Drug Name Stock Mechanism of Indications/ Side/ Nursing

Dosage Action Contraindications Adverse Considerations

Effects

Generic: 250 mg, Semisynthetic Indications: Determine history of

Body as a
Ceftriaxone 500 mg, third-generation Infections caused hypersensitivity
Whole:
Sodium 1 g, 2 g cephalosporin by susceptible reactions to
Pruritus,
injection antibiotic. organisms in cephalosporins and
fever,
Brand: Preferentially lower respiratory penicillins and history
chills, pain
Rocephin Dose: binds to one or tract, urinary tract, of other allergies,
GI:
IV/IM 1– more of the bones and joints; particularly to drugs,
Diarrhea,
Class: 2g penicillin-binding also meningitis. before therapy is
abdominal
Antiinfective; q12– proteins (PBP) initiated.
cramps,
Antibiotic; 24h located on cell Contraindications:
pseudome
Third- (max: 4 walls of Hypersensitivity to Lab tests: Perform
mbranous
generation g/d) susceptible cephalosporins culture and sensitivity
colitis,
Cephalosporin organisms. This and related tests before initiation
biliary
inhibits third and antibiotic of therapy and
sludge.
final stage of periodically during
Urogenital
bacterial cell wall therapy. Dosage may
: Genital
synthesis, thus be started pending
pruritus;
killing the test results. Periodic
moniliasis.
bacterium. coagulation studies
(PT and INR) should
be done.

Monitor for
manifestations of
hypersensitivity.
Report their
appearance promptly
and discontinue drug.

Watch for and report

signs: petechiae,
ecchymotic areas,
epistaxis, or any
unexplained bleeding.
Ceftriaxone appears
 to alter vitamin K–
producing gut
bacteria; therefore,
hypoprothrombinemic
bleeding may occur.

Check for fever if

diarrhea occurs:
Report both promptly.
The incidence of
antibiotic-produced
pseudomembranous
colitis is higher than
with most
cephalosporins. Most
vulnerable patients:
chronically ill or
debilitated older adult
patients undergoing
abdominal surgery.

Drug Name Stock Mechanism of Indications/ Side/ Nursing Considerations

Dosage Action Contraindications Adverse
Effects
 Generic: 125 mg, A broad- Indications: Body as a
Determine previous
Ampicillin 250 mg, spectrum Infections of GU, Whole: hypersensitivity reactions
500 mg, semisynthetic, respiratory, Similar to to penicillins,
Brand: 1 gm, 2 aminopenicillin bacterial those for cephalosporins, and other
Ampicin gm vials is highly meningitis penicillin G. allergens prior to therapy.
bactericidal Hypersensiti
Class: Dose: even at low Used parenterally vity (pruritus, Lab tests: Baseline C&S
Anti-infective; IV/IM concentrations only for urticaria, tests prior to initiation of
Antibiotic; 250 mg– , but is moderately eosinophilia, therapy; start drug
Aminopenicillin 2 g q6h inactivated by severe to severe hemolytic pending results. Baseline
penicillinase infections. anemia, and periodic assessments
(beta- interstitial of renal, hepatic, and
lactamase). Contraindications: nephritis, hematologic functions,
Hypersensitivity anaphylactoi particularly during
to penicillin d reaction); prolonged or high-dose
derivatives; superinfectio therapy.
infectious ns. CNS:
mononucleosis. Convulsive Inspect skin daily and
seizures with instruct patient to do the
high doses. same. The appearance of
GI: Diarrhea, a rash should be carefully
nausea, evaluated to differentiate
vomiting, a nonallergenic ampicillin
pseudomem rash from a
branous hypersensitivity reaction.
colitis. Other: Report rash promptly to
Severe pain physician.
(following
IM); phlebitis Note: Incidence of
(following ampicillin rash is higher in
IV). Skin: patients with infectious
Rash.. mononucleosis or other
viral infections,
Salmonella infections,
lymphocytic leukemia, or
hyperuricemia or in
patients taking allopurinol.

Take medication around

the clock; continue taking
 medication until it is all
gone (usually 10 d)
unless otherwise directed
by physician or
pharmacist.

Drug Name Stock Mechanism of Indications/ Side/ Nursing

Dosage Action Contraindications Adverse Effects Considerations

Generic: 500 mg, Prepared from Indications: Special Senses:

Monitor BP and heart
Vancomycin 1g Streptomyces Active against Ototoxicity rate continuously
Hydrochloride injection orientalis, with many gram- (auditory portion through period of
bactericidal positive of eighth cranial drug administration.
Brand: Dose: and organisms, nerve).
Vancocin IV 500 bacteriostatic including group A Urogenital: Lab tests: Monitor
mg q6h actions. Acts beta-hemolytic Nephrotoxicity urinalysis, kidney &
Class: or 1 g by interfering Streptococci, leading to liver functions, and
Ant-iinfective; q12h, with cell Staphylococci, uremia. Body as hematologic studies
Antibiotic infuse membrane Pneumococci, a Whole: periodically.
over synthesis in Enterococci, Hypersensitivity
60–90 multiplying Clostridia, and reactions (chills, Monitor serial tests
min organisms. Corynebacteria. fever, skin rash, of vancomycin blood
Gram-negative urticaria, shock- levels (peak and
organisms, like state), trough) in patients
mycobacteria, anaphylactoid with borderline
and fungi are reaction with kidney function, in
highly resistant. vascular infants and
collapse, neonates, and in
Contraindications superinfections, patients >60 y.
: severe pain, Assess hearing.
Known thrombophlebitis Drug may cause
hypersensitivity at injection site, damage to auditory
to vancomycin, generalized branch (not
allergy to corn or tingling following vestibular branch) of
corn products, rapid IV infusion. eighth cranial nerve,
previous hearing Hematologic: with consequent
loss, concurrent Transient deafness, which may
 or sequential use leukopenia, be permanent.
of other ototoxic eosinophilia. GI:
or nephrotoxic Nausea, warmth. Be aware that serum
agents, IM Other: Injection levels of 60–80
administration. reaction that mcg/mL are
includes associated with
hypotension ototoxicity. Tinnitus
accompanied by and high-tone
flushing and hearing loss may
erythematous precede deafness,
rash on face and which may progress
upper body even after drug is
("red-neck withdrawn. Older
syndrome") adults and those on
following rapid IV high doses are
infusion. especially
susceptible.

Monitor I&O: Report

changes in I&O ratio
and pattern. Oliguria
or cloudy or pink
urine may be a sign
of nephrotoxicity
(also manifested by
transient elevations
in BUN, albumin, and
hyaline and granular
casts in urine).

Drug Name Stock Mechanism of Indications/ Side/ Nursing

Dosage Action Contraindications Adverse Considerations
Effects

Generic: 50mg/ml Antiviral Indications: Assessment:

CNS:
Acyclovir activity; inhibits Herpes simplex Headache, ● History: Allergy
Dose: viral DNA encephalitis vertigo, to acyclovir,
Brand: 5–10 replication. depression, seizures, CHF,
Zovirax mg/kg Contraindications: tremors, renal disease,
 infused Contraindicated encephalopathi lactation,
Class: IV over 1 with allergy to c changes pregnancy
Antiviral, hr, q 8 hr acyclovir, ● Physical: Skin
Dermatologic:
Purine (15 seizures, CHF color, lesions;
Inflammation
nucleoside mg/kg/da and renal disease or phlebitis at orientation; BP,
analogue y) for 7– injection sites, P, auscultation,
10 days. rash, hair loss perfusion,
edema; R,
GI: Nausea, adventitious
vomiting, sounds; urinary
diarrhea,
output; BUN,
anorexia
creatinine
GU: clearance
Crystalluria
with rapid IV Ensure that the patient
administration, is well hydrated.
hematuria

Drug Name Stock Mechanism of Indications/ Side/ Nursing

Dosage Action Contraindications Adverse Effects Considerations

Generic: 200 mg Semisynthetic Indications: Report sudden onset

Special Senses:
Doxycycline injection broad- Similar to those ofInterference with of painful or difficult
Hyclate spectrum tetracycline, e.g.,
color vision. GI: swallowing promptly
Dose: tetracycline chlamydial and Anorexia, to physician.
Brand: PO/IV antibiotic mycoplasmal nausea, Doxycycline (capsule
Doxy 100 mg derived from infections; vomiting, and tablet forms) is
q12h on oxytetracycline. gonorrhea, diarrhea, associated with a
Class: day 1, More syphilis in enterocolitis; comparatively high
Anti-infective; then 100 completely penicillin-allergic
esophageal incidence of
Antibiotic, mg/d as absorbed with patients; rickettsial
irritation (oral esophagitis,
Tetracycline single effective blood diseases; acute capsule and especially in patients
dose levels exacerbations of tablet). Skin: >40 y.
(max: maintained for chronic bronchitis.Rashes,
100 mg longer periods photosensitivity Report evidence of
q12h) and excreted Contraindications: reaction. superinfections
more slowly Sensitivity to any Other:Thrombop
than most other of the hlebitis (IV use), Avoid exposure to
tetracyclines. tetracyclines direct sunlight and
 Thus it requires superinfections. ultraviolet light during
smaller and and for 4 or 5 d after
less frequent therapy is terminated
dosing. to reduce risk of
phototoxic reaction.
Phototoxic reaction
appears like an
exaggerated
sunburn.Sunscreens
provide little
protection.

Drug Name Stock Mechanism Indications/ Side/ Nursing

Dosage of Action Contraindications Adverse Considerations
Effects

Generic: 5%, 10% Sterile Indications: Body as a

Make sure
Immune solution; 50 concentrated Principally as Whole: Pain, emergency drugs and
Globulin mg/mL solution maintenance tenderness, appropriate
Intravenous powder for containing therapy in muscle emergency facilities
(IGIV) injection globulin patients unable to stiffness at are immediately
Brand: Dose: (primarily manufacture IM site; local available for
IGIV IV IgG) sufficient inflammatory treatment of
Gammagard Gammagard, prepared quantities of IgG reaction, anaphylaxis or
Sandoglobulin 100 from large antibodies, in erythema, sensitization.
mg/kg/mo; pools of patients requiring urticaria, Note: Hypersensitivity
Class: Sandoglobuli normal an immediate angioedema, reactions are most
Biologic n, 200 human increase in headache, likely in patients
Response mg/kg/mo plasma of immunoglobulin malaise, receiving large IM
Modifier; either venous levels fever, doses, repeated
Immunoglobulin or placental arthralgia, injections, or rapid IV
origin and Contraindications: nephrotic infusion.
processed by History of syndrome,
 a special anaphylaxis or hypersensiti Monitor vital signs
fractionating severe reaction to vity (fever, and infusion rate
technique. human immune chills, closely when patient
serum globulin anaphylactic is receiving IGIV.
(IG) or to any shock), Note: IGIV has a mild
ingredient in the infusion diuretic effect in some
formulation such reactions patients due to
as thimerosal (nausea, presence of maltose.
(mercury flushing,
derivative) chills,
preservative in IM headache,
formulations and chest
maltose tightness,
(stabilizing agent) wheezing,
in IV formulations; skeletal
persons with pain, back
clinical hepatitis pain,
A; IGIV for abdominal
patients with cramps,
class-specific anaphylaxis)
anti-IgA , renal
deficiencies; IGIM dysfunction,
in severe renal failure.
thrombocytopenia
or other bleeding
disorders