Name of DrugGeneric(Brand)

Classification DoseFrequency

Route

Mechanismof Action

SpecificIndication

Side Effects Nursing Implications

Vitamin B complex

Vitaminsand

Minerals

A coenzyme that stimulate metabolic function and is needed for cell replication, hematopoiesis, and nucleoprotein and myelin synthesis.

Pernicious anemiaCONTRA:~ hypersen-sitive to vitamin B12 or cobalt.~ early Leber’s disease

CV: peripheral vascular thrombosis, heart failure.GI: transient diarrhea.Respi: pulmonary edema.Skin: itching, transitory exanthema, urticaria.Other: anaphylaxis, anaphylactoid reactions with parenteral administration, pain or burning at injection site.

BEFORE:~ Determine reticulocyte count, hct, Vit. B12, iron, folate levels before beginning therapy.~ Obtain a sensitivity test history before administration~ Avoid I.V. administration bec. faster systemic elimination will reduce effectiveness of vitamin.DURING:~ Don’t give large doses of vitamin B12 routinely; drug is lost through excretion.~ Don’t mix parenteral preparation in same syringe with other drugs.AFTER:~ Protect Vit. B12 from light. Don’t refrigerate or freeze.~ Monitor patient for hypokalemia for first 48 hours, as anemia correct itself. Give potassium supplements, as needed.

Name of DrugGeneric(Brand)

Classification DoseFrequency

Route

Mechanismof Action

SpecificIndication

Side Effects Nursing Implications

Acetaminophen(Paracetamol)

antipyretics, nonopioid analgesics

1.2 mLq 4 hr PRN

od

Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS

Mild pain Fever

Hema: hemolytic anemia, neutropenia, leukopenia, pancytopenia.

Hepa: jaundiceMetabolic:

hypoGGI: HEPATIC

FAILURE, HEPATOTOXICITY (overdose)GU: renal failure (high doses/chronic use). Derm: rash, urticaria.

BEFORE:~ Advise parents or

caregivers to check concentrations of liquid preparations. Errors have resulted in serious liver damage.

~ Assess fever; note presence of associated signs (diaphoresis, tachycardia, and malaise).

DURING:~ Adults should not take

acetaminophen longer than 10 days and children not longer than 5 days unless directed by health care professional.

~ Advise mother or caregiver to take medication exactly as directed and not to take more than the recommended amount.

AFTER:~ Advise patient to consult

health care professional if discomfort or fever is not relieved by routine doses of this drug or if fever is greater than 39.5°C (103°F) or lasts longer than 3 days.

DRUG ORDER

TRADE/

BRAND

NAME

PHARMACOLOGIC ACTION

OF DRUG

INDICATIONS AND CONTRA-INDICATIONS

ADVERSE EFFECTS OF THE DRUG

DESIRED ACTION ON THE

CLIENT

Nursing Implications

Omeprazole 20mg tab OD

Omepron

Gastric acid-pump inhibitor: Suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.

INDICATIONS:Short-term treatment of active duodenal ulcer; First-line therapy in treatment of heartburn or symptoms of gastroesophageal reflux disease (GERD); Short-term treatment of active benign gastric ulcer; GERD, severe erosive esophagitis, poorly responsive symptomatic GERD; Long-term therapy: Treatment of pathologic hypersecretory conditions (Zollinger-Ellison syndrome, multiple adenomas, systemic mastocytosis); Eradication of H. pylori with amoxicillin or metronidazole and clarithromycin; Prilosec OTC: Treatment of frequent heartburn (2 or more days per wk); Unlabeled use: Posterior laryngitis; enhance efficacy of pancreatin for the treatment of steatorrhea in cystic fibrosisCONTRAINDICATIONS:Contraindicated with hypersensitivity to omeprazole or its components;Use cautiously with pregnancy, lactation.

CNS: Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalitiesDermatologic: Rash, inflammation, urticaria, pruritus, alopecia, dry skinGI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophyRespiratory: URI symptoms, cough, epistaxisOther: Cancer in preclinical studies, back pain, fever

Treatment of active benign gastric ulcer

AssessmentHistory: Hypersensitivity to omeprazole or any of its components; pregnancy, lactationPhysical: Skin lesions; T; reflexes, affect; urinary output, abdominal exam; respiratory auscultationInterventionsAdminister before meals. Caution patient to swallow capsules whole—not to open, chew, or crush them.Arrange for further evaluation of patient after 8 wk of therapy for gastroreflux disorders; not intended for maintenance therapy. Symptomatic improvement does not rule out gastric cancer, which did occur in preclinical studies.Administer antacids with omeprazole, if needed.Teaching pointsTake the drug before meals. Swallow the capsules whole; do not chew, open, or crush them. This drug will need to be taken for up to 8 wk (short-term therapy) or for a prolonged period (> 5 yr in some cases).Have regular medical follow-up visits.These side effects may occur: Dizziness (avoid driving or performing hazardous tasks); headache (request medications); nausea, vomiting, diarrhea (maintain proper nutrition); symptoms of upper respiratory tract infection, cough (do not self-medicate; consult with your health care provider if uncomfortable).Report severe headache, worsening of symptoms, fever, chills.