DRUG STUDYName: Arroyo, Sally Shane Z. Year and Sec: BSN 4-1

Name Mechanism of Action

Indication Contraindication Adverse effect Side effect Nursing Responsibilities

Generic name:Ipratropium Bromide

Brand Name:Apo-Ipravent (CAN), Atrovent, Novo-Ipramide (CAN)

Classification:AnticholinergicAntimuscarinic drugParasympatholytic

Frequency:Thrice a day

Route:inhalation

Anticholinergic, chemically related to atropine, which blocks vagally mediated reflexes by antagonizing the action of acetylcholine. Causes bronchodilation and inhibits secretion from serous and seromucous glands lining the nasal mucosa

Bronchodilator for maintenance treatment of bronchospasm associated with COPD (solution, aerosol), chronic bronchitis, and emphysema Nasal spray: Symptomatic relief of rhinorrhea associated with perennial rhinitis, common cold

Contraindicated with hypersensitivity to atropine or its derivatives, soy bean or peanut allergies (aerosol). Use cautiously with narrow-angle glaucoma, prostatic hypertrophy, bladder neck obstruction, pregnancy, lactation.

CNS:, fatigue, insomniaGI: GI distress, dry mouthRespiratory: Dyspnea, bronchitis, bronchospasms, URI, exacerbation of symptoms, hoarsenessOther: Back pain, chest pain, allergic-type reactions, palpitations, rash

CNS: Nervousness, dizziness, headache,GI: NauseaRespiratory:, cough

1. Protect solution for inhalation from light. Store unused vials in foil pouch. 2.Use nebulizer mouthpiece instead of face mask to avoid blurred vision or aggravation of narrow-angle glaucoma.3.Can mix albuterol in nebulizer for up to 1 hr4.Ensure adequate hydration, control environmental temperature to prevent hyperpyrexia5.Have patient void before taking medication to avoid urinary retention.Teach patient proper use of inhalator.

DRUG STUDYName: Arroyo, Sally Shane Z. Year and Sec: BSN 4-1

Name Mechanism of Action

Indication Contraindication Adverse effect Side effect Nursing Responsibilities

Generic name:albuterol sulfateBrand Name:AccuNeb, Novo-Salmol (CAN), Proventil, Proventil HFA, Salbutamol (CAN), Ventodisk (CAN), Ventolin HFAClassification:SympathomimeticBeta2-selective adrenergic agonistBronchodilatorAntasthmaticFrequency:Thrice a dayRoute:inhalation

In low doses, acts relatively selectively at beta2-adrenergic receptors to cause bronchodilation and vasodilation; at higher doses, beta2 selectivity is lost, and the drug acts at beta2 receptors to cause typical sympathomimetic cardiac effects.

Relief and prevention of bronchospasm in patients with reversible obstructive airway disease Inhalation: Treatment of acute attacks of bronchospasm Prevention of exercise-induced bronchospasm Unlabeled use: Adjunct in treating serious hyperkalemia in dialysis patients; seems to lower potassium concentrations when inhaled by patients on hemodialysis

Contraindicated with hypersensitivity to albuterol; tachyarrhythmias, tachycardia caused by digitalis intoxication; general anesthesia with halogenated hydrocarbons or cyclopropane (these sensitize the myocardium to catecholamines); unstable vasomotor system disorders; hypertension; coronary insufficiency, CAD; history of stroke; COPD patients with degenerative heart disease.

bronchospasm CNS: Restlessness, apprehension, anxiety, fear, CNS stimulation, hyperkinesia, insomnia, tremor, drowsiness, irritability, weakness, vertigo, headache CV: Cardiac arrhythmias, tachycardia, palpitations, PVCs (rare), anginal pain Dermatologic: Sweating, pallor, flushingGI: Nausea, vomiting, heartburn, unusual or bad taste in mouthGU: Increased incidence of leiomyomas of uterus when given in higher than human doses in preclinical studies Respiratory: Respiratory difficulties

Do not exceed recommended dosage; adverse effects or loss of effectiveness may result. Read the instructions that come with respiratory inhalant.· You may experience these side effects: Dizziness, drowsiness, fatigue, headache (use caution if driving or performing tasks that require alertness); nausea, vomiting, change in taste (eat frequent small meals); rapid heart rate, anxiety, sweating, flushing, insomnia.· Report chest pain, dizziness, insomnia, weakness, tremors or irregular heart beat, difficulty breathing, productive cough, failure to respond to usual dosage.

DRUG STUDYName: Arroyo, Sally Shane Z. Year and Sec: BSN 4-1

Name Mechanism of Action

Indication Contraindication Adverse effect Side effect Nursing Responsibilities

Generic name:Isoniazid

Brand Name:Niazid

Classification:Antituberculotic

Frequency:Thrice a day

Route:oral

This medication is used with other medications to treat active tuberculosis (TB) infections or alone to prevent those who have a positive TB test from developing symptoms of TB. Isoniazid belongs to a class of drugs known as antibiotics that are active against tuberculosis. Interferes with lipid and nucleic acid biosynthesis in

Tuberculosis of all forms Prophylaxis in specific patients who are tuberculin reactors (positive Mantoux test) or who are considered to be high risk for TB.

Isoniazid is contraindicated in patients who develop severe hypersensitivity reactions, including drug -induced hepatitis; previous isoniazid-associated hepatic injury; severe adverse reactions to isoniazid such as drug fever, chills, arthritis; and acute liver disease of any etiology

Peripheral neuritis, optic neuritis; psychotic reactions, convulsions, nausea, vomiting, fatigue, epigastric distress, visual disturbances, fever, rash, pyridoxine deficiency.Potentially Fatal: Hepatotoxicity.

Peripheral neuropathy Nausea and vomitting Thrombocytopenia Local irritation at IM site Epigastric distress Elevated AST

1. History: allergy to the drug.Can cause peripheral neuropathy which is manifested by tingling sensation on extremities. It can be prevented through use of supplemental vitamin B6 (pyridoxine).2. Physical: skin color, lesions, T; orientation, reflexes, peripheral sensirivity, bilaterally grip strength ophthalmologic examination; R, adventitious sounds; liver evaluation; CBC;LFTs renal fxn tests, blood glucose. 3. Give in an empty stomach 1 hr before or 2 after meals; may be given with food if GI UPSET OCCURS. Give in a single daily dose. Reverse parenteral dose for pt unable to take oral meds. Dec. foods containing tyramine or histamine in pt diet. 4. Consult doctor and arrange for daily pyridoxine

actively growing tubercle bacilli.

in diabetic, alcoholic or malnourished pt also for pt that develops peripheral neuritis, and those with HIV. 5. Family health teachings: Take this drug in single daily dose. Take drug on an empty stomach, 1 hour before or 2 hours after meals. 6. If GI distress occurs, may be taken with food. Take this drug regularly, avoid missing doses, do not discontinue without first consulting your health care provider.7. Do not drink alcohol or drink as little as possible. There is an inc. risk of heap if these two drugs are combined. Avoid foods containing tyramine, consult a dietitian to obtain a list of foods containing tyramine or histamine.8. Have periodic medical check-ups, including an eye examination and blood test, to evaluate the drug effects. Report for weakness, fatigue, loss of appetite, n/v, yellowing of skin or eyes, darkening of the urine, numbness or tingling in hands or feet,

DRUG STUDYName: Arroyo, Sally Shane Z. Year and Sec: BSN 4-1

Name Mechanism of Action

Indication Contraindication Adverse effect Side effect Nursing Responsibilities

Generic name:Rifampicin/rifampinBrand Name:Rifadin, Rimactane

Classification:Antibiotic, Antituberculotic (first line)

Frequency:Thrice a day

Route:Oral

Inhibits DNA-dependent RNA polymerase activity in susceptible bacterial cells.

Treatment of Pulmonary TB in conjunction with at least one other effective antituberculotic.Neisseria meningitidis carriers, for asymptomatic carriers to eliminate meningococci from nasopharynx; not for treatment of meningitis.

Contraindicated with allergy to any rifamycin, acute hepatic disease, lactation. Use cautiously with pregnancy (teratogenic effects have been reported in preclinical studies; safest antituberculous regimen for use in pregnancy is condidered to be rifampin, isoniazid, and ethambutol).

CNS: headache, drowsiness, fatigue, dizziness, inability to concentrate, mental confusion, generalized numbness, muscle weakness, visual disturbances. Dermatologic: Rash, pruritus, urticaria, flushing, reddish discoloration of body fluids—tears, saliva, urine, sweat, sputum. GI: heartburn, distress, anorexia, vomiting gas, cramps, diaarhea, hepatitis, pancreatitis. GU: hemoglobinuria, hematuria, renal insufficiency, acute renal failure, menstrual disturbances. Hematologic:

fever, chills, body aches, flu symptoms;

joint pain or swelling;

easy bruising or bleeding, weakness;

urinating less than usual or not at all; or

nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

1. Administer on an empty stomach, 1 hr before or 2 hr after meals. Administer in a single daily dose.

2. Consult pharmacist for rifamoin suspension for patients unable to swallow capsules.

3. Prepare patient for the reddish-orange coloring of body fluids (urine, sweat, sputum, tears, feces, saliva); soft contact lenses may be permanently stained; advise patients not to wear them during therapy. Warning: arrange for follow-up visits for liver and renal function tests, CBC, and ophthalmic examinations.

4. Health Teachings During Rifampicin Therapy< Teach client to take drug in a single daily dose. Take on an empty stomach, 1 hr before or 2 hrs after meals. Inform client to take this

eosinophilia, thrombocytopenia, transient leucopenia, hemolytic anemia, decreased Hgb, hemolysis. Other: pain in extremities, osteomalacia, myopathy, fever, flulike symptoms.

drug regularly; avoid missing any doses; do not discontinue this drug without consulting the health care provider.

5. Tell client to have periodic medical checkups, including eye examinations and blood test, to evaluate the drug effects.

6. Inform client that he may experience the drug’s side effects (especially the red colored secretion)

7. Instruct client to see his physician if he experience fever, chills, muscle and bone pain, excessive tiredness or weakness, loss of appetite, N/V, yellowing of eyes/skin, unusual bleeding or bruising, skin rash or itching. Instruct client to remove contact lenses as they may discolor Share:

DRUG STUDYName: Arroyo, Sally Shane Z. Year and Sec: BSN 4-1

Name Mechanism of Action

Indication Contraindication Adverse effect Side effect Nursing Responsibilities

Generic name:EthambutolBrand Name:Myambutol, ServambutolClassification:Antituberculotic ActionFrequency:Thrice a day

Route:Oral

Ethambutol is bacteriostatic against actively growing TB bacilli, it works by obstructing the formation of cell wall. Mycolic acids attach to the 5 -hydroxyl ′groups of D-arabinose residues of arabinogalactan and form mycolyl-arabinogalactan-peptidoglycan complex in the cell wall. It disrupts arabinogalactan synthesis by inhibiting the enzyme arabinosyltransferase. Disruption of the

Ethambutol eliminates certain bacteria that cause tuberculosis (TB). It is used with other medicines to treat tuberculosis and to prevent you from giving the infection to others. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. Side-effects loss of appetite upset stomach vomiting numbness and tingling in the hands or fee optic neuritis–blurring of vision

Ethambutol hydrochloride is contraindicated in patients who are known to be hypersensitive to this drug. It is also contraindicated in patients with known optic neuritis unless clinical judgemnet determines that it may be used. Ethambutol hydrochloride is contraindicated in patients who are unable to appreciate and report visual

Optic neuropathy including optic neuritis or retrobulbar neuritis occurring in association with ethambutol therapy may be characterized by one or more of the following events: decreased visual acuity, scotoma, color blindness, and/or visual defect. These events have also been reported in the absence of a diagnosis of optic or retrobulbar neuritis

changes in vision

1. Assess patient for infection (appearance of wounds, sputum, VS, urine and stool and WBC.) at beginning and during therapy.

2. Obtain specimens before initiating therapy. Take drug as indicated. Not to be given to children 6 years below due to optic neuritis

3. Provide supplemental vitamin A. if not contraindicated

arabinogalactan synthesis inhibits the formation of this complex and leads to increased permeability of the cell wall.

DRUG STUDYName: Arroyo, Sally Shane Z. Year and Sec: BSN 4-1

Name Mechanism of Action

Indication Contraindication Side Effect Nursing Responsibilities

Generic name:Vitamin B Complex

Brand Name:Diavit

Classification:Vitamins and Minerals

Frequency:Once a day

Route:Oral

Coenzyme that stimulate metabolic function and is needed for cellreplication,hematopoiesis,andnucleoproteinandmyelinsynthesis.

Pernicious anemia

~ hypersen-sitive to vitamin B12or cobalt .~earlyLeber’s disease

CV: peripheralvascular thrombosis,heart failure.GI:transientdiarrhea.Respi:pulmonaryedema.Skin:itching,transitoryexanthema,urticaria.Other:anaphylaxis,anaphylactoidreactionswithparenteraladministration, pain or burning

BEFORE:~ Determine reticulocytecount, hct, Vit.B12, iron,folate levels beforebeginning therapy.~ Obtain a sensitivity testhistorybeforeadministration~ Avoid I.V. administrationbec. fastersystemicelimination will reduceeffectiveness of vitamin.DURING:~ Don’t give large doses of vitaminB12 routinely; drugis lost through excretion.~Don’t mix parenteralpreparation in samesyringe with other drugs.AFTER:~ Protect Vit.B12 fromlight. Don’t refrigerate or freeze.~ Monitor patient for hypokalemia for first 48hours, as anemia correctitself. Give potassiumsupplements, as needed