Medications

Name of drug, generic, dosage

Indications
Paracetamol is an analgesic and antipyretic drug. It is used for the relief of:

Actions

Nursing considerations

Dosage : Capsule, Granules, Elixir, moderate pain Oral solution, Fever Oral suspension, Migraine Tablets,Supposit Tension ories, Wafers. headaches Adults: 325650 mg q 4 hr; doses up to 1 g q.i.d. may be used. Daily dosage should not exceed 4 g. Pediatric: Doses given 4-5 times/day. Up to 3 months: 40 mg/dose; 4-12 months; 80 mg/dose; 1-2 yrs old; 120 mg/dose; 2-3 yrs; 160 mg/dose; 4-5 yrs; 240 mg/dose; 6-8 yrs; 320 mg/dose; 9-10 yrs; 400 mg/dose; 11-12 yrs; 480 mg/dose. Alternative pediatric dose:

-Inhibits the Administration/storage synthesis 1. Suppositories of prostaglandin should be stored s that may below 80 f (27 serve as C) mediators 2. Treatment of of pain and overdose: fever, primarily initially, induction in the CNS. of emesis, gastric lavage, activated charcoal.Oral Nacetylcysteine is said to reduce/prevent hepatic damage by inactivating acetaminophen metabolites, w/c cause liver effects. CNS stimulation, excitement, delirium are symptoms of toxicity. Have acetylcysteine available for treatment of overdosage. Assessment: 1. If the client is to receive long term therapy, liver function studies should be conducted prior to initiating drug therapy.

10 mg/ kg/dose. Suppositories. Adults, 650 mg q 4- 6 hr not to exceed 6 suppositories per day. Pediatric, Less than 3 yrs: Physician should be consulted; 3- 6 yrs: 120 mg q 4-6 hr, not to exceed 2.6 g/day; 6-12 yrs: 325 mg q 4-6 hr not to exceed 720 mg/day. Buffered. Adult, usual: 1 or 2 three-quarter capfuls are placed into an empty glass of cool water. May be taken while fizzing or after settling. Can be repeated every 4 hr as required or directed by physician.

2. Document presence of fever. Question client concerning pain, noting type, location, duration & intensity INTERVENTION: 1. Note the presence of bluish color of the mucosa-fingernails or clients complaints of dyspnea, weakness, headache or vertigo. These symptoms of methamoglobinemia are caused by anoxia & require immediate action. 2. To assess for evidence of nephritic, check the clients urine for occult blood and the presence of albumin on a routine basis esp. when the client is receiving longterm drug therapy. CLIENT/ FAMILY TEACHING: 1. Teach symptoms of acute toxicity such as nausea, vomiting and abdominal pain. 2. Provide printed information to familiarize clients with the signs and symptoms of severe poisoning. Instruct them to report all such signs and

-The name of the drug is Cyklokapron. -The generic name is Tranexamic Acid. Dosages: Hemophiliac s requiring tooth extraction: IV, immediately before surgery, 10 mg/kg; then, after surgery, tablets, 25 mg/kg t.i.dq.i.d. For 2-8 days. Alternative regimen: PO, 25 mg/kg t.i.dq.i.d. One day prior to surgery. If client unable to take PO medication, give IV, 10 mg/kg t.i.dq.i.d.

-All fibrinolytic bleeding states: Profuse mentrual bleeding, gastrointestina l haemorrhage, haemoptysis, recurrent nosebleeds, bleeding after dental extractions, haemophilia and other bleeding disorders, hereditary angioneurotic edema.

-Tranexamic acid acts by competitively inhibiting activation of plasminogen, thus decreasing the conversion of plasminogen to plasmin( the enzyme that breaks down fibrin clots). Up to 50% of an oral dose is an absorbed from G.I. Tract; absorption is not affected by food. Peak Plasma Levels: 8 mg/L 3 hr after 1 g and 15 mg/L 3 hr after 2 g. Effective Tissue Levels: Maintained for 17 hr. Effective Serum Levels: Maintai ned for 7- 8 hrs. t1/2: 2 hr( after IV use of 1 g). Over 95 % of the drug is excreted via the kidney unchanged.

symptoms. 3. Instruct them to report all such signs and symptoms immediately. Administration Storage 1. tranexamic acid may be mixed with any of the following solutions for IV infusion: Carbohydrate, Amino acid, Electrolyte, Dextran. 2. The mixture should not be prepared on the day of use. 3. The mixture should not be with either blood or penicilin. Assessment: 1. Determine client's blood pressure and pulse before starting IV infusion of drug to establish a baseline against which to measure findings during and after drug therapy. 2. Review client's history and question client/family for evidence of defective color vision. 3. Assess for any evidence of nausea, vomiting, or diarrhea. Intervention: 1. Monitor client frequently for hypotension during IV infusion, which indicates that the rate of infusion is too fast. Slow the rate of infusion and report to the physician. 2. Anticipate reduced dosage in clients with impaired renal function.

-The name of the drug is Natrapharm. -The generic is Fixcom 3. - Dosages: Antituberculosis shortcourse chemotherapy recommended by World Health Organization (WHO) involves an initial phase and a continuation phase. The continuation phase of 4-6 months using combination drugs with the aim of elimination of any remaining organisms and thus preventing recurrence. For the continuation: Fixcom 3 is given for 46 months as follows: Patients <55 kg: 3 tabs/day. Patients 55-70 kg: 4 tabs/day. Patients >70 kg: 5 tabs/day. The tablets should be taken 1 hr before or 2 hrs after meals. -The name of the drug is Vitamin B complex.

-Treatment of pulmonary &extrapulmonary TB.

Evaluation: Evaluate client for: 1. Clinical and laboratory evidence of control or prevention of hemorrhage. 2. Freedom from complications of drug therapy. -Treatment -Administer on an empty of pulmonary & stomach 1hror 2hr before extra pulmonary meals. TB by sterilizing -Prepare patient for Mycobacterium the reddish-orange tuberculosis. coloring of body fluids; soft contact lenses may be permanently stained; advise patients not to wear them during therapy.

Pernicious anemia CONTRA:

-A coenzyme that stimulate metabolic

BEFORE: ~ Determine reticulocytecount, hct, Vit.

-The generic name is Vitamin B complex. -Dosage: The solution for injection is applied parenterally intramuscularly or (rarely) intravenously in dose 1-2 ml daily or each second day, within 5-10 days. The film-coated tablets are used orally in following doses: adults - 2-6 tablets daily; children 12 tablets daily.

~ hypersensitive to vitamin B12or cobalt.~ early Lebers disease

function and is needed for cell replication, hematopoiesis ,and nucleoprotein and myelin synthesis.

B 12, iron, folate levels before beginning therapy.~ Obtain a sensitivity test history before administration~ Avoid I.V. administration bec. faster systemic elimination will reduce effectiveness of vitamin. DURING: ~ Dont give large doses of vitamin B 12 routinely; drugis lost through excretion. ~ Dont mix parenteralpreparation in samesyringe with other drugs. AFTER: ~ Protect Vit. B 12 fromlight. Dont refrigerate or freeze.~ Monitor patient for hypokalemia for first 48hours, as anemia correctitself. Give potassiumsupplements, as needed

Anatomy and Physiology

UPPER RESPIRATORY TRACT Respiration is defined in two ways. In common usage, respiration refers to the act of breathing, or inhaling and exhaling. Biologically speaking, respiration strictly means the uptake of oxygen by an organism, its use in the tissues, and the release of carbon dioxide. By either definition, respiration has two main functions: to supply the cells of the body with the oxygen needed for metabolism and to remove carbon dioxide formed as a waste product from metabolism. This lesson describes the components of the upper respiratory tract. The upper respiratory tract conducts air from outside the body to the lower respiratory tract and helps protect the body from irritating substances. The upper respiratory tract consists of the following structures: The nasal cavity, the mouth, the pharynx, the epiglottis, the larynx, and the upper trachea. The esophagus leads to the digestive tract. One of the features of both the upper and lower respiratory tracts is the mucociliary apparatus that protects the airways from irritating substances, and is composed of the ciliated cells and mucus-producing glands in the nasal epithelium. The glands produce a layer of mucus that traps unwanted particles as they are inhaled. These are swept toward the posterior pharynx, from where they are either swallowed, spat out, sneezed, or blown out. Air passes through each of the structures of the upper respiratory tract on its way to the lower respiratory tract. When a person at rest inhales, air enters via the nose and mouth. The nasal cavity filters, warms, and humidifies air. The pharynx or throat is a tube like structure that connects the back of the nasal cavity and mouth to the larynx, a passageway for air, and the esophagus, a passageway for food. The pharynx serves as

a common hallway for the respiratory and digestive tracts, allowing both air and food to pass through before entering the appropriate passageways. The pharynx contains a specialised flap-like structure called the epiglottis that lowers over the larynx to prevent the inhalation of food and liquid into the lower respiratory tract. The larynx, or voice box, is a unique structure that contains the vocal cords, which are essential for human speech. Small and triangular in shape, the larynx extends from the epiglottis to the trachea. The larynx helps control movement of the epiglottis. In addition, the larynx has specialised muscular folds that close it off and also prevent food, foreign objects, and secretions such as saliva from entering the lower respiratory tract.