Micah-Ela Lajarnie C.

Lao BSN-IV
Generic Name (Brand Name) Methergine (Methylergonovine maleate) Drug Classification & Indication PC: Ergot Alkaloid and Derivative TC: oxytocic, lactation stimulant Indication: Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution Dosage, Route, Frequency IV: 0.2 mg after delivery of anterior shoulder, after delivery of placenta, or during puerperium; may be repeated as required at intervals of 2-4 hours Mechanism of Action Methergin Stimulates uterine smooth muscles producing sustained contractions thereby shortens the third stage of labor Adverse Reaction Cardiovascular: hypertension, temporary chest pain, palpitation CNSHallucinations, dizziness, seizure, headache Gastrointestinal: Nausea, vomiting, diarrhea, foul taste Local: Thrombophlebitis Otic: Tinnitus Renal: Hematuria Respiratory: Dyspnea, nasal congestion Miscellaneous: Diaphoresis Contraindication > Contraindicated in patients hypersensitive to methylergonovine or any component of the formulation. >ergot alkaloids are contraindicated with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics); hypertension; toxemia; pregnancy Nursing Responsibility >Be alert for adverse reactions and drug interactions. >This drug should be used extremely carefully because of its potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely.

Generic Name (Brand Name) Cefuroxime

Drug Classification & Indication Used to treat otitis media, respiratory tract, genitourniary tract, gynecologic, skin, and bone infections. It is also used in the treatment of speticemia, bacterial meningitis, gonorrhea, and other gonococcal infections.

Dosage, Route, Frequency IM/IV: ADULTS, ELDERLY: 750 mg to 1.5 g every 8 hours. CHILDREN: 75-100 mg/kg/day divided every 8 hours. Maximum: 8 g/day. NEONATES : 50-100 mg/kg/day divided every 12 hours.

Mechanism of Action Binds to bacterial membranes. It inhibits synthesis of bacterial cell wall.

Adverse Reaction Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhoea, GI disturbances; erythema multiforme, Stevens-Johnson syndrome, epidermal necrolysis. Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.

Contraindication

Nursing Responsibility

Hypersensitivity to Question for history of cephalosporins. allergies, particularly cephalosporins and penicillins. Give without regards to meals. If GI upset occurs give with food or milk. Avoid crushing tablets due to bitter taste. Suspension must be given with food. Intramuscular injections must be administered deep IM to minimize discomfort.

Generic Name (Brand Name) Hydrocortisone (Solu-Cortef)

Drug Classification & Indication Primary or Secondary adrenocortical insufficiency. Acute adrenoortical insufficiency. Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful. Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected.

Dosage, Route, Frequency 100 mg, 250 mg, 500 mg Sterile Powder for Injection (IM/IV)

Mechanism of Action Has the same metabolic and antiinflammatory action as hydrocortisone. When given parenterally and in equimolar quantities, the two compounds are equivalent in biologic activity. Following the intravenous injection of hydrocortisone sodium succinate, demonstrable effects are evident within one hour and persist for a variable period.

Adverse Reaction Stomach upset, headache, dizziness, menstrual period changes, trouble sleeping, increased appetite, weight gain, or pain/redness/swelling at the injection site may occur.

Contraindication Systemic fungal infections and known hypersensitivity to the drug or any component of formulation. Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids.

Nursing Responsibility Corticosteroids may mask some signs of infection, and new infections may appear during their use. There may be decreased resistance and inability to localize infection when corticosteroids are used. Infections with any pathogen including viral, bacterial, fungal, protozoan or helminthic infections. In any location of the body, may be associated with the use of corticosteroids alone or in combination with other immunosuppressive agents that affect cellular immunity, humoral immunity or neutrophil function.

Generic Name Generic Name (Brand Name) (Brand Name) Combivent Montelukast (Ipratropium (Singulair) Bromide)

Drug Classification & Indication used regularly to Indicated for use prevent the in patients with wheezing chronic and shortness of obstructive breath caused by disease pulmonaryasthma and decrease (COPD) on a the number of asthma regular aerosol attacks. bronchodilator Montelukast to who continueis also evidence of haveused before exercise to prevent bronchospasm and breathing who require a problems second during exercise bronchodilator. (bronchospasm).

Dosage, Dosage, Route, Route, Frequency Frequency The dose of recommended Combivent dose of Inhalation montelukast Aerosol is is 4, 5, two or 10 mg daily. The inhalations4 and times four 5 mg a tablets are used day. Patients in children. may take Montelukast additional should be inhalations as taken in required;the evening with however, the or without total number food. of inhalations should not exceed 12 in 24 hours. Safety and efficacy of additional doses of Combivent Inhalation Aerosol beyond 12 puffs/24 hours have not been studied.

Mechanism of Mechanism of Action Action IsThe anticholinergic an effects of some (parasympatholytic) drugs can change if agent which, based you take other drugs or herbal products at on animal studies, the same time. This appears to inhibit vagally-mediated can increase your risk for serious side reflexes by effects or may the antagonizing cause your medications action of acetylcholine, the not to work transmitter agent correctly. These drug interactions are released at the possible, but do not neuromuscular junctions in occur. always the lung. Anticholinergics prevent the increases in intracellular concentration of Ca+ + which is caused by interaction of acetylcholine with the muscarinic receptors on bronchial smooth muscle.

Adverse Reaction Adverse Reaction Edema, fatigue, The most common hypertension, side effects with dizziness, are montelukast nervousness, headache, dizziness, paresthesia,pain, sore abdominal tremor, dysphonia, insomnia, throat, and rhinitis diarrhea, dry mouth, (inflammation of the dyspepsia, vomiting, inner lining of the arrhythmia, side nose). These palpitation, in 1 in effects occur tachycardia, persons 50 to 1 in 7 arthralgia, angina, who take increased sputum, montelukast. Rarely, taste perversion, and patients may urinary tract experience infection/dysuria. nosebleeds. Allergic-type reactions such as skin reactions including rash, pruritus, and urticaria (including giant urticaria), angioedema including that of tongue, lips and face, laryngospasm and anaphylactic reaction

Contraindication Contraindicated in Hypersensitivity to patients with a history any component of this of hypersensitivity to product. soya lecithin or related food products such as soybean and peanut. Combivent Inhalation Aerosol is also contraindicated in patients hypersensitive to any other components of the drug product or to atropine or its derivatives.

Nursing Responsibility Nursing Responsibility Before should Patientstaking be montelukast, tell your cautioned to avoid doctor or pharmacist spraying the aerosol if you their eyes and be into are allergic to it; or if you have this may advised thatany other allergies. This product result in precipitation or may contain narrowworsening ofinactive ingredients, which angle glaucoma, can cause allergic reactions mydriasis, increased or other problems. Talk intraocular pressure, to your pharmacist acute eye pain or for more details.Before discomfort, temporary using this vision, blurring ofdrug, tell your doctor or pharmacist visual halos or colored your medical history, images in association especially of: liver with red eyes from disease.Before having conjunctival and surgery, tell your doctor corneal congestion. or dentist about all the Patients should also be products you use advised that should any (including prescription combination of these drugs, nonprescription symptoms develop, drugs, and herbal they should consult products). their physician immediately.