Acetazolamide

Acetazolamide
Trade name: Diamox
Drug class: Diuretics
Therapeutic action:
• Carbonic anhydrase inhibitor.
Dosage:
Indication:
• Treatment of glaucoma.
• Reduce pressure of the eye.
• Adjunctive treatment of edema due to C.H.F.
Contraindication:
• Hypersensitivity.
• Pt with diabetes or gout.
• Pt on restricted Na intake.
• Pregnant and lactation.
Side effects:
• GI upset.
• loss of appetite .
• numbness and tingling .
• increased thirst and urination.
• drowsiness, headache, confusion, fever.
• blood in urine .
• painful urination .
• yellowing of the skin or eyes.
• unusual bleeding or bruising.
Nursing consideration:
• Instruct pt not to drive the car when he take this drug
• Monitor intake and output.
• Measure electrolytes levels.
• Tell pt about predictable side effects.
• Advise pt avoid prolonged exposure to sunlight.

Alporazolam
Trade name : Xanax.
Drug class: Benzodiazepines.
Therapeutic action: It works by decreasing abnormal excitement in the brain.
Dosage: Tab 0.25 - 0.5 mg t.i.d.
Indications:
• Treatment of anxiety disorders.
• Panic attacks.
• Treatment of depression.
• Fear of open spaces (agoraphobia).
• Premenstrual syndrome.
Contraindications:
• Hypersensitivity.
• Respiratory depressant.
• Acute pulmonary insufficiency.
Side effects:
• Drowsiness, confusion, dizziness, irritability.
• Light-headedness
• Tiredness
• Talkativeness, Dry mouth
• Changes in sex drive or ability
• Changes in appetite
• Weight changes
• Difficulty urinating
Nursing considerations:
• Given with caution to pt with:
1. Hepatic diseases, and Chronic renal failure.
2. Chronic pulmonary insufficiency.
3. Pregnancy, labor, and lactation.
• Advise pt avoid prolonged exposure to sunlight.
• Instruct pt not to drive the car when he take this drug
Haloperidol
Trade name: Haldol.
Drug class: Antipsychotic drugs.
Therapeutic action:
• Causes antidopaminergic activity in the limbic systems.
Dosage: 0.5 – 5 mg p.o b.i.d/t.i.d. increasing p.r.n.
Indications:
• Treatment symptoms of mania such as over activity.
• Treatment and control of acute sings of schizophrenia.
• Treatment of organic syndromes such as brain damage.
• May prescribe for control nausea and vomiting.
Contraindications:
• Hypersensitivity.
Side effects:
• Drowsiness, confusion.
• Dry mouth.
• Constipation.
• Headache, fever.
• Weight gain.
• Tremor
• Seizures or convulsions.
• Fast, irregular, or pounding heartbeat.
Nursing considerations:
• Assess for vital sings.
• Advise pt avoid prolonged exposure to sunlight.
• Instruct pt not to drive the car when he take this drug
• Advice pt to take fibers diets to prevent constipation.
• urine may turn pink or reddish-brown; this effect is not harmful.




Thioradazin
Trade name: Ridazin, Mellaril.
Drug class: Phenothiazine group II - antipsychotic.
Therapeutic action: block postsynaptic dopaminergic, act as antiemetic by inhibition of medullary chemoreceptors.
Dosage: Adult : 25mg p.o t.i.d.
Children: 0.5 – 3 mg/kg b.i.d.
Indications:
• Second line for treatment of schizophrenia.
Contraindications:
• Hypersensitivity.
• Sever CNS depress.
• Comatose states.
• Hypotension.
• Hepatic diseases.
Side effects:
• Drowsiness, dizziness, blurred vision
• Unusual face, mouth, or jaw movements
• Upset stomach, diarrhea, constipation, vomiting.
• Dry mouth
• Headache
• Weight gain
• Yellowing of the skin or eyes
Nursing considerations:
• Assess for dehydration.
• Advise pt avoid prolonged exposure to sunlight.
• Instruct pt not to drive the car when he take this drug
• Given with caution to Pregnant, labor, and lactation women.
• Shake the liquid suspension well before each use to mix the medication evenly


Valproic acid
Trade name: Depalept.
Drug class: Antiepileptic
Therapeutic actions:
Mechanism of action not understood: antiepileptic activity may be related to the metabolism of the inhibitory neurotransmitter.
Dosage: 10–15 mg/kg/day p.o, and maximum dose 60 mg/kg/day.
Indications:
• Sole and adjunctive therapy in simple and complex absence seizures
• Treatment of epilepsy in children > 10 yr; treatment of acute manic or mixed episodes associated with bipolar disorder.
• Adjunctive therapy with multiple seizure types, including absence seizures
• Treatment of bipolar mania
• Prophylaxis of migraine headaches
• Treatment of complex partial seizures as monotherapy or with other antiepileptics
Contraindications:
• hypersensitivity, hepatic disease or significant hepatic dysfunction.
Side effects:
• CNS: Sedation, tremoremotional upset, depression, psychosis, aggression, hyperactivity, behavioral deterioration, weakness.
• Dermatologic: Transient increases in hair loss, rash, petechiae.
• GI: GI up set , abdominal cramps, anorexia with weight loss, increased appetite with weight gain, pancreatitis, hepatic failure.
Nursing consideration:
• Take this drug exactly as prescribed.
• Have frequent checkups, including blood tests, to monitor your drug response. Keep all appointments for checkups.
• Use contraceptive techniques at all times. If you wish to become pregnant, you should consult your health care provider.
• If you have diabetes, this drug may interfere with urine tests for ketones.
• Use cautiously with children < 2 years.
Lithium
Trade name: Eskalith, Lithobid.
Drug class: Antimanic drug
Therapeutic actions:
Mechanism is not known; alters sodium transport in nerve and muscle cells; inhibits release of norepinephrine and dopamine, but not serotonin, from stimulated neurons; slightly increases intraneuronal stores of catecholamines.
Dosage: Individualize dosage according to serum levels and clinical response.
• Acute mania: 600 mg PO tid
• Long-term use: 300 mg PO tid–qid
Indications:
• Treatment of manic episodes of manic-depressive illness; maintenance therapy to prevent or diminish frequency and intensity of subsequent manic episodes
• Unlabeled use: Improvement of neutrophil counts in patients with cancer.
Contraindications:
• Contraindicated with hypersensitivity to tartrazine; significant renal or CV disease; severe debilitation, dehydration; sodium depletion, patients on diuretics (lithium decreases sodium reabsorption, and hyponatremia increases lithium retention); pregnancy; lactation.
Side effects:
• CNS: Tremor, confusion, drowsiness, blurred vision, ataxia.
• GI: Persistent GI upset, gastritis, abdominal pain,flatulence, indigestion.
• CV: ECG changes; hyperkalemia, rhythmias, CHF, diffuse myocarditis.
• Dermatologic: Pruritus with or without rash.
Nursing considerations:
• Take this drug exactly as prescribed, after meals or with food or milk.
• Eat a normal diet with normal salt intake; maintain adequate fluid intake (at least 2.5 quarts/day).
• Arrange for frequent checkups, including blood tests. Keep all appointments for checkups to get the most benefits with the least toxicity.
• Assess for S & S of side effects
• Discontinue drug when toxicity occur.
• Use cautiously with protracted sweating and diarrhea; suicidal or impulsive patients; infection with fever.
Potassium chloride
Drug class: Electrolytes.
Therapeutic actions:
Principal intracellular cation of most body tissues, participates in a number of physiologic processes—maintaining intracellular tonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscle, maintenance of normal renal function; also plays a role in carbohydrate metabolism and various enzymatic reactions.
Dosage: Prevention of hypokalemia: 16–24 mEq/day PO.
Treatment of potassium depletion: 40–100 mEq/day PO
Indications:
• Prevention and correction of potassium deficiency; when associated with alkalosis, use potassium chloride; when associated with acidosis, use potassium acetate, bicarbonate, citrate, or gluconate
• IV: Treatment of cardiac arrhythmias due to cardiac glycosides
Contraindications:
• allergy to tartrazine, aspirin, severe renal impairment with oliguria, anuria,untreated Addison's disease; hyperkalemia; adynamia episodica hereditaria; acute dehydration; heat cramps;
• GI disorders that delay passage in the GI tract.
• Use cautiously with cardiac disorders, especially if treated with digitalis, pregnancy, lactation.
Side effects:
• Dermatologic: Rash
• GI: GI upset, GI obstruction, GI bleeding, GI ulceration or perforation
• Hematologic: Hyperkalemia, ECG changes.
• Local: Tissue sloughing, local necrosis, local phlebitis, and venospasm with injection.
Nursing consideration:
• Take drug after meals or with food and a full glass of water to decrease GI upset.
• Do not use salt substitutes.
• You may find wax matrix capsules in the stool. The wax matrix is not absorbed in the GI tract.
• Have periodic blood tests and medical evaluation.
• Report tingling of the hands or feet, unusual tiredness or weakness, severe nausea, vomiting, black or tarry stools, pain at IV injection site.
Imipramine
Trade name: Tofranil.
Drug class: Antidepressant.
Indications:
• Treatment of depression.
• Treatment of chronic pain.
• Treatment of panic disorders.
• Treatment of eating disorders.
Contraindications:
• Hypersensitivity.
Side effects:
• Upset stomach, constipation.
• Drowsiness
• Weakness or tiredness
• Excitement or anxiety
• Insomnia
• Nightmares
• Dry mouth
• Changes in appetite or weight
• Difficulty urinating
• Blurred vision
• Excessive sweating
• Skin more sensitive to sunlight than usual
Nursing considerations:
• Smoking may decrease the effectiveness of this drug.
• Advise pt avoid prolonged exposure to sunlight.
• Instruct pt not to drive the car when he take this drug
• Given with caution to Pregnant, labor, and lactation women.
• Taken with or without food



Sodium bicarbonate
Trade name: Baking Soda, Citrocarbonate.
Drug class: Antacid.
Indications:
• Relieve heartburn
• Acid indigestion.
• Make your blood or urine less acidic in certain conditions.
Contraindication:
• Heart diseases
• Dehydration.
Side effects:
• Increased thirst
• Gas
• Headache
• Irritability
• Upset stomach
• Loss of appetite
• Weakness
• Slow breathing
• Swelling of feet or lower legs
• Bloody, black, or tarry stools
• Blood in your urine
• Frequent urge to urinate.
Nursing consideration:
• Be aware if the pt take another antacid drugs.
• Monitor intake and output.
• Assess for respiratory rate.



Magnesium sulfate
Class: Electrolytes.
Use: hypomagnesaemia
Dosage:
• Adult: 8-4 mEq daily added to hyperelemination solution.
• Children: 2-10 mEq daily added to hyperelemination solution.
Contraindications:
• Impaired renal function.
• Myocardial damage.
• Heart block.
Side effects:
CNS: hypokalemia, hypoglycemia, drowsiness, respiratory depressant, toxicity lead to absent deep tendon reflexes
CV: slow, weak pulse, hypotension.
Skin: flushing, sweating.
Nursing considerations;
• Monitor V/S.
• IV bolus dose must be injected slowly to avoid respiratory depressant.
• Keep I.V calcium available to reverse Mg toxicity.
• Monitor intake and output.
• Check Mg level after repeated doses.