Name of Drug

Sodium Bicarbonate

Classification
Electrolytes

Mechanism of Action
Sodium bicarbonate raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralizes the hydrogen ion concentration. It also neutralizes gastric acid via production of carbon dioxide.

Indication
Urine alkalinisation. To prevent development of uricacid renal calculi in the initial stages of uricosuric therapy forhyperuricaemia in chronic gout.

Side Effects
Metabolic alkalosis; mood changes, tiredness, shortness of breath, muscle weakness, irregular heartbeat; muscle hypertonicity, twitching, tetany; hypernatraemia, hyperosmolality, hypocalcaemia, hypokalaemia; stomach cramps, flatulence. Tissue necrosis at inj site.

Nursing Consideration
- Assess the clients fluid balance throughout the therapy. This assessment includes intake and output, daily weight, edema and lung sounds. - Symptoms of fluid overload should be reported such as hypertension, edema, difficulty breathing or dyspnea, rales or crackles and frothy sputum. - IV sites should be observed closely. Extravasation should be avoided as tissue irritation or cellulitis may occur when taking sodium bicarbonate.

Name of Drug
Gentamycin

Classification
Topical Antibiotics/Anti Infectives & Antiseptics

Mechanism of Action
Gentamicin is an aminoglycoside that binds to 30s and 50s ribosomal subunits of susceptible bacteria disrupting protein synthesis, thus rendering the bacterial cell membrane defective.

Indication
Parenteral use restricted to treatment of serious infections of GI, respiratory, and urinary tracts, CNS, bone, skin, and soft tissue (including burns) when other less toxic antimicrobial agents are ineffective or are contraindicated. Has been used in combination with other antibiotics. Also used topically for primary and secondary skin infections and for superficial infections of external eye and its adnexa.

Side Effects
Ototoxicity (vestibular disturbances, impaired hearing), optic neuritis. Neuromuscular blockade: skeletal muscle weakness, apnea, respiratory paralysis (high doses); arachnoiditis (intrathecal use). Hypotension or hypertension, Nausea, vomiting, transient increase in AST, ALT, and serum LDH and bilirubin; hepatomegaly, splenomegaly

Nursing Consideration
- Draw blood specimens for peak serum gentamicin concentration 30 min1h after IM administration, and 30 min after completion of a 30 60 min IV infusion. Draw blood specimens for trough levels just before the next IM or IV dose. Use no heparinized tubes to collect blood.

Name of Drug
Salbutamol

Classification
Bronchodilator

Mechanism of Action
It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following mechanism that takes place when Salbutamol is administered.

Indication
To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder

Side Effects
Nervousness Restlessness Tremor Headache Insomnia Chest pain Palpitations Angina Arrhythmias Hypertension Nausea and vomiting Hyperglycemia Hypokalemia

Nursing Consideration
- Assess lung sounds, PR and BP before drug administration and during peak of medication. - Observe for paradoxical spasm and withhold medication and notify physician if condition occurs. - Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth. Inform the patient that Albuterol may cause an unusual or bad taste.

Name of Drug
Diazepam

Classification
Central Nervous System Agent, Anti Convulsant

Mechanism of Action
Psychotherapeutic agent related to chlordiazepoxide; reportedly superior in antianxiety and anticonvulsant activity, with somewhat shorter duration of action. Like chlordiazepoxide, it appears to act at both limbic and subcortical levels of CNS

Indication
Drug of choice for status epilepticus. Management of anxiety disorders, for short-term relief ofanxiety symptoms, to allay anxiety and tension prior to surgery, cardioversion and endoscopic procedures, as an amnesic, and treatment for restless legs.

Side Effects
Psychological and physical dependence with withdrawal syndrome, fatigue, drowsiness, sedation, ataxia, vertigo, confusion, depression, GI disturbances, changes in salivation, amnesia, jaundice, paradoxical excitation, elevated liver enzyme values; muscle weakness, visual disturbances, headache, slurring of speech and dysarthria, mental changes, incontinence, constipation, hypotension, tachycardia, changes in libido, pain.

Nursing Consideration
- Monitor V/S Frequently prior to therapy and frequently during IV therapy - Assess IV site frequently during administration, Diazepam may cause phlebitis and Venous Thrombosis

Name of Drug
Nalbuphine

Classification
Analgesics

Mechanism of Action
Nalbuphine is a phenanthrene derivative opioid analgesic with mixed opioid agonist and antagonist activity. It inhibits the ascending pain pathways, altering the perception of and response to pain by binding to opiate receptors in the CNS. It also produces generalized CNS depression.

Indication

Side Effects

Nursing Consideration
- Give diretct IV undiluted 10mg or less over 3-5 mins or more

Relief of Moderate to Sedation, dizziness, severe pain. vertigo, miosis, headache; nausea, Preoperative vomiting, dry analgesia, as a mouth; itching, supplement to burning, urticaria. surgical anesthesia. Respiratory depression, dyspnoea, asthma; speech difficulty, urinary urgency, blurred vision, flushing, warmth; clamminess.

Name of Drug

Classification

Mechanism of Action
Stimulates smooth muscles Produces sustained contractions

Indication

Side Effects

Nursing Consideration
- Be alert for drug interactions and side effects - Use drug carefully due to potent vasoconstrictor action

Methergine

Drugs acting on the Uterus

Active management of the 3rd stage of labor.

Headache, HTN, skin eruptions, abdominal pain, Dizziness, convulsions, chest pain, hypotension, nausea, vomiting, hyperrhidosis, Bradycardia, tachycardia

Name of Drug
Phenobarbital

Classification
Anti- Convulsants

Mechanism of Action
Phenobarbitone is a short-acting barbiturate. It depresses the sensory cortex, reduces motor activity, changes cerebellar function, and produces drowsiness, sedation and hypnosis. Its anticonvulsant property is exhibited at high doses.

Indication
Sedative treatment of generalized tonicclonic and cortical focal seizures Emergency control of certain acute seizures

Side Effects
Bradycardia, hypotension, syncope; drowsiness, lethargy, CNS excitation or depression, impaired judgment, hangover effect, confusion, somnolence, agitation, hyperkinesia, ataxia, nervousness, headache, insomnia, nightmares, hallucinations, anxiety, dizziness; rash, exfoliative dermatitis; nausea, vomiting, constipation; agranulocytosis, thrombocytopenia.

Nursing Consideration
- Check the doctors order - Check V/S - Check drug history for hypersensitivity and condition of patient if not contraindicated - Watch out for Patients with acute pain and depressive disorders

Name of Drug
Epinephrene

Classification
Cardiac Drugs

Mechanism of Action
Epinephrine, an active principle of the adrenal medulla, is a direct-acting sympathomimetic. It stimulates - and adrenergic receptors resulting in relaxation of smooth muscle of the bronchial tree, cardiac stimulation and dilation of skeletal muscle vasculature. It is frequently added to local anaesthetics to retard diffusion and limit absorption, to prolong the duration of effect and to lessen the danger of toxicity.

Indication
Temporary relief of bronchospasm, acute asthmatic attack, mucosal congestion, hypersensitivity and anaphylactic reactions, syncope due to heart block or carotid sinus hypersensitivity, and to restore cardiac rhythm in cardiac arrest. Ophthalmic preparation is used in management of simple (open-angle) glaucoma, generally as an adjunct to topical miotics and oral carbonic anhydrase inhibitors.

Side Effects
epigastric pain; dyspnoea; hyperglycaemia; sweating; hypersalivation; weakness, tremors; coldness of extremities; hypokalaemia. Gangrene, tissue necrosis and sloughing, when used in addition to local anaesthetics. Eye drops: Severe smarting, blurred vision, photophobia; naso-lachrymal ducts obstruction. Oedema, hyperaemia and inflammation of the eyes with repeated administration.

Nursing Consideration
- Watch out for palpitations, and other Side effects - Instruct patient for any anaphylactic reaction - Instruct patient on proper administration technique, depending on formulation used