Drug HYDROCORTISO NE Brand Name: Cortef, Hydrocortone CLASSIFICATION: antiasthmatics, corticosteroids Pharmacologic: corticosteroids (systemic) Pregnancy Category C (prednisolone),

UK (all others)

Action Replace endogenous cortisol deficiency states Also have potent mineralocortico id activity

Indication Management of adrenocortical insufficiency; chronic use in other situations is limited because of mineralocortic oid activity

Adverse Effect CNS: depression, euphoria, headache, increased intracranial pressure (children only), personality changes, psychoses, restlessness EENT: cataracts, increased intraocular pressure CV: hypertension GI: peptic ulceration, anorexia, nausea, vomiting Derm: acne, decreased wound healing , ecchymoses, fragility, hirsutism, petechiae Endo: adrenal suppression, hyperglycemia F and E: fluid retention (long term high doses), hypokalemia, hupokalemic alkalosis Hemat:

Contraindication Active untreated infections (may be used in patients being treated for some forms of meningitis) Lactation (avoid chronic use) Known alcohol bisulfate or tartrazine hypersensitivity or intolerance (some products contain these and should be avoided in susceptible patients)

NURSING CONSIDERATION Assess patients for signs of adrenal insufficiency (hypotension, weight loss, weakness, nausea, vomiting, anorexia, lethargy, confusion, restlessness) before and periodically during therapy Monitor intake and output ratios daily weighs. Observe patient for peripheral edema, steady weght gain, rales/crackes or dyspnea.

thromboembolism, thrombophlebitis Metab: weight gain, weight loss MS: muscle wasting, osteoporosis, aseptic necrosis of joints, muscle pain Misc: cushingoid appearance (moon face, buffalo hump), increased susceptibility to infection

Drug SALBUTAMOL Brand Name: Pronventil, Ventolin HFA, Vomax CLASSIFICATIO N Therapeutic: broncodilators Pharmacologic: adrenergics Pregnancy category C

Action Binds to adrenargic receptors in airway smooth muscle, leading to activation of adenyl cyclase and increased levels of cyclic-3, 5 adenosine monophosphate (cAMP). Increases in cAMP activate kinases, which inhibit the phosphorylation of myosin and decrease intracellular calcium. Decreased intracellular calcium relaxes smooth muscle airways Relaxation ofairway smooth muscle with subsequent bronchodilation.

Indication Used as a bronchodilator to control and prevent reversible airway obstruction caused by asthma or COPD Inhaln: used as a quickly agent for acute bronchospasm and for prevention of exerciseinduced bronchospasm PO: uses as a long term control agent in patients with chronic/persist ent bronchospasm

Adverse Effect CNS: nervousness, restlessness, tremor, headache, insomnia CV: chest pain, palpitations, angina, arrhythmias, hypertension GI: nausea, vomiting Endo: hyperglycemia F and E: hypokalemia Neuro: tremor

Contraindication Hypersensitivity to adrenergic amines Hypersensitivity to fluorocarbons (some inhalers)

NURSING CONSIDERATION Assess lung sounds, pulse, and blood pressure before administration and during peak of medication. Note amount, color, and character of sputum produced Monitor pulmonary function test before initiating therapy and periodically during therapy to determine effectiveness of medication

Drug

Actions

Indications

Adverse effects

Contraindications

Nursing Responsibilities Assess patient for infection (vital signs, wound appearance, sputum, urine, stool, and WBC) at beginning of and throughout therapy

CEFUROXIME

Exerts it bactericidal effects by binding to an enzyme or enzymes known as penicillinbinding proteins (PBPs) involved in bacterial cell wall synthesis causing cell death.

Indicated for treatment of patients with mild to moderate severe infections caused by susceptible strains of the designated organisms.

GI: diarrhea, nausea, vomiting, loose stools. CNS: headaches and dizziness.

Contraindicated to people who have shown type1 hypersensitivity to cefuroxime, or to any cephalosporin group of antibiotics.

Drug

Actions No one is sure how paracetamol works

Indications Mild pain or fever

Side effects Skin rashes Blood disorders and a swollen pancreas have occasionally happened in people taking the drug on a regular basis for a long time.

Contraindications Contraindicated in patients hypersensitive to drug. Use cautiously in patients with long alcohol use because therapeutic doses cause hepatotoxicity in these patients

Nursing Responsibilities Many OTC and prescription products contain acetaminophen, be aware of this when calculating total daily dose. Use liquid form for children and patients who have difficulty swallowing. In children do not exceed 5 doses in 24hr.

PARACETAMOL

CUES S> bakit ba namamaga ung kamay nya? O> patients family seems to be determined to learn about the patient condition.

NSG.DIAGNOSIS Readiness for enhanced therapeutic regimen management.

INFERENCE A pattern of regulating and integrating into daily living a program for treatment of illness and its sequelae that is sufficient for meeting healthrelated goals and can be strengthened.

GOALS AND OBJECTIVES Goal: after an hour of therapeutic communication and nursing interventions, the family will: > assume responsibility for managing treatment regimen. >demonstrate proactive management by anticipating and planning for eventualities of condition/potential complications. >determined the cause of the disease >enumerate some of the way how to prevent the disease Objectives: Identify/ use additional resources as appropriate.

NSG. INTERVENTION Discuss present resources used by client. Identify steps necessary to reach desired health goals.

RATIONALE To note whether changes can be arranged. Understanding the process enhances commitment and the likelihood of achieving the goals

EVALUATION Goal met. The client family assumes responsibility for managing treatment regimen.

Drug COMBIVENT

Actions Combivent is a combination of the anticholinergic bronchodilator, ipratropiumbromide, and the beta adrenergic bronchodilator, salbutamol sulfate. Ipratropium bromide is a quartermary ammonium derivative af atropine and is an anticholinergic drug which has bronchodilator properties. SALBUTAMOL produces bronchodilation through stimulation of beta adrenergic receptors in brochial smooth muscle, thereby causing relaxation of muscle fibers.

Indications For management of bronchospasm in patients suffering from COPD who require regular treatment of ipratronium bromide and salbutamol.

Adverse effects Hypertension, nervousness, tachycardia, tremor, and palpitations, fatigue, abdominal pain, dyspepsia, sinusitis, and dysuria.

Contraindications In patients with tachyarrhythmias, hypertropic obstructive cardiomyophathy and patients with a history of hypersensitivity to any of its components or to atropine or its derivatives.

Nursing Responsibilities Patient should be instructed on the proper way of administering the drug. Assess lung sounds, pulse, and blood pressure before administration and during peak of medication. Note amount, color, and character of sputum produced Monitor pulmonary function test before initiating therapy and periodically during therapy to determine effectiveness of medication