DRUG STUDY (Furosemide)

NAME OF ADVERSE NURSING

DRUG USE INDICATIONS/DOSAGES CONTRAINDICATIONS REACTIONS RESPONSIBILITIES

Furosemide ● Furosemide is used ● Acute pulmonary edema ● Contraindicated in CNS:vertigo, headache, ● To prevent
(Lasix) to treat hypertension Adults: 40mg I.V. injected clients dizziness, paresthesia, nocturia, give
(high blood slowly over 1 to 2 minutes; then hypersensitive to weakness, restlessness, P.O. and I.M.
pressure). It is also 80mg I.V. in 60 to 90 minutes if drug and in those fever. preparations in
used to treat edema. needed. with anuria. the morning.
This is swelling due CV: orthostatic Give second
to fluid buildup in ● Edema ● Use cautiously in hypotension, dose in early
the body. Edema can Adults: 20 to 80mg P.O. daily in clients with hepatic thrombophlebitis with afternoon.
be caused by other the morning. If response is cirrhosis and in I.V. administration.
medical conditions inadequate, give a second dose, those allergic to ● Alert: Monitor
such as heart failure,
and each succeeding dose, every sulfonamides. Use EENT: transient weight, blood
cirrhosis of the liver,
6 to 8 hours. Carefully increase during pregnancy deafness, blurred or pressure and
or kidney disease. dose in 20 to 40mg increments up only if potential yellowed vision, pulse rate
to 600mg daily. Once an effective benefits to the tinnitus. routinely with
● Furosemide may be dose is attained, may give once or mother clearly long-term use
used as part of a twice daily. Or, 20 to 40mg I.V. outweigh risks to GI: abdominal and during
combination therapy or I.M., increased by 20mg every the fetus. discomfort and pain, rapid diuresis.
to treat high blood 2 hours until desired effect diarrhea, anorexia, Use can lead to
pressure. This means achieved. nausea, vomiting, profound water
you may need to constipation, and electrolyte
take it with other Infants and Children: 2mg/kg pancreatitis. depletion.
medications. P.O. daily, increased by 1 to 2
mg/kg in 6 to 8 hours if needed; GU: nocturia, polyuria, ● If oliguria or
carefully adjusted up to 6mg/kg frequent urination, azotemia
daily if needed. oliguria. develops or
increases, drug
● Hypertension Hematologic: may need to be
Adults: 40mg P.O. b.i.d. Dosage agranulocytosis, stopped.
adjusted based on response. May aplastic anemia,
be used as adjunct to other leukopenia, ● Monitor fluid
antihypertensives if needed. thrombocytopenia, intake and
azotemia, anemia. output and
Children: 0.5 to 2mg/kg P.O. electrolyte,
once or twice daily. Increase dose Hepatic: hepatic BUN and
as needed up to 6mg/kg daily. dysfunction, jaundice. carbon dioxide
levels
I.V. Administration Metabolic: volume frequently.
● If it is discolored yellow, depletion and
don’t use it. dehydration, ● Watch for signs
● For direct injection, give asymptomatic of hypokalemia,
over 1 to 2 minutes. hyperuricemia, such as muscle
● For infusion, dilute with impaired glucose weakness and
D5W, normal saline tolerance, hypokalemia, cramps.
solution, or Lactated hypochloremic
Ringer solution. alkalosis, ● Consult
● To avoid ototoxicity, hyperglycemia, prescriber and
infuse no more than dilutional dietitian about a
4mg/minute. hyponatremia, high-potassium
● Use prepared infusion hypocalcemia, diet or
solutions within 24 hours. hypomagnesemia. potassium
supplements.
Musculoskeletal: Foods rich in
muscle spasm. potassium
include citrus
Skin: dermatitis, fruits, tomatoes,
purpura, bananas, dates
photosensitivity and apricots.
reactions, transient pain
at I.M. injection site. ● Monitor
glucose level in
Other: gout. diabetic clients.

● Drugs may not

be well
absorbed orally
in clients with
severe heart
failure. Drugs
may need to be
given I.V. even
if the client is
taking other
oral drugs.
 ● Monitor uric
acid level,
especially in
clients with a
history of gout.

● Store tablets in
light-resistant
containers to
prevent
discoloration
(doesn’t affect
potency).
Refrigerate oral
solution to
ensure drug
stability.

● Look
alike-sound
alike: Don’t
confuse
furosemide
with torsemide
or Lasix with
Lonox, Lidex
or Luvox.

DRUG STUDY (Prednisone)

NAME OF ADVERSE NURSING
DRUG USE INDICATIONS/DOSAGES CONTRAINDICATIONS REACTIONS RESPONSIBILITIES

Prednisone ● Prednisone is used to ● Severe inflammation, ● Contraindicated CNS: euphoria, ● Determine

(Prednisone treat conditions such immunosuppression with clients insomnia, psychotic whether the
Intensol) as arthritis, blood Adults: 5 to 60mg P.O. daily in a hypersensitive to behavior, pseudotumor client is
disorders, breathing single dose or as two to four drug or its cerebri, vertigo, sensitive to
problems, severe divided doses. Maintenance dose ingredients, in headache, paresthesia, other
allergies, skin given once daily or every other those with seizures. corticosteroids.
diseases, cancer, eye day. Dosage must be systemic fungal
problems, and individualized. infections, and in CV: heart failure, ● Drugs may be
immune system those receiving hypertension, edema, used for
disorders. Children: 0.14 to 2mg/kg or 4 to immunosuppressiv arrhythmias, alternate-day
Prednisone belongs 60mg/m2 daily P.O. in four e doses together thrombophlebitis, therapy.
to a class of drugs divided doses. with live-virus thromboembolism.
known as vaccines. ● Always adjust
corticosteroids. It ● Contact dermatitis; EENT: cataracts, to the lowest
decreases your poison ivy ● Use cautiously in glaucoma. effective dose.
immune system's Adults: Initially, 30mg (six 5-mg clients with recent
response to various tablets); taper by 5mg daily until MI, GI ulcer, renal GI: peptic ulceration, ● Most adverse
diseases to reduce 21 tablets have been given. disease, pancreatitis, GI reactions to
symptoms such as hypertension, irritation, increased corticosteroids
swelling and osteoporosis, appetite, nausea, are dose- or
allergic-type ● Acute exacerbations of diabetes mellitus, vomiting. duration-depen
reactions. multiple sclerosis hypothyroidism, dent.
Adults: 200mg P.O. daily for 7 cirrhosis, active GU: menstrual
days; then 80mg P.O. every other hepatitis, irregularities, increased ● For better
day for 1 month. diverticulitis, urine calcium level. results and less
nonspecific toxicity, give a
● Advanced pulmonary ulcerative colitis, Metabolic: once-daily dose
tuberculosis recent intestinal hypokalemia, in the morning.
Adults: 40 to 60mg P.O. daily for anastomoses, hyperglycemia,
30 days; taper over 4 to 8 weeks. thromboembolic hypocalcemia, ● Unless
disorders, seizures, carbohydrate contraindicated,
● Tuberculosis meningitis myasthenia gravis, intolerance, give oral dose
Adults: 1mg/kg P.O. daily for heart failure, hypercholesterolemia. with food when
30days; taper over several weeks. tuberculosis, ocular possible to
herpes simplex, Musculoskeletal: reduce GI
● Adjunctive treatment in emotional growth suppression in irritation.
Pneumocystis jiroveci instability, and children, muscle Clients may
(carinii) pneumonia in psychotic weakness, osteoporosis. need
clients with AIDS tendencies or in medication to
Adults and Children age 13 and breastfeeding Skin: hirsutism, delayed prevent GI
older: 40mg P.O. b.i.d. For 5 women. wound healing, acne, irritation.
days; then 40mg P.O. daily for 5 various skin eruptions.
days; then 20mg P.O. daily for 11 ● The oral
days or until completion of Other: cushingoid state, solution may be
anti-infective therapy. susceptibility to diluted in juice
infections, acute adrenal or other
insufficiency, after flavored diluent
increased stressor or semi-solid
abrupt withdrawal after food such as
long-term therapy. applesauce
before using.
After abrupt
withdrawal: rebound ● Monitor client’s
inflammation, fatigue, blood pressure,
weakness, arthralgia, sleep patterns
fever, dizziness, and potassium
lethargy, depression, level.
fainting, orthostatic
hypotension, dyspnea, ● Weigh clients
anorexia, hypoglycemia. daily; report
After prolonged use, sudden weight
sudden withdrawal may gain to
be fatal. prescriber.

● Monitor client
for cushingoid
effects,
including moon
face, buffalo
hump, central
obesity,
thinning hair,
hypertension
and increased
susceptibility to
infection.

● Drugs may
mask or worsen
infections,
including latent
amebiasis.

● Unless
contraindicated,
give a
low-sodium
diet that’s high
in potassium
and protein.
Give potassium
supplements, as
needed.