DRUG STUDY

CEFEROXIME
CLASSIFICATION: ANTI-INFECTIVE DRUG

ACTION:

A second generation cephalosporin that inhibits cell wall

synthesis, promoting osmotic instability; usually
bactericidal.

INDICATION:

• Ceferoxime sodium: Serious infections of the lower respiratory and urinary tracts, skin
and skin structure infections, bone and joints infections, septicaemia, meningitis,
gonorrhoea, and perioperative prophylaxis.

• Ceferoxime axetil: Otitis media, pharyngitis, tonsillitis, infections of the urinary and
lower respiratory tracts, and skin and skin-structure infections caused by Streptococcus
pneumoniae, and S. Pyogenes, Haemophilus influezae, Staphylococcus aureaus,
Escherichia coli, Moraxella catarrhalis Neisseria gonorrhoea, and Klebsiella and
Enterobacteria species.

• Uncomplicated urinary tract infections.

• Otitis media

• Perioperative prophylaxis.

• Early Lyme’ disease caused by Borrelia burgdorferi.

• Secondary bacterial infections of acute bronchitis

• Uncomplicated gonorrhoea
 • Acute bacterial maxillary sinusitis caused by Streptococcus pneumonia or Haemophilus
influenza.

CONTRAINDICATION:

Contraindicated in patients hypersensitivity to drug or other cephalosporins.

ADVERSE REACTION:

CV: phlebitis, thrombophlebitis

GI: Pseudomembranous colitis, nausea, anorexia, vomiting, diarrhea

Hematologic: transient neutropenia, eosinophilia, haemolytic anemia,thrombocytopenia.

Skin: maculopapular and erythematous rashes, urticaria, pain, induration, sterile abscesses,
temperature elevation, tissue sloughing at I.M injection site.

Other: hypersensitivity reactions, serum sickness, anaphylaxis.

PATIENT TEACHING:

• Tell patient to take all of the drugs as prescribed, even after he feels better.

• Do not take any new medication during therapy unless approved by prescriber.

• Instruct patient to take oral form with food. If patient has difficulty swallowing tablets,
show him how to dissolve or crush tablets but warn him that the bitter taste is hard to
mask, even with food. If suspension is being used, tell patient to shake container well
before measuring dose.

• Instruct patient to notify prescriber about rash or evidence of superinfection.

• Advise patient receiving drug I.V to report discomfort at I.V insertion site.

• Tell patient to notify prescriber about loose stool or diarrhea.

• Oral suspension should be taken as directed, at regular intervals around-the-clock (with

or without food).
 • Chilling suspension improves flavor (do not freeze).

• Report unusual bruising or bleeding; or opportunistic infection (vaginal itching or

drainage, sores in mouth, blood in urine or stool).

METRONIDAZOLE

Brand Name: Flagyl

CLASSIFICATION: Anti-infective Drug

ACTION:

A direct-acting trichomonacide and amebicide that works at

both intestinal and extraintestinal sites. It’s thought to enter the cells of microorganisms that
contain nitroreductase. Unstable compounds are then formed that bind DNA and inhibit
synthesis, causing cell death.

Indications:

• Amebic liver abscess

• Intestinal Amebiasis

• Trichomoniasis

• Refractory trichomoniasis

• Bacterial infections caused by anaerobic microorganisms

• Prevention of postoperative infection in contaminated or potentially contaminated

colorectal surgery
 • Bacterial vaginosis

CONTRAINDICATION:

Contraindicated in patients hypersensitive to drug or other nitroimidazole derivatives and in

patients in first trimester of pregnancy.

ADVERSE EFFECT:

• CNS: vertigo, headache, ataxia, dizziness, sycope, incoordination, confusion, irritability,

depression, weakness, insomnia, seizures, peripheral neuropathy.

• CV: flattened T wave, edema, flushing, thrombophlebitis after I.V infusion.

• EENT: rhinitis, sinusitis, pharyngitis

• GI: abdominal cramping or pain, stomatitis, epigastric distress, nausea, vomiting,

anorexia, diarrhea, constipation, proctitis, dry mouth, metallic taste.

• GU: darkened urine, polyuria, dysuria, cystitis, dyspareunia, dryness of vagina and vulva,
vaginal candidiasis, vaginitis, genital pruritis.

• Hematologic: transient leukopenia, neutropenia.

• Muscoloskeletal: fleeting joint pains

• Respiratory: upper respiratory tract infection

• Skin: rash

• Other: fever, decreased libido, over growth of nonsusceptible organisms, especially

Candida.

PATIENT TEACHING:
• Instruct patient to take oral form with food to minimize GI upset, although extended-
release tablets should be taken at least 1 hour before or 2 hours after meals.

• Inform patient that sexual partners should be treated simultaneously to avoid reinfection.

• Instruct patient in proper hygiene.

• Tell patient to report symptoms of candidal overgrowth.

• Tell patient that metallic taste and dark and red-brown urine may occur.

• Tell patient to avoid alcohol or alcohol containing drugs during therapy and for at least 3
days after therapy is completed.

• Urge the patient to complete full course of therapy even if he feels better.

• Instruct users of topical drug to report worsening of rocasea promptly to prescriber.

ACETAMINOPHEN

CLASSIFICATION: Non-opoid analgesic, Antipyretic

ACTION:

Chemical Effect: Blocks pain impulses,probably by

inhibiting prostaglandins or pain receptor sensitizers. May
relieve fever by acting in hypothalamic heat-regulating
center.

Therapeutic effect: Relieves pain and reduces fever.

CONTRAINDICATION:

INDICATIONS:

• Mild pain or fever

• Osteoarthritis.

ADVERSE EFFECT:

Hematologic: haemolytic anemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia

Hepatic: liver damage, jaundice

Metabolic: hypoglycaemia
Skin: rash, urticaria

PATIENTS TEACHING:

• Tell patient not to use drug for fever that’s higher than 103.1 F (39.5 C), lasts longer than
3 days, or recurs.

• Tell patient that drug is for short-term use. Explain the need to contact the prescriber if a
child takes the drug for longer than 5 days or an adult takes it for longer than 10 days.

• Warm patient that high doses or unsupervised long-term use can cause liver damage.
Excessive alcohol use may increase risk of hepatotoxicity.

• Tell patient to keep tract of daily acetaminophen intake, including OTC and prescription
medications.

• Tell breast feeding woman that drug appears in breast milk in levels less than 1% of dose.
VITAMIN A

CLASSIFICATION: Vitamin

ACTION:

Chemical effect: Stimulates retinal function, bone growth, reproduction, and integrity of
epithelial and mucosal tissues.

Therapeutic effect: Raises Vitamin A level in body.

INDICATIONS:

RDA

Severe vitamin A deficiency.

Maintenance dosage to prevent recurrence of vitamin A deficiency.

CONTRAINDICATION:

Contraindicated for oral administration in patients with malabsorption syndrome; if

malabsorption syndrome is from inadequate bile secretion, oral route may be used with
administration of bile salts. Also contraindicated in patients hypersensitive to other ingredients in
product with hypervitaminosis A.
ADVERSE EFFECT:

CNS: fatigue headache, increased intracranial pressure, irritability, lethargy, malaise.

EENT: exopthalmus, papilledema

GI: hypomenorrhea, polyuria,

Hepatic: cirrhosis, hepatomegaly, jaundice,

Metabolic: cortica; thickening over radius and tibia, decalcification of bone, hypercalcemia,
migratory arthralgia, periostitis, premature closure of epiphysis, slow growth.

Skin: alopecia; dry,cracked, scaly skin; erythema; increased pigmentation; inflamed tounge, lips,
and gums; lip fissures; massive desquamation; night sweats, pruritus.

Other: anaphylactic shock, splenomegaly.

Patient teaching:

• Warn patient against taking megadoses of vitamins without specific indications. Also
stress that he not shares prescribed vitamins with others.

• Explain importance of avoiding prolonged use of mineral oil while taking this drug
because it reduces vitamin A absorption.

• Review the signs and symptoms of Vitamin A toxicity, and tell patent to report them
immediately.

• Advise patient to consume adequate protein, vitamin E, and zinc, which, along with bile,
are needed for vitamin A absorption.

• Instruct patient to store vitamin A in tight, light resistant container.

ZINC SULFATE

CLASSIFICATION: Minerals

FUNCTION OF ZINC:

• Cofactor of various enzymes involved in cell division and growth.

• Required for the normal development and maintenance of the immune system; helps
regulate the activity of cells involved in immune function.

• Functions as antioxidants by being a cofactor of the enzyme superoxide dismutase which

is involve in the removal of harmful free radicals.

USED OF THE MEDICINE:

• As an adjunct in the management of acute diarrhea.

• To help boost immune function.

• To help support optimum physical growth and development.

ADVERSE EFFECTS:

GI: nausea and vomiting

CARE THAT SHOULD BE TAKEN WHEN TAKING MEDICINE

• Do not take more than the recommended dose.

• Do not use after the expiry date on the label.