Submitted by: BSN405 - Group 17 Submitte to: Mrs.

Quizaggan FAR EASTERN UNIVERSITY

July 14, 2012

DRUG STUDY
DRUG METH OD OF ADMI NISTR ATION ROUTE : PO DOSE: 1 tab (30mg) FREQU ENCY: OD @ HS MECHANIS M OF ACTION INDICATION ADVERSE EFFECTS CONTRAINDICATION NURSING IMPLICATIO NS

GENERIC NAME: lactulose CLASSIFICATION: Laxative

Lactulose promotes peristalsis by producing an osmotic effect in the colon with resultant distention. In hepatic encephalop athy, it reduces absorption of ammonium ions and toxic

Treatment of constipation an hepatic encephalophaty.

Flatulence, intestinal cramps. Diarrhea in excessive dose. Nausea and vomiting.

Low galactose diet and intestinal obstruction.

Advice that this can be taken with meals to reduce GI discomfort. Mix it with about onehalf glass of water, milk, or fruit juice

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GENERIC NAME: isosorbidemonon itrate(ISMN) CLASSIFICATION: Anti-anginal drug

ROUTE : PO DOSE: 1 tab (60mg) FREQU ENCY: OD @ HS

nitrogenous compounds, resulting in reduced blood ammonia concentrati ons. Thought to reuce cardiac oxygen eman by decreasing preload an afterload. Drug may also increase blood flow through the collateral coronary vessels.

Prevention and long-term treatment of angina pectoris. Treatment of CHF in combination with cardiac glycosides, diuretics, ACE inhibitors & arterial vasodilators; pulmonary HTN

Headache, weakness, dizziness, hypotension, light-headedness, vomiting, diarrhea, and skin redness.

GENERIC NAME: amlodipine CLASSIFICATION: Calcium

ROUTE : PO DOSE:

Inhibits calcium ion influx across cardiac an

Treatment of HTN and prophylaxis of angina

Pregnancy and lactation. Hypersensitivi ty or indiosyncrasy to nitrates and in those with severe hypotension, angle-closure glaucoma, increased intracranial pressure, shock, or acute MI with low left ventricular filling. Edema, headache, Severe arrhythmias including hypotension ventricular tachycardia and aortic stenosis,

Advice to swallow whole; do not chew or crush. Monitor BP and HR and intensity and duration of drug response.

Can be admininister ed with or without

Antagonist

1 tab (5mg) FREQU ENCY: OD

smoothmuscle cells, ilates coronary arteries and arterioles, decreases BO and myocardial oxygen demand.

extreme bradycardia or heart failure, hepatic impairment.

food. Monitor BP frequently during initiation of therapy. Because drug-induced vasodilation has a gradual onset, acute hypotension is rare. Notify prescriber of signs of heart failure occur, such as swelling of hands and feet or SOB. Monitor ECG and electrolyte levels. Monitor renal function.
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GENERIC NAME: Potassium chloride CLASSIFICATION: Potassium supplement

ROUTE : PO DOSE: 1 tab FREQU ENCY: TID

Replaces potassium and maintains potassium level.

Hypokalemia or significant loss of potassium in the body.

CNS: paresthesia of limbs, listlessness, confusion, weakness or heaviness of limbs, flaccid paralysis. CV: post-infusion phlebitis, arrhythmias, heart block, cardiac

Severe renal impairment with oliguria, anuria, or azotemia; with untreated addisons

arrest, ECG changes, hypotension. GI: nausea, vomiting, abdominal pain, diarrhea.

disease; or with acue dehydration, heat cramps, hyperkalemia, extensive tissue breakdown.

After surgery, dont give any drug until urine flow is established. Treat sensitivity Assess lung sounds, PR and BP before drug administratio n and during peak of medication. Observe for paradoxical spasm and withhold medication and notify physician if condition occurs. Advice to take 1 hour
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GENERIC NAME: salbutamol CLASSIFICATION: Anti-asthmatic/ COPD preparation

ROUTE : PO DOSE: 1 tab FREQU ENCY: q6hr

It is a beta 2 Asthma and other conditions adrenocept associated with reversible or agonist. It airway onbstruction. binds therefore to Beta 2 receptors found particularly in the bronchioles of the respiratory system. In binding to these receptors it activates the Gs protein that the receptor

Fine tremor of skeletal muscle, palpitations, tachycardia, nervous tension, headache, peripheral vasodilation. Hypersensitivity reactions including paradoxical bronchospasm, angioedema, urticaria, hypotension and collapse.

Threatened abortion, eclampsia and severe preeclampsia, intrauterine infection and fetal death, antepartum hemorrhage, placenta previa and cord compression. 1st trimester of pregnancy.

is associated with and GDP is exchanged for GTP. This then activates the enzyme adenylatecy clase that coverts ATP into cAMP (a secondary messenger). Increased intracellular cyclic AMP (cAMP) increases the activity of cAMP dependent protein kinase A, which alters the phosphoryla tion of myosin and lowers

before or two hours after meals. Extendedrelease tablet should be swallowedwhole. It should not be crushed or chewed. If administerin g medication through inhalation, allow at least 1 minute between inhalation of aerosol medication. Advise the patient to rinse mouth with water after each
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GENERIC NAME: omeprazole CLASSIFICATION: Antacid

ROUTE : PO DOSE: 1 tab (40 mg) FREQU ENCY: OD @ HS

intracellular calcium levels within the muscle. Lower levels of calcium cause relaxation of the smooth muscle and therefore bronchodila tation. Inhibits Duodenal and Gastric Ulcer, proton Zollinger-Ellison syndrome, pump reflux esophagitis activity by binding to hydrogenpotassium adenosine triphosphat ase, locate at secretory surface of gastric parietal cells, to suppress gastric acid secretion.

inhalation to minimize dry mouth. Inform the patient that Albuterol may cause an unusual or bad taste.

Diarrhea, skin rashes, headache; confusional states, agitation, depression, hallucination.

Hypersensitivi ty to drug or to its components, long-term administratio n of bicarbonate with calcium or milk can cause milkalkali syndrome.

Advice to take immediately before meal

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GENERIC NAME:Carvedilol CLASSIFICATION: Alpha- and betaadrenergic blocker, Antihypertensive

ROUTE : PO DOSE: 1 tab FREQU ENCY: OD

Carvedilol causes vasodilation by blocking the activity of blockers, mainly at alpha-1 receptors. It exerts antihyperte nsive effect partly by reducing total peripheral resistance and vasodilation . It is used in patients with renal impairment, NIDDM or IDDM.

Hypertension, alone or with other oral drugs, especially diuretics. Treatment of mild to severe CHF of ischemic or cardiomyopathic origin with digitalis, diuretics, ACE inhibitors. Left ventricular dysfunction (LVD) after MI Unlabeled uses: Angina (25 50 mg bid)

Hypersensitivity; severe chronic heart failure, bronchial asthma or related bronchospastic conditions; severe hepatic impairment. Patients with NYHA class IV cardiac failure, 2nd or 3rd AV block, sick sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock or severe bradycardia.

For the treatment of acute DVT when administered in conjunction with warfarin; for the treatment of acute pulmonary embolism (PE) when administered in conjunction with warfarin when initial therapy is administered in the hospital; for the prophylaxis of DVT, which may lead to PE in the following patients undergoing: hip fracture surgery,

WARNING: Do not discontinue drug abruptly after chronic therapy (hypersensiti vity to catecholamin es may have developed, causing exacerbation of angina, MI, and ventricular arrhythmias); taper drug gradually over 2 wk with monitoring. Consult with physician about withdrawing drug if patient is to undergo surgery
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including extended prophylaxis; hip replacement surgery; knee replacement surgery; and abdominal surgery in patients who are at risk for thromboemb olic complications . Hypersensitivi ty; severe chronic heart failure, bronchial asthma or related bronchospasti c conditions; severe hepatic impairment. Patients with NYHA class IV cardiac

(withdrawal is controversial ). Give with food to decrease orthostatic hypotension and adverse effects. Monitor for orthostatic hypotension and provide safety precautions. Monitor diabetic patient closely; drug may mask hypoglycemi a or worsen hyperglycemi a. WARNING: Monitor patient for any sign of hepatic
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GENERIC NAME:Fondapari nux Sodium CLASSIFICATION: Selective factor Xa inhibitor

ROUTE : SQ DOSE: 2.5 mg FREQU ENCY: OD

Antithromb oticthe antithromb otic activity of fondaparinu x is the result of antithrombi n III [ATIII]mediated selective inhibition of Factor Xa. By selectively

impairment (pruritus, dark urine or stools, anorexia, jaundice, pain); arrange for LFTs and discontinue drug if tests indicate liver injury. Do not restart carvedilol. For the treatment of acute Anemia,major Patients with Neuraxial DVT when administered in bleeding, minor severe renal anesthesia conjunction with warfarin; for bleeding, impairment and post-op the treatment of acute thrombocytopenia, (CrCl less than indwelling pulmonary embolism (PE) bleeding index 2 or 30 mL/min); epidural when administered in more, postoperative body weight catheter or conjunction with warfarin hemorrhage, clinically less than 50 spinal when initial therapy is overt bleeding, kg (venous puncture administered in the hospital; epistaxis, reoperation thromboemb (risk of for the prophylaxis of DVT, caused by bleeding olism epidural or which may lead to PE in the ,bleeding prophylaxis spinal following patients undergoing: complications. only); active hematoma); hip fracture surgery, including Insomnia and dyspnea. major monitor for extended prophylaxis; hip bleeding; signs and replacement surgery; knee bacterial symptoms of replacement surgery; and endocarditis; neurologic
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failure, 2nd or 3rd AV block, sick sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock or severe bradycardia.

binding to ATIII, fondaparinu x potentiates the innate neutralizatio n of Factor Xa by ATIII. Neutralizati on of Factor Xa interrupts the blood coagulation cascade and thus inhibits thrombin formation and thrombus developmen t. Fondaparinu x does not inactivate thrombin (activated Factor II) and has no

abdominal surgery in patients who are at risk for thromboembolic complications.

thrombocyto penia associated with positive in vitro test for antiplatelet antibody in the presence of fondaparinux; hypersensitivi ty to any component of the product.

impairment. Hepatic or moderate renal impairment (CrCl 30 50mL/min). Monitor hepatic and renal function; discontinue if severe renal impairment develops. Bleeding disorders. Acute ulcerative or angiodysplas tic GI disease. Hemorrhagic stroke. Uncontrolled hypertension . Diabetic retinopathy. Recent brain, spinal, or eye surgery.
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known effect on the platelet function. At the recommend ed dose, fondaparinu x does not affect fibrinolytic activity or bleeding time.

History of heparininduced thrombocyto penia. Obtain CBCs, platelets, serum creatinine level, stool occult blood tests during therapy; discontinue if platelets <100,000 per mm3. Not interchangea ble (unit-forunit) with heparin, low molecular weight heparins, or heparinoids. PE and DVT treatment: low body weight (<50kg). Latex allergy.
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Elderly. GENERIC NAME:Atorvasta tinCLASSIFICATIO N:Statins that lowers the cholesterol in the body ROUTE : PO DOSE: 1 TAB FREQU ENCY: OD Inhibits HMG-CoA, the enzyme that catalyzes the first step in the cholesterol synthesis pathway, resulting in a decrease in serum cholesterol, serum LDLs (associated with increased risk of CAD), and increases serum HDLs (associated with decreased risk of CAD); increases hepatic LDL recapture In adult patients without clinically evident coronary heart disease, but with multiple risk factors for coronary heart disease such as age, smoking, hypertension, low HDL-C, or a family history of early coronary heart disease, LIPITOR is indicated to: Reduce the risk of myocardial infarction Reduce the risk of stroke Reduce the risk for revascularization procedures and angina In patients with type 2 diabetes, and without clinically evident coronary heart disease, but with multiple risk factors for coronary heart disease such as retinopathy, albuminuria, smoking, or hypertension, LIPITOR is indicated to: Reduce the risk of myocardial infarction Constipation, diarrhea, fatigue, gas, heartburn, and headache. Atorvastatin may cause liver and muscle damage. Serious liver damage caused by statins is rare. Liver tests should be performed at the beginning of treatment then as needed thereafter. Inflammation of the muscles caused by statins can lead to serious breakdown of muscle cells called rhabdomyolysis. Rhabdomyolysis causes the release of muscle protein (myoglobin) into the blood, and myoglobin can cause kidney failure and even death. When used alone, statins cause Constipation, diarrhea, fatigue, gas, heartburn, and headache. Atorvastatin may cause liver and muscle damage. Serious liver damage caused by statins is rare. Liver tests should be performed at the beginning of treatment then as needed thereafter. Inflammation of the muscles caused by statins can lead to Evaluate reports of vision changes. (Drug may cause photosensitiv ity. Monitor blood cholesterol and triglyceride levels at intervals during therapy. After beginning treatment levels are rechecked in 2-3 months (to ascertain drug effectiveness ).
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sites, enhances reuptake and catabolism of LDL; lowers triglyceride levels.

Reduce the risk of stroke In patients with clinically evident coronary heart disease, LIPITOR is indicated to: Reduce the risk of non-fatal myocardial infarction Reduce the risk of fatal and non-fatal stroke Reduce the risk for revascularization procedures Reduce the risk of hospitalization for CHF Reduce the risk of angina

rhabdomyolysis in less than one percent of patients. To prevent the development of serious rhabdomyolysis, patients taking atorvastatin should contact their health care professional immediately if they develop unexplained muscle pain, weakness, or muscle tenderness.

serious breakdown of muscle cells called rhabdomyolys is. Rhabdomyoly sis causes the release of muscle protein (myoglobin) into the blood, and myoglobin can cause kidney failure and even death. When used alone, statins cause rhabdomyolys is in less than one percent of patients. To prevent the development of serious rhabdomyolys is, patients

Monitor CPK levels if muscle tenderness or weakness develops. Monitor liver function studies as these drugs may affect liver function.

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GENERIC NAME: Perindopril CLASSIFICATION: Ace inhibitor

ROUTE : PO DOSE: 1 TAB FREQU ENCY: OD

Inhibits angiotensin converting enzyme (ACE) both in vitro and in vivo. It is thought that ACE inhibitors reduce blood pressure by inhibiting the enzyme whichcataly ses the

Essential hypertension. Stable coronary artery disease: reduction of risk of cardiac events in patients with a history of myocardial infarction and/or revascularization. Treatment of symptomatic heart disease or failure.

Hypotension and effects related to hypotension, palpitations, flushing, impaired peripheral circulation, arrhythmia, angina pectoris, myocardial infarction and stroke possibly secondary to excessive hypotension in high risk patients, vasculitis

taking atorvastatin should contact their health care professional immediately if they develop unexplained muscle pain, weakness, or muscle tenderness. Situations where a patient has a history of hypersensitivi ty to Coversyl (perindopril). Renal failure

Hypertension should be managed according to appropriate guidelines. Treatment with an ACE inhibitor can be started in the community in the majority of people with heart failure.
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conversion of angiotensin I to angiotensin II. Decreased plasma angiotensin II leads to increased plasma renin activity and a decrease in aldosterone. In addition to its effects on circulating ACE, perindopril binds to and inhibits tissue converting enzyme, predominan tly in the kidney and

In patients taking diuretics, close supervision is needed when commencing treatment. The initial dose of ACE has a risk of first-dose hypotension, therefore patients should be advised to sit or lie down for 2-4 hours after this.

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Generic name:Acetylcyst eine Classification:Mu colytic

ROUTE : PO DOSE: 1 TAB FREQU ENCY: OD

vascular wall. Acetylcystei nemay decrease the viscosity of secretions by splitting of disulphide bonds in mucoprotei ns. It also promotes the detoxificatio n of an intermediat e paracetamol metabolite which is used in the managemen t of paracetamol overdosage

Treatment of respiratory affections characterized by thick and viscous hypersecretions: acute bronchitis, chronic bronchitis and its exacerbations; pulmonary emphysema, mucoviscidosis and bronchieactasis.

Hypersensitivity reactions have been reported in patients receiving acetylcysteine, including bronchospasm, angioedema, rashes and pruritus. Other adverse effects reported with acetylcysteine include nausea and vomiting, fever, syncope, sweating, arthralgia, blurred vision, disturbances of liver function.

Known hypersensitivi ty to acetylcestein e. As Acetylcystein e (Fluimucil) granules and tablets contain aspartame, it is contraindicat ed in patients suffering from phenylketonu ria.

Patients should be kept hydrated by I.V. infusion of 0.45% (halfnormal) saline at a rate of 1mL/kg of body weight/hour for 12 hours before and 12 hours after the administratio n of the contrast agent according to the patients cardiac or fluid status (a few patients may need frusemide
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20-80mg. If frusemide is used, ensure that overdiuresis does not occur, as this may result in dehydration, which exacerbates contrast nephropathy Check serum urea and creatinine levels on the day before the administratio n of the contrast agent and on the day after the procedure. The renal consultant/r egistrar
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GENERIC NAME:Clopidogr el bisulfate Classification: P2Y12 inhibitors

ROUTE : PO DOSE: 1 TAB FREQU ENCY: OD

Inhibits plateletaggr egation byblocking ADPrecepto rs onplatelets, preventingcl umping of platelets.

Treatment of patients at risk forischemic eventshistory of MI,ischemic stroke,peripheral arterydisease Treatment of patients withacute coronarysyndrome.

CNS: Headache,dizziness, weakness, syncope, flushing Hypertension, edema Rash, pruritus Nausea, GI distress,constipation, diarrhea, GIbleed

should indicate if ACE inhibitors or Angiotensin II (A II) blockers (egirbesartan ) should be suspended before the procedure. Contraindicat Assess edwith allergy forsymptoms toclopidogrel, of stroke, MI activepatholo duringtreatm gicalbleeding ent. such aspeptic ulcer Monitor orintracranial liverfunction hemorrhage,l studies:AST, actation. ALT,bilirubin, creatinine if patient is onlongtermtherapy Monitor bloodstudies: CBC,Hgb, Hct,protime,
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Generic Name:acetylsalic ylic acid Classification:no nsteroidalantiinfl ammatory drug (NSAID)

ROUTE : PO DOSE: 1 TAB FREQU ENCY: OD

Exhibitsanti pyretic, antiinflammator y andanalgesi c effects. The antipyretice ffect is due to anaction on thehypothal amus,resulti ng in heatloss byvasodilati on of peripheral bloodvessel s. Antiinflammator

For pain onintegumentarystructures,m yalgia,neuralgia,headache,dys menorrhea,gout. Arthritis, SLE,acute rheumaticfever

Dyspepsia, heartburn,anorexia, nausea,epigastric discomfort,potentiatio n of pepticulcer. Bronchospasm,asthma -like symptoms,anaphylaxis , skin rashes, urticarial. Prolongation of bleedingtime, thrombocytopenia,leu copenia, Other: Thirst, fever,dimness of vision

cholesterol if thepatient is onlongtermtherapy; thrombocyto penia andneutrope nia mayoccur. Hypersensitivi Assess for ty pain:type, tosalicylates, locationand severeanemia pattern , history of blood Note for coagulationde asthma. fects, vitamin K deficiency, Monitor 1 weekbefore renal,LFTs and and CBC aftersurgery. Determinehis tory of pepticulcers orbleedingte ndencies.

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Generic Name:Spirinolact one Classification:Pot assium-sparing diuretic

ROUTE : PO DOSE: 1 TAB FREQU ENCY: OD

yeffects aremediate d by adecrease inprostaglan dinsynthesis . It alsodecreas es plateletaggr egation. Mild diuretic thatacts on the distaltubule to inhibitsodiu m exchange forpotassiu m, resulting in increasedse cretion of sodiumand waterconser vation of potassium. An Aldosterone antagonist

Primaryhyperaldosteronism, adjunctivetherapy in thetherapy in thetreatment of edemaassociated withCHF, nephriticsyndrome,hepatic cirrhosis,treatment of hypokalemia orprevention of hypokalemia inpatients at highrisk if hypokalemiaoccurs; essentialhypertension.

Dizziness,headache,dr owsiness, rash, cramping, diarrhea,hyperkalemia ,hirsutism,gynecomast ia,deepening of thevoice, irregularmenses.

Acute renalinsufficie ncy,progressi ve renalfailure,h yperkalemia, andanuria. Clientsreceivi ng potassiumsup plements,amil oride ortriamterene .

Instruct clientnot todrive/oper atemachiner y untildrug effects arerealized; maycause drowsiness or uneasy gait. Report if deep,rapidre spirations,he adaches ormental slowingoccur s; mayindicateh yper
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Generic Name: Furosemide Classification: Electrolytic and water balance agent; loop diuretic

ROUTE : PO DOSE: 1 TAB FREQU ENCY: OD

.Manifests a slightantihy pertensiveef fect. Interfereswi th synthesis of testosteron e andmay increasefor mation of estradiol fromestroge n thusleading to endocrineab normalities. Rapid-acting potent sulfonamide loop diuretic and antihyperte nsive with pharmacolo gic effects and uses almost identical to those of

chloremic metabolic acidosis. Remind clientthat intake of Spironolacto nemay causebreast swellingand diminishedse x drive due toreduction of testosterone levels.

Treatment of edema associated with CHF, cirrhosis of liver, and kidney disease, including nephrotic syndrome. May be used for management of hypertension, alone or in combination with other antihypertensive agents, and for treatment of hypercalcemia. Has been used concomitantly with mannitol for treatment of severe cerebral edema, particularly in

Hypovolemia, dehydration, hyponatremia hypokalemia, hypochloremia metabolic alkalosis, hypomagnesemia, hypocalcemia (tetany), hyperglycemia, glycosuria, elevated BUN, hyperuricemia. GI: Nausea, vomiting, oral and gastric

History of hypersensitivi ty to furosemide or sulfonamides; increasing oliguria, anuria, fluid and electrolyte depletion states; hepatic coma;

Observe patients receiving parenteral drug carefully; closely monitor BP and vital signs. Sudden death from cardiac
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ethacrynic acid. Exact mode of action not clearly defined; decreases renal vascular resistance and may increase renal blood flow.

meningitis.

burning, anorexia, diarrhea, constipation, abdominal cramping, acute pancreatitis, jaundice.

pregnancy (category C), lactation.

arrest has been reported. Monitor BP during periods of diuresis and through period of dosage adjustment. Observe older adults closely during period of brisk diuresis. Sudden alteration in fluid and electrolyte balance may precipitate significant adverse reactions. Report symptoms to
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physician. Lab tests: Obtain frequent blood count, serum and urine electrolytes, CO2, BUN, blood sugar, and uric acid values during first few months of therapy and periodically thereafter. Monitor for S&S of hypokalemia. Monitor I&O ratio and pattern. Report decrease or unusual increase in output. Excessive
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diuresis can result in dehydration and hypovolemia, circulatory collapse, and hypotension. Weigh patient daily under standard conditions. Monitor urine and blood glucose & HbA1C closely in diabetics and patients with decompensa ted hepatic cirrhosis. Drug may cause hyperglycemi a. Monitor
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Generic name:

ROUTE

Digoxin is a

Coronary Heart Failure

Extra beats, anorexia,

Digitalis

Digoxin Classification:Car diac glycoside, Cardiotonic

: PO DOSE: 1 TAB FREQU ENCY: OD

cardiac glycoside which has positive inotropic activity characterize d by an increase in the force of myocardial contraction. It also reduces the conductivity of the heart through the atrioventric ular (AV) node. Digoxin also exerts direct action on vascular smooth muscle and indirect effects mediated primarily by the

Atrial fibrillation

nausea and vomiting. Diarrhea in elderly, confusion, dizziness, drowsiness, restlessness, nervousness, agitation and amnesia, visual disturbances, gynecomastia, local irritation (IM/SC inj), rapid IV admin may lead to vasoconstriction and transient hypertension. Potentially Fatal: Cardiac arrhythmias in combination with heart bloc.

toxicity, ventricular tachycardia/fi brillation, obstructive cardiomyopat hy. Arrhythmias due to accessory pathways (e.g. WolffParkinsonWhite syndrome).

apical pulse for 1 min before administerin g; hold dose if pulse < 60 in adult or < 90 in infant; retake pulse in 1 hr. If adult pulse remains < 60 or infant < 90, hold drug and notify prescriber. Note any change from baseline rhythm or rate.

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autonomic nervous system and an increase in vagal activity.

INTAVENOUS THERAPHY TREATMENT/INFUSION PLAIN NORMAL SALINE SOLUTION CLASSIFICATION ISOTONIC INTAVENOUS SOLUTION INDICATION Intravenously, it is used for hydration, and as a carrier to get other things like drugs, banked blood into a person. Irrigating solution during surgery. Medication dilution. Wound cleaning CONTAINDICATION No known contraindication. NURSING RESPONSIBILITIES Sodium chloride injection, USP should be used with great care, if at all, in all patients with congestive heart failure (CHF), severe renal insufficiency, and clinical states in which there is existing edema with sodium retention. Do not connect flexible plastic containers of IV solutions in series connections. Such use could result in air embolism due to
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residual air being drawn from one container before administration of the fluid from a secondary container is completed. Vented IV administration sets with the vent in the open position should not be used with flexible plastic containers. DEXTROSE 5% WATER
Isotonic then hypotonic (once inside the body) Nonpyrogenic Parenteral fluid Electrolyte Nutrient replenisher Refer to complete directions accompanying set Clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such Lactated Ringers and 5% Dextrose Injection, is indicated as a source of water, electrolytes and calories or as an alkalinizing agent. Solutions containing dextrose may be contraindicated in patients with known Allergy to corn or corn products. Suspend container from eyelet support. Remove plastic protector from outlet port at bottom of container. Attach administration set.

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evaluation. Lactated Ringers and 5% Dextrose Injection, USP should be used with caution. Excess administration may result in metabolic alkalosis. Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ions to patients receiving corticosteroids or corticotrophin. Solution containing acetate should be used with caution as excess administration may result in metabolic alkalosis. If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures

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