NAME OF DOSAGE/RO MECHANISM INDICATIONS CONTRAINDICATIONS SIDE NURSING

DRUG UTE/ OF ACTION EFFECTS RESPONSIBILITY

FREQUENCY Geriatric patients may be at
Alendronate  Alendronate is Treatment and increased risk for the Common WARNING: Give in AM
sodium 10 mg qd a second- prevention of development of adverse GI side with full glass of water at
(Fosamax) PO generation osteoporosis in reactions during alendronate effects of least 30 min before the
bisphosphonate postmenopausal therapy Fosamax first beverage, food, or
Drug that binds to women Hypocalcemia, vitamin D include medication of the day.
Classification: bone Treatment of deficiency constipation Patient must stay upright
Bisphosphonat hydroxyapatite men with , for 30 min.
e and specifically osteoporosis Preexistent hypocalcemia heartburn, Monitor serum calcium
inhibits the Treatment must be corrected before diarrhea, levels before, during, and
activity of of glucocorticoid- initiating alendronate therapy. bloating, after therapy.
osteoclasts, the induced Similarly, vitamin D deficiency nausea, Ensure 6-mo rest period
bone-resorbing osteoporosis must also be corrected. vomiting, after treatment
cells. Treatment Adequate intake of calcium stomach for Paget’s disease
Alendronate of Paget’s diseas and vitamin D during treatment pain, if retreatment is required.
reduces bone e of bone in are essential. This is most joint pain or Ensure adequate vitamin
resorption with patients with important for patients with swelling, D and calcium intake.
no direct effect alkaline phospha Paget's disease who are to swelling in Provide comfort
on bone tase at least two receive alendronate. your hands measures if bone pain
formation, times upper limit Alendronate can decrease or feet, returns
although the of normal, those serum calcium and phosphate dizziness,
latter process is who are in these patients, who may headache, Report fever, especially
ultimately symptomatic, have a higher rate of bone eye pain, when accompanied by
reduced those at risk for turnover. back pain, arthralgia and myalgia.
because bone future Sunlight (UV) exposure or Do not breast feed while
resorption and complications Alendronate may cause a rash weakness. taking this drug.
formation are that is worsened by sunlight
coupled during (UV) exposure. However, erious side
bone turnover.  patients should be advised that effects of
inadequate sunlight exposure Fosamax
can increase the risk of vitamin include
D insufficiency. severe pain
 (joints,
Cardiac disease, heart bone,
failure, hypertension, muscle,
sodium restriction jaw, back or
Each alendronate effervescent heartburn),
tablet contains 650 mg of chest pain,
sodium, which is equivalent to difficulty
approximately 1650 mg of salt swallowing,
(NaCl). When possible, use of bloody
the effervescent tablet stools,
formulation should be avoided eye pain,
in patients that require sodium skin blisters
restriction, including patients , and
with heart failure, swelling of
hypertension, and other the face,
cardiac disease. tongue, or
throat.

DRUG NAME DOSAGE AND ADVERSE NURSING

ACTION INDICATION CONTRAINDICATION
ROUTE EFFECTS RESPONSIBILITY
Ibuprofen Unknown. May Ibuprofen contains the CNS  Contraindicated in  Tell patient to take with
300 to 800 mg P.O. inhibit active ingredient  Headache, patients hypersensitive to meals or milk to reduce
Apo-Ibuprofen t.i.d. or q.i.d. prostaglandin ibuprofen, which dizziness, drug and in those with adverse GI reactions.
Maximum daily synthesis, to belongs to a group of nervousness, angioedema, syndrome of  Note: Drug is available
dose is 3.2 g. produce anti- medicines called non- aseptic nasal polyps, or at OTC. Instruct patient
inflammatory, steroidal anti- meningitis. bronchospastic reaction to not to exceed 1.2 g
analgesic, and inflammatory drugs CV aspirin or other NSAIDs. daily, not to give to
antipyretic (NSAIDs).  Peripheral  Contraindicated in chidren younger than
effects. It works by blocking edema, fluid pregnant women. age 12, and not to take
the action of a retention, edema.  Use cautiously in patients for extended periods
substance in the body EENT with GI disorders, history ( longer than 3 days for
called cyclo-oxygenase.  Tinnitus of peptic ulcer disease, fever or longer than 10
Cyclo-oxygenase is GI cardiac decompensation, days for pain) without
involved in the  Epigastric hypertension, asthma, or consulting presciber.
production of various distress, nausea, intrinsic coagulation  Tell patient that full
chemicals in the body, occult blood defects. therapeutic effect for
some of which are loss, peptic arthritis may be
known as ulceration, delayed for 2 to 4
prostaglandins. diarrhea, weeks. Although pain
Prostaglandins are constipation, relief occurs at low
produced in response to abdominal pain, dosage levels,
injury or certain bloating, GI inflammation doesn’t
diseases and would fullness, improve at dosages less
otherwise go on to dyspepsia, than 400 mg q.i.d.
cause pain, swelling flatulence,  Teach patient to watch
and inflammation. heartburn, for and report to
Ibuprofen is therefore decreased prescriber immediately
used to relieve pain and appetite. signs and symptoms of
inflammation. GU GI bleeding, including
All the medicines in  Acute renal blood in vomit, urine,
this group (NSAIDs) failure, azotemia, or stool or coffee
reduce inflammation cystitis, ground vomit, and
caused by the body's hematuria. black, tarry stool.
own immune system, HEMATOLOGIC  Warn patient to avoid
and are effective pain  Plonged bleeding hazardous activities
killers. Ibuprofen can time, anemia, that require mental
be used to relieve pain neutropenia, alertness until effects
such as muscular pancytopenia, on CNS are known.
aches and pains, period thrombocytopeni  Advise patient to wear
pains, headache, a, aplastic sunscreen to avoid
backache, rheumatic anemia, hypersensitivity to
pain, dental pain and leucopenia, sunlight.
neuralgia. It can also agranulocystocis.
reduce feverishness and METABOLIC
the symptoms of colds  Hypoglycemia,
and flu. hyperkalemia.
RESPIRATORY:
 Bronchospasm
SKIN
 Pruritus, rash,
urticaria, stevens
Johnson
syndrome.