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8/6/2019 Eent Drug Study2
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Drug DrugClass.
TherapeuticActions
Indications Contraindications Adverse Effect
Ranitidine
Brand name:Taladine, Zantac
Histamine-stimulatesthestomach
cells to produce
acid.
Anti -ulcer agents
Treatment and prevention of heartburn, acidindigestion,
and sour stomach
•Hypersensitivity,
Cross-sensitivity may
occur; some oral
liquids contain alcohol
and should be avoided
in patients with known
intolerance.
Use Cautiously in:
• Renal impair- ment
• Geriatric patients
(more
susceptible to adverse
CNS reactions)
• Pregnancy or
Lactation
• CNSConfusion, dizziness, drowsiness,hallucinations,headache
• CV:Arrhythmias
• GI:
Altered taste, black tongue,
constipation, dark stools,
diarrhea, drug-induced hepatitis, nausea
• GU:Decreased sperm count, impotence• ENDO:Gynecomastia
• HEMAT:
Agranulocytosis, Aplastic Anemia,
neutropenia,
thrombocytopenia
• LOCAL:Pain at IM site
• MISC:
Hypersensitivity reactions, vasculitis
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Tramadol
Brand name:
Rybix ODT, Ryzolt,Ultram
Analgesics(centrallyacting)
PhysiologicMechanism
• Decreased pain.
PharmacologicMechanism
• Binds to mu-opioidreceptors.
• Inhibitsreuptake of
serotonin and
norepinephrinein the CNS.
Moderate tomoderately severe
pain• where opioids
are
contraindicated,
including acute
intoxication with
any of the
following: alcohol,
hypnotics,
narcotics, centrally
acting analgesics,
opioids or
psychotropic
drugs.
• worsen central
nervous systemand respiratory
depression in these
patients.
Body as a Whole – Asthenia, fatigue,hot flushes
Central and Peripheral NervousSystem – Dizziness, headache, tremor
Gastrointestinal System – Abdominal pain, constipation, diarrhea, dyspepsia,flatulence, dry mouth, nausea, vomiting
Psychiatric Disorders – Anorexia,anxiety, confusion, euphoria, insomnia,nervousness, somnolence
Skin and Appendages – Pruritus, rash,increased sweating.
Selected Adverse events occurring atless than 1%: the following lists
clinically relevant adverse reactions thatoccurred with an incidence of less than
1% in ULTRACET® clinical trials.
Body as a Whole – Chest pain, rigors,syncope, withdrawal syndrome
Cardiovascular Disorders–
Hypertension, aggravated hypertension,hypotension
Central and Peripheral Nervous
System – Ataxia, convulsions,hypertonia, migraine, aggravatedmigraine, involuntary muscle
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contractions, paresthesias, stupor,vertigo
Gastrointestinal System– Dysphagia,melena, tongue edema
Hearing and Vestibular Disorders –
Tinnitus
Heart Rate and Rhythm Disorders –
Arrhythmia, palpitation, tachycardia
Liver and Biliary System– Hepaticfunction abnormal
Metabolic and Nutritional Disorders
– Weight decrease
Psychiatric Disorders – Amnesia,depersonalization, depression, drugabuse, emotional lability, hallucination,impotence, paroniria, abnormal thinking
Red Blood Cell Disorders – Anemia
Respiratory System – Dyspnea
Urinary System – Albuminuria,micturition disorder, oliguria, urinaryretention
Vision Disorders – Abnormal vision
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Ciprofloxacin brandname: Cipro
Antibacterial
Fluoroquinolone Bactericidal;
interferes withDNAreplication insusceptible
bacteria preventing cell
reproduction.
For the treatment of infections caused bysusceptible gram-negative bacteria,including E. coli, P.
mirabilis, K. pneumoniae,Enterobacter cloacae,P. vulgaris, P.rettgeri, M. morganii,P. aeruginosa,Citrobacter freundii,
S. aureus, S.epidermidis, group D
streptococci
Contraindicated withallergy tociprofloxacin,norfloxacin or other fluoroquinolones,
pregnancy, lactation.
Use cautiously withrenal dysfunction,seizures, tendinitis or tendon ruptureassociated withfluoroquinolone use.
CNS: Headache, dizziness, insomnia,
fatigue, somnolence, depression, blurred vision
CV: Arrhythmias, hypotension, angina
EENT: Dry eye, eye pain, keratopathy
GI: Nausea, vomiting, dry mouth,diarrhea, abdominal pain
Hematologic: Elevated BUN, AST,
ALT, serum creatinine and alkaline phosphatase; decreased WBC,neutrophil count, Hct
Other: Fever, rash
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Calciumcarbonate
Brand name: Alka-Mints, Alkets,
Alkums, Amilac-antacids
- Calcium
carbonate isused to prevent
and to treatcalcium
deficiencies.
- As a dietarysupplement wherecalcium intake may
be inadequate:childhood,
adolescence,adulthood, pregnancy, lactation, perimenopausal and postmenopausalwomen and in theaged.
- Hypercalcemia andhypercalciuria (e.g.hyperparathyroidism,vitamin D overdosage,decalcifying tumorssuch as
plasmocytoma, bonemetastases); severerenal disease; and incalcium loss due toimmobilization.Hypersensitivity toany of thecomponents.
-
• upset stomach• vomiting
• stomach pain• belching• constipation
• dry mouth• increased urination• loss of appetite
• metallic taste
-
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Vitamin bcomplex
- thiamine(B1),
riboflavin(B2),niacin(B3),
pantothenicacid (B5),
pyridoxine(B6), biotin(B7), folicacid or folate (B9),
cobalamin(B12)
- essential for growth,development,and a variety of other bodilyfunctions. They
play a major role in the
activities of enzymes,
proteins thatregulate
chemicalreactions in the
body, whichare importantin turning foodinto energy andother neededsubstances.
-patients with chronicobstructive
pulmonary disease
(COPD) on a regular aerosol bronchodilator whocontinue to haveevidence of
bronchospasm andwho require a second
bronchodilator
-history of hypersensitivity tosoya lecithin or relatedfood products such assoybean and peanut.
-cardiac
-allergic reactions (Rash, Oropharyngealedema, angioedema, bronchospasm)
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CombiventBrand name:Combivent, DuoNeb
bronchospasms
(combination of
ipratropiumand
albuterolinhaler )
-prevent airwayspasms
-osteoarthritis,
rheumatoid arthritis, acute pain, painfulmenstruation and
menstrual symptoms,ankylosingspondylitis and toreduce the number of colon and rectal
polyps in patientswith familialadenomatous
polyposis. It wasoriginally intended torelieve pain whileminimizing thegastrointestinaladverse effectsusually seen withconventional
NSAIDs.
-with allergies tosulfonamides,
celecoxib, NSAIDS,or aspirin, significantrenal empairment;
pregnancy (third tri),lactation
-headache, abdominal pain, dyspepsia,diarrhea, nausea, flatulence, andinsomnia.
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CelecoxibBrandname:celebrex
-analgesics
-nonsteroidalantiinflammatory drug(NSAID) thatis used to treatarthritis, pain,menstrualcramps, and
colonic polyps.Prostaglandinsare chemicalsthat are
importantcontributors to
theinflammation
of arthritis thatcauses pain,
fever , swelling
and tenderness.
- lower respiratory
tract infections,skinand skin structureinfections, urinary
tract infections, bacterial septicemia, bone and jointinfections,gynecologicinfections, intraabdominal infections(including
peritonitis), andcentral nervoussystem infections(includingmeningitis).
- hypersensitivity toceftazidime or thecephalosporin groupof antibiotics.
- Diarrhea; headache; nausea; numbnessor tingling of skin; stomach pain;vomiting.
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CeftazidimeBrand name: Fortazand Tazicef
-antibiotics
-Treating bacterialinfections.
DRUG DRUG CLASS THERAPEUTICACTIONS
INDICATIONS CONTRAINDICATIONS ADVERSE AFFECT
9.CeftazidimeBrand name: Fortaz
and Tazicef
-antibiotics -Treating bacterialinfections.
- lower respiratorytract infections,skin
and skin structureinfections, urinarytract infections,
bacterial septicemia, bone and jointinfections,gynecologicinfections, intra
- hypersensitivity toceftazidime or the
cephalosporin group of antibiotics.
- Diarrhea; headache;nausea; numbness or
tingling of skin;stomach pain;vomiting.
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10.CelecoxibBrandname: celebrex
-analgesicsnonsteroidalantiinflammatorydrug (NSAID) that isused to treat arthritis,
pain, menstrualcramps, and colonic
polyps.Prostaglandins arechemicals that areimportantcontributors to theinflammation of arthritis that causes
pain, fever , swellingand tenderness.
abdominal infections(including
peritonitis), andcentral nervous
system infections(including
meningitis).
-osteoarthritis ,rheumatoid arthritis,acute pain, painfulmenstruation andmenstrual
symptoms,ankylosing
spondylitis and toreduce the number
of colon and rectal polyps in patients
with familialadenomatous
polyposis. It wasoriginally intendedto relieve pain whileminimizing thegastrointestinaladverse effectsusually seen withconventional
-with allergies tosulfonamides, celecoxib,
NSAIDS, or aspirin,significant renalempairment; pregnancy
(third tri), lactation
--headache,abdominal pain,dyspepsia, diarrhea, nausea, flatulence, and insomnia.
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11.CombiventBrand name:Combivent, DuoNeb
-bronchospasms(combination of ipratropium andalbuterol inhaler )
-prevent airwayspasms
NSAIDs.
-patients withchronic obstructive
pulmonary disease(COPD) on a regular aerosol
bronchodilator whocontinue to haveevidence of
bronchospasm andwho require asecond
bronchodilator -history of hypersensitivity to soyalecithin or related food
products such as soybeanand peanut.
-cardiac
-allergic reactions(Rash, Oropharyngealedema, angioedema,
bronchospasm)
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12.Vitamin bcomplex
- thiamine (B1),riboflavin (B2),niacin (B3),
pantothenic acid(B5), pyridoxine(B6), biotin (B7),folic acid or folate(B9), cobalamin(B12)
- essential for growth,
development, and avariety of other
bodily functions.
They play a major role in the activities
of enzymes, proteinsthat regulate
chemical reactions inthe body, which are
important in turningfood into energy and
other neededsubstances.
- As a dietarysupplement wherecalcium intake may
be inadequate:childhood,
adolescence,adulthood,
pregnancy, lactation, perimenopausal and
postmenopausal
women and in theaged.
- Hypercalcemia andhypercalciuria (e.g.
hyperparathyroidism,vitamin D overdosage,
decalcifying tumors suchas plasmocytoma, bone
metastases); severe renaldisease; and in calciumloss due toimmobilization.Hypersensitivity to any of the components.
• upset
stomach•
vomiting• stomach pain• belching
• constipation• dry mouth• increased
urination• loss of
appetite• metallic taste
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13.Calciumcarbonate
Brand name: Alka-Mints, Alkets,Alkums, Amilac
-antacids
-Calcium carbonateis used to prevent
and to treat calciumdeficiencies.
- For the treatment
of infections caused by susceptible gram-negative bacteria,
including E. coli, P.mirabilis, K.
pneumoniae,Enterobacter cloacae, P. vulgaris,P. rettgeri, M.morganii, P.aeruginosa,
Citrobacter freundii,S. aureus, S.epidermidis, groupD streptococci
- Moderate to
moderately severe
pain
- Contraindicated withallergy to ciprofloxacin,norfloxacin or other fluoroquinolones,
pregnancy, lactation.
Use cautiously with renaldysfunction, seizures,tendinitis or tendonrupture associated withfluoroquinolone use.
•
CNS: Headache,
dizziness, insomnia,fatigue, somnolence,
depression, blurredvision
CV: Arrhythmias,
hypotension, angina
EENT: Dry eye, eye pain, keratopathy
GI: Nausea,vomiting, dry mouth,diarrhea, abdominal
pain
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15.Tramadol
Brand name:
Rybix ODT, Ryzolt,Ultram
Analgesicsnonsteroidalantiinflammatorydrug (NSAID) that isused to treat arthritis,
pain, menstrualcramps, and colonic
polyps.Prostaglandins are
chemicals that areimportant
contributors to theinflammation of
arthritis that causes pain, fever , swelling
and tenderness.
Disorders –
Anorexia, anxiety,confusion, euphoria,insomnia,nervousness,somnolence
Skin and
Appendages –
Pruritus, rash,increased sweating.
Selected Adverse
events occurring atless than 1%: the
following listsclinically relevant
adverse reactions thatoccurred with anincidence of less than1% in ULTRACET®
clinical trials.
Body as a Whole –
Chest pain, rigors,syncope, withdrawal
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syndrome
Cardiovascular
Disorders–
Hypertension,aggravatedhypertension,hypotension
Central and
Peripheral Nervous
System – Ataxia,convulsions,hypertonia, migraine,aggravated migraine,involuntary muscle
contractions, paresthesias, stupor,vertigo
Gastrointestinal
System– Dysphagia,melena, tongueedema
Hearing and
Vestibular
Disorders – Tinnitus
Heart Rate and
Rhythm Disorders –
Arrhythmia, palpitation,
tachycardia
Liver and Biliary
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Treatment and
System– Hepaticfunction abnormal
Metabolic and
Nutritional
Disorders – Weightdecrease
Psychiatric
Disorders –
Amnesia,depersonalization,depression, drugabuse, emotionallability, hallucination,impotence, paroniria,
abnormal thinking
Red Blood Cell
Disorders – Anemia
Respiratory System
– Dyspnea
Urinary System –
Albuminuria,micturition disorder,
oliguria, urinaryretention
Vision Disorders –
Abnormal vision
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16.RanitidineBrand name:Taladine, Zantac
Histamine-stimulates the
stomach cells to produce acid.
Anti -ulcer agents prevention of heartburn, acidindigestion,and sour stomach
•Hypersensitivity, Cross-
sensitivity may occur;
some oral liquids containalcohol and should be
avoided in patients with
known intolerance.
Use Cautiously in:
• Renal impair- ment
• Geriatric patients (more
susceptible to adverse
CNS reactions)• Pregnancy or Lactation
• CNSConfusion, dizziness,
drowsiness,hallucinations,headache• CV:Arrhythmias
• GI:
Altered taste, black
tongue, constipation,
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dark stools,
diarrhea, drug-
induced hepatitis,
nausea
• GU:Decreased spermcount, impotence• ENDO:Gynecomastia
• HEMAT:
Agranulocytosis,
Aplastic Anemia,
neutropenia,
thrombocytopenia
• LOCAL:Pain at IM site• MISC:
Hypersensitivityreactions, vasculitis
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ASSESSMENT NURSINGDIAGNOSIS
INFERENCE OBJECTIVES INTERVENTION/IMPELEMTATION
RATIONALE EVALUATION
S: “nahihirapan po siyang
magsalita” asverbalized by the
patients relative.
O:
Impaired verbalcommunication
related to Physical barrier
( tracheostomy,nasogastric tube)
Upper airwayobstruction
Tracheostomy,
nasogastric tubeinserted
Difficultyvocalizing words
After 4 hours of nursing
intervention the patient will be
able to:- use a form of
communication to
get needs met andto relateeffectively with
persons and his or her environment.
- Provide alternativemethods of
communication, like pictures or visual
cues,gestures or
demonstration.
- Place importantobjects withinreach.
-Anticipate and provide for patient’s needs
- Providecommunication
needsor desires based
onindividual
situation or
underlying deficit.
- This maximizes
patient’s sense of independence.- Helpful indecreasingfrustration whendependent onothers
After 4 hours of nursing
intervention the patient able to:
- use a form of communication to
get needs met and
to relateeffectively with persons and his or
her environment.
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- Talk directly to
patient.
Speaking slowlyanddirectly. Use yes or
noquestion to begin
with.
- Speak in normaltones
and avoid talkingtoo fast.Give patient ampletimeto respond.
- Encourage familymembers andvisitors to
persist efforts to
communicate withthe
patient.
and unable tocommunicatedesires.- It reduces
confusionor anxiety and
having
to process andrespond to largeamount of
information at onetime.
- Patient is notnecessary hearingimpaired andraisingvoice may irritateor
anger the patient.- It is importantfor family memberstocontinue talkingtothe patient toreduce
patients isolation, promote
establishment of effectivecommunicationandmaintain sense of
connectedness or bonding with the
family.
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ASSESSMENT NURSINGDIAGNOSIS
INFERENCE OBJECTIVES INTERVENTION/IMPELEMTATION
RATIONALE EVALUATION
S: “di po xamasyadonagkikilos” as
verbalized by the patients relative.
O:
Activityintolerance relatedto Imposed
activity restriction
Insufficient physiological or psychological
energy to endureor completerequired or desired dailyactivities
After 5 hours of nursingintervention the
patient will beable to:- maintainsactivity levelwithincapabilities, asevidenced bynormal heart rateand blood
pressure duringactivity, as well as
absence of shortness of
breath, weakness,and fatigue.
- Establishguidelines and goalsof activity with the
patient andcaregiver.
- Assess the level of mobility and the
physical conditionof the patient
-Assess thenutritional status of the patient
- Support patient in
doing ROMexercises at least 3
times a day.
- Note changes in
balance/ gaitdisturbance, muscle
weakness.
- Motivation isenhanced if the
patient
participates ingoal setting.
- Helps inknowing thecapability of
patientwhich is neededin settinggoals.- Adequate energy
isneeded for activities to bedone.
- Exercise sustain
muscle strengthand ROM.
- May indicateneurological
changesassociated
with vitamin B12deficiency,
affecting patient safety or
risk of injury.
- Promotes
After 5 hours of nursingintervention the
patient able to:- maintainsactivity levelwithincapabilities, asevidenced bynormal heart rateand blood
pressure duringactivity, as well asabsence of
shortness of breath, weakness,and fatigue.
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s:
O:- t/c malignant
Risk for infectionrelated toInadequateacquired
immunity
At increased risk for being invaded
by pathogenicorganisms
After 3 hours of nursingintervention the
patient will:
- Identifyinterventions
techniques to
prevent/ reducerisk factors-Demonstrate
techniques,lifestyle changes
to promote safeenvironment
- Teach patient towash handsoften,especially
beforetoileting,
before meals
and before andafter administering
self-care
-Discuss to patientsthefollowing signsof infection-redness,swelling,increased pain,
or purulentdrainage on thesite and fever
- Note risk factorsfor occurrence of infection.
- observed for localized sign of infection at
insertion sites of invasive lines,surgical incisions or wounds.- Review
environmentalfactors.
- Hand washingreduces therisks for infection
- To impart to
the patientwhen thewound
becomeinfected andwhen to
soughtmedicalcare- to evaluate
presence/character of infection.- to evaluate
presence/character of infection.
- to assess if thereis
a need of avoidance
or modification of environment to
After 3 hours of nursingintervention the
patient will now:
- Identifyinterventions
techniques to
prevent/ reducerisk factors-Demonstrate
techniques,lifestyle changes
to promote safeenvironment
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- Monitor clientsvisitors/ caregivers
for respiratory
illnesses. Offer masks and tissues toclient/ visitors who
are coughing/sneezing.
- Instruct client intechniques to
protect the integrityof skin, care of lesions and
prevention of spreadof infection.
reduce incidenceof infection.- To limit
exposures, thisreduce cross
contamination
- Instruct client
in techniques to protect theintegrity of skin,care of lesionsand prevention of spread of
infection.
ASSESSMENT NURSINGDIAGNOSIS
INFERENCE OBJECTIVES INTERVENTION/IMPELEMTATION
RATIONALE EVALUATION
S: “ Risk for aspiration relatedto Presence of tracheostomy andtube feedings
At risk for entryof gastrointestinalsecretions,oropharyngealsecretions, or solids or fluids
After 5 hours of nursingintervention the
patient will beable to:- Patient’s risk of
- Assess pulmonarystatus for clinicalevidence of aspiration.Auscultate breathsounds for
-Aspiration of small amounts canoccur withoutcoughing or sudden onset of respiratory
After 5 hours of nursingintervention the
patient risk of aspiration isdecreased as a
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intotracheobronchial
passages
aspiration isdecreased as aresult of ongoingassessment and
early intervention.
development of crackles and/or rhonchi.
- In patients with
endotracheal or tracheostomy tubes,monitor the
effectiveness of thecuff. Collaborate
with the respiratorytherapist, as needed,to determine cuff
pressure.- Keep suction setupavailable (in both
hospital and homesettings) and use asneeded.- Notify the
physician or other health care provider immediately of noted decrease incough and/or gagreflexes or difficultyin swallowing.
- Provide oral careafter meals.
-
distress,especially in
patients withdecreased levels
of consciousness.- An ineffective
cuff can increase
the risk of aspiration.
- This is necessaryto maintain a
patent airway.
- Earlyintervention
protects the patient’s airwayand preventsaspiration.
- This removesresiduals and
reduces pocketingof food that can
be later aspirated.-
result of ongoingassessment andearly intervention.