DRUG STUDY Name of Drug Mode of Action Antagonizes the effect of histamine at H1 receptor sites; does not bind

or inactivate histamine. Route and Indications Dosage 4 PO 25 50mg q Relief of symptoms 6 hrs, 50mg 20 associated with 30 minutes before perennial and seasonal bedtime. allergic rhinitis; vasomotor rhinitis; allergic conjunctivitis; mild, uncomplicated urticaria and angioedema; amelioration of allergic reactions to blood or plasma; dematographism; adjunctive therapy in anaphylactic reactions. Active and prophylactic treatment for motion sickness Night time sleep aid Parkinsonism or druginduced extrapyramidal effects Contraindications Contraindicated with allergy to antihistamines, third trimester of pregnancy and lactation. Side Effects Watch out for: Dry mouth Constipation Difficulty voiding Muscle weakness or aches and pains Adverse Reactions Watch out for: Nursing Responsibilities

Generic Name: diphenhydramine hydrochloride

Brand Name: Benadryl

Classifications: Antihistamine Anti motion sickness drug Antiparkinsonian Cough suppressant Sedative hypnotic

1. Observe for 10 rights in giving medication. CNS: headache, 2. Caution the client that the fatigue, anxiety, medication may cause tremors, vertigo, drowsiness, creating confusion, difficulties or hazards or other depression, activities that require seizures, alertness. hallucinations 3. Tell the client to take the CV: tachycardia, medication with food to palpitations, decrease GI upset. orthostaic 4. Explain to the client that hypotension, heart arising quickly forms a lying or failure sitting position may cause EENT: blurred orthostatic hypotension. vision 5. Adverse effects of these GI: dry mouth, drugs occur more commonly nausea, vomiting, in elderly clients. constipation, 6. Explain to the client that use flatulence of these drugs in warm GU: urinary weather may increase the hesitancy or likelihood of heatstroke. frequency, urine 7. Administer syrup if patient is retention unable to take tablets. Hematologic: 8. Monitor patient response, and leucopenia arrange adjustment of dosage Skin: to lowest possible effective photosensitivity, dose. dermatitis 9. Tell the patient to avoid alcohol while taking the medication; serious sedation may occur. 10. Tell patient to report difficulty of breathing, hallucinations, tremors, loss of coordination, unusual bleeding or bruising, visual disturbances and irregular heart rate.

DRUG STUDY Name of Drug Mode of Action 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. Route and Indications Dosage Adult: To relieve PO 24 mg 34 bronchospasm times/day, 48 mg associated with sustained release 2 acute or times/day chronic Inhaled: 12 asthma, inhalations q46h bronchitis, or other reversible Child: obstructive PO 26 y, 0.10.2 airway mg/kg T.I.D. (max: diseases. Also 4 mg/dose); 612y, used to prevent 2mg 34 times/day exerciseInhaled: 612y, 1 induced 2 inhalations q46h bronchospasm. Contraindications Contraindicated in patients hypersensitive to drug or its ingredients. Side Effects Watch out for: Dizziness Fatigue Drowsiness Headache Nausea Vomiting Change in taste Rapid heart rate Anxiety Sweating Flushing Insomnia Adverse Reactions Watch out for: Nursing Responsibilities

Generic Name: albuterol sulfate

Brand Name: AccuNeb ProAir HFA Proventil Proventil HFA Ventolin Ventolin HFA VoSpire ER

Classifications: bronchodilator

1. Observe for 10 rights in giving medication. 2. Prepare solution for inhalation CNS: tremor, by diluting 0.5 ml 0.5% solution nervousness, headache, with 2.5 ml normal saline; hyperactivity deliver over 5 15 minutes by Insomnia, dizziness, nebulization. Weakness, CNS 3. Warn patient about risk of stimulation, malaise paradoxical bronchospasm and CV: tachycardia, to stop drug immediately if it palpitations, occurs. hypertension, 4. Teach patient to perform oral EENT: dry and irritated inhalation correctly. Give the nose and throat with following inhaled form, nasal 5. If prescriber orders more than 1 congestion, epistaxis, inhalation, tell patient to wait at hoarseness least 2 minutes before GI: nausea, vomiting, repeating procedure. heartburn, anorexia, 6. Tell patient that use of a spacer altered taste, increased device may improve drug appetite delivery to lungs. Metabolic: hypokalemia Musculoskeletal: muscle 7. Tell patient to remove canister and wash inhaler with warm, cramps, soapy water at least once a Respiratory: bronchospa week. sm, cough, wheezing, 8. Advice patient to contact dyspnea, bronchitis, prescriber if using more than 4 increased sputum inhalations per day for 2 or Other: hypersensitivity more days or more than one reactions canister in 8 weeks. 9. Advise patient not to chew or crush extended-release tablets or mix them with food. 10. Advice patient to report any signs of Dizziness, Fatigue, Drowsiness, Headache, Nausea, Vomiting, Change in taste, Rapid heart rate, Anxiety, Sweating, Flushing and Insomnia

DRUG STUDY Name of Drug Mode of Action Inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle. Route and Indications Dosage Acute pulmonary edema Oral, IV: Adults: 40 mg I.V. injected Edema slowly over 1 to 2 minutes; associated then 80 mg I.V. in 60 to 90 with heart minutes if needed. failure, Edema cirrhosis and Adults: 20 to 80 mg P.O. renal disease. daily in the morning. If IV: Acute response is inadequate, pulmonary give a second dose, and edema each succeeding dose, Oral: every 6 to 8 hours. Hypertension Carefully increase dose in 20- to 40-mg increments up to 600 mg daily. Once effective dose is attained, may give once or twice daily. Or, 20 to 40 mg I.V. or I.M., increased by 20 mg every 2 hours until desired effect achieved. Infants and children: 2 mg/kg P.O. daily, increased by 1 to 2 mg/kg in 6 to 8 hours if needed; carefully adjusted up to 6 mg/kg daily if needed. Hypertension Adults: 40 mg P.O. B.I.D. Dosage adjusted based on response. May be used as adjunct to other antihypertensive if needed. Children : 0.5 to 2 mg/kg P.O. once or twice daily. Increase dose as needed up to 6 mg/kg daily. Contraindications Contraindicated in patients hypersensitive to drug and in those with anuria. Side Effects Watch out for: Increased volume and frequency of urination Dizziness Feeling of faint on arising Drowsiness Sensitivity to sunlight Increased thirst Loss of body potassium Adverse Reactions Watch out for: Nursing Responsibilities

Generic Name: furosemide

Brand Name: Furosemide Special, Lasix, Novo-semide

Classification: Antihypertensive Loop diuretic

1. Observe for 1o rights in giving medication. CNS: vertigo, headache, 2. Administer drug with food dizziness, paresthesia, or milk to prevent GI weakness, restlessness, fever upset. CV: orthostatic hypotension, 3. Give drug early in the day thrombophlebitis with I.V. so that increased administration urination will not disturb EENT: transient deafness, sleep. blurred or yellowed vision, 4. Inform patient of possible tinnitus need for potassium or GI: abdominal discomfort and magnesium supplements. pain, diarrhea, anorexia, 5. Instruct patient to stand nausea, vomiting, constipation, slowly to prevent pancreatitis dizziness. GU: azotemia, nocturia, 6. Advise patient to polyuria, frequent urination, immediately report ringing oliguria in ears, severe abdominal Hematologic: agranulocytosis, pain, or sore throat and aplastic anemia, leucopenia, fever; these symptoms thrombocytopenia, anemia may indicate toxicity. Hepatic: hepatic dysfunction, 7. Measure and record jaundice weight of patient to Metabolic: volume depletion monitor fluid changes, and dehydration, asymptomatic 8. Teach patient to avoid hyperuricemia, impaired direct sunlight and to use glucose tolerance, protective clothing and a hypokalemia, hypochloremic sun block because of risk alkalosis, hyperglycemia, of photosensitivity dilutional hyponatremia, reactions. hypocalcemia, 9. Monitor uric acid level, hypomagnesemia especially in patients with Musculoskeletal: muscle a history of gout. spasm 10. Consult prescriber and Skin: dermatitis, purpura, dietitian about a highphotosensitivity reactions, potassium diet or transient pain at I.M. injection potassium supplements. site Other: gout

Requirement in Nursing Care Management 106 (Drugs Related in Acute Biologic Crisis)
Submitted by: Jehannah Dayanara B. Hayudini 4BSN A Student

Submitted to: Melvilyn Bravo, RN, MAN Clinical Instructor