74

IX. PHARMACOLOGIC MANAGEMENT

Generic
Name
P

Brand
Name

Classification Indication
Analge

sic

Antipyr

etic

Common
cold,

Mechanism
Of
Action
Decreases

Dosage
And
Adverse
Frequency Reactions
500 mg 1 CNS:

flu, fever

by tab

q4,

otherviral

inhibiting

the now

and

effects

of reduced to

bacterialinfe

pyrogens

on PRN

ctions

pain

hypothalamus

andfever

heat regulating

with the

Headache
CV:

centers & by a

hypothalamic

action

leading

to sweating &
vasodilatation.

Assess patients fever or

pain: typeof pain, location,
intensity,

Chest

temperature,

pain,dyspnea

diaphoresis.

GI:

Nursing Consideration

duration,
and

Assess allergic reactions:

Hepatictoxicit

rash,

y andfailure,

occur, drug may have to be

jaundice
GU:
Acute
kidneyfailure,
renal
tubularnecros

urticaria;

if

these

discontinued.
Take with food or milk to
minimize GI upset.
Report paleness, weakness
and heart beat skips
This drug is not for regular

75

is

use with any form of liver

disease.
Check

I&O

ratio;decreasingoutput
mayindicate renalfailure.

76

Generic
Name
O

Brand
Name

Classification
Gastrointestinal

Agent;

Pump Inhibitor

Indicatio
n
Duodenal

Proton and

Mechanism
Of
Action
An

Dosage
And
Adverse
Frequency Reactions
40 mg IV CNS:Headache,

antisecretory

q12

Nursing Consideration
Assessment & Drug Effects

dizziness,

Lab tests: Monitor urinalysis

for hematuria and proteinuria.
Periodic liver function tests
with prolonged use.

gastric

compound that

fatigue.

ulcer.

is a gastric acid

GI:Diarrhea,

Gastroeso

pump inhibitor.

abdominal pain,

phageal

Suppresses

nausea,

reflux

gastric

transient

disease

secretion

by

including

inhibiting

the

severe

H+, K+-ATPase

Report any changes in urinary

elimination such as pain or
increases in liver discomfort associated with
urination, or blood in urine.
function
tests.
Report severe diarrhea; drug
Urogenital:Hem may need to be discontinued.

erosive

enzyme system

aturia,

esophagiti

[the

acid

proteinuria.

H+)

Skin:Rash.

acid

s (4 to 8 (proton
wk

pump]

in

the

treatment)

parietal cells.

Patient & Family Education

mild

Do not breast
taking this drug.

feed

while

77

Long-

term
treatment
of
pathologic
hypersecr
etory
conditions
such

as

ZollingerEllison
syndrome,
multiple
endocrine
adenomas
,

and

systemic

78

mastocyto
sis.

In

combinati
on

with

clarithrom
ycin

to

treat
duodenal
ulcers
associate
d

with

Helicobact
er pylori.

Generic
Name

Brand
Name

Classification Indication

Mechanism
Of
Action

Dosage
And
Adverse
Frequency Reactions

Nursing Consideration

79

gastroin To

prevent Potent

central 10

mg

1 CNS:

Assessment & Drug Effects

testinal

nausea and dopamine

tab q5, for Restlessness,dro

agent;

vomiting ; to receptor

vomiting

prokinet facilitate

antagonist.

fatigue,lassitude,

the onset of

ic agent intubation of Structurally

insomnia,extrapy

restlessness,

(gi

small bowel; related

stimula

symptomatic

nt);

treatment of but

autono

gastroesoph

antiarrhythmic

akathisia,dystoni

Extrapyramidal

mic

ageal reflux.

or

a,

symptoms are most

nervous

activity.

myoclonus,dizzin

likely to occur in

system

mechanism

ess, anxiety

children, young

agent;

action not clear

CV:

direct-

but appears to

Transienthyperte

acting

sensitize

nsion

choliner

smooth muscle

GI:

associated with

gic

to

Nausea, diarrhea

cancer

to

procainamide
has

ramidalreactions,
parinsonism-like

little

anesthetic
Exact

effects

wsiness,

of

GI

of

reactions,

Report immediately

involuntary
movements, facial
grimacing, rigidity,
or tremors.

adults, and the

older adult and with
high-dose treatment
of vomiting

80

(parasy

acetylcholine

mpatho

by

mimetic

action.

);

chemotherapy.

direct

Symptoms can take

months to regress.

Be aware that
during early

antieme

treatment period,

tic

serum aldosterone
may be elevated;
after prolonged
administration
periods, it returns to
pretreatment level.

Lab tests: Periodic

serum electrolyte.

Monitor for possible

hypernatremia and
hypokalemia,
especially if patient
has CHF or

81

cirrhosis.

Adverse reactions
associated with
increased serum
prolactin
concentration
(galactorrhea,
menstrual
disorders,
gynecomastia)
usually disappear
within a few weeks
or months after
drug treatment is
stopped.

Patient & Family Education

Avoid driving and

other potentially

82

hazardous activities
for a few hours after
drug administration.

Avoid alcohol and

other CNS
depressants.

Report S&S of
acute dystonia,
such as trembling
hands and facial
grimacing,immediat
ely.

Do not breast feed

while taking this
drug without
consulting
physician.