Medication: Ferrous Sulfate
Category Class: Iron supplements; Hematinic
Pharm Action: Provide elemental iron, an essential component in the formation of hemoglobin
Therapeutic Action: Provide treatment for Iron deficiency anemia
Complications: GI discomfort. Melena, hypersensitivity, hypotension, nausea
Contraindications:
-
Hemochromatosis, hemosiderosis, or other evidence of iron overload; Anemias not due to iron
deficiency
Contraindicated to hypersensitivity of the drug.
Contraindicated to peptic ulcer
Precautions: Peptic ulcer, Pregnancy, severe hepatic impairment, rheumatoid arthritis
Interactions: Iron supplements, tetracycline, vitamin E, ACE Inhibitors, penicillamine
Medication Admin: PO
Liquid - 75 mg/mL, 300 mg/mL; Tablets - 200 mg, 300 mg, 324 mg, 325 m
Nursing Inter: Assess nutritional status and dietary history to determine possible cause of anemia and
need for patient teaching
Client Education: Explain purpose of iron therapy to patient.
-
Advise patient that stools may become dark green or black and that this change is harmless
Instruct patient to follow a diet high in iron
Evaluation of Effectiveness: Increased Hemoglobin
Improvement in iron deficiency
Med effectiveness: Improvement of iron deficiency.
Medication: Flonase/ Fluticasone Propionate Nasal Spray
Category Class: anti-inflammatories
Pharm Action: Potent, locally acting anti-inflammatory and immune modifier.
Therapeutic Action: Decrease in symptoms of allergic and nonallergic rhinitis
Complications: Dizziness, headache, bronchospasm, dry mouth, oral fungal infection, anaphylaxis, angioedema
Contraindications: Hypersensitivity
Precautions:
-
Active untreated infections
Diabetes or glaucoma
-Underlying immunosuppression(due to disease or concurrent therapy)
-Systemic corticosteroid therapy(should not be abruptly discontinued when intranasal therapy is started)
-Concurrent use of ritonavir Recent nasal trauma,
-septal ulcers, or
-surgery (wound healing may be impaired by nasal corticosteroids)
-OB: Lactation: Pedi: Pregnancy, lactation, or children <4 yr (for Flonase) or <2 yr (for Veramyst)(safety not
established; prolonged or high-dose therapy may lead to complications
Interactions: Increase effects of budesonide, ciclesonide and fluticasone.
Ritonavir increase effects of fluticasone
Medication Admin: Intranasal
1 spray in each nostril
Nursing Inter: monitor degree of nasal stiffness, amount and color of nasal discharge, and frequency of sneezing
Client Education:
-
Practice good hygiene
-Do not wash the inhaler or get
any part of it wet
-Clean the mouthpiece weekly
-Discard the inhaler by the printed
date on the canister
Med Effectiveness: Resolution of nasal stiffness, discharge and sneezing due to
seasonal or perennial allergic rhinitis. Decrease in symptoms
of nasal polyps
Medication: Furosemide (Lasix)
Category Class: Loop diuretic
Pharm Action: Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal
tubule
Therapeutic Action: Edema due to heart failure, hepatic impairment, or renal disease. Hypertension
Complications: dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia,
hyponatremia, hypovolemia, metabolic alkalosis, increased BUN, excessive urination, aplastic anemia,
agranulocytosis, leukopenia, and thrombocytopenia
Contraindications: Contradicted in hepatic coma or anuria. avoid in patients with alcohol intolerance.
use caution in severe liver disease, electrolyte imbalance, DM, hypoproteinemia, severe renal
impairment. Geri pts have increased risk of hypotension & electrolyte imbalance
Interactions: increased risk of hypotension with antihypertensives, nitrates, or acute ingestion of
alcohol, increased risk of hypokalemia with other diuretics, amphotericin B, stimulant laxatives, and
corticosteroids. Hypokalemia may increased of digoxin toxicity
Medication Admin: PO: 20-80 mg/day as single dose initially, may repeat in 6-8 hours. May increase
dose by 20-40mg q6-8 hrs until desired outcome. maintenance dose may be given once or twice daily
Nursing Inter: Monitor daily weight, intake and output ratios, amount and location of edema, lung
sounds, skin turgor, and mucous membranes. monitor BP & HR. Assess for tinnitus & hearing
Client Education: call Dr immediately if rash, muscle weakness, cramps, nausea, dizziness, numbness, or
tingling of extremities occurs. change positions slowly, monitor weight gain for change of 3lbs/day. use
sunscreen when in the sun.
Medication: Glucophage
Category Class: ANTI-DIABETIC biguanides
Pharm Action: Decrease hepatic glucose production and intestinal glucose absorption
Therapeutic Action: Management of high blood sugar related to type two diabetes
Complications: lactic acidosis & hypoglycemia, Abdominal bloating, diarrhea, vomiting
Contraindications: Metabolic acidosis, dehydration, hepatic impairment, renal
disfunction, heart failure
Interactions: Furosemide and Cimetidine may increase the effects of this medication. Nifedipine may
increase absorption and effects
Medication Admin: The recommended amount for an adult is 500 mg and may be increased up to 2000
mg depending on the necessity of the patient
Nursing Inter: Monitor the patients serum blood glucose levels and notate any significant changes.
Monitor patients I/O and weight accordingly. Observe for signs and symptoms of hypoglycemic
reactions
Client Education: Inform client that medication does not cure diabetes, instead aids in the alleviation of
hypoglycemic events. Inform patient to try and stick to the diet as much as is possible.
Med Effectiveness: Control of blood glucose levels without the appearance of hypoglycemic or
hyperglycemic episodes
Medication: HCTZ (Hydrochlorothiazide)
Category Class: Diuretic
Pharm Action: Inhibits sodium reabsorption in distal tubules. Layman, makes you pee more to help
control your high blood pressure.
Therapeutic Action: Used to treat edema and help in lowing high blood pressure.
Complications: Diarrhea, headache, nausea, cough, dehydration, fatigue,
hyper/hypokalemia, and hypotension
Contraindications: Pregnancy Cat B, nursing mothers, diabetes, renal or liver disease, parathyroid
disease, hypoglycemia, fluid/electrolyte imbalance, or gout. Hypersensitivity to HCTZ or other
sulfonamide derived drug.
Interactions: Amphotericin, antidiabetics, corticosteroids, loop diuretics,
barbiturates, alcohol, or salt substitutes.
Medication Admin: PO: 25mg-100mg.Medication should be administered of the morning
Nursing Inter: Monitor electrolyte levels, bp, edema. Monitor I&O's. Observe for changes in LOC,
dizziness, fatigue, postural hypotension. Monitor renal and metabolic function test
Client Education: Do Not take with alcohol. Report adverse effects. Stop immediately if swelling occurs.
Withhold medication for if BP is below what physician instructed. Caution for light headedness and
cough, avoid salt substitutes. Adequate fluid intake.
Med Effectiveness: Exhibit a reduction in systolic/diastolic blood pressure. Demonstrate electrolyte
levels within normal limits during drug therapy. Demonstrate understanding of the drug's action by
accurately describing drug side effects and precautions. Demonstrate urinary output within normal
levels