NURS 343 - Medication drugs
 Anti-inflammation
1. NSAIDs
 Drug Class: Acetylsalicylic Acid (aspirin/ASA), Salicylates
 Brand name: Bayers
 Generic name: Aspirin
 Expected pharmacological outcome/ actions:
- Inhibit synthesis of prostaglandin, used to treat mild to moderate pain and fever
- Antithrombotic effect: used in the treatment of MI and other thromboembolic disorders
 Therapeutic action and indications: Treatment of inflammation conditions, including rheumatoid
arthritis and osteoarthritis, Fever reducer, Blood thinner, Pain reliever, Prophylaxis of transient
Ischemic attacks of MI or stroke; reduction of risk of myocardial infarction.
 Pharmacokinetics:
- Oral: Onset: 5-30 min, Peak: 0.25 -2 h, Duration: 3-6 h
- Rectal: Onset: 1-2 h, Peak: 4-5 h, Duration: 6- 8 h
- T1/2: 15 minutes to 12 hours; metabolized in the liver and excreted in the urine
 Medication administer:
- PO: 80-325 mg daily (antiplatelet)
- Rectal/PO: 325-1000 mg q 4-6 h (pain & fever)
 Adverse effects:
- Nausea, vomiting, heartburn, epigastric discomfort, occult blood loss, dizziness, tinnitus, acidosis,
mental confusion, lassitude, GI bleeding, dyspepsia, epigastric distress, abdominal pain, anorexia,
anemia, hemolysis, rash, urticaria, anaphylaxis, laryngeal edema, eighth cranial nerve stimulation.
 Contraindication/ Precautions:
- Presence of other NSAIDS,
- Known allergy, bleeding abnormalities, impaired renal function
 Drug-drug interactions:
- May increase risk of bleeding with warfarin, heparin, and heparin-like agents.
- Increases anticoagulant effect and bleeding risk with arnica, chamomile, clove, feverfew, garlic,
ginger, ginkgo, Panax ginseng, and others.
 Nursing intervention: Monitor liver and renal function, electrolytes, bleeding time, complete blood
count, and serum drug levels if the patient is on long-term therapy. Also, monitor for drug effectiveness.
 Client education: Take food or milk. Report tinnitus (toxicity level reached). Avoid taking it with other
NSAIDs. If the tabs smell like vinegar, they are no longer effective. Contraindicated for children
younger than 16 years of age (Reye's syndrome)
2. NSAIDs
 Drug Class: Nonsteroidal anti-inflammatory drugs (NSAIDs)
 Brand name: Advil, Motrin
 Generic name: Ibuprofen
 Expected pharmacological outcome/ actions: It inhibits prostaglandin synthesis by blocking COX-1
and COX-2 receptor sites, leading to an anti-inflammatory, analgesic, and antipyretic effect.
 Therapeutic action and indications: Relief of the signs and symptoms of rheumatoid arthritis and
osteoarthritis; relief of mild to moderate pain; treatment of primary dysmenorrhea; fever reduction.
 Pharmacokinetics:
- Oral: Onset: 30 min, Peak: 1-2 h, Duration: 4-6 h
- IV: Onset: Start of infusion, Peak: minutes, Duration: 4-6 h
- T1/2:1.8 to 2.5 hours; metabolized in the liver and excreted in the urine
 Medication administer:
- PO: Administer 30 minutes before or 2 hours after meals. It can be administered with food, milk,
or antacids to reduce GI inflammation. The tablets can be crushed and mixed with fluids or food,
and the 800 mg tablet can be dissolved in water.
 Adverse effects: Nausea, vomiting, heartburn, epigastric discomfort, dizziness, tinnitus, acidosis,
headache, nervousness, MI, seizures, heart failure, abdominal cramps, anorexia, GI bleeding,
hemorrhage, renal failure, bronchospasm, bleeding, hypokalemia
 Contraindication/ Precautions: contraindicated with an active GI bleed or ulcer disease, chewable
tablets contain aspartame and should not be used in patients with phenylketonuria precaution CABG
surgery, history of recent MI, and severe HF
 Drug-drug interactions:
- may limit antiplatelet effects of aspirin,
- added GI adverse effects with aspirin, oral K+ other NSAIDs, corticosteroids, or alcohol.
- decrease the effectiveness of diuretics, ACE inhibitors, or other antihypertensives.
- increase hypoglycemic effects,
- increase lithium levels
- increased risk of nephrotoxicity.
 Nursing intervention:
- Assess for rhinitis, asthma, and urticaria (hypersensitivity).
- patients with asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing
hypersensitivity reactions.
- Monitor VS and pain level
 Client education:
- Take food or milk and remain upright for 30 minutes to decrease irritation of the lower esophagus.
Alcohol increases the potential for stomach irritation. It may cause drowsiness or dizziness. Report
abdominal/stomach pain or black-red, odorous stools. Report rash or sore throat immediately
3. NSAIDs
 Drug Class: Nonsteroidal anti-inflammatory drugs (NSAIDs)
 Brand name: Celebrex
 Generic name: Celecoxib
 Expected pharmacological outcome/ actions: Inhibiting cyclooxygenase (COX-2) results in
decreased inflammation, fever, and pain but does not decrease platelet aggregation.
 Therapeutic action and indications: Inflammation suppression, analgesia for mild to moderate pain,
fever reduction, dysmenorrhea
 Pharmacokinetics:
- Oral:
 Medication administer:
- PO: 2 hrs. before or after magnesium or aluminum-based antacids
 Adverse effects: Gastric upset, heartburn, nausea, diarrhea, gastric ulceration, kidney dysfunction,
cardiovascular and cerebrovascular events.
 Contraindication/ Precautions:
- Pregnancy
- Severe hepatic or kidney impairment
- Children younger than 18
- Allergy to celecoxib, sulfa, and sulfonamides.
- Alcohol use disorder, heart failure, cardiovascular disease, hypertension, diabetes mellitus, asthma,
a history of GI bleeding, peptic ulcer disease, renal impairment, and cerebrovascular accident
- History of induced nasal polyps with bronchospasm
- Treatment of pain after coronary artery bypass graft surgery
 Drug-drug interactions:
- Celecoxib interacts with furosemide (Lasix), decreasing its diuretic effects.
- Fluconazole (Diflucan) can increase celecoxib levels.
- Celecoxib increases the anticoagulant effects of warfarin.
 Nursing intervention:
- Monitor for gastric upset, heartburn, nausea, diarrhea, or GI bleeding
- low urine output & fluid retention
- Monitor for rapid rises in BUN & creatinine
- Test for and treat Helicobacter pylori infection
- Monitor for signs of myocardial infarction and cerebrovascular accident
 Client education:
- Instruct patient to swallow whole with a full glass of water and food to prevent an upset stomach
- Avoid alcohol consumption and smoking
- Take dose exactly as prescribed; altering dosage can cause serious adverse reactions Celebrex
increases the risk of CHF and serious adverse GI bleeding
- Reinforce the use of low-dose aspirin once daily.
- Report persistent gastric irritation and signs of gastrointestinal bleeding, changes in urine output,
weight gain, and signs of fluid retention such as edema or bloating.
- Report chest pain or heaviness, shortness of breath, headache, numbness, weakness, visual
disturbances, or confusion.
4. Antihistamine – first generation (drowsy)
 Drug Class: Antihistamine
 Brand name: Benadryl
 Generic name: diphenhydramine
 Expected pharmacological outcome/ actions: Competitively blocks the effects of histamine at
histamine1 receptor sites; has atropine-like antipruritic and sedative effects.
 Therapeutic action and indications: Symptomatic relief of perennial and seasonal rhinitis, vasomotor
rhinitis, allergic conjunctivitis, urticaria, and angioedema; also used for treating motion sickness and
parkinsonism and as a nighttime sleep aid and to suppress coughs.
 Pharmacokinetics:
- Oral: Onset: 15-30 min, Peak: 1-4 h, Duration: 4-7 h
- IM: Onset: 20-30 min, Peak: 1-4 h, Duration: 4-8 h
- IV: Onset: Rapid, Peak: 30-60 min, Duration: 4-8 h
- T1/2: 2.5 to 7 hours; metabolized in the liver and excreted in the urine.
 Medication administer:
- PO: Give with food
- IV: May be given undiluted, Give IV injections over at least 1 min, Maximum rate: 25 mg/min
- IM: Give deep IM into large muscle mass.
 Adverse effects: Drowsiness, sedation, dizziness, epigastric distress, thickening of bronchial
secretions, urinary retention, rash, bradycardia, muscle weakness, hypotension, dry mouth, nose, throat,
and lips.
- In the elderly: sedation, dizziness; Occasional: Epigastric distress, flushing, visual/hearing
disturbances, paresthesia, diaphoresis, chill
 Contraindication/ Precautions:
- Acute exacerbation of asthma, neonates or premature infants, breastfeeding.
- Cautions: Narrow-angle glaucoma, stenotic peptic ulcer, COPD, prostatic hypertrophy, pylori
duodenal/bladder neck obstruction, CV disease, asthma, increased IOP, hyperthyroidism, patient
with a history of arrhythmias or prolonged QT intervals because fatal cardiac arrhythmias have
been associated with the use of certain antihistamines and drugs that increase QT intervals,
including erythromycin.
 Drug-drug interactions: antihypertensives, beta-blockers, calcium channel blockers, aspirin,
ergotamine, heparin, alcohol use.
 Nursing intervention:
- Monitor bp
- Monitor children closely for paradoxical reactions
- Monitor vitals, auscultate lungs and heart
- Monitor for worsening allergic reactions.
 Client education:
- sedative effect may occur.
- Avoid tasks that require alertness and motor skills until a response to the drug is established.
- Dry mouth, drowsiness, and dizziness may be an expected response to the drug.
- Avoid alcohol.
5. Antihistamine – Second-generation (less-drowsy)
 Drug Class: Antihistamine
 Brand name: Zyrtec
 Generic name: Cetirizine
 Expected pharmacological outcome/ actions: Blood vessels do not dilate; reduced swelling; mucus,
other nasal, eye, respiratory secretions are reduced; narrowed airways widen; hives decrease in size,
itchiness
 Therapeutic action and indications: It temporarily relieves the symptoms of hay fever (allergy to
pollen, dust, or other substances in the air) and allergy to other substances (such as dust mites, animal
dander, cockroaches, and molds).
- Symptoms include sneezing, runny nose, itchy, red, watery eyes, and itchy nose or throat.
 Pharmacokinetics:
- Oral: Onset: 20-60 min, Peak: 1 h, Duration: 24 h
 Medication administer:
- PO: Tablet, a chewable tablet, an extended-release tablet, and a syrup (liquid) to take by mouth
 Adverse effects: Seizures (rare), increased intraocular pressure, Sleepiness, dry mouth, blurred vision,
tachycardia, urinary retention.
 Contraindication/ Precautions: Cetirizine is also contraindicated in anyone with a known
 hypersensitivity to hydroxyzine, as cetirizine is a metabolite of hydroxyzine; not recommended to
children under two years of age. Renal impairment.
 Drug-drug interactions: Benzodiazepine, Other antihistamine, Relaxant, Opioid pain relievers, Cough
medicines
 Nursing intervention:
- Check before: Glaucoma, high blood pressure, prostate enlargement. Other drugs being taken that
cause sedation
- Check after: Vital signs, Assist patient when getting out of bed
- Assess history and Physical Exam and known allergy
- Pregnancy or lactation; and prolonged QT interval, renal or hepatic impairment
- Skin, orientation, affect, and reflexes
- Respirations and adventitious sounds
- Appropriate lab values
 Client education:
- Avoid alcohol
- Avoid driving or operating machinery within 6 hours of administration
6. Corticosteroids/Glucocorticoids
 Drug Class: Glucocorticoids
 Brand name: Rayos, Deltasone
 Generic name: Prednisone
 Expected pharmacological outcome/ actions: Initiate many complex reactions responsible for antiinflammatory and immunosuppressive effects.
- Reduced redness, pain, swelling at site of inflammation; increased function of affected area
 Therapeutic action and indications:
- Short-term treatment of many inflammatory disorders (respiratory inflammation, joint pain)
- To relieve discomfort
- To give the body a chance to heal from the effects of inflammation
 Pharmacokinetics:
- Oral: Onset: varies, Peak: 1-2 h, Duration: 1-1.5 d h
- T1/2: 3.5 hours; metabolized in the liver and excreted in the urine
 Medication administer:
- PO: 5-60 mg/day
 Adverse effects: Adrenal gland atrophy, masking of infection
- Short-term therapy—hypertension, acne, insomnia, nervousness
- Long-term therapy—adrenal gland suppression, reduced immune function, delayed wound healing,
“Cushingoid appearance”
 Contraindication/ Precautions: Known allergy, Acute infection, Lactation
- Caution: Diabetes, acute peptic ulcer
 Drug-drug interactions: Fungal infection, Seizure disorder, Ulcerative colitis, Coagulopathy, Insulin
and oral hypoglycemics, Concurrent use of salicylates and NSAIDs, Digoxin: Because of the risk for
hypokalemia, there is an increased risk of dysrhythmias caused by digoxin. Live virus vaccines
 Nursing intervention:
- Physical assessment: Symptoms of infection, baseline weight, height, intake and output status,
Hydration/nutritional status, vital signs (especially blood pressure), immune status, Baseline labs
- Assess for edema and electrolyte imbalance, skin condition.
- Assess for contraindications to adrenal drugs, especially the presence of peptic ulcer disease.
- Assess for Drug allergies and potential drug interactions (prescription and over-the-counter drugs).
- Glucose levels: Be aware that these drugs may alter serum glucose and electrolyte levels.
- Prepare and administer according to manufacturer’s directions.
- Steroid medications are taken at the same time every day, usually in the morning, with meals or
food.
- Assess: Known allergies, acute infections, peptic ulcer disease, pregnancy, lactation, endocrine
disturbances, and renal dysfunction weight; temperature
- Orientation and affect; grip strength; eye examination; blood pressure, pulse, peripheral perfusion,
and vessel evaluation; respiration and adventitious breath sounds; glucose tolerance, renal function,
serum electrolytes, and endocrine function tests as appropriate
 Client education:
- Do not stop medication abruptly.
- Avoid grapefruit juice and limit caffeine intake
7. Corticosteroids/Glucocorticoids
 Drug Class: Glucocorticoids
 Brand name: Decadron
 Generic name: Dexamethasone
 Expected pharmacological outcome/ actions: suppresses inflammation and the normal immune
response.
 Therapeutic action and indications: Suppression of inflammation and modification of the normal
immune response.
 Pharmacokinetics:
- Parental: Peak: 0.5 – 4 h
 Medication administer:
- 10 mg intravenous, then 4 mg intramuscular or intravenous every 6 hours until maximal response
is achieved, then switch to a by-mouth regimen and taper over 5 to 7 days
 Adverse effects: Peptic ulceration, Thromboembolism, hypertension, adrenal suppression, acne,
decreased wound healing, ecchymoses, hirsutism, petechiae, anorexia, nausea, edema, increased
appetite, muscle wasting, osteoporosis, euphoria,
 Contraindication/ Precautions:
- Active untreated infections (may be used in patients being treated for tuberculous meningitis)
- known alcohol or bisulfite hypersensitivity or intolerance
- epidural use (may result in serious neurological injury or death)
- lactation, chronic treatment, stress, and potential infection
- Older adults: Extra precautions to avoid infection, Monitor blood glucose levels. Adrenal crisis
would be when you use dexamethasone on something intravenous.
 Drug-drug interactions: CYP3A4 inhibitors/inducers, thiazide-increased risk of hypokalemia,
digoxin-increased risk of toxicity, increased insulin, decreased levels of phenytoin and isoniazid,
increased levels with oral contraceptives, adverse gastrointestinal effects with NSAIDS, warfarin
 Nursing intervention:
- Assess for signs of adrenal insufficiency before and during therapy.
- Assess changes in the level of consciousness and headache during therapy.
- Monitor serum electrolytes and glucose.
 Client education:
- instruct patient to inform physician promptly if severe abdominal pain or tarry stools occur.
- inform patient periodic lab tests or eye exams may be needed.
 Analgesics
8. Opioids (narcotic agonist)
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Drug Class: Opioids
Brand name: Roxanol, Astra morph
Generic name: Morphine
Expected pharmacological outcome/ actions:
- Act at specific opioid receptor sites in the CNS.
- Produce analgesia, sedation, and a sense of well-being
Therapeutic action and indications:
- Relief of severe acute or chronic pain
- Analgesia during anesthesia
Pharmacokinetics:
- Oral: Onset: Varies, Peak: 60 min, Duration: 5-7 h
- PR: Onset: Rapid, Peak:20-60 min, Duration: 5-7 h
- Subcutaneous: Onset: Rapid, Peak: 50-90 min, Duration: 5-7 h (absorption varies between sexes)
- IM: Onset: Rapid, Peak: 30-60 min, Duration: 5-6 h (absorption varies between sexes)
- IV: Onset: Immediate, Peak: 20 min, Duration: 5-6 h (most reliable way)
- T1/2: 1.5 to 2 hours; metabolized in the liver, excreted in the urine and bile.
Medication administer: oral, IM, IV, SC, rectally, or epidural
Adverse effects: Respiratory depression with apnea, cardiac arrest, shock, orthostatic hypotension,
nausea, vomiting, constipation, biliary spasm, dizziness, psychoses, anxiety, fear, hallucinations
Contraindication/ Precautions: Known allergy, pregnancy, labor, lactation, Diarrhea caused by
poisons
- Caution: Respiratory dysfunction, GI or GU surgery, Acute abdomen or ulcerative colitis
Drug-drug interactions: Barbiturate general anesthetics, phenothiazines, and MAOIs
Nurse intervention:
- assess the risk of tolerance and dependence, assess bowel function
- Assess pain level and monitor vitals. If the respiratory rate is less than 12, notify the provider and
withhold medication.
- Have naloxone and resuscitation equipment available.
- Monitor I&O's and bowel patterns
- Encourage position changes deep breathing, and coughing
- monitor for nausea and orthostatic hypotension
Client education:
- Avoid the consumption of alcohol and meds that have CNS effects
- Avoid hazardous activities such as driving due to the sedative effects
- Report trouble breathing and shortness of breath.
- discuss safe storage (theft/kids), abuse potential
- Report constipation
- Pregnancy: crosses the placenta and breast milk
9. Narcotic antagonist
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Drug Class: Opioids
Brand name: Narcan
Generic name: Naloxone
Expected pharmacological outcome/ actions: Drugs that bind strongly to opioid receptors, but they
do not activate the receptors. Reverse effects of opioids
Therapeutic action and indications: Reversal of the adverse effects of narcotics, Treat narcotic and/or
alcoholic dependence.
Pharmacokinetics:
- Subcutaneous: Onset: 3-5 min, Peak: Unknown, Duration: 4-6 h
- IM: Onset: 3-5 min, Peak: Unknown, Duration: 4-6 h
- IV: Onset: 2 min, Peak: Unknown, Duration: 4-6 h
- T1/2: 30 to 81 minutes; metabolized in the liver, excreted in the urine.
Adverse effects: Tachycardia, Blood pressure changes, Dysrhythmias
Contraindication/ Precautions: Hypersensitivity to Naloxone or its components. Do not mix naloxone
with any other solution unless you verify that the drugs are compatible; the drug is incompatible with
alkaline, bisulfate, and metabisulfite solutions.
Drug-drug interactions: Alcohol, Antihistamines, Barbiturates, Benzodiazepines, Monoamine
oxidase inhibitors
Nurse intervention:
- Check before: Pain intensity using the preferred pain scale: FACES, Scale 1 - 10
- When the patient last received the drug
- Check dosages carefully. Follow proper administration guidelines for IM injections, including site
rotation. Follow proper guidelines for IV administration, including dilution, rate of administration.
- Oral forms should be taken with food to minimize gastric upset.
- Ensure safety measures, such as keeping side rails up, to prevent injury.
- Withhold the dose and contact the physician if there is a decline in the patient’s condition or if vital
signs are abnormal, especially if the respiratory rate is less than 10 to 12 breaths/min.
- Constipation is a common adverse effect and may be prevented with adequate fluid and fiber intake.
- Instruct patients to follow directions for administration carefully and to keep a record of their pain
experience and response to treatments.
- Patients should be instructed to change positions slowly to prevent possible orthostatic
hypotension.
- Monitor for adverse effects. Contact the physician immediately if vital signs change, the patient’s
condition declines, or the pain continues.
- Respiratory depression may be manifested by respiratory rate of less than 10 breaths/min, dyspnea,
diminished breath sounds, or shallow breathing. Respiratory depression, addiction, dependence,
withdrawal, Known drug allergy, Severe asthma
- Use with extreme caution in patients with: Respiratory insufficiency, Elevated intracranial pressure,
Morbid obesity or sleep apnea, Paralytic ileus, Pregnancy
Client education:
- Educate best pain relief occurs when drugs are taken on a regular schedule rather than PRN;
Reduce dose but maintain schedule if pain is lessened
- Take with food, Do not drive or operate heavy machinery, Change positions slowly
10. Non-narcotic analgesics
 Drug Class: Analgesics
 Brand name: Tylenol
 Generic name: Acetaminophen
 Expected pharmacological outcome/ actions:
- Acts directly on the thermoregulatory cells of the hypothalamus
- Mechanism of action unknown but related to analgesic effects
- Used to treat pain and fever:
- Treat pain and fever associated with a variety of conditions, including influenza
- Prophylaxis of children receiving diphtheria–pertussis–tetanus (DPT) immunizations
- Relief of musculoskeletal pain associated with arthritis
 Therapeutic action and indications: It treats mild to moderate pain, fever, or signs and symptoms of
the common cold or flu, as well as musculoskeletal pain associated with arthritis and rheumatic
disorders.
 Pharmacokinetics:
- PO: Onset: varies, Peak: 0.5-2 h, Duration: 3-6 h
- IV: Onset: Beginning of infusion, Peak: End of infusion, Duration 4-6 h
- T1/2: 1 to 3 hours; Absorbed in the GI tract, metabolized in the liver and excreted in the urine
 Medication administer: PO (Adults and Children >12 yr): 325–650 mg every 6 hr or 1 g 3–4 times
daily or 1300 mg every 8 hr (not to exceed 3 g or 2 g/24 hr in patients with hepatic/renal impairment)
 Adverse effects:
- Headache, hemolytic anemia, renal dysfunction, skin rash and fever
- Hepatotoxicity usually associated with chronic use and overdose
 Contraindication/ Precautions:
- Known allergy
- Use with caution in pregnancy and lactation
- Hepatic dysfunction or chronic alcoholism
 Drug-drug interactions:
- Oral anticoagulants increase bleeding
- Hepatotoxicity with barbiturates, carbamazepine, hydantoins, or rifampin
 Nurse Intervention:
- Do not exceed the recommended dosage.
- Consult physician if needed for children < 3 yr; if needed for longer than 10 days; if continued
fever, severe or recurrent pain occurs (possible serious illness).
- Avoid using multiple preparations containing acetaminophen. Carefully check all OTC products.
- Give the drug with food if GI upset occurs.
- Discontinue the drug if hypersensitivity reactions occur.
 Client education:
- Advise pt not to exceed recommended dose; not to take for longer than 10 days (for adult) or 5 days
(for child). Advise taking the drug only for complaints indicated; it is not an anti-inflammatory
agent.
- Inform patients with diabetes that acetaminophen may alter results of blood glucose monitoring.
- Advise patients to consult Dr. if discomfort of fever is not relieved by routine doses of this drug or
if fever is greater than 39.5 C (103 F) or less longer than 3 days
 Muscle relaxant
11. Central-acting skeletal muscle relaxants
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Drug Class: Skeletal muscle relaxant
Brand name: Amrix
Generic name: Cyclobenzaprine
Expected pharmacological outcome/ actions:
- Work in upper levels of CNS to interfere with reflexes causing muscle spasm
- Possible depression anticipated with their use
Therapeutic action and indications: Alleviation of signs and symptoms of spasticity; use in spinal
cord injuries or diseases; relief of spasms of acute musculoskeletal conditions that occur in adults
Pharmacokinetics:
- PO: Rapidly absorbed and metabolized in the liver, Excreted in the urine
Medication administer: PO: This may be administered with meals to minimize gastric irritation.
Swallow extended-release capsules whole; do not open, crush, or chew. Capsules may be opened and
contents sprinkled onto applesauce; swallow immediately without chewing. Rinse mouth to make
sure contents have been swallowed.
Adverse effect: Drowsiness, Fatigue, Weakness, Confusion, Headache, Nausea, Dry mouth,
Hypotension
Contraindications/ Precautions: Known allergy, Rheumatic disorders
- Cautions: Epilepsy, Cardiac dysfunction, Conditions marked by muscle weakness
Drug-drug interactions: Additive CNS depression with other CNS depressants such as alcohol,
antihistamines, opioid analgesics & sedatives/hypnotics
Nurse Intervention:
- Assess for pain, muscle stiffness & range of motion
- Assess for serotonin syndrome
Client education:
- Instruct patients to notify health care professionals immediately if signs and symptoms of serotonin
syndrome occur.
- Instruct patients to take medication as directed at the same time each day; do not take more than
the prescribed amount. Take missed doses within 1 hr. of the time ordered; otherwise, return to
normal dose schedule. Do not double doses
12.
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Direct-acting skeletal muscle relaxant
Drug Class: Skeletal muscle relaxant
Brand name: Dantrium, revontp
Generic name: Dantrolene
Expected pharmacological outcome/ actions:
- Interfering with the release of calcium from the muscle tubules
- This prevents the fibers from contracting
- Does not interfere with neuromuscular transmission
Therapeutic action and indications:
- Treatment of spasticity directly affecting peripheral muscle contraction
- Management of spasticity associated with neuromuscular diseases
- Treatment of prevention of malignant hypothermia
Pharmacokinetics:
- PO: Slowly absorbed from the GI tract
- T1/2: 4-8 h, metabolized in the liver and excreted in the urine
Medication administer:
Adverse effects:
Contraindications/ Precautions:
- Known allergy
- Spasticity- that contributes to locomotion, upright position, or increased function
- Hepatic disease
- Lactation
- Caution: Women, all patient older than 35 yrs., cardiac disease
Drug-drug interactions:
- Estrogen
- Neuromuscular junction blockers and others that interfere with neuromuscular transmission
Nurse Intervention:
- Assess History and Physical Exam
- Assess Known allergies cardiac depression, epilepsy, muscle weakness, or rheumatic disorder
- Assess CNS orientation, affect, reflexes, bilateral grip strength, and spasticity
- Assess Respiration and adventitious sounds; pulse, electrocardiogram, and cardiac output; bowel
sounds and reported output; and liver and renal function tests
Client education:
- Inform provider if muscle weakness occurs
- Avoid driving/activities that require mental alertness if drowsy
- Avoid CNS depressants (alcohol)-Contact provider if diarrhea occurs
- Report signs of liver dysfunction: abdominal pain, jaundice