Question

1. List why this Medications below are being taken for patient with cystic fibrosis

2. For this medications below, name the class of drugs, Mechanism of actions, Indication, Contraindications, Adverse Effect and Nursing Action.

These are the Medications-

A. Pancrelipase (Creon) 3 capsules PO with meals, 1-2 PO snacks

B. Azithromycin (Zithromax) 5 mg/kg/day PO at 1200

C. Dornase alfa (Pulmozyme) 2.5 mg via nebulize every day

D. Levalbuterol (Xopenex) 2.5 mg via nebulizer 4 times a day

E.Vitamin E 400 International Units PO every day

F. Multivitamin 2 tablets PO every day

3. Give the  Definitions of this procedures below-

A. Respiratory chest physiotherapy

B. Mucus clearance device

C. Sweat test

D. Auscultation of heart and Lungs sounds

Answer 1

Pancrelipase-

Drug class- enzymes

Mechanism of action- creon is taken with meal so that it enter in stomach with food. it releases tiny coated spheres containing pancreatic enzymes. These spheres dissolve in small intestine there they break down fats, proteins, carbohydrates in food

Indication- this drug is indicated for the treatment of chronic pancreatitis, cystic fibrosis

Contraindications- person having Crohn's disease, blockage of stomach or intestine, high amount of uric acid in blood can not take creon.

Adverse effects- vomitting, nausea, diarrhea,gas, stomach pain

Nursing action- nurse should monitor weight of patient, note appetite, hunger, thirst, polyuria.

Azithromycin-

Drug class- Antibiotics

Mechanism of action- it induces MRP overexpression and restore chloride conductance in airways of cystic fibrosis patients.

Indications- it is indicated for the treatment of acute otitis media, community aquired pneumonia.

Contraindications- patients having hypersensitivity, cholestactic jaundice can not take azithromycin.

Adverse effects- stomach upset, nausea, vometting.

Nursing actions- nurse should monitor patient for signs of anaphylxis,pus in stool, diarrhea

Dornase alfa-

Drug class- Enzyme

Mechanism of action- this is enzymewhich cleaves DNA in sputum of cystic fibrosis patients and reduces sputum viscoelasticity.

Indications- it is indicated for the treatment of cystic fibrosis patient to improve pulmonary function.

Contraindications- Patient having hypersensitivity can not take dornase alfa.

Adverse effects- Rash, eye inflammation, runny nose,dry throat.

Nursing action- inform patient a proper technique of taking dornase alfa. proper hygine to be maintained before assemble nebulizer and clean each and every parts of nebulizer.

Levalbuterol-

Drug class- beta agonist

Mechanism of action- it binds with beta-2-adrenergic receptors on smooth muscles of airways and activates receptors. So muscle relaxation takes place.

Indications- it is indicated for treatment of bronchospasm

Contraindication- patients having history of hypersensitivity to levalbuterol should not take drug.

Adverse effects- dizziness, headache, dry mouth.

Nursing action- instruct patient to wash or rinse mouth with water after each inhalation dose to overcome with dry mouth.

Vitamin E-

Drug class- it is group of 8 fat soluble compounds. That contains 4 tocopherols and 4 tocotrienols.

Mechanism of action- it inhibits production of reactive oxygen molecules when fat undergoes oxidation.

Indications- it is indicated for treatment of liver disease, prostate cancer.

Contraindications- patient having bleeding disorders, diabetes, liver disease should consult doctor before taking vitamin E.

Adverse effects- Nausea, diarrhea, rash, headache.

Definations-

1.Respiratory chest physiotherapy-

It is treatment of removal of mucus from the breathing passage of patient.

2.Mucus clearance device-

It is device used to clear the lungs and airways secreations.

3. Sweat test-

sweat test measures the concentration of chloride that is excreted in sweat.

4. Auscultation of heart and lung sound-

Listening of internal sounds of body by using stethoscope. It is performed for purpose of examining the circulatory system and respiratory system.