VIII.

DRUG STUDY
DRUG GENERIC NAME: Ranitidine Hydrochloride BRAND NAME: Zantac THERAPEUTIC CLASS: Anti Ulcer dr!" PHARMAC#L#GIC CLASS: H$ rece%tor anta"oni&t& D#CT#R'S #RDER: Ranitidine () *" I+ , -. /hile on NP# DATE STARTED: 0e1r!ary 2$3 $)2) DATE d4c: 0e1r!ary 2-3 $)2) ACTION Co*%etiti5ely inhi1it& action o6 hi&ta*ine on the H$ rece%tor &ite& o6 %arietal cell&3 Decrea&in" "a&tric acid &ecretion7 INDICATIONS Acti5e d!odenal and "a&tric !lcer7 Maintenance thera%y 6or d!odenal or "a&tric !lcer7 Patholo"ic hy%er&ecretory condition& &!ch a& Zollin"er Elli&on Syndro*e7 Ga&troe&o%ha"eal re6l!8 Heart1!rn CONTAINDICATIONS Containdicated in %atient& hy%er&en&iti5e to dr!" and to tho&e /ith ac!te %or%hyria U&e ca!tio!&ly in %atient& /ith he%atic dy&6!nction7 Ad9!&t do&a"e in %atient& /ith i*%aired renal 6!nction7 SIDE / ADVERSE REACTIONS CNS: headache3 *alai&e3 5erti"o EENT: Bl!rred 5i&ion HEPATIC: ana%hyla8i&3 an"ioede*a3 1!rnin" and itchin" at in9ection &ite7 NURSING CONSIDERATION A&&e& %atient 6or a1do*inal :%ain7 Note %re&ence o6 1lood in e*e&i&3 &tool& or "a&tric a&%irate7 Dr!" *ay 1e added to total %arenteral n!trition7 Loo; ali;e < &o!nd ali;e: Don't con6!&e ranitidine /ith ri*antidine= Don't con6!&e >antac /ith 8ana8 or >yrtec7

DRUG GENERIC NAME: Ce6!ro8i*e a8etil BRAND NAME: Ce6tin THERAPEUTIC CLASS: Anti in6ecti5e& PHARMAC#L#GIC CLASS: Second Generation Ce%halo&%orin D#CT#R'S #RDER: Ce6!ro8i*e ?()*" I+ , -. ANST @ A DATE STARTED: 0e1r!ary )B3 $)2) DATE DISC#NTINUE:

ACTION Second "eneration ce%halo&%orin that inhi1it cell /all &ynthe&i&3 %ro*otin" o&*otic in&ta1ility= !&!ally 1actericidal7

INDICATIONS Serio!& re&%iratory tract in6ection&3 UTI3 &;in or &;in &tr!ct!re in6ection&3 1one or 9oint n6ection3 &e%tice*ia3 *enin"iti&3 "onorrhea7 Peri o%erati5e %re5ention Bacterial e8acer1ation o6 chronic 1ronchiti& or &econdary 1acterial in6ection o6 ac!te 1ronchiti& Ac!te 1acterial *a8illary &in!&iti&7 Pharyn"iti& and ton&illiti& #titi& *edia Unco*%licated &;in and &;in &tr!ct!re in6ection& Unco*%licated UTI Unco*%licated "onorrhea Early li*e de&ea&e7

CONTAINDICATIONS Containdicated in %atient& hy%er&en&iti5e to dr!" or other ce%halo&%orin7 U&e ca!tio!&ly in %atient& hy%er&en&iti5e to %enicillin 1eca!&e o6 %o&&i1ility o6 cro&& &en&iti5ity /ith other lacta* anti1iotic& U&e ca!tio!&ly in 1rea&t6eedin" /o*en and in %atient& /ith hi&tory o6 coliti& and renal in&!66iciency7

SIDE / ADVERSE REACTIONS C+: Phle1iti&3 thro*1o%hle1iti&7 GI: Diarrhea3 %&e!do*e*1rano!& coliti&3 na!&ea3 5o*itin"7 HEMAT#L#GIC: he*olytic ane*ia3 thro*1ocyto%enia3 tran&ient ne!tro%enia3 eo&ino%hilia7 SCIN: *ac!lo%o%!lar and erythe*ato!& ra&he&3 !ricaria3 %ain3 ind!ration3 &terile a1&ce&&e&3 te*%erat!re ele5ation3 ti&&!e &lo!"hin" at I7+ 7&ite7 #THER: ana%hyla8i&3 hy%er&en&iti5ity reaction&3 &er!* &ic;ne&&7

NURSING CONSIDERATION Be6ore "i5in" dr!"3 a&; %atient i6 he i& aller"ic to %enicillin or other ca%halo&%horin&3 #1tain &%eci*en 6or c!lt!re and &en&iti5ity te&t& 1e6ore "i5in" 6ir&t do&e7 Thera%y *ay 1e"in /hile a/aitin" re&!lt&7 0or I77M7 !&e3 in9ect dee% into lar"e *!&cle&3 &!ch a& the "l!te!& *a8i*!& or the &ide o6 the thi"h7 A1&or%tion o6 oral dr!" i& enhanced 1y 6ood7 Ta1let& *ay 1e cr!&hed3 i6 a1&ol!tely nece&&ary3 6or %atient& /ho can't &/allo/ can't &/allo/ ta1let&t Ta1let& *ay 1e di&&ol5e in &*all a*o!nt o6 a%%le3 oran"e3 or "ra%e 9!ice or chocolate *il;7Ho/e5er the dr!" *ay 1e 1itter in ta&te that i& di66ic!lt to *a&;3 e5en /ith 6ood7 Alert: Ta1let& and &!&%en&ion aren't 1ioe,!i5alent and can't 1e &!1&tit!ted *illi"ra* 6or *illi"ra*7 Monitor %atient 6or &i"n and &y*%to*& o6

DRUG GENERIC NAME: Tra*adol hydrochloride BRAND NAME: Ultra* THERAPEUTIC CLASS: #%iod anl"e&ic PHARMAC#L#GIC CLASS: Synthetic3 centrally actin" anal"e&ic D#CT#R'S #RDER: Tra*adol 2a*% I+ , -. DATE STARTED: 0e1r!ary )?3 $)2) DATE DISC#NTINUE:

ACTION Un;no/n7 Arally actin" anal"e&ic co*%o!nd not che*ically related to o%iod&7 Tho!"ht to 1ind to o%iod rece%tor& and inhi1it re!%ta;e o6 nore%ine%hrine and &erotonin7

INDICATIONS Moderate to *oderately &e5ere %ain7

CONTAINDICATION S Contraindicated in %atient& hy%er&en&iti5e to dr!" or other o%iod&3 in 1rea&t 6eedin" /o*en3 and in tho&e /ith ac!te into8ication 6ro* alcohol3 hy%notic&3 centrally actin" anal"e&ic&3 o%iod3 %&ychotro%ic dr!"&3 &erio!& hy%er&en&iti5ity reaction& can occ!r3 !&!ally a6ter the 6ir&t do&e7 Patient& /ith hi&tory o6 ana%hylactic reaction to codeine and other o%iod& *ay 1e at increa&e ri&;7

SIDE / ADVERSE REACTIONS CNS: di>>ine&&3 headache7 So*nolence3 5erti"o3 &ei>!re&3 an8iety3 a&thenia3 CNS &ti*!lation3 con6!&ion3 coordination3 di&t!r1ance3 e!%horia3 *alai&e3 ner5o!&ne&&3 *alai&e di&order7 C+: +a&odilation EENT: +i&!al di&t!r1ance&7 GI: con&ti%ation3 na!&ea3 5o*itin"3 a1do*inal %ain3 anore8ia3 diarrhea3 dry *o!th3 dy&%e%&ia3 6lat!lence7 GU: *eno%a!&al &y*%to*&3 %rotein!ria3 !rinary 6re,!ency3 !rine retention7 MUSCUL#SCELET AL: hy%ertonia7 RESPIRAT#RD: re&%iratory de%re&&ion SCIN: dia%hore&i&3 %r!rit!&3 ra&h7

NURSING CONSIDERATION Rea&&e& %atient& le5el o6 %ain atlea&t E) *in a6ter ad*ini&tration7 Monitor C+ and re&%iratory &tat!&7 Fithold clo&e and noti6y %re&cri1er i6 %re&cr1er i6 re&%iration& decrea&e o6 rate i& 1elo/ 2$1%*7 Monitor 1o/el and 1ladder 6!nction7Antici%ate need 6or la8ati5e 0or 1etter anal"e&ic e66ect3 "i5e dr!" 1e6ore on&et o6 o6 inten&e %ain7 Monitor %atient at ri&;& 6or &ei>!re thre&hold7 In the ca&e o6 o5erdo&e3 nalo8one *ay al&o increa&e ri&; o6 &ei>!re7 Monitor %atient 6or dr!" de%endence

&i*ilar to that o6 codeine or de8tro%ro%o8y%hene and th!& ha& %otential 6or a1!&e7 Fithdra/al &y*%to*& *ay occ!r i6 dr!" i& &to%%ed a1r!%tly7 Red!ce do&a"e "rad!ally7

DRUG GENERIC NAME: Ce6tria8one BRAND NAME: Roce%hin THERAPEUTIC CLASS: Anti in6ecti5e& PHARMAC#L#GIC CLASS: Third "eneration ce%halo&%orin& D#CT#R'S #RDER: Ce6tria8one 2" I+ , 2$ . ANST @ A DATE STARTED: 0e1r!ary 2?3 $)2) DATE DISC#NTINUE:

ACTION Third "eneration ce%halo&%orin that onh1it cell /all &ynthe&i&3 %ro*oin" o&*otic in&ta1ility= !&!ally 1actericidal7

INDICATIONS Unco*%licatad "onococcal 5a"initi& UTI= lo/er re&%iratory tract3 1one o%r 9oint3 intra a1do*inal3 &;in or &;in &tr!ct!re= &e%tice*ia7 Menin"iti& Peri o%erati5e %re5ention Ac!te 1acterial otiti& *edia Ne!rolo"ic co*%lication&3 carditi&3and arthriti& 6ro* %enicillin7

CONTAINDICATION S Contraindicated in %atient& hy%er&en&iti5e to dr!" or other ce%halo&%horin&7 U&e ca!tio!&ly in %atient& hy%er&en&iti5e to %enicillin 1eca!&e o6 %o&&i1ility o6 cro&& &en&iti5ity /ith other 1eta lacta* anti1iotic&7 U&e ca!tio!&ly in 1rea&t 6eedin" /o*en and in %atient& /ith hi&tory o6 coliti& and renal in&!66iciency7

SIDE / ADVERSE REACTIONS CNS: 6e5er3 headache3 di>>ine&& C+: %hle1iti& GI: %&e!do*e*1rano!& coliti&3 diarrhea GU: "enital %r!rit!&3 candidia&i&3 HEMAT#L#GIC:eo&i no%hilia3 thro*1ocyto&i&3 le!co%enia7 SCIN: %ain3 in d!ration3 tenderne&& at in9ection &ite3 ra&h3 %r!rit!&7 #THER: hy%er&en&iti5ity reaction&3 &er!*&ic;ne&&3ana%hyl a8i&3 chill&7

NURSING CONSIDERATION Be6ore "i5in" dr!"3 a&; %atient i6 he i& aller"ic to %enicillin& or other ce%halo&%orin& #1tain &%eci*en 6or c!lt!re and &en&iti5ity te&t& 1e6ore "i5in" 6ir&t do&e7 Thera%y *ay 1e"in /hile a/aitin" re&!lt&7 An I7M7 ;it containin" 2G lidocaine a& a dil!ent i& a5aila1le 6ro* the *an!6act!rer7 0or I7M7 !&e in9ect dee% into a lar"e *!&cle3 &!ch a& the "l!te!& *a8i*!& and the lateral a&%ect o6 the thi"h7 I6 lar"e do&e& are "i5en3 thera%y i& %rolon"ed73 or %atient i& at hi"h ri&;3 *onitor %atient 6or &i"n and &y*%to*& o6

&!%er in6ection7 Dr!" i& co**only !&ed in ho*e anti1iotic %ro"ra*& 6or o!t%atient treat*ent o6 &erio!& in6ection&7

DRUG GENERIC NAME: Aceta*ino%he n4 %araceta*ol BRAND NAME: A%enol3Bane&i n3 Dy*adon THERAPEUTIC CLASS: Non o%iod anal"e&ic and anti%yretic&7 PHARMAC#L#GIC CLASS: Para a*ino%henol deri5ati5e D#CT#R'S #RDER: Paraceta*ol 2 a*% , HI PRN DATE STARTED: )$ 2)3 $)2) DATE DISC#NTINUE:

ACTION Tho!"ht to %rod!ce anal"e&ia 1y 1loc;in" %ain i*%!l&e& 1y inhi1itin" &ynthe&i& o6 %ro&ta"landin in the CNS or o6 other &!1&tance& that &en&iti>e %ain rece%tor& to &ti*!lation7 The dr!" *ay relie5e 6e5er thro!"h central action in hy%othala*ic heat re"!latin" center7

INDICATIONS Mild %ain or 6e5er7

CONTRAINDICATIO NS Contraindicated in %atient& hy%er&en&iti5e to dr!"7 U&e ca!tio!&ly in %atient& /ith lon" ter* alcohol !&e 1eca!&e thera%e!tic do&e& ca!&e he%atoto8icity in %atient&7

SIDE / ADVERSE REACTIONS HEMAT#L#GIC: he*olytic ane*ia3 le!co%enia3 ne!tro%enia3 %ancyto%enia7 HEPATIC: 9a!ndice METAB#LIC: hy%o"lyce*ia S;in: ra&h3 !rticaria7

NURSING CONSIDERATION Alert: Many #TC and %re&cri%tion %rod!ct& contain aceta*ino%hen= 1e a/are o6 thi& /hen calc!latin" daily do&e7 U&e li,!id 6or* 6or children and %atient& /ho ha5e di66ic!lty &/allo/in"7 In children3 don't e8ceed 6i5e do&e& in $H ho!r&7

Sa*1on" @Bl!*ea Bal&a*i6eraA Doctor'& #rder: Sa*1on" ())*" $ ca% TID Date Started: 0e1r!ary 223 $)2)
A %lant that reache& 2 J to E *eter& in ht /ith ro!"h hairy lea5e&7 Do!n" %lant& aro!nd *other %lant *ay 1e &e%arated /hen they ha5e E or *ore lea5e&7 USES: Anti ede*a3 di!retic3 anti !rolithia&i&7 Boil cho%%ed lea5e& in a "la&& o6 /ater in 2( *in7 !ntil one "la&& re*ain&7 Cool and &train

NAME OF DRUG

ACTION

INDICATION

CONTRAINDICATIO NS

SIDE EFFECTS / ADVERSE REACTIONS Sli"ht "a&trointe&tinal di&order& *ay a%%ear /hich can 1e %alliated 1y *ean& o6 the 9oint ad*ini&tration o6 6ood7

NURSING CONSIDERATIONS

Generic Na*e: Pota&&i!* Citrate

The ai* o6 the treat*ent i& to re&tore the le5el o6 the !rinary citrate and to increa&e the %H o6 !rine to K ?7

Brand Na*e: Acal;a

Cla&&i6ication: CLINICAL: Anti!rolithic D#CT#R'S #RDER: Acal;a 2)*" 2 ta1 TID DATE STARTED: 0e1r!ary 223 $)2) DATE DISC#NTINUE:

Treat*ent o6 %atient& /ith renal lithia&i& and hy%ocitrat!ria3 chronic 6or*er& o6 calci!* o8alate3 %ho&%ate calc!lia7 Uric acid lithia&i& alone or acco*%anied 1y calci!* lithia&i&7 Renal t!1!lar acido&i& /4 Ca ne%hrolithia&i&7

renal in&!66iciency3 %er&i&tent al;aline !rinary in6ection&3 o1&tr!ction o6 the !rinary tract3 hy%er;ale*ia3 re&%iratory or *eta1olic al;alo&i&3 acti5e %e%tic !lcer3 inte&tinal o1&tr!ction3 %atient& &!1*itted to anticholiner"ic thera%y3 %atient& /ith &lo/ "a&tric e*%tyin"3 adrenal in&!66iciency7

The ta1let& *!&t not 1e *a&ticated or dil!ted7 The acti5e co*%onent o6 Acal;a i& contained /ith a %oro!& /a8 *atri87 A& thi& /a& *atri8 i& in&ol!1le3 it can 1e eli*inated in 5i&i1le 6or* in the 6ece&7 The acti5e co*%onent3 ho/e5er3 ha& 1een relea&ed in the "a&trointe&tinal tract7 M!&t not 1e ad*ini&tered to %atient& recei5in" %ota&&i!* &%arin" di!retic& @trai*terene3 &%irolactone3 or a*ylorideA7 It i& ad5i&a1le to carry o!t an e5al!ation o6 electrolyte& @Na C ClA and C#$3 creatinine and he*o"ra* e5ery H hr&7 It i& reco**ended that the %atient& in treat*ent /ith Acal;a 6ollo/ a diet /4o &alt and increa&e the inta;e o6 6l!id&7

The reco**ended treat*ent in ca&e o6 hy%er%ota&&e*ia i&: I+ ad*ini&tratioin 6 2)G de8tro&e &ol!tion3 containin" 2) 2$ !nit& o6 in&!lin42)))*l7 Correction o6 the %o&&i1le acido&i& /ith I+ &odi!* 1icar1oate and he*odialy&i& or %eritoneal dialy&i&7

DRUG GENERIC NAME: 0!ro&e*ide BRAND NAME: La&i8 PHARMAC#L#GI C CLASS: Loo% Di!retic D#CT#R'S #RDER: 0!ro&e*ide H) *" no/ DATE STARTED: 0e1r!ary -3 $)2) DATE DISC#NTINUE:

ACTION inhi1it& &odi!* and chloride rea1&or%tion at the %ro8i*al and di&tal t!1!le& and the a&cendin" loo% o6 Henle

INDICATIONS ac!te %!l*onary ede*a ede*a hy%erten&ion

CONTRAINDICATIO NS An!ria he%atic co*a L %reco*a &e5ere hy%o;ale*ia L4or hy%onatre*ia hy%o5ole*ia /4 or /4o hy%oten&ion Hy%er&en&iti5ity to 6!ro&e*ide or &!l6ona*ide&

SIDE / ADVERSE REACTIONS 5erti"o3 di>>ine&&3 headache3 %are&the&ia3 ortho&tatic hy%oten&ion3 thro*1o%hle1iti&3 a1do*inal %ain3 hy%o;ale*ia3 ane*ia *!&cle &%a&*

NURSING CONSIDERATION To %re5ent noct!ria3 "i5e %re%aration in the *ornin" and early in the a6ternoon Fatch 6or &i"n& o6 h%o;ale*ia do not con6!&e /ith Tor&e*ide or La&i8 /ith Lono8 ad5i&e %atient to ta;e dr!" /ith 6ood to %re5ent GI !%&et in6or* %atient o6 %o&&i1le need 6or %ota&&i!* or *a"ne&i!* &!%%le*ent&

DRUG GENERIC NAME: Nat!ral Ter%ene BRAND NAME: Ro/atine8 CLASSI0ICATI# N Anti!rolithi c D#CT#R'S #RDER: Ro/atine8 2ca% TID DATE STARTED: 0e1r!ary 223 $)2) DATE DISC#NTINUE:

ACTION Pro*ote& a di!re&i& and rela8e& !rinary tract &%a&*3 th!& a&&i&tin" the %a&&a"e o6 &tone&7 The thera%e!tic e66ect& o6 the 1alanced co*1ination o6 ter%ene& red!ce& !rinary tract in6la**ation3 &ti*!latin" renal 1lood 6lo/ thro!"h the ;idney& and increa&in" the o!t%!t o6 le&& concentrated !rine7

INDICATIONS Li,!id inta;e &ho!ld 1e increa&ed d!rin" thera%y Store at te*%7 not e8ceedin" E)oc7Ne%hrolithi a&i&3 Urolithia&i&3Cy& ti&i&3 Renal Colic3 UTI3 Po&t o% %ro%hyla8i& o6 calc!li3 treat*ent o6 !rinary tract &%a&* and in6la**ation7

CONTRAINDICATIO NS Contraindicated in %atient& hy%er&en&iti5e to dr!"

SIDE / ADVERSE REACTIONS CNS: di>>ine&&3 headache GI: Na!&ea3 con&ti%ation7

NURSING CONSIDERATION Li,!id inta;e &ho!ld 1e increa&ed d!rin" thera%y Store at te*%7 not e8ceedin" E)oc7

DRUG GENERIC NAME: #r%henadin e THERAPEUTIC CLASS: S;eletal *!&cle rela8ant& PHARMAC#L#GI C CLASS: Di%henhydr a*ine D#CT#R'S #RDER: #r%henadin eM Paraceta*ol 2ta1 TID DATE STARTED: 0e1r!ary 2$3 $)2) DATE DISC#NTINUE:

ACTION S;eletal *!&cle rela8ation3 %ro1a1ly d!e to CNS de%re&&ion7 Thera%e!tic e66ect&: S;eletal *!&cle rela8ation3 /ith decrea&ed di&co*6ort7

INDICATIONS Ad9!nct to re&t and %hy&ical thera%hy in the treat*ent o6 *!&cle &%a&*7

CONTRAINDICATIO NS Hy%er&en&iti5ity3 Bladder nec; o1&tr!ction3 Pro&tatic hy%er%la&ia3 Gla!co*a3 Mya&thenia Gra5i&3 Pe%tic !lcer di&ea&e3 GI o1&tr!ction7

SIDE / ADVERSE REACTIONS CNS: CNS E8citation3 con6!&ion3 di>>ine&&3dro/&ine&&3 EENT: 1l!rred 5i&ion3 dry eye& GI: con&ti%ation3 dry *o!th GU: Urinary retention

NURSING CONSIDERATION Ad5ice %atient to ta;e *edication a& directed7 Ta;e *i&&ed do&e& /ithin one ho!r=i6 noy3ret!rn to re"!lar do&in" &ched!le7Do not do!1le do&e&7 Enco!ra"e %atient to co*%ly /ith additional thera%ie& %re&cri1ed 6or *!&cle &%a&*@re&t3%hy&ical thera%y3heatA May ca!&e di>>ine&&3dro/&ine&&31l! rred 5i&ion7Ad5ice %atient to a5oid dri5in" and other acti5itie& re,!irin" alertne&& !ntil re&%on&e to dr!" i& ;no/n In&tr!ct %atient to *a;e %o&ition chan"e& &lo/ly to *ini*i>e ortho&tatic retention7 Ad5ice %atient to a5oid conc!rrent !&e o6 alcohol and other CNS de%re&&ant& /hile ta;in" thi& *edication

DRUG GENERIC NAME: 0erro!& S!l6ate THERAPEUTIC CLASS: Anti ane*ic& PHARMAC#L#GI C CLASS: Iron &!%%le*ent D#CT#R'S #RDER: 0erro!& S!l6ate 2ca% #D DATE STARTED: 0e1r!ary 2$3 $)2) DATE DISC#NTINUE:

ACTION An e&&ential *ineral 6o!nd in he*o"lo1in3 *yo"lo1in3 and *any en>y*e&7 Enter& the 1lood &trea* and i& tran&%orted to the or"an& o6 the retic!loendothelial &y&te*@ li5er3 &%leen3 1one *arro/A3 /here it i& &e%arated o!t and 1eco*e& %art o6 iron &tore&7

INDICATIONS Pre5ention or treat*ent o6 iron de6iciency ane*ia in %atient /ith chronic ;idney di&ea&e incl!din" %atient& /ho are not in dialy&i& and %atient& de%endent on dialy&i&

CONTRAINDICATIO NS He*ochro*ato&i&7 He*o&idero&i&3 or other e5idence o6 Iron o5erload= &o*e %rod!ct& contain alcohol3 Tartra>ine3or &!l6ite& &ho!ld 1e a5oided in %atient& /ith ;no/n intolerant& or hy%er&en&iti5ity

SIDE / ADVERSE REACTIONS CNS:di>>ine&&3 headache GI: na!&ea3 dar; &tool&3 "a&tric %ain C+:hy%oten&ion

NURSING CONSIDERATION E8%lain %!r%o&e o6 iron thera%y to %atient7 Enco!ra"e %atient to co*%ly /ith *edication re"i*en Ad5ice %atient that &tool& *ay 1eco*e dar; "reen or 1lac; and that thi& chan"e *ay 1e har*le&&7 In&tr!ct %atient to 6ollo/ a diet hi"h in Iron7

DRUG GENERIC NAME: Si*5a&tatin THERAPEUTIC CLASS: Li%id lo/erin" a"ent& PHARMAC#L#GI C CLASS: HMG CoA Red!cta&e Inhi1itor& D#CT#R'S #RDER: Si*5a&tatin $)*" 2ta1 #D DATE STARTED: 0e1r!ary $(3 $)2) DATE DISC#NTINUE

ACTION Inhi1it& an en>y*e3 E hydro8y E *ethyl"l!tarine coEn>y*e red!cta&e3 /hich i& re&%on&i1le6or cataly>in" an early &te% in the &ynthe&i& o6 chole&terol7

CONTRAINDICATIO NS Ad9!ncti5e Hy%er&en&iti5ity= *ana"e*ent o6 Acti5e Li5er di&ea&e %ri*ary or !ne8%lained hy%erchole&terole* %er&i&tent increa&e in ia and *i8ed AST or ALT=#B3 dy&li%ide*ia& Lactation: Pre"nancy or Secondary lactation @%otential %re5ention o6 6or 6etal ano*alie&A= Cardio5a&c!lar conc!rrent !&e o6 e5ent& in %atient& Ge*6ri1ro>il or /ith clinically A>ole anti6!n"al= CHD or tho&e at conc!rrent !&e o6 hi"h ri&; 6or CHD Nel6ina5ir or Ritona5ir @/ith Lo5a&tatin or Si*5a&tatinA INDICATIONS

SIDE / ADVERSE REACTIONS CNS: di>>ine&&3 headache GI: con&ti%ation3 a1do*inal cra*%& Der*i&: ra&he&

NURSING CONSIDERATION #1tain a dietary hi&tory3 e&%ecially /ith re"ard to 6at con&!*%tion7 LAB te&t con&ideration&: E5al!ate &er!* chole&terol and Tri"lyceride le5el& 1e6ore initiatin"3 a6ter H K /ee;& o6 thera%y3 and %eriodically therea6ter Monitor li5er 6!nction te&t3 incl!din" AST3 1e6ore3 at 2$ /ee;& a6ter initiation o6 thera%y or a6ter do&e ele5ation3 and then e5ery , K *o7 I6 AST le5el increa&e to three ti*e& nor*al3 HMG CoA Red!cta&e Inhi1itor Thera%y &ho!ld 1e red!ce or di&contin!ed7May al&o ca!&e increa&e al;aline %ho&%hata&e and 1ilir!1in le5el7

NAME OF DRUG

ACTION

INDICATION

CONTRAINDICATIO NS

SIDE EFFECTS / ADVERSE REACTIONS Dry *o!th3 1l!rred 5i&ion3 red!ced a1ility to &/eat3 tachycardia3 con&ti%ation3 !rinary retention3 aller"ic &;in reaction&

NURSING CONSIDERATIONS

Generic Na*e: Hyo&ci ne N 1!tyl1 ro*ide

Brand Na*e: A*!ci n B!&co %an

Hyo&cine &to%& the &%a&*& in the &*ooth *!&cle 1y %re5entin" acetylcholine 6ro* actin" on the *!&cle7 It doe& thi& 1y 1loc;in" the rece%tor& on the *!&cle cell& that the acetylcholine /o!ld nor*ally act on7

Cla&&i6ication: CLINICAL: Anti&%a&*odi c D#CT#R'S #RDER: HNBB 2a*% I+ e5ery ho!r&7 DATE STARTED: 0e1r!ary E3 $)2) DATE DISC#NTINUE:

S%a&*& o6 the &to*ach3 inte&tine& or 1ile d!ct @"a&trointe&tina l tractA3 incl!din" tho&e a&&ociated /ith irrita1le 1o/el &yndro*e @IBSA7 S%a&*& o6 the re%rod!cti5e or !rinary &y&te*& @"enito!rinary tractA3 6or e8a*%le %eriod %ain cra*%&7 Mana"e*ent o6 *otion &ic;ne&& L other 6or*& o6 na!&ea L 5o*itin"

Gla!co*a3 %ro&tatic hy%ertro%hy3 tachycardia3 *e"acolon L *echanical &teno&i& in GIT7

Monitor %!l&e and 1lood %re&&!re7 May ca!&e dro/&ine&&3 di>>ine&&3 1l!rred 5i&ion7 A5oid ta&;& re,!irin" alertne&&3 *otor &;ill& !ntil re&%on&e to dr!" i& e&ta1li&hed7 In6or* %hy&ician i6 &e5ere con&ti%ation occ!r7 Dry crac;er&3 cola *ay relie5e na!&ea7 Pal%ate 1ladder 6or !rinary retention7 Si%& o6 te%id /ater *ay relie5e dry *o!th7 Enco!ra"e oral 6l!id& 6or con&ti%ation7