Patient Initials: A.B.B.

Age: 73 years old Admitting Diagnosis: Acute Respiratory Failure Secondary to Community Acquired Pneumonia-High Risk, Bronchial Asthma Drug Name Classification Generic Name: Mannitol Brand Name: Osmitrol Dosage: 75 ml q 8 Route: intravenous Date ordered: August 02, 2013 Osmotic diuretics Mechanism of Action Increases the osmotic pressure of the glomerular filtrate thereby, inhibiting reabsorption of water and electrolytes. Causes excretion of: water, sodium, potassium, chlorine, phosphorous, magnesium, urea, uric acid. Indication Adjunct in the treatment of: Acute oliguric renal failure, edema, increase intracranial pressure, toxic overdose. Contraindication Mannitol is contraindicated in patients having hypersensitivity to it. Anuria, dehydration, active intracranial bleeding. Side Effects CNS: Confusion, headache EENT: Blurred vision rhinitis CV: transient volume expansion, chest pain, CHF, pulmonary edema, tachycardia GI: nausea, thrist, vomiting GU: renal failure, urinary retention Nursing Responsibilities Monitor vital signs, urine output, CVP and pulmonary artery pressure(PAP) before and hourly throughout administration. Assess patient for signs and symptoms of dehydration( decreae skin turgor, fever, dry skin, and mucuous membranes, thrist) or igns of fluid overload (increase CVP, dyspnea, rales/crackles,

edema) Misc: dehydration, hyperkalemia, hypernatremia, hypokalemia, hyponatremia, phlebitis at IV site. Assess patient for anorexia, muscle weakness, numbness, tingling, paresthesia, confusion, and excessive thrist. Report signs of electrolyte imbalance. Increase Intracranial Pressure:Monitor neurologic status and intracranial pressure readings in patients receiving this medication to decreases cerebral edema.

Increase Intraocular Pressure: Monitor for persisitent or increase eye pain or decreased visual acuity.

Patient Initials: A.B.B. Age: 73 years old Admitting Diagnosis: Acute Respiratory Failure Secondary to Community Acquired Pneumonia-High Risk, Bronchial Asthma

Drug Name Classification Mechanism of Action Generic Name: Omeprazole Brand Name: Zegerid Dosage: 40 mg OD Route: Intravenous Date ordered: Proton Pump Binds to an Inhibitor enzyme on gastric parietal cells in the presence of acidic gastric pH, preventing the final transport of hyrogen ions into the gastric lumen.

Indication GERD/ maintenance of healing in erosive esophagitis: Duodenal ulcers short term treatment of active benign gastric ulcer. Patholoigichypersecretory conditions, including Zollinger-Ellison syndrome. Reduction of risk GI bleeding in critically ill patients.

Contraindication Omeprazole is contraindicated with patients having hypersensitivity to it. Metabolic alkalosis and hypocalcemia, liver disease, increased risk of hip fractures in patient using high- doses for > 1 year old; Barter;s syndrome, hypokalemia, and respiratory alkalosis.

Side Effects CNS: Dizziness, drowsiness, headache, fatigue, weakness

Nursing Responsibilities

Administer on empty stomach, at least 1 hour before a meal. For patient with NGT or enteral feeding, suspend CV: chest feeding for 3 pain hours before and 1 hour after GI: administration. abdominal If administered pain, acid through a regurgitation, nasogastric constipation, tube, suspend in diarrhea, 20 ml of water. flatulence, Stir well and nausea, drink vomiting immediately. DERM: May cause

August 02, 2013

itching, rash

occasional drowsiness or Misc: allergic dizziness. reactions Caution patient to avoid driving and other activities requiring alertness until response to medication is known. Advise patient to report onset of black, tarry stools, diarrhea, abdominal pain or persistent headache to healthcare professional promptly.

Patient Initials: A.B.B. Age: 73 years old Admitting Diagnosis: Acute Respiratory Failure Secondary to Community Acquired Pneumonia-High Risk, Bronchial Asthma Drug Name Generic Name: Classification Mechanism of Action Indication Treatment of skin and skin structure infections, respiratory tract infections, septicemia, intraabdominal infections, gynecologic infections, osteomyelitis, endocarditis prophylaxis. Contraindication Contraindicated with patients having hypersensitivity to it. Previous pseudomembranous colitis, severe liver impairment, diarrhea, known alcohol intolerance. Side Effects CNS: Dizziness,headache, CV:arrhythmias, hypotension GI: pseudomembranous colitis, diarrhea, bitter taste, nausea, vomiting,flatulence, bloody or tarry stools. DERM: rashes If adverse GI Misc: phlebitis at IV reactions site occurs, monitor patients hydration. Nursing Responsibilities Before giving first dose, obtain specimen for culture and sensitivity test, begin therapy pending results. Monitor renal, hepatic, and hematopetic functions during prolonged therapy.

Anti-infectives Inhibits bacterial protein Clindamycin synthesis by binding Brand to 50S Name: subunit of ribosome. Dosage: 300 mg cap q8 Route: Intravenous Date ordered: August 2013 02, 2

Drug Name Classification Mechanism of Action Generic Name: Anti-infectives It is similar to that of other Piperacillin penicillins. / Interfere Tazobactam with bacterial Brand cell wall Name: synthesis promotes loss of Dosage: membrane integrity 4.5 mg q 8 and leads to death of Route: the organism. Intravenous Date ordered: August 02, 2013

Indication

Contraindication

Side Effects CNS: Insomnia, headache, fever

Nursing Responsibilities

Treatment Hypersensitivity of moderate to penicillins, to severe cephalosphorins, appendiciti or other drugs. s, uncomplica ted and complicated skin and skin structure infections, nosocomial or communityacquired pneumonia caused piperacillinresistant, piperacillin /tazobacta m susceptible, betalactamaseproducing

Obtain history of hypersensitivity to penicillins, cephalosphorins, or other drugs prior to administration, Obtain specimen for culture and CV:arrhythmi sensitivity prior to first dose of the as, drug; start drug pending results. hypotension Periodic CBC with differential, platelet count, Hgb & Hgt, and GI: diarrhea, serum electrolytes. nausea, Monitor for hypersensitivity constipation, response; discontinue drug and vomiting, notify physician if allergic pseudomemb response noted. ranous colitis Monitor for hemorrhagic manifestations because high dose DERM: may induce coagulation hypersensitivi abnormalities. ty reactions Monitor vital signs because of ,rash, cardiac arrhythmias, hypertension pruritus and fever as adverse reactions.

bacteria.

Drug Name Generic Name: Paracetamol Brand Name: Dosage: 500 mg q 4 for temp 37.5 C Route: Intravenous Date ordered: August 2013 02,

Classification Antipyretic

Mechanism of Action Decrease fever by inhibiting the effects of pyrogens in the hypothalamus heat regulating centers and by a hypothalamic action leading to sweating and vaso dilation

Indication

Contraindication

Side Effects Hepatoxicity Drowsiness Renal failure (high, prolonged dosage) Hepatic seizure(over)

Nursing Responsibilities Assess allergic reactions: rash, urticia if these occur you may discontinue Assess the patients fever or pain; type of pain, location, duration, intensity, temperature, and diaphoresis Monitor CBC, liver and renal functions

Relief of Contra indicated mild-topeople with moderate hypersensitivity, pain; allergy to treatment of acetaminophen fever.

Drug Name Classification Generic Name: Citicoline Brand Name: Dosage: 500 mg 1 tab OD Route: Date ordered: August 02, 2013 Neurotropic

Mechanism of Action Citicoline is a derivative of choline and cytidine involved in the biosynthesis of lecithin. It is claimed to increase blood flow and oxygen consumption in the brain.

Indication CVA in acute and recovery phase. Symptoms and signs of cerebral insufficiency i.e., dizziness, headache, poor concentration, memory loss, disorientation. Recent cranial trauma.

Contraindication Hypertonia of parasympathethic nervous system. Meclofenoxate (clophenoxate)

Side Effects Shock, hypersensitivity, hypotension, insomnia, excitement.

Nursing Responsibilities Monitor blood pressure, pulse and heart rate. Assess allergic reaction like GI disturbances. Instruct relative to give only prescribed dose. Advise relative to consult the physician if any problems occur to the patient during medication.