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مجموعه متنوعه من الادويه بشرح كامل

ملتقى الرعاية الصيدلية
موضوع مغلق
  رقم المشاركة : [ 11 ]
قديم 03-30-2012, 11:43 PM
كبار الشخصيات
 

عفويه will become famous soon enoughعفويه will become famous soon enough
افتراضي

Cloxacillin

Trade name: Orbenin
Class: antibiotic - penicillinase-resistant penicillins
Pregnancy: Category B


Action: Inhibit bacterial cell wall synthesis

Uses
Infections caused by penicillinase- producing staphylococci, streptococci, pneumococci
Osteomylitis
pneumonia
infected wounds & burns
Septic arthritis

Dose : by mouth, 250–500 mg every 6 hours, at least 30 minutes before food; Child under 2 years quarter adult dose; 2–10 years half adult dose
By intramuscular injection, 250–500 mg every 6 hours; Child under 2 years quarter adult dose; 2–10 years half adult dose

By slow intravenous injection or by intravenous infusion, 025–2 g every 6 hours; Child under 2 years quarter adult dose; 2–10 years half adult dose
Endocarditis 12 g daily in 6 divided doses for 4 weeks
Osteomyelitis up to 8 g daily in 3–4 divided doses

Contraindications
Hypersensitivity to penicillins & cephalosporin

Side effects
Allergic: skin rashes, pruritis, wheezing, fever…
Diarrhea, abdominal cramps pain, nausea, vomiting
Psendomembranous colitis, thrombocytopenia, leucopenia
Thrombophlebitis + Electrolytes imbalance following IV use
Hepatotoxicity

Nursing considerations
Administer on an empty stomach
Refrigerate reconstituted solution & discard remaining amount after 14 days
NB: To prepare oral suspension, add amount of water stated on label and shake well
Shake the bottle well before each use



من مواضيع : عفويه
عفويه غير متواجد حالياً  
  رقم المشاركة : [ 12 ]
قديم 03-30-2012, 11:44 PM
كبار الشخصيات
 

عفويه will become famous soon enoughعفويه will become famous soon enough
افتراضي

Dexamethasone

Trade name: dexacort
Class: adrenocorticosteroid –synthetic, glucocorticoid type
Pregnancy: Category C/D if used in 1st trimester


Action• They are a group of natural hormones produced by the adrenal cortex
They are used for a variety of therapeutic purposes
Many slightly modified synthetic variants are available today
Some patients respond better to one substance than to another
These hormones influence many metabolic pathways & all organ systems & are essential for survival
The release of corticosteroids is controlled by hormones such as corticotropin- releasing factor produced by the hypothalamus & ACTH produced by the anterior pituitary


Uses


Replacement therapy: adrenal insufficiency (Addison’s disease)
Rheumatic disorders: rheumatoid arthritis & osteoarthritis
Collagen diseases: systemic lapus erythematosus, rheumatic cardiac
Allergic diseases: drug hypersensitivity, urticarial transfusion reaction
Respiratory diseases: bronchial asthma, rhinitis
Ocular diseases : allergic & inflammatory conjunctivitis, keratitis
Dermatological diseases: psoriasis, contact dermatitis, urticaria
Diseases of the GIT: ulcerative colitis
Nervous system: Myasthenia gravis
Malignancies: leukemia, lymphoma
Nephrotic syndrome• Hematologic diseases: hemolytic anemia, thrombocytopenic purpura
Miscellaneous: septic shock, liver cirrhosis, stimulation of surfactant
Production, prevention of organ rejection


Dose

By mouth, usual range 05–10 mg daily;
by intramuscular injection or slow intravenous injection or infusion (as dexamethasone phosphate), initially 05–20 mg; CHILD
200–500 micrograms/kg daily

Cerebral edema (as dexamethasone phosphate), by intravenous injection, 10 mg initially, then 4 mg by intramuscular injection every 6 hours as required for 2–10 days
Shock (as dexamethasone phosphate), by intravenous injection or infusion, 2–6 mg/kg, repeated if necessary after 2–6 hours
Note Dexamethasone 1 mg = dexamethasone phosphate 12 mg = dexamethasone sodium phosphate 13 mg


Contraindications

If infection is suspected (Mask signs & symptoms)
Peptic ulcer
Acute glomerulonephritis
Cushing’s syndrome
Congestive heart failure
Hypertension
Hyperlipidemia


Side effects

Edema, alkalosis, hypokalemia, hypertension, CHF muscle wasting, weakness, osteoporosis, nausea & vomiting
Headache, hypercholesterolemia, hirsutism, amenorrhea, depression
Redistribution of body fats: thin extremities and fat trunk, moon-like face, buffalo hump

Nursing considerations

 Administer oral forms with food to minimize ulcerogenic effect
 For chronic use, give the smallest dose possible
 Corticosteroids should be discontinued gradually if used chronically
 Document baseline weight, BP, Pulse & temperature
 Frequently take BP, monitor body weight - signs of Na+ & H2O retention
 Periodic serum electrolytes, blood sugar monitoring
 Report signs & symptoms of side effects - Cushing-like syndrome
 Discuss with female client potentials of menstrual difficulties
 Instruct the client to take diet high in protein & potassium
 Instruct the client to avoid falls & accidents - osteoporosis causes Pathological fracture
 Remind the client to carry a card identifying the drug being used
 Stress the need for regular medical supervision
 Advice the client to delay any vaccination while taking these medications Weakened immunity
 Explain the need to maintain general hygiene & cleanliness to prevent Infection



من مواضيع : عفويه
عفويه غير متواجد حالياً  
  رقم المشاركة : [ 13 ]
قديم 03-30-2012, 11:44 PM
كبار الشخصيات
 

عفويه will become famous soon enoughعفويه will become famous soon enough
افتراضي

Digoxin

Trade name: Lanoxicaps, Lanoxin, Novo-Digoxin (CAN)

Drug classes
Cardiac glycoside
Cardiotonic agent
Pregnancy: (Category C)


Therapeutic actions
Increases intracellular calcium and allows more calcium to enter the myocardial cell during depolarization via a sodium---potassium pump mechanism; this increases force of contraction (positive inotropic effect), increases renal perfusion (seen as diuretic effect in patients with CHF),decreases heart rate (negative chronotropic effect), and decreases AV node conduction velocity

Indications
CHF
Atrial fibrillation
Atrial flutter
Paroxysmal atrial tachycardia

Dose

by mouth, rapid digitalization, 1–15 mg in divided doses over 24 hours; less urgent digitalization, 250–500 micrograms daily (higher dose may be divided), Maintenance, 625–500 micrograms daily (higher dose may be divided) according to renal function and, in atrial fibrillation, on heart-rate response; usual range, 125–250 micrograms daily (lower dose may be appropriate in elderly)
Emergency loading dose by intravenous infusion, 075–1 mg over at least 2 hours then maintenance dose by mouth on the following day

Contraindications
Contraindications: allergy to digitalis preparations, ventricular tachycardia, ventricular fibrillation, heart block, sick sinus syndrome, IHSS, acute MI, renal insufficiency and electrolyte abnormalities (decreased K+, decreased Mg++, increased Ca++)
Use cautiously with pregnancy and lactation

Side effects
CNS: Headache, weakness, drowsiness, visual disturbances
GI: GI upset, anorexia
CV: Arrhythmias

Nursing Considerations
Monitor apical pulse for 1 min before administering; hold dose if pulse <60 in adult or <90 in infant, retake pulse in 1 h If adult pulse remains <60 or infant <90, hold drug and notify prescriber Note any change from baseline rhythm or rate
Check dosage and preparation carefully
Avoid IM injections, which may be very painful
Follow diluting instructions carefully, and use diluted solution promptly
Avoid giving with meals; this will delay absorption
Have emergency equipment ready; have K+ salts, lidocaine, phenytoin, atropine, and cardiac monitor on standby in case toxicity develops
Monitor for therapeutic drug levels: 05---2 ng/mL



من مواضيع : عفويه
عفويه غير متواجد حالياً  
  رقم المشاركة : [ 14 ]
قديم 03-30-2012, 11:47 PM
كبار الشخصيات
 

عفويه will become famous soon enoughعفويه will become famous soon enough
افتراضي

Dobutamine hydrochloride

Trade name: Dobutrex
Drug classes:
• Sympathomimetic
• β1-selective adrenergic agonist
Pregnancy: Category B


Therapeutic actions
Positive inotropic effects are mediated by β1- adrenergic receptors in the heart; increases the force of myocardial contraction with relatively minor effects on heart rate, arrhythmogenesis; has minor effects on blood vessels

Indications
For inotropic support in the short-term treatment of adults with cardiac decompensation due to depressed contractility, resulting from either organic heart disease or from cardiac surgical procedures
Investigational use in children with congenital heart disease undergoing diagnostic cardiac catheterization, to augment CV function

Dosage
Available Forms: Injection 125 mg/mL
Administer only by IV infusion
Titrate on the basis of the patient's homodynamic/renal response
Close monitoring is necessary

Adult
25---15 µg/kg/min IV is usual rate to increase cardiac output; rarely, rates up to 40 µg/kg per minute are needed

IV facts
Preparation: Reconstitute by adding 10 mL Sterile Water for Injection or 5% Dextrose Injection to 250-mg vial If material is not completely dissolved, add 10 mL of diluent Further dilute to at least 50 mL with 5% Dextrose Injection, 09% Sodium Chloride Injection, or Sodium Lactate Injection Store reconstituted solution under refrigeration for 48 h or at room temperature for 6 h Store final diluted solution in glass or via flex container at room temperature Stable for 24 h Do not freeze (Note: drug solutions may exhibit a color that increases with time; this indicates oxidation of the drug, not a loss of potency

Infusion: May be administered through common IV tubing with dopamine, lidocaine, tobramycin, nitroprusside, potassium chloride, or protamine sulfate Titrate rate based on patient response--P, BP, rhythm; use of an infusion pump is suggested
Incompatibilities: Do not mix drug with alkaline solutions, such as 5% Sodium Bicarbonate Injection; do not mix with hydrocortisone sodium succinate, cefazolin, cefamandole, neutral cephalothin, penicillin, sodium ethacrynate; sodium heparin
Y-site Incompatibilities: Do not mix with acyclovir, alteplase, aminophylline, foscarnet

Adverse effects

CNS: Headache
GI: Nausea
CV: Increase in heart rate, increase in systolic blood pressure, increase in ventricular ectopic beats (PVCs), anginal pain, palpitations, shortness of breath

Clinically important interactions
Drug-drug
Increased effects with TCAs (eg, imipramine), furazolidone, methyldopa
Risk of severe hypertension with β-blockers
Decreased effects of guanethidine with dobutamine

Nursing Considerations
Arrange to digitalize patients who have atrial fibrillation with a rapid ventricular rate before giving dobutamine--dobutamine facilitates AV conduction
Monitor urine flow, cardiac output, pulmonary wedge pressure, ECG, and BP closely during infusion; adjust dose/rate accordingly



من مواضيع : عفويه
عفويه غير متواجد حالياً  
موضوع مغلق

مواقع النشر (المفضلة)

الكلمات الدليلية (Tags)
متنوعه, مجموعه, الادويه, بشرى, كامل


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