DRUG STUDY Patient name: Ruben Pinggoy Mananguit Age: 48 years old Gender: Male Brand name Plasil

Duncan Generic name Metoclopramide Admitting diagnosis: PTB Class II and DM type II Chief complaint: Body weakness Diet: Diabetic diet Classification Gastrointestinal stimulant Indication w/ mode of action >Nausea and vomiting, central and peripheral origin associated metabolic disease. Infectious disease Dopamine antagonist that acts by increasing sensitivity to acetylcholine; result in increased motility of the upper GI tract relaxation of the pyloric sphincter of duodenal tract AP: Dr. Tanudtanud Date of admission: July 18, 2011 Present Problem: Contraindication, Side effect, Drug interaction CI> GI, hemorrhage, mechanical obstruction or perforation pheochromocytoma AR> Restlessness, drowsiness, fatigue and lassitude, insomnia, headache, dizziness, nausea, galactorrhea, bowel disturbance DI>Additive effect with alcohol, sedative, hypnotics necrotics or tranquilizer Actual dose 1 amp IVTT q 8hrs Usual dose 1amp 8hrs Nursing Responsibilities > 10Rs >Assess for any side effect of the drug >Inform patient that it may cause drowsiness or dizziness >Determine route of administration to tract diabetic gastro paresis by the severity of symptoms >Inject slowly to IV 1-2 min to prevent transient feeling >Assess abdomen or bowel sound distention N & V

DRUG STUDY
Patient name: Ruben Pinggoy Mananguit Age: 48 years old Gender: Male Brand name Zantac Generic name Ranitidine Admitting diagnosis: PTB Class II and DM type II Chief complaint: Body weakness Diet: Diabetic diet Classification Anti-ulcer Indication w/ mode of action > inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cell, resulting in inhibition or gastric acid secretion. Treatment and prevention of heart burn, acid indigestion, and sour stomach AP: Dr. Tanudtanud Date of admission: July 18, 2011 Present Problem: Contraindication, Side effect, Drug interaction Contraindicated for hypersensitivity. Some oral liquid contain alcohol and should be avoided in patient with intolerance to side effect SE> confusion, dizziness, drowsiness, hallucination, headache. Altered taste black tongue, constipation, dark stool, Actual dose 50mg IVTT q8hrs 150mg 1 tab BID Usual dose 20mg IV q8hrs Nursing Responsibilities >10 Rs >inform patient that it may cause drowsiness or dizziness >instruct patient that report onset of black, tarry stool, fever, sore throat >instruct the patient that it may temporarily cause stool and tongue to appear gray black >assess for any side effect of the drug

DRUG STUDY
Patient name: Ruben Pinggoy Mananguit Age: 48 years old Gender: Male Brand name Afrixon MI Biopharm Generic name Ceftriaxone Na Admitting diagnosis: PTB Class II and DM type II Chief complaint: Body weakness Diet: Diabetic diet Classification Antibiotic Indication w/ mode of action Treatment of susceptible infection including chancroid, endocarditis gastroenteritis, gonorrhea, rhengitis septicemia, typhoid fever AP: Dr. Tanudtanud Date of admission: July 18, 2011 Present Problem: Contraindication, Side effect, Drug interaction CI> Contraindicated to hypersensitivity to cephalosporin SE> Skin rashes, urticarin eosinophilia, fever reaction eg; serum sickness anaphylaxis. Hypoprothrom benemia and or platelet disfunction transient increase in liver enzymes level. Neutropenia DI>Alcohol Actual dose Ceftriaxone IVTT q hours ANST Usual dose 1-2g OD or BID Nursing Responsibilities >10 Rs >Assess for GI disease especially colitis use drug cautiously, report any bruising, bleeding and diarrhea >Inject slowly to IV 1-2 minutes to prevent transient feeling >Assess for any side effect of the drug >instruct patient to report any unusual feeling after taking medicine

DRUG STUDY
Patient name: Ruben Pinggoy Mananguit Age: 48 years old Gender: Male Brand name Coregica Generic name Carvidol Admitting diagnosis: PTB Class II and DM type II Chief complaint: Body weakness Diet: Diabetic diet Classification Alpha-beta adrenergic blocking agent Indication w/ mode of action >essential hypertension used either alone or in combination with other anti hypertensive drug Decreases cardiac output, reduces exercise, induced tachycardia, reduce reflex, thoslatic hypotension, cause vasodilatation AP: Dr. Tanudtanud Date of admission: July 18, 2011 Present Problem: Contraindication, Side effect, Drug interaction CI> client with NYHA class IV decompensate cardiac failure requiring the use of IV isotonic therapy. Impaired hepatic function SE> Dizziness, headache, N&V, diarrhea, URTI, fatigue, pain, bradycardia, hypotension, weight increase, hyperglycemia, increase cough DI> Antidiabetic/increase hypoglycenmic control Actual dose 6.25 mg tab BID Usual dose 6.25mg BID Nursing Responsibilities >10 Rs >Assess for any side effect of the drug >instruct patient to report any unusual feeling after taking medicine >Instruct patient to reportrash, severe abdominal pain, bloody diarrhea

DRUG STUDY
Patient name: Ruben Pinggoy Mananguit Age: 48 years old Gender: Male Brand name Piotaz Generic name Pioglitazone HCL Admitting diagnosis: PTB Class II and DM type II Chief complaint: Body weakness Diet: Diabetic diet Classification Antidiabetic, thiazolidineione Indication w/ mode of action >as an adjunct to diet and exercise to improve glycemic control with DM type II Monotherapy or in combination with insulin when diet anexercise plus the single agent does not result in adequate glycemic control AP: Dr. Tanudtanud Date of admission: July 18, 2011 Present Problem: Contraindication, Side effect, Drug interaction CI> type 1 DM, diabetic ketoacidosis SE> Headache, URTI, Mylagia, sinusitis, pharyngitis Actual dose 50mg 1 tab OD Usual dose 15-30mg OD Nursing Responsibilities >10 Rs >Assess for any side effect of the drug >instruct patient to report any unusual feeling after taking medicine >discontinue if sign of heart failure emerge >review diet, exercise and other lifestyle changes to ensure good glucose control

DRUG STUDY
Patient name: Ruben Pinggoy Mananguit Age: 48 years old Gender: Male Brand name Biogesic Generic name Paracetamol Admitting diagnosis: PTB Class II and DM type II Chief complaint: Body weakness Diet: Diabetic diet Classification
Anti-pyretic

AP: Dr. Tanudtanud Date of admission: July 18, 2011 Present Problem:

Indication w/ mode of action Symptomatic Relief of pain and fever.

Contraindication, Side effect, Drug interaction Contraindicated in patients Hypersensitive to drug. > Use cautiously in patients with long term alcohol use because therapeutic doses cause hepatotoxicity in these patients. Hematologic: hemolytic anemia, neutropenia, leucopenia, pancytopenia. > Hepatic: Jaundice >Metabolic: Hypoglycemia > Skin: rash, urticaria

Actual dose 1 tab PRN q4 hours

Usual dose 500-1000mg q4 hours

Nursing Responsibilities >10 Rs >Assess for any side effect of the drug >instruct patient to report any unusual feeling after taking medicine

>Warn patient that high doses or Unsupervised long term use can Cause liver damage.

DRUG STUDY
Patient name: Ruben Pinggoy Mananguit Age: 48 years old Gender: Male Brand name Generic name Classification Admitting diagnosis: PTB Class II and DM type II Chief complaint: Body weakness Diet: Diabetic diet Indication w/ mode of action AP: Dr. Tanudtanud Date of admission: July 18, 2011 Present Problem: Contraindication, Side effect, Drug interaction Actual dose Usual dose Nursing Responsibilities

PATHOPHYSIOLOGY
Predisposing Factor genetic predisposing to DM Precipitating factor > lifestyle > Socio economic factor > (+) DM > (+) PTB > (-) Immunization Exposure to epidemic of Influenza to Streptococcal Infection Bacterial Infection Inflammatory of lung tissue
Hypertrophy of mucous membrane -Increase sputum production -Wheezing -dyspenia -cough -rales Increase capillary permeability -increase fluid in ISC -consolidation -hypoxemia Inflammation of pleura -chest pain -dullness -breath sound Hypoventilation -chest expansion -respiratory acidosis Protective mechanism -increase WBC -increase respiratory rate -Fever