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gemcitabine hydrochloride
Brand Name: Gemzar
Actions Exhibits antitumor activity; indicated as first-line treatment of locally advanced or metastatic adenocarcinoma of the pancreas
Side effects: Myelosuppression; nausea and vomiting; macular papular pruritic rash
Nursing interventions Monitor: CBC. Provide antiemetic to control nausea and vomiting. Provide relief measures to control pruritus
Lactulose
Brand Name: Chronulac, Cephulac
Actions: Acidifies colonic contents, thus decreasing absorption of ammonia from gut; also has cathartic laxative properties; primarily used in hepatic encephalopathy
Side Effects: Nausea, vomiting, diarrhea
Nursing Interventions Titrate dose to three or four loose stools per day; monitor for dehydration; monitor for serum ammonia levels and improved mental status
Spironolactone
Brand Name Aldactone
Action: Competes with aldosterone at receptor sites in distal tubule, resulting in excretion of sodium chloride and water and retention of potassium and phosphate; used in cirrhosis of the liver with ascites
Side Effects Headache, confusion, diarrhea, bleeding, dysrhythmias, impotence, hypokalemia
NURSING INTERVENTIONS Assess electrolytes, sodium, chloride, potassium, BUN, serum creatinine. Weigh daily; monitor I&O. Administer in the morning to avoid interference with sleep
meperidine
Brand NAme: Demerol
Action: Binds to opiate receptors in CNS; alters perception of and response to painful stimuli, while producing generalized CNS depression; used for biliary pain because morphine may cause spasms of the sphincter of Oddi
Side effects: Sedation, confusion, respiratory depression, hypotension, bradycardia, nausea, vomiting, urinary retention
Nursing interventions: Assess type, location, intensity of pain before and 1 hr after administration. If respiratory rate is <10 breaths/min, assess level of sedation
propantheline
Brand Name: Pro-BanthineAction: Antisecretory and antispasmodic agent; slows GI motility through anticholinergic activity; decreases pancreatic activity
Side effects: Drowsiness, confusion, dry mouth, constipation, urinary retention, tachycardia, blurred vision
Nursing interventions: Avoid use with other CNS depressants or alcohol; avoid driving or other activities until accustomed to effects; may cause hypotension when given intravenously; do not use in patients with Parkinson's disease
vasopressin
Brand Name: Pitressin
Action: Synthetic pituitary agent; antidiuretic effects on kidney; a potent vasoconstrictor; used to treat bleeding esophageal varices
Side effects: Hypertension; ischemia to heart, mesenteric organs, and kidneys; angina; myocardial infarction; water retention; hyponatremia
Nursing interventions: Use with caution in older adults and in patients with known coronary artery disease or known CHF; discontinue if chest pain develops; monitor urinary output and serum sodium
neomycin
Brand Name: Mycifradin, MyciguentAction: Inhibits protein synthesis in bacteria at the level of the 30S ribosome subunit; decreases the number of ammonia-producing bacteria in the gut as part of management of hepatic encephalopathy
Side effects: Ototoxicity; local stinging, burning; nephrotoxicity
Monitor neurologic status and renal function
cholestyramine
Brand Name: QuestranActions: Binds bile acids in the GI tract, forming an insoluble complex; relief of pruritus associated with elevated levels of bile acids
Side effects: Nausea, constipation, abdominal discomfort
Assess severity of pruritus and skin integrity
pancrelipase
Brand Name: Pancrease, Cotazym
Action: Increased digestion of fats, carbohydrate, and proteins in the GI tract; treatment of pancreatic insufficiency associated with chronic pancreatitis, pancreatectomy.
Side effects: Diarrhea, nausea, stomach cramps, abdominal painAssess patient's nutritional status; monitor stools for high fat content;
assess patient for allergy to pork; administer immediately before meals or with meals
carbamazepine
Brand: Tegretol
Class: Anticonvulsants
It can treat seizures, nerve pain, and bipolar disorder.
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