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Drug study

ACTION

Inhibits both basal and stimulated gastric acid secretion by suppressing the final step in acids production, through the inhabitation of the proton pump by binding to and inhibiting hydrogen-potassium adenosine triphosphatase, the enzyme system located at the secretory surface of the gastric parietal cell. INDICATION: Duodenal and gastric ulcer, moderate and severe reflux esophagitis. Eradication of H. pylori in patient with peptic ulcers, pathological hyper secretory conditions.

ADVERSE EFFECT:

Occasionally headache or diarrhea. Isolated cases of edema, blurred vision, fever, dizziness, thrombophlebitis, depression or myalgia subsiding after termination of therapy.
SIDE EFFECT: Diarrhea; headache; nausea; stomach pain; vomiting. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bone pain; chest pain; dark urine;

NURSING CONSIDERATION AND RESPONSIBILITY: Assess underlying condition before therapy and thereafter to monitor drug effectiveness. Assess GI symptoms: epigastric/abdominal pain, bleeding and anorexia. Monitor for possible drug induced adverse reaction CNS: headache, insomnia, migraine, anxiety, dizziness, pain; CV: chest pain; EENT: pharyngitis, rhinitis, sinusitis; GI: diarrhea, flatulence, abdominal pain, constipation, dyspepsia, gastroenteritis, nausea, vomiting; GU: urinary frequency, UTI; Metabolic: hyperglycemia, hyperlipidemia; Musculoskeletal: back pain, neck pain, arthralgia, hypertonia; Respiratory: bronchitis, increased cough, dyspnea, URTI; Skin: rash; Other: flu-like syndrome, infection.

ACTION

Inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death by binding to cell membrane.
INDICATION: Treatment for infections caused by e.coli, proteus mirabilis, klebsiella sp., lower respiratory tract infections.

ADVERSE EFFECT

Thrombophlebitis, gastrointestinal tract irritation, hypersensitivity reactions, decreased hemoglobin count, decreased hematocrit, Transient rise in SGOT and SGPT, alkaline phosphatase,LDH, and bilirubin levels, Elevations in serum creatinine and/or blood urea nitrogen and a decreased creatinine clearance
SIDE EFFECT: Pain, swelling, or redness at the injection site. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or bloody stools; decreased urination; fever, chills, or sore throat

NURSING CONSIDERATION AND RESPONSIBILITY Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy isinitiated.

Inspect IM and IV injection sitesfrequently for signs of phlebitis. Report onset of loose stools or diarrhea. Although pseudomembranouscolitis.
Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

Action
Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death

Indication
Dermatologic infections caused by S. Aureus , S.Epidermis, streptococci, E.Coli. UTIs caused byE. Coli P.Mirabilis, Klebsiella.Intraabdominal infections caused by E. Coli,klebsiella

Contra indication
Contraindicat ed with allergy to cephalosporin s or penicillins. Use cautiously with renal failure, lactation, pregnancy

Adverse effect
CNS: headache, dizziness, lethargy, paraesthesias GI : Nausea, omitting, diarrhea ,anorexia, abdominal pain, flatulence GU : Nephrotoxicity HEMATOLOGIC

Nursing consideration: Avoid alcohol while taking this drug and for 3days after because severe reactions often occur. You may experience these side effects: stomach upset, diarrhea. Report severe diarrhea, difficulty breathing, unusual tiredness or fatigue, pain at injection site.

Action It acts directly on the bowels, stimulating the bowel muscles to cause a bowel movement

Indication

Contra indication Short term relief of with ileus,intestinal constipation. obstruction, acute Constipation, either abdominal condition chronic or of recent including onset, whenever a appendicitis, acute stimulant laxative is inflammatory bowel required. Bowel diseases, and clearance before severe abdominal surgery or radiological pain associated with investigation. nausea and Replacement of the vomiting evacuant enema in all its indications

Adverse effect

Nursing consideration

IS Assess patient for abdominal distension, Anaphylactic presence of bowel sounds, and usual reactions, pattern of bowel function. angioneurotico Assess color, consistency and amount of edema and stool produced. other hypersensitivit y. GI vomiting, Abdominal discomfort, pain, abdominal cramps nausea and diarrhoea

Action

Contra indication Mode of Action: Constipation Contraindication The drug passes unchanged into , : the colon where bacteria break it salmonellosi down to organic acids that s. Treatment Contraindicated increase the osmotic pressure in of hepatic with allergy to the colon and slightly acidify the encephalop lactulose, lowcolonic contents, resulting in athy. galactose diet increase in stool water content, stool softening, laxative action. Caution: This also in migration of blood ammonia into the colon contents Use cautiously with subsequent trapping and with diabetes, expulsion in the feces pregnancy, and lactation

Indication

Adverse effect GI : transient flatulence, distension, intestinal cramps, severe belching, diarrhea ,nausea Other: acid-base imbalances, electrolyte imbalance

Nursing consideration

* Assess patients condition before therapy and reassess regularly thereafter to monitor drugs effectiveness. Identify cause of constipation: Assess lifestyle in relation to fluids, bulk and exercise *For patient with hepatic encephalopathy, regularly assess mental condition (clearing of confusion, lethargy, restlessness, irritability) and ammonia level (30-70 mg/100 mL). *Monitor for possible adverse GI reaction: nausea, vomiting, abdominal cramps, belching, diarrhea, flatulence and distension.

Action Acts as agonist at specific opioid receptors in the CNS to produce analgesia, euphoria, sedation; the receptors mediating these effects are thought to be the same as those mediating the effects of endogenous opioids (enkephalins, endorphins).

Indication

Contra indication Relief of moderate to severe pain (oral, parenteral) Preoperative medication, support of anesthesia, and obstetric analgesia (parenteral)

Relief of moderate to severe pain (oral, parenteral) Preoperative medication, support of anesthesia, and obstetric analgesia (parenteral)

Adverse effect

Nursing consideration

dizziness, sedation, insomnia, agitation, anxiety, fear, hallucinations, disorientation, drowsiness, lethargy, impaired mental and physical performance, coma, mood changes, weakness, headache, tremor, convulsions, visual disturbances, suppression of cough reflex

. Be sure to teach the patient the following about this medication Instruct patient how and when to ask for pain medication. Advise patient to call for assistance when ambulating. Advise patient to change positions slowly to minimize orthostatic hypotension. Advise ambulatory patients that nausea and vomiting may be decreased by lying down.

Action (HNBB) acts by interfering with the transmission of nerve impulses by acetylcholine in the parasympathetic nervous system. Buscopan exerts a spasmolytic action on the smooth muscle of the gastrointestinal, biliary and urinary tracts. As a quaternary ammonium derivative, hyoscine-N- butylbromide does not enter the central nervous system. Therefore, anticholinergic side effects at the central nervous system do not occur. Peripheral anticholinergic effects result from a ganglion-blocking action within the visceral wall as well as from anti- muscarinic activity.

Indication

Contra indication Buscopan Tablets are indicated for Buscopan Tablets should the relief of spasm of the genitonot be administered to urinary tract or gastro- intestinal patients with myasthenia tract and for the symptomatic relief gravis, mega colon and of Irritable Bowel Syndrome narrow angle glaucoma. In addition, they should not ) be given to patients with a known hypersensitivity to hyoscine-N-butylbromide or any other component of the product.

Adverse effect

CNS: dizziness, anaphylactic reactions, anaphylactic shock, increased ICP, disorientation, restlessness, irritability, dizziness, drowsiness, headache, confusion, hallucination, CV:hypotension, tachycardia, palpitations, flushing GI: Dry mouth, constipation, nausea, epigastric distress DERM: Flushing, dyshidrosis GU: Urinary retention, urinary hesitancy Resp: dyspnea, bronchial plugging, depressed respiration EENT:mydriasis, dilated pupils, blurred vision, photopobia, increased intraocular pressure, difficulty of swallowing.

Nursing consideration . Drug compatibility should be monitored closely in patients requiring adjunctive therapy Avoid driving & operating machinery after parenteral administration. Avoid strict heat Raise side rails as a precaution because some patients become temporarily excited or disoriented and some develop amnesia or become drowsy. Reorient patient, as needed, Tolerance may develop when therapy is prolonged Atropine-like toxicity may cause dose related adverse reactions. Individual tolerance varies greatly Overdose may cause curare-like effects, such as respiratory paralysis. Keep emergency equipment available.

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