XI.

DRUG STUDY
DRUGS

Generic Name:
RANITIDINE

Brand Name:
Ranitac
Classification:
Gastro intestinal
agent; H-2 receptor
antagonist.
Dosage:
50 g IV q 8

ACTION

Potent
Anti-ulcer that
competitively and
reversibly inhibits
histamine actions
on parietal cells,
thus blocking
gastric acid
secretion.

INDICATION

Short term (4-8

weeks)
Treatment of
active duodenal
ulcer.
Short term
treatment of
active, benign
gastric ulcers.
Gastro
esophageal
disease
Maintenance of
healing of
gastric ulcers
Maintenance
therapy for
duodenal ulcer
at reduce dosage

CONTRAINDICATION

Contra indicated
with allergy to
ranitidine, lactation
Cirrhosis of the
liver
Impaired renal or
hepatic function

ADVERSE EFFECT

NURSING
CONSIDERATION

GI :
Constipation,
N&V, Diarrhea,
Abdominal pain
CNS:
Head ache, dizziness,
insomnia, vertigo
CV
Bradycardia or
tachycardia, cardiac
arrest
Hepatic
Hepatotoxicity,
Jaundice
Dermatologic
Rash, Alopecia

Document
indications for
therapy, onset,
characteristics of
symptoms, other
agents used and
anticipated
treatment.
Assess stomach
Pain, noting
Characteristics,
frequency of
occurrence and
things that alter it
Obtain CBC.

DRUGS

Generic Name:
KETOROLAC

Thrometamine

Brand Name:

Toradol

CLASSIFICATION:
Non-Steroidal AntiInflammatory Drug
(NSAID)

DOSAGE:
1 amp IV q 6

ACTION

Inhibit
prostaglandin
synthesis to
produce antiinflammatory,
analgesic and
anti-pyretic
effect.

INDICATION

Short- term
management
of moderately
severe, acute
pain for single
dose treatment
Short term
management
of moderately
severe, acute
pain for
multiple dose
treatment.

CONTRAINDICATIO
N
Contraindicated in
patients hypersensitive
to drug and those with
active peptic ulcer
disease, recent GI
bleeding or
perforation, advance
renal impairment,
cerebro vascular
bleeding, hemorrhagic
diathesis, or
incomplete
hemostasis, and those
at risk for renal
impairement from
volume depletion or at
risk of bleeding.

ADVERSE
EFFECT
CNS:
Headache,
Dizziness,
Drowsiness,
Sedation
CV:
Arrhythmias,
Edema,
Hypertension,
Hematologic:
Decreased
platelet,
Adhesion,
Prolonged
bleeding time,
Skin:
Diaphoresis,
Pruritus, Rash

NURSING
CONSIDERATION
S
Correct
hypovolemia
before giving.
Put pressure on
site for 15-30
seconds.
Dont give drug
epiduraly because
of alcohol content.
Tell patient not to
take drugs for
more than 5 days
in a row.

DRUGS

ACTION

INDICATION

CONTRAINDICATIONS

ADVERSE EFFECT

NURSING
CONSIDERATION

Generic Name:
METRONIDAZOLE

Brand Name:
Cetaz

Classification:
Anti-infectives
Anti-protozoal

Dosage:
500mg IV q 8

Disrupts DNA
and protein
synthesis in
susceptible
organism
Bactericidal, or
amebicidal action

Asymptomatic
and symptomatic
tricomoniasis in
females and
males; acute
intestinal
amebiasis and
amebic liver
abscess;
IV metronidazole
is used for the
treatment of
serious infection
caused by
susceptible
anaerobic bacteria
in intra abdominal
infections, skin
i9nfections,
gynecologic
infections,
septicemia, and
for both pre- and
postoperative
prophylaxis

Blood dyscariasis;
active CNS disease;
first trimester of
pregnancy (catergory
B), lactation.

Body as a whole:
hypersensitivity
(rash, urticaria,
pruritus,
flushing) fever,
fleeting joint
pains, overgrowth
of Candida.
CNS: vertigo,
headache, ataxia,
confusion,
irritability,
depression,
restlessness,
weakness,
drowsiness,
insomnia
GI: Nausea,
vomiting,
anorexia,
epigastric
distress,
abdominal
cramps, diarrhea,
constipation, dry,
maouth, metallic
or bitter taste,
proctitis.
Urogenital:
Polyuria, dysuria,
pyuria,
incontinence
CV:ECG changes
(flattening of T
wave)

Administer with
food or milk to
minimize GI
irritation. Tablets
may be crushed
for patients with
difficulty in
swallowing
Discontinue
therapy
immediate if
symptoms of
CNS toxicity
develop. Monitor
especially for
seizures and
peripheral
neuropathy (e.g.
numbness, and
parasthesia of
extremities)
Lb test: Obtain
total and
differential WBC
counts before,
during, after
therapy,
especially if a
second course is
necessary
Monitor for S&S
of sodium
retention,
especially in
patients on
corticosteroids

therapy or with a
history of CHF
Monitor patients
on lithium for
elevated lithium
levels.
Report
appearance of
candidiasis (milkvaginal discharge,
stomatitis, fury
tongue) or its
becoming more
prominent with
therapy to
physician
promptly.
Repeat feces
examinations,
usually up to 3
months to ensure
that amebae have
been eliminated.
Urine may appear
dark or reddish
brown (especially
with higher than
recommended
doses ). This
appears to have
no clinical
significance.

DRUGS
Generic Name:
PARACETAMOL/
ACETAMINOPHEN

Brand Name:
Sinomol

Classification:
Non-narcotic analgesic;
Antipyretic

Dosage/Route:
300mg IV prn

ACTION

Decrease fever by
a hypothalamic
effect leading to
sweating and
vasodilatation.
Also inhibits the
effect of
pyrogenes on the
hypothalamic heat
regulating centers.
May cause
analgesia by
inhibiting CNS
prostaglandin
synthesis.

INDICATION

Control of pain
due to headache,
dysmenorrhea,
To reduce fever in
the bacterial or
viral infections
Generally as
substitute when
latter is not
tolerated or is
contraindicated.

CONTRAINDICATION

Renal
insufficiency,
anemia.
Clients with
cardiac or
pulmonary disease
are more
susceptible to
acetaminophen.

SIDE EFFECTS

Hematologic:
Hemolytic
Anemia
Allergic:
Erythematous skin
reaction, fever
Miscellaneous:
jaundice,
drowsiness,
glossitis

NURSING
CONSIDERATION

Monitor for S/Sx

of:
hepatotoxicity,
even with
moderate
acetaminophen
doses, especially
in individuals
with poor
nutrition or who
have ingested
alcohol over
prolonged
periods; potential
abuse from
psychological
dependence.
Give drugs with
food if GI upset
occurs.
Avoid using
multiple
preparations
containing
acetaminophen.

DRUG

ACTION

INDICATION

CONTRAINDICATION

SIDE EFFECT

NURSING
RESPONSIBILITY

GENERIC:
Celecoxib
BRAND:
Celeberex
Classification:
Non steroidal
cyclooxegenase-2 (COX2) inhibitor, anti
inflammatory drug
(NSAID)
DOSAGE :
250 mg IV
p.r.n

Exhibits antiinflammatory,
analgesic, and
antipyretic action
due to inhibition
of the enzyme
COX-2

Adjunctive
treatment of
decrease the
number of
adenomatous
colorectal polyps
in familial
adenomatous
polyposis

Hypersensitivity to
drug, sulfonamides,
or other NSAIDs
Severe hepatic
impairment
History of asthma
or urticaria
Advanced renal
disease
Late pregnancy
Breastfeeding

CNS : dizziness,
drowsiness,
headache,
insomnia, fatigue
CV: peripheral
edema
EENT:
ophthalmic
effects, tinnitus,
pharyngitis,
rhinitis, sinusitis
GI: nausea,
diarrhea,,
constipation,
abdominal pain,
dyspepsia,
flatulence, dry
mouth, GI
bleeding
GU: constipation,
dry mouth, tongue
atrophy
Respiratory:
URI symptoms, cough,
epistaxis
OTHER: Cancer
in preclinical
studies, back pain,

Before:
Asses pt. history
of allergic
reaction to the
drug
Monitor CBC,
electrolyte
levels, creatinine
clearance, and
occult fecal
blood test and
liver function
test results every
6-12 months
During :
Instruct pt. to
take drug with
food or milk
Teach pt. to
avoid aspirin and
other NSAIDs
(such as
Ibuprofen and
Naproxen)
during therapy

fever

Drug Name

Action

GENERIC:
Cefixime

Cefixime binds to one or

more of the penicillinbinding proteins (PBPs)
which inhibits the final
transpeptidation step of
peptidoglycan synthesis
in bacteria cell wall, thus
inhibiting biosynthesis
and arresting cell wall
assembly resulting in
bacterial cell death.

BRAND:
Suprax

Classification:
Antibiotic
cephalosporin
DOSAGE :
250 mg IV
p.r.n

Indication
Uncomplicated
urinary tract
infections caused
by Escherichia coli
and Proteus
mirabilis,
Otitis media
caused by
Haemophilus
influenzae (Betalactamase positive
and negative
strains), Moraxella
catarrhalis (most
of which are betalactamse positive),
and S.pyrogenes
Acute bronchitis
and acute
exacerbations of
chronic bronchitis
caused by
streptococcus
pneumonia and
Haemophilus
infuenzae( betalactamase positive
and negative
strains), and
Uncomplicated
gonorrhea
(cervical/urethral)

Contraindication
Hypersensitivity to
cephalosporin.
History of allergy to
penicillins;
pregnancy,
lactation; renal
failure; GI disease.

Adverse effect
DIARRHEA:
Difficulty
breathing or
swallowing
Headache
Hives
Itching
Mild skin rash
Severe skin rash
Upset stomach
Vaginal infection
Vomiting
Wheezing

Nursing Responsibility
Assess patients
previous reaction
to penicillin or
other
cephalosporins.
Cross sensitivity
between penicillin
is common.
Assess patient for
signs and
symptomsof
infection before
and during
treatment; fever,
earache,
characteristics of
wounds, sputum,
urine, stool, and
WBC>10,000/mm
Obtain C&N
before beginning
drug therapy to
identify if correct
treatment has
been initiated
Assess for allergic
reactions
Assess renal
function before
and during
therapy; urine
output.BUN and

caused by
Neisseria
gonorrheae
(penicillinase- and
non-penicillinaseproducing strains)

creatinine.

DRUG

ACTION

INDICATION

CONTRAINDICATIO
N

ADVERSE EFFECT

NURSING
MANAGEMENT

Generic Name:
Omeprazole

Brand Name:
Prilosec

Classification:
Proton pump inhibitor

Dosage:
40mg IV OD

Inhibits activity of
acid(proton)pump and
binds to hydrogen
potassium adenosine
triphosphatase at
secretory surface of the
gastric parietal cells to
block formation of
gastric acid.

Symptomatic
gastroesophagea
l reflux disease.
Duedunal
ulcer(short term
treatment)
Short term
treatment of
active benign
gastric ulcer.
Frequent heart
burn (2 or more
days a week).

Contraindicated
in patient
hypersensitive
to drug or its
components.
Use cautiously
in patients with
Barther
syndrome,
hypocalemia,
and respiratory
alcalosis.
Long term
administration
of bicarbonate
with calcium or
milk can cause
milk alkaline
syndrome.

CNS: Dizziness,
headache.
GI: abdominal
pain,
constipation,
diarrhea,
flatulence,
nausea
and
vomiting,
Musculoskeletal
: back pain.
Respiratory:
cough,
upper
respiratory tract
infection.
Skin: rash
Other: cancer in
preclinical
studies,
back
pain, fever.

Assessment
History:
Hypersensitivit
y to omeprazole
or any of its
components
;pregnancy
Physical:
Skin lesion:
reflexes, affect,
urinary output,
abdominal
exam,
respiratory
auscultation
intervention.
2. Administer before
meals. Caution patient to
swallow capsules whole,
not to open chew, or
crush them

DRUGS

GENERIC NAME:
Amino acid sorbitol
BRAND NAME:
Celemin

CLASSIFICATION:
Parenteral
Nutritional
Products
Dosage:
Incorporate to IVF(250cc
q8x2doses)

ACTION

Amino acids
promote the
production of
proteins
(anabolism)
needed for
synthesis of
structural
components,
reduce the rate of
the protein
breakdown
(anabolism),
promote wound
healing and act as
a buffers in the
extracellular and
intracellular
fluids.
Sorbitol is a
source of calories.
Non protein
calories are
required for
efficient
utilization of
amino acid. It
decreases protein
and nitrogen
losses, promotes
glycogen
deposition and

INDICATION

Celemin 10-plus
is highly used as a
parenteral
nutrition
supplement in the
following
condition:
prophylaxis and
therapy for protein
deficiency; preand post-operative
conditions; in
adequate or
impossible oral
feeding, eg.
Following
operative
procedure on GIT,
GI
bleeding,corrosive
injury to
esophagus or
stomach; stenosis
in the GIT;
inflammatory
bowel disease and
short-gut
syndrome; chronic
diarrhea and
vomiting;
malabsorption
syndrome; sepsis;

CONTRAINDICATION

Disturbances of
the amino acid
metabolism;
hepatic coma;
serious renal
disturbances;
hypernatremia and
hyperkalemia;
congestive cardiac
failure;
hyperhydration;
metabolic
acidosis; sorbitol
intolerance

ADVERSE EFFECT

Occasional chest
discomfort and
palpitations.
Nausea, vomiting,
chill, fever and
vasalgia may
occur if the
recommended rate
of infusion is
exceeded.

NURSING
MANAGEMENT
Monitor for S/Sx
of hepatotoxicity.
Do not administer
simultaneously
with blood
through the same
infusion site
because of
possible
pseudoagglutinati
on. Antibiotics,
steroids and
pressor agents
should not be
added to these
solutions.

prevents ketosis.
Electrolytes are
provided to
compensate for
normal sensible
and insensible
losses as well as
the additional
losses often
present in patient
requiring
parenteral nutrion.

diffuse peritonitis;
fistulas; chylous
ascites;
malnutrition and
clinical outcomes;
persistent pyrexial
state; nephrosis;
amyloidosis;
immunocompromi
sed patients; HIV
infection;
transplantations;
cancer and related
cachexia ; burns;
pregnancy; head
injuries;prolonged
,

DRUGS

ACTION

INDICATIONS

CONTRAINDICATIONS

ADVERSE EFFECT

NURSING
MANAGEMENT

GENERIC:
Cefuroxime

CLASSIFICATION:
Antibiotic cephalosporins

Dosage and Route:

750 mg IV q8

Inhibits cell wall

synthesis,
promoting
osmotic
instability;
usually
bactericidal.

Serious lower
respiratory
infection, UTI,
skin or skinstructure
infections, bone
or joint infections,
septicemia,
meningitis and
gonorrhea

Hypersensitivity to
drug or other
cephalosporins.
Use cautiously in
patients
hypersensitivity to
penicillin because
of possibility of
cross-sensitivity
with other betalactam antibiotics

CV: phlebitis,
thrombophlrbitis
GI: diarrhea,
nausea, vomiting
Hematologic:
hemolytic anemia,
thrombocytopenia
, transient
neutropenia,
eosinophilia
Skin:
maculopapular
and erythematous
rashes, urticaria,
pain, induration,
sterile abscess,
+temperature
elevation,
Other:
anaphylaxis,
serum suckness

Obtain specimen
for culture and
sensitivity test
before giving first
dose.Therapy may
begin while
awaiting results.
Monitor patient
for signs and
symptoms of
superinfection
Advise patient
receiving drug IV
to report
discomfort at IV
insertion site
Instruct patient to
notify prescriber
about rash, loose
stools, diarrhea,
or evidence of
superinfection