V.

DRUGSTUDY

Name of Drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

Brand Name: Diafat, Gludin, Glumet, Paradim

Decrease intestinal absorption of glucose and hepatic glucose production. It also improves insulin sensitivity (increase peripheral glucose uptake and utilization) Classification: Antihyperglycemic agent

Initially 500mg 1-3x a day and if necessary, increased up to 1g 3x a day with meals.

Hyperglycemia urinary tract infection thrombocytopenia

monitor glucose and glycosylated Hgb levels before therapy to monitor drug effectiveness. assess renal status (BUN, creatinine) before therapy and reassess at least annually. monitor patients hematologic status. Note for megaloblastic anemia. monitor glucose, electrolytes (Na, K, and Cl), lactate, pyruvate, ketones.

Generic Name: Metformin

lactic acidosis

Name of Drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

Brand Name: Manowel, Panafox

Generic Name: Cefoxitin

Inhibits bacterial cell, wall synthesis, thus promoting osmotic instability which eventually leads to bacterial cell death. Classification:

Administer to IV/IM. 1/2g 3x/day. For patients with renal insufficiency and those undergoing hemodialysis leading dose: 1-2g.

renal impairment liver function disorders allergic signs

assess for renal function before and during therapy: urine output, BUN, and creatinine. monitor hepatic status if patient is on long term therapy. obtain C&S before beginning drug therapy to identify if correct treatment has been initiated.

Name of Drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

Brand Name: Dostan, Hemostan

Generic Name: Tranexemic Acid

inhibits breakdown of fibrin clots. It acts primarily by blocking the binding of plasminogen occurs only to a limited degree. Classifications: Anti-fibrinolytic, antihemorrhagic

1 cap daily, should be swallowed whole with water ideally in the morning after food.

fatigue headache dizziness depression sleep disturbances

Unusual change in bleeding pattern should be immediately reported to the physician.

Name of Drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

Brand name: Duphalac, lilac

Generic name: Lactulose

Causes an influx of fluid in the intestinal tract by increasing the osmotic pressure with in the intestinal lumen

Administer with full glass of fruit juice, water or milk Consideration: adult: 1545mlinitial dose, 15-30ml maintainance dose. Dose given for 3 days.

Diarrhea on prolonged use Abdominal discomport associated with flactulence and intestinal cramps.

Name of Drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

Brand Name: Baciflox, celsus ofloxacin Ear/ eyedrops, exogan Generic name: Ofloxacin

DNA gyrase inhibitor. Interferes with conversion of intermediate DNA fragments into high molecular weigth. DNA in bacteria.

Administer 1 hrs before 2 hours after meals. Do not administer concurrently with antiacids. Avoid administering mineral supplements/vita mins with iron/zinc with 2 hours of drug. UTIs adults: by mouth/IV200mg every hours.

Diarrhea Abdominal pain Fever Dizziness Fatigue

Name of drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

Brand name: Crestor

Inhibits HMG-CoA reductase enzyme, which reduces cholesterol systhesis.

Take with or without food. Primary hypercholesterole mia, mixed dyslipidemia and isolated trigyceridemia. Initial dose 10 mg once daily. For patient with severe renal impairement. Maximum dose: 10mg once a day.

Headache Constipation Dizziness pruritus

Generic name: Rosuvastatin

Name of drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

Brand name: Acifre famazole, lopep losec

Generic name: Omeprazole

suppresses gastric secretor by inhibiting hydrogen/K, ATPase enzyme system in the gastric parietal cell. Classification Gatric acid pump inhibitor Proton Pump Inhibitor

take before meals active duodenal ulcer adults by mouth, 20 mg/day for 48weeks. Gastric ulcer. Adults: PO 40 mg once daily for 4-8 weeks.

Tachycardia Cough Back pain Palpitation

Administer before meals. Caution patient to swallow capsules whole not to open, chew, or crush them. Arrange for further evaluation of patient after 8 wk of therapy for gastro reflux disorders; not intended for maintenance therapy. Symptomatic improvement does not rule out gastric cancer, which did occur in preclinical studies. Administer antacids with omeprazole, if needed.

Take the drug before meals. Swallow the capsules whole; do not chew, open, or crush them.

This drug will need to be taken for up to 8wk (short-term therapy) or for a prolonged period(> 5 yr in some cases). Have regular medical follow-up visits. These side effects may occur: Dizziness (avoid driving or performing hazardous tasks);headache (request medications); nausea, vomiting, diarrhea (maintain proper nutrition);sympto ms of upper respiratory tract

infection, cough (do not selfmedicate; consult with your health care provider if uncomfortable).Re port severe headache, worsening of symptoms, fever, chills

Name of drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

Brand name: Uriflow Generic name:

Directly stimulates muscarinic acetyl choline receptors. It mimics the effects of

Adult: 10-50 mg 3x a day/ 4x a day

Salivation Urinary urgency Sweating

Monitor vital signs frequently, especially respirations. Always have

Bethanedol

acetylcholine in the stimulation of the parasymphathetic nervous system. Classification:

Hypotension reflex tachycardia

atropine injection available, and be prepared to give 0.6 subcutaneously or by slow IV push. Provide respiratory support, if needed.

Cholinergics (parasympathomimetics)

Monitor patient for orthostatic hypotension. Watch for toxicity, especially for subcutaneous use. Monitor blood pressure, pulse, respiration for 1hour after parenteral dose.

Name of drug

Action

Recommended dose with special precaution

Adverse reaction

Nursing intervention

BRAND NAME: Micardis

GENERIC NAME: Telmisartan

Telmisartan is an angiotensin II receptor blocker that shows high affinity for the angiotensin II receptor type 1 (AT1), with a binding affinity 3000 times greater for AT1 than AT2. It has the longest half-life of any ARB (24 hours) and the largest volume of distribution

40 mg P.O BID

Headache upper respiratory tract infection dizziness Anorexia muscle spasm sleep disturbances

Monitor client for hypotension after starting drug. Place client supine if hypotension occurs, and give IV normal saline, if needed. For patient whose renal function may depend on the activity of the rennin angiotensin aldosterone system (such asthose with severe heart failure)treatment with ACE inhibitors and angiotensin receptors antagonist has caused oliguria or progressive azotemia and acute renal failure or death.

Assessment

Diagnosis Urinary retention related to infection

Planning After 8 hours of nursing intervention the patient will void in sufficient amounts with no palpable bladder detention.

Intervention Sit upright on bedpan/ commode or stand. Characterize with intermittent or indwelling catheter. Drain bladder slowly with straight catheter in increment of 200ml at a time. Encourage client to report problems immediately.

Rationale To provide functional position of voiding To resolve acute retention To prevent possibility of occurrence of hematuria, syncope. So treatment can be instituted promptly.

Evaluation After 8 hours of nursing intervention the patient void in sufficient amounts with no palpable bladder detention.