DRUG STUDY

DRUG NAME GENERIC NAME: Piperacillin / Tazobactam BRAND NAME: Zosyn CLASSIFICATI ON: Antiinfective; Beta-lactam antibiotic; Antipseudomonal penicillin

ACTION It is similar to that of other penicillins. Interfere with bacterial cell wall synthesis promotes loss of membrane integrity and leads to death of the organism.

INDICATION Treatment of moderate to severe appendicitis, uncomplicated and complicated skin and skin structure infections, nosocomial or communityacquired pneumonia caused piperacillinresistant, piperacillin/tazob actam susceptible, beta-lactamaseproducing bacteria.

CONTRAINDICA TION Hypersensitivit y to penicillins, cephalosphorins, or other drugs. Safety in children < 12 years old, pregnancy, lactation.

ADVERSE EFFECTS CNS: headache, insomnia, fever

DOSAGE

NURSING RESPONSIBILITIES

280 mg Obtain history of IVTT hypersensitivity to every penicillins, GI: diarrhea, 12hr cephalosphorins, or other nausea, drugs prior to constipation, administration, vomiting, - Obtain specimen for pseudomembran culture and sensitivity prior ous colitis to first dose of the drug; start drug pending results. SKIN: Periodic CBC with hypersensitivity differential, platelet count, reactions ,rash, Hgb & Hgt, and serum pruritus electrolytes. Monitor for hypersensitivity response; discontinue drug and notify physician if allergic response noted. - Monitor for hemorrhagic manifestations because high dose may induce coagulation abnormalities. - Instruct family/significant others to report significant, unexplained diarrhea. Monitor vital signs because of cardiac arrhythmias, hypertension and fever as adverse reactions. - Instruct the mother not to breast feed the baby while taking the drug without consulting physician.

NAME: KHARMELA CZAREN L. HIBAYA, RN DRUG STUDY

Program: batch 5 mcn-nurse trainee

DRUG NAME GENERIC NAME: Metronidazol e BRAND NAME: Flagyl, Metizol, Protostat, Metric 21 CLASSIFICATI ON: Antiinfective; Antitrichomo nal; Amebicide; Antibiotic

ACTION It is synthetic compound with direct trichomonaci dal and amebicidal activity as well as antibacterial activity against anaerobic bacteria and some gramnegative bacteria.

INDICATION It is used for preoperative prophylaxis In colorectal surgery. IV metronidazole is used for the treatment of serious infections caused by susceptible anaerobic bacteria in intraabdominal infections, skin infections and for both preand post operative prophylaxis.

CONTRAINDIC ATION

ADVERSE EFFECTS

DOSAG E

NURSING RESPONSIBILITIES

Blood BODY AS A dyscrasias; WHOLE: Active CNS Hypersensitivit disease; First y, fever, trimester of fleeting joints pregnancy and pains, lactation overgrowth of candida

10 gm - Discontinue therapy immediately IVTT if CNS toxicity develops. Monitor every especially for seizures and 12hr peripheral neuropathy. - Obtain specimen for total and differential WBC counts before, during, and after therapy, especially if a second source is necessary. CNS: Vertigo, - Monitor signs and symptoms of headache, sodium retention, especially in confusion, patients on corticosteroid therapy irritability, or with history of CHF. fatigue - Monitor patients on lithium for elevated lithium levels. GI: Nausea, Report appearance of vomiting, candidiasis or its becoming more anorexia, prominent with therapy to diarrhea, physician promptly. constipation, - Obtain specimen for repeat feces dry mouth examinations; usually up to 3 months, to secure that amoebae SPECIAL have been eliminated. SENSES: Nasal -Instruct patient to adhere closely congestion to regimen without schedule interruption CV: ECG -Instruct not to drink alcohol changes during therapy; may induce a (flattening of T disulfiram-type reaction. Avoid wave) alcohol and alcohol-containing medication for at least 48 hour after treatment is completed. - Inform the patient that urine may appear darker reddish brown. This appears to have no clinical significance. Instruct to refrain from intercourse during therapy for trichomoniasis unless male partner wears a condom to prevent reinfection. -Instruct patient not to breast feed while taking the drugs without consulting physician.

NAME: KHARMELA CZAREN L. HIBAYA, RN DRUG STUDY

Program: batch 5 mcn-nurse train

DRUG NAME GENERIC NAME: Ranitidine HCl BRAND NAME: Zantac CLASSIFICATIO N: Gastrointestin al agent, Antisecretory (H2 Receptor Antagonist)

ACTION Potent anti-ulcer drug that competitivel y and reversibly inhibits histamine action at H2-receptor sites on parietal cells, thus blocking gastric acid secretion. Indirectly reduces pepsin secretion but appears to have minimal effect on fasting and postprandial serum gastrin concentratio ns or secretions of gastric intrinsic factor or mucus.

INDICATION

CONTRAINDICA TION

ADVERSE EFFECTS BODY AS A WHOLE: Hypersensitivity reactions

DOSAGE

NURSING RESPONSIBILITIES

Short-term Safe use treatment of during pregnancy active duodenal or lactation is not ulcer; indicated. maintenance therapy of duodenal ulcer patients after healing of acute ulcer; treatment of GERD; shortterm treatment of active benign gastric ulcer; treatment of pathologic GI hypersecretory conditions.

2 mg - Monitor for potential IVTT toxicity results from every decreased clearance 12hr (elimination) and therefore prolong action; greatest in CNS: headache, the older adult patients or malaise. those with hepatic and insomnia, renal dysfunction. dizziness, - Monitor for creatinine somnolence, clearance if renal mental dysfunction is present or confusion, those with pancreatic liver vertigo, agitation function. When clearance is <50 mL/min, CV: Bradycardia ( manufacturer recommends with rapid IV reduction of the dose to push) 150 mg once every 24 hours with cautious and GI: nausea, gradual reduction of diarrhea, interval to Q12 or less, if constipation, necessary. abdominal pain - Be alert of early signs of hepatotoxicity (though low SKIN: rash and thought to be a hypersensitivity reaction); HEMATOLOGIC: jaundice (dark urine, Reversible pruritus, yellow sclera and decrease in RBC skin), elevated count, transaminases (especially thrombocytopeni ALT) and LDH. a - Be alert that long-term therapy may lead to Vitamin B12 deficiency. - Inform that long duration of action provides ulcer pain relief that is maintained through the night as well as the day. - Instruct patient not to smoke; research shows smoking decreases ranitidine efficacy and adversely affects ulcer healing.

NAME: KHARMELA CZAREN L. HIBAYA, RN

Program: batch 5 mcn-nurse train