DRUG Dexamethasone - corticosteroid

INDICATION Adjunctive treatment in bacterial meningitis tuberculosis meningitis

ACTION Not clearly defined. Decreased inflammation, mainly by stabilizing leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrow; and influences protein, fat, and carbohydrate metabolism. Increases osmotic pressure of glomerular filtrate, inhibiting tubular reabsorption of water and electrolytes; drug elevates plasma osmolality, increasing water flow into extracellular fluid.

ADVERSE REACTION CNS- pseudotumor cerebri, seizures CV- heart failure, arryhtmias, thromboembolism GI- pancreatitis

Mannitol osmotic diuretic

To prevent oliguria or acute renal failure Diuresis in drug intoxication

CNS- seizures CV- heart failure

Acyclovir anti-infectives

Herpes simplex encephalitis

Interferes with DNA synthesis and inhibits viral multiplication.

CNS: encephalopathic changes( lethargy,obtundation, tremors, confusion, hallucination, agitation, seizures, coma)

NURSING CONSIDERATION assess pt. for signs of adrenal insufficiency before and periodically during therapy Monitor intake and output ratios and daily weights. Observe pt. for peripheral edema, steady weight gain rales/crackles, or dyspnea. Assess pt. for changes in the level of consciousness Assess patient for anorexia, muscle weakness, numbness, tingling, paresthesia, confusion, and excessive thirst. Report signs of electrolyte imbalance Monitor neurologic status and intracranial pressure readings in patient receiving this medication. Monitor for persistent or increase eye pain or decrease visual acuity. Explain purpose of therapy to patient. Ensure that the patient is well hydrated.

Complete the full course of oral therapy, and do not exceed the prescribed

GU: acute renal failure Hematologic: leukopenia, thrombocytopenia

dose. Oral acyclovir is not a cure for your disease but should make you feel better. Avoid sexual intercourse while visible lesions are present. You may experience these side effects: Nausea, vomiting, loss of appetite, diarrhea; headache, dizziness. Report difficulty urinating, rash, increased severity or frequency of recurrences.

Omeprazole - antiulcer drugs

Short-term treatment of active benign gastric ulcer

Inhibits activity of acid pump and binds to hydrogen-potassium adenosine triphosphatase at secretory surface of gastric parietal cells to block formation of gastric acid.

CNS: dizziness, headache GI: abdominal pain, n/v, constipation

Assess patient routinely for epigastric pain or abdominal pain and frank or occult blood in the stool, emesis or gastric aspirate. Instruct patient to take medication as directed for the full course of therapy, even if feeling better. Caution patient to avoid driving or other activities requiring alertness until response to medication is known. Advise patient to avoid alcohol, products containing aspirin or

Hydrocortisone corticosteroid

Severe inflammation, adrenal insufficiency Shock Adjunctive treatment for ulcerative colitis

Not clearly defined. Decreases inflammation, mainly by stabilizing leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrow; and influences protein, fat, and carbohydrate metabolism.

CNS: pseudotumor cerebri, seizures CV: heart failure, thromboembolism GI: pancreatitis

NSAIDS, and foods that may cause an increase in GI irritation. Monitor for persistent backache or chest pain; compression and spontaneous fractures of long bones and vertebrae present hazards. Monitor for and report changes in mood and behavior, emotional instability, or psychomotor activity, especially with long-term therapy. Be alert to possibility of masked infection and delayed healing (antiinflammatory and immunosuppressive actions). Do not ignore dyspepsia with hyperacidity. Report symptoms to physician and do NOT selfmedicate to find relief. Do NOT use aspirin or other OTC drugs unless prescribed specifically by the physician. Do not abruptly discontinue drug; doses are gradually reduced to prevent withdrawal

symptoms. Report exacerbation of disease during drug withdrawal. Assess overall health status and alcohol usage before administering. Assess amount, frequency, type of drugs taken in patient self medicating, especially with the over the counter drugs. Advice patient to take medication as exactly as directed and not to take more than the recommended amount. Advice patient to avoid alcohol. Assess client for abdominal pain distention, bowel sound Assess client for extrapyramidal reactions Monitor for tardive dyskinesian

Paracetamol antipyretic and nonopioid analgesics

Mild pain or fever

Thought to produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in the CNS or of other substances that sensitize pain receptors to stimulation. The drug may relieve fever through central action in the hypothalamic heatregulating center.

Hematologic: leukopenia, neutropenia, pancytopenia Metabolic: hypoglycemia

Placilantidepressant Depression, chronic pain Unknown. A TCA that inhibits reuptake of serotonin and norepinephrine at the presynaptic neuron. CNS: seizures