NURS 237 Nursing Research : Premenstrual Dysphoric Disorder

SL No.

Drug

Generic name/ Brand name

Classification

Therapeutic use

Action

Safe dosage for Adult

Onset

Peak

Duration

1.

Bronchophan (PO)

Dextromethorphan/ Balminil DM, Benylin DM

Antitussives

Treatment of irritating nonproductive cough, Symptomatic relief of coughs caused by viral upper respiratory tract infection or inhaled irritants (davisplus.fadavis.com, 2017).

Structurally related to opioids devoid of analgesic properties and acts by directly acting on the cough centre in medulla thereby causing suppression of the cough reflex.

15 mg

15-30 min

Unknown

3-6 hour

2.

Cetirizine(PO)

Cetirizine/ Zyrtec

Antihistamine

Provides relief from allergic symptoms caused by release of histamine in conditions encompassing se

Dose dependent sedation effects with minimal anticholinergic effects and exerts the antagonizing impacts of histamine at H₁ receptor site without binding or inactivating histamine(davisplus.fadavis.com, 2017).

10 mg/day

30 min

4-8 hour

24 hour

3.

Citalopram(PO)

Citalopram Hydrobromide/ Celexa

Antidepressants, Selective Serotonin Reuptake Inhibitor (SSRIs)

Treatment of depressive disorders including Premenstrual dysphoric disorder (PMDD). Obsessive-compulsive disorder (OCD). Panic disorder. Generalized anxiety disorder (GAD). Posttraumatic stress disorder (PTSD). Social anxiety disorder (social phobia).

The reuptake of the neurotransmitter serotonin is selectively inhibited in the Central Nervous System (CNS) (davisplus.fadavis.com, 2017).

40 mg/day

1-4 week

Unknown

Unknown

4.

Diclofenac gel topical

Diclofenac/ Voltaren Gel

Non-opioid analgesics, Non-steroidal anti inflammatory drug (NSAID).

Pain management and treatment of Actinic keratoses, Osteoarthritis in the knee region.

Causes inhibition of inflammatory markers like prostaglandins, thereby suppressing pain and inflammation. Clearance of actinic keratosis lesions also occur (davisplus.fadavis.com, 2017).  

32 g/day

Unknown

10-20 hour

Unknown

5.

Gabapentin(PO)

Gabapentin/ Neurontin, Gralise

Anticonvulsants, GABA analogs

Adjunct and holistic treatments for disorders like Partial seizures, Post-herpetic neuralgia, Restless legs syndrome, Neuropathic pain, migraine headache, Bipolar disorder, Anxiety, Diabetic peripheral neuropathy.

Mechanism of action is unknown till date and might affect the transport of amino acids across neuronal membranes thereby imparting stabilization (davisplus.fadavis.com, 2017).

400 mg

Rapid

2-4 hour

8 hour

6.

Levothyroxine(Po)

Levothyroxine Sodium/ Levothroid, Levoxyl, Synthroid, Unithroid

Thyroid Products

Used as thyroid supplementation for hypothyroidism, Suppression or management of euthyroid goiters, Adjunctive treatment in case of thyrotropin-dependent thyroid cancer.

Acts as replacement of supplementation of endogenous thyroid hormones and cause of increment of metabolic rate of body tissues by means of promoting gluconeogenesi, accentuated utilization and mobilization of glycogen stores, stimulation of protein synthesis, promotion of cell growth and differentiation alongside aiding in the development of brain and CNS (davisplus.fadavis.com, 2017).

200 mcg/day

Unknown

1-3 week

1-3 week

7.

Ondansetron(PO)

Ondansetron Hydrochloride/ Zofran, Zofran ODT, Zuplenz

Selective Serotonin Receptor Antagonist (SSRA)

Used for the treatment and prevention of post operative as well as radiation associated nausea and vomiting.

Blocking of the chemoreceptor trigger zone in the CNS apart from blocking the effects presented by the serotonin at the 5-HT₃ receptor sites situated in the vagal nerve terminals.  

24 mg

Rapid

15-30 min

4-8 hour

8.

Hydrocortisone (topical)

Hydrocortisone/ Instacort, Scalpicin

Mild topical corticosteroid

Used in managing the adrenocortical insufficiency besides systematic and local use in variety of disorders including Inflammatory, Allergic, Hematologic, Neoplastic, Autoimmune disorders, Septic shock.

Causes suppression of inflammation and normal immune responses by suppressing adrenal function and exerting intense metabolic effects.

10 mg in 1 g

Unknown

1-2 hour

1.25-1.5 days

9.

Vitamin D (PO)

Vitamin D/ Drisdol, Calciferol, cholecalciferol, 1,25-Dihydroxycholecalciferol, ergocalciferol

Fat-soluble vitamins

Used for treatment or prevention of Vitamin D related deficiency.

Action is exerted by means of activation in the liver and kidneys to generate the active form of vitamin D₃ and facilitates the intestinal absorption of dietary calcium.

50000 IU

Unknown

Unknown

Unknown

10.

Warfarin (Po)

Warfarin Sodium/ Coumadin

Anticoagulant

Treatment and prophylaxis of venous thrombosis, pulmonary embolism, atrial fibrillation with embolization, Other potential uses include management of myocardial infarction, abatement of thrombus formation and embolization in post prosthetic valve replacement condition.

Acts by interfering with the vitamin K dependent clotting factors including II, VII, IX and X (davisplus.fadavis.com, 2017).  

5 mg

36-72 hour

5-7 days

2-5 days

11.

ISoptotear  eye drops lubricating gel ( 0.5%)

Hypromellose / Artificial Tears, Celluvisc, Clear Eyes CLR, GenTeal

Ocular lubricant

Used in treatment of pain and inflammation associated with ocular surgery.  

Acts by decreasing the inflammatory markers.

1 drop four times daily

Unknown

Unknown

Unknown

12.

Pantroprazole(PO)

Pantroprazole Sodium/ Protonix

Proton Pump Inhibitors

Effective in treating conditions related to erosive esophagitis associated to GERD and pathologic gastric hypersecretory conditions. Helps in diminishing the relapse rates of both daytime and night time heartburn symptoms for GERD patients.

In the presence of gastric acidic pH, capable of binding to an enzyme thereby preventing the ultimate transportation of the hydrogen ions into the gastric lumen.

40 mg

2.5 hour

Unknown

1 week

13.

Benzocaine- menthol (PO)

Benzocaine/menthol/ Cepacol Sore Throat, Chloraseptic

Topical anesthetic

Responsible for reliving of pruritus or pain associated with minor skin disorders including burns, abrasions, bruises, insect stings/bites, dermatitis, hemorrhoids, or other forms of skin irritation.

Acts by means of inhibiting the initiation and conduction of sensory nerve impulses especially those carrying the nociceptive stimuli.

15% Topical Liquid

About 1 min

Unknown

15-20 min

Drug

Patient teaching

Adverse reaction

Contraindications

Precaution

Interactions

Ondansetron(PO)

Compliance to drug regime as directed, Immediate referral to physician in case of symptoms including arrhythmia, involuntary movement of eyes  or limbs

Headache, Dizziness, Fatigue, Dry mouth, Abdominal pain, Extrapyramidal reactions

Hypersensitivity, Congenital long QT syndrome, Concurrent application of apomorphine

Hepatic impairment, Abdominal surgery, lactation, pregnancy and children < 3year

Increased risk of severe hypotension alongside loss of consciousness

(davisplus.fadavis.com, 2017)

Hydrocortisone (tropical)

Adherence to medication regime, Caution for adrenal insufficiency on sudden cessation of medication, Possible effects on body image

Depression, hypertension, cataract, weight loss or weight gain

Active untreated infection and during lactation

Chronic treatment, Application in lowest possible dose at the shortest duration of time in course of chronic ailments

Additive hypokalemia with additive loop diuretics, amphotericin B and thiazide., decreased metabolism with oral contraceptives, NSAIDs increase the risk of adverse GI effects

(davisplus.fadavis.com, 2017)

Vitamin D(PO)

Compliance to medication, Diet modifications reviewing with patient, Caution of self medication, Avoidance of concurrent use of antacids having magnesium, evaluation of follow up programs for evaluating progress

Hypercalcemia, Headache, Conjunctivitis, Arrhythmia, Anorexia, Polyuria, Muscle and bone pain

Hypersensitivity, Vitamin D toxicity,  Malabsorption issues

Concurrent use of Vitamin D supplements or magnesium containing antacids

Mineral oil reduces the absorption of Vitamin D analogues, while corticosteroids decrease the effectiveness of vitamin D analogues (davisplus.fadavis.com, 2017)

ISoptotear  eye drops lubricating gel ( 0.5%)

Correct method and frequency for instillation of eye drops, Avoidance of wearing contact lenses during application, Notification to the physician in case of irritation, redness and swelling

Increased intraocular pressure, cataract, corneal oedema, infection, photophobia

Active mycobacterial, viral or fungal infection of eyes and neighborhood structures

Safety in case of children, pregnant and lactating women

Not noted (davisplus.fadavis.com, 2017)

Pantroprazole(PO)

Compliance to medication, Avoidance with simultaneous intake of alcohol, NSAID and  gastric irritants

Headache, diarrhea, flatulence, hyperglycemia, hypermagnesemia, bone fracture

Hypersensitivity, Unnecessary use in pregnancy, Discontinuation of breast feeding in lactating mothers to prevent serious adverse reactions in infants

Patients under high doses of medication for longer than 1 year due to increased propensity to fractrure

 Decreased absorption of drugs requiring acidic pH for its functioning, increased risk of bleeding when used with warfarin  (davisplus.fadavis.com, 2017)

Benzocaine- menthol (PO)

Harm from overuse, Caution and referral to physician in case of erythema, rash

Allergic reactions and anaphylaxis, burning, irritation, oedema, stinging

Hypersensitivity

Not for children<2 years, caution in debilitated patients, application in large and abraded areas of skin

Increase in toxicity of ester type agents due to repeated use of cholinesterase inhibitors

(davisplus.fadavis.com, 2017)

SL No.

Disease

Pathophysiology

Risk factor

Sign and Symptoms

Physical assessment finding

1.

Spinal stenosis

Narrowing of the open spaces of the spine that exerts pressure on the spinal cord and the nerves travelling down the spine to the arms and legs, occurring mostly in the lower back and neck region due to wearing and tearing of spine because of osteoarthritis (Costandi et al., 2015).

Age 50 years and beyond, Osteoarthritis, Herniated discs, Tumors, Paget’s disease, spinal injuries, thickened ligaments

Sciatica, Foot drop, Loss of bladder or bowel control, Difficulty in standing  or walking, Worsening balance

Numbness, weakness, paralysis, homeostasis, balance problems, incontinence

2.

Gastro-oesophageal reflux

Digestive disorder causing heart burn or acid indigestion by means of affecting the lower esophageal sphincter (LES) whereby the contents of the stomach travel back and flow up towards the esophagus (El-Serag et al., 2013).

Obesity, Hiatal hernia, Pregnancy, Asthma, Smoking, Scleroderma, Dry mouth, Diabetes, Delayed emptying of stomach

Burning sensation in chest (heartburn), Dysphagia, Dry cough, Chest pain, Sore throat, Acid reflux, Sensation of lump in throat

Acid regurgitation, Pain or difficulty while swallowing, Bad breath, Chest pain

SL No.

Disease

Nursing Intervention

Diagnostic Test

Teaching

Patient Information

1.

Spinal stenosis

Pain relievers through prescribed medications and application of hot or cold packs, Excess weight management through diet and nutrition, Utilization of canes or walkers as assistive devices for maintaining stability while walking.

X-rays, Magnetic Resonance Imaging (MRI), Computed Tomography (CT) Scan

Therapeutic exercise to build up strength and endurance, maintenance of stability and flexibility of the spine and improvement of balance.

First appearance of symptom, Extent of pain, Family history, Associated medical problems, Ongoing medications or supplements

2.

Gastro-oesophageal reflux

Encouragement of lifestyle modifications through losing weight, quitting smoking, reducing alcohol and caffeine consumption, limiting meal size and avoiding heavy evening meals, avoiding lying down within two to three hours of sleeping

X-ray of the upper gastrointestinal tract, Endoscopy, Ambulatory acid (pH) test, Esophageal impedance test

Lifestyle and dietary modifications to reduce the damage of the lining of the esophagus from refluxed materials. Avoidance of foods and beverages that might weaken the LES. Elevating the head of the bed while lying down.

Ongoing medical treatments or medications, Familial history, Symptoms experienced, Severity and frequency of occurrence of symptoms, Experience in post meal hour, Information about body weight