Viii. Pharmacologic Intervention (Drug Study)
Viii. Pharmacologic Intervention (Drug Study)
OMEPRAZOLE
Pharmacologic Class: Block gastric acid Contraindicated in Abdominal pain Monitor for diarrhea
secretion by patients with known Nausea and abdominal pain
Proton Pump Inhibitor inhibiting acid pump hypersensitivity. Vomiting Administer one hour
in gastric parietal Used cautiously in Diarrhea before meals.
cells. pregnant and Instruct the patient to
Dosage: PPI; binds to H+/K+ breastfeeding patient. swallow the capsules
exchanging ATPase whole and not to chew
40 mg
in gastric parietal or crush them.
cells, resulting in Instruct the patient to
suppression of basal avoid gastric irritants
Frequency: and stimulated acid such as smoking,
secretion. alcohol, product
O.D ( 1 x a day)
containing aspirin,
caffeine, NSAID’s and
foods that cause GI
Route: irritation.
IVTT
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Generic Name: Mechanism of Action Contraindication Adverse Effect Nursing Responsibility
DEXAMETHASONE
LEVETIRACETAM
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Pharmacologic Class: Block gastric acid Contraindicated in Abdominal pain Monitor for diarrhea
secretion by patients with known Nausea and abdominal pain
Proton Pump Inhibitor inhibiting acid pump hypersensitivity. Vomiting Administer one hour
in gastric parietal Used cautiously in Diarrhea before meals.
cells. pregnant and Instruct the patient to
Dosage: PPI; binds to H+/K+ breastfeeding patient. swallow the capsules
exchanging ATPase whole and not to chew
500 mg
in gastric parietal or crush them.
cells, resulting in Instruct the patient to
suppression of basal avoid gastric irritants
Frequency: and stimulated acid such as smoking,
secretion. alcohol, product
BID (2x a day)
containing aspirin,
caffeine, NSAID’s and
foods that cause GI
Route: irritation.
oral
DIAZEPAM
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Table VIII.6
Table VIII.8
Pharmacologic Class: Depress the CNS, Contraindicated in dizziness Monitor BP, PR, RR
probably by patients with known drowsiness prior to periodically
Anticonvulsants potentiating GABA, hypersensitivity. lethargy throughout therapy
an inhibitory hangover and frequently during
neurotransmitter. - headache IV therapy. -
Dosage: Produces skeletal depression Assess IV site
muscle relaxation by frequently during
5 mg
inhibiting spinal administration,
polysynaptic afferent diazepam may cause
pathways. - Has phlebitis and venous
Frequency: anticonvul-sant thrombosis.
properties due to Prolonged high-dose
PRN for active seizure
enhanced therapy may lead to
presynaptic psychological or
inhibition. physical dependence.
Route: Restrict amount of
IVTT drug available to
patient. Observe
depressed patients
closely for suicidal
tendencies.
PARACETAMOL
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Pharmacologic Class: Thought to produce Contraindicated in Hematologic: If there is fever,
analgesia by blocking patients with known Hemolytic assess patient’s
Analgesic; Antipyretic generation of pain hypersensitivity. anemia, fever or pain: type of
impulses, probably neutropenia, pain, location,
by inhibiting leukopenia, intensity, duration,
Dosage: prostaglandin pancytopenia temperature, and
synthesis in the CNS Hepatic: diaphoresis.
600 mg
or the synthesis or liver damage, Tell patient not to use
action of other jaundice for marked fever
substances that Metabolic: Fever persisting
Frequency: sensitize pain hypoglycemia longer than 3 days, or
receptors to Skin: recurrent fever unless
Q6h
mechanical or rash, directed by prescriber.
chemical stimulation. urticaria Avoid giving patient
aspirin or aspirin-like
Route: analgesics because it
IVTT inhibits platelet
aggregation
NALBUPHINE
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painful stimuli while Use cautiously Confusion after parenteral
producing inpatients with history Depression administration
Dosage: generalized CNS of drug abuse Dysphoria Nalbuphine acts as an
5 mg depression euphoria opioid antagonist and
faintness may cause withdrawal
floating syndrome.
feeling
hallucinations
Frequency:
seizures
Q 4 h PRN for pain
score ≥ 4/10
Route:
IVTT
METROCLOPRAMIDE
Pharmacologic Class: Dopamine antagonist Metoclopramide should Depression (with Inject IV slowly over
that acts by not be used whenever suicidal ideation), 1-2 mins to prevent
increasing sensitivity stimulation of seizures,
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Gastrointestinal to acetylcholine; gastrointestinal motility agranulocytosis, transient feelings of
stimulant results increase might be dangerous, hypotension anxiety
motility of the upper e.g., in the presence of Note reasons for
GI tract and gastrointestinal therapy
Dosage: relaxation of pyloric hemorrhage, Assess abdomen
sphincter and mechanical bowel sounds,
10 mg duodenal bulb obstruction, or distention,
perforation
Frequency:
Route:
IVTT
MANNITOL
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Osmotic diuretics thus, inhibiting the Dehydration Intracranial Signs and symptoms
reabsorption of water bleeding of dehydration (e.g.
and electrolytes (for Headache poor skin turgor, dry
Dosage: relief of edema) and Blurred vision skin, fever, thirst)
mobilizing fluids in Nausea and Signs of electrolyte
20% 75 cc the cerebral and vomiting imbalance/deficit (e.g.
ocular spaces Volume muscular weakness,
(lowers intracranial or expansion paresthesia,
intraocular pressure). Chest pain numbness, confusion,
Frequency: Pulmonary tingling sensation of
edema extremity and
Q6h Thirst excessive thirst)
Tachycardia (for increase ICP)
Neurologic status and
intracranial pressure
Route: readings.
IVTT
ONDANSETRON
Pharmacologic Class: Block the effects of Contraindicated in Headache Be sure to teach the
serotonin at 5-HT3 patients with known Constipation client the following
Antiemetic receptor sites located hypersensitivity. Diarrhea about this medication
in vagal nerve Notify physician
terminals and the immediately if
40
Dosage: chemoreceptor involuntary movement
trigger zoned in the of eye, face or limbs
4 mg CNS occur
Frequency:
Not indicated
Route:
IVTT
TRAMADOL
Pharmacologic Class: Binds to mu-opioid Pregnancy; allergy to Dizziness Assess bowel function
receptors. Inhibits tramadol; acute in Sedation routinely.
Antiemetic reuptake of serotonin toxification with alcohol Confusion Minimize
and norepinephrine Hypotension constipation.
in the CNS tachycardia
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Dosage: Assess previous
analgesic history.
50 mg Tramadol is not
recommended for
opiod dependent
patients(with drawal
Frequency: symptoms)Monitor
patients for seizures
Q8h
Route:
IVTT
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