Professional Documents
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SPECIFIC
ACTION(S)
INDICATION(
S)
Date Admitted:
M
CONTRAINDICATION(S
)
11/20/2015
Address:
DRUG
INTERACTION(
S)
Chief Complaint:
Bleeding, Profuse
ADVERSE
REACTION(S)
SPECIFIC
PRECAUTION(S)
Case Number:
Ward:
NURSING
RESPONSIBILITI
ES
Generic
Name:
TRANEXAMIC
ACID
Brand
Name:
Hemostan
Dosage:
500mg
Route:
PO
Frequency:
q 8
Classificatio
n:
Anti-fibrinolytic,
antihemorrhagi
c
Tranexamic
acid is a
synthetic
derivative of
the amino
acid lysine. It
exerts its
antifibrinolyti
c effect
through the
reversible
blockade of
lysine-binding
sites on
plasminogen
molecules.
Antifibrinolytic
drug inhibits
endometrial
plasminogen
activator and
thus prevents
fibrinolysis
and the
breakdown of
blood clots.
The
plasminogenplasmin
enzyme
system is
known to
cause
coagulation
For
bleeding
Allergic
reaction to
the drug or
hypersensiti
vity.
Presence of
blood clots
(eg, in the
leg, lung,
eye, brain),
have a
history of
blood clots,
or are at risk
for blood
clots.
Current
administrati
on of factor
IX complex
concentrates
or antiinhibitor
coagulant
concentrates
Anti-inhibitor
coagulant
complex or
Factor IX
complex:
Concurrent
use may
increase the
risk of
thrombotic
complications
.
Contraceptive
s, estrogencontaining,
oral or
Estrogens:
Concurrent
use with
tranexamic
acid may
increase the
potential for
thrombus
formation.
CNS:
Confusion,
Severe or
persistent
headache,
Slurred
speech,
vision
changes.
Respiratory:
Chest pain,
Coughing up
blood,
Shortness of
breath.
Integumenta
ry: Severe
allergic
reactions
such as
rash, hives,
itching,
dyspnea,
tightness in
the chest,
swelling of
the mouth,
face, lips or
tongue
GU:
Decreased
urination
MS: Severe
Use cautiously in
patients who are using
birth pills and other
types of birth control
should n Anti-inhibitor
coagulant complex or
Factor IX complex:
ot use this medication.
This medicine may
cause serious allergic
reaction including
anaphylaxis.
Observe five
Rs in drug
administration
Be alert for the
unusual change
in bleeding
pattern should
be immediately
reported to the
physician.
For women who
are taking
tranexamic acid
to control
heavy bleeding,
the medication
should only be
taken during
the menstrual
period.
The medication
can be taken
with or without
meals.
Swallow
Tranexamic
Acid whole with
plenty of
liquids. Do not
break, crush, or
chew before
swallowing.
Inform the
client that
defects
through lytic
activity on
fibrinogen,
fibrin and
other clotting
factors. By
inhibiting the
action of
plasmin
(finronolysin).
the antifibrinolytic
agents
reduce
excessive
breakdown of
fibrin and
effect
physiological
hemostasis.
STUDENT NURSE:
or persistent
body
malaise.
Others: Calf
pain,
swelling or
tenderness.
CLINICAL INSTRUCTOR:
he/she should
inform the
physician
immediately if
the following
severe side
effects occur:
Tightness of
chest
Swelling of
mouth, lips, or
tongue.
Calf pain
Vision changes
Shortness of
breath.
SPECIFIC
ACTION(S)
Date Admitted:
Civil Status:
INDICATION(S
)
11/20/2015
M
CONTRAINDICATION(S)
Address:
Chief Complaint:
Bleeding, Profuse
DRUG
INTERACTION(S)
ADVERSE
REACTION(S)
Case Number:
Ward:
MS/W
SPECIFIC
PRECAUTION(
S)
NURSING
RESPONSIBILITIE
S
Generic
Name:
Mefenamic
Acid
Brand Name:
Ponstel
Dosage:
500g
Route:
PO
Frequency:
TID
Anthranilic
acid
derivative.
Like ibuprofen
inhibits
prostaglandin
synthesis and
affects
platelet
function. No
evidence that
it is superior
to aspirin.
Pain
Contraindicate
d to patient
hypersensitive
to drug.
Contraindicated
to patients
with
inflammatory
intestinal
diseases.
Contraindicated
to patient with
renal failure.
Classification
:
NSAID
( Non-steroidal
antiInflammatory
Drug)
CNS:
Drowsiness,
insomnia,
dizziness,
nervousness,
confusion,
headache.
GI: Severe
diarrhea,
ulceration, and
bleeding;
nausea,
vomiting,
abdominal
cramps, flatus,
constipation,
hepatic toxicity.
Hematologic:
Prolonged
prothrombin
time,
severe autoimm
une hemolytic
anemia (longterm use),
leukopenia,
eosinophilia,
agranulocytosis,
thrombocytopeni
c purpura,
megaloblastic
anemia,
pancytopenia,
bone marrow
Use
cautiously in
patients with
asthma or
frequent
runny or
stuffed nose.
Observe five
Rs in drug
administration.
Assess patients
who develop
severe diarrhea
and vomiting
for dehydration
and electrolyte
imbalance.
Lab tests: With
long-term
therapy (not
recommended)
obtain periodic
complete blood
counts, Hct and
Hgb, and
kidney function
tests.
Discontinue
drug promptly
if diarrhea,
dark stools,
hematemesis,
ecchymoses,
epistaxis, or
rash occur and
do not use
again. Contact
physician.
Notify
physician if
persistent GI
effect-of furosemide
and thiazides in some
patients. This
response has been
attributed to inhibition
of
renal prostaglandin sy
nthesis. During
concomitant therapy
of NSAIDs, the patient
should be observed
closely for signs of
renal failure.
Lithium: NSAIDs
have produced an
elevation of plasma
lithium levels and a
reduction in renal
lithium clearance. The
mean minimum
lithium concentration
increased 15% and
the renal clearance
decreased by
approximately 20%.
These effects have
been attributed to
inhibition of renal
prostaglandin
synthesis by
the NSAID. Thus,
when NSAIDs and
lithium are
administered
concurrently, subjects
should be observed
carefully for signs of
lithium toxicity.
Methotrexate:
NSAIDs have been
reported to
hypoplasia.
Urogenital:
Nephrotoxicity,
dysuria,
albuminuria,
hematuria,
elevation of
BUN.
Skin: Urticaria,
rash, facial
edema.
Spec Senses:
Eye irritation,
loss of color
vision
(reversible),
blurred vision,
ear pain.
Body Whole:
Perspiration.
CV: Palpitation.
Respiratory:
Dyspnea; acute
exacerbation of
asthma.
discomfort,
sore throat,
fever, or
malaise occur.
Do not drive or
engage in
potentially
hazardous
activities until
response to
drug is known.
It may cause
dizziness and
drowsiness.
competitively inhibit
methotrexate
accumulation in
rabbit kidney slices.
This may indicate that
they could enhance
the toxicity of
methotrexate. Caution
should be used when
NSAIDs are
administered
concomitantly with
methotrexate.
Warfarin: The effects
of warfarin and
NSAIDs on GI bleeding
are synergistic, such
that users of both
drugs together have a
risk of serious GI
bleeding higher than
users of either drug
alone.
Antacids: In a single
dose study (n=6),
ingestion of an
antacid containing
1.7-gram of
magnesium hydroxide
with 500-mg of
mefenamic acid
increased the Cmax
and AUC of
mefenamic acid by
125% and 36%,
respectively.1
Drug/Laboratory
Test Interactions:
Ponstel (mefenamic
acid) may
prolong prothrombin
STUDENT NURSE:
CLINICAL INSTRUCTOR:
Generic
Name:
Cefazolin
sodium
Brand
Name:
Ancep
Dosage:
1g
Route:
TIV
Frequency:
q8
Classificati
on:
SPECIFIC ACTION(S)
Cefazolin
Inhibits cell-wall
synthesis
Promoting osmotic
instability
Hinders/kills susceptible
bacteria
11/20/2015
Address:
DRUG
INTERACTION(
S)
CONTRAINDICATION(S)
INDICATION(S)
Pire operative
prevention in
contaminated
surgery.
Contraindicated
to patient
hypersensitive
to drug.
Contraindicated to
patients with
inflammatory
intestinal
diseases.
Contraindicated to
patient with
renal failure.
ADVERSE
REACTION(S)
Ace
inhibitors:
may diminish
the
antihypertens
ive effect of
ACE
inhibitors.
Probenecid:
decreases
renal
elimination of
cefazolin
CNS: dizziness,
headache,
malaise
GI: nausea,
vomiting,
diarrhea,
glossitis,
dyspepsia
Respiratory:
Dyspnea
Skin:
Erythematous
D
rashes
Case Number:
Ward:
SPECIFIC
PRECAUTION
(S)
Use
cautiously
in patients
with
asthma or
frequent
runny or
stuffed
nose.
270788
NURSING
RESPONSIBILIT
IES
Observe five Rs
in drug
administration
Ask patient
about previous
reaction to
cephalosporin
or penicillin
before starting
the therapy
If GI reaction
occurs, monitor
hydration.
Lab tests:
Perform culture
and sensitivity
testing prior to
and during
NSAID
(Nonsteroidal
antiinflammatory
drug)
therapy.Therap
y may be
initiated
pending results.
Monitor I&O
rates and
pattern: Be
alert to
changes in
BUN, serum
creatinine.
Prompt
attention
should be given
to onset of
signs of
hypersensitivity
.
Promptly report
the onset of
diarrhea.
Pseudomembra
nous colitis, a
potentially lifethreatening
condition, starts
with diarrhea.
Report
promptly any
signs or
symptoms of
superinfection
such as easy
bruising and
nosebleeds.
STUDENT NURSE:
CLINICAL INSTRUCTOR:
Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES
University town, Catarman, N. Samar
COLLEGE OF NURSING
DRUG ANALYSIS
SPECIFIC ACTION(S)
INDICATION(S)
11/20/2015
Chief Complaint:
Address:
CONTRAINDICATION(S)
DRUG
INTERACTION
(S)
Bleeding, Profuse
ADVERSE
REACTION(S)
Case Number:
Ward:
MS/W
SPECIFIC
PRECAUTION
(S)
NURSING
RESPONSIBILIT
IES
Generic
Name:
Ferrous
Sulfate
Brand
Name:
Sorbifer
Dosage:
1 tab
Route:
PO
Frequency:
BID
Classificati
on:
Antianemic
Ferrous Sulfate is an
essential component
in the formation of
hemoglobin,
myoglobin and
enzymes. It is
necessary for effective
erythropoiesis and
transport or utilization
of oxygen.
or treatment of
ANTACIDS
receiving
iron deficiency
decrease iron
repeated blood
anemia due to
absorption;
transfusions;
inadequate
iron
anemia not
diet,
decreases
malabsorption
absorption of
due to iron
pregnancy, and
TETRACYCLIN
deficiency.
blood loss.
ES,
ciprofloxacin,
ofloxacin;
chloramphen
icol may
delay iron's
effects; iron
may
decrease
absorption of
penicillamine
.
Food: Food
decreases
absorption of
iron; ascorbic
acid (vitamin
C) may
increase iron
absorption.
GI:
Constipation,
gastric
irritation, N&V,
abdominal
cramps,
anorexia,
diarrhea, and
dark-colored
stools. These
effects may be
minimized by
administering
preparations
as a coated
tablet.
Soluble iron
preparations
may stain the
teeth.
Use
cautiously
in patients
with a
history of
hypersensi
tivity to
drug.
In
pregnant
and
lactating
women.
Observe 5rs
in drug
administration
.
Store all forms
at room
temperature.
Give between
meals with
water but may
give with
meals if
gastrointestin
al discomfort
occurs.
Transient
staining of
mucous
membranes
and teeth will
occur with
liquid iron
preparation.
To avoid,
place liquid on
the back of
the tongue
with dropper
or use straw.
Avoid
simultaneous
administration
of antacids or
tetracycline.
Do not
crush
sustainedrelease
preparations.
Eggs and
milk inhibit
absorption.
Monitor
serum iron,
total ironbinding
capacity,
reticulocyte
count,
hemoglobin,
and ferritin.
Monitor
daily pattern
of bowel
activity and
stool
consistency.
Assess for
clinical
improvement,
record of relief
of symptoms
(fatigue,
irritability,
pallor,
paresthesia,
and
headache).
STUDENT NURSE:
CLINICAL INSTRUCTOR: