Drug Study

1.Generic Name: Paracetamol, Acetaminophen Brand Name: Biogesic, Panadol, Tylenol Classification: Non-narcotic analgesic, Antipyretic Actions: -Decreases fever by a hypothalamic effect leading to sweating and vasodilation -Inhibits pyrogen effect on the hypothalamic-heat-regulating centers -Inhibits CNS prostaglandin synthesis with minimal effects on peripheral prostaglandin synthesis -Does not cause ulceration of the GI tract and causes no anticoagulant action. Contraindications: -Renal Insufficiency -Anemia Special Concerns: -Liver toxicity (hepatocyte necrosis) may occur with doses not far beyond labeled dosing. -If 3 or more alcoholic drinks per day is consumed, consult a physician prior use. Side-Effects: -Minimal GI upset. -Methemoglobinemia -Hemolytic Anemia -Neutropenia -Thrombocytopenia -Pancytopenia -Leukopenia -Urticaria -CNS stimulation -Hypoglycemic coma -Jaundice -Glissitis -Drowsiness -Liver Damage Dosage: -Per Orem: 325-650mg q4h up to a maximum of 1 gram q6h. -Suppositories: 650mg q4h not to exceed 4 grams a day for up to 10 days. Nursing Considerations: -Do not exceed 4gm/24hr. in adults and 75mg/kg/day in children. -Do not take for >5days for pain in children, 10 days for pain in adults, or more than 3 days for fever in adults. -Extended-Release tablets are not to be chewed. -Monitor CBC, liver and renal functions. -Assess for fecal occult blood and nephritis. -Avoid using OTC drugs with Acetaminophen. -Take with food or milk to minimize GI upset. -Report N&V. cyanosis, shortness of breath and abdominal pain as these are signs of toxicity. -Report paleness, weakness and heart beat skips -Report abdominal pain, jaundice, dark urine, itchiness or clay-colored stools. -Phenmacetin may cause urine to become dark brown or wine-colored. -Report pain that persists for more than 3-5 days -Avoid alcohol. -This drug is not for regular use with any form of liver disease.

2. Generic Name: Cefuroxime Axetil Cefuroxime Sodium Brand Name: Cefuroxime Axetil (Ceftin [P.O.]) Cefuroxime Sodium (Zinacef [Parenteral])

Indications: * Pharyngitis, tonsillitis, infections of the urinary and lower respiratory tracts, and skin and skinstructure infections caused by Streptococcus pneumoniae and S. pyogenes, Haemophillus influenzae, Staphylococcus aureus, Escherichia coli, Moraxella catarrhalis (including beta-lactamase-producing strains), Neisseria gonorrheae, and Klebsiella and Enterobacter species. * Serious lower respiratory tract infections, UTIs, skin and skin-structure infections, bone and joint infections, septicemia, meningitis, and gonorrhea * Uncomplicated UTIs * Otitis Media * Pharyngitis and Tonsillitis * Perioperative Prevention * Early Lyme Disease (erythema migrans) caused by Borrelia burgdorferi * Secondary bacterial infection of acute bronchitis * Uncomplicated gonorrhea * Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenza (only strains that don’t produce beta-lactamase) Mechanism of Action: Second-generation cephalosporin that inhibits cell-wall synthesis, promoting osmotic instability; usually bactericidal. Adverse Reactions: CV: phlebitis, thrombophlebitis GI: pseudomembranous colitis, nausea, anorexia, vomiting, diarrhea Hematologic: transient neutropenia, eosinophilia, hemolytic anemia, thrombocytopenia Skin: maculopapular and erythematous rashes, urticaria, pain, induration, sterile abscesses, temperature elevation, tissue sloughing at intramuscular injection site Other: hypersensitivity reactions, serum sickness, anaphylaxis. Effects on Lab Test Results: * May increase ALT, AST, alkaline phosphatase, bilirubin, and LDH levels. May decrease hemoglobin and hematocrit level. * May increase PT and INR and eosinophil count. May decrease neutrophil and platelet counts. * May falsely increase serum or urine creatinine level in tests using Jaffe reaction. May cause falsepositive results of Coomb’s test and urine glucose tests using cupric sulfate (Benedict’s reagent or Clinitest). Contraindications and Cautions: * Contraindicated in patients hypersensitive to drug. * Use cautiously in patients hypersensitive to penicillin because of possibility of cross-sensitivity with other beta-lactam antibiotics. * Use with caution in breast-feeding women and in patients with history of colitis or renal sufficiency. Nursing Consideration * Before administering, make sure patient is not allergic to penicillins or cephalosporins. * Absorption of cefuroxime axetil is enhanced by food. * Cefuroxime axetil tablets may be crushed if swallowing is a difficulty. Cefuroxime axetil tablets may be dissolved in small amounts of apple, orange or grape juice, even chocolate milk. However, drug’s bitter taste is difficult to mask even with food.

* High-fat meals increased drug bioavailability. * ALERT! Cefuroxime axetil film-coated tablet and oral suspension are not bioequivalent. * If large doses are given, therapy is prolonged, or patient is at high risk, monitor patient for signs and symptoms of superinfection. * Unlike other second generation cephalosporins, cefuroxime can cross the blood-brain-barrier. * ALERT! Do not confuse with other cephalosporins that sound alike. * Take medication as prescribed, even after feeling better. * Take oral form with food. * If suspension is being used, shake the container well before measuring dose. * Notify prescriber about rashes or superinfections. * Notify prescriber about loose stools or diarrhea. 3.