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University of the Philippines The Health Sciences Center COLLEGE OF NURSING Sotejo Hall, Pedro Gil Street, Manila Drug StudyDRUG ORDER(Genericname,Dosag

e,Route,Frequency,etc.)PHAR MACOLOGIC ACTION OFDRUGINDICATIONS ANDCONTRAINDICATION SADVERSE EFFECTSOF THE DRUGDESIRED ACTIONON THE CLIENTNURSINGRESPON SIBILITIES/PRECAUTION S
1.

Paracetamol(250mg/5ml) 3ml q4hfor fever

2.

Paracetamol 145mg IVq4h for T >38

o

C Antipyretic: Reduces fever byacting directly onthe hypothalamicheatregulatingcenter to causevasodilation andsweating, whichhelps dissipateheat. Analgesic: Siteand mechanismof action unclear Indications

- Analgesic-antipyretic inpatients with aspirinallergy, hemostaticdisturbances, bleedingdiatheses, upper GIdisease, gouty arthritisArthritis and rheumaticdisorders involvingmusculoskeletal pain (butlacks clinically significantantirheumatic and anti-inflammatory effects)Common cold, flu, otherviral and bacterialinfections with pain andfever- Unlabeled use:Prophylactic for childrenreceiving DPT

vaccinationto reduce incidence of fever and pain Contraindications - Contraindicated withallergy to acetaminophen.- Use cautiously withimpaired hepatic function,chronic alcoholism,pregnancy, lactation. CNS: Headache CV: Chest pain,dyspnea, myocardialdamage whendoses of 58 g/dayare ingested daily forseveral weeks

orwhen doses of 4g/day are ingestedfor 1 yr GI: Hepatictoxicity andfailure, jaundice GU: Acute kidneyfailure, renal tubularnecrosis Hematologic: Methemoglobinemia cyanosis;hemolytic anemia hematuria, anuria;neutropenia,leucopenia,p ancytopenia,thrombocytopenia,h ypoglycemia

Hypersensitivity: Rash, feverF e v e r r e d u c t i o n M o n i t o r l i v e r function studies;may causehepatic toxicityat doses>4g/dayM o n i t o r r e n a l function studies;albuminindicatesnephriti sM o n i t o r b l o o d studies,especi ally CBCand pro-time if patient is onlong-termtherapy.

Check I&O ratio;decreasingoutput

mayindicate renalfailure.Assess for feverand painA s s e s s hepatotoxicity:dark urine, clay-colored stoolsAssess allergicreactions: rash,

urticaria

Ibuprofen(200mg/5ml)4ml q6h for T>/= 39

o

CInhibitsprostaglandinsynthesis bydecreasingenzyme neededfor biosynthesis;analgesi c, anti-inflammatory,antipyretic Indications

-Relief of signs andsymptoms of rheumatoidarthritis andosteoarthritis-Relief of mild tomoderate pain-Treatment of primarydysmenorrhea-Fever reduction-Unlabeled uses:Prophylactic for migraine;abortive treatment formigraine Contraindications -Contraindicated withallergy to ibuprofen,salicylates, or otherNSAIDs (more common inpatients with rhinitis,asthma, chronic urticaria,nasal polyps).

CNS: Headache,dizziness,somnolence, insomnia, fatigue,tiredness, dizziness,tinnitus,ophthalmologi ceffects CV: Hypertension,palpitations,arrhyt hmia Dermatologic: Rash, pruritus,sweating, drymucous membranes,stomatitis GI: Nausea,dyspepsia, GI pain,

diarrhea, vomiting, constipation, flatulence, GIbleedingGU: Dysuria, renalimpairment,menorrhagia Hematologic: Bleeding, plateletinhibition with higherdoses, neutropenia,eosinophilia,leukop enia,pancytopenia,aplastic anemia,decreased Hgb orHct, bone marrowdepression Respiratory: Dyspnea,hemoptysis,pharyngitis,

bronchospasm ,rhinitis Other: Peripheraledema, anaphylactoidreactions to Fever reductionAssess painA s s e s s musculoskeletalstatus : ROMbefore dose and1 hr after.- M o n i t o r l i v e r function studiesM o n i t o r r e n a l function studiesM o n i t o r b l o o d studies: CBC,Hgb, Hct,protime if

patientis on long-termtherapyCheck I&O ratioA s s e s s hepatotoxicityA s s e s s f o r allergicreactions, visualchanges andototoxicityI d e n t i f y p r i o r drug historyIdentify fever:length of time inevidence andrelatedsymptoms Precautions: -Pregnancy B , lactation,children,bleedingdis orders, GIdisorders,cardiacdisorders,hy persensitivityto other anti-

inflammatoryagents, elderly,CHF

anaphylacticshock

Cotrimoxazole(200mg/5ml)5ml BIDBlocks synthesisof tetrahydrofolicacid; combinationblocks twoconsecutive steps Indications - Uncomplicated UTIscaused by susceptiblestrains of E. coli, Proteusmirabilis, Klebsiella Dermatologic: Rash, pruritus,exfoliative dermatitis GI: Epigastricdistress,

nausea,P r e v e n t i n f e c t i o n - A s s e s s a l l e r g i c reactionsMonitor I&O ratio M o n i t o r k i d n e y function

of 5

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Drug Study paracetamol, ibuprofen, cotrimoxazole, allopurinol

paracetamol, ibuprofen, cotrimoxazole, allopurinol antipyretic analgesic nursing drug study precaution

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