Complete the drug study of the ordered drug below.
You may use a drug handbook such as Lippincott’s Nursing Drug Guide as your reference.
Dr. Garcia ordered the drug: Diazepam 10mg p.o q6h-q8h PRN
Patient HRN: 1234567 Age/Gender: 30/M Rm: 102
Admitting Diagnosis: Alcohol Withdrawal Birthday: 1/24/1990
Drug Mechanism of Action Indications or Contraindications Side Effects Adverse Reactions Nursing Responsibilities
Purpose
Diazepam is a benzodiazepine Valium is indicated for Side effects most
Generic Name: tranquilliser with anticonvulsant, the management of Valium is commonly reported Like most benzodiazepines, It is crucial to monitor respiratory and
sedative, muscle relaxant and anxiety disorders or for were drowsiness, the adverse reactions of
contraindicated in cardiovascular status, blood pressure, heart
amnesic properties. the shortterm relief of diazepam include CNS and
Diazepam patients with a known fatigue, muscle rate, and symptoms of anxiety in patients
the symptoms of weakness, respiratory depression,
hypersensitivity to taking diazepam. With long-term use,
anxiety. Anxiety or and ataxia. The dependence, and
_______________ Benzodiazepines, such as diazepam, diazepam and, monitor liver enzymes, CBC, and for signs of
bind to receptors in various regions tension associated with because of lack of following have also benzodiazepine withdrawal propylene glycol toxicity, including serum
the stress of everyday been syndrome.
of the brain and spinal cord. This sufficient clinical creatinine, BUN, serum lactate, and
binding increases the inhibitory life usually does not experience, in reported:Central Serious adverse effects of osmolality gap. With critically ill patients,
effects of gamma-aminobutyric acid require treatment with pediatric patients Nervous diazepam include: monitor the depth of sedation
Brand Name: an anxiolytic. In acute System: confusion,
(GABA). GABAs functions include under 6 months of
CNS involvement in sleep induction. alcohol withdrawal, age. Valium is also depression, dysarthri Respiratory Assess blood pressure, pulse and respiration
Valium Also involved in the control of Valium may be useful in contraindicated in a, headache, slurred depression if IV administration.
hypnosis, memory, anxiety, epilepsy the symptomatic relief patients speech, tremor, verti
_______________ and neuronal excitability of acute with myasthenia go Gastrointestinal Seizures
- Provide frequent sips of water for dry
agitation, tremor, gravis, severe System: constipation
Suicidality mouth.
impending or respiratory ,nausea, gastrointes
acute delirium insufficiency, severe tinal disturbances Dependency and - Provide fluids and fibre for constipation.
tremens and hepatic insufficiency, Special abuse
hallucinosis. and sleep Senses: blurred
apnea syndrome. It vision, diplopia, Withdrawal - Evaluate therapeutic response, mental
Classification: state and physical dependency after long-
may be used in dizziness symptoms
Cardiovascular term use.
patients with open-
Cardiovascular
angle glaucoma who System: hypotension
Psychiatric and
Paradoxical collapse
Benzodiazepines are receiving
appropriate therapy, Reactions: stimulatio Bradycardia
_______________ but is contraindicated n, restlessness,
in acute narrow- acute hyperexcited Hypotension
angle glaucoma. states, anxiety,
agitation, Syncope
aggressiveness,
Paradoxical CNS
irritability, rage,
stimulation
hallucinations,
Dose, Route & Timing: psychoses,
delusions, increased
Depending upon muscle spasticity,
severity of symptoms— insomnia, sleep
2 mg to 10 mg, 2 to 4 disturbances, and
times daily nightmares.
Inappropriate
Rectal, Oral, IM, IV behavior and other
adverse behavioral
2 to 4 times daily.. effects have been
reported when
using benzodiazepin
es. Should these
occur, use of the
drug should be
discontinued. They
are more likely to
occur in children and
in the elderly.
Reference/s:
https://www.rxlist.com/valium-drug.htm
https://www.infomed.ch/100drugs/dialit.html
Complete the drug study of the ordered drug below. You may use a drug handbook such as Lippincott’s Nursing Drug Guide as your reference.
Dr. Postrano ordered the drug: Dantrolene 25mg p.o OD for 7 days
Patient HRN: 1234567 Age/Gender: 30/F Rm: 102
Admitting Diagnosis: Multiple Sclerosis Birthday: 10/24/1990
Drug Mechanism of Action Indications or Contraindications Side Effects Adverse Reactions Nursing Responsibilities
Purpose
Unlike the classic paralytic drowsiness, Monitor for therapeutic effectiveness.
Generic Name: medications that function by Dantrium is indicated in Active hepatic disease, dizziness, The most frequently Improvement may not be apparent until 1
blocking postsynaptic acetylcholine controlling the such as hepatitis and weakness, occurring side effects of wk or more of drug therapy.
Dantrolene receptors, dantrolene acts manifestations of cirrhosis, is a tiredness, Dantrium have been Monitor vital signs during IV infusion. Also
intracellularly in skeletal muscle to clinical spasticity contraindication for nausea, drowsiness, dizziness, monitor ECG, CVP, and serum potassium.
_______________
lessen the excitation-contraction resulting from upper use of Dantrium. vomiting, weakness, general malaise, Supervise ambulation until patient's
coupling interaction between actin motor neuron disorders Dantrium is stomach pain, fatigue, and diarrhea. These reaction to drug is known. Relief of
and myosin within the individual (e.g., spinal cord injury, contraindicated where and are generally transient, spasticity may be accompanied by some loss
sarcomere. stroke, cerebral palsy, spasticity is utilized to diarrhea as the occurring early in of strength.
or multiple sclerosis). It sustain upright body adjusts to treatment, and can often be Note: Most common adverse effects are
Brand Name: generally transient, lasting up to 14 d after
is of particular benefit posture and balance in this medication, obviated by beginning with
to the patient whose locomotion or which usually a low dose and increasing initiation of therapy. Keep physician
Dantrium functional rehabilitation whenever spasticity is dosage gradually until an informed.
lessens after
has been retarded by utilized to obtain or several days optimal regimen is Monitor patients with impaired cardiac or
_______________ the sequelae of maintain increased established. Diarrhea may pulmonary function closely for
spasticity. Such patients function. be severe and may cardiovascular or respiratory symptoms
must have presumably necessitate temporary such as tachycardia, BP changes, feeling of
reversible spasticity withdrawal of Dantrium suffocation.
where relief of spasticity therapy. If diarrhea recurs Monitor for and report symptoms of allergy
will aid in restoring upon readministration of and allergic pleural effusion: Shortness of
Classification: residual function. Dantrium, therapy should breath, pleuritic pain, dry cough.
Dantrium is not probably be withdrawn Alert physician if improvement is not
indicated in the permanently. evident within 45 d. Drug may be
direct-acting skeletal
treatment of skeletal discontinued because of the possibility of
muscle relaxant
muscle spasm resulting
hepatotoxicity (see Appendix F).
_______________ from rheumatic Lab tests: Perform baseline and regularly
disorders. scheduled hepatic function tests (alkaline
phosphatase, AST, ALT, total bilirubin),
blood cell counts, and renal function tests.
Monitor bowel function. Persistent diarrhea
may necessitate drug withdrawal. Severe
constipation with abdominal distention and
Dose, Route & Timing:
signs of intestinal obstruction have been
reported.
25 mg once daily for
seven days, Oral, Once
a day
Reference/s:
JHP Pharmaceuticals, LLC. Rochester, MI, 48307 retrieved from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/017443s043s046s048s049lbl.pdf
https://www.rxlist.com/dantrium
Ratto D, Joyner RW. Dantrolene. [Updated 2020 Apr 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK535398/
Complete the drug study of the ordered drug below. You may use a drug handbook such as Lippincott’s Nursing Drug Guide as your reference.
Dr. Garcia ordered the drug: Nalbuphine 10mg q6h x6 doses
Patient HRN: 1234567 Age/Gender: 30/F Rm: 102
Admitting Diagnosis: G2P1 38 weeks AOG for CS Birthday: 10/24/1990
Drug Mechanism of Action Indications or Contraindications Side Effects Adverse Reactions Nursing Responsibilities
Purpose
Common side effects
Generic Name: Nalbuphine is an agonist at kappa NUBAIN is indicated for NUBAIN is of Nubain include: The most frequent adverse ● Assess type, location, and intensity of pain
opioid receptors and an antagonist the management of contraindicated in reaction in 1066 patients before and 1 hr after IM or 30 min (peak)
Nalbuphine at mu opioid receptors. pain severe enough to patients with: flushing treated in clinical studies after IV administration. When titrating
require an opioid (warmth, tingling, or with NUBAIN was sedation opioid doses, increases of 25– 50% should be
_______________ analgesic and for which • Significant redness), 381 (36%). Less frequent administered until there is either a 50%
alternative treatments respiratory depression nausea, reactions were: reduction in the patient’s pain rating on a
are inadequate. NUBAIN vomiting, sweaty/clammy 99 (9%), numeric or visual analogue scale or the
can also be used as a • Acute or severe nausea/vomiting 68 (6%), patient reports satisfactory pain relief. A
stomach
supplement to balanced bronchial asthma in an cramps or pain, dizziness/vertigo 58 (5%), repeat dose can be safely administered at
Brand Name: anesthesia, for unmonitored setting dry mouth 44 (4%), and the time of the peak if previous dose is
upset
preoperative and or in the absence of stomach, headache 27 (3%). Other ineffective and side effects are minimal.
Nubain postoperative analgesia, adverse reactions which Patients requiring doses higher than 20 mg
resuscitative dizziness,
and for obstetrical equipment occurred (reported should be converted to an opioid agonist.
_______________ spinning
analgesia during labor incidence of 1% or less) Nalbuphine is not recommended for
sensation,
and delivery. were: CNS Effects: prolonged use or as first-line therapy for
• Known or suspected dry mouth,
Nervousness, depression, acute or cancer pain.
gastrointestinal bitter or
restlessness, crying,
obstruction, including unpleasant taste in
euphoria, floating, hostility, ● An equianalgesic chart (see Appendix B)
paralytic ileus your mouth,
unusual dreams, confusion, should be used when changing routes or
sweating,
Classification: faintness, hallucinations, when changing from one opioid to another.
• Hypersensitivity to skin itching dysphoria, feeling of
nalbuphine to any of or burning heaviness, numbness, ● Assess BP, pulse, and respirations before
Opioid Analgesics the other ingredients sensation, tingling, unreality. The and periodically during administration. If
in NUBAIN. rash, Reference ID: 4027891 respiratory rate is 10/min, assess level of
_______________ headache, incidence of
nervousnes sedation. Physical stimulation may be
psychotomimetic effects, sufficient to prevent significant
s, such as unreality, hypoventilation. Dose may need to be
restlessness depersonalization, decreased by 25– 50%. Nalbuphine produces
, delusions, dysphoria and respiratory depression, but this does not
depression, hallucinations has been
strange dre
Dose, Route & Timing: ams, shown to be less than that markedly increase with increased doses.
slurred which occurs with
10mg/mL, speech, or pentazocine. ● Assess previous analgesic history.
intramuscular, blurred Antagonistic properties may induce
subcutaneous, or vision. withdrawal symptoms (vomiting,
intravenous, 3-6hr restlessness, abdominal cramps, and
increased BP and temperature) in patients
physically dependent on opioids.
● Although this drug has a low potential for
dependence, prolonged use may lead to
physical and psychological dependence and
tolerance. This should not prevent patient
from receiving adequate analgesia. Most
patients who receive nalbuphine for pain do
not develop psychological dependence. If
tolerance develops, changing to an opioid
agonist may be required to relieve pain.
● Lab Test Considerations: May
causeqserum amylase and lipase
concentrations.
● Toxicity and Overdose: If an opioid
antagonist is required to reverse respiratory
depression or coma, naloxone (Narcan) is
the antidote. Dilute the 0.4-mg ampule of
naloxone in 10 mL of 0.9% NaCl and
administer 0.5 mL (0.02 mg) by direct IV
push every 2 min. For children and patients
weighing 40 kg, dilute 0.1 mg of naloxone in
10 mL of 0.9% NaCl for a concentration of 10
mcg/mL and administer 0.5 mcg/kg every 2
min. Titrate dose to avoid withdrawal,
seizures, and severe pain.
Reference/s: https://davisplus.fadavis.com/3976/meddeck/pdf/nalbuphine.pdf
