VIII.

DRUG STUDY

INDICATION

SPECIFIC ACTION

SIDE EFFECT/ ADVERSE EFFECT

NURSING CONSIDERATION Assess for hyperglycemic and hypoglycemic reactions (sweating, weakness, dizziness, anxiety, tremors and hunger) Monitor glucose level Assess renal status (BUN) Closely monitor patient in times of stress such as infection. Insulin therapy may be necessary

PATIENT TEACHING Educate patient on signs and symptoms of hypo/hyperglycemia and proper action regarding each condition Teach patient to use capillary blood glucose test or chemstrip regularly. Advise patient to take drug in the morning to prevent hypoglycemia at night. Advise patient to avoid taking OTC medications without medical advice.

Generic Name: Metformin Brand Name: Pharex Metformin Classification: Anti-Diabetic Drug; Biguanides Dosage: 500 mg Route PO Frequency BID Date Ordered: 08/26/2011

For non-insulin dependent diabetes mellitus with blood sugar levels cannot be controlled adequately by diet, physical exercise and weight reduction alone.

Decreases intestinal absorption of glucose and hepatic glucose production. It also improves insulin sensitivity.

CNS: headache, fatigue GI: Urinary tract infection, diarrhea, anorexia, nausea, flatulence, abdominal distention Derm: allergic, photosensitivity Weight gain, back pain, metallic taste in mouth

INDICATION

SPECIFIC ACTION

SIDE EFFECT/ ADVERSE EFFECT Lipodystrophy: insulin resistance Allergic reactions: redness, pain, itching, hives, swelling, or inflammation Hypoglycemia Temporary visual impairment Insulin antibodies to form: edema, refraction anomalies

NURSING CONSIDERATION Assess for

hyperglycemic and hypoglycemic reactions (sweating, weakness, dizziness, anxiety, tremors and hunger) Monitor blood glucose level 2 hours before meal Observe injection sites for signs and symptoms of local hypersensitivity such as redness, itching, or burning Give after warming to room temperature by rotating palms to prevent injecting cold insulin; use only insulin syringes with markings or syringe matching U/ml; rotate injection sites within one area: abdomen, upper back, thighs, upper arm, buttocks; keep record of sites.

PATIENT TEACHING Instruct patient on proper technique for administration. Include type of insulin, equipment, storage, and place to discard syringe. Inform the patient of the warning signs of low blood glucose level. Inform the patient about the importance of diet and exercise Instruct patient not to dilute or mix insulin aspart with any other insulin insulin when using external insulin pump.

Generic Name: Isophane + Regular insulin Brand Name: Humulin Classification: Anti-Diabetic Drug; Intermediate acting insulin Dosage: 10 units Route SQ Frequency BID Date Ordered: 08/25/2011

Management of type I and type II Diabetes Mellitus which cannot be controlled by diet, physical exercise or weight reduction alone.

Decreases intestinal absorption of glucose and hepatic glucose production. It also improves insulin sensitivity.

INDICATION

SPECIFIC ACTION

SIDE EFFECT/ ADVERSE EFFECT Diarrhea, abdominal pain and other gastro intestinal disturbances Fatigue and weakness Dry mouth Tachycardia Palpitations Dizziness and paresthesia Anxiety Taste disturbances Increased Urination

NURSING CONSIDERATION

PATIENT TEACHING

Generic Name: Multivitamins Brand Name: Multivitamins Classification: Nutritional preparations; Vitamins and minerals Dosage: 500 mg Route PO Frequency OD Date Ordered: 08/26/2011

Supportive treatment and for patient with vitamin deficiency and prevention of infection.

Needed for digestion and metabolism of polyunsaturated fats, decreases platelet aggregation, decreases blood clot formation, promotes normal growth and development of muscle tissue.

Assess patient Teach patient condition before necessary foods to and after therapy be included in the diet Assess dietary intake Instruct patient to omit if dose is Monitor blood missed pressure and pulse rate Instruct patient to avoid vitamin Evaluate for supplements unless adverse effect of the directed by drug physician because Assess for the input overdose may and output occur. Assess for nutritional status and vitamin deficiency