ASPIRIN, ALPRAZOLAM and PHENYTOIN

Aspirin (Acetylsalicylic Acid)

• As analgesics, antipyretics, and anti-inflammatory medications.
• Aspirin reduces platelet aggregation when taken in low doses.

Indication

• Treatment of headache, joint pain, bodyache etc..
• Fever,
• Gout,
• Rheumatoid Arthritis,
• Anti-platelet effect: angina pectoris and myocardial infarction.

Dose

• Adult: 300-900mg 4-6 hourly; maximum 4g daily.

Contraindication

Peptic ulcer, Liver diseases, Pregnancy, Lactation, Kidney diseases

Side Effect

Nausea and vomiting, Hypersensitivity, Epigastric distress, Peptic ulceration, Excitement and mental confusion, Impairment and hearing loss, Vertigo, Dizziness, Overdose of aspirin causes: Kidney damage & pepticulcer.

Nursing Consideration

• All NSAIDS, including aspirin, may induce peptic ulcers; thus, offer an anti-ulcer medication to combat the negative effects.
• All NSAIDS should only be administered by nurses post-meal. Children should not be given aspirin.
• Children may exhibit Reye's syndrome, a breathing problem. Nurses are advised to keep an eye out for the symptoms of salicylate poisoning since salicylism (salicyclic acid in the blood) may cause patients some problems.
• Patients risk bleeding if the dentist is not informed if they are using NSAIDS, especially aspirin. Warfarin should not be administered with NSAIDS, including aspirin (anticoagulant)
• The majority of NSAIDs can induce allergies; if so, visit a physician or pharmacist.
• It is advised that nurses avoid giving NSAIDS on a frequent basis (for a long time)

Alprazolam

Mechanism of Action

Benzodiazepines bind nonspecifically to benzodiazepine receptors.

• Benzodiazepine1: mediates sleep.
• Benzodiazepine2: affects muscle relaxation, anticonvulsant activity, motor coordination, and memory.

Indication

• Anxiety disorders,
• Alcohol withdrawal,
• Hyperexcitability and agitation,
• Preoperative relief of anxiety,
• To aid in balanced anesthesia.

Dose

Adult: 0.25 to 0.5mg tid (maximum daily dose of 4 mg, given in divided doses).

Contraindication

Acute narrow angle glaucoma; pulmonary disease; use alone in primary or depression psychotic disorder, lactation.

Side Effect

• Drowsiness, sedation, light-headedness, dizziness, headache, confusion, insomnia, unsteadiness, restlessness, paradoxical excitement, hallucinations, tachycardia, hypotension, ECG changes, blurred vision, nervousness, fatigue,clumsiness, dyspnea.

Nursing Consideration

• Watch out for lethargy and sedation, especially in the elderly.
• When stopping a medicine, gradually reduce the dosage.
• regularly check on cardiovascular and respiratory health.
• Follow up on lab test findings, such as complete blood count (CBC), testing for the kidneys and liver, etc.The
• The physical and psychological addiction may result from the extended.

Phenytoin

• Molecule phenytoin belongs to the hydantion group, which shares structural similarities with barbiturates.
• It is the medicine of choice for first therapy, especially when treating adults, and is excellent at suppressing tonic-clonic, partial seizures.

Mechanism of Action:

• By obstructing sodium channels in neuronal membranes, it seems to work.
• This lessens the excitability of nerve cells and stops the propagation of aberrant brain discharge.

Indication:

Phenytoin is most widely used antiepileptic drug, used for:

• Generalized tonic-clonic, simple & complex partial seizure,
• Status epilepticus,
• Trigeminal neuralgia (a neurological condition of trigeminal facial nerve),
• Cardiac arrhythmia- especially digitalis induced.

Dose:

• Adult: 100 mg bd, maximum upto 400mg / day.
• Children: 5 - 8mg / k * g / day.

Contraindication:

Hypersensitivity

Side Effect:

• The patient is sedated, has ataxia, and may exhibit nystagmus if the dosage is too high (rapid, involuntary eye movement)
• In women, hirsutism & oily skin may be problematic.
• Folic acid deficiency causes macrocytic anemia.
• Gum hypertrophy - Good dental hygiene is essential.
• swelling of the lymph nodes.
• Oral suspension of phenytoin: Each 5ml of this suspension typically contains 100mg of the drug.
• There are phenytoin tablets with a sodium dosage of 100 mg available.

Nursing Consideration

• It could lead to gingivitis (inflammation of Gum). Patients are encouraged to periodically clean their gums.
• During and following IV treatment, careful cardiac monitoring is required.
• reduced bone mineral density associated with long-term usage
• When given to a pregnant woman, it might be harmful to the fetus.
• Exercise cautious if you have heart problems.
• Acute alcohol consumption could raise serum blood levels, whereas chronic alcohol use could lower serum levels.