Drug Case Study ZY

CLARK COLLEGE OF SCIENCE AND TECHNOLOGY

Drug Study

Name of Drug Classification Indication/Usage Contraindication Adverse Reaction Nursing Intervention

Generic Name:

Losartan

Brand Name:

Cozaar

angiotensin II receptor blocker

Treating high blood

pressure alone or with

other medicines. It is

used in certain patients

to decrease the risk of

stroke. It is used in

certain patients to treat

kidney problems caused

by diabetes (diabetic

nephropathy). It may

also be used for other

conditions as

determined by your

doctor.

Losartan is an

angiotensin II receptor

blocker (ARB). It works

by relaxing blood

Do not use if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Losartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.

Slideshow: 2014 Update - First Time Brand-to-Generic Switches 2014 Update - First Time Brand-to-Generic SwitchesYou should not use this medication if you are allergic to losartan.

If you have diabetes, do not use losartan together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).

Abdominal or stomach painanxietybladder painbloody or cloudy urineblurred visionchillscold sweatscomaconfusioncool, pale skindepressiondifficult breathingdifficult, burning, or painful urinationdizzinessfast heartbeatfrequent urge to urinateheadacheincreased hungerirregular heartbeatlower back or side painnausea or vomitingnightmaresnumbness or tingling in the hands, feet, or lipspale skinseizuresshakinessshortness of breathslurred speechtroubled breathing with exertionunusual bleeding or bruisingunusual tiredness or weaknessweakness or heaviness of the legs

M aintain hydration. Assess for evidence of URI, cough. Assist with ambulation if drowsiness. Monitor daily bowel movement, monitor B/P, pulse


vessels. This helps to

lower blood pressure.


Generic Name:

Ambroxol

Brand Name:

Acolyt

Expectorant

Mucolytic agent

All forms of tracheobronchitis, emphysema with bronchitis pneumoconiosis, chronic inflammatory pulmonary conditions, bronchiectasis, bronchitis with bronchospasm asthma. During acute exacerbations of bronchitis it should be given with the appropriate

There are no absolute contraindications but in patients with gastric ulceration relative caution should be observed.

Occasional gastrointestinal side effects may occur but these are normally mild.

Advice patient to drink plenty of fluids, particularly hot fluids to facilitate moistair passages and to refrain from things that can irritate the throat such assmoke


antibiotic.


Generic Name:

Pantoprazole

Brand Name:

Pantozol

proton pump inhibitor Pantoprazole (Protonix) is in a group of drugs called proton pump inhibitors. It decreases the amount of acid produced in the stomach.

Pantoprazole is used to treat erosive esophagitis (damage to the esophagus from stomach acid), and other conditions involving excess stomach acid such as Zollinger-Ellison syndrome.

Pantoprazole is not for immediate relief of heartburn symptoms.

Pantoprazole may also be used for purposes not listed in this medication guide.

You should not use this medication if you are allergic to pantoprazole or to any other benzimidazole medication such as albendazole (Albenza), or mebendazole (Vermox).


Heartburn is often confused with the first symptoms of a heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill feeling.

fast or uneven heart rate;jerking muscle movements;feeling jittery;diarrhea that is watery or bloody;muscle cramps, muscle weakness or limp feeling;cough or choking feeling; orheadache, trouble concentrating, memory problems, weakness, loss of appetite, feeling unsteady, confusion, hallucinations, fainting, seizure, or shallow breathing.Less serious pantoprazole side effects are more likely to occur, such as:

weight changes;nausea, vomiting, mild diarrhea;gas, stomach pain;dizziness, drowsiness, tired feeling;joint pain; orsleep problems (insomnia).

This is a proton pump inhibitor. It destroy the ability of the G-cells in the stomach to produce HCl (Hydrochloric acid), so that the stomach content is less acid. One important side effect is that your own enzymes (in particular pepsin and proteases) no lunger function well, and food may remain undigested. But at the same time it has an effect similar to a meal, which would serve to neutralize some of the HCl during the digestive process.



Generic Name:Aldactone

Brand Name:

Spironolactone

steroidal antimineralocorticoid, antiandrogen,

Aldactone (spironolactone) is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

Aldactone is used to diagnose or treat a condition in which you have too much aldosterone in your body. Aldosterone is a hormone produced by your adrenal glands to help regulate the salt and water balance in your body.

Aldactone also treats fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome. This medication is also used to treat or prevent hypokalemia (low potassium levels in the blood).

Aldactone may also be used for purposes not listed in this medication guide.

You should not use Aldactone if you have kidney disease, high levels of potassium in your blood, Addison's disease (an adrenal gland disorder), if you are unable to urinate, or if you are also taking eplerenone.

Slideshow: Can Prescription Drugs Lead to Weight Gain? Can Prescription Drugs Lead to Weight Gain?In animal studies, Aldactone caused certain types of cancers or tumors. It is not known whether these effects would occur in people using this medicine. Ask your doctor about your risk.

mild nausea or vomiting, diarrhea;breast swelling or tenderness;dizziness, headache, mild drowsiness;leg cramps; orimpotence, difficulty having an erection.

Mark calendars of edema outpatients as reminders of alternate day or 3- to 5-day/wk therapy.· Give daily doses early so that increased urination does not interfere with sleep.· Make suspension as follows: Tablets may be pulverized and given in cherry syrup for young children. This suspension is stable for 1 mo if refrigerated.· Measure and record regular weight to monitor mobilization of edema fluid.· Avoid giving food rich in potassium.· Arrange for regular evaluation of serum electrolytes, BUN.



Generic Name:Citicholine

Brand Name:

psychostimulant/nootropic

Citicoline seems to increase a brain chemical called phosphatidylcholine. This brain chemical is important for brain function. Citicoline might also decrease brain tissue damage when the brain is injured.

You should not use this medication if you are allergic to pantoprazole or to any other benzimidazole medication such as albendazole (Albenza), or mebendazole (Vermox).


Heartburn is often confused with the first symptoms of a heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill feeling.

Occasional gastrointestinal side effects may occur but these are normally mild.

M aintain hydration. Assess for evidence of URI, cough. Assist with ambulation if drowsiness. Monitor daily bowel movement, monitor B/P, pulse


Conclusions

Effectiveness of physical exercise on airway inflammation is yet unproven. There is, however, some evidence to suggest that physical exercise may reduce inflammation in an asthmatic airway. Should such evidence emerge in future research, physical exercise may well prove to be an affordable, accessible, healthy, non-invasive, and enjoyable asthma management strategy. We urgently need to design studies to understand if this non-pharmacological adjunctive strategy can effectively decrease airway inflammation, control symptoms of asthma, and be safely administered in the community.

RECOMMENDATIONExercises can work on distinctive ways for people with bronchial asthma. It can either relieve the symptoms of asthma or it may worsen the condition. Anyone who is physically active must know their limits and boundaries when exercising. This is crucial especially to anyone who has pulmonary problems such as bronchial asthma.

Physical activities such as exercise are important. It does not only provide essential benefits such as improving healthy lifestyle but it works to relieve the symptoms of asthma, as well. Additionally, it helps strengthens the muscles and develop the function of the lungs. Exercise can improve the cardiac muscle, which may develop its maximum level of workload.

When exercising, one should do it on a slow phase (gradual manner). The purpose for this is to help the lungs and the heart to cope with the increasing level of exertion. Moreover, doctors are advising people with asthma to perform exercises because this will increase the resistance of the lungs to accommodate sufficient amount of air.

Furthermore, it is important that anyone who has asthma must avoid too much exertion when exercising. There are exercises that can trigger the occurrence of asthma attack. These are strenuous exercises that require overexertion of the body. Exercising in the field can also predispose someone from asthma attack. This is because they are exposed to several allergens that can precipitate the condition.

MEDICAL SURGICAL NURSING


JOURNAL

BRONCHIAL ASTHMA IN ACUTE EXACERBATION

ZANDY LAGMAN SINGIANPN231

MR.VIRGILIO CARPIO


Generic Name:CatapresBrand Name:

Oral Antihypertensive

Catapres (clonidine) lowers blood pressure by decreasing the levels of certain

. Before you take Catapres, tell your doctor if you have heart disease or severe coronary artery disease,

drowsiness, dizziness;feeling tired or irritable;cold symptoms

Monitor BR closely. Determine positional changes (supine, sitting, standing).With epidural administration, frequently


Clonidine chemicals in your blood. This allows your blood vessels to relax and your heart to beat more slowly and easily.

Catapres is used to treat hypertension (high blood pressure). The Kapvay brand of clonidine is used to treat attention deficit hyperactivity disorder (ADHD).

Catapres may also be used for purposes not listed in this medication guide.

a heart rhythm disorder, slow heartbeats, low blood pressure, a history of heart attack or stroke, kidney disease, or if you have ever had an allergic reaction to a Catapres transdermal skin patch (Catapres TTS).

such as runny or stuffy nose, sneezing, cough, sore throat;mood changes;sleep problems (insomnia), nightmares;headache, ear pain;mild fever;feeling hot;constipation, diarrhea, pain in your upper stomach;dry mouth, increased thirst; orloss of interest in sex, impotence, difficulty having an orgasm.

monitor BP and HR. Hypotension is a common side effect that may require intervention.Monitor BP closely whenever a drug is added to or withdrawn from therapeutic regimen.Monitor I&O during period of dosage adjustment. Report change in I&O ratio or change in voiding pattern.Determine weight daily. Patients not receiving a concomitant diuretic agent may gain weight, particularly during first 3 or 4 d of therapy, because of marked sodium and water retention.Supervise closely patients with history of mental depression, as they may be subject to further depressive episodes.


Generic Name:

Ceftriaxone

Brand Name:

Cephalosporin

Antibiotic Ceftriaxone is a cephalosporin antibiotic. It works by interfering with the formation of the bacteria's cell wall so that the wall ruptures, resulting in the death of the bacteria.

you are allergic to any ingredient in ceftriaxone or to any other cephalosporin antibiotic (eg, cephalexin, cefprozil)the patient is a newborn (younger than 29 days old) with high blood bilirubin

LOCAL REACTIONS — Phlebitis was reported in < 1% after IV administration.

HYPERSENSITIVITY — rash (1.7%). Less frequently reported ( < 1 %) were pruritus, fever or chills.

HEMATOLOGIC — eosinophilia (6%), thrombocytosis (5.1%) and leukopenia (2.1%). Less frequently reported ( < 1%) were anemia, hemolytic anemia, neutropenia, lymphopenia, thrombocytopenia and prolongation of the prothrombin time.

Culture infection and arrange for sensitivity tests before and during therapy is expected response is notseen.Reconstitute for IM use with sterile water for injection; 0.9% sodium chloride solution, 5%


(hyperbilirubinemia) or jaundicethe patient is a newborn and is receiving or is expected to receive an intravenous (IV) medicine that contains calcium

GASTROINTESTINAL — diarrhea (2.7%). Less frequently reported ( < 1%) were nausea or vomiting, and dysgeusia. The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment (see WARNINGS).

HEPATIC — elevations of SGOT (3.1%) or SGPT (3.3%). Less frequently reported ( < 1%) were elevations of alkaline phosphatase and bilirubin.

RENAL — elevations of the BUN (1.2%). Less frequently reported ( < 1 %) were elevations of creatinine and the presence of casts in the urine.

CENTRAL NERVOUS SVSTEM — headache or dizziness were reported occasionally ( < 1%).

GENITOURINARY — moniliasis or vaginitis were reported occasionally ( < 1 %).

dextrosesolution, inject deeply into a large muscle group.Protect drug from light.Do not mix with any other antimicrobial drug.Have vitamin K in case hypo thrombinemia occurs.Stomach upset and diarrhea is expected normal side effects of the drug.Report severe severe diarrhea, difficulty breathing, unusual fatigue or pain at injection site0



Generic Name:

Metronidazole

Brand Name:

Noritade

AntibacterialAntiprotozoal

General Indications>amebic hepaticabscess>intestinalamebiasis>trichomoniasis>retractorytrichomoniasis>bacterial infectioncaused byanaerobicmicroorganisms>to preventpostoperativeinfection incontaminatedcolorectal surgery>pelvicinflammatory

. Contraindications>hypersensitivity>hypersensitivity toparabens>first trimester of pregnancyPrecautions>history of blood dyscrasias;seizures or neurologicproblems>severe hepatic impairment>pregnancy, lactation andchildren

Tearing(topicalonly)GI: abdominal pain,anorexia, nauseaand vomiting,diarrhea, drymouth, glossitisDerm: rashes,urticarial, milddryness, skinirritationHemat: leukopeniaLocal: Phlebitis atIv siteNeuro: peripheralneuropathyMisc:superinfection

Before:

Watch carefully for edema because itmay cause sodium retention>assess skin for severity areas of localadverse reactions>record number and character of stools>assess pt’s and family’s knowledge of drug therapyDuring>give drug with meals to minimize GIdistress>to treat trichomoniasis, give drug for7days instead of 2-g single dose>use only after T.vaginalis has beenconfirmed by wet smear>tablets may be crushed for pt’s. withdifficult swallowing>do not use aluminium needles or hubs,color will turn orange/rust After >tell pt. that metallic taste and dark orred brown urine may occur>instruct pt. to take oral form with mealsto minimize reactions>instruct to complete full course of therapy>tell pt. not to use alcohol or drugs thatcontain alcohol.>may cause dizziness/ light headedness



Generic Name:

Nalbuphine

Brand Name:Nubain.

synthetic opioid agonist-antagonist analgesic of the phenanthrene series

Nalbuphine is indicated for the relief of moderate to severe pain. It can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery.

Hypersensitivity. CNS effects: Nervousness, depression, restlessness, crying, euphoria, floating[clarification needed], hostility, unusual dreams, confusion, faintness, hallucinations, dysphoria, feeling of heaviness, numbness, tingling, unreality. The incidence of psychotomimetic effects, such as unreality, depersonalization, delusions, dysphoria and hallucinations has been shown to be less than that which occurs with pentazocine.Cardiovascular: Hypertension, hypotension, bradycardia, tachycardia, pulmonary edema.Gastrointestinal: Cramps, dyspepsia, bitter taste.Respiration: Depression, dyspnea, asthma.Dermatological: Itching, burning, urticaria.Obstetric: Pseudo-sinusoidal fetal heart rhythm.

Assess respiratory rate before drug administration. Withhold drug and notify physician if respiratory rate falls below 12.Watch for allergic response in persons with sulfite sensitivity.Administer with caution to patients with hepatic or renal impairment.Monitor ambulatory patients; nalbuphine may produce drowsiness.Watch for respiratory depression of newborn if drug is used during labor and delivery.Avoid abrupt termination of nalbuphine following prolonged use, which may result in symptoms similar to narcotic withdrawal: nausea, vomiting, abdominal cramps, lacrimation, nasal congestion, piloerection, fever, restlessness, anxiety.


Generic Name:

Brand Name:

Naproxen is a nonsteroidal anti-inflammatory

It works by reducing hormones that cause inflammation and

You should not use naproxen if you have a history of allergic reaction to aspirin or other NSAID (nonsteroidal anti-inflammatory drug).

upset stomach, mild heartburn or stomach pain, diarrhea,

Give with food or after meals if GI upset occurs.· Arrange for


drug (NSAID). pain in the body.

Naproxen is used to treat pain or inflammation caused by conditions such as arthritis, ankylosing spondylitis, tendinitis, bursitis, gout, or menstrual cramps.

Naproxen may also be used for purposes not listed in this medication guide.

Naproxen may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Slideshow: Living with Your Migraines: Tips for Treatment and Prevention Living with Your Migraines: Tips for Treatment and PreventionGet emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

Naproxen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking naproxen.

constipation;bloating, gas;dizziness, headache, nervousness;skin itching or rash;blurred vision; orringing in your ears.

periodic ophthalmologic examination during long-term therapy.· WARNING: If overdose occurs, institute emergency procedures—gastric lavage, induction of emesis, supportive therapy.



Generic Name:

Metronidazole

Brand Name:

MetroGel

AntibacterialAntiprotozoal

General Indications>amebic hepaticabscess>intestinalamebiasis>trichomoniasis>retractorytrichomoniasis>bacterial infectioncaused byanaerobicmicroorganisms>to preventpostoperativeinfection incontaminatedcolorectal surgery>pelvicinflammatory

. Contraindications>hypersensitivity>hypersensitivity toparabens>first trimester of pregnancyPrecautions>history of blood dyscrasias;seizures or neurologicproblems>severe hepatic impairment>pregnancy, lactation andchildren

Tearing(topicalonly)GI: abdominal pain,anorexia, nauseaand vomiting,diarrhea, drymouth, glossitisDerm: rashes,urticarial, milddryness, skinirritationHemat: leukopeniaLocal: Phlebitis atIv siteNeuro: peripheralneuropathyMisc:superinfection

Before:

Watch carefully for edema because itmay cause sodium retention>assess skin for severity areas of localadverse reactions>record number and character of stools>assess pt’s and family’s knowledge of drug therapyDuring>give drug with meals to minimize GIdistress>to treat trichomoniasis, give drug for7days instead of 2-g single dose>use only after T.vaginalis has beenconfirmed by wet smear>tablets may be crushed for pt’s. withdifficult swallowing>do not use aluminium needles or hubs,color will turn orange/rust After >tell pt. that metallic taste and dark orred brown urine may occur>instruct pt. to take oral form with mealsto minimize reactions>instruct to complete full course of therapy>tell pt. not to use alcohol or drugs thatcontain alcohol.>may cause dizziness/ light headedness

MEDICAL SURGICAL NURSING


JOURNALJULAO JENNIFERPN231

MR. VIRGILIO CARPIO

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Drug Case Study ZY