Name of Drug Classification Mechanism Indication Contraindication Adverse Reactions Nsgr.

Ressponsibilities
of Action
Generic name: Pharmalogical Cefuroxime bactericidal Contraindicated CV: phlebitis, Determine history of hypersensitivity
Cefuroxime Sodium Class: inhibits cephalosporin in patients thrombophlebitis reactions to cephalosporins, penicillins, and
2nd generation bacterial cell antibiotic which hypersensitive to history of allergies, particularly to drugs,
Trade name: cephalosporin wall is resistant to drug or other GI: diarrhea, anorexia, before therapy is initiated.
Zinacef synthesis by most beta- cephalosporin. vomiting
binding to lactamases and Lab tests: Perform culture and sensitivity
Therapeutic Class: one 1 or is active against Use cautiously in Hematologic: hemolytic tests before initiation of therapy and
Cephalosporin more of the a wide range of patients anemia, periodically during therapy if indicated.
penicillin- Gram-positive hypersensitive to thrombocytopenia,tran Therapy may be instituted pending test
binding and Gram- penicillin sient neutropenia, results. Monitor periodically BUN and
proteins negative because of eosinophilia creatinine clearance.
(PBPs) which organisms. possibility of
in turn inhibit It is indicated cross-sensitivity Inspect IM and IV injection sites frequently
the final for the with other beta for signs of phlebitis.
transpeptidat treatment of lactam antibiotic
ion step of infections Report onset of loose stools or diarrhea.
peptidoglyca before the Although pseudomembranous colitis (see
n synthesis in infecting Signs & Symptoms, Appendix F) rarely occurs,
bacterial cell organism has this potentially life-threatening complication
walls, thus been identified should be ruled out as the cause of diarrhea
inhibiting or when caused during and after antibiotic therapy.
cell wall by sensitive
biosynthesis bacteria. Monitor for manifestations of
and arresting hypersensitivity (see Appendix F).
cell wall Discontinue drug and report their appearance
assembly promptly.
resulting in
bacterial cell Monitor I&O rates and pattern: Especially
death. important in severely ill patients receiving
high doses. Report any significant changes.
Patient & Family Education
 Report loose stools or diarrhea promptly.
Report any signs or symptoms of
hypersensitivity (see Appendix F).
Do not breast feed while taking this drug.

Dosage:

Adult : PO Susceptible infections 250 mg bid. Uncomplicated UTI 125 mg bid. Resp tract infections 250-500 mg bid. Lyme disease 500 mg bid for
20 days. Uncomplicated gonorrhoea 1 g as a single dose. May be given w/ oral probenecid 1 g. IM/IV Susceptible infections 0.75 g 8 hrly, may
increase up to 1.5 g 6-8 hrly in more severe infections. Pneumonia 1.5 g bid, followed by an oral dose of 0.5 g bid. Acute exacerbations of chronic
bronchitis 750 mg bid, followed by an oral dose 500 mg bid. Prophylaxis of surgical infections 1.5 g IV before the procedure, followed by 750 mg
IM 8 hrly for up to 24-48 hr. For total joint replacement: 1.5 g, may be mixed w/ methylmethacrylate cement. IV Meningitis 3 g 8 hrly. IM
Gonorrhea 1.5 g as a single dose divided between 2 inj sites. May be given w/ oral probenecid 1 g.
Name of Drug Classification Mechanism Indication Contraindication Adverse Reactions Nsgr. Ressponsibilities
of Action
Generic Name Anti-infectives Interferes Treatment of History EENT: 1.)Perform skin testing before giving the
Cloxacillin (Penicillins) withcell infections of hypersensitivit occasionally,laryngeal medication.
Trade Name wallreplicatio causedby y to edema, RATIONALE:
Avastoph n of pneumococci,Gr penicillinsandcep Skin: To prevent anaphylactic shock
susceptibleor oup A beta- hallosporins. urticaria, skinrashes, whenadministered.2.)Administer drug slowly
Dosage ganisms, hemolyticstrept Sever pneumonia exfoliativedermatitis, to the IV line
150 mg every6 thecell ococci, ,emphysema,bac rash RATIONALE:
hours wall,rendere andpenicillin teremia,pericardi GI: The drug is very irritating to the tissue
Routes of dosmotically Gsensitivestaph tis,meningitis GI disturbances,nausea, andblood vessels. Injecting slowly the drug
administration unstable, ylococci.Prophyl andpurulent vomiting,epigastric prevents phlebitis3.)Explain to the patient
IVTT ANST (-) swell,bursts axis:Staphylococ andseptic distress,diarrhea that antibiotic therapy lastsfor 7 days will
fromosmotic calinfection arthritisduring andflatulence, take the drug without any miss.
pressure; duringmajor theacute antibiotic- RATIONALE:
resiststhe cardiovascular thestage. Sub- associatedpseudomem Taking the drug for 7 days helps to kill
penicillinasea andorthopedic conjunctival branouscolitis thebacteria and growth.4.)Make sure that the
ction surgery infections. GU: patient takes the drug at thesame time of the
thatinactivat interstitialnephritis and day. And also to prevent thembeing drug
espenicillins vasculitis resistant.
Hematologic: RATIONALE:
eosinophilia,agranulocy To prevent growth of bacteria and tocontinue
tosis,anemia,thromboc the efficacy of the drug.5.)Provide rest and
ytopenia,transient rise comfort.
intransminases RATIONALE:
andalkaline phophatase the drug may cause dizziness which is
Other: anormal side effect of the drug.6.)Assess for
 hypersensitivityreactio any signs of hypersensitivity reactionsuch as
ns, serumsickness-like purpura, rash, urticaria, exfoliativedermatitis,
reactions,fever itching
RATIONALE:
to discontinue the therapy andimmediately
call the physician for an antidote

Dosage Adult : PO 250-500 mg 6 hrly. IM/IV 1-2 g 6 hrly.

Dosage Details Oral

Staphylococcal infections resistant to benzylpenicillin
Adult: 250-500 mg 6 hrly.
Child: <7 days and <2 kg: 25 mg/kg 12 hrly; 7-28 days and <2 kg or ≤7 days and ≥2 kg: 25 mg/kg 8 hrly; 7-28 days and ≥2 kg: 25 mg/kg 6 hrly; ≥1 mth and <20 kg: 50-100
mg/kg daily 6 hrly. Max: 4 g daily. For severe infection, up to 200 mg/kg daily in divided doses. Max: 12 g daily.

Parenteral
Staphylococcal infections resistant to benzylpenicillin
Adult: 1-2 g 6 hrly. For more severe infections (e.g. meningitis, endocarditis), 2 g 4 hrly.
Child: <7 days and <2 kg: 25 mg/kg 12 hrly; 7-28 days and <2 kg or ≤7 days and ≥2 kg: 25 mg/kg 8 hrly; 7-28 days and ≥2 kg: 25 mg/kg 6 hrly; ≥1 mth and <20 kg: 50-100
mg/kg daily 6 hrly. Max: 4 g daily. For severe infection, up to 200 mg/kg daily in divided doses. Max: 12 g daily.
Name of Drug Classification Mechanism Indication Contraindication Adverse Reactions Nsgr. Ressponsibilities
of Action
Generic name: Nasal Ephedrine PO: Coronary Tachycardia, anxiety,
Ephedrine sulfate Decongestants & stimulates Temporary thrombosis, nausea, restlessness,
Other Nasal both α- and relief of ischaemic heart insomnia, tremor, dry
Trade name: Preparations / β-receptors, shortness of disease, HTN, mouth, impaired
Drinex Vasoconstrictors thereby breath, thyrotoxicosis, circulation to the
causing tightness of DM, prostatic extremities, HTN,
bronchodilati chest, and hypertrophy, headache, cardiac
on, wheezing due angle-closure arrhythmia.
peripheral to bronchial glaucoma; post Potentially Fatal:
vasoconstrict asthma or nasal or sinus Coronary artery
ion and CNS bronchospasm surgery (nasal thrombosis, MI,
stimulation. soln). Lactation. seizures, psychotic
It also has Parenteral: Patients taking reactions,
stimulant -Allergic MAOIs (or w/in 2 nephrolithiasis,
action on the disorders, wk of myocarditis.
resp centre. including withdrawal),
bronchial other
asthma sympathomimeti
-Pressor agent, c drugs, β-
especially blockers, and
during spinal those who are
anesthesia given volatile
when anaesth.
hypotension
occurs
frequently
-Stokes-Adams
syndrome with
complete heart
block
-Myasthenia
gravis
 -CNS stimulant
in narcolepsy

Investigational:
Depression (to
enhance
physical and
mental energy)

DOSAGE:

Bronchodilator, Nasal Decongestant

Adult: PO 25–50 mg q3–4h prn (max: 150 mg/24 h) IM/IV/SC 12.5–25 mg

Child: PO >2 y, 2–3 mg/kg/d in 4–6 divided doses; 6–12 y, 6.25–12.5 mg q4h (max: 75 mg/24 h)

Hypotension

Adult: PO 25 mg 1–4 times/d (max: 150 mg/24 h) IM/SC/IV 10–50 mg IM/SC or 10–25 mg slow IV, may repeat in 5–10 min if necessary (max: 150
mg/24 h)

Child: PO/IM/SC/IV 3 mg/kg/d in 4–6 divided doses (max: 75 mg/24 h)

Myasthenia Gravis

Adult: PO 25 mg t.i.d. or q.i.d.

Enuresis
Adult: PO 25 mg h.s.

Urinary Incontinence

Geriatric: PO 25–50 mg q6h.

Nasal Decongestant

Adult: Intranasal 2–4 drops or a small amount of jelly in each nostril no more than q.i.d. for 3–4 consecutive days

ADMINISTRATION/STORAGE

1. Tolerance may develop; temporary cessation of therapy restores original drug response.

IV 2. May administer 10 mg IV undiluted over at least 1 min.

3. Use only clear solutions; discard any unused solution. Protect against exposure to light; drug is subject to oxidation

ASSESSMENT

1. Note reasons for therapy; symptom characteristics

2. Assess mental status, pulmonary function; monitor ECG and VS. If administered for hypotension, monitor BP until stabilized.
3. Monitor carefully with asthma, heart disease, and pregnancy.
4. If used for prolonged periods, assess for drug resistance. Rest without medication n for 3–4 days, then resume to regain response

CLIENT/FAMILY TEACHING

1. Method of administration depends on condition being treated. Report if SOB unrelieved by medication and accompanied by chest pain,
dizziness, or palpitations; any elevated or irregular pulse.
2. Review proper method for nasal instillation. Nasal burning/stinging may occur with nasal drops or spray. Do not share nasal spray
container with others.
3. Use topical decongestants only in acute states and not for more than 3 to 5 days
4. Avoid activities that require mental alertness until drug effects realized. Do not take within 2 hr of bedtime; may cause insomnia.
5. With males, report difficulty or pain with voiding; may see drug-induced urinary retention.
 6. Report any depression, lack of interest in personal a
7. ppearance, complaints of insomnia, anorexia or decreased ef fectiveness. Tolerance may occur within 1-2 months.
8. Avoid OTC drugs and alcohol.
9. Keep all F/U to assess response, adverse SE

OUTCOMES/EVALUATE

•Relief of SOB, chest tightness and wheezing with asthma

• decreased Nasal congestion/mucus

• increased BP

• Control of narcolepsy
Name of Classificati Mechanism Indication Contraindication Adverse Reactions Nsgr. Ressponsibilities
Drug on of Action
Generic NSAIDs Ibuprofen >Relief of mild >Hypersensitivity CNS:Headache, dizziness,
Assessment & Drug Effects
name: (Non- inhibits to moderate >Treatment of light-headedness, anxiety,
Ibuprofen steroidal synthesis of pain & perioperative emotional lability, fatigue,
Anti- prostaglandi inflammation pain in the malaise, drowsiness,  Monitor for therapeutic effectiveness.
Trade name: Inflammato ns in body associated w/ setting of CABG anxiety, confusion,
Optimum response generally occurs within 2
Advil ry Drugs) tissues by dysmenorrhea surgery. Patient depression, aseptic
inhibiting , headache whom asthma, meningitis. wk (e.g., relief of pain, stiffness, or
cyclooxygen including urticaria or other swelling; or improved joint flexion and
ase-1 and 2. migraine, allergic-type CV:Hypertension,
strength).
It has anti- post-op & reaction are palpitation, congestive
inflammator dental pain, precipitated by heart failure (patient with  Observe patients with history of cardiac
y, analgesic musculoskelet aspirin or other marginal cardiac decompensation closely for evidence of fluid
and al & joint NSAIDs. Active or function); peripheral
retention and edema.
antipyretic disorders eg, history of peptic edema.
properties. ankylosing ulcer; history of  Lab tests: Baseline and periodic evaluations
spondylitis, GI bleeding. SpecSenses:Amblyopia of Hgb, renal and hepatic function, and
OA & RA >Neonates w/ (blurred vision, decreased
auditory and ophthalmologic examinations
including congenital heart visual acuity, scotomas,
juvenile disease, changes in color vision); are recommended in patients receiving
idiopathic suspected nystagmus, visual-field prolonged or high-dose therapy.
arthritis. necrotising defects; tinnitus, impaired
 Monitor for GI distress and S&S of GI
enterocolitis, and hearing.
>Peri-articular impaired renal bleeding.
disorders eg, function. 3rd GI:Dry mouth, gingival  Note: Symptoms of acute toxicity in children
bursitis & trimester of ulcerations, dyspepsia,
include apnea, cyanosis, response only to
tenosynovitis pregnancy, and heartburn, nausea,
& soft tissue lactation. vomiting, anorexia, painful stimuli, dizziness, and nystagmus.
disorders eg, diarrhea, constipation, Patient & Family Education
sprains & bloating, flatulence,
strains. epigastric or abdominal
Reduction of discomfort or pain, GI  Notify physician immediately of passage of
fever. dark tarry stools, “coffee ground” emesis,
ulceration, occult blood frankly bloody emesis, or other GI distress,
loss.
as well as blood or protein in urine, and
Hematologic:Thrombocyt onset of skin rash, pruritus, jaundice.
openia, neutropenia,
 Do not drive or engage in other potentially
hemolytic or aplastic
anemia, leukopenia; hazardous activities until response to the
decreased Hgb, Hct; drug is known.
transitory rise in AST, ALT,
 Do not self-medicate with ibuprofen if taking
serum alkaline
phosphatase; rise in (Ivy) prescribed drugs or being treated for a
bleeding time. serious condition without consulting
other: Acute renal failure,
physician.
polyuria, azotemia,
cystitis, hematuria,  Do not take aspirin concurrently with
nephrotoxicity, decreased ibuprofen.
creatinine clearance.
 Avoid alcohol and NSAIDs unless otherwise
Skin:Maculopapular and advised by physician. Concurrent use may
vesicobullous skin increase risk of GI ulceration and bleeding
eruptions, erythema
tendencies.
multiforme, pruritus,
rectal itching, acne.  Do not breast feed while taking this drug
without consulting physician.
BodyWhole:Fluid
retention with edema,
Stevens-Johnson
syndrome, toxic hepatitis,
hypersensitivity reactions,
anaphylaxis,
bronchospasm, serum
sickness, SLE,
angioedema.
Route & Dosage

Inflammatory Disease
adult: PO 400–800 mg t.i.d. or q.i.d. (max: 3200 mg/d)
child: PO < 20 kg, up to 400 mg/d in divided doses; 20–30 kg, up to 600 mg/d in divided doses; 30–40 kg, up to 800
mg/d in divided doses
Mild to Moderate Pain, Dysmenorrhea
adult: PO 400 mg q4–6h up to 1200 mg/d
Fever
adult: PO 200–400 mg t.i.d. or q.i.d. (max: 1200 mg/d)
child: PO 6 mo–12 y, 5–10 mg/kg q4–6h up to 40 mg/kg/d

Availability:
100 mg, 200 mg, 400 mg, 600 mg, 800 mg tablets; 50 mg, 100 mg chewable tablest; 100 mg/5 mL, 100 mg/2.5 mL
suspension; 40 mg/mL drops