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Darvon/Propoxyphene Hydrochloride
Class: narcotic (opiate), agonist, analgesic. Therapeutic: narcotic analgesic Route/Dosage: Adult PO 65 mg HCl or 100 mg napsylate q4h prn (max: 390 mg HCl/d, 600 mg napsylate/d) Pr: Morphine, Preg C or D, Schedule IV Action: centrally acting opioid structurally related to methadone. weak agonist @ opiate receptors w/in the CNS. potency about -2/3 that of codeine. potent analgesic . Contraindications: hypersensitivity, suicidal individuals, alcoholism, dependence on opiates. Cautions: kidney/liver disease, heart disease, bilary tract disease, pulmonary insufficiency. Adverse Effects: ( 1%) CNS-coma, Respiratory-respiratory depression, CV-circulatory collapse. Interactions: alcohol, warfarin, carbamazepine, orphenadrine, St. Johns Wort. Nursing Implications: need?, monitor CNS effects, resp. status, effectiveness, overdose (fatal w/in 1 h), activities, activities, excessive use. PNDG 10 pg 1307-1308
Lanoxin/Digoxin Pr
Class: cardiac glycoside, antiarrhythmic. Therapeutic: cardiac glycoside, antiarrhythmic. Route/Dosage: Adult PO 0.75-1.5 mg IV 0.5-1 mg Child 2-10y IV 20-35 mg/kg PO 30-40mcg/kg; >10y IV 8-12 mcg/kg PO 10-15 mcg/kg Action: widely used cardiac glycoside of Digitalis lanata. acts by the force & velocity of myocardial systolic contraction. conduction velocity through AV node. action is more prompt & less prolonged than digitalis/digitoxin. increases contractility of heart muscle, has antiarrhythmic properties that result from its effects on the AV node. Contraindications: digitalis hypersensitivity, sick sinus syndrome, Wolff-Parkingson-White syndrome, ventricular fibrillation, ventricular tachycardia unless due to CHF, full digitalizing dose not given if pt has received digoxin w/in past wk. or if slowly excreted cardiotonic glycoside has been given w/in past 2 wk. Cautions: renal insufficiency, hypokalemia, advance heart disease, cardiomyopathy, acute MI, incomplete AV block, cor pulmonale, hypothyroidism, lung disease, premature/immature infants, children, older adults, debilitated pts, pregnancy (Preg C). Adverse Effects: ( 1%) CV-AV block,GI-anorexia, nausea, vomiting, diarrhea, or visual disturbances. Interactions: cholestryramine, colestipol, amphotericin B, sodium polystyrene sulfonate, calcium IV, quinidine,verapamil, amiofarone, flecainide, erythromycin, succinylcholine,
nefazodone, ginseng,ma huang, ephedra, St. Johns wort, panax ginseng. Nursing Implications: take apical pulse for full minute, noting rate, rhythm, and quality before admin. drug. withhold med & notify physician if apical pulse ordered parameters, know pts baseline data, lab test: baseline serum digoxin, potassium, magnesium, and calcium. draw blood for determining plasma digoxin levels at least 6 h after daily dose & just before next dose. monitor for S&S of drug toxicity, I&O ratio, serum digoxin levels, observe pt when being transferred from one preparation to another. weigh each day, report weight gain > 1 kg, take precisely, no OTC meds, report anorexia, nausea, vomiting, diarrhea, or visual disturbances. PNDG 10 pg 476-478
Lasix/Furosemide Pr
Class: electrolyte & water balance agent; loop diuretic; antihypertensive. Therapeutic: loop diuretic, antihypertensive. Route/Dosage: Adult PO 20-80 mg in 1 or more divided doses up to 600 mg/d if needed IV/IM 20-40 mg in 1 or more divided doses up to 600 mg/d Child PO 2 mg/kg may be increased by 12 mg /kg q6-8h (max: 6mg/kg/dose) IV//IM 1-2 mg/kg, may be increased by1 mg/kg q2h if needed (max: 6mg/kg/dose) Neonate PO 1-4 mg/kg q12-24h IV/IM 1 mg/kg q12-24h Hypertension Adult PO 10-40 mg b.i.d. (max: 480 mg/d) Action: rapid-acting potent sulfonamide loop diuretic & antihypertensive. inhibit reabsorption of sodium & chloride primarily in loop of Henle & in proximal/distal renal tubules. renal vascular resistance & may increase renal blood flow. an antihypertensive that edema & intravascular volume. Contraindications: HO hypersensitivity to furosemide or sulfonamides, oliguria, anuria, fluid & electrolyte depletion states, hepatic coma, preeclampsia, eclampsia, pregnancy (Preg c). Cautions: infants, older adults, hepatic disease, hepatic cirrhosis, renal disease, nephrotic syndrome, cardiogenic shock associated w/ acute MI, ventricular arrhythmias, CHF, diarrhea, HO SLE, HO gout, diabetes ,mellitus, pts receiving digitalis glycosides or potassium-depleting steroids, lactation.
Adverse Effects: ( 1%) CV- circulatory collapse, Hematologic- aplastic anemia, agranulocytosis. Interactions: other diuretics, digoxin, nondepolarizing neuromuscular blocking agents, amphotericin B, lithium, insulin. Nursing Implications: observe pts receiving parenteral drug, monitor BP & VS, death from cardiac arrest has been reported, monitor S&S of hypokalemia, lab tests: blood count, serum & urine electrolytes, CO2, BUN, blood sugar, uric acid, monitor I&O ratio, monitor urine & blood glucose & HbAic closely in diabetic pts & pts w/ decopensated hepatic cirrhosis, dehydration most likely to occur in older adults, consult physician on allowable salt/fluid intake, report muscle cramps/weakness, no H2O in excess. PNDG 10 pg 697-699
Mylanta
