DRUG STUDY NAME Generic Name: hydrocortison e Brand name: Solu-Cortef 100mg TIV Classification: Antiinflammatory drug ACTION

Enters target cells and binds to cytoplasmic receptors; initiates many complex reactions that are responsible for its anti-inflammatory, immunosuppressive (glucocorticoid), and salt-retaining (mineralocorticoid) actions. Some actions may be undesirable, depending on drug use INDICATION Replacement therapy in adrenal cortical insufficiency Hypercalcemia associated with cancer Short-term inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (SLE), dermatologic diseases (pemphigus), status asthmaticus, and autoimmune disorders CONTRAINDICATION ADVERSE EFFECT tuberculosis, fungal Vertigo, infections, amebiasis, headache, hepatitis B, vaccinia, or varicella, and paresthesias, antibiotic-resistant insomnia, infections; kidney convulsions, disease (risk to edema); liver disease, psychosis cirrhosis Hypotension, shock, hypertension and CHF secondary to fluid retention, thrombophlebitis, fat embolism, cardiac arrhythmias secondary to electrolyte disturbance NURSING RESPONSIBILITIES Give daily before 9 AM to mimic normal peak diurnal corticosteroid levels and minimize HPA suppression. Space multiple doses evenly throughout the day. Do not give IM injections if patient has thrombocytopenic purpura. Rotate sites of IM repository injections to Use minimal doses for minimal duration to minimize adverse effects. Taper doses when discontinuing high-dose or long-term therapy. Arrange for increased dosage when patient is subject to unusual stress. Use alternate-day maintenance therapy with short-acting corticosteroids

thromboembolism, avoid local atrophy.

whenever possible. Do not give live virus vaccines with immunosuppressive doses of hydrocortisone. Provide antacids between meals to help avoid peptic ulcer Drug Name Generic Name: clarithromycin Brand Name: Klaz 500mg tb BID Classification: antibiotic Action Clarithromycin prevents bacteria from growing by interfering with their protein synthesis. Clarithromycin binds to the subunit 50S of the bacterial ribosome and thus inhibits the translation of peptides.. Indication -Treatment of Respiratory Tract Infection. -Treatment of Leprosy and for prophylaxis. -Treatment of Opportunistic Mycobacterial Infection. Contraindication -hypersensitivity to Macrolides. -Pregnancy and Lactation -History of acute porphyria -Severe Liver damage -Impaired kidney function -Hypokalemea Adverse Reaction -GI disturbances -Diarrhea -Dyspepsia -Abnormal pain or discomfort -Stomatitis -Instruct patient to take all medication prescribed for the length of time ordered and to continue drug Thrombocytopenia therapy as prescribed even if he/she feels better. -Tooth discoloration -Assess bowel pattern, discontinue drug if severe diarrhea appears. Nursing Responsibilities -Assess patients infection before therapy and regularly thereafter.

Drug Name Generic Name: ciprofloxacin Brand Name: Ciprobay Cirok Iprolan 200mg TIV Classification: antibiotic

Action Ciprofloxacin is a broad-spectrum antibiotic active against both Grampositive and Gramnegative bacteria. It functions by inhibiting DNA gyrase, a type II topoisomerase, and topoisomerase IV, enzymes necessary to separate bacterial DNA, thereby inhibiting cell division. ACTION Paracetamol exhibits analgesic action by peripheral blockage of pain impulse generation. It produces antipyresis by inhibiting the hypothalamic heatregulating centre. Its weak antiinflammatory

Indication - Infection of the respiratory tract, middle ear, paranasal sinuses, eyes, kidneys and/or urinary tract, Genital organs including adnexitis, gonorrhea, prostatitis.

Contraindication Hypersensitivity to quinolones, concurrent administration with tizanidine, drugs that inhibits peristalsis, infants and children, growing adolescents. Pregnancy and lactation.

Adverse Reactions Nausea, diarrhea, injection site reactions, vomiting, rash, anorexia, psychomotor hyper activity, agitation, headache, dizziness.

Nursing Considerations - assess patient for previous sensitivity reaction. - assess patient for signs and symptoms of infection before and during treatment. - assess renal function before and during therapy. -give round the clock to maintain proper blood levels. - instruct patient to take medication for length of time ordered. NURSING RESPONSIBILITIES - Monitor renal and liver function - Check input and output ratio. Decreasing output may indicate renal failure - Give with milk or food to decrease gastric symptom.

NAME Generic Name: > paracetamol Brand Name: > Tylenol >Biogesic >Tempra 500mg tab PRN >37.8 Classification:

INDICATION > Relief of mild to moderate pain >Treatment of fever

CONTRAINDICATION ADVERSE EFFECT > Hypersensitivity > Abdominal pain >Drowsiness >Intolerance to >Hepatotoxiciity tartrazine, alcohol, >Renal failure table sugar, >Leukopinea saccharine. >Neuthropinea >Thrombocytopinea >Rash >Urticaria >Hypersensitivity >Cyanosis

Antipyretic

activity is related to inhibition of prostaglandin synthesis in the CNS. ACTION binds to the cell sulfonyl urea receptor (SUR1). This binding subsequently blocks the ATP sensitive potassium channels. The binding results in closure of the channels and leads to a resulting decrease in potassium efflux leads to depolarization of the cells. This opens voltagedependent calcium channels in the cell resulting in calmodulin activation, which in turn leads to exocytosis of insulin containing secretorty granules INDICATION Gliclazide belongs to second generation sulfonylureas. It is indicated in: Non insulin dependant diabetes milletus, maturity onset diabetes and in insulin resistant diabetes.It stimulates insulin secretion by beta cells of the pancreas. Gliclazide can inhibit platelet aggregation and increase fibrinolysis CONTRAINDICATION ADVERSE EFFECT pregnancy, lactation, Nausea, stomach hypersensitivity, renal upset impairment, juvenile or diarrhea may onset diabetes, occur as your unstable or brittle body adjusts to diabetes, diabetic the medication ketoacidosis NURSING RESPONSIBILITIES . Test fasting and postprandial blood glucose frequently . Patients who are NPO may need to have their dose held to avoid hypoglycemia . Notify physician if symptoms of Hypoglycemia occurs

NAME Generic Name: gliclazide Brand Name: Diamicron (Servier) 800mg/tab OD Classification: Hypoglycemic Agents Sulfonylureas -Antidiabetic

Drug Name Generic Name: Metformin Brand Name: Diafat Glucophage Neoform Vimetrol 500mg tab TID Classification: biguanides

Action Metformin improves hyperglycemia primarily by suppressing glucose production by the liver (hepatic gluconeogenesis)

Indication Non-insulin dependent diabetes mellitus (type 2) particularly overweight patients if blood sugar levels cannot be controlled adequately by diet, physical exercise and weight reduction alone. And in cases where there is primary or secondary resistance to sulfonylurea

Contraindication Renal impairment, cardiac failure, diabetic coma, severe liver disorder, pancreatitis, severe feverish ailments, alcoholics, those on slimming diets, shock, severe lung disorders very poor blood circulation, necrosis.

Adverse Reactions Urinary tract infection, headache, back pain, hyperglycemia, fatigue, sinusitis, diarrhea, viral infection, arthralgia, weight gain, gastrointestinal complaints.

Nursing Considerations Assess for hyperglycemic and hypoglycemic reaction. Monitor patients hematological status. assess for lactic acidosis. Give twice a day with meals. Give tablet crushed and mix with meals or fluids for patient with difficulty swallowing. Educate patient with s/sx of hypo/hyperglycemia. Teach patient to use capillary blood glucose test regularly. Tell patient to take drug in the morning to prevent hypoglycemia at night. Tell patient to consume all food diet plan to prevent

hypoglycemia.

NAME Generic Name: Potassium chloride Brand name: Kalium durule 1tab TID Classification electrolytes

ACTION Replace potassium and maintain potassium level

INDICATION To prevent hypokalemia, prophylaxis during treatment with diuretics

CONTRAINDICATION ADVERSE EFFECT Oliguria, anuria, Arrythmias, heart untreated Addisons block, disease hypotension, cardiac arrest

NURSING RESPONSIBILITIES o Monitor pulse, BP during therapy. o Assess for signs and symptoms of hypokalemia (weakness, fatigue, arrhythmia, polyuria, polydipsia) and hyperkalemia. o Do not use salt substitutes, eat low-sodium foods, especially some breads and canned foods, or drink lowsodium milk unless you are told to do so by your doctor, since these products may contain potassium. It is important to read the labels carefully on all low-sodium food products . o Check with your doctor before starting any physical exercise program, especially if you are out of condition and are taking any other

medicine. Exercise and certain medicines may increase the amount of potassium in the blood. o Check with your doctor at once if you notice blackish stools or other signs of stomach or intestinal bleeding. This medicine may cause such a condition to become worse, especially when taken in tablet form