Drug Study

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 9

Name of Drug Classification Dose Mechanism Indication Contraindication Adverse Effect Nursing

of Action Responsibilities
Generic Name: Antidiabetic 30 min. Increases  Treatment of Contraindicated Hypersensitivity:  Assessment
Insulin Hormone AC glucose type 1 (insulin- with allergy to pork Rash, anaphylaxi
 History: Allergy to
(Regular ) transport dependent) products (varies s or angioedema
pork products;
across muscle diabetes with preparations;  Local: Allergy—
 Physical: Skin color,
Brand Name: and fat cell  Treatment of human insulin not local reactions at
lesions;
Humulin R membranes to type 2 (non– contraindicated injection site—
eyeball turgor;
reduce insulin- with pork allergy). redness,
orientation, reflexes,
glucose level. dependent) swelling, itching;
peripheral sensation,
Promotes diabetes that Contraindicated in usually resolves
BP, adventitious
conversion of cannot be hypoglycemia and in a few days to
sounds; adventitious
glucose into controlled by in patients a few weeks; a
sounds; urinalysis,
its storage diet or oral hypersensitive to change in type or
blood glucose
form, agents insulin or its species source of
 
glycogen  Regular insulin ingredients. insulin may be
Interventions
(Williams & injection: tried;
1. Assess patient’s
Wilkins, 2009, Treatment of Drug-drug: AIDS lipodystrophy;
glucose level before
page 689) severe ketoacid antiretrovirals, pruritus
starting therapy and
osis or diabetic corticosteroids, Metabolic: Hypogl
regularly thereafter. If
coma dextrothyroxine, ycemia; ketoacid
patient is under stress,
 Treatment epinephrine, osis
unstable, pregnant,
of hyperkalemia  thiazide diuretics
recently diagnosed, or
with infusion of may increase
taking drugs that can
glucose to insulin response.
interact with insulin,
produce a shift Beta blockers may
monitor level more
of potassium conceal signs of
frequently.
into the cells hypoglycemia.
 Highly purified 2. Monitor patient’s
and Hormonal
glycosylated
human insulins p contraceptives may
hemoglobin level
romoted for decrease glucose
regularly.
short courses of tolerance, monitor
therapy glucose level and
3. Monitor urine ketone
(surgery, intercu adjust insulin
level when glucose level
rrent disease), dosage carefully.
is elevated.
newly diagnosed (Williams &
Wilkins, 2009, page
patients, 690) 4. Be alert for adverse
patients with reaction and drug
poor metabolic interactions.
control, and
patients with 5. Monitor injection
gestational sites for local reactions.
diabetes
 Insulin injection 6. Assess patient and
concentrated: family’s knowledge of
Treatment of drug therapy.
diabetic patients  
with marked Teaching points
insulin  Use the same type
resistance and brand of syringe;
(requirements use the same type
of > and brand of insulin
200 units/day) to avoid dosage
 Glargine errors.
(Lantus):  Do not change the
Treatment of order of
adult patients mixing insulins.
with type 2 Rotate injection sites
diabetes who regularly (keep a
require basal chart) to prevent
insulin control of breakdown at
hyperglycemia injection sites.
Treatment of adults  Dosage may vary with
and children > 6 yr activities, stress, diet.
who require Monitor blood or
baseline insulin urine glucose levels,
control and consult physician
if problems arise.
 Monitor urine or
blood for glucose
and ketones as
prescribed.
 Wear a medical alert
tag stating that you
have diabetes and are
taking insulin so that
emergency medical
personnel will take
proper care of you.
  Avoid alcohol;
serious reactions can
occur.
 Report fever, sore
throat, vomiting,
hypoglycemic or
hyperglycemic
reactions, rash.

Generic Name: Anti-infective, 500 BID Is primarily a To reduce the Hypersensitivity to Adverse effects: Pre-administration
Doxycycline tetracycline bacteriostatic. development of any of the CNS: benign  Check doctor’s
It enters the drug-resistant tetracyclines. intracranial order
gram negative bacteria and hypertension  Observe 10 Rs
bacteria by maintain the Children less than 8 (higher in Intra-administration
passive effectiveness of years of age. children)  Administer 1 hr or
diffusion DORYX and other GI: esophagitis, 2 hrs after meals.
through the antibacterial drugs, Pregnancy and hepatotoxicity,  May be taken with
porin channels DORYX should be lactation pancreatitis. food if GI irritation
and gram used only to treat Derm: rashes occurs
positive or prevent Porphyria Hemat: blood  Administer with a
channels and infections that are dyscrasias. full glass of liquid
gram positive proven or strongly Severe hepatic Local: phlebitis at and at least 1 hr
bacteriaand suspected to be dysfunction IV site. before going to bed
other caused by Misc: to avoid
organisms by susceptible hypersensitivity esophageal
energy- bacteria. When reactions, ulceration.
dependent culture and superinfection.  Avoid
active susceptibility Side effects: administration of
transport. It is information are GI: diarrhea, calcium, zinc,
concentrated available, they nausea, vomiting antacids,
intracellularly should be Derm: magnesium- or
by vulnerable considered in photosensitivity aluminum-
cells. selecting or containing
Tetracyclines modifying medications,
after entering antibacterial sodium
the cell are therapy. In the bicarbonate, or
bound absence of such iron supplements
reversibly to data, local within 1-3 hr of
the 30S epidemiology and oral tetracyclines.
subunit of the susceptibility
ribosomes of patterns may Post administration:
bacteria. Here contribute to the  Document
the empiric selection of Observe for adverse
aminoacyl- therapy. reactions
tRNA is
prevented
from attaching
to the
acceptor site
which is
present on the
ribosomal
complex of
mRNA. This
leads to
inhibition of
the process of
adding amino
acids to the
emerging

Name: Insulin Timing: Lowers blood  To  Headach


degludec Therapeutic QID glucose level improve  Contraindi e Prolonged effect of
class: by stimulating glycemic cated  Pyrexia long-acting insulin may
Antidiabetics peripheral control in during (fever) delay recovery from
glucose patients episodes  Peripher hypoglycemia. Monitor
Pharmacologic uptake by with type of al edema patient carefully.
class: Insulins binding to 1 diabetes hypoglyce  HTN
(Long-acting) insulin mellitus mia or (hyperte Monitor patients taking
receptors on  To diabetic nsion) other medications with
skeletal improve ketoacidos  Pharyngi insulin more closely.
muscle and in glycemic tis
fat cells, and control in is  Rhinitis because other drugs
by inhibiting patients Contraindicated in  Cataract can mask signs and
hepatic with type patient’s  Retinopa symptoms of
glucose 2 diabetes hypersensitive to thy hypoglycemia or cause
production; mellitus drug or its  Abdomin an increase or a
also inhibits components al pain decrease in blood
lipolysis and  Gastroen glucose level
proteolysis, teritis
and enhances  Nausea Adjust dosages
protein  Vomiting regularly, depending on
synthesis  Diarrhea patient-specific glucose
 UTI measurements.
 Hypoglyc
emia Monitor patient
 Sodium carefully for signs and
retention symptoms of
 Weight hypoglycemia,
gain especially in long-
standing disease. Treat
 Back
according to individual
pain
facility policy and
 URI
procedure if necessary.
(Upper
Respirat
Mild episodes of
ory
hypoglycemia may be
Infection
treated with oral
)
glucose. More severe
 Bronchiti
episodes of
s
hypoglycemia, such as
 Injection
coma, seizure, or
-site
neurologic impairment,
reactions
may be treated with
 Lipodystr
I.M. or subcutaneous
ophy
glucagon or
 Pruritus
concentrated I.V.
 Rash glucose
 Allergic
reactions
 Infection Assess patient for s/sx
of hypoglycemia
(sweating, shaking,
trembling, confusion)
and hyperglycemia
(drowsiness, fruity
breath odor, frequent
urination, thirst). Notify
prescriber if any of
these signs or
symptoms occur

Periodically measure
HbA1c levels

Increase frequency of
glucose monitoring in
patients who are
acutely ill or under
emotional stress, or if
changes in diet,
exercise, or medication
regimen occur, as these
may affect the rate of
insulin absorption. Also,
closely monitor patient
after changes to insulin
dosage

Teach patient that


alcohol may affect
glucose levels and
should be avoided

Instruct patient to keep


hard candy or glucose
tablets on hand to treat
mild cases of
hypoglycemia

Instruct patient to
rotate injection sites
within same region to
reduce risk of
lipodystrophy

Teach patient to watch


for s/sx of
hypoglycemia
(sweating, shaking,
trembling, confusion)
and hyperglycemia
(drowsiness, frequent
urination, thirst)
Generic name: Hypoglycemic 15mg Increases To control blood • Hypersensitivity CNS: dizziness, • Monitor blood
Glyburide BID insulin binding glucose in type 2 to drug • Type 1 drowsiness, glucose level, especially
Brand name: and sensitivity (non- (insulindependent) headache, during periods of
Diabeta Glycron at receptor insulindependent) diabetes weakness increased stress.
Glynase sites, diabetes mellitus in • Severe renal, • Monitor CBC and
Micronase stimulating patients who have hepatic, thyroid or CV: increased CV renal function test
insulin release some pancreatic other endocrine mortality risk results.
from beta function and don’t disease • If patient is ill or has
cells in respond to diet • Pregnancy or EENT: visual abnormal laboratory
pancreas and therapy. breastfeeding accommodation findings, monitor
reducing changes, blurred electrolyte, ketone,
blood glucose vision glucose, pH, lactate
level. Also dehydrogenase, and
decreases GI: nausea, pyruvate levels.
production of vomiting, • Evaluate
basal glucose diarrhea, cardiovascular status.
in liver, constipation, • Advise patient to take
enhances cramps, daily dose with
sensitivity of heartburn, breakfast (and second
peripheral epigastric dose, if prescribed, with
tissue to distress, anorexia dinner).
insulin, • Teach patient how to
inhibits Hematologic: selfmonitor his glucose
platelet aplastic anemia, level as prescribed; tell
aggregation, leukopenia, him to report significant
and causes thrombocytopeni changes.
mild diuresis a, • Teach patient how to
agranulocytosis, recognize signs and
pancytopenia symptoms of
Hepatic: hypoglycemia and
cholestatic hyperglycemia.
jaundice, • Instruct patient to
hepatitis keep sugar source
available at all times.
Metabolic: • Encourage patient to
hyponatremia, drink plenty of fluids.
hypoglycemia • Stress importance of
diet and exercise in
Skin: rash, helping to control
pruritus, urticaria, diabetes.
eczema, • Advise patient to
erythema, wear or carry medical
photosensitivity, identification stating he
angioedema has diabetes.
• Caution patient to
Other: increased avoid driving and other
appetite hazardous activities
until he knows how
drug affects
concentration and
alertness.
• Tell patient he’ll
undergo regular blood
testing during therapy.
• As appropriate,
review all other
significant and
lifethreatening adverse
reactions and
interactions, especially
those related to the
drugs, tests, herbs, and
behaviors mentioned
above.

You might also like