DRUG STUDY: Paracetamol (Aeknil)
BS
CI: Ma’am Valencia
Brand Name Dosage Mechanism of Action
Pharmacology: Paracetamol p
• Aeknil • Adult & childn roduces analgesia by raising the
≥10 yr 2-3 mL, ≤10 threshold of the pain center in
Generic Name: yr 1-2 mL. the brain and by obstructing
• Paracetamol Depending on impulses at the pain-mediating
severity of case, chemoreceptors. The drug
Classification: dose may be produces antipyresis by an
• Analgecsic (Opioid) repeated 4 hrly. In action on the hypothalamus;
severe cases, dose heat dissipation is increased as
may be a result of vasodilation and
administered by IV increased peripheral blood flow.
very slowly.
Pharmacokinetics: Paracetam
Form: ol is rapidly and almost
IV completely absorbed from the
gastrointestinal tract. Following
oral administration, peak plasma
levels are attained in 10 min to 1
hr and the half-life is 75 min to 3
hrs.
Distribution of paracetamol to
most body tissues and fluids is
both rapid and uniform.
Paracetamol is excreted in the
urine primarily as the
glucuronide and smaller
amounts as the sulfate,
mercapturate and unchanged
drug. Approximately 85% of a
dose of paracetamol is excreted
in the urine within 24 hrs after
administration.
Indications Adverse Reaction Nursing Considerations
• Pyrexia of • A paracetamol overdose is • Use liquid form for children
unknown particularly dangerous because the and patients who have
origin. Fever & pai liver damage may not be obvious for difficulty swallowing.
n associated w/ four to six days after the drug has
common childhood been taken. Even if someone who has • In children, don’t exceed
disorders, tonsilliti taken a paracetamol overdose seems five doses in 24 hours.
s, upper resp tract fine and doesn't have any symptoms,
infections post- it's essential that they are taken to • Advise patient that drug is
immunization hospital urgently. An overdose of only for short term use and
reactions, after paracetamol can be fatal. to consult the physician if
tonsillectomy & giving to children for longer
other conditions. • When taken at the recommended than 5 days or adults for
Prevention of dose, side-effects of paracetamol are longer than 10 days.
febrile rare. Skin rashes, blood disorders and
convulsion.Heada a swollen pancreas have occasionally • Advise patient or caregiver
che, happened in people taking the drug on that many over the counter
cold, sinusitis, mus a regular basis for a long time. products contain
cle acetaminophen; be aware of
pain, arthritis & too this when calculating total
thache. dailydose.
• Warn patient that high
doses or unsupervised long
term use can cause liver
damage.
 DRUG STUDY: Metoclopramide (Plasil)
dsds
BSN III B
CI: Ma’am Valencia

Brand Name Dosage Mechanism of Action Indications Adverse Reaction Nursing Considerations

• Plasil • Tab Adult 1 tab Pharmacology: Metoclopramid • Disturbances of • Restlessness, drowsiness, fatigue & • Give 30 mins before
tid. Childn 5-14 e, a dopamine antagonist, GI motility lassitude. Extrapyramidal symptoms, meals and at bed time
Generic Name: yr 2.5-5 mg tid, 3-5 stimulates motility of the upper including GERD &
yr 2 mg bid-tid, 1-3 gastrointestinal tract without diabetic
insomnia, headache, dizziness,
• Metoclopramide
yr 1 mg bid-tid, <1 stimulating gastric, biliary or gastroparesis. Nau nausea, galactorrhea, gynecomastia, • Assess mental status
Classification: yr 1 mg bid. Max: pancreatic secretions. Its mode sea &vomiting of rash including urticaria, bowel during treatment
• GIT Regulators, 0.5 of action is unclear. It seems to central & disturbances. Increased prolactin
Antiflatulents, Anti- mg/kg/day. Syr Ad sensitize tissues to the action of peripheral origin levels; gastroparesis. • Tell patient to avoid
infammatories ult 10 mL acetylcholine. The effect of associated w/ driving & other hazardous
tid. AmpIM/IV Adul metoclopramide on motility is surgery, metabolic activities for at least 2 hrs
t 1 amp 8 not dependent on intact vagal diseases,
hrly. Radiological innervation but it can be infectious
exam of GIT 1-2 abolished by anticholinergic diseases, migraine • Advice pt. to avoid
amp IM or IV 10 drugs. Metoclopramide headache or drugs alcohol and other CNS
min before increases the tone and including cancer depressant that enhance
procedure. Renal amplitude of gastric (especially chemotherapy. sedating properties of this
Impairment (CrCl antral) contractions, relaxes the Facilitate small drug
<40 mL/min) ½ the pyloric sphincter and the bowel intubation &
recommended duodenum and jejunum, radiological
dose. resulting in accelerated gastric procedures of GIT.
emptying and intestinal transit. It
increases the resting tone of the
Form: lower esophageal sphincter.
IV Pharmacokinetics: Peak
TAB plasma levels are reached 30-
60 min following an oral dose.
Excretion is primarily in the
urine. The plasma half-life is
about 3 hrs. Metoclopramide
undergoes minimal hepatic
metabolism, except for simple
conjugation. Its safe use has
been described in patients with
advanced liver disease whose
renal function was normal.
 DRUG STUDY: Cotrimoxazole susp. (Macromed)
dsdsdsds
BSN III B
CI: Ma’am Valencia

Brand Name Dosage Mechanism of Action Indications Adverse Reaction Nursing Considerations

• Macromed • Cap Adult 1-2 • Blocks synthesis of • Uncomplicated Dermatologic: Rash, pruritus, • Assess allergic reactions
cap bid for 10-14 tetrahydrofolic UTIs caused by exfoliative dermatitis • Monitor I&O ratio
Generic Name: days. Susp Childn acid;combination blocks two susceptible strains • Monitor kidney function
• Cotrimoxazole 6-12 yr 1-2 tsp, 2- consecutive steps in bacterial of E. coli, GI: Epigastric distress, nausea, • Assess type of infection;
5 yr ½-1 tsp bid. synthesis of essential nucleic Proteus mirabilis, vomiting, glossitis obtain C&S before starting
Classification: acids, protein Klebsiella therapy
• Antibacterial Form: pneumoniae, Hematologic: Thrombocytopenia, • Assess blood dyscrasias
Combinations SUSP Enterobacter leukopenia, neutropenia,
CAP species, and megaloblastic anemia, Precautions:
coagulase- methemoglobinemia, elevated serum Pregnancy C, renal disease,
negative transaminase and bilirubin, increased eldery, G6PD deficiency,
Staphylococcus BUN and serum creatinine levels impaired hepatic/renal
species, including disease, possible folate
Staphylococcus Other: Fever deficiency, severe allergy,
saprophyticus bronchial asthma

• Treatment of
acute otitis media
due to susceptible
strains of S.
pneumoniae and
H. influenza in
children
 DRUG STUDY: Pedialyte
sdsds
BSN III B
CI: Ma’am Valencia

Brand Name Dosage Mechanism of Action Indications Adverse Reaction Nursing Considerations

• Pedialyte • Mix one pack • Pedialyte and Gatorade are • To supplement • As sole therapy in severe • Assess allergic reactions.
with 8oz of water advocated for the treatment of fluid & continuing diarrhea. Intractable
Generic Name: and drink. <1yr: dehydration in viral electrolyte loss vomiting. Adynamic ileus. Intestinal • Monitor I&O ratio.
• Dextrose 5.7g, sodium not recommended. gastroenteritis, but there is due to active play, obstruction or perforated bowel.
10.6Eq, potassium ≥1yr: Give every limited evidence to support prolonged sun Anuria, oliguria, or impaired • Note for the drugs,
4.7mEq, chloride 1–4hrs; intake: their use. exposure, hot & homeostatic mechanism. dosage, time,r oute, client.
8.3mEq, Calories 23; 32–64oz/day. humid
per pack; contains environment. • Note the side effects of
acesulfame; apple, fruit Form: the drugs.
punch, grape, or Liq (falvored)—
strawberry flavor. 1L
Liq (unflavored)—
Classification: 2oz, 1L
• Electrolytes Singles—8oz
• A07CA - Oral Pwd (packets)—4,
rehydration salt 8
formulations ; Used in Pops—16
the treatment of
diarrhea.
 Drug Study : Cefuroxime

DRUG ORDER NURSING

PHARMACOLOGIC
(Generic name, Dosage,
ACTION OF DRUG
Route, Frequency, etc.)
Cefuroxime 500mg/tab 1 tab Inhibits bacterial wall synthesis,
BID (p.o.) for 7 days rendering cell wall osmotically
unstable, leading to cell death
by binding to cell wall
membrane
INDICATIONS AND
CONTRAINDICATIONS
Indications:
• Urinary tract infections,
Otitis media,
• Severe infections
Contraindications:
• Sensitivity to
cephalosporins
ADVERSE EFFECTS OF
THE DRUG
CNS: Dizziness, headache,
fatigue, paresthesia, fever,
chills, confusion
GI: Diarrhea, nausea, vomiting,
anorexia, glossitis, bleeding,
increased AST, ALT, bilirubin,
LDH, alkaline phosphatase,
abdominal pain, loose stools,
flatulence, heartburn, stomach
cramps, colitis, jaundice
GU: vaginitis, pruritus,
candidiasis, increased BUN,
nephrotoxicity, renal failure,
pyuria, dysuria, reversible
interstitial nephritis
RESPONSIBILITIES
/PRECAUTIONS
• Assess patient for signs
and symptoms of
infection
• Assess for anaohylaxis:
rash, urticaria, chills,
fever, dyspnea
• Identify urine output
• Assess bowel pattern
daily
• Monitor for bleeding

DRUG ORDER
(Generic name, Dosage, Route,
Frequency, etc.)
Norxifloxacin 400mg/tab 1 tab
BID (p.o.)
DRUG STUDY : NORXIFLOXACIN
PHARMACOLOGIC
ACTION OF DRUG
Interferes with conversion of
intermediate DNA fragments
into high-molecular weight
DNA in bacteria
NURSING
INDICATIONS AND ADVERSE EFFECTS OF
RESPONSIBILITIES
CONTRAINDICATIONS THE DRUG
/PRECAUTIONS
CNS: headache, dizziness,  Assess patient for
fatigue, somnolence, previous sensitivity
Indications:
depression, insomnia reaction
• UTI, uncomplicated
EENT: visual disturbances  Assess patient for signs
gonorrhea
GI: nausea, constipation, and symptoms of
decreased ALT, AST, infection, allergic
Contraindications:
flatulence, heartburn, reactions
• Hypersensitivity to vomiting, diarrhea, dry  Monitor blood studies
quinolones mouth  Assess bowel pattern
INTEG: rash daily
 DRUG STUDY : SIMVASTATIN

DRUG ORDER NURSING

(Generic name, Dosage, Route,
Frequency, etc.)
Simvastatin 40mg/tab 1 tab
OD at hs (p.o.)
PHARMACOLOGIC
ACTION OF DRUG
Inhibits HMG-CoA reductase,
the enzyme that catalyzes the
first step in the cholesterol
synthesis pathway, resulting
in a decrease in serum
cholesterol, serum LDLs, and
either an increase or no
change in serum HDLs.
INDICATIONS AND ADVERSE EFFECTS OF
RESPONSIBILITIES
CONTRAINDICATIONS THE DRUG
/PRECAUTIONS
Indications
• Adjunct to diet in the
treatment of elevated CNS: Headache, asthenia, • Assess nutrition: fat,
total cholestrol and sleep disturbances protein, carbohydrates
LDL cholesterol with GI: Flatulence, diarrhea, • Monitor bowel pattern
primary abdominal pain, cramps, daily
hypercholesterolemia constipation, nausea, • Monitor triglycerides,
(types IIa and IIb) in dyspepsia, heartburn, liver cholesterol baseline
those unresponsive to failure throughout treatment
dietary restriction of Respiratory: Sinusitis,
saturated fat and pharyngitis Precautions:
cholesterol and other Other: Rhabdomyolysis, • Past liver disease,
nonpharmacologic acute renal failure, alcoholism, severe acute
measures arthralgia, myalgia infections, trauma,
• To reduce the risk of severe metabolic
coronary disease, disorders, electrolyte
mortality, and CV imbalances, elderly,
events, including stroke, renal disease
TIA, MI and reduction
in need for bypass
surgery and
angionplasty in patients
with coronary heart
disease and
hypercholesterolemia
• Treatment of patients
with isolated
hypertriglyceridemia

DRUG STUDY : CELECOXIB

 DRUG ORDER
PHARMACOLOGIC
(Generic name, Dosage, Route,
ACTION OF DRUG
Frequency, etc.)
Generic: Celecoxib Analgesic and anti-
inflammatory activities
related to inhibition of the
COX-2 enzyme,
Brand Name: which is activated in
• Celebrex inflammation to cause the
• Celebra signs and symptoms
associated with
Available forms inflammation; does not affect
Capsules—100, 200 mg the COX-1 enzyme, which
protects the lining of the GI
tract and has blood clotting
and renal functions.
INDICATIONS AND
CONTRAINDICATIONS
Indications: Celecoxib is
licensed for use
in osteoarthritis, rheumatoid
arthritis, acute pain,
painful menstruation and
menstrual
symptoms, ankylosing
spondylitis and to reduce the
number of colon and rectal
polyps in patients with familial
adenomatous polyposis. It was
originally intended to relieve
pain while minimizing the
gastrointestinal adverse effects
usually seen with
conventional NSAIDs.
Contraindications:
Contraindicated with allergies
to sulfonamides, celecoxib,
NSAIDs, or aspirin;
significant renal impairment;
pregnancy; lactation.
Use cautiously with impaired
hearing, hepatic and
cardiovascular conditions
ADVERSE EFFECTS OF
THE DRUG
Adverse effects
CNS: Headache, dizziness,
somnolence,
insomnia, fatigue, tiredness,
dizziness,
tinnitus, ophthamologic
effects
Dermatologic:Rash, pruritus,
sweating, dry mucous
membranes, stomatitis
GI: Nausea, abdominal
pain,dyspepsia, flatulence,
GI bleed
Hematologic: Neutropenia,
eosinophilia, leukopenia,
pancytopenia,
thrombocytopenia,
agranulocytosis,
granulocytopenia, aplastic
anemia, decreased inflammation (eg warmth,
hemoglobin or hematocrit,
bone marrow depression,
NURSING
RESPONSIBILITIES
/PRECAUTIONS
• Administer drug with
food or after meals if GI
upset occurs.
• Establish safety
measures if CNS, visual
disturbances occur.
• Arrange for periodic
ophthalmologic
examination during
long-term therapy.
• If overdose occurs,
institute emergency
procedures—gastric
lavage, induction of
emesis, supportive therapy.
• Provide further comfort
measures to reduce pain
(eg positioning,
environmental
control), and to reduce
positioning, rest