Drug Features
Mechanism of Action Exact mechanism of action not understood; acts mainly at the limbic system and reticular formation; may act in spinal cord and at supraspinal sites to produce skeletal muscle relaxation; potentiates the effects of GABA, an inhibitory neurotransmitter; anxiolytic effects occur at doses well below those necessary to cause sedation, ataxia; has little effect on cortical function.
Diazepam Brand Name: Valium Diastat Diastat AcuDial Diazepam Intensol Dosage: 2.5 mg Frequency: Parenteral (IV) Route: prn
Therapeutics Indication Contraindicatio ns and cautions Management of anxiety Contraindicated disorders or for short- with term relief of symptoms hypersensitivity of anxiety to benzodiazepines; acute alcohol withdrawal; psychoses, acute may be useful in narrow-angle symptomatic relief of glaucoma, shock, acute agitation, tremor, coma, acute delirium tremens, alcoholic hallucinosis intoxication; pregnancy (cleft muscle relaxant: adjunct lip or palate, for relief of reflex ingunal hernia, skeletal muscle spasm cardiac defects, due to local pathology microcephaly, (inflammatory of muscle pyloric stenosis or joints) or secondary to when used in trua; spasticity caused by first trimester; upper motoneuron neonatal disorders (cerebral palsy withdrawal and paraplegia); syndrome athetosis, stiff-man reported in syndrome newborns); lactation. Parenteral: treatment of tetanus Use cautiously Antiepileptic: adjunct in with elderly or status epilepticus and debilitated
Adverse Effects
Nursing Consideration History: hypersensitivity to Benzodiazepines; psychoses, acute narrow-angle glaucoma, shock , coma, acute alcoholic intoxication; elderly or debilitated patients; impaired liver or renal function; pregnancy, lactation Physical: weight; skin color, lesions; orientation, affect, reflexes, sensory nerve function, opthalmologic examination ; P, BP,R, adventitious sounds; bowel sounds, normal output, liver evaluation; normal output; LFTs, renal function tests, CBC
CNS: transient mild drowsiness, initially; sedation, lethargy, depression, apathy, fatigue, disorientation, light-headedness, restlessness, confusion, crying, delirium, headache, slurred speech, dysarthria, stupor, rigidity, tremor, dystonia, vertigo, euphoria, nervousness, difficulty in concentration, vivid dreams, psychomotor retardation, extrapyramidal symptoms; mild paradoxical excitatory reactions during first 2 wk of treatment, visual and auditory disturbances, diplopia, nystagmus, depressed hearing , nasal congestion CV: bradycardia, tachycardia, CV
severe recurrent convulsive seizures (parenteral); adjunct in seizure disorders (oral)
patients; impaired liver or renal function; and in patients with history of Preoperative (parenteral): substance abuse. relief of anxiety and tension and to lessen recall in patients prior to surgical procedures, cardioversion, and endoscopic procedures Rectal: management of selected , refractory patients with epilepsy who require intermittent use to control bouts of increased seizure activity unlabeled use: treatment of night terrors
collapse, hypertension and hypotension, palpitations , edema dependence: drug dependence with withdrawal syndrome when drug is discontinued 9 common with abrupt discontinuation of higher dosage used for longer than 4 mo); IV diazepam: 1.7 % incidence of fatalities; oral benzodiazepines ingested alone, no welldocumented fatal overdoses Dermatologic: urticaria, pruritus, skin, rash, dermatitis GI: constipation, diarrhea, dry mouth; salivation,; nausea; anorexia; vomiting; elevations of blood enzyme-LDH, alkaline, phosphatase, AST, ALT; hepatic impairement; jaundice
GU: Incontinence, urinary retention , changes in libido, menstrual irregularities hematologic: decreased hct, blood dyscrasias other: phlebitis and thrombosis at IV injection sites, hiccups, fever, diaphoresis, parathesias, muscular disturbances, gynecomasta; pain burning, and redness after IM injection
Drug Features
Mechanism of Action General CNS depressant; barbiturates inhibit impulse conduction in the ascending RAS, depress the cerebral cortex, alter cerebral function, depress motor output, and can produce excitation, sedation, hypnosis, anesthesia, and deep coma; at subhypnotic doses, has anti-seizure activity, making it suitable for long term use as an antiepileptic.
Phenobarbital Brand Name: Luminal Solfoton Dosage: 20 mg Frequency: Q12 stat Route: Parenteral (IV)
Therapeutics Indication Contraindicatio ns and cautions -oral or parenteral: Contraindicated Sedative with hypersenstivity -oral or to barbiturates, parenteral:hypnotic, manifest, or treatment of insomia for latent porphyria, up to 2 week marked liver impairment, -oral: Long term nephritis, severe treatment of generalized respiratory tonic-clonic and cortical distress, previous focal seizure addiction to sedative -oral: emergency control hypnotic drugs of certain acute seizures (may be (e.g. those associated ineffective and with status epilepticus, may contribute eclampsia, meningitis, to further tetanus and toxic addiction), reactions to strychnine or pregnancy (fetal local anesthetics. damage, neonatal -Parenteral: Preanesthetic withdrawal syndrome). -Parenteral: tretment of generalized tonic-clonic -use cautiously and cortical focal with acute or seizures chronic pain (drug may cause -Parenteral: emergency paradoxical
Adverse Effects
Nursing Consideration
CNS: somnolence, agitation, confusion, hyperkinesia, ataxia, vertigo, CNS depression, nightmares, lethargy, residual sedation (hangover), paradoxical excitement, nervousness,psychiatric disturbance, hallucinations,insomnia, anxiety, dizziness, thinking abnormality
History; hypersensitivity to barbituarates, manifest or latent porphyria, marked liver impairment, nephritis, severe respiratory distress, previous addiction to sedativehypnotic drugs, pregnancy, acute or chronic pain, seizure disorders, lactation, fever, hyperthyroidism, CV:Bradycardia, diabetes mellitus, hypotension, syncope anemia, cardiac disease, shck, uremia, GI: nausea, vomiting, impaired liver or renal constipation, diarrhea, function, debiliation epigastric pain -Hypersensivity: rashes, angioneurotic edema, serum sickness, morbiliform rash, urticaria; rarely, exfoliative dermatitis, Steven-Johnson syndrome
Physical: weight, T, skin olor, lesions; orientation, affect, reflexes; P,BP, orthostatic BP; R, adventitious sounds, bowel sounds, normal output, liver evaluation;
control of acute seizures excitement or (epilepticus, eclampsia, mask important tetanus) symptoms); seizure disorders (abrupt discontinuation of daily doses can result in epilepticus); lactation (secrreted in breast milk; drowainess in nursing infants); fever, hyperthyroidism, diabetes mellitus , sever anemia , pulmonary or cardiac disease, status asthmaticus, shock, uremia, impaired liver or renal function, debilitation
LFTs, renal function -Resipratory: hypoventilation, apnea, test blood and urine respiratory depression, glucose, BUN laryngospasm, brochospasm, circulatory collapse other: tolerance, psychological and physical dependence, withdrawal synrome
Drug Features
Ceftriaxone Brand Name: Forgram Dosage: 1 mg Frequency: OD Route: Parenteral (IV)
Therapeutics Indication Contraindicatio ns and cautions Works by inhibiting Treatment of infections Hypersensitivity the mucopeptide of the lower resp tract, to synthesis in the acute bacterial otitis cephalosporins. bacterial cell wall. media, skin & skin Hypersensitivity The beta-lactam structure infection, UTI, to lidocaine (IM moiety of uncomplicated inj) Ceftriaxone binds gonorrhea, pelvic to inflammatory disease, carboxypeptidases, bacterial septicemia, endopeptidases, and bone & joint infections, transpeptidases in intra-abdominal the bacterial infections, meningitis. cytoplasmic membrane. These enzymes are involved in cellwall synthesis and cell division. By binding to these enzymes, Ceftriaxone results in the formation of of defective cell walls and cell death.
Mechanism of Action
Adverse Effects
Nursing Consideration Assess patients previous sensitivity reaction to penicillin or other cephalosphorins. Assess patient for signs and symptoms of infection before and during the treatment Obtain C&S before beginning drug therapy to identify if correct treatment has been initiated. Assess for allergic reaction. Monitor hematologic,electro lytes, renal and hepatic function. Assess for possible superinfection: itching fever, malaise, redness, diarrhea
Pain Induration Phlebitis Rash Diarrhea Thrombocytosis Leucopenia Glossitis Respiratory superinfections
Drug Features
Mechanism of Action Competitively inhibits action of histamine at H2receptor sites of parietal cells, decreasing gastric and acid secretion.
Ranitidine Brand Name: Dosage: 10 mg Frequency: Q8 Route: Parenteral (IV)
Therapeutics Indication Contraindicatio ns and cautions Active duodenal and Contraindicat gastric ulcer ed in patients hypersensitiv Maintenance therapy e to drug and for duodenal and in those with gastric ulcer acute Gastroesophageal porphyria. reflux disorder Use Erosive esophagitis cautiously in Heartburn patients with hepatic dysfunction. Adjust dosage in patients with impaired renal function.
Adverse Effects
Nursing Consideration Monitor vital signs of the patient. Administer medication as prescribed by the physician. Assist the patient when administering the medication. Advise patient to report abdominal pain, blood in stool or emesis, black, tarry stools, or coffee-ground emesis. Assess patient for abdominal pain. Note presence of blood in emesis, stool, or gastric aspirate.
CNS: headache, malaise, vertigo EENT: blurred vision Hepatic: Jaundice Other: anaphylaxis, angioedema, burning and itching at injection site. Adverse Effects: Diarrhea, dizziness, tiredness, headache & rash. Reversible confusional state. Fever, arthralgia, myalgia, blood & CV disorders
Drug Features
Paracetamol Brand Name: Biogesic Dosage: 100 mg Frequency: Q4 Route: Parenteral (IV)
Therapeutics Indication Contraindicatio ns and cautions Works by inhibiting Treatment of infections Hypersensitivity the mucopeptide of the lower resp tract, to synthesis in the acute bacterial otitis cephalosporins. bacterial cell wall. media, skin & skin Hypersensitivity The beta-lactam structure infection, UTI, to lidocaine (IM moiety of uncomplicated inj) Ceftriaxone binds gonorrhea, pelvic to inflammatory disease, carboxypeptidases, bacterial septicemia, endopeptidases, and bone & joint infections, transpeptidases in intra-abdominal the bacterial infections, meningitis. cytoplasmic membrane. These enzymes are involved in cellwall synthesis and cell division. By binding to these enzymes, Ceftriaxone results in the formation of of defective cell walls and cell death.
Mechanism of Action
Adverse Effects
Nursing Consideration Assess patients previous sensitivity reaction to penicillin or other cephalosphorins. Assess patient for signs and symptoms of infection before and during the treatment Obtain C&S before beginning drug therapy to identify if correct treatment has been initiated. Assess for allergic reaction. Monitor hematologic,electro lytes, renal and hepatic function. Assess for possible superinfection: itching fever, malaise, redness, diarrhea
Pain Induration Phlebitis Rash Diarrhea Thrombocytosis Leucopenia Glossitis Respiratory superinfections
Drug Features
Mechanism of Action Inhibits protein synthesis in susceptible strains of gram negative bacteria; appears to disrupt functional integrity of bacterial cell membrane, causing cell death.
Gentamicin Brand Name: Gentamycin Dosage: 35 mg Frequency: OD Route: Parenteral (IV)
Therapeutics Indication Contraindicatio ns and cautions Serious infection when Use cautiously causative organism are with renal or not known. hepatic disease Treatment of superficial sulfite ocular infections due to sensitivity; strains of microorganism preexisting susceptible to hearing loss; gentamicin. active infection with herpes, vaccinia, and fungal infection.
Adverse Effects CNS: Ototoxicity, tinnitus, dizziness, vertigo, deafness, vestibular paralysis, confusion, lethargy CV: Palpitation, Hypotension GI: Hepatic toxicity, nausea, vomiting, anorexia, weight loss GU: Nephrotoxicity
Nursing Consideration Monitor serum concentration when feasible to avoid potentially toxic levels. Assess patient for signs and symptoms of infection before and during the treatment Culture infected area before therapy Assess for allergic reaction. Avoid long tren therapies because of increased risk of toxicities.
