NAME OF DRUG Generic name: celecoxib Brand name: Celebrex

CLASSIFICATION General Classification: NSAID Analgesic (nonopioid) Functional Classification

Patients Dose: 200mg BID

Specific COX-2 enzyme blocker

MECHANISM OF ACTION Analgesic and antiinflammatory activities related to inhibition of the COX-2 enzyme, which is activated in inflammation to cause the signs and symptoms associated with inflammation; does not affect the COX-1 enzyme, which protects the lining of the GI tract and has blood clotting and renal functions.

Drug Study of INDICATION Celecoxib CONTRAINDICATION

ADVERSE REACTION Acute and long Contraindicated CNS: term treatment of with allergies to headache signs and symptoms sulfonamides, dizziness of rheumatoid celecoxib, NSAIDs, somnolenc arthritis and or aspirin; significant e osteoarthritis. renal impairment; insomnia pregnancy (third fatigue trimester); lactation. Reduction of the tiredness number of tinnitus colorectal polyps in Use cautiously familial with impaired CV: adenomatous hearing, hepatic and MI polyposis (FAP). CV conditions. CVA Management of acute pain. Treatment of primary dysmenorrheal. Relief of signs and symptoms of ankylosing spondylitis. Dermatologic: rash pruritus sweating dry mucous membrane s stomatitis GI: nausea abdominal pain dyspepsia flatulence GI bleed Hematologic: neutropenia eosinophilia leukopenia thrombo cytopenia Other: peripheral

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NURSING RESPONSIBILITIES In patients weighing less than 50kg (110 lb), start therapy at lowest recommended dose. Although drug can be given with or without food, food may decrease GI upset. Before therapy, rehydrate patient. Although celecoxib may be used with low dose aspirin, the combination may increase the risk of GI bleeding. NSAIDs such as celecoxib can cause fluid retention. Closely monitor patient who has hypertension, edema, or heart failure while taking this drug. Instruct patient to immediately report to prescriber signs of GI bleeding (such as bloody vomitus, blood in urine or stool, and black, tarry stools). Instruct patient to take if drug with food if stomach upset occurs. Advise patient that all NSAIDs, including celecoxib, may adversely affect the

Drug Study of Vitamin A NAME OF DRUG Generic name: Vitam in A Brand name: Aquas ol A Patients Dose: CLASSIFICATION General Classification: Multivitamins MECHANISM OF ACTION a coenzyme that stimulates retinal function, bone growth, reproduction, and integrity of epithelial and mucosal tissues. INDICATION RDA Severe Vitamin A deficiency Maintenance dose to prevent reoccurrence of the deficiency CONTRAINDICATION ADVERSE REACTION Contraindicated CNS: with hypersensitivity irritability to any ingredient of headache the drug. ICP contraindicated fatigue orally in patients lethargy with malabsorption syndrome EENT: use cautiously in papillary pregnant patients, edema avoiding doses exopthalm exceeding 800mcg os RE. orthostatic hypotensi on edema Dermatologic: alopecia NURSING RESPONSIBILITIES Assess patients vitamin A intake from all sources. Liquid products are available for nasogastric route. Preparation maybe mixed with cereal or fruit juice. Adequate vitamin A absorption needs suitable dietary protein, fat, vitamin E, and zinc intake and bile secretion Monitor for adverse reaction Warn patient not to take megadoses of vitamins without specific indications, to avoid toxicity. Stressed out to the patient that the drug cant be shared. Instruct patient to protect the drug

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from light. Teach patient about good food sources of vitamin A, such as green and yellow vegetables, hepatic: cantaloupe, and liver jaundice hepatomega Advise patient that liquid product can be mixed with food, if desired. ly Tell patient to notify prescriber for cirrhosis any sign s of overdose(nausea,vomiting,appetite GI: loss, malaise, dry and cracking anorexia skin and lips, irritability, hair loss, epigastric headache, visual disturbances, pain vertigo, bulging area on the top of vomiting the head(fontanels for infants)). and polydipsia dry,cracke d,scaly skin Metabolic: slow growth hypercalce mia and weight loss Musculoskeletal: decalcificati on, periostitis, premature closure of the epiphyses cortical thickening over [Type text]

the radius and tibia Other: splenomegaly, anaphylactic shock Drug Study of Methyldopa NAME OF DRUG Generic name: methyldo pa Brand name: NuMedopa (CAN) Patients Dose: 250mg TID CLASSIFICATION Antihypertensive Sympathetic (centrally acting) MECHANISM OF ACTION Mechanism of action not conclusively demonstrated; probably due to drugs metabolism to alpha-methyl norepinephrine, which lowers arterial BP by stimulating CNS alpha2-adrenergic receptors, which in turn decreases sympathetic outflow from the CNS. INDICATION Hypertension IV methyldopate: Acute hypertensive crisis; not drug of choice because of slow onset of action. Unlabeled use: hypertension of pregnancy. CONTRAINDICATION Contraindicated with hypersensitivity to methyldopa, active hepatic disease, previous methyldopa therapy associated with liver disorders. Use cautiously with previous liver disease, renal failure, dialysis, bilateral cerebrovascular disease, pregnancy, lactation. ADVERSE REACTION CNS: sedation headach e asthenia weaknes s bells palsy parkinso nism NURSING RESPONSIBILITIES Advice patient to report signs of infection, such as fever and sore throat. Tell patient to report adverse reactions but not to stop taking drug. Tell patient to check his weight daily and to report weight gain of more than 5lb (2.227kg). Diuretics can relieve sodium and CV: bradycar water retention. Warn patient that drug dia myocardi may impair mental alertness, particularly at tis orthostat start of therapy. Once daily dose h.s. ic

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hypoten sion edema Dermatologic: rash lupus like syndro me Endocrine: gynecomasti a lactation amenorrh ea galactorrh ea impotence decrease libido GI: nausea vomiting distention constipatio n flatus hepatic necrosis Hematologic: positive [Type text]

minimizes daytime drowsiness. Tell patient to rise slowly and avoid sudden position changes. Tell patient that dry mouth can be relieved with ice chips, sugarless gum, or hard candy. Advise patient that urine may turn dark in bleached toilet bowls.

Coombs test hemolytic anemia leukopenia Other: nasal stuffiness Drug study of Ferrous Sulfate Name of Drug Generic name: ferrous sulfate Brand name: Feosol Classification Oral iron supplement Mechanism of Action Provides elemental iron, an essential component in formation of hemoglobin. Relieves iron deficiency. Indication For iron deficiency. Contraindication Contraindicated in patients hypersensitive to drug or its ingredients; patients with primary hemochromatosis, hemosiderosis, hemolytic anemia, peptic ulcer disease, regional entiritis or ulcerative colitis; and patients receiving repeated blood transfusions. Adverse Reactions GI: N/V Epigastric pain Constipation Diarrhea Black stools Anorexia Other: Temporary staining of teeth Nursing Responsibilities Give tablets with juice or water, but not with or antacids. Dilute liquid forms in juice or water, but not in milk or antacids. To avoid staining teeth, give suspension or elixir with straw and place drops at back of throat. Dont crush or allow patient to chew extended-release forms. GI upset may be related to dose. Preferably, give drug between meals, but if GI upset continues, may give with food, except eggs, milk products,

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coffee and tea, which may impair absorption. Entericcoated or sustained-release forms reduce GI upset but also reduce amount absorbed. Oral iron may turn stools black. Although this unabsorbed iron is harmless, it could mask presence of blood. Drug Study of Hydralazine Name of Drug Generic name: Hydralazi ne Brand name: Apresoli ne Mechanism of Action General Action is Classification: unknown. It is a Antihypersent direct acting ive vasodilator that mainly relaxes arteriolar smooth muscle. Classification Indication . Essential hypertension Preeclampsi a, eclampsia Heart failure Contraindication Adverse Reactions Nursing Responsibilities -Monitor patients blood pressure, pulse rate and body weight frequently. -Monitor CBC, lupus erythematosus cell prepation, and artinuclear antibody titer determination before therapy and periodically during longterm therapy. -Monitor patient closely for any signs of lupuslike syndrome (sore throat,fever, muscle and joint aches,rash). Notify physician immediately if these develop. -Instruct patient to take the

Patients Dose: cap

Contraindicated to CNS: patients with headache hypersensitive to the peripheral drug, with coronary neuritis artery disease, or mitral dizziness valvular rheumatic CV: heart disease. orthostatic use cautiously to hypotension patient with suspected tachycardia cardiac disease, CVA, or edema severe renal inpairment angina pectoris palpitation Dermatologic: rash GI: nausea and vomiting

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diarrhea anorexia Hematologic: neutropenia agronulocytopenia leukopenia thrombocytopenia with or without purpura

drug with food to increase absorption -Inform patient that low blood pressure and dizziness upon standing can be minimized by rising slowly and avoiding Sudden position changes.

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General Action is Classification: unknown. It is Antihypersentive a direct acting vasodilator that mainly relaxes arteriolar smooth muscle.

Essential hypertension Preeclampsia, eclampsia Heart failure

Contraindicated to patients with hypersensitive to the drug, with coronary artery disease, or mitral valvular rheumatic heart disease. use cautiously to patient with suspected cardiac disease, CVA, or severe renal inpairment

CNS: headache peripheral neuritis dizziness CV: orthostatic hypotension tachycardia edema angina pectoris palpitation Dermatologic: rash GI: nausea and vomiting diarrhea anorexia Hematologic: neutropenia agronulocytopen ia leukopenia thrombo Cytopenia with or without purpura EENT: nasal congestion Other: lupuslike syndrome

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Monitor patients blood pressure, pulse rate and body weight frequently. Monitor CBC, lupus erythematosus cell prepation, and artinuclear antibody titer determination before therapy and periodically during long-term therapy. Monitor patient closely for any signs of lupuslike syndrome (sore throat,fever, muscle and joint aches,rash). Notify physician immediately if these develop. Instruct patient to take the drug with food to increase absorption Inform patient that low blood pressure and dizziness upon standing can be minimized by rising slowly and avoiding Sudden position changes. Instructed patient to notify physician if pregnancy is presence.

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