3ECN 2nd Sem Duty Gat Drug Studies

13
San Beda College 638, Mendiola St.,1005 San Miguel, Manila COLLEGE OF NURSING P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131 www.sanbeda.edu.ph GENERIC NAME: Ranitidine Brand Name: Zantac, Zantac EFFERdose, Zantac GELdose, Zantac-75 Dosage / Ava ilable Stock: 50mg Route of Administration: PO Pregnancy Category: B DRUG CLASSIFICATION MODE OF ACTION INDICATIONS AND CONTRAINDICATIONS ADVERSE DRUG REACTION DRUG INTERACTIONS NURSING CONSIDERATIONS HEALTH TEACHING GASTROINTESTINAL AGENT; ANTISECRETORY (H2- RECEPTOR ANTAGONIST) Potent anti-ulcer drug that competitively and reversibly inhibits histamine action at H 2 -receptor sites on parietal cells, thus blocking gastric acid secretion. Indirectly reduces pepsin secretion but appears to have minimal effect on fasting and postprandial serum gastrin concentrations or secretion of gastric intrinsic factor or mucus Short-term treatment of active duodenal ulcer; maintenance therapy for duodenal ulcer patient after healing of acute ulcer; treatment of gastroesophagea l reflux disease; short-term treatment of active, benign gastric ulcer; treatment of pathologic GI hypersecretory conditions (e.g., Zollinger-Ellison syndrome, • CNS: Confusion, 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, The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and Ranitidine (Zantac(tm)), is used to treat (or prevent) gastric ulcers. Caregivers will attempt to observe the following:  Renal and Hepatic patients are not a good candidate for this med.  No anti- inflamatories should be given. This includes aspirin and the like.  Antacids should be • Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate. • Nurse should know that it may cause false-positive results for urine protein; test with sulfosalicyl ic acid. • Inform patient that it may cause drowsiness or dizziness. • Inform patient that increased fluid and fiber intake may minimize constipation. • Advise patient to report onset of black,

Transcript of 3ECN 2nd Sem Duty Gat Drug Studies

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San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131

www.sanbeda.edu.ph 

GENERIC NAME: Ranitidine Brand Name: Zantac, Zantac EFFERdose, Zantac GELdose, Zantac-75 Dosage / Available Stock: 50mg

Route of Administration: PO Pregnancy Category: B

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHING 

GASTROINTESTINAL

AGENT;

ANTISECRETORY (H2-

RECEPTOR

ANTAGONIST)

Potent anti-ulcer drug

that competitively and

reversibly inhibits

histamine action at

H2-receptor sites on

parietal cells, thus

blocking gastric acid

secretion. Indirectly

reduces pepsin

secretion but appearsto have minimal effect

on fasting and

postprandial serum

gastrin concentrations

or secretion of gastric

intrinsic factor or

mucus

Short-term

treatment of 

active duodenal

ulcer;

maintenance

therapy for

duodenal ulcer

patient after

healing of acute

ulcer; treatmentof 

gastroesophagea

l reflux disease;

short-term

treatment of 

active, benign

gastric ulcer;

treatment of 

pathologic GI

hypersecretory

conditions (e.g.,

Zollinger-Ellison

syndrome,

• CNS: 

Confusion, 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,

The effects of somedrugs can change if 

you take other drugs

or herbal products at

the same time. Thiscan increase your

risk for serious side

effects or may cause

your medications not

to work correctly.These drug

interactions are

possible, but do not

always occur. Yourdoctor or pharmacist

can often prevent or

manage interactions

by changing howyou use your

medications or by

close monitoring.To

help your doctor and

Ranitidine (Zantac(tm)),

is used to treat (or

prevent) gastric ulcers.

Caregivers will attempt

to observe the

following:

  Renal andHepatic

patients are

not a good

candidate for

this med.

  No anti-inflamatories

should be

given. This

includesaspirin and the

like.

  Antacids

should be

• Assess patient for

epigastric or

abdominal pain and

frank or occult blood

in the stool, emesis,

or gastric aspirate.

• Nurse should know

that it may cause

false-positive results

for urine protein; testwith sulfosalicylic

acid.

• Inform patient that

it may cause

drowsiness or

dizziness.

• Inform patient that

increased fluid and

fiber intake may

minimize

constipation.

• Advise patient to

report onset of black,

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systemic

mastocytosis,

and

postoperative

hypersecretion);

heartburn.

Aplastic Anemia,

neutropenia,

thrombocytopenia

• LOCAL: 

Pain at IM site

• MISC: 

Hypersensitivityreactions, vasculitis

pharmacist give you

the best care, be sure

to tell your doctorand pharmacist about

all the products you

use (including

prescription drugs,

nonprescriptiondrugs, and herbal

products) before

starting treatment

with this product.While using this

product, do not start,

stop, or change the

dosage of any othermedicines you are

using without your

doctor's

approval.Some

products that mayinteract with this

drug include:

procainamide, propantheline,

warfarin.This

medication decreases

the amount of acid inyour stomach. This

can change the

amount of 

medication absorbed

from your stomach

taken one

hour before or

one hour afterranitidine, as

they inhibit

the

effectiveness.

  Avoidstomach and

GI irritants --

this includessmoking and

ETOH

  Watch forsigns of GI

bleeds.

tarry stools; fever,

sore throat; diarrhea;

dizziness; rash;

confusion; or

hallucinations to

health car

professional

promptly.• Inform patient that

medication may

temporarily cause

stools and tongue to

appear gray black.

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which may affect

how these

medications work.Examples of affected

drugs include

atazanavir, 

delavirdine, 

dasatinib, gefitinib, glipizide, raltegravir, 

triazolam among

others. Azole

antifungals such asketoconazole may

also be affected.This

medication can slow

down the removal of other medications

from your body,

which may affect

how they work.

Examples of affecteddrugs include

metoprolol and

phenytoin amongothers.Check the

labels on all your

medicines because

they may containaspirin or aspirin-

like NSAIDs (e.g.,

ibuprofen, naproxen) 

that can cause

stomach

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irritation/ulcers. Ask 

your pharmacist

about the safe use of those products. Low-

dose aspirin, as

prescribed by your

doctor for specific

medical reasons suchas heart attack  or

stroke prevention 

(usually at dosages

of 81-325 milligramsper day), should be

continued. Consult

your doctor or

pharmacist for moredetails.This

medication and

similar H2 histamine

blockers (e.g.,

cimetidine,famotidine) are

available both over-

the-counter and byprescription. Do not

take them at the

same time.This

medication mayinterfere with certain

laboratory tests (e.g.,

urine protein),

possibly causing

false test results.

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Make sure laboratory

personnel and your

doctors know youuse this drug.This

document does not

contain all possible

interactions.

Therefore, beforeusing this product,

tell your doctor or

pharmacist of all the

products you use.Keep a list of all

your medications

with you, and share

the list with yourdoctor and

pharmacist.

Clinical Instructor: Student Nurse:

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San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131www.sanbeda.edu.ph

GENERIC NAME: Cefuroxime Sodium Brand Name: Zinacef  Dosage / Available Stock: 700mg

Route of Administration: IV Pregnancy Category: B

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHING

Second generation

cephalosporin that

inhibits cell wall

synthesis promoting

osmotic instabilityusually bactericidal 

  Use cautiously inbreastfeeding

women andhistory of colitis

or renal

insufficiency.

  UncomplicatedUTI

  Tonsilitis and

pharyngitis  Early lyme

disease.

CV: Phebitis

Other: Anaphylaxis

GI: anorexia,

vomiting, diarrhea 

Drug – Food: may

increase absorption. Loop Diuretics: May

inc. risk of adverse

renal reactions.

  Give with food

  Before giving

drug, ask

patient if 

he/she is

allergic to

penicillin and

cephalosporins

.

Advice patients

receiving drug IV

report discomfort a

the I.V. insertion

site. 

Clinical Instructor: Prof. Rodeo Aguilar Student Nurse: Glenn Mar E, Rubio Jr.

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San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131www.sanbeda.edu.ph

GENERIC NAME: Diazepam Brand Name: Valium Dosage / Available Stock: __10mg_________

Route of Administration: IV Pregnancy Category: D

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHIN

Depresses the CNS

and suppresses the

spread of seizure

activity . 

  Use cautiously in

patients with liver or

renal failure.

  Contraindicated in

patients

hypersensitive to

drug or soyprotein. 

  Acute alcohol

withdrawal   Muscle spasm 

CNS: drowsiness,

dysarthrea, headache,

anxiety,

hallucinations.

CV: Hypotension,

bradycardia.

EENT: blurred vision

GI: Nausea,

constipation 

Cimetidine: may dec.

clearance of diazepam

and inc. risk of adverse

effects. CNS depressants: may

inc CNS depression. Smoking: May dec.

effectiveness of 

benzodiazepines. 

  Monitor pt.

closely

  Monitor pt. and

digoxin level

closely.

Warned patients to

avoid activities that

require alertness an

good coordination

until effects of drug

are known.

Tell patient to avoid

alcohol while taking

drug.

Clinical Instructor: Student Nurse:

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San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131www.sanbeda.edu.ph

GENERIC NAME: Metronidazole Brand Name:Metrogel Dosage / Available Stock: __500 mg

Route of Administration: IV Pregnancy Category: B

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHING 

May cause

bactericidal effect

by interacting with

bacterial DNA. 

Use cautiously in

patients with history or

evidence of blood

dyscrasia and in those

with severe hepaticdiseases. 

EENT: Lacrimation if 

applied around the

eyes.

GI: Cramps, pain,

nausea, metallic orbad taste in mouth. 

Lithium: may inc.

lithium level. Alcohol use: May cause

disulfiram – like

reaction when used

with vaginal form. 

  Don’t use

Vaginal gel in

pt. who have

taken

disulfiram

within the past

2 weeks. 

  Advice

patient to

avoid sexual

intercourse

while using

vaginal

preparation.

  Caution

patient to

avoid alcohol

while treated

with vaginal

preparation.

Clinical Instructor: Student Nurse:

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San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131www.sanbeda.edu.ph

GENERIC NAME: Ampicilin Brand Name: Apo-Ampi Dosage / Available Stock: 500mg 

Route of Administration: PO Pregnancy Category: B

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHING 

Antibiotic  Bacterial action

against sensitive

organisms; inhibits

synthesis of bacterial

cell wall causing death 

>Respiratory Tract or

Skin and Skin-

Structure Infections

>G.I. Infections or

U.T.I’s >Bacterial Meningitis

or Septicemia

>UncomplicatedGonorrhea

>TO preventendocarditis to patients

having dental G.I. and

G.U. procedures

>Contraindicated to

patients hypersensitive

to drug or penicillin

CNS: Lethargy.

Hallucinations,

seizures, anxiety,

confusion, agitation,

dizziness, fatigue CV: Vein irritation,

thrombophlebitis G.I: N&V, diarrhea,

glossitis, gastritis,

abdominal pain, black

hairy tongue G.U. Nephropathy,

vaginitis Hematologic: Anemia,

thrombocytopenic

purpura, leukopenia,

agranulocytosis 

Drug-Drug Allopurinol may

increase risk for rash

may decrease

ampicilin absorptions

and serum levels Hormonal

contraceptives may

decrease hormonal

contraceptives

effectiveness Oral anticoagulants

may increase risk of 

bleeding Probenecid may

increase level of 

ampicilin and other

penicillin 

Before giving drug ask

patient about allergic

reaction to penicillin Obtain specimen for

CNS before giving 1st

 

dose Give drug 1-2hrs before

or 2-3 hrs after meal Monitor sodium level

Watch for signs and

symptoms of 

hypersensitivity such

as; erythymatous

maculopapular rash,

urticaria and

anaphylaxis 

Tell patient to take

entire quantity

exactly as prescribed

even after he feels

better Instruct patient to

take oral form on an

empty stomach 1hr

before or 2hrs after

meal Inform patient to

notify prescriber if 

rash, fever or chills

develop Advise patient to

report discomfort at

IV injection site 

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Clinical Instructor: Student Nurse:

San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131www.sanbeda.edu.ph

GENERIC NAME: Furosemide Brand Name: Lasix Dosage / Available Stock: 20mg

Route of Administration: IV Pregnancy Category: C

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHING

Diuretics  Inhibits Na and Cl

reabsorption at

proximal and distal

tubules and ascending

loop of henle 

Edema Hypertension 

  Contraindicated

hypersensitive to

drug and in those

with anuria

  Use cautiously withhepatic cirrhosis

and in those allergic

to sulfonamides

CNS: Vetigo, headache,

dizziness, paresthesia,

weakness,

restlessness CV: Orthostatic

hypotension,

thrombophlebitits EENT: Transient deafness,

blurred or yellow

vision G.I: Abdominal discomfort

and pain, diarrhea,

anorexia, N&V,

constipation G.U: Nocturia, polyuria,

frequent urination,

oliguria 

Drug-Drug Aminoglycoside

antibiotics may

increase ototoxicity Antidiabetics may

decrease

hypoglycemic effects Antihypertensives may

increase risk of 

hypotension Lithium mmay

decrease lithium

excretion NSAIDS may inhibit

diuretic response Phenytoin may

decrease diuretic

effects of furosemide

Salicylates may cause

salicylate toxicity Durg to lifestyle Sun exposure may

To prevent nocturia

give PO and IM

preparations in the

morning Monitor weight, BP,

and PR routinely with

long term use and

during rapid dieresis Monitor I&O,

electrolyte, BUN, and

CO2 levels frequently WOF signs of 

hypokalemia such as

muscle weakness and

cramps Monitor glucose levels

in diabetic patiens Monitor uric acid level

Advise patient to

take drug with food

to prevent GI upset Inform patient of 

possible need or

potassium or

magnesium

supplements Instruct patient to

stand slowly to

prevent dizziness an

to limit alchol intake

and strenuous

exercise in hot

weather to avoid

worsening dizziness

upon standing

Advise patient to

immediately report

ringing in ears,

severe abdominal

pain or sore throat o

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Musculoskeletal: Muscle spams 

increase risk for

photosensitivity

reactions 

fever Tell patient to check

with prescriber

orpharmacies before

taking OTC drugs 

Clinical Instructor: Student Nurse:

San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131www.sanbeda.edu.ph

GENERIC NAME:Vitamin K Brand Name: Mephyton Dosage / Available Stock: 1amp 

Route of Administration: IM Pregnancy Category: C

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHING 

Vitamins and Minerals Antihemoragic factor

that promotes hepatic

formation or activecoagulation factors 

Hypoprothombenemia

caused by vit.k

malabsorption, drugtherapy or excessive vit.

A dosage Hypoprothombenemia

cause by effect of oral

anticoagulants to

prevent hemoragic

disease of new borns

CNS: Dizziness 

CV: Flushing , transient

hypotension Skin: diaphoresis 

Drug-Drug

Anticoagulant may

cause temporaryresistance to

prothrombin-

depressing

anticoagulants Cholestyramine

mineral oil may inhibit

GI absorption of oral

Vit. K 

Check label for

administration route

restrictionsWatch out for allergic

reactions Monitor PT or IMR to

determine dosage

effectiveness If sever bleeding occurs

give fresh frozen

plasma or whole blood

STAT Watch for flushing,

weakness, tachycardia,

and hypotension 

Explain purpose of 

drug 

Tell patient to avoidhazardous activities if 

dizziness occurs 

Clinical Instructor: Student Nurse:

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San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131www.sanbeda.edu.ph

GENERIC NAME: Ca. Gluconate Brand Name: Ca. Gluconate Dosage / Available Stock: 1amp 

Route of Administration: IV Pregnancy Category: C

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHING 

For drugs or F&E

Balance Replaces calcium and

maintains calcium

level

Hypocalcemic

emergency

Hypocalcemic tetany

Adjunctive treatment for

magnesium intoxication

during exchange

transfusion

Hyperphosphatemia Dietary supplement Hyperkalemia with

secondary cardiactoxicity

CNS: Tingling sensation,

sense of oppression

or heat waves

CV: Mild drop in BP,

vasodilation,

bradycardia

GI: Irritation,

constipation, chalkytaste, N&V,

abdominal pain GU: Polyuria, renal calculi 

Drug-Drug Atenolol may decrease

bioavailability of this

drug

Ca. channel blocker

may decrease calcium

effectiveness

Cardiac glycosides may

increase digoxin

toxicity 

Phenytoin maydecerase absorption

of both drugs

Thiazide diuretics may

cause hypercalcemia 

use all calcium

products with

extreme caution in

digitalized patient

and patients withsarcoidosis and renal

or cardiac disease

give IM injections ingluteals in adults and

in side of the thigh in

infants

monitor Ca. levels

frequentlygive drug in divided

doses

Tell patient to take

oral Ca. with full glass

of water Warn patient that in

the meal before he

takes Ca. he

shouldn’t have

spinach, bran, and

whole grain cereals

or dairy products 

Clinical Instructor: Student Nurse:

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San Beda College638, Mendiola St.,1005 San Miguel, Manila

COLLEGE OF NURSING

P.O. BOX 4457 1005 MANILA, PHILIPPINES TELEFAX: 735-6011 to 15 Loc.4131www.sanbeda.edu.ph

GENERIC NAME: Chloramphenicol Brand Name: Chloromycetin Otic Dosage / Available Stock: 1g 

Route of Administration: Otic Pregnancy Category: NR

DRUG CLASSIFICATION  MODE OF ACTION  INDICATIONS AND

CONTRAINDICATIONS ADVERSE DRUG

REACTION DRUG INTERACTIONS  NURSING

CONSIDERATIONS HEALTH TEACHING

Otic  Inhibits or destroy

bacteria in ear canal

External ear canal infection

  Contraindicated

hypersensitive to

drug

EENT: Ear itching or burning Hematologic: Bone marrow

depression, aplastic

anemia Metabolic: Lactic acidosis Skin: Pruritus, uticaria 

None significant  Obtain history of 

drug use and reactionMonitor patient for

signs and symptoms

of superinfections

Reculture persistent

drainageMonitor patient for

sore throat

Show patient or care

giver how to take

drug Warn patient not to

touch ear with

dropper 

Clinical Instructor: Student Nurse:

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