NCM118RLE
Care of Clients with Life-threatening Conditions, Acutely Ill/Multi-organ Problems, High Acuity and Emergency Situation
S.Y. 2022-2023 | 1st Semester
MEDICATION CLASSIFICATION USE OF MEDICATION
NAME (Specific Action) (Book based & Patient
(Generic and Centered)
Brand)
Vancomycin Binds to bacterial Treatment of infections
(Vancocin) cell walls, altering caused by staphylococcal,
cell membrane streptococcal spp.
permeability, bacteria. PO: Treatment
inhibiting of C. difficile–associated
RNA synthesis. diarrhea and treatment of
Therapeutic enterocolitis caused by S.
Effect: aureus (including MRSA).
Bactericidal. OFF-LABEL: Treatment
of infections caused by
gram-positive organisms
in pts with serious
allergies to
beta-lactam antibiotics;
treatment of beta-
lactam–resistant gram-
positive
infections. Surgical
prophylaxis, treatment of
prosthetic joint infection.
DRUG STUDY
DOSAGE CONTRAINDICATIONS AND NURSING
(Book based & SIDE EFFECTS RESPONSIBILITIES
Patient Centered) (Patient & Family
Teachings)
Capsules Contraindications: Baseline assessment
(Vancocin): 125 Hypersensitivity to Avoid other ototoxic,
mg, 250 mg. vancomycin. Cautions: Renal nephrotoxic medications
Infusion (Premix impairment; concurrent if possible. Obtain
[Vancocin HCl]): therapy with other ototoxic, culture,
500 mg/100 mL, nephrotoxic medications, sensitivity test before
750 mg/150 mL, 1 elderly pts, dehydration. giving first dose (therapy
g/200 mL. may begin before results
Injection, Powder Side Effects are
for Frequent: PO: known). Consider
Reconstitution Bitter/unpleasant taste, placement of central
(Vancocin HCl): nausea, vomiting, mouth venous line/PICC line.
500 mg, 750 mg, 1 irritation (with
g. Solution, Oral: oral solution). Rare: Intervention/evaluation
25 Parenteral: Phlebitis, Monitor serum renal
mg/mL, 50 mg/mL. thrombophlebitis, pain at function tests, I&O.
Suspension, Oral: peripheral Assess skin for rash.
50 mg/mL. IV site, dizziness, vertigo, Check hearing
tinnitus, chills, fever, rash, acuity, balance. Monitor
necrosis with B/P carefully during
extravasation. PO: Rash. infusion. Monitor for
"red man"
syndrome. Evaluate IV
site for phlebitis (heat,
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 pain, red streaking over
vein).
Obtain vancomycin
peak/trough level as
ordered by physician or
pharmacist.
Therapeutic serum level:
peak: 20–40 mcg/mL;
trough: 10–20 mcg/mL.
Toxic serum level: peak:
greater than 40 mcg/mL;
trough: greater than 20
mcg/mL.

Patient/ family teaching

• Continue therapy for
full length of treatment.
• Doses should be evenly
spaced.
• Report ringing in ears,
hearing loss, changes in
urinary frequency or
consistency.
• Lab tests are important
part of total therapy.
Rosuvastatin Interferes with Adjunct to diet therapy in Tablets: 5 mg, 10 Contraindications: Baseline assessment
(Apo- cholesterol pts with primary mg, 20 mg, 40 mg. Hypersensitivity to Obtain dietary history,
Rosuvastatin biosynthesis by hyperlipidemia and mixed rosuvastatin. Active hepatic esp. fat consumption.
and inhibiting dyslipidemia; to decrease disease, Question for possibility
Crestor) conversion of the elevated total, LDL breastfeeding, pregnancy, of
enzyme cholesterol, serum unexplained, persistent pregnancy. Assess
HMG-CoA to triglyceride elevations of hepatic enzymes. baseline lab results:
mevalonate, a levels; increases HDL. serum cholesterol,
precursor to Adjunct to diet to slow triglycerides, LFT.

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cholesterol. progression of Cautions: Anticoagulant
Therapeutic atherosclerosis in therapy, hepatic impairment, Intervention/evaluation
Effect: pts with elevated substantial alcohol Monitor serum
Decreases LDL, cholesterol. Treatment of consumption, elective major cholesterol, HDL, LDL,
VLDL, plasma primary surgery, renal impairment, triglycerides for
triglyceride levels; dysbetalipoproteinemia, acute renal failure, therapeutic response.
increases HDL homozygous familial uncontrolled hypothyroidism, Lipid levels should be
concentration. hypercholesterolemia elderly pts. monitored within 2–4
(FH). Treatment of pts wks of initiation of
ages 10–17 Side Effects therapy or
yrs with heterozygous Generally, well tolerated. Side change in dosage.
familial effects are usually mild, Monitor LFT at 12 wks
hypercholesterolemia transient. Occasional following initiation of
(HeFH) to reduce elevated (9%–3%): Pharyngitis, therapy, at any
total cholesterol, LDL headache, diarrhea, elevation of dose, and
cholesterol, and dyspepsia, nausea, periodically (e.g.,
apolipoprotein B. Primary depression. Rare semiannually) thereafter.
prevention of (Less Than 3%): Myalgia, Monitor CPK
cardiovascular disease asthenia, back pain. if myopathy is suspected.
(risk reduction of MI, Monitor daily pattern of
stroke, arterial bowel activity, stool
revascularization) consistency. Assess for
without clinically evident headache, sore throat.
CAD, but with multiple Be alert for myalgia,
risk factors. weakness.

Patient/family teaching
• Use appropriate
contraceptive measures.
• Periodic lab tests are
essential part of therapy.
• Maintain appropriate
diet (important part of
treatment).

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 • Report unexplained
muscle pain, tenderness,
weakness, esp. if
associated with
fever, malaise.
Clonidine Stimulates Immediate-Release, Injection Solution Contraindications: Baseline assessment
(Apo- alpha2-adrenergic Transdermal Patch: (Duraclon): 100 Hypersensitivity to cloNIDine. Obtain B/P immediately
CloNIDine, receptors, Treatment of mcg/mL, 500 Epidural: Contraindicated in before each dose is
Catapres, reducing hypertension alone or mcg/mL. Tablets pts with bleeding diathesis or administered, in addition
Catapres-TTS, sympathetic CNS in combination with other (Catapres): 0.1 mg, infection at the injection site; to regular
Dixarit, response. antihypertensive agents. 0.2 mg, 0.3 mg. pts receiving anticoagulation monitoring (be alert to
Duraclon, Epidural: Prevents Kapvay: Treatment of (Kapvay): 0.1 mg, therapy. Cautions: Depression, B/P fluctuations).
Kapvay, pain signal attention-deficit 0.2 mg. elderly. Severe coronary
Novo- transmission to hyperactivity disorder Transdermal insufficiency, recent MI, Intervention/evaluation
CloNIDine) brain and (ADHD). Epidural: Patch (Catapres- cerebrovascular disease, Monitor B/P, pulse,
produces Combined with TTS): 2.5 mg chronic renal impairment, mental status. Monitor
analgesia at opiates for relief of (release at 0.1 preexisting bradycardia, sinus daily pattern of bowel
pre- and post- severe cancer pain. OFF- mg/24 hrs), 5 mg node dysfunction, conduction activity, stool
alpha-adrenergic LABEL: Opioid or nicotine (release at 0.2 disturbances; concurrent use consistency. If cloNIDine
receptors in spinal withdrawal, prevention of mg/24 hrs), 7.5 mg with digoxin, diltiaZEM, is to be withdrawn,
cord. ADHD: migraine headaches, (release at 0.3 metoprolol, verapamil. discontinue concurrent
Mechanism of treatment of diarrhea in mg/24 hrs). betablocker
action unknown. diabetes Extended-Release Side Effects therapy several days
Therapeutic mellitus, treatment of Tablets:(Kapvay): Frequent (40%–10%): Dry before discontinuing
Effect: Reduces dysmenorrhea, 0.1 mg. mouth, drowsiness, dizziness, cloNIDine (prevents
peripheral menopausal flushing, sedation, constipation. cloNIDine withdrawal
resistance; alcohol dependence, Occasional (5%–1%): Tablets, hypertensive crisis).
decreases glaucoma, cloZAPine- Injection: Depression, pedal Slowly reduce cloNIDine
B/P, heart rate. induced sialorrhea, edema, loss of appetite, dosage
Produces Tourette’s syndrome, decreased sexual function, over 2–4 days.
analgesia. insomnia in itching eyes, dizziness, nausea,
children. vomiting, nervousness. Patient/family teaching
Transdermal: Pruritus, redness
or darkening of

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 skin. Rare (less than
1%): Nightmares, vivid
dreams, feeling of coldness in
distal extremities (esp.
the digits).
• Sugarless gum, sips of
water may relieve dry
mouth.
• Avoid tasks that require
alertness, motor skills
until response to drug is
established.
• To reduce hypotensive
effect, rise slowly from
lying to standing.
• Skipping doses or
voluntarily discontinuing
drug may produce severe
rebound
hypertension.
• Avoid alcohol.
• If patch loosens during
7-day application period,
secure with adhesive
cover.