DRUG STUDY

[Audio] Drug Study. DRUG STUDY.

[Audio] The drugs used in our case study are the following: Drug Name: Tylenol, is a Non-opioid analgesics. It Inhibits the synthesis of prostaglandins that may serve as mediators of pain, primarily in the CNS. It is use in the Treatment for mild to moderate pain such as muscle aches, back pain, headache, arthritis, sinus pain, toothaches, and menstrual cramps, Fever reduction. Contraindications to using Tylenol include hypersensitivity to acetaminophen, severe hepatic impairment, or severe active hepatic disease. Nursing Responsibilities includes: 1. Assess for an allergy to acetaminophen. 2. Assess for pain by having the patient rate on a scale of 1- 10, and describe characteristics, duration, and frequency. Assess for chronic conditions that warrant the use of acetaminophen such as arthritis. 3. If given as an antipyretic, assess temperature. 4. Assess for pregnancy or lactation. Acetaminophen is a category B risk meaning the risk of fetal harm is possible but unlikely. Administration is safe under the prescription and supervision of a healthcare provider. 5. Assess for acetaminophen toxicity such as nausea, vomiting, abdominal pain, elevated bilirubin and liver enzymes. 6. Routinely monitor the effectiveness of acetaminophen by assessing pain levels and fever reduction. 7. For patients who are at risk for hepatotoxicity or renal toxicity, the nurse should closely monitor AST and ALT levels and BUN and creatinine. 8. Acetaminophen can cause hematologic reactions. The nurse should monitor for anemia and decreased red and white blood counts. 9. The antidote for acetaminophen overdose is N-acetylcysteine given either orally or IV..

[Audio] Drug Name: Ponstan, is a Non-steroidal anti-inflammatory drug. It Blocks a substance in the body called cyclo – oxygenase which is involved in the production of prostaglandins. Prostaglandins are produced in response to injury and certain diseases causing pain, swelling and inflammation. Mefenamic acid blocks the production of prostaglandins therefore effective at reducing inflammation and pain. It is use to to reduce pain, decrease inflammation, fever and prevents blood clots. Contraindications to using Ponstan include Hypersensitivity to drug; GI inflammation,or ulceration. Safety in children < 14 years old, during pregnancy (category C), or lactation is not established. Nursing Responsibilities includes: 1. Assess pain and limitation of movement following the administration. 2. Assess fever and associated signs like tachycardia and chills. 3. Monitor periodically in prolonged high – dose therapy to assess for GI blood loss. 4. Instruct to take medication exactly as prescribed. 5. Instruct to take with full glass of water and to remain in an upright position for 1 – 30 minutes. 6. Advise patient that this may cause drowsiness and blurred vision. 7. Advise patient to avoid concurrent use of alcohol to minimize possible gastric irritation. 8. Inform patient that most Non-steroidal anti-inflammatory drug prolong bleeding time due to suppressed platelet aggregation. 9. Caution patient to avoid taking acetaminophen, salicylates to prevent analgesic nephropathy. 10. Advise patient to notify health care professional before treatment or surgery or when adverse effects occur..

[Audio] Drug Name: Ranitidine, is an Anti-ulcer. It Inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion and has some antibacterial action against H. pylori It is use in the Treatment and prevention of heartburn, acid indigestion, and sour stomach and a Prophylaxis of GI hemorrhage from stress ulceration. Contraindication includes: Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be avoided in patients with known intolerance Nursing Responsibilities includes: 1. Instruct patient not to take new medication w/o consulting physician 2. Instruct patient to take as directed and do not increase dose. 3. Allow 1 hour between any other antacid and ranitidine 4. Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate 5. Nurse should know that it may cause false-positive results for urine protein, a test with sulfosalicylic acid 6. Inform patient that it may cause drowsiness or dizziness 7. Inform patient that increased fluid and fiber intake may minimize constipation 8. Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea; dizziness; rash; confusion; or hallucinations to health care professional promptly 9. Inform patient that medication may temporarily cause stools and tongue to appear gray black 10. Instruct patients to monitor for and report occurrence of drug-induced adverse reaction.

[Audio] Drug name: Dexamethasone, is an Anti inflammatory Glucocorticoid drugs. It is a synthetic glucocorticoid which decreases inflammation by inhibiting the migration of leukocytes and reversal of increased capillary permeability. It suppresses normal immune response Dexamethasone is use for the treatment of Hypercalcemia associated with cancer . Short-term management of various inflammatory and allergic disorders dermatologic diseases, status asthmaticus, autoimmune disorders , Hematologic disorders, Ulcerative colitis, acute exacerbations of MS, and palliation in some leukemias and lymphomas, Cerebral edema associated with brain tumor, craniotomy, or head injury Testing adrenocortical hyperfunction. Dexamathasone used is contraindicated to those with with infections, especially tuberculosis, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections, allergy to any component of the preparation used. It is Use cautiously with renal or hepatic disease; hypothyroidism, ulcerative colitis with impending perforation; diverticulitis; active or latent peptic ulcer, inflammatory bowel disease; CHF, hypertension, thromboembolic disorders, osteoporosis; seizure disorders; diabetes mellitus; lactation. Nursing Responsibilities includes: 1. Monitor intake and output of patient. 2 .Observe the patient for peripheral edema, steady weight gain, rales or crackles or dyspnea. 3. Notify the physician immediately if these clinical manifestations are noted. 4. For patients with cerebral edema, assess then for level of consciousness changes and headache during the therapy. 5. Guaiac-test stools should be carried out. Guaiac-positive stools should be reported to the physician immediately. 6. Administer with meals to minimize GI irritation. 7. Instruct patient to avoid people with known infection and contagious illnesses as corticosteroids causes immunosuppression and may mask symptoms of infection. 8. For systemic administration, do not give drug to nursing mothers for it is secreted in breast milk.

[Audio] 10. Give daily doses before 9 AM to mimic normal peak corticosteroid blood levels. 11. Increase dosage when patient is subject to stress. 12. Taper doses when discontinuing high-dose or long-term therapy. 13. Do not give live virus vaccines with immunosuppressive doses of corticosteroids..

[Audio] Drug Name: Zofran is an anti emetic. It blocks the effects of serotonin at 5-HT3 receptor sites (selective antagonist) located in vagal nerve terminals and the chemoreceptor trigger zone in the CNS. It is indicated to prevent nausea and vomiting caused by cancer drug treatment ( chemotherapy) and radiation therapy. It is also used to prevent and treat nausea and vomiting after surgery. The following conditions are contraindicated to Zofran use: low amount of magnesium in the blood low amount of calcium in the blood low amount of potassium in the blood extrapyramidal disease, a type of movement disorder neuroleptic malignant syndrome, a reaction characterized by fever, muscle rigidity and confusion serotonin syndrome, a type of disorder with high serotonin levels torsades de pointes, a type of abnormal heart rhythm slow heartbeat prolonged QT interval on EKG chronic heart failure abnormal EKG with QT changes from birth severe liver disease Seizures Nursing Responsibilities includes: 1. Observe for the improvements within the gastrointestinal symptoms to take down if the drug therapy is working well with patients. Symptoms to include reduced incidents of nausea and vomiting and improved appetite. 2.. Check for the patient's motor function. Report to the doctor if any extrapyramidal reaction occur such as tardive dyskinesia, pseudo parkinsonism, akathisia or restlessness. 3. Monitor for dizziness and drowsiness for it may affect gait, balance, and movement. 4. Advised the patient to report recurring and severe side effects such as prolonged headache, weakness, tiredness, abdominal pain, diarrhea, constipation and dry mouth. 5. Check the status of fluid and electrolytes. In cases of diarrhea which is one of the adverse effect of this drug, severe fluid and electrolytes may happen. Thus dehydration and electrolytes imbalance may happen..

[Audio] Drug Name: 0.9% NS is a Minerals and electrolytes, Miscellaneous respiratory agents. It Creates an oncotic gradient for expanding plasma volume. Then a greater percentage of the infused fluid stays within the vascular space and does not leak out into the extra vascular spaces. It would be available to rapidly rehydrate the extra vascular volumes in the extracellular fluid ( ECF) and intracellular fluid ( ICF) spaces. It is indicated for extracellular fluid replacement, treatment of metabolic alkalosis in the presence of fluid loss and mild sodium depletion. 0.9% Sodium Chloride Injection USP is contraindicated in patients with hypersensitivity to the solution, patients with CHF, Ischemic stroke or who have severe renal insufficiency. Nursing Responsibilities includes 1. Assess for hypersensitivity to Sodium Chloride. 2. Stop the if patient complain of nausea, vomiting, swelling of feet, ankle, arms or dyspnea. 3. Make sure that the IV is regulated as per the doctor's order.