DRUG study

Nomenclature of the
drug/dosage, route, frequency

Generic Name: Sodium

bicarbonate NaHCO
Brand Name:
Classification/s:
Antacid,
Electrolyte,
Systemic
Alkalinizer,
Urinary
Alkalinizer
DOSA
GE
1.0
mEqs
+ 10
cc of
sterile
HO

ROUT
E
SIVTT

FREQU
ENCY

Mechanisms of action

Indications & contrainications

Side effects, adverse effect

Action of the Drug:

Indications;

Adverse Effects:

Increase
plama
bicrbonate;
buffers
excess
hydrogen
ion
concentration;
raise blood pH;
reverses clinical
manifestation of
acidosis;
increases
the
excretion of free
base in the urine,
effectively raising
the urinary pH;
neutralize
or
reduces
gastric
acidity, resulting
to an increase in
pH, which inhibits
the
proteolyrtic
activity of pepsin.

Treatment
of
metabolic acidosis,
with measures to
control the caue of
acidosis.
Adjunctive
treatment in evere
diarrhea
with
accompanying los of
bicarbonate.
Treatment of certain
drug
intoxications
that
require
alkalinization, of the
urine, prevention of
methotrexate
nephrotoxicity
by
the alkalinization of
the urine.
Minimization of uric
acid crystalluria in
gout, with uricosuric
agents.
Minimization
of
ulfonamide
crystalluria.
Oral:
symptomatic
relief of stomach
upset
from
hyperacidity
associated
with
peptic
ulcer,
gastritis,,
peptic

GI: gastric rupture

ff ingestion.
Hematologic:
sytemic alkalosis
(headache,
nausea, irritability,
weakness, tetany,
confusion),
hypokalemia
secondary
to
intracellular
shifting
of
potassium,
hypernatremia.
Local:
chemical
cellulitis,
tissue
necrosis,
ulceration
and
sloughing at the
site of infiltration.

Nursing responsibilities

Asses for history of

allergy
to
component
of
preparation,
low
serum
chloride,
metabolic
&
respiratory alkalosi,
hypocalcemia,
impaired
renal
function,
HF,
edema, oliguria or
anuria,
potassium
depletion,
pregnancy.
Assess skin color,
turgor,
injection
site,
peripheral
rhythm, peripheral
edema,
bowel
sounds, abdominal
exam,
urinary
output,
serum
electrolytes,
erum
bicarbonate, ABGs,
urinalyis, renal fxns.
Monitor ABG and
calculate
base
deficit
when
administering
parenterally. Adjust
dosage based on
response.
Administer slowly.
Check
potasium
level
before
IV

esophagitis, gastric
hyperacidity, hiatal
hernia.
Oral: prophylaxis of
GI bleeding, tress
ulcers,
aspiration
pneumonia.
To reduce incidences
of chemical phlebitis,

and
patient
discomforts due to
vein irritation at/or
near the infusion site
by raising the pH of IV
acid solutions.

Contraindications:

Contraindicated with
allergy
to
component
of
preperation,
low
serum
chloride
(secondary
to
vomiting,
continuous
GI
suction,
diuretics
associated
with
hypochloremic
alkalosis); metabolic
and
respiratory
alkalosis,
hypokalemia
(alkalosis
may
precipitate tetany).

Caution:

Among patient with

impaired
renal

adminitration, risk
of
metabolic
acidosis is increased
in
states
of
hypokalemia,
requiring reduction
of NaHCO.
If infiltration occur,
promptly
elevate
the site, apply warm
compress.
Instruct to chew
tablet
thoroughly,
and follow with a
glass of full water.
Do not use within 12 hours of any other
drugs to decrease
risks
of
drug
interactions.
Advise
to
have
periodic blood tests
and
medical
evaluations.
Monitor
cardiac
arrythmias. Report
irritability,
headache, tremors,
periopheral edema,
DOB, blac or tarry
tools, and pain at IV
site.

function,
HF,
edematous
or
sodium-retaining
states,
oliguria,
anuria,
potassium
depletion
(may
predispose
to
metabolic alkalosis),
pregnancy, lactation

Nomenclature of the
drug/dosage, route, frequency

Generic Name: Penicillin G

sodium
Brand Name: Harbipen
Classification/s:
Antibacterial
DOSA
GE
550,0
00 u
as
drip

ROUT
E
IV

FREQU
ENCY
q6

Mechanisms of action

Indications & contrainications

Side effects, adverse effect

Action of the Drug:

Indications;

Adverse Effects:

Bactericidal:
inhibits
syntheis
of cell wall of
sensitive
organisms,
causing
cell
death.

Treatment of severe
infections caused by
enitive
organism
e,g.
streptococci,
pneumococci,
straphylococci,
Neisseria
gonorrhoeae,
Triponema pallidum,
meninggococci.
Actinomyces israelii,
Clostridium
perfringens,
and
tetani,
Leptotricia
buccalis,
Spirillum
minus
or
Streptobacillus
moniliformis,
Listeria
monocytogenes,
Fusobacterium
fusiformisans,
Pasteurella

CNS:
lethargy,
hallucinations,
seizures
GI:
glossitis,
stomatitis,
gastritis,
sore
mouth,
furry
tongue,
black
hairy
tongue,
nausea, vomitting,
diarrhea,
abdominal
pain,
bloody
diarrhea,
enterocolitis,
pseudomembranou
s colitis, nonpecific
hepatitis
GU:
nephritis--oliguria,
proteinuria,
hematuria,
cast,
pyuria axotemia

Nursing responsibilities

Assess hitory of
allergy
to
penicillins,
cephalosporins,
imipenem,
betalactaminase
inhibitors,
and
other
allergens,
renal
diease,
lactation
&
pregnancy.
Assess for culture
infections,
skin
rashes,
lesions,
adventitious
sounds,
bowel
sound, and normal
output: CBC, LFTs,
renal
fxn
test,
serum electrolytes,
Hct, urinalysis, skin
test
with
benzylpenicyllolpolylysine
if
hypersensitivity

multocida,
Erysipelothrix
insidiosa, E. coli,
Enterobacter
aerogenes,
Alkaligenes faecalis,
Salmonella,
Shigella,
Proteus
mirabilis,
Corynebacterium
diptheriae,
Bacillu
anthrax
Treatment
of
syphillis, gonococcal
infection.
Lyme
disease
(unlabeled use).

Contraindications:

Contraindicated
among with allergy
to
penicillins,
cephalosporins,
imipenem,
betalactaminase
inhibitors, and other
allergens.

Caution:

In
patients
with
renal
diease,
pregnancy,
lactation,
(may
cause diarrhea, or
candidiasi
in
infants)

Hematologic;
anemia,
thrombocytopenia,
leukopenia,
neutropenia,
prolonged bleeding
time
Hypersensitivity
reactions;
rash,
fever,
wheezing,
anaphylaxis
Local:
pain,
phlebitis,
thrombosis
at
injection ite, JarichHercheimer
rxns
when used to treat
syphilis
Others:
superinfection;
odium
overloadleading to
HF

rxns to penicillin
hace occurred.
Culture
infection
prior to treatment,
reculture if respone
is not as expected.
Use the smallest
volume possible for
IM
injections
to
avoid
pain
&
discomfort.
Continue treatment
for 48-72 hr after
the
patient
is
assymptomatic.
Monitor
serum
electrolytes
and
cardiac status.
Keep epinephrine,
IV
fluids,
vasopressors,
bronchodilators,
oxygen,
and
emergency
equipment readily
available in case of
serious
hyperenitivity rxn.
Arrange
for
cortcosterod
or
antihistamine
for
kin rxns.
Advise
to
eat
frequent meals to
counteract nausea
&
vomiting;
do
frequent oral care
for mouth sores.
Report
unusual

bleeding,
sore
throat, rash, hives,
fever,
severe
diarrhea, DOB.

Nomenclature of the drug/dosage,

route, frequency

Generic
Name:
5%
Dextrose in 1/3 NaCl soln
Brand Name:
Classification/s: IV fluid
(hypertonic solution)
DOSAG
E
80
gtts/
min or
20
gtts/mi
n
(-) ANST

ROUT
E
IV

Mechanisms of action

Indications & contrainications

Side effects, adverse effect

Action of the Drug:

Indications;

Adverse Effects:

FREQU
ENCY

When
administered
intravenously,
these
solutions
provide a source
of
water,
carbohydrate
and
electrolytes.
Solutions
which
provide
combinations
of
hypotonic
or
isotonic
concentrations of
dextrose and of
sodium
chloride
are suitable for
parenteral
maintenance
or
replacement
of
water
and
electrolyte
requirements with
minimal
carbohydrate
calories.

Intravenous

solutions containing
dextrose
and
sodium chloride are
indicated
for
parenteral
replenishment
of
fluid,
minimal
carbohydrate
calories, and sodium
chloride as required
by
the
clinical
condition
of
the
patient.

Contraindications:
None known.
Cautions:

Solutions containing
sodium ions should
be used with great
care, if at all, in
patients
with
congestive
heart

Reactions
which
may occur because
of the solution or
the technique of
administration
include
febrile
response, infection
at the site of
injection,
venous
thrombosis
or
phlebitis extending
from the site of
injection,
extravasation and
hypervolemia.
Too rapid infusion
of
hypertonic
solutions
may
cause local pain
and
venous
irritation. Rate of
administration
should be adjusted
according
to
tolerance. ss
Symptoms

Nursing responsibilities

may

Maintain
sterility
throughout
preparation, infusion
& discontinuation of
IV fluid solutions.
Check IVF bottles,
and cannula set for
integrity
and
optimal functioning.
Monitor
serum
electrolytes
prior
and closely during
recurrent
administrations.
Adjust
rate
according
to
an
individuals
tolerance/per
doctors order.
Use of the largest
peripheral vein and
a small bore needle
is recommended.
If
an
adverse
reaction does occur,
discontinue
the
infusion,
evaluate
the patient, institute
appropriate

Solutions
containing
carbohydrate
in
the
form
of
dextrose
restore
blood
glucose
levels
and
provide
calories.
Carbohydrate
in
the
form
of
dextrose may aid
in
minimizing
liver
glycogen
depletion
and
exerts
a
protein-sparing
action. Dextrose
injected
parenterally
undergoes
oxidation
to
carbon dioxide
and water.
Sodium
chloride
in
water
dissociates
to
provide
sodium
(Na+)
and
chloride (Cl) ions.
Sodium (Na+) is
the
principal
cation
of
the
extracellular fluid
and plays a large
part
in
the
therapy of fluid
and
electrolyte

failure, severe renal

insufficiency and in
clinical
states
in
which there exists
edema with sodium
retention.
Excessive
administration
of
potassium-free
solutions may result
in
significant
hypokalemia.

In
patients
with
diminished
renal
function,
administration
of
solutions containing
sodium ions may
result
in
sodium
retention.

The
intravenous
administration
of
these solutions can
cause fluid and/or
solute overloading
resulting in dilution
of serum electrolyte
concentrations,
overhydration,
congested states or
pulmonary edema.

The risk of dilutional

states is inversely
proportional to the

result
from
an
excess or deficit of
one or more of the
ions present in the
solution; therefore,
frequent
monitoring
of
electrolyte levels is
essential.
Hypernatremia
may be associated
with edema and
exacerbation
of
congestive
heart
failure due to the
retention of water,
resulting
in
an
expanded
extracellular fluid
volume. If infused
in large amounts,
chloride ions may
cause a loss of
bicarbonate ions,
resulting
in
an
acidifying effect.

therapeutic
countermeasures
and
save
the
remainder of the
fluid for examination
if
deemed
necessary.

disturbances.
Chloride (Cl) has
an integral role in
buffering
action
when oxygen and
carbon
dioxide
exchange occurs
in the red blood
cells.
The
distribution
and
excretion
of
sodium (Na+) and
chloride (Cl) are
largely under the
control
of
the
kidney
which
maintains
a
balance between
intake and output.

Water
is
an
essential
constituent of all
body tissues and
accounts
for
approximately
70% of total body
weight. Average
normal adult daily
requirements
range from two to
three liters (1.0 to
1.5 liters each for
insensible water
loss
by
perspiration and
urine production).
Water balance is
maintained
by

electrolyte
concentrations
of
administered
parenteral solutions.
The risk of solute
overload
causing
congested
states
with peripheral and
pulmonary edema is
directly proportional
to the electrolyte
concentrations
of
such solutions.

various regulatory
mechanisms.
Water distribution
depends primarily
on
the
concentration of
electrolytes in the
body
compartments
and sodium (Na+)
plays a major role
in
maintaining
physiologic
equilibrium.

Nomenclature of the
drug/dosage, route, frequency

Generic
Name:
Iron+Vitamin B Complex
Brand Name: Ferlin
Classification/s:Hematinic
DOSA
GE
5ml

ROUT
E
PO

FREQU
ENCY
OD

Mechanisms of action

Indications & contrainications

Side effects, adverse effect

Action of the Drug:

Indications;

Side Effects:

Iron is irregularly
and incompletely
absorbed from the
gastrointestinal
tract, the main
sight of absorption
being
the
duodenum
and
jejunom.
Absorption
is
aided by the acid
secretion of the
stomach or by the

For the prevention

and treatment of
iron
deficiency
anemia in infants
and children.

Contraindications:

Primary
hemochomatosis,
peptic
ulcers,
regional enteritis, or
ulcerative colitis.

Orally
administered iron,
due
to
its
astringent action,
produces
GI
irritation
and
abdominal
pain
with nausea and
vomiting
(these
irritant
side
effects are usually
related
to
the
elemental
iron

Nursing responsibilities

Monitor history of
anemia. Do not use
iron
to
treat
hemolytic anemias
unless
an
iron
deficient state also
exists.
Do not administer
therapeutic
iron
doses longer than 6
months
except
under
the
supervision
of
a
physician.
Do not administer

dietary acids and

is more readily
effected when the
iron is in the
ferrous
state.
Absorption is also
increased
in
conditions of iron
deficiency or in
fasting state but is
decreased if the
body stores are
overloaded.
Ferrous
iron
passes through GI
mucosa
directly
into the bl;ood
and
is
immediately
bound
to
transferrin.
Transferrin
transports iron to
the bone marrow
where
it
is
incorporated into
hemoglobin.
Most of the iron
liberated by the
struction
of
hemoglobin
is
conserved
and
reused by he body.
Iron
excretion
occurs
primarily
as desquamation
of cells such as
skin, GI mucosa,
naIls and
hair;

taken rather than

the
type
of
preparation).
Other effects may
include
either
diarrhea
or
constipation (side
effects may be
reduced
by
administration
with or after food
or
by
starting
therapy with a
small dose and
increasing
gradually).
May
cause
staining of teeth.
Stools
may
appear darker in
color.
Prolonged
folic
acid therapy may
cause a decrease
in vitamin B12
serum
concentration.

parenteral
iron
together with oral
iron to avoid iron
overload.
Do not administer
iron
to
patients
receiving repeated
blood
tranfusions,
since
there
is
considerable
amount of iron in
the hemoglobin of
transfused
erythrocytes.
Folic acid should be
administered
with
caution to patients
with
undiagnosed
anemia since it may
obscure
the
diagnosis
of
pernicious
anemia
resulting
to
progression
of
neurologic
complications.
Administer with food
or after meals to
minimize irritation.
To promote better
absorption,
take
along with vitamin C
or citric juices and
NO to milk within
and 1-2 hours after
intake.
Advise to drink with
straw to prevent
staining on teeth.

Research Paper help

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only
trace
amounts of iron
are excreted in
the
bile
and
sweat.
The B complex
vitamins
are
generally readily
absorbed from the
GI tract. They are
also
widely
distributed in the
body
tissues.
Excretion
is
through the urine
as metabolites or
in
the
original
form

Inform that straining

with defecation is
expected
with
prolong therapy and
that
stools
may
appear
darker
(greenish black) in
color.