Download - Final Drug Study (Eclampsia Patient)
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GenericName
(BrandName)
Dosage,Timing
andRoute
ClassificationGeneral Class
and Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
Lactulose(Duphalac)
15cc,(HS)OD, PO
Ammoniareductiondrug
Laxative
Treatment ofconstipationPreventionand treatmentof postal-systemicencephalopath
y
Drug passesunchanged intocolon wherebacteria break itdown to organicacid that increasethe osmotic
pressure in colonand slightlyacidify coloniccontents resultingin increase stoolwater content,stool softening.This also result inmigration of bloodammonia into
colon contentswith subsequenttrapping andexpulsion infeces.
GI: flatulence,distention,intestinalcramps,belching,diarrhea,nausea
Other: acid-baseimbalance,electrolyteimbalance
Extremely darkor cloudy syrupmay be unsafe.Dont use.
Give with fruitjuice, water or
milk
Administerretention enemausing rectalballoon catheter,dont usecleansing enema
Dont administer
with otherlaxative
Monitor serumammonia levelCarefully monitorblood glucoselevels in diabeticpatients
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Generic Name(Brand Name)
Dosage,Timing
andRoute
ClassificationGeneral Class
and Family
Indications Mechanismof Action
Side Effects Nursing Considerations
KetorolacTromethamine(Acular LS,Acular PF)
10 mg(1tab),q8, PO
Antipyr
etic
Nonopi
oid
analges
ic
NSAID
Short-termmanagement of pain(up to 5days)
Opthalmic:relief ofocularitching dueto seasonalconjuctivitisand relief ofpostopearativeinflammation aftercataractsurgery
Anti-inflammatoryandanalgesicactivity,inhibitsprostaglandi
ns andleukotrienesynthesis
CNS: drowsiness,abnormalthinking,dizziness,euphoria,headacheRESP: asthma,
dyspneaCV:Edema, pallor,vasodilationGI:GI Bleeding,abnormal taste,diarrhea, drymouth,dyspepsia, GI
pain, nauseaGU:Oliguria,renal toxicity,urinary frequencyDERMA:pruritis,purpura,sweating,urticaria
Patients who haveasthma, aspirin-inducedallergy, and nasal polypsare at increased risk fordevelopinghypersensitivityreactions. Assess for
rhinitis, asthma, andurticaria.
Assess pain (note type,location, and intensity)prior to and 1-2 hrfollowing administration
Ketorolac therapyshould always be given
initially by the IM or IVroute. Oral therapyshould be used only asa continuation ofparenteral therapy.
Caution patient to avoidconcurrent use ofalcohol, aspirin,
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HEMA:prolongedbleeding timeLOCAL: injection
site pain NEURO:paresthesiaMISC:allergic reaction,anaphylaxis
NSAIDs,acetaminophen, or otherOTC medicationswithout consulting health
care professional.
Advise patient to consultif rash, itching, visualdisturbances, tinnitus,weight gain, edema,black stools, persistentheadche, or influenza-like syndromes(chills,fever,muscles
aches, pain) occur.
Effectiveness of therapycan be demonstrated bydecrease in severity ofpain. Patients who donot respond to oneNSAIDs may respond toanother.
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GenericName(BrandName)
Dosage,TimingandRoute
ClassificationGeneralClass andFamily
Indications Mechanism ofAction
Side Effects NursingConsiderations
N-Acetylcysteine
(Broncoflem)
20mgsachet+ 50
mLwater,BIDOD,PO
Respir
atory
and
intratracheal
inhala
nt
Mucoly
tic
An
Antidot
e.
adjuncttreatment forabnormally
viscid mucoussecretionspresent in acuteand chronicbronchopulmonary disease andpulmonarycomplication ofcystic fibrosis,tracheostomy
care
treatment ofacetaminophenoverdose.prevention ofrenal damagefrom dyes givenduring certain
Acetylcysteine splitslinkage ofmucoproteins. It
reduces theviscosity ofpulmonarysecretions,facilitates removalby coughing,postural drainage,mechanical means.Acetylcysteineprotects against
acetaminophenoverdose-inducedliver toxicity.
Stickiness onface
Transientunpleasant odor
Increasedbronchialsecretions
Irritated throat
Nausea
Vomiting
Rhinorrhea
Skin rash
Assesspretreatment
respirations forrate, depth, andrhythm.
If bronchospasmoccurs, stop thetreatment andnotify thephysician.
Monitor rate,depth, rhythm,and type ofrespiration
Check sputum forcolor, consistencyand amount.
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diagnostic testslike CT scan.
Facial edema
Bronchospasm
Wheezing
GenericName(BrandName)
Dosage,TimingandRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects Nursing Considerations
Amlodipi
ne(Alzor)
10mg
(1tab),OD, PO
Calciu
mchannel
blocker
anti-
hyperte
nsive
anti-
anginal.
used to
managehypertension, chronicstableangina, andvasospasticangina. Itmay beused aloneor with
other anti-hypertensives or anti-anginals.
Amlodipine
inhibits calciummovementacross cellmembranes ofcardiac andvascularsmoothmuscle. Itdilatescoronary
arteries,peripheralarteries andarterioles.Amlodipinedecreases totalperipheralvascularresistance by
Peripheraledema
Headache
Flushing
Dizziness
Palpitations
Nausea
Unusualtiredness orweakness
Chest pain
Assess baseline renaland liver function.
Assess blood pressure.
Assess apical pulse.
Assess for peripheraledema behind medialmalleolus.
Assess skin forflushing.
Question for headacheand weakness.
May be given without
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vasodilation. Bradycardia
OrthostaticHypotension
regards to food.
Grapefruit juice mayincrease drug
concentration
GenericName(BrandName)
Dosage,TimingandRoute
ClassificationGeneralClassandFamily
Indications Mechanism ofAction
Side Effects NursingConsiderations
Furosemide(Lasix)
50mg(1tab),OD, PO
Loopdiuretic
Treatment ofedemaassociated withcongestiveheart failure,chronic renalfailure, hepaticcirrhosis, andacute
pulmonaryedema
It is also usedfor treatment ofhypertension,alone or incombinationwith other
Enhancesexcretion ofsodium,chloride,potassium bydirect action atascendinglimb of loop ofHenle and
produces adiuretic effect.
Increase inurinaryfrequency orvolume
Nausea
Gastric upset
with cramping
Diarrhea orconstipation
Electrolytedisturbances
Dizziness or light
Give with food toavoidgastroinestinalupset, preferablywith breakfast (toprevent nocturia).
Check vital signs
especially bloodpressure forhypotension priorto administration.
Assess baselineelectrolyte,particularly check
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hypertensive
Can also beused for
treatment ofhypercalcemia.
headedness
Headache
Blurred Vision
Paresthesia
Photosensitivity
Rash
Weakness
Bladder spasm
for low potassium.
Assess edema,skin turgor, and
mucousmembranes forhydration status.
Assess musclestrength andmental status.
Obtain baselineweight..
Note extent ofdiuresis
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GenericName(BrandName)
Dosage,TimingandRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects Nursing Considerations
Metropol
ol(Lopressor)
100mg
(1tab),BID, PO
autonomic
nervoussystem
agent
beta-
adrenergic
antagonist
(sympathol
ytic);
antihyperte
nsive
Metoprolol
isprescribedfor patientswith highbloodpressure(hypertensionIt is alsoused totreat chestpain(anginapectoris)related tocoronaryarterydisease.slowing and
Metoprolol
blocks theaction of thesympatheticnervoussystem, aportion of theinvoluntarynervoussystem, byblocking betareceptors onsympatheticnerves. Sincethesympatheticnervoussystem isresponsible forincreasing the
Constipation;
diarrhea;dizziness; drymouth or eyes;gas; headache;heartburn;lightheadedness; milddrowsiness;muscle aches;nausea;stomach pain;trouble sleeping;unusualtiredness orweakness;vomiting.
Take apical pulse andBP beforeadministering drug.Report to physiciansignificant changes inrate, rhythm, or qualityof pulse or variationsin BP prior toadministration.
Monitor BP, HR, andECG carefully duringIV administration.
Take several BPreadings close to theend of a 12 h dosinginterval to evaluateadequacy of dosage
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regulatingcertaintypes ofabnormally
rapid heartrates
Other usesinclude thepreventionof migraineheadacheandtreatment
of certaintypes oftremors(familial orhereditaryessentialtremors).
rate withwhich theheart beats,by blocking
the action ofthese nervesmetoprololreduces theheart rate andis useful intreatingabnormallyrapid heartrhythms.
for patients withhypertension,particularly in patientson twice daily doses.
Some patients requiredoses 3 times a day tomaintain satisfactorycontrol.
Monitor I&O, dailyweight; auscultatedaily for pulmonaryrales.
Withdraw drug ifpatient presentssymptoms of mentaldepression because itcan progress tocatatonia.
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GenericName(Brand
Name)
Dosage,Timing andRoute
ClassificationGeneralClass and
Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
Captopril(Capoten)
125 mg(1tab), q6hold ifSBB
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renal failure,polyuria, oliguria,urinary frequencyHematologic:
Neutropenia,agranulocytosis,thrombocytopenia,hemolytic anemia,pancytopeniaOther: Cough,malaise, drymouth,lymphadenopathy
mark patient's chartwith notice thatcaptopril is beingtaken; the
angiotensin IIformation subsequentto compensatoryrenin release duringsurgery will beblocked; hypotensionmay be reversed withvolume expansion.
Monitor patientclosely for fall in BPsecondary toreduction in fluidvolume
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GenericName(Brand
Name)
Dosage,Timingand
Route
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects Nursing Considerations
Amikacin
sulfate
(Amikin)
500mg,q12,IVTT
Aminoglycoside Short-termtreatment ofseriousinfectionscaused bysusceptiblestrains ofPseudomonasspecies,Escherichia coli,indole-positiveand indole-negativeProteusspecies,Klebsiella,Enterobacter,and Serratiaspecies,Acinetobacterspecies.
Bactericidal:Inhibits proteinsynthesis insusceptiblestrains of gram-negativebacteria cellmembraneappears to bedisrupted,causing celldeath.
Ototoxicity,nausea,vomiting,diarrhea,superinfections
Correct dehydrationbefore therapybecause of increase riskof toxicity.
Watch for signs andsymptomsofsuper infection(especially URT),such as continuedfever, chills, andincreased pulse rate.
Weigh patient andreview renalfunctionstudies beforetherapybegins.
Evaluate patientshearing beforeand during therapy if hewill be receiving drug forlonger than 2weeks. Notify prescriberif patienthas tinnitus, vertigo, orhearing loss
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Obtain specimen forculture andsensitivity test beforegiving first
dose. Therapy maybegin whileawaiting the results.
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GenericName(Brand
Name)
Dosage,Timing andRoute
ClassificationGeneral Classand Family
Indications Mechanismof Action
Side Effects NursingConsiderations
Potassium
Chloride
(KaliumDurule)
1 tab, PO Electrolytesand Minerals For hypokalemia
As prophylaxisduring treatmentwith diuretics
To prevent and
treat potassium,
deficitsecondary
to diuretics or
corticosteroid
therapy.
Also indicated
when
potassium,
is depleted by
severe vomiting,
prolonged
diuresis and
diabetic
acidosis.
Supplementalpotassium inthe form ofhighpotassiumfoodor potassiumchloridemay be ableto restorenormalpotassiumlevels.
Renal insufficiency,hyperkalemia,nausea, vomiting,muscle weakness,difficulty inswallowing
Some patients
find it difficult
to swallow the
large sized KCl
tablet.
Administer
while patient is
sitting up or
standing (neverin recumbent
position) to
prevent drug-
induced
esophagus.
Watch out forlevels of
potassiumelectrolyte levelto preventhyperkalemia.
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GenericName(BrandName)
Dosage,TimingandRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects Nursing Considerations
Cefazolin
(Ancef)
500mg(1tab) q8,PO
Anit-
infectives
Pharmacol
ogic: first
generation
Cephalosp
horins
Skin & skinstructureinfections;pneumonia;urinary tractinfections;bone & jointinfections
Bind to
bacterial cell
wall
membrane,
causing cell
death.
Active against
many gram-positive cocciincluding:Streptococcuspneumoniae,Group A beta-hemolyticstreptococci;Penicillinas-producing
staphylococci.
diarrhea,nausea,vomiting,cramps,Rashes,allergicreactionsincludingAnaphylaxisand Serumsickness,superinfection
Assess patient forinfection (vital signs;appearance of surgicalsite, urine; WBC) atbeginning and duringtherapy.
Before initiatingtherapy, obtain a historyto determine previoususe of and reactions topenicillins orcephalosphorins.Persons with a negativehistory of penicillinsensitivity may still havean allergic response.
Obtain specimens forculture and sensitivitybefore initiating therapy.
Observe patient forsigns and symptoms ofanaphylaxis (rash,pruritis, laryngealedema, wheezing).Discontinue drug andnotify physician or other
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health care professionalimmediately if theseproblems occur. Keepepinephrine, anantihistamine, andresuscitation equipmentclose by in case ofanaphylactic reaction.
Instruct patient to reportsigns of superinfection(furry overgrowth on thetongue, vaginal itchingor discharge, loose orfoul-smelling stools) andallergy.
Instruct patient to notifyhealth care professionalif fever and diarrheadevelop, especially ifdiarrhea contains blood,mucus, or pus. Advisenot to treat diarrheawithout consultinghealthcare professional.
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GenericName(BrandName)
Dosage,TimingandRoute
ClassificationGeneralClass andFamily
Indications Mechanism ofAction
Side Effects Nursing Considerations
Paracetamol
(Biogesic)
300mg,STATorder,IVT
Anti-pyretic Symptomatic
relief of pain
and fever.
Acetaminophenrelieves pain byelevating the painthreshold, that is,by requiring agreater amount ofpain to developbefore a personfeels it. It reducesfever through itsaction on the heat-regulating centerof the brain.Specifically, it tellsthe center to lowerthe body'stemperature whenthe temperature iselevated.
hemolyticanemia,
neutropenia,leucopenia,
pancytopenia,jaundice,
hypoglycemia,rash, urticaria.
Use liquid form forchildren andpatients who havedifficultyswallowing.
Advise patient that drugis only for short termuse.
Advise patient thatmany over the counterproducts containacetaminophen; beaware of this whencalculating total dailydose.
Warn patient that highdoses orunsupervised long termuse cancause liver damage.
Use cautiously inpatients with longterm alcohol use
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because therapeuticdoses causehepatotoxicity in thesepatients.
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GenericName(BrandName)
Dosage,TimingandRoute
ClassificationGeneral Class and Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
Diazepam
(Valium)
5mg(1tab),STATorder,IVTT
Benzodiazepine
Anxiolytic
Antiepileptic
Skeletal muscle
relaxant (centrallyacting)
Managementof anxietydisorders orfor short-termrelief ofsymptoms ofanxiety.
Exactmechanisms ofaction notunderstood; actsmainly at thelimbic systemand reticularformation; mayact in spinal cordand atsupraspinal sitesto produceskeletal musclerelaxation;potentiates theeffects of GABA,an inhibitoryneurotransmitter;anxiolytic effectsoccur at doseswell below thosenecessary tocause sedation,ataxia; has littleeffect on corticalfunction.
Throat, chestpain,
drowsiness,fatigue,
confusion,dizziness,headache,
slurred speech,hypotension,tachycardia,
edema, blurredvision, nausea,constipation,
urinaryretention,hiccups,
coughing.
Superviseambulation.Adversereactions suchas drowsinessand ataxia aremore likely tooccur in olderadults anddebilitated orthose receivinglarger doses.Dosageadjustment maybe necessary.
Monitor I and Oratio, includingurinary andbowelelimination.
Observe patientclosely andmonitor vitalsigns when
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Name(BrandName)
TimingandRoute
General Classand Family
Action Considerations
Magnesium
Sulfate
(Epsomsalt,sulfamag)
2g, PRNmed,IVTT
Electrolyteimmediate control of life-threatening convulsionsin the treatment of severetoxemias (pre-eclampsia and eclampsia)of pregnancy .
believed toreduceacetylcholinereleased bynerve impulses,resulting inanticonvulsanteffects andcentral nervoussystemdepression andblockingperipheralneuromusculartransmission.Becausemagnesiumantagonizescalcium andblocks calciumchannels inbronchial andvascular smoothmuscle, it alsohasantihypertensiveactions.
Flushing,nausea,vomiting,palpitations,headache,generalmuscleweakness,lethargy,constipation.
serummagnesiumlevels, bloodpressure andrespiratory rateshould bemonitored;patellar reflexescan beassessed todetect onset ofmagnesiumintoxication.
antidote forrespiratorydepression iscalcium chlorideor calciumgluconate.
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GenericName(BrandName)
Dosage,TimingandRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
Ranitidinehydrochloride(Zantac)
50mg,q8, IVTT
H2- receptorantagonistantiulcerative
For occasionalheartburn, acidindigestion,and sourstomach
Chemical:Competitivelyinhibits actionof H2 receptorsites ofparietal cells,decreasinggastric acidsecretion
Therapeutic:Relieves GIdiscomfort
CNS: vertigo,malaiseEENT: blurredvisionHematologic:reversibleleukopenia,pancytopenia,thrombocytopeniaHepatic: jaundiceOther:anaphylaxis,angioedema
assess patientscondition beforestarting therapy andregularly thereafter tomonitor drugseffectiveness
be alert for adversereactions and druginteractions
Dont use aluminium-based needles orequipment whenmixing or giving drugparenterally becausedrug is incompatiblewith aluminum.
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Generic Name(Brand Name)
Dosage,TimingandRoute
ClassificationGeneral Class andFamily
Indications Mechanism ofAction
Side Effects NursingConsiderations
Spironolactone(Aldactone)
25mg,BID,PO
Aldosterone
Antagonist
Potassium-
sparing
diuretic
Foradjunctivetherapy inedemaandhypertension
Chemical:Completelyblocks theeffects ofaldosterone in therenaltubule,causingloss ofsodiumand waterandretention ofpotassium.
Therapeutic:Lowers
bloodpressure
CNS:Dizziness,headache,drowsiness,fatigueDermatologic: Rash,UrticariaGI:Cramping,Diarrhea, drymouth, thirst,vomitingGU:impotence,amenorrhea,irregularmensesHematologic
:Hyperkalemia,HyponatremiaOther:hirsutism
take the drugearlybecause ofincreasedurination.
weigh patienton regularbasis at thesame timeand in thesameclothing andrecord theweight.
avoid foodsthat are richin potassium
(e.g banana,potatoes,watermelon,tomatoes,nuts, avocado,grapefruitandoranges).
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GenericName(BrandName)
Dosage,Timing andRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
Omeprazole(Losec)
20mg,OD, PO
Antisecretory
Drug
Proton Pump
Inhibitor
Short termtreatmentof activeduodenalulcer.
Chemical:Gastricacid-pumpinhibitor:Suppressesgastric acidsecretion byspecificinhibition ofthehydrogen-potassiumATPaseenzymesystem atthe
secretorysurface ofthe gastricparietalcells; blocksthe finalstep of acidproduction.
CNS: Headache,dizziness,vertigo, anxiety,insomniaDermatologic:Rash,inflammation,urticaria, pruritus,alopecia, dryskinGI: Diarrhea,abdominal pain,nausea,vomiting,constipation, drymouth, tongue
atrophyRespiratory:cough, epistaxisOther: back pain,fever
take drugbefore meals.
swallow thecapsulewhole; do notchew, open,or crush themand followwith a glassof water.
have regularmedicalfollow-upvisits.
report severeheadache,worsening ofsymptoms,fever, chills.
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GenericName(Brand Name)
Dosage,TimingandRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
Cefuroxime(Zinacef)
750mg,q8, IVTT
Antibiotic
Cephalospo
rin (second
generation)
To Lowerrespiratoryinfections.
Chemical:Bactericidal:Inhibits synthesisof bacterial cellwall, causing celldeath.
CNS:Headache,dizziness,lethargyGI: Nausea,vomiting,diarrhea,anorexia,abdominal pain,flatulenceHematologic:decreasedplateletsHypersensitivity:rash, feverLocal: PainOther:superinfections
take full courseof therapy evenif feeling better.
discontinue ifhypersensitivityreaction occurs.
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GenericName(Brand Name)
Dosage,TimingandRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
Tramadolhydrochloride(Ultram)
50mg,q8, IVTT
Analgesic
Opioid
analgesic
Relief ofmoderate tomoderatelysevere pain
Chemical:Binds to mu-opioidreceptors andinhibits thereuptake ofnorepinephrineand serotonin;causes manyeffects similar tothe opioids--dizziness,somnolence,nausea,constipation-- butdoes not have therespiratorydepressanteffeffects.
CNS: Sedation,Dizziness,headache,confusion,dreaming,sweating,anxiety,seizuresCV:Hypotension,tachycardia,bradycardiaDermatologic:sweating,pruritus, rash,pallor, urticariaGI: Nausea,vomiting, dry
mouth,constipation,flatulenceOther:anaphylactoidreactions
controlenvironment ifsweating orCNS effectsoccur.
limit in use inpatients withpast or presenthistory ofaddiction to ordependence onopioids.
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GenericName(Brand Name)
Dosage,TimingandRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
TranexamicAcid(Cyklokapron)
50mg,q8, PO
Antifibrinolytic For excessivebleeding
Chemical:Exerts itsantifibrinolyticeffect through thereversibleblockade oflysine-bindingsites onplasminogenmolecules. Itinhibitsendometrialplasminogenactivator and thuspreventsfibrinolysis andthe breakdown ofblood clots.
CNS: Headache,dizziness,lethargyGI: Nausea,vomiting,diarrhea,anorexia,abdominal pain,flatulenceHematologic:Arterialthrombosis,thromboembolismHypersensitivity:rash, feverLocal: PainOther:superinfections
The dose ofCYKLOKAPRON Injectionshould bereduced inpatients withrenalinsufficiencybecause of therisk ofaccumulation.
Patients with aprevious historyofthromboembolicdisease may beat increased riskfor venous or
arterialthrombosis.
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GenericName(Brand Name)
Dosage,TimingandRoute
ClassificationGeneral Classand Family
Indications Mechanism ofAction
Side Effects NursingConsiderations
HydralazineHydrochloride(Apresoline)
5mg, q6,IVTT
Antihypertensi
ve
Vasodilator
(peripheral)
For severeessentialhypertension.
Chemical:Acts directly onvascular smoothmuscle to causevasodilation,primarilyarteriolar,decreasingperipheralresistance;maintains orincreases renaland cerebralblood flow.
CNS: Headache,peripheral neuritis,dizziness,tremors,anxiety,disorientationCV: Hypotension,tachycardia,palpitations, anginapectorisGI: Nausea,vomiting, dry mouth,anorexia, diarrhea,constipationGU: impotenceHematologic: BlooddyscrasiasHypersensitivity:Rash, urticaria, fever,chills, hepatitis
Other: nasalcongestion, flushingedema,splenomegaly,dyspnea
use parenteraldrugimmediatelyafter openingampule. Use asquickly aspossibleafterdrawing to aneedle into asyringe.
Hydralazinechanges colorafter contactwith metal, anaddiscoloredsolutions shouldbe discarded.