DRUG CLASSIFICA NAME TION Granisetra Antiemetics n : serotonin receptor (Kytril) antagonist

MECHANISM OF ACTION Binds to serotonin receptors in chemoreceptor trigger zone and vagal nerve terminal, blocking serotonin release & controlling nausea& vomiting

INDICATIONS To prevent nausea & vomiting caused by chemotherap y Acute postoperative n/v

SIDE EFFECTS Headache, anxiety, drowsiness, dizziness, diarrhea/ constipation, abdominal pain

CONTRAINDICA TION Hypersensitivity to drug CAUTION: Pregnant or breastfeeding px.

NURSING CONSIDERATIONS 1.monitor hepatic enzyme leves & CBC 2.monitor temp & BP 3.advice Px to minimize GI upset by eating frequent small servings of healthy foods.

ADVERSE EFFECTS

Anemia, alopecia, altered taste, dec. appetite

DRUG CLASSIFICA MECHANISM OF NAME TION ACTION Ondasetro Antiemetics Block serotonin at n HCL 5-HT3 receptor sites in vagal (zofran) nerve terminals by disrupting CNS chemoreceptors trigger zone

INDICATIONS To prevent nausea and vomiting caused by moderately emotogenicc hemotherapy

SIDE EFFECTS Headacvhe, dizziness, fatigue, weakness

CONTRAINDICA TION Hypersensitivity to drug Use cautiously in: Hepatic diseas Pregnant or breasfeeding px

ADVERSE EFFECTS

Bronchospasm Urinary retention anaphylaxis

NURSING CONSIDERATIONS 1.Assess VS 2.evaluate fluid intake and output 3.tell Px to take 30-60mins before a meal preferably In morning 4.caution x to avoid driving & other hazardous activities.

DRUG NAME Palonoset ron HCL (aloxi)

CLASSIFICA MECHANISM OF TION ACTION Antiemetics Selectively binds to & antaginizes 5-HT3 receptors on vagal nerveterminals & in chemoreceptor trigger zone. This action blocks serotonin release, reducing the vomiting reflex

INDICATIONS To prevent n/v caused by cancer chemotherap y

SIDE EFFECTS Pain, conjunctivitis, sinusitis, diarrhea

ADVERSE EFFECTS

CONTRAINDICA TION Hypersensitivity to drug and its components

Asthma, apnea Fungal dermatitis cough

NURSING CONSIDERATIONS 1.Monitor liver function test & CBC 2.assess Px weight & hydration status 3.inform px that drug may cause GI symptoms & failure to thrive. Provide dietary consultations needed.

DRUG NAME dronabino l (Marinol)

CLASSIFICA TION Antiemetics : Cannabinoi ds

MECHANISM OF ACTION Unknown. May exert antiemetic effect by inhibiting vomiting control mechanism in medulla oblongata

INDICATIONS Prevention of n/v caused by chemotherap y

SIDE EFFECTS Anxiety, irritability, headache,

CONTRAINDICA TION Hypersensitivity to cannabinoids & breasfeeding Precaution: Pregnant woman & HPN

ADVERSE EFFECTS

Suicidal ideation Diaphoresis Syncope Visual disturbances

NURSING CONSIDERATIONS 1.Monitor VS for hypotension & tachycardia 2.monitor nutritional status and hydration 3.caution Px to avoid driving & other hazardous activities until he knows how drug affects concentration & alertness

DRUG NAME Aprepitan t (Emend)

CLASSIFICA TION Antiemetics : miscellaneo us

MECHANISM OF ACTION Augments antiemetics activity of ondansetronand dexamethasone. Also inhibits cisplatin-induced emesis

INDICATIONS To prevent acute & delayed n/v caused by highly emotogenic cancer chemotherap y; Postoperative n/v

SIDE EFFECTS Headache, fatigue, anorexia, abdominal pain

ADVERSE EFFECTS

CONTRAINDICA TION Hypersensitivity to drug Concurrent primozide or crisapide therapy breastfeeding

NURSING CONSIDERATIONS 1.assess nutritional & hydration status 2.tell Px that drugs may cause CNS effects. Explain that hell be monitored to ensure his safety 33.advise px to minimize GI upset by eating small, frequent serving food & drinking of plenty of fluids.

Neutropenia Hiccups Tinnitus gastritis

DRUG NAME Haloperid ol (haldol)

CLASSIFICA TION Antipsychot ic: butyrophen ones

MECHANISM OF ACTION Unknown. Thought to block postsynaptic dopamine receptors in brain & increase dopamine turnover rate, inhibiting sings & symptoms of psychosis.

INDICATIONS Symptomatic treatment of psychotic disorders or tourette syndrome

SIDE EFFECTS Restlessness, drowsiness Sedation, Lethargy insomia

CONTRAINDICA TION Hypersensitivity to drug, tartazine, sesame oil or benzyl alcohol Severe CNS depression

ADVERSE EFFECTS

Seizures Neuroleptic malignat syndrome Drug-indced hepatitis bronchospasm

NURSING CONSIDERATIONS 1.monitor CNS status closely, especially for seizures & Neuroleptic malignat syndrome 2.assess respiratoy status 3.tell Px to di;lute oral concentrate w/ water, cola or juice immediately before taking. 3.advise px to minimize GI upset by eating frequent, small servings of food & drinking adequate fluid.

DRUG NAME Diazepam (valium)

CLASSIFICA TION Anticonvuls ant, sedativehypnotic: benzodiaze pines

MECHANISM OF ACTION Produces anxiolytic effect & CNS depression by stimulating gamma aminobutyric acid receptors. Relaxes skeletal muscles of spine by inhibiting polysynaptic afferent pathways. Control seizures by enhancing presynaptic inhibition.

INDICATIONS Anxiety disorders Status epilepticus & severe recurrent convulsive seizures

SIDE EFFECTS Dizziness, lethargy, lightheadedness, restlessness, headache, tachycardia

CONTRAINDICA TION Hypersensitivity to drug, other benzodiapines, alcohol or tartrazine Coma or CNS depression Narrow angle glaucoma

ADVERSE EFFECTS

Cardiovascular collapse. Thrombocytope nia. Hepatic dysfunction. Respiratory depression.

NURSING CONSIDERATIONS 1.enforce bedrest for atleast 3hrs after IV injection 2.avoid sudden drug withdrawal. Taper dosage gradually to termination of therapy. 3.inform Px that he may take drug w/ or w/o food; recommend taking it w/ food if causes stomach upset. 4.instruct px to move slowly when sitting up or standing to avoid dizziness.

DRUG NAME Dexameth asone (decadron )

CLASSIFICA TION Glucocortic oid

MECHANISM OF ACTION Reduces anti inflammation by suppressing polymorphonucle ar leukocute migration, reversing increased capillary permeability & stabilizing leukocyte lysosomal membranes.

INDICATIONS Allergic & inflammatory condition cerebral edema

SIDE EFFECTS Headache, malaise, vertigo,hypoten sion, muscle pain, diaphoresis, n/v Facial edema
ADVERSE EFFECTS

CONTRAINDICA TION Hypersensitivity to drug, benzyl alcohol, creatinine or methylparaben Systemic fungal infection

Peptic ulcer. Increased intracranial pressure. Thromboemboli sm. Hypokalemic alkalosis. seizures

NURSING CONSIDERATIONS 1.monitor Hgb & Potassium level. 2.tell Px to take oral drug with or after meals 3.Inform Px that drugs make him susceptible to infection. Advise him to avoid crowds & exposure to illness.

CLASSIFICA TION Glucocortic Methylpre oids dnisolone (medrol)

DRUG NAME

MECHANISM OF ACTION Reduces inflammatuion & reduces edema by stabilizing membranes 7 reducing permeability of leukocytic cells. Suppresses immune system by interfering w/ antigen-antibody interact=ions of microphages & T cells.

INDICATIONS Diseases 7 disordered of endocrine system, sollagen, skin, eye, GI tract, respiratory & hematologic system/

SIDE EFFECTS Headache, restlessness, hypotension, nasal irritation, amenorrhea, cough, hypokalemia
ADVERSE EFFECTS ESOPHAGEAL ULCER, PEPTIC ULCER, PANCREATITIS, BRONCHOSPASM ADRENAL SUPPRESION, OSTEOPOROSIS

CONTRAINDICA TION Hypersensitivity to drug, or its components Systemic fungal infection

NURSING CONSIDERATIONS 1.Monitor fluid & electrolytes balance, weight & BP. 2.tell Px to take with food to minimize GI upset. 3.Advise diabetic Px to monitor blood glucose level carefully. 4.Advise Px to report unusual weight gain, swelling, muscle weakness, black tarry stools, sore throat or infection.