phlegm.

-There are no absolute contraindications but in patients with gastric ulceration relative caution should be observed. -gastric ulceration

-Occasional -Advise the patient to take gastrointestinal side the medicationwith food. effects may occur but -The patient should be these are normally mild instructed to swallow the tablet whole and not chew to prevent choking or reduced effectiveness. -Encourage the patient to spit into a tissue rather than swallow the sputum. Take note of the color and consistency and report any changes to the physician. -Prior to administering and immediately after, listen to the patients lung sounds and note any abnormalities. Regularly assess these sounds to ensure the medication is working properly. -Suctioning equipment to clear the airways of excess mucus should be kept near