Name of Drug/ Therapeutic Class Action Indications Side Effect Nursing Considerations Paracetamol
Name of Drug/ Therapeutic Class Action Indications Side Effect Nursing Considerations Paracetamol
Name of Drug/ Therapeutic Class Action Indications Side Effect Nursing Considerations Paracetamol
Action Antipyretic-Reduces fever by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating, which helps dissipate heat. Analgesic: Site and mechanism of action unclear
Indications Analgesic-antipyretic in patients with aspirin allergy, hemostatic disturbances, bleeding diatheses, upper GI disease, gouty arthritis Arthritis and rheumatic disorders involving musculoskeletal pain (but lacks clinically significant antirheumatic and antiinflammatory effects) Common cold, flu, other viral and bacterial infections with pain and fever Unlabeled use: Prophylactic for children receiving DPT vaccination to reduce incidence of fever and pain
Side Effect CNS: Headache CV: Chest pain, dyspnea, myocardial damage when doses of 58 g/day are ingested daily for several weeks or when doses of 4 g/day are ingested for 1 yr GI: Hepatic toxicity and failure, jaundice GU: Acute kidney failure, renal tubular necrosis Hematologic: Methemoglobinemia cyanosis; hemolytic anemia hematuria, anuria; neutropenia, leukopenia, pancytopenia, thrombocytopenia, hypoglycemia Hypersensitivity: Rash, fever
Nursing Considerations Assessment History: Allergy to acetaminophen, impaired hepatic function, chronic alcoholism, pregnancy, lactation Physical: Skin color, lesions; T; liver evaluation; CBC, LFTs, renal function tests Interventions Do not exceed the recommended dosage. Consult physician if needed for children < 3 yr; if needed for longer than 10 days; if continued fever, severe or recurrent pain occurs (possible serious illness). Avoid using multiple preparations containing acetaminophen. Carefully check all OTC products. Give drug with food if GI upset occurs. Discontinue drug if hypersensitivity reactions occur. Treatment of overdose: Monitor serum levels regularly, Nacetylcysteine should be
Antipyretic Analgesic
available as a specific antidote; basic life support measures may be necessary. Teaching points Do not exceed recommended dose; do not take for longer than 10 days. Take the drug only for complaints indicated; it is not an antiinflammatory agent. Avoid the use of other over-the-counter preparations. They may contain acetaminophen, and serious overdosage can occur. If you need an over-the-counter preparation, consult your health care provider. Report rash, unusual bleeding or bruising, yellowing of skin or eyes, changes in voiding patterns. Review dosing schedule and prescribed length of therapy with patient. Instruct patient or caregiver to shake well before measuring dose, and to measure and administer prescribed
Treatment of uncomplicated UTIs, otitis media, pharyngitis, tonsillitis, acute bronchitis, acute exacerbations of chronic bronchitis, and uncomplicated gonorrhea caused by susceptible strains of specific
Dermatologic Erythema multiforme, facial edema, pruritus, skin rash, Stevens-Johnson syndrome,
organisms.
toxic epidermal necrolysis, urticaria (less than 2%). GI Diarrhea (16%); nausea (7%); loose or frequent stools (6%); flatulence (4%); abdominal pain, dyspepsia (3%); vomiting (less than 2%); pseudomembranous colitis. Genitourinary Acute renal failure, candidiasis, genital pruritus, transient elevations in BUN or creatinine, vaginitis (less than 2%). Hematologic-Lymphatic Eosinophilia, leukopenia, neutropenia, prolongation in PT, transient thrombocytopenia (less than 2%); agranulocytosis, pancytopenia. Hepatic Hepatitis, jaundice, transient elevations in alkaline phosphatase, ALT, and AST (less than 2%). Hypersensitivity Anaphylactic/anaphylactoid reactions (including shock
dose using dosing spoon, dosing syringe, or medicine cup. Advise patient to take without regard to meals but to take with food if GI upset occurs. Instruct patient to complete entire course of therapy even if symptoms of infection have disappeared. Advise patient to discontinue therapy and contact health care provider immediately if skin rash, hives, itching, or shortness of breath occur. Advise patient to report the following signs of superinfection to health care provider: black furry tongue, foul-smelling stools, vaginal itching or discharge, white patches in mouth. Instruct patient to notify health care provider if infection does not appear to improve or worsens. Instruct patient to
and death), angioedema, drug fever, serum sicknesslike reactions (less than 2%). Monitor Monitor PT and patient's response to therapy Adverse reactions Monitor patient for GI, CNS, general body adverse reactions, and signs of superinfection.
immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.
Pregnancy Category B .
Lactation Undetermined.
Children Safety and efficacy not established in children younger than 6 mo of age.
Hypersensitivity If administered to penicillinallergic patients, use with caution because crosssensitivity has been documented and may occur in up to 10% of patients with penicillin allergy.
with renal function impairment. Dosage adjustment based on renal function may be required. Ensure that reduced dose is administered to patient with renal function impairment (CrCl less than 60 mL/min) following manufacturer's guidelines. Superinfection May result in bacterial or fungal overgrowth of nonsusceptible microorganisms. GI disease Use with caution, especially for colitis. Prothrombin activity A fall in prothrombin activity may occur; patients at risk include patients with renal or hepatic function impairment, poor nutritional status, patients receiving protracted antimicrobial therapy, and patients previously stabilized on anticoagulant therapy. CNS: Transient, mild drowsiness initially; sedation, depression, lethargy, apathy, fatigue, light-headedness, disorientation, restlessness, confusion,crying, delirium, headache, slurred speech,
Diazepam
Exact mechanisms of action not understood; acts mainly at the limbic system and reticular formation; may act in spinal cord and at supraspinal sites to produce skeletal muscle
Management of anxiety disorders or for short-term relief of symptoms of anxiety Acute alcohol withdrawal; may be useful in symptomatic relief of acute
Take this drug exactly as prescribed. Do not stop taking this drug (longterm therapy, antiepileptic therapy) without consulting your health care provider.
relaxation; potentiates the effects of GABA, an inhibitory neurotransmitter; anxiolytic effects occur at doses well below those necessary to cause sedation, ataxia; has little effect on cortical function.
agitation, tremor, delirium tremens, hallucinosis Muscle relaxant: Adjunct for relief of reflex skeletal muscle spasm due to local pathology (inflammation of muscles or joints) or secondary to trauma;spasticity caused by upper motoneuron disorders (cerebral palsy and paraplegia); athetosis, stiff-man syndrome Parenteral: Treatment of tetanus Antiepileptic: Adjunct in status epilepticus and severe recurrent convulsive seizures (parenteral); adjunct in seizure disorders (oral) Preoperative (parenteral): Relief of anxiety and tension and to lessen recall in patients prior to surgical procedures, cardioversion, and endoscopic procedures Rectal: Management of selected, refractory patients with epilepsy who require intermittent use to control bouts of increased seizure activity Unlabeled use: Treatment of panic attacks
dysarthria, stupor, rigidity, tremor, dystonia, vertigo, euphoria, nervousness, difficulty in concentration, vivid dreams, psychomotor retardation, extrapyramidal symptoms; mild paradoxical excitatory reactions, during first 2 wk of treatment, visual and auditory disturbances, diplopia, nystagmus, depressed hearing, nasal congestion CV: Bradycardia, tachycardia, CV collapse, hypertension and hypotension, palpitations, edema Dependence: Drug dependence with withdrawal syndrome when drug is discontinued (common with abrupt discontinuation of higher dosage used for longer than 4 mo); IV diazepam: 1.7% incidence of fatalities; oral benzodiazepines ingested alone; no well-documented fatal overdoses Dermatologic: Urticaria, pruritus, skin rash, dermatitis GI: Constipation; diarrhea, dry mouth; salivation; nausea; anorexia; vomiting; difficulty in swallowing; gastric disorders; elevations of blood enzymesLDH, alkaline phosphatase, AST, ALT; hepatic impairment; jaundice GU: Incontinence, urinary
Caregiver should learn to assess seizures, administer rectal form, and monitor patient. Use of barrier contraceptives is advised while using this drug; if you become or wish to become pregnant, consult with your health care provider. It is advisable to wear a medical alert ID indicating your diagnosis and treatment (as antiepileptic). You may experience these side effects: Drowsiness, dizziness (may lessen; avoid driving or engaging in other dangerous activities); GI upset (take drug with food); dreams, difficulty concentrating, fatigue, nervousness, crying (reversible).
Clonidine Anti-hypertensive
Stimulates central alpha-adrenergic receptors to inhibit sympathetic cardioaccelerator and vasoconstrictor centers.
Management of all grades of hypertension (HPN) with the exception of HPN due to phaeochromocytoma. Prophylactic treatment of migraine or recurrent vascular treatment of migraine. For relief of cancer of pain , in combination with opiates for epidural use.
retention, changes in libido, menstrual irregularities Hematologic: Decreased hematocrit, blood dyscrasias Other: Phlebitis and thrombosis at IV injection sites, hiccups, fever, diaphoresis, paresthesias, muscular disturbances, gynecomastia; pain, burning, and redness after IM injection Local skin irritation Drowsiness Dry mouth Dizziness Headache Constipation Depression Fatigue Nausea Urinary retention
Assess BP and apical pulse before initial dose. If systolic BP is less than 90 mm Hg or pulse is less than 60 bpm, withhold drug and notify physician. Check for edema in feet, legs daily; monitor inputoutput ratio: check for decreasing output. Assess for symptoms of CHF: edema, dyspnea, wet rales, B/P, weight gain, report significant changes. Inform patient that drug may impair ability to drive or operate machinery, thus should be avoided in tasks that require mental alertness. Drug may cause dizziness, fainting; light headedness.Teach patient to administer 1 hour before meals.