NURS 237 Nursing Research


Question:


Disseminate about Nursing Research, Treatment of Depression Disorders, Premenstrual dysphoric disorder, and other related topics.

Answer to Question: NURS 237 Nursing Research

Medication Research

SL No.

Drug

Generic name/Brandname

Classification

Therapeutic Use

AccuracySafe dosage for Adult

At the beginningPeak

Duration1.

Bronchophane (PO).Dextromethorphan/ Balminil DM, Benylin DM

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

Opioids structurally devoid analgesic property and act by directly activating the cough centre of the medulla.

15 mg

15-30 minutes

Unknown

3-6 hours2.Cetirizine(PO)Cetirizine/ ZyrtecAntihistamine

The treatment provides relief from the symptoms of allergic reactions caused by the release histamine. It is used in cases such as chronic urticaria, seasonal allergic rhinitis, and perennial allergic rhinitis.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 Hours

24 hour3.Citalopram(PO)

Celexa/ Citalopram Hydrobromide/ Celexa

Antidepressants and Selective Serotonin Recovery Inhibitor (SSRIs).

Treatment of depressive disorders, such as Premenstrual Dysphoric disorder (PMDD). Obsessive-compulsive disorder (OCD).

Panic disorder.

Generalized anxiety disorders (GAD).

Posttraumatic Stress Disorder (PTSD).

Social anxiety disorder (socialphobia).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

Unknown4.Diclofenac gel topicalDiclofenac/ Voltaren GelNon-opioid analgesics, Non-steroidal anti inflammatory drug (NSAID).

The treatment and management of Actinic keratoses and Osteoarthritis, in the knee area.

This causes inhibition of inflammatory markers such as prostaglandins which in turn suppresses pain and inflammation. Clearance of actinic keratosis lesions also occur (davisplus.fadavis.com, 2017).32 g/day

Unknown

10-20 hours

Unknown5.Gabapentin(PO)Gabapentin/ Neurontin, Gralise

Anticonvulsants, GABA analogs

Adjunct treatments and holistic therapies for disorders like Partial seizures.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 mgRapid

2-4 hours

8 hours6.Levothyroxine(Po)Levothyroxine Sodium/ Levothroid, Levoxyl, Synthroid, UnithroidThyroid ProductsUsed 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 weeks

1-3 Weeks7.Ondansetron(PO)Ondansetron Hydrochloride/ Zofran, Zofran ODT, Zuplenz

Selective Serotonin Receptor Antagonists

Useful for treating and preventing nausea and vomiting post-operatively and radiation-associated.

Blocking the chemoreceptor trigger region in the CNS in addition to blocking the effects presented serotonin 5-HT3 receptor site in the vagal neuro terminals.

24 mgRapid

15-30 min

4-8 Hours8.

Hydrocortisone (topical).Hydrocortisone/ Instacort, Scalpicin

Mild topical steroids

Useful in managing the adrenocortical shortage. Also, for local and systematic use in various disorders, including Inflammatory.

Reduces inflammation and normal immune reactions by suppressing adrenal function.

10 mg per g

Unknown

1-1/2 hours

1.25-1.25 days9.

Vitamin D (PO).Vitamin D/ Drisdol, Calciferol, cholecalciferol, 1,25-Dihydroxycholecalciferol, ergocalciferolFat-soluble vitamins

Useful for the prevention and treatment of Vitamin D deficiencies.

Through activation of the liver and kidneys, vitamin D3 is produced and absorbed by the intestinal system.50000 IU

Unknown

Unknown

Unknown10.Warfarin (Po)Warfarin Sodium/ CoumadinAnticoagulant

Prophylaxis, treatment and prevention of venous and pulmonary thrombosis, atrial fibrillation and embolization.Acts by interfering with the vitamin K dependent clotting factors including II, VII, IX and X (davisplus.fadavis.com, 2017).

5 mg

36-72 hours

5-7 Days

2-5 Days11.ISoptotear eye drops lubricating gel ( 0.5%)Hypromellose / Artificial Tears, Celluvisc, Clear Eyes CLR, GenTealOcular lubricant

Used to treat inflammation and pain associated with ocular surgical procedures.

It reduces inflammation.1 drop four times daily

Unknown

Unknown

Unknown12.Pantroprazole(PO)Pantroprazole Sodium/ Protonix

Inhibitors for the Proton Pump

Efficient in the treatment of erosive esophagitis caused by GERD or pathologic gastric Hypersecretory Conditions.

This treatment helps reduce the relapse rates for patients with GERD.

When there is gastric acidic pH, the enzyme can be bound to it and thus prevent the ultimate transport of hydrogen ions through the gastric lumen.

40 mg

2.5 hour

Unknown

1 week13.Benzocaine- menthol (PO)Benzocaine/menthol/ Cepacol Sore Throat, Chloraseptic

Topical anesthetic

Responsible for the treatment of minor skin problems such as dermatitis or hemorhoids and burns.

The act of preventing the initiation and conduct of sensory nerve impulses.15% Topical Liquid

About 1 minute

Unknown

15-20 minutes

Drug

Teaching patient

Reaction adverse

Contraindications

Caution

InteractionsOndansetron(PO)

Conform to the prescribed drug regime. Immediate referral for physician in case arrhythmias, involuntary movement or eye pain occurs.

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

Hypersensitivity, Congenital Long QT Syndrome, Concurrent Application of Apomorphine

Hepatic impairments, Abdominal surgery and lactation.

Increased danger of severe hypotension.(davisplus.fadavis.com, 2017)Hydrocortisone (tropical)

Conform to the prescribed dosage, Be aware of adrenal insufficiency when suddenly stopping medication.

Depression, hypertension or cataracts, weight gain, weight loss or weight regain

Active untreated infected and during lactation

Chronic treatment, Lowest dose and for the shortest amount of time.

Additive hypokalemia associated with additive loop-diuretics, amphotericinB, and thiazide.(davisplus.fadavis.com, 2017)

Vitamin D(PO).

Compliance with medication, Diet modification review with patient. Caution of self-medicating. Avoid concurrent use of antacids which have magnesium. Evaluation of followup programs to evaluate progress.

Hypercalcemia. Headache. Conjunctivitis. Arrhythmia. Anorexia. Polyuria. Muscle. bone pain.

Hypersensitivity, Vitamin D toxicity, Malabsorption issues

Take vitamin D supplements with magnesium 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%)

Proper method and frequency of instillation of eye drop. Wearing contact lenses at application. Notification to doctor in the case of irritation, redness or swelling.

Increased intraocular tension, cataract, corneal erosion, infection, photophobia

Active mycobacterial or viral infection of eyes and nearby structures

Safety for pregnant and breastfeeding women, as well as childrenNot noted (davisplus.fadavis.com, 2017)Pantroprazole(PO)

Respect for medication. Avoidance of simultaneous intakes of alcohol, NSAIDs or other stomach irritants.

Flatulence, headache, diarrhea, hyperglycemia, and hypermagnesemia can all be caused by bone fractures.

Hypersensitivity, Unnecessary Pregnancy Use, Discontinuation Breastfeeding to Lactating Mothers to Avoid Serious Adverse Reactions

Patients receiving high doses for more than one year of medication have a higher propensity to fracture. 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)

Avoid excessive use.

Allergic reactions and anaphylaxis – burning, irritations, oedema, stinging

Hypersensitivity

Apply in large areas of skin that have been abraded or damaged, not for children younger than 2 years.

Repeated use cholinesterase inhibitors can cause an increase in toxicities of ester type agents(davisplus.fadavis.com, 2017)Pathophysiology Research

SL No.

Disease

PathophysiologyRisk factor

Signs and Symptoms

Physical assessment1.

Spinal Stenosis

An opening in the spine that narrows, which puts pressure on the spinal canal and nerves traveling down the spine, to the arms or legs. This is mostly due to osteoarthritis, which causes wear and tear of the spine.

Age 50 years or older, Osteoarthritis. Herniated and Tumors. Paget disease. Spinal injuries. Thickened ligaments.

Sciatica. Foot drop. Loss of bladder and bowel control. Difficulty with standing or walking. Worsening equilibrium.

Numbness, weakness or paralysis.2.Gastro-oesophageal reflux

Digestive disorder causing acid indigestion or heartburn by altering the lower esophageal Sphincter (LES), where the contents of your stomach travel back and flow towards the esophageal. (El-Serag. et. al., 2013, El-Serag).

Obesity. Hiatal hernia. Pregnancy. Asthma.

Heartburn, Dry cough and chest pain.

Acid regurgitation. Pain or difficulty when swallowing. Bad breath. Chest pain.

SL No.

Disease

Nursing InterventionDiagnostic Test

TeachingPatient Information1.

Spinal Stenosis

Prescription medications to relieve pain, as well as application of heat or cold packs. Exercise and nutrition for excess weight.

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

The purpose of therapeutic exercise is to improve strength and endurance, balance and stability as well as flexibility and stability of the spine.

Initial symptoms, extent of pain, Family history and Associated medical problems. Current medication or supplements.2.Gastro-oesophageal reflux

Lifestyle changes are encouraged, such as weight loss, quitting smoking, reducing alcohol, caffeine consumption, and avoiding heavy dinner meals. Also, avoid lying down for more than two to three hours after sleeping.

X-rays of upper gastrointestinal tract. Endoscopy.

Lifestyle and dietary adjustments can be made to minimize the damage done by refluxed material.

Avoid eating and drinking foods or beverages that may cause LES damage.

While lying down, raise the head of the mattress.

Continuous medical treatment or medications

Refer toCostandi, S., Chopko, B., Mekhail, M., Dews, T., & Mekhail, N. (2015).

Lumbar spinalstenosis: Review of the therapeutic options.

Pain Practice 15(1), 68–81.Davisplus.fadavis.com. (2017). benzocaine. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/anestheticstopicalmucosal.pdfDavisplus.fadavis.com. (2017). cholecalciferol. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/cholecalciferol.pdfDavisplus.fadavis.com. (2017).

difluprednate is an ophthalmic. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/difluprednateophthalmic.pdfDavisplus.fadavis.com. (2017). hydrocortisone. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/hydrocortisone.pdfDavisplus.fadavis.com. (2017). ondansetron. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/ondansetron.pdfDavisplus.fadavis.com. (2017). pantoprazole. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/pantoprazole.pdfDavisplus.fadavis.com. (2017). cetirizine. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/cetirizine.pdfDavisplus.fadavis.com. (2017). citalopram. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/citalopram.pdfDavisplus.fadavis.com. (2017). dextromethorphan. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/dextromethorphan.pdfDavisplus.fadavis.com. (2017). diclofenac. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/diclofenac.pdfDavisplus.fadavis.com. (2017). gabapentin. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/gabapentin.pdfDavisplus.fadavis.com. (2017). levothyroxine. Retrieved 6 May 2017, from https://davisplus.fadavis.com/3976/meddeck/pdf/levothyroxine.pdfDrugguide.com. (2017).

Davis’s Drug Guide.

Update on the epidemiology, gastro-oesophageal and reflux disease: A systematic overview. Gut, gutjnl-2012.