DRUG

Generic Name:
omeprazole

Brand Name:
Prilosec

Drug
Classification:
proton pump
inhibitors (PPI)

INDICATION

ACTION

Short-term
treatment of
activeduodenal
ulcer; Firstlinetherapy in
treatment
of heartburn or
symptoms
of gastroesophagea
l refluxdisease
(GERD); Shorttermtreatment of
active benigngastric
ulcer; GERD,
severeerosive
esophagitis,
poorlyresponsive
symptomatic
GERD;Long-term
therapy:
Treatmentof
pathologic
hypersecretorycond
itions (ZollingerEllisonsyndrome,
multiple
adenomas,systemic
mastocytosis);Eradi
cation of
H. pylori
With amoxicillin or
metronidazole.

Gastric acidpump inhibitor:

Suppresses
gastric acid
secretion by
specific inhibition
of the hydrogenpotassium ATP as
enzyme system
at the secretory
surface of the
gastric parietal
cells; blocks the
final step of acid
production.

DRUG INTERACTION

CONTRAINDICATION

Contraindicated with
Omeprazole potentially hypersensitivity to
omeprazoleor its
can increase the
components;Use
concentrations in blood cautiously with
of diazepam (Valium), w pregnancy,lactation.
arfarin (Coumadin),
andphenytoin (Dilantin)
by decreasing the
elimination of these
drugs by the liver. The
absorption of certain
drugs may be affected
by stomach acidity.
Therefore, omeprazole
as well as other PPIs
reduce the absorption
and concentration in
blood
of ketoconazole (Nizoral
) and increase the
absorption and
concentration in blood
of digoxin (Lanoxin).
This may reduce the
effectiveness of
ketoconazole or
increase digoxin toxicity

ADVERSE
EFFECT

NURSING
CONSIDERATION

Caution patient to
swallow capsules
wholenot to open,
chew, or crush
them. Arrange for
further evaluation
of patient after 8
weeks of therapy
for gastro reflux
disorders; not
intended for
maintenance
therapy.
Administer antacids
with omeprazole, if
needed.
Teaching points:
Take the drug
before meals.
Swallow the
capsules whole; do
not chew, open, or
Potentially
Fatal: Anaphylaxi crush them. This
drug will need to be
s.
taken for up to 8wk
(short-term
therapy) or for a
prolonged period(>
5 yr in some
cases).Have regular
medical follow-up
visits.
Diarrhea, nausea,
fatigue,
constipation,
vomiting,
flatulence, acid
regurgitation,
taste perversion,
arthralgia,
myalgia, urticaria,
dry mouth,
dizziness,
headache,
paraesthesia,
abdominal pain,
skin rashes,
weakness, back
pain, upper
respiratory
infection, cough.

Drug Data

Classification

Generic Name
Hydrocortisone

Pharmacologic
Class
Adrenal cortical
steroid

Trade Name
Corticosteroid
Cortef, SoluCortef,
Hydrocortone,
Cortenema

Glucocorticoid

Therapeutic
Class
Content

Hormone

Hydrocortisone

Mechanism of Action

Indication

Contraindications

Adverse Reaction

Enters target cells and binds

to cytoplasmic receptor;
initiates many complex
reactions that are responsible
for its anti-inflammatory,
immunosuppressive
(glucocorticoid), and saltretaining (mineralocorticoid)
actions. Some actions may
be undesirable, depending
on drug use.

-Replacement therapy
in adrenal cortical
insufficiency

- Allergy to any
component of the drug

CNS: Vertigo, headache,

paresthesias, insomnia,
seizures, psychosisCV:
Hypotension, shock, HPN and
heart failure secondary to fluid
retention, thromboembolism,
thrombophlebitis, fat embolism,
cardiac
arrhythmiasDermatologic:
Thin, fragile skin, petechiae,
ecchymoses, purpura, striae,
subcutaneous fat
atrophyEENT: Cataracts,
glaucoma, increased
IOPEndocrine: Amenorrhea,
irregular mens, growth
retardation, decreased
carbohydrate tolerance and
DM, cushingoid state, HPA
suppression systemic ,
hyperglycemiaGI: Peptic or
esophageal ulcer, pancreatitis,
abdominal distention, nausea,
vomiting, increased appetite
and weight gainHematologic:
Na and fluid retention,
hypocalcemia, increased blood
sugar, increased serum
cholesterol, decreased T3 and
T4 levelsHypersensitivity:
Anaphylactoid or
hypersensitivity
reactionsMusculoskeletal:
Muscle weakness, steroid
myopathy and loss of muscle
mass, osteoporosis,
spontaneous fracturesOther:
Immunosuppression,
aggravation or masking of
infections, impaired wound
healing

- Allergic states
severe or
incapacitating allergic
conditions
- Hematologic
disorders

- Fungal infections
- Amebiasis
- Hepatitis B
- Vaccinia or varicella
- Antibiotic-resistant
infections

- Ulcerative colitis
- Immunosuppression
- Kidney disease
- Liver disease

Dosage
20-240 mg/day in
single dose or
divided doses

Pregnancy
category

- Cirrhosis
- Hypothyroidism

C
- Ulcerative colitis with
impending perforation
- Diverticulitis

vial

- Recent GI surgery
- Active or latent peptic
ulcer
- Inflammatory bowel
disease
- Hypertension
- Heart failure

Nursing Responsibilities
- Assess for contraindications.
- Assess body weight, skin color,
V/S, urinalysis, serum electrolytes,
X-rays, CBC.
- Arrange for increased dosage when
patient is subject to unusual stress.
- Do not give live vaccines with
immunosuppressive doses of
hydrocortisone.
- Observe the 15 rights of drug
administration.
- Give daily before 9am to mimic
normal peak diurnal corticosteroid
levels.
- Space multiple doses evenly
throughout the day.
- Use minimal doses for minimal
duration to minimize adverse effects.
- Do not give IM injections if patient
has thrombocytopenic purpura.
- Taper doses when discontinuing
high-dose or long-term therapy.
- Monitor client for at least 30
minutes.
- Educate client on the side effects of
the medication and what to expect.
- Instruct client to report pain at
injection site.

Name of Drug
Generic Name:
Ipratropium Br,
Salbutamol/
albuterol sulfate

Brand Name:
Combivent,
Ventolin

Classification
Antasthmatic &
COPD
Preparations
ACTION:
In low doses,
acts relatively
selectively at
beta 2
adrenergic
receptors to
cause
bronchodilation
and

Dosage, Route, & Frequency

Neb q 4 hours

Indication
>Relief and prevention
ofbrochospasm in
patients with reversible
obstructive airway
disease.
>Inhalation: treatment
of
acute attacks of
brochospasm.
>Prevention of
exerciseinduced
brochospasm.

doses, beta 2
selectivity is

>Unlabeled use:
adjunct in treating
serious hyperkalemia
in dialysis patients;
seems to lower

lost, and the

drug acts at

potassium
concentration

beta 2 receptors
to cause

when inhaled by
patients

typical
sympathomimet
ic

on hemodialysis.

vasodilation; at
higher

cardiac effect.

Contraindication

Adverse Reaction

Nursing Responsibilities

>Patients who is
allergic to the Drugs.

Fine tremor of Skeletal

Muscle; Palpitations;
Headache, dizziness,
nervousness; Dryness of the
mouth, throat irritation;
urinary retention.

>Use Cautiously to patients with

known sensitivity to atropine,
soybeans, soya lecithin, and
peanuts.

>Patients with
Hypertropic obstructive
cardiomyopathy
>Patients having
tachyarrythmia

>Assess Vital Signs Before drug

administration
>Observe for paradoxical
bronchospasm (Wheezing). If
Condition occurs, withhold
Medication and notify physician or
other health care professional
immediately.
>Instruct patient to contact health
care professional immediately if
shortness of breath is not relieved by
medication or is accompanied by
diaphoresis, dizziness, palpitations,
or chest pain.
>Advise the patient to rinse mouth
with water after using the nebulizer
to minimize dry mouth.

DRUG

Fluimucil
-cough & cold
preparation

INDICATION

Treatment of
respiratory affections
characterized by thick
and viscous
hypersecretions: acute
and chronic bronchitis
and its exacerbation,
pulmonary
emphysema,
mucoviscidosis and
bronchiectasis.
Antidote in poisoning
caused by paracetamol.

ACTION

Decreases viscosity of
respiratory tract secretions and
promote their removal by
breaking disulfide bonds. In
acetaminophen overdose, it
protects the liver from injury
by restoring glutathione levels
or by acting as alternate
substrate for acetaminophen
metabolism. Duavent

ADVERSE EFFECTS

Nausea, vomitting and other GI

symptoms, generalized urticaria
accompanied by mild fever,
hypotension, wheezing,
dyspnea and stomatitis.

CONTRAINDICATION

Hypersensitivity. Phenylketonuria.

NURSING
RESPONSIBILITY

Instruct the patient to

follow directions
exactly.
Teach patient how to
use and clean
nebulizer.
Inform patient that
drug may have foul
smell or taste.
Tell patient to avoid
driving or other
hazardous activities.

Name of
the
medication
:
Generic
Name

Dosage,
Frequency and
Route:

Action:

Adverse
reactions:

Indication:

Contraindication:

Nursing interventions:

(Brand
name)

Lanoxin*

Adults:
Loading dose:

Classificatio
n:
Inotropic
Antiarrhyth
mic
Cardiac
glycoside

0.751.25 mg
PO or 0.125
0.25 mg IV.
Maintenance
dose: 0.125
0.25 mg/day PO.
Lanoxicaps
capsules
Loading dose:
0.40.6 mg PO.
Maintenance
dose, 0.1 0.3
mg/day PO.

Inhibits
sodiumpotassiumactivated
adenosine
triphosphata
se,
promoting
movement
of calcium
from
extracellular
to
intracellular
cytoplasm
and
strengthenin
g
myocardial
contraction.
Also acts on
CNS to
enhance
vagal tone,
slowing
conduction
through the
SA and AV
nodes.

CNS:
fatigue,
generalized
muscle
weakness,
agitation,
hallucinatio
ns, CV:
arrhythmia
s, heart
block.
EENT:
yellowgreen halos
around
visual
images,
blurred
vision, light
flashes,
photophobi
a, diplopia.
GI:
anorexia,
nausea

Heart failure,
paroxysmal
supraventric
ular
tachycardia,
atrial
fibrillation
and flutter

Contraindicated in patients
hypersensitive to drug and
in those with digitalisinduced toxicity,
ventricular fibrillation, or
ventricular tachycardia
unless caused by heart
failure.
Patients with WolffParkinson-White syndrome
unless the conduction
accessory pathway has
been pharmacologically or
surgically disabled.
Elderly patients and in
those with acute MI,
incomplete AV block, sinus
bradycardia, PVCs, chronic
constrictive pericarditis,
hypertrophic
cardiomyopathy, renal
insufficiency, severe
pulmonary disease, or
hypothyroidism.

Drug-induced arrhythmias may

increase the severity of heart
failure and hypotension.
Before giving loading dose,
obtain baseline data (heart rate
and rhythm, blood pressure,
and electrolytes) and ask
patient about use of cardiac
glycosides within the previous 2
to 3 weeks.
Monitor digoxin level.
Therapeutic level ranges from
0.8 to 2 ng/ml. Obtain blood for
digoxin level at least 6 to 8
hours after last oral dose,
preferably just before next
scheduled dose.
Alert: Excessively slow
pulse rate (60 beats/minute
or less) may be a sign of
digitalis toxicity. Withhold
drug and notify prescriber.
Monitor potassium level
carefully. Take corrective
action before hypokalemia
occurs. Hyperkalemia may
result from digoxin toxicity.
Look alike-sound alike:
Don't confuse digoxin with
doxepin.