NAME OF THE DRUG Ampicillin 200mg IVTT Q6 NST (2-8) CLASSIFICATION: Antibiotics MECHANISMS OF ACTION: Interferes with cell

wall synthesis of susceptible organisms, preventing bacterial multiplication, it also renders the cell wall osmotically unstable and burst due to osmotic pressure. Deactivated by beta-lactamase, an enzyme produced by resistant bacteria. INDICATION: Treatment of respiratory tract and soft tissue infections, bacterial meningitis, septicemia, and gonococcal infections caused by susceptible microorganisms. CONTRAINDICATION: Hypersensitivity to penicillins, cephalosporins or imipenem. Oral form not used to treat severe pneumonia, emphysema, bacteremia, pericarditis, and purulent or septic arthritis during acute stage. ADVERSE REACTION: Thrombophlebitis at injection site, fatigue, insomnia, reversible hyperactivity, neurotoxicity (lethargy, neuromuscular irritability, hallucinations, convulsions, seizures) urticaria, maculopapular to exfoliative dermatitis, vesicular eruptions, skin rashes, diarrhea, pseudomembranous, colitis, iinterstitial nephritis (e.g., oliguria, proteinuria, hematuria, hyaline casts, pyuria) decreased Hgb, Hct, WBC, RBC, neutrophis, eosinophils and platelets, pain at injection site, hyperthermia. NURSING RESPONSIBILITIES: 1. Obtain patient history of infection before and during therapy to assess response. 2. Assess patient for signs and symptoms of infection. Fever, characteristics of wounds, sputum, urine, stool, earache,and WBC count >10,000/mm3, obtain baseline information and during treatment. 3. Otain C & S before drug therapy to identify if correct treatment has been initiated. 4. Assess history of previous sensitivity reactions to penicillins or other cephalosporins. Crosssensitivity between penicillins and cephalosporins is common fever; joint pain, pruritus and rash. Angioedema may occur a few days after therapy begins. Epinephrine ad resuscitation equipment should be on unit for anaphylactic reaction. 5. Monitor blood studies: CBC, Hct 6. Assess for overgrowth infection: perineal itching, fever, malaise, redness, pain, swelling,

drainage, rash, diarrhea or change in character of cough and sputum.

NAME OF THE DRUG Ranitidine 3mg IV Q8h CLASSIFICATION: Histamine2 (H2) antagonist, antacid MECHANISM OF ACTION: Ranitidine blocks histamine H2-receptors in the stomach and prevents histamine-mediated gastric acid secretions. It does not affect pepsin secretion, pentagastrin-stimulated factor secretion or serum gastrin. INDICATIONS: Short-term treatment of active duodenal ulcer, maintenance therapy for duodenal ulcer at reduced dosage, short-term treatment of active benign gastric ulcer, short-term treatment of GERD, pathologic hypersecretory conditions (e.g.,Zollinger-Ellison syndrome) treatment of erosive esophagitis, and treatment of heartburn, acid indigestion, and sour stomach. CONTRAINDICATIONS: Hypersensitivity. History of acute porphyria. Long-term therapy. ADVERSE REACTION: Headache, dizziness. Rarely hepatitis, thrombocytopenia, leucopenia, hypersensitivity, confusion, gynecomastia, impotence, somnolence, vertigo, and hallucinations. NURSING RESPONSIBILITIES: 1. Decrease doses in renal and liver failure. 2. Administer IM dose diluted, deep into large muscle group. 3. Provide concurrent antacid therapy to relieve pain. 4. Arrange for regular follow-up, including blood tests to evaluate effects. Report fever, unusual bruising or bleeding, headache, muscle or joint pain.

NAME OF THE DRUG Metronidazole 45mg IVTT CLASSIFICATION: Antibiotic MECHANISM OF ACTION: Direct-acting amebicide/trichomonacide. It binds to bacterial and protozoal DNA to cause loss of helical structure, strand breakage, inhibition of nucleic acid synthesis and cell death. INDICATIONS: Infections in the intra-abdominal, skin and skin structure, bone and joint, gynecologic, bacterial, bacterial septicemia, CNS, lower respiratory system and endocarditis. Treatment of susceptible protozoal infections and in the treatment and prophylaxis of anaerobic bacterial infections. Anaerobic infections, trichomoniasis, amoebiasis, giardiasis. CONTRAINDICATIONS: Blood dyscrasias. Active CNS diseases. Hypersensitivity to imidazole. Tuberculosis of mucous membranes and certain viral conditions. ADVERSE REACTION: Convulsive seizures; peripheral neuropathy; rash, pruritus. GI discomfort, anorexia, nausea, furred tongue, dry mouth and unpleasant metabolic taste, headache, less frequently vomiting, diarrhea, weakness, dizziness and darkening of the urine. Leucopenia. NURSING RESPONSIBILITIES: 1. Obtain baseline information on patient s infection: fever, characteristic of wounds, WBC count (>10,000/mm3) and regularly assess during treatment. 2. Obtain patient history of infection before and during therapy to identify if correct treatment has been initiated. 3. Assess for allergic reactions: rash, urticaria, pruritus. 4. Monitor bowel pattern, discontinue drug if severe diarrhea occurs.