Drug Study

Mechanism of Action Generic Name: Ciprofloxacin Brand name: Quinosyn Classification: Antibacterial Dosage: 500mg Frequency: BID Route: Per Orem Inhibition of topoisomerase (DNA gyrase) enzymes, which inhibits relaxation of supercoiled DNA and promotes breakage of double stranded DNA. Indication Contraindication Adverse Reactions ♣ Nausea ♣ Vomiting ♣ Stomach pain ♣ Heartburn ♣ Diarrhea Nursing Responsibilities ◙ Instruct patient not to take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice. He may eat or drink dairy products or calcium-fortified juice with a regular meal, but do not use them alone when taking ciprofloxacin. They could make the medication less effective.

 Ciprofloxacin is Ciprofloxacin is contraindicated in used to treat persons with a infections of the history of skin, lungs, airways, bones, and hypersensitivity to ciprofloxacin, any joints caused by member of the susceptible quinolone class of bacteria. antimicrobial agents, Ciprofloxacin is also frequently used or any of the product components. to treat urinary infections caused by bacteria such as  Coadministration E. coli. of ciprofloxacin with Ciprofloxacin is effective in treating other drugs primarily infectious diarrheas metabolized by CYP1A2 results in caused by E. coli, increased plasma Campylobacter concentrations of jejuni, and Shigella these drugs and bacteria. could lead to clinically significant adverse events of the coadministered drug.  Contraindicated for the treatment of certain sexually

♣ Feeling an urgent need to ◙Tell patient that Ciprofloxacin can cause side effects that may impair his thinking or reactions. urinate Tell patient to be careful if he plans to drive or do ♣ Headache anything that requires him to be awake and alert. ♣ Difficulty breathing or ◙Instruct patient to take ciprofloxacin with a full swallowing glass of water (8 ounces). ♣ Hoarseness or throat tightness ♣ Rapid, irregular, or pounding heartbeat ♣ Fainting ♣ Fever ♣ Joint or muscle pain ♣ Unusual bruising or bleeding ♣ Extreme tiredness ♣ Lack of energy of ◙ Instruct patient to avoid taking antacids, vitamin or mineral supplements, sucralfate (Carafate), or didanosine (Videx) powder or chewable tablets within 6 hours before or 2 hours after you take ciprofloxacin. These other medicines can make ciprofloxacin much less effective when taken at the same time. ◙Inform patient that Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. These effects may be more likely to occur if you are over 60, if you take an oral steroid medication, or if you have had a kidney, heart, or

transmitted diseases by some experts due to bacterial resistance.  Concomitant administration with tizanidine is contraindicated.

appetite ♣ Seizures ♣ Dizziness ♣ Confusion ♣ Nervousness ♣ Restlessness ♣ Anxiety ♣ Difficulty falling asleep or staying asleep ♣ Pain in the upper right part of the stomach ♣ Yellowing of the skin or eyes ♣ Dark urine

lung transplant. ◙Instruct patient to stop taking ciprofloxacin and call the doctor at once if he has sudden pain, swelling, tenderness, stiffness, or movement problems in any of your joints. Also instruct patient to rest his joint until he receive medical care or instructions.

Drug name
Generic name: Paracetamol

Dosage

Indication
• Relief of mild-tomoderate pain Temporary reduction of fever

Contraindication
• Contraindicat ed with allergy to acetaminophe n Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation. •

Drug Action
Decreases fever by inhibiting the effects of pyrogens on the hypothalamic heat regulating centers and by a hypothalamic action leading to sweating and vasodilation. Relieves pain by inhibiting prostaglandins synthesis at the CNS but does not have antiinflammatory action because of its minimal effect on the peripheral prostaglandin synthesis.

Adverse and Side Effects
• CNS: weakness, fatigue, nervousness, sedation, drowsiness, dizziness, depression, tremor, headache, seizures Dermatologic: pruritus, urticaria, rash GI: Anorexia, nausea, vomiting, constipation, hepatic insufficiency GU: Hematuria, glycosuria, urinary frequency, renal colic, crystaluria, polyuria

Nursing Responsibilities
• Assess patient’s fever or pain: type of pain, location, intensity, duration, temperature Assess allergic reactions: rash, urticaria; if these occur, drug may have to be discontinued Assesss for  chronic poisoning: rapid, weak pulse  dyspnea: cold, clammy extremities

Brand Name: Biogesic

• •

Classification: Analgesics Antipyretic

report immediately to prescriber.
• Give with food or milk if GI upset occurs

Route and Dosage:

Other: weight loss, fever , acidosis

Drug name

Dosage

Mechanism of

Indication

Contraindication

Adverse Reactions

Nursing Responsibilities

Action Hidrasec capsule: Hidrasec 100 mg Hidrasec powder: Hidrasec (infant) 10 mg Hidrasec 30 mg Hidrasec should be given in conjunction with oral or parenteral rehydration therapy in patients where dehydration has occurred or is suspected. Capsule: Adults: Treatment should be initiated with a single 100-mg cap given regardless of the time. Further treatment is given approximately 8hourly until cessation of diarrhea. The daily dose should not exceed 300 mg and the duration of treatment must not exceed >7 days. Powder: The usual daily dose is determined according to Pharmacology: Hidrasec is an inhibitor of enkephalinase, the enzyme responsible for breaking down enkephalins. It is a selective but reversible inhibitor and protects endogenous enkephalins which are physiologically active in the digestive tract. Hidrasec has a pure intestinal antisecretory agent which has been shown to have no effect on gastrointestinal motility. It reduces intestinal hypersecretion of water and electrolytes caused by cholera toxin or For the treatment of acute diarrhea Known hypersensitivity to racecadotril. Renal or hepatic impairment. Special Precaution: A few cases of drowsiness have been reported during clinical trials. Nausea and vomiting, constipation, dizziness and headaches have also been reported rarely. The side effects have been mild, and equivalent in nature, frequency and intensity to those reported with placebo. Post-marketing surveillance has indicated side effects to be extremely rare in general use. Rehydration is the essential element of the treatment of acute diarrhea in infants. In children >24 months, it shoud be planned automatically. The prevention or treatment of dehydration will be done with oral rehydration solution. It is recommended to use solutions intended for this purpose and to follow the instructions for reconstitution and use. The sodium concentration should be between 30 and 60 mmol/L, with solutions with a lower content (30 mmol/L) being reserved for less severe dehydration. Provision of chlorine and potassium is necessary in order to correct digestive losses. The recommended glucosae concentration is between 74 and 110 mmol/L. The addition of hydrolyzed proteins or amino acids does not seem to improve rehydration or the nutritional state . It is essential to offer the child very frequent drinks, every quarter of an hour for example. As a guideline, the proposed volume of oral rehydratio should be equivalent to the weight loss ie, 50-100 mL/kg for dehydration of 5-10% of bodyweight. In the case of severe or prolonged diarrhea, severe vomiting or refusal of food, IV rehydration should be considered. In the case of infectious diarrhea with clinical manifestations suggesting an invasive phenomenon, use antibacterial with good

bodyweight on the basis of 1.5 mg/kg per dose, with 1 initial dose and 3 doses spread over the day. Children >9 years (approx >27 kg): 2 sachets/dose; 30 months - 9 years (approx 13-27 kg): 1 sachet/dose; 9-30 months (approx 9-13 kg): 2 sachets/dose; 1-9 months: 1 sachet.dose. Children: Hidrasec is not recommended for use in children. Elderly: An adjustment of dose is not necessary in elederly subjectcs

inflammation without affecting basal secretion. There is therefore no effect in the normal intestine. When given orally, enkephalinase inhibition is purely peripheral. Racecadotril does not affect central nervous system enkephalinase activity and has not been shown to produce habituation or central nervous stimulant or sedative effects. Pharmacokinetic s: Racecadotril is rapidly absorbed by the oral route. It is rapidly hydrolyzed to (RS)-N-(1-oxo-2(mercaptomethyl) -3-phenylpropyl) glycine, its active

systemic diffusion. Hidrasec 30 mg: If rehydration by rehydration solution is prescribed, the conditions of use and the method of reconstitution should be explained clearly and precisely. It is not necessary to prescribe such rehydration, it is nonetheless necessary to explain clearly the need to rehydrate the child plentiful salty or sweetened drinks in order to make up for the loss of fluid due to the diarrhea (the average daily ration of water is 2 L). Maintain feeding during period of diarrhea: Excluding certain product, especially fruit, green vegetables, spicy food and also iced foods or drinks; giving preferen to grilled meat and rice; withdrawal of milk and dairy products should be considered in each individual case. In the case of diabetes, take into account the quantity of sugar in a sachet ie, about 2.899 g of sucrose per sachet of 3 g powder. If the quantity of sucrose (source of glucose and fructose) in daily dose of this drug >5 g/day, it should be taken into account in the daily ration. In the absence of any studies in these situations, Hidrasec should not be used as treatment of first intent for acute dysentery with blood in the stools or high fever and it should not be used in the case of diarrhea occurring during treatment

metabolite, which is in turn converted into inactive metabolites which are eliminated through the kidneys, feces and lungs. The extent and duration of action of racecadotril depends on the dose administered. Activity against plasma enkephalinase starts within 30 min, with peak activity corresponding to 75% inhibition for a dose of 100 mg, occurring 1-3 hrs after administration. The biological half-life of racecadotril is 3 hrs. For a dose of 100 mg, the

with a broad-spectrum antibiotic. Effects on the Ability to Drive or Operate Machinery: No adverse effects on the ability to drive or operate machinery have been identified. Use in pregnancy & lactation: Adequate human data on use during pregnancy are not available. However, animal studies have not identified any risk to pregnancy or embryo-fetal development. Hidrasec should not be used in pregnancy unless the potential benefits outweigh the risks.

duration of activity against plasma enkephalinase is about 8 hrs. (RS)-N-(1-oxo-2(mercaptomethyl) -3-phenylpropyl) glycine, the active metabolite of racecadotril, is 90% bound to plasma proteins, mainly albumin. Tissue distribution only affects about 1% of the administered dose.The pharmacokinetic properties of racecadotril are not changed by repeated administration or in elderly subjects. The bioavailability of racecadotril is not affected by food but the peak activity is delayed

by 1½ hrs

Drug name

Indication

Contraindication

Drug Action

Adverse and Side Effects

Nursing Responsibilities

Hidrasec

Known hypersensitivity to racecadotril. Renal or hepatic impairment Special precautions:

No specific studies in humans have been performed.
Racecadotril does not inhibit or induce cytochrome P-450 in animal models

A few cases of drowsiness have been reported during clinical trials. Nausea and vomiting, constipation, dizziness and headaches have also been reported rarely. The side effects have been mild, and equivalent in nature, frequency and intensity to those reported with placebo. Post-marketing surveillance has indicated side effects to be extremely rare in general use.

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