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Name Indication Action Adverse Reaction Nursing Responsibilities

Mupirocin >This medication is >It works by stopping >Contraindicated in patients >Mupirocin ointment is for external use only. Do not get
Ointment an antibiotic, production of essential with hypersensitivity to the in eyes or mouth
prescribed for proteins needed for bacterial drug >Use Mupirocin Ointment with caution on skin with open
impetigo. surveillance. wounds
>It is not effective >Be sure to use the drug for the full course of treatment
against fungal or viral >Long term or repeated use of Mupirocin ointment may
infections cause second infection
>Apply a small amount of ointment 3x a day
>Wash and completely dry the affected area. Gently rub
the medicine in until it is evenly distributed. The affected
area may be covered with gauze or bandage
>Wash hands immediately after using the ointment
TRAMADOL Analgesic Binds to -opiatereceptors in Hypersensitivity to tramadol, >Instruct client to report any adverse reaction to
Management of pain the CNS causing inhibition opioids, or any component of the physician or nurse. Tell patient that tolerance or drug
in the operation site. of ascending pain pathways, the formulation; opioid- dependence may result from extended use (withdrawal
altering the perception of and dependent patients; acute symptoms have been reported); abrupt discontinuation
response to pain; also inhibits intoxication with alcohol, should be avoided.
the reuptake hypnotics, centrally-acting >
of norepinephrine and analgesics, opioids, You should not take Ultram if you have ever been
serotonin, which also modifies or psychotropic drugs addicted to drugs or alcohol. Should be used only with
the ascending pain pathway. extreme caution in patients receiving MAO inhibitors

Paracetamol  Mild Pain  Inhibits the synthesis BEFORE DRUG ADMINISTRATION:
 Fever of prostaglandins GI: HEPATIC FAILURE,  Assess overall health status and alcohol usage
that may serve as HEPATOXICITY before administering.
mediators of pain GU: renal failure  Assess amount, frequency and type of drugs
and fever, primarily DERM: rash, urticaria taken in patients self-medicating.
in the CNS  Pain: Assess type, location and intensity prior or
 Has no significant to and 30-60 min following administration
anti –inflammatory  Fever: Assess fever; note presence of associate
properties or GI signs.
toxicity DURING DRUG ADMINISTRATION
Therapeutic Effects  General: When combined with opiods do not
 Analgesia exceed the maximum recommended daily dose
Antipyresis of drug.
 PO: Administer with a full glass of water.
 May be taken with food or an empty stomach
AFTER DRUG ADMINISTRATION

diarrhea. paradoxical rash. perversion inhalations. taste dry. PATIENT obstructive monophosphate tachycardia. urticaria Other: Angioedema.Albuterol can m in adenylate cyclase to arrhythmias. WARNING Use asthma membranes. less effective.dry mouth and throat. pallor. .  To prevent  Albuterol attaches to Adverse Reactions CNS: Administer pressurized inhalations of albuterol during Sabutamol exercise.pulmonary edema SKIN: Diaphoresis. mellitus. This reaction hypertension. to check labels on all OTC products. second half of inspiration. to wash mouthpiece with water once a week and let it air- intracellular levels of pharyngitis. hyperkinesia.chest pain. dyspnea.itching. vertigo. TEACHING •Teach patient to use inhaler. extrasystoles. rash. •Instruct patient tic attack increases oropharyngeal edema. into the air while looking for a fine mist. flushing. •Advise patient to wait at least 1 minute between cAMP. including atrial worsen these conditions. irritability. these ENDO:Hyperglycemia before using other inhaled drugs. •Tell patient to check with his prescriber Together. drowsiness. nausea. digitalis intoxication. hyperthyroidism. dizziness. dysphagia. exceed prescribed dose or frequency.and tolerance can develop with prolonged use.Tell him to shake airway (cAMP). •Warn patient not to effects relax GI:Anorexia.  Caution pt. pruritus.  Advise pt. •Monitor serum potassium level because albuterol may with triphosphate (ATP) to supraventricular cause transient hypokalemia. as shown. It also ear pain. cautiously in patients with cardiac disorders. to take medication exactly as directed and not to take more than the recommended amount. such as difficulty swallowing. heartburn. (once to four times based on manufacturer instructions) bronchospas levels. cough. hypotension. to avoid alcohol if taking more than an occasional 1-2 doses and to avoid taking concurrently with salicylates or NSAIDs for more than a few days. and aerosol distribution is more effective. bronchospas intracellular enzyme weakness CV: Angina. diabetes  To treat stimulates the nervousness.  Inform patients with diabetes that acetaminophen may alter results of blood glucose monitoring. patients convert adenosine fibrillation. bronchospasm. allergic reaction. hypertension. beta 2 receptors on Anxiety. tremor.tell patient to contact his prescriber.  Advise pt. If doses become bronchial smooth. when airways are open wider Sulfate induced bronchial cell headache. or history of seizures. canister before use and to check that a new canister is disease or decreases palpitations EENT: Altered working by spraying it the appropriate number of times acute intracellular calcium taste. hoarseness. rhinitis. which insomnia. glossitis. •Tell muscle cells and vomiting GU:UTI MS: Muscle patient to immediately report signs and symptoms of inhibit histamine cramps RESP: Bronchospasm. •Be aware that drug reversible cyclic adenosine tachycardia.and release.

to volume depletion. diarrhea. Prostaglandins mediate during surgery if homeostasis is >Inject IM ketorolac slowly. advise against use for longer than 4 days. cerebrovascular bleeding. sinusitis. PATIENT TEACHING •Caution patient in bronchi and vision. an >Advanced renal impairment >>Read ketorolac label carefully. breastfeeding. deep into a large muscle inflammatory response and critical. dyspnea. epistaxis. RESP:Bronchitis.or bladder and COPD cholinergic fibers. cause local vasodilation. dysfunction. and vision changes. supraventricular •As prescribed. insomnia •Use ipratropium cautiously in patients with angle- bromide bronchitis released from CV: Atrial fibrillation (oral closure glaucoma. Don’t use IM form for IV to severe pain. it from attaching to palpitations. angioedema. dryness. inhalation). mass. Know that ketorolac isn’t for intrathecal or epidural prostaglandins. instruct patient to flush them with cool constipation. contact with eyes. mydriasis. bronchioles. •Advise patient to keep spray out of his eyes because it tinnitus (with nasal spray) may irritate them or blur his vision. hypokalemia. before or use. taste perversion drug from leaking out around mask and causing blurred acetycholine’s effects (all drug forms). apply a mouthpiece to prevent blocking laryngospasm. hypertension. Monitor site for bleeding. not to use ipratropium to treat acute bronchospasm. flulike symptoms KETOROLAC >To treat moderate Blocks cyclooxygenase. nasal dryness and irritation. ileus.eye irritation and pain.tachycardia ipratropium inhalation solution with cromolyn inhalation smooth-muscle cells. rhinitis. SKIN:Dermatitis. . bronchodilation. If spray comes in GI:Bowel obstruction. bruising. enzyme needed to synthesize or risk of renal impairment due route. tap water for several minutes and to contact prescriber. edema. and preservative-free on membranes of inhalation). bronchospasm. •If patient is using 0. nasal Other: Anaphylaxis. Tell him to shake inhaler well at each use. •Teach patient to use inhaler or nasal spray. cough. bradycardia (nasal neck obstruction and in patients with hepatic or renal ipratropium prevents spray). pruritus. or hematoma. mix ipratropium inhalation solution with muscarinic receptors tachycardia (oral preservative-free albuterol. benign prostatic hyperplasia. >Give IV injection over at least 15 seconds. •Advise patient to report decreased response to urticarial ipratropium as well as difficulty voiding. glaucoma or worsening of •Inform patient that although some people feel relief ipratropium relaxes existing glaucoma (if nasal within 24 hours of drug use. maximum effect may take up smooth muscles and spray comes in contact with to 2 weeks.blurred vision or eye pain. EENT: Acute eye pain.06% nasal spray for a common cold. rash. palpitations. eye pain. metabolic acidosis ipratropium  To treat  After acetylcholine is CNS: Dizziness. urine retention inhaler treatment to help minimize throat dryness and MS: Arthritis irritation. vomiting GU: •Instruct patient to rinse mouth after each nebulizer or Prostatitis. as shown at right. Use within 1 hour. pharyngitis. •When using a nebulizer. increased sputum •Teach patient to track canister contents by counting and production. nausea. causes eyes). infection. wheezing recording number of doses. nose bleeds. By mouth or pharyngeal area.dry solution.

and decreasing salivary and diphenhydramine to prevent additive effects. and itching. thus producing false- and histamine. •Urge patient to avoid alcohol while taking rhinitis.competing with palpitations. Diphenhydramine’s antiemetic and antivertigo effects may be related to its ability to bind to CNS muscarinic receptors and depress vestibular stimulation and labyrinthine function. when oral ingestion isn’t possible. which reduces prevent photosensitivity reactions. vity receptors. PATIENT TEACHING •Instruct patient to seasonal produces antihistamine anemia. Its sedative effects are related to its CNS depressant action. •Expect to discontinue drug at least 72 hours before ch as preventing it from reaching its GI:Epigastric distress.hemolytic negative results. tachycardia EENT: tightly closed. and GI smooth. decreasing capillary diphenhydramine. by inhibiting acetylcholine in and the CNS. flares. swelling and pain. this NSAID reduces inflammation and relieves pain. diplopia light. other NSAIDs from periphery to spinal cord. avoid taking other OTC drugs that contain s. They also concurrent use of aspirin or promote pain transmission other salicylates. or probenecid. •Instruct her to use sunscreen to allergic permeability.su histamine for these sites and Blurred vision. Photosensitivity distress. rhinitis. dizziness. ed allergic Diphenhydramine produces skin antidyskinetic effects. By blocking HEME: cutaneous histamine response. history of GI By blocking cyclooxygenase bleeding.hypersensitivity to and inhibiting prostaglandins. inhibiting respiratory. Protect elixir and parenteral forms from reactions. secretions SKIN: •Advise her to take drug with food to minimize GI vasomotor muscle contraction. •Advise patient to conjunctiviti wheals. uncomplicat lacrimal gland secretions. It also produces transfusion antitussive effects by directly reactions suppressing the cough center in the medulla oblongata in the brain. nausea skin tests for allergies because drug may inhibit perennial site of action. RESP: Thickened bronchial exposure to situations that may cause motion sickness. . Expect to give parenteral form ofdiphenhydramine only ine hypersensiti peripheral H1 drowsiness CV: Arrhythmias.. thrombocytopenia take diphenhydramine at least 30 minutes before allergic effects. •Keep elixir container hydrochloride. vascular.possibly eruptions. diphenhydramine Agranulocytosis. ketorolac. diphenhydram  To treat Binds to central and CNS:Confusion.

hepatitis B. or their >To give drug via NGT. diabetes mellitus. and varicella. severe pulmonary obstruction. such as those with fungal inflammatio receptors and euphoria. give acetazolamide by mouth or IV injection if enzyme inhibition decreases severe renal. superinfections involving >Report hematuria or Oliguria as high doses can be respiratory tract. encephalopathy in patients with hepatic cirrhosis plexus. . Or. without esophageal inhibiting the hydrogen. >Advised patient to avoid hazardous activities if dizziness or drowsiness occurs Co-amoxiclav >Known or suspected >It destroys bacteria by >History of penicillin >Assess bowel patterns before and during treatment as amoxicillin-resistant disrupting their ability to from hypersensitivity. to prevent potassium-adenosine components. including amebiasis. in increase the risk for gastric carcinoma. and >Observe for anaphylaxis ear and nose and >Ensure that the patient has adequate fluid intake during throat infections. pregnancy and lactation >Assess respiratory status genitourinary. hepatic or possible aqueous. depression. any diarrhea attack OMEPRAZOLE Antiulcer Omeprazole interferes with >Hypersensitivity to >Give omeprazole before meals preferably in the morning >To treat GERD gastric acid secretion by omeprazole. dizziness. behavioral •Systemic hydrocortisone shouldn’t be given to e severe glucocorticoid changes. hyponatremia. >Know that the drug may increase risk of hepatic processes. > To provide short term treatment of active benign gastric ulcer. mood changes. In the eyes. insufficiency immune responses malaise. >Use drug cautiously in patients with calcium-based renal e simple glaucoma anhydrase. immunocompromised patients. and kidneys’ proximal hypokalemia. adrenal inflammatory and with papilledema. brain’s choroid hyperchloremic acidosis. >Monitor blood tests during drug therapy to detect which lowers intraocular electrolyte imbalances pressure. gastric parietal cells. erosive esophagitis. pseudomembranous colitis may occur infections including cell walls. humor secretion. headache. solution). adrenocortical impairment. calculi. erosive esophagitis triphosphatase enzyme >Be aware of the long term use of omeprazole may >To treat GERD with system or proton pump. and other infections. pump inhibitors. because enteric coating dissolves in alkaline pH. nephrotoxic and soft tissue. other proton for once a day dosing. insomnia. vaccinia. cirrhosis. >Inform patient that acetazolamide tablets may crushed and suspended in chocolate or another sweet syrup. Hydrocortison  To treat  Binds to intracellular CNS: Ataxia. or respiratory impairment appears in the eyes’ ciliary angle glaucoma. >To avoid painful IM injections (caused by alkaline tubule cells.Acetazolamid > To treat chronic >Inhibits the enzyme carbonic >Hypersensitivity to the drug. which normally chronic non-congestive closed. gout. fatigue. n or acute suppresses increased intracranial pressure tuberculosis. mix granules in acidic juice lesions. one tablet may be dissolved in 10 ml hot water and added to 10 ml honey or syrup. skin pseudomonas or candida.

m. •Give hydrocortisone sodium succinate as a direct I.by: •inhibiting paresthesia. vomiting •Anticipate the possibility of acute adrenal insufficiency GU: Amenorrhea.M. blood pressure. steroid •Give daily dose of hydrocortisone in morning to mimic neutrophil and psychosis. distention. moon face. and mellitus.hiccups. accumulation at hypokalemia). such as increase insulin or oral antidiabetic drug dosage. before each use. and rotate macrophages and subcapsular cataracts injection sites to prevent muscle atrophy. and electrolyte levels GI: Abdominal regularly during therapy. and underlying tip with warm water. or pain (rectal form).V. cushingoid •Shake foam container vigorously for 5 to 10 seconds of cellular mediators symptoms (buffalo hump. increased •Expect hydrocortisone to worsen infections or mask appetite. prescribed. bactericidal activity thrombophlebitis injection over 30 seconds to several minutes.leukocytosis reduce dosage gradually and monitor response. or as an •stabilizing lysosomal EENT: Exophthalmos. and suppressing their hypotension. wash applicator.Administer rectal foam only cytokines. nausea. seizures. syncope. posterior •Inject I. as bleeding. •When possible. dextrose 5% in normal saline solution. trauma. perineal burning or tingling WARNING Avoid withdrawing drug suddenly after long- HEME: Easy term therapy because adrenal crisis can result. •inhibiting synthesis during stress. Be alert for depression and psychotic episodes. the fill-line on the applicator barrel while container is response. •High-dose therapy shouldn’t be given for longer than 48 negative nitrogen balance from hours. hyperglycemia. form deep into gluteal muscle. route. glycosuria. hypertension. with stress. peptic ulcer. osteoporosis during long-term therapy.or menstrual irregularities. fat embolism. burning. prostaglandins.aseptic necrosis PATIENT TEACHING offemoral and humeral heads. such as emotional upset. signs and symptoms. Subcutaneous helper T cells ENDO: Adrenal insufficiency injection may cause atrophy and sterile abscess. and abnormalities.dilute membranes glaucoma. interleukins. or •suppressing antigen intraocular pressure. vertigo normal peak in adrenocortical secretion of monocyte CV:Arrhythmias (from corticosteroids. such as supraclavicular fat pad upright on a level surface.V. give oral dose with food or milk to avoid inflammation site heart failure. increased to 1 mg/ml or less with D5W.Increase hydrocortisone dosage. •Don’t give acetate injectable suspension by I. After each use. GI distress. growth suppression in container cap. itching. MS: Arthralgia. children. rectal •Monitor blood glucose level in diabetic patients. Gently withdraw applicator plunger past of inflammatory central obesity. as prescribed. diabetes with provided applicator. phagocytic and thromboembolism. protein catabolism •Monitor weight. blistering. intermittent or a continuous infusion.For infusion. •Advise patient to take daily dose of hydro compression fractures. response of nystagmus. muscle cortisone at 9 a. enlargement). normal saline solution.Expect to bruising. •Know that elderly patients are at high risk for ulcerative esophagitis. .surgery.fever. pancreatitis.

•Inform patient that he may bruise easily. erythema. altered skin •Instruct patient to report early evidence of adrenal pigmentation. masking of signs of need prophylactic care. stroke and to start therapy before results are available. milk or food. pharyngitis GI: sodium chloride for injection. steroid prescribed. piperacillin To treat moderate to  Binds to specific CNS: Dizziness. Shake solution vigorously . SKIN: Acne. tendon rupture without first consulting prescriber. lower Uninhibited autolytic Diarrhea. diaphoresis.osteoporosis. insufficiency: anorexia. Displaces plasminogen from > Active thromboembolic > Tranexamic acid therapy isn’t recommended for women ACID antihemorrhagic surface of fibrin by binding to disease. parabens or benzyl alcohol.urticaria Other: •Caution patient to avoid people with infections because Anaphylaxis. nausea. twitching. atrophy. purpura. palpitations. hirsutism.dextrose 5% in normal infections. rash.V. metabolic alkalosis. difficulty breathing. history or intrinsic risk who use hormonal contraceptives or who take factor IX >To treat cyclic heavy high affinity lysine site of of thrombosis or complex concentrates or anti-inhibitor coagulant menstrual bleeding.thin. This diminishes thromboembolism. •Advise patient on long-term therapy to have periodic scarring. or bacteriostatic water that contains respiratory tract enzymes destroy the intestinal necrosis. or •Instruct patient to take tablets or oral suspension with weakness. weight gain TRANEXAMIC Anti-fibrinolytic. muscle weakness. subcutaneous fat •If patient receives long-term therapy. striae. fainting. •For initial dilution for I. increasing risk of hypokalemia. If patient comes into contact with chickenpox alkalosis.fragile or wear medical identification. necrotizing vasculitis. hypocalcemia. promyelocytic leukemia taking oral tretenoin for remission induction because of possible exacerbation of the pro coagulant effect of tretenoin. sterile abscess. joint pain. infusion. eye examinations. which decreases hypersensitivity to tranexamic >Use tranexamic acid cautiously in patients with acute bleeding acid or its components.spontane •Teach patient how to use foam or enema form. culture and sensitivity testing before giving piperacillin infections. seizures.or other samples for sodium severe bacterial penicillin-binding hallucinations. fatigue. fibrin. Expect to obtain blood. stage of bacterial cell hypotension. fever. •Caution patient not to stop drug abruptly myopathy. reconstitute each infections. for dilution but won’t alter drug potency. plasminogen. impaired wound or measles. including concentrated because of the increased risk of dissolution of hemostatic retinal vein or artery occlusion. interfering with an vasovagal reactions EENT: Oral gram of drug with at least 5 ml sterile water for injection. epigastric distress. petechiae. gynecologic wall synthesis by tachycardia. •Be aware that sunlight may darken piperacillin powder infections.instruct him to call prescriber because he may healing. drug can suppress immune system. bone and joint the third and final CV: Cardiac arrest. urge her to carry atrophy. vasodilation. skin. saline solution. candidiasis. suppressed skin test reaction. if ous fractures. infection. D5W. thromboembolism.sputum. hypokalemic infection. and nausea. dizziness. myalgia. intraabdominal autolysin inhibitor. headache. including proteins and inhibits lethargy.

aeruginosa. sinusitis. difficile. Solutions diluted with lactated Ringer’s solution species. •Give aminoglycosides 1 hour before or after piperacillin. species. Enterobacter anemia. and tubing. leukopenia. after adding diluent. I. bag. Peptidoglycan makes CV:Edema EENT:Glossitis. Bacteroides eosinophilia. fever. Escherichia neutropenia. especially in patients mottling. urticaria Other: expect to stop piperacillin. Proteus MS: Arthralgia •Don’t give more than 2 g I. GI:Abdominal cramps. and skin cell lysis. as ordered. notify prescriber and expect to withhold piperacillin and treat with fluids. Klebsiella thrombocytopenia with at least 2 ml of an appropriate diluent listed above. pulmonary area cautiously and only if well developed to avoid Pseudomonas embolism. infections. within 48 hours of ceftriaxone. proteinuria. in one site. injection. Notify prescriber. vaginal candidiasis solution. •For I. hematologic abnormalities. use a separate site.hypokalemia. can decrease platelet aggregation. especially if patient has cystic fibrosis. impotence. pancytopenia. and an antibiotic effective against C. caused by nephritis. use sodium chloride for infections. and joints. RESP: Dyspnea. injection. •For intermittent cocci. and skin ulcer. and inspect for particles and septicemia. protein. If diarrhea occurs. seizures given through a different I.and expect to stop drug. Anaphylaxis. anaerobic HEME: Agranulocytosis. Use deltoid species. pulmonary injuring radial nerve. diarrhea. . coli.Without it. hemolytic infusion. and liver function test results. and hypertension •Watch for bleeding or excessive bruising because drug Serratia species SKIN: Exfoliative dermatitis. susceptible strains of priapism. •For further dilution.M. •Monitor serum potassium level to detect pain. strands. If bleeding occurs.V. infuse appropriate dose over 20 to 30 minutes. injection site neutropenia. •Watch for hypersensitivity reactions. superinfection •Check for diarrhea during and after therapy because it may indicate pseudomembranous colitis caused by Clostridium difficile. stomatitis lungs and kidneys and could be fatal. notify prescriber and necrolysis. hypokalemia from urinary potassium loss. reversible I.facial •Monitor CBC regularly. cell wall and result in pseudomembranous colitis. protective. WARNING Calcium-containing products must not be given sodium the lower respiratory wall synthesis by inhibiting hypertonia. the cell membrane rigid and hearing loss. rash. vomiting discoloration before giving.line and at a different site. neurogenic bladder. skin. renal lactated Ringer’s solution.D5W.V. or dextran 6% in normal saline Acinetobacter failure. species. dextrose 5% in normal saline solution. toxic epidermal with renal failure. phlebitis. Haemophilus prolonged bleeding time. species. including solutions tract. should be given within 2 hours. to detect edema. electrolytes. reconstitute each gram of piperacillin influenzae.M. cholestasis.V. tissue. because a ceftriaxone-calcium salt may precipitate in the bones. ceftriaxone To treat infections of Interferes with bacterial cell CNS:Chills. soft cross-linking of peptidoglycan hyperactivity. occurred in about 10% of such patients. such as leukopenia and hyponatremia. and soft-tissue GU: Hematuria. headache. •Use ceftriaxone cautiously in patients who are intraabdominal bacterial cells rupture and die. elevated hypersensitive to penicillins because cross-sensitivity has infections. urinary tract.

8 ml.dyspnea solutions may be given sequentially if infusion lines are species. add 19. For piggyback bottles. thoroughly flushed with a compatible fluid between mirabilis. erythema. drug fever.8 ml. concentration.V. hematocrit.V.hemorrhage. serum sickness. If diarrhea occurs. •If possible.redness.6 ml. Serratia Stevens-Johnson syndrome. •Monitor BUN and serum creatinine levels to detect early organisms (including superinfection signs of nephrotoxicity. •For I. pyogenes) LD. further dilute to Citrobacter species. add 9. infusions. including such continuous calcium-containing coli. reconstitute with an appropriate diluent. severe diarrhea may indicate pseudomembranous colitis caused by Clostridium difficile. for 500-mg vial. toxic epidermal necrolysis. Streptococcus •Assess CBC. add 2. oliguria. Bacteroides bivius.Haemophilus bleeding infusions as parenteral nutrition via Y-site. •Assess bowel pattern daily. reconstitute with an appropriate species. neutropenia. pseudolithiasis. and some strains of urticarial and for 2-g vial. vulgaris. notify prescriber.After reconstitution. pruritus. reconstitute gramnegative candidiasis with 10 ml of diluent indicated above for 1-g bottle and organisms (including HEME: Aplastic anemia. chloride for injection. Salmonella exanthema.nephrotoxicity.unusual time.4 ml. such as sterile water for injection or sodium chloride for melaninogenicus. Streptococcus •Monitor patient for allergic reactions a few days after pneumoniae. oral candidiasis. rash. •For I. nephrotoxicity. for 1-g vial. and for 2-g vial. Drug may need to be discontinued.2 ml to make a 250-mg/ml Pseudomonas Other:Anaphylaxis. notify prescriber and expect to . diluent.septicemia caused by gallbladder dysfunction. for 1-g vial. Proteus SKIN:Allergic dermatitis.2 species). and injection site pain. eosinophilia. add 1. ceftriaxone and calcium-containing species. aerogenes. as anaerobes (including hepatic failure. bilirubin. 4.Inject deep into large muscle aeruginosa). ordered. gram-positive swelling. use. For patients influenzae. as and GU: Elevated BUN follows: for 250-mg vial. hepatomegaly. add 3. rombinemia.hypoproth 30 minutes. 20 ml for 2-g bottle. as follows: for 250-mg vial.and serum AST. decreasing urine output may indicate aureus. such as sterile water for injection or sodium species. Providencia erythema multiforme.6 ml. hemolytic 50 to 100 ml with diluent indicated above and infuse over Enterobacter anemia. before giving drug. If abnormalities occur. for 500-mg vial. and alkaline phosphatase levels during long-term therapy. WARNING Never give ceftriaxone by I. vomiting injection. renal failure. add 0. administration.M. add Peptostreptococcus level. obtain culture and sensitivity results. Neisseria pneumonitis. such as the gluteus maximus. and mass. Proteus ecchymosis. •Protect powder from light. Also monitor fluid intake and Staphylococcus output.9 marcescens. Shigella. infusion and calcium-containing IV solutions at the same Escherichia thrombocytopenia.Shake well. ml. nausea. Bacteroides fragilis. pancreatitis. Klebsiella MS: Arthralgia RESP:Allergic other than neonates. Bacteroides pseudomembranous colitis. add 7. and therapy starts. ALT. vaginal ml to yield 100 mg/ml.

Also or S. such with rapid the conduction rate Other:Electrolyte imbalances as altered mental status. fluoroquinolones.Ventricular rate . atrial myocardial weakness. failure. and vomiting. moderate skin and replication by inhibiting the hypersensitive to drug. resulting CV:Arrhythmias. Digoxin halos around objects •Before giving each dose. electrolytes. notify prescriber.headache. withhold cefotaxime and treat with fluids. specified level).syncope normal saline solution. nausea. give immediately. such caused by S. which may mimic gallstones. especially in diabetic patient who takes an oral antidiabetic or uses an insulin. Discard if solution is fibrillation. Levofloxacin >To treat mild to >Interferes with bacterial cell >Contraindicated in patients >Use drug cautiously in patients with renal insufficiency. flutter. >Expect to obtain culture and sensitivity tests before levofloxacin treatment begins >Know that levofloxacin therapy should begin as soon as possible after suspected or confirmed exposure to Y.or dilute with a heart and velocity of drowsiness. pestis >Avoid giving drug within 2 hours of antacids >Monitor blood glucose level. vomiting •Monitor patient closely for signs of digitalis toxicity. •If patient has acute or unstable chronic atrial fibrillation.Monitor ECG tracing continuously. Aureus which is essential for components. other >Monitor renal function as appropriate drug treatment soft tissue infections bacterial enzyme DNA gyrase.protein.nausea. arrhythmias. If they effective refractory appear. extreme fourfold or greater volume of sterile water for injection. anorexia.and an antibiotic effective against C. because levofloxacin may alter blood glucose level. colored markedly discolored or contains precipitate. in positive inotropic EENT: Blurred vision. because of increased risk of tendon rupture.heart digitalization and increasing the block. vomiting) because drug may cause ceftriaxonecalcium salt to deposit in the gallbladder.administration.or D5W for I.assess for drug effectiveness.V. heart block Once diluted. difficile. myasthenia as epilepsy. known. •Give parenteral digoxin undiluted. tachycardia effects by decreasing nausea. atrial contraction. diarrhea.and expect to withhold drug until level is node.vision disturbances. and effects. elderly patients. •Monitor patient for evidence of gallbladder disease (abdominal pain. depression. that may lower the seizure threshold. Expect drug to be discontinued if gallbladder disorders arise. Pyogenes replication and repair of gravis use cautiously in patients taking corticosteroids especially bacterial DNA.check serum digoxin level as period of the AV ordered. take patient’s apical pulse and paroxysmal produces GI: Abdominal discomfort or notify prescriber if it’s below 60 beats/minute (or other atrial antiarrhythmic pain. or their >Use drug cautiously in patients with CNS disorders. Digoxin  To treat  Increases the force CNS: Confusion.

Furosemide stomatitis. and uric acid levels. prolonged or high-dose I. electrolyte. cardiac output pancreatitis.blood glucose. GU:Bladder spasms.ototoxicity.over 1 to 2 minutes to calcium. •Monitor blood pressure and hepatic and renal function fluid volume. fever. n. decreases cardiac output. vomiting hypotensive and electrolytealtering effects and thus are returns to normal. restlessness. By reducing GI: Abdominal cramps. give potassium (rare).raising the dosage probably won’t produce a therapeutic effect and may lead to toxicity. may not normalize even when serum drug level falls within therapeutic range. and ENDO: Hyperglycemia •Expect patient to have periodic hearing tests during phosphate. magnesium. nausea. yellow vision prevent ototoxicity. drug may lead to lethal hepatic coma. or D5W. WARNING Use furosemide cautiously in patients with mild to reabsorption in the loop of paresthesia. ammonium. •Obtain patient’s weight before and periodically during to treat aldosterone production thromboembolism. therapy. HEME:Agranulocytosis •If patient is at high risk for hypokalemia. constipation. intracellular and extracellular anorexia. as prescribed.V. •For once-a-day acute increases. •Frequently obtain ECG tracings as ordered in elderly patients because of their smaller body mass and reduced renal clearance. indigestion. drug for infusion with normal saline solution. and serum creatinine. •Monitor paptient’s serum potassium level regularly because hypokalemia predisposes to digitalis toxicity and serious arrhythmias. transient Ringer’s solution. weakness have a history of electrolyte imbalance or hepatic hypertensio formation. as well as BUN.As the body’s CV: Orthostatic encephalopathy. lactated hypertensiv hydrogen ions. •Prepare edema and loss of potassium and irritation. as adjunct plasma volume decreases. hypotension. leukopenia. give drug in the morning so patient’s sleep won’t pulmonary sodium reabsorption and the EENT:Blurred vision. •Administer drug slowly I. the drug diarrhea.shock.especially those with coronary insufficiency.anemia. oliguria persists for more than 24 hours thrombocytopenia . are more suscepti ble to arrhythmias—particularly ventricular fibrillation—if digitalis toxicity occurs. reduces blood pressure and hepatocellular insufficiency. e crisis also increases the excretion of hearing loss (rapid I. jaundice. advanced hepatic cirrhosis.V. tinnitus. headache.hemolytic •Expect to discontinue furosemide at maximum dosage if anemia. as appropriate. furosemide therapy to monitor fluid loss. especially those who also moderate Henle and increases urine vertigo. injection).azotemia.V. Elderly patients. •Be aware that elderly patients are more susceptible to Over time. (rare).Also monitor potassium level often when giving potassium salts because hyperkalemia in patients receiving digoxin can be fatal. gastric irritation.oral be interrupted by increased need to urinate. aplastic anemia supplements along with furosemide. Furosemide  To manage Inhibits sodium and water CNS:Dizziness. which promotes thrombophlebitis dosing. glycosuria at greater risk for shock and thromboembolism. bicarbonate.

pruritus. secretion by suppressing the >Assess GI symptoms: epigastric/abdominal pain. weak pulse sodium/tsp.6 forms of ions. vertigo. free bicarbonate ions in urine. photosensitivity.9 g. hyponatremia. gastric parietal cell. Other:Allergic reaction (interstitial nephritis. dehydration. acidosis acidosis. sodium  To treat less Increases plasma bicarbonate CNS: Mental or mood changes •Monitor sodium intake of patient taking sodium bicarbonate urgent level. infusion. •Notify prescriber if patient experiences hearing loss. or other standard electrolyte solution before raising urine pH. hypovolemia Pantoprazole >Duodenal and gastric > Inhibits both basal and >Hypersensitivity to the drug >>Assess underlying condition before therapy and ulcer. hyperuricemia.2-mEq tablet.7-mEq tablet.9-mEq tablet. pathological by binding to and inhibiting hyper-secretory hydrogen. also increases the excretion of GI: Abdominal cramps. systemic vasculitis). MS: Muscle spasms.V. hypokalemia. hypertrophy and adversely affect glucose tolerance and erythema multiforme. buzzing. bicarbonate because effervescent powder contains 700. peripheral edema (with large mg of sodium/ 3. or ringing. lipid metabolism. or sense of fullness in her purpura. alkalinity of urine may help to . >Symptomatic adenosine triphosphatase in improvement and the enzyme system located at healing of mild reflux the secretory surface of the esophagitis. pylori inpatient through the inhabitation >Monitor for possible drug induced adverse reaction. increased administration. dilute drug with normal saline solution. exfoliative dermatitis. Sodium bicarbonate EENT: Dry mouth 520 mg/6. and tablets contain 325 mg/ 3. buffers excess hydrogen CV: Irregular heartbeat. severe reflux esophagitis. bleeding and anorexia. necrotizing vasculitis. Drug may need to be discontinued. >Eradication of final step in acids production. rash. MS: Muscle spasms . urticaria ears. oral powder contains 952 mg of metabolic thereby reversing metabolic doses). myalgia D5W. H. hypochloremia. •Be aware that furosemide may worsen left ventricular SKIN:Bullous pemphigoid.potassium conditions.thirst •For I. with peptic of the proton pump ulcers. and 650 mg/7. moderate and stimulated gastric acid thereafter to monitor drug effectiveness. and raises blood pH. >Prevention of gastro- duodenal ulcers induced by NSAID in patients at risk with a need for continuous NSAID treatment.

thereby increasing the effectiveness as urine alkalizer.and vomiting. •Be aware that parenteral forms are hypertonic and that increased sodium intake can produce edema and weight gain. •If patient on long-term sodium bicarbonate therapy is consuming calcium or milk. severe anemia. hypertrohic baseline and during treatment reduces left ventricular cardiomyopathy. or alkalosis. Elevate the limb. time started. postdural myocardial oxygen hypotension consumption . or buffering existing stomach •Monitor urine pH. headache. to determine drug’s acid. performed. which can cause severe addition. metabolic acidosis. pH of stomach contents. watch for milk-alkali syndrome.apply warm compresses. narrow-angle workload and decreases glaucoma. In SKIN: Extravasation with •Avoid rapid I. which hemorrhage. characterized by anorexia. cerebral >Assess orthostatic hypotension. as ordered. blood pressure at decrease in arterial BP. activity being Dinitrate prevention of angina muscle with a resultant to nitrates. character. and expect prescriber to administer a local injection of hyaluronidase or lidocaine. Isosorbide >Treatment and >Relaxes vascular smooth >Contraindicated with allergy >Assess for pain: duration.V. Be aware that during cardiac arrest. hypercalcemia. catheter. risk of ofhyperacidity by neutralizing ulceration death from acidosis may outweigh risks of rapid infusion. site often for evidence of extravasation. dissolve uric acid calculi.it relieves symptoms necrosis. •Assess I. If it occurs. confusion. intensity pectoris decrease in venous return and head trauma. nausea. infusion. notify prescriber at once and remove I.V. tissue sloughing.V. renal insufficiency.