DRUG STUDY Name of drug Generic Name Vitamin B complex Brand Name Classification Indication / contraindication Indication Pernicious

Anemia Contraindication Hypersensitivity to vitamin B12 or cobalt. early Lebers disease Mode of Action Adverse effect/ side effects CV: Peripheral vascular thrombosis, heart failure. GI:transient Diarrhea. Respiratory: pulmonary Edema. Skin: itching, Transitory exanthema, urticaria. Other: anaphylaxis, anaphylactoid reactions with parenteral administration , pain or burning at injection site Nursing responsibilities BEFORE: ~ Determine reticulocyte count, hct, Vit.B12, iron, folate levels before beginning therapy. ~ Obtain a sensitivity test history before administration ~ Avoid I.V. administration bec. faster systemic elimination will reduce effectiveness of vitamin. DURING: ~ Dont give large doses ofvitaminB12 routinely; drugis lost through excretion.

Vitamins and Minerals

A coenzyme that stimulate metabolic function and is needed for cell replication, hematopoiesis, and nucleoprotein and myelin synthesis

~ Dont mix parenteral preparation in same syringe with other drugs. AFTER: ~ Protect Vit.B12 from light. Dont refrigerate or freeze. ~ Monitor patient for hypokalemia for first 48 hours, as anemia correct itself. Give potassium supplements, as needed

Name of drug

Classificatio n Antibacterial

Indication / contraindication Indications Uncomplicated UTIs caused by susceptible strains of E. coli, Proteusmirabilis, Klebsiella pneumoniae, Entero-bacter species, and coagulasenegative Staphylococcus species, including Staphylococcus saprophyticus Treatment of acute otitis media due to susceptible strains of S. pneumonia and H. influenza in children Contraindications Allergy to trimethoprim,pregnancy (teratogenic inpreclinical studies),megaloblastic anemiadue to folate deficiency.

Mode of Action Blocks synthesisof tetr ahydrofolicaci d;combination blocks twoconsecutive steps in bacterialsynthesi s of essential nucleicacids, protein

Adverse effect/ side effects Dermatologic: Rash, pruritus,exfoliative dermatitis GI: Epigastric distress, nausea vomiting, glossitis Hematologic: Thrombocytopenia,leukopenia ,neutropenia,megaloblastica nemia,methemoglobinemia,e levated serumtransaminase andbilirubin, increasedBUN and serumcreatinine levels Other: Fever

Nursing responsibilities Assess allergic reactions Monitor I and O ratio Monitor kidney function Assess type of infection: obtain C&S before starting therapy

Generic Name: Cotrimoxazole (200mg/5ml)5ml BID Brand Name: Septra, Bactrim and Sulfatrim

Name of drug Generic Name: Tramadol Brand Name: Ultram

Classification

Indication / contraindication Indications Moderate to moderately severe pain Contraindications Hypersensitivity totramadol, opioids, or any componen t of theformulation; opioiddependent patients;acute intoxicationwith alcohol,hypnotic s, centrallyacting analgesics,opioid s, or psychotropic drugs.

Mode of Action Decreased pain. Pharmacologi c Mechanism Binds to muopioid receptors. Inhibits reuptake of serotonin and norepinephrine in the CNS.

Adverse effect/ side effects Dizziness Nausea Drowsiness Dry mouth Constipation Headache Sweating Vomiting Itching Rash Visualdisturbances Vertigo

Nursing responsibilities Tell patient thatdriving or operatingmachine ry should beavoided until the effectof drug wears off. Instruct patient torepot cravings to physician immediately. Inform client that medication may c auseCNS depression and/or respiratory depression, partic ularly whencombined with other CNS depressants

Analgesic opiate

Name of drug Generic Name: hydroxyzine hydrochlori de Brand Name: hydroxyzine

Classification

Indication / contraindication Indications Symptomatic relief of anxiety and tension associated with psychoneurosis; adjunct in organic disease states in which anxiety is manifested; alcoholism and asthma; prior to dental procedures Contraindications Contraindicated with allergy to hydroxyzine, pregnancy, lactation. \u2022 Use cautiously with uncomplicated vomiting in children (may contribute to Reye's syndrome or unfavorably

Mode of Action
Competitively blocks the effects of histamine at peripheral H1 receptor sites; has skeletal muscle relaxing, bronchodilator, antiemetic and analgesic properties.

Adverse effect/ side effects CNS:Drowsiness, involunta ry motor activity, including tremor and seizures \u2022 GI: Dry mouth \u2022 Hypersensitivity: Wheezing , dyspnea, chest tightness

Nursing responsibilities

Sedative

History: Allergy to hydroxyzine or cetirizine, uncomplicated vomiting in children, lactation, pregnancy \u2022 Physical: Skin color, lesions, texture; orientation, reflexes, affect; R, adventitious sounds

influence its outcome; extrapyramidal effects may obscure diagnosis of Reye's syndrome)

Name of drug Generic Name: Lactulose Brand Name:

Cephulac Chronulac Movelax Lilac

Classification

Indication / contraindication Indications

relief of chronic constipation

Mode of Action
Reduces blood ammonia; appears to involve metabolism of lactose to organic acids by resident intestinal bacteria.

Adverse effect/ side effects

Flatulence, borborygmi, belching, abdominal cramps ,pain, and distention (initial dose);diarrhea (excessive dose); nausea, vomiting, colon accumulation of hydrogen gas; hypernatremia.

Nursing responsibilities

Laxative

Contraindication

Assessment & Drug Effects In children if the initial dose causes diarrhea, dosage is reduced immediately. Discontinue if diarrhea persists. Promote fluid intake (>=15002000 mL/d) during drug therapy for constipation; older adults often self-limit liquids. Lactuloseinduced osmotic changes in the bowel support intestinal water loss and potential

hypernatremia. Discuss strategy with physician. Patient & Family Education Laxative action is not instituted until drug reaches the colon; therefore, about 2448 h is needed. Do not self-medicate with another laxative due to slow onset of drug action. Notify physician if diarrhea (i.e., more than 2 or 3 soft stools/d) persists more than 2448 h. Diarrhea is a sign of overdosage. Dose adjustment may be indicated. Do not breast feed while taking this drug without consulting physician.