De Macale, Mikhail B.

CHN Group P

DRUG STUDY

1. Losartan
Generic name: losartan
Brand name: Cozaar
Indication: It is used to treat high blood pressure. It is used to protect kidney function in
diabetic patients who have protein loss. It is used to lower the chance of stroke in people
with high blood pressure and some certain heart problems. It may be given to you for
other reasons.
Special Precautions: Do not take if you are pregnant. Use during pregnancy may cause
birth defects or loss of the unborn baby. If you get pregnant or plan on getting pregnant
while taking losartan, call your doctor right away.
Drug to Drug Interaction: Losartan enhance antihypertensive effects of other
antihypertensive agents. Avoid combination of these drugs.
aspirin, Benadryl (diphenhydramine), hydrocodone, ibuprofen, Iisinopril, pregabalin,
meloxicam, naproxen, sildenafil
Side Effects: Common side effect are; cold or flu symptoms such as stuffy nose,
sneezing, sore throat, fever; dry cough; muscle cramps; pain in your legs or back;
stomach pain, diarrhea; headache, dizziness; tired feeling; or sleep problems (insomnia).
Nursing Considerations:
Avoid given first dose at night due to increase hypotensive risk.
Monitor blood pressure and pulse frequently.
Enquire the complete health history of patient specially any renal disease
Check patient s/s for angioedema.
Monitor electrolytes specially sodium and potassium levels, uric acid levels and CBC

2. Amoxicillin
Generic name: Amoxicillin
Brand name: Polymox
Indication: It binds to Penicillin-binding proteins in the cytoplasmic membranes of
bacteria, thus inhibiting cell-wall synthesis. It also inhibits cell growth and cell division.
Special Precautions: Safe use during pregnancy has not been established.
Drug may decrease effectiveness of oral contraceptives.
Drug to Drug Interactions: Methotrexate is also known as Rheumatrex or Trexall. It is
an anti-cancer medication. It can be used to help treat some forms of head and neck,
skin, breast and lung cancer. It can also be used for severe forms of psoriasis and
rheumatoid arthritis. The problem is that if a person takes large amounts of amoxicillin,
for a serious infection, then the levels of methotrexate may increase in their blood.
Side Effects: Hypersensitivity, Nausea, Vomiting, Gastritis, Stomatitis
Nursing Considerations:
Note for any hypersensitivity reaction
Instruct clients that therapeutic regimen must be completed even if symptoms subside.
Child’s dose should not exceed maximum adult dose.
Clients with GFR of 10-30 mL/min should receive 250-500mg q12h.
Monitor CBC, renal and liver function tests.
May be taken with food.
Antibiotic resistance may occur if used without practitioner consultation as duration of
therapy may not be completed.
Report: bleeding, sore throat, rash, diarrhea, worsening of symptoms, lack of response.
3. Paracetamol
Generic name: Paracetamol
Brand name: Biogesic
Indication: 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.
Special Precautions: 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.
Drug to Drug Interactions:
Anticonvulsant drugs - anticonvulsants particularly barbiturates makes the paracetamol
less effective and more toxic.
Certain non-narcotic analgesic - Diflunisal (a non-narcotic analgesic) increases the
plasma levels of paracetamol by approximately 50%.
Certain antibiotics - Chronic use of isoniazid, an antibiotic drug often prescribed for
tuberculosis, may increase the risk of liver damage when combined with paracetamol
even at recommended “safe” doses.
Oral anticoagulants (blood thinners) - Paracetamol can possibly potentiate the effects of
blood thinners, increasing the risk of bleeding.
Certain cholesterol-lowering agents - Cholestyramine, a bile acid sequestrant used for
reducing blood cholesterol, binds with acetaminophen thereby preventing it from being
absorbed by the body.
Side Effects: Minimal GI upset, Methemoglobinemia, Hemolytic Anemia, Neutropenia,
Thrombocytopenia, Pancytopenia, Leukopenia, Urticaria, CNS stimulation,
Hypoglycemic coma, Jaundice, Glossitis, Drowsiness, Liver Damage
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.

4. Co-amoxiclav
Generic name: Co-amoxiclav
Brand name: Augmentin
Indication: An antibiotic that combines amoxicillin and clavulanic acid. It destroys
bacteria by disrupting their ability to form cell walls. Clavulanic acid blocks the chemical
defence, known as beta-lactamase, that some bacteria have against penicillins.
Co-amoxiclav is active against bacterial infections that have become resistant to
amoxicillin.
Special Precautions: History of allergy, Renal impairment, Erythematous rashes
common in glandular fever, Cytomegalovirus infection, Acute or chronic lymphocytic
leukaemia, Hepatic impairment, Pregnancy, Cholestatic jaundice.
Drug to Drug Interactions: Avoid combinations of these medicines;
Penicillin - This is because combining the 2 medications can cause a range of
unpleasant and sometimes serious side effects.
Cephalosporins - Cephalosporins may increase the chance of bleeding if you're taking
blood-thinning medications
Aminoglycosides - The risk of damage to your kidneys and hearing is increased
Side Effects: Hepatitis, Cholestatic jaundice, Erythema multiforme (including
Stevens-Johnson syndrome), Toxic epidermal necrolysis, Exfoliative dermatitis,
Vasculitis, Dizziness, Headache, Convulsions (especially in high doses or in renal
impairment), Superficial teeth staining when using the suspension,Phlebitis at injection
site.
Nursing Considerations:
Assess bowel pattern before and during treatment as pseudomembranous colitis may
occur.
Report haematuria or oliguria as high doses can be nephrotoxic.
Assess respiratory status.
Observe for anaphylaxis.
Ensure that the patient has adequate fluid intake during any diarrhea attack.

5. Metronidazole
Generic name: Metronidazole
Brand name: Noritate
Indication:
Acute infection with susceptible anaerobic bacteria, Acute intestinal amebiasis, Amebic
liver abscess, Trichomoniasis, Preoperative, intraoperative, postoperative prophylaxis
for patients undergoing colorectal surgery.
Topical application: Treatment of inflammatory papules, pustules, and erythema of
rosacea
Special Precautions: Before taking metronidazole, tell your doctor or pharmacist if you
are allergic to it; or to other antibiotics (such as tinidazole); or if you have any other
allergies. This product may contain inactive ingredients, which can cause allergic
reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history,
especially of: liver disease, kidney disease, certain blood disorders (low blood cell
counts).
During pregnancy, this medication should be used only when clearly needed.
Drug to Drug Interactions: If you take disulfiram, cimetidine, or certain other
medications with metronidazole, drug interactions could occur. These interactions can
reduce the effectiveness of the medicines or increase your risk for potentially dangerous
side effects. In order to help minimize your risk of developing these and other problems,
tell your healthcare provider about all other medications you are taking.
Side Effects: Dizziness, headache, stomach upset, nausea, vomiting, loss of appetite,
diarrhea, constipation, or metallic taste in your mouth may occur.

Nursing Considerations:
Before
Assess pt. Infection
Watch carefully for edema because it may cause sodium retention
Assess skin for severity areas of local adverse reactions
Record number and character of stools
Assess pt.’s and family’s knowledge of drug therapy
During
Give drug with meals to minimize GI distress
To treat trichomoniasis, give drug for 7 days instead of 2-g single dose
Use only after T.vaginalis has been confirmed by wet smear
Tablets may be crushed for pt’s. with difficult swallowing
Do not use aluminium needles or hubs, color will turn orange/rust
After
Tell pt. that metallic taste and dark or red brown urine may occur
Instruct pt. to take oral form with meals to minimize reactions
Instruct to complete full course of therapy
Tell pt. not to use alcohol or drugs that contain alcohol.
May cause dizziness/ light headedness

6. Salbutamol (syrup)
Generic name: Salbutamol
Brand name: Ventolin
Indication:
Quick relief of bronchospasm induced through both exercise and physiological
alterations.
To control and prevent reversible airway obstruction caused by bronchial asthma,
chronic obstructive pulmonary diseases such as emphysema and chronic bronchitis as
well as other obstructive pulmonary diseases.
Special Precautions:
Hypersensitivity to salbutamol
Tachyarrhythmias and tachycardia caused by digitalis intoxication
Patients with degenerative heart diseases
Use cautiously with patients who have diabetes as this can aggravate diabetes and
ketoacidosis
Use cautiously in elderly because they are more sensitive to CNS effects
Drug to Drug Interactions:
Salbutamol affects the nervous system in the same way as monoamine oxidase (MAO)
inhibitors and tricyclic antidepressants do, which can increase the severity of
cardiovascular side effects. Some kinds of diuretics can lower potassium levels in the
blood, which is also a side effect of salbutamol. Salbutamol activates beta receptors, so
beta-blocking drugs may render it ineffective. People taking digoxin should know that
salbutamol could decrease its intended effects. Other drugs that should not be taken at
the same time as salbutamol are furazolidone, linezolid, and procarbazine.
Side Effects:
CNS: Restlessness, apprehension, anxiety, fear, CNS stimulation, vertigo, headache,
weakness, tremors, drowsiness
CV: Cardiac arrhythmias, palpitations, tachycardia
Dermatologic: Sweating, pallor, flushing
GI: Nausea, vomiting, heartburn, unusual or bad taste in the mouth
Respiratory: Respiratory difficulties, pulmonary edema, coughing, bronchospasm,
paradoxical airway resistance with repeated, excessive use of inhalation preparations
Nursing Considerations:
Check and verify with doctor’s order and Kardex.
Observe rights in medication administration such as giving the right drug to the right
patient using the right route and at the right time.
Monitor ECG, serum electrolytes and thyroid function test results.
Administer accurately because adverse reactions and tolerance might occur.
Raise side rails up because client might be restless and drowsy because of this drug.
Keep room well-lit and see to it that client has a person with him closely in case of
vertigo.
Assess pulse for rhythm.
Provide oral care or let patient gurgle after inhalation to get rid of the unpleasant
aftertaste of the inhalation.
Auscultate lungs for presence of adventitious breath sounds that may signal pulmonary
edema, airway resistance or bronchospasm.
Inspect client’s nail bed and oral mucosa for pallor.
Place client in position of comfort to facilitate optimum rest and sleep.

7. Cloxacillin
Generic name: Cloxacillin
Brand name: Cloxapen
Indication: Cloxacillin is used to treat a wide variety of bacterial infections. This
medication is a type of penicillin antibiotic. It works by stopping the growth of bacteria.
Special Precautions: Allergic to these specific drugs, or if pregnant (pregnancy B)
Drug to Drug Interactions: aminoglycosides (e.g., gentamicin, tobramycin), birth
control pills, methotrexate, tetracyclines (e.g., minocycline, doxycycline), typhoid vaccine,
warfarin
Side Effects: Upset stomach, nausea, vomiting, diarrhea, gas, and mouth sores may
occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
Nursing Considerations:
Determine previous exposure and sensitivity to penicillins and cephalosporins and other
allergic reactions of any kind before treatment is initiated.
Monitor of anaphylactoid reaction or other signs or symptoms of hypersensitivity reaction
as with other penicillins.
Lab tests: Periodic assessments of renal, hepatic, and hematopoietic function are
advised in patients on long-term therapy.

8. Oresol
Generic name: Oral Rehydration Salts
Brand name: Guaifenesin
Indication: Oresol is an expectorant which increases the output of phlegm (sputum) and
bronchial secretions by reducing adhesiveness and surface tension. The increased flow
of less viscous secretions promotes ciliary action and changes a dry, unproductive cough
to one that is more productive and less frequent. By reducing the viscosity and
adhesiveness of secretions, guaifenesin increases the efficacy of the mucociliary
mechanism in removing accumulated secretions from the upper and lower airway.
Special Precautions: Hypersensitivity to any of the ingredients. The use of
dextromethorphan-containing products are contraindicated in patients receiving
monoamine oxidase inhibitors (MAOIs).
Drug to Drug Interactions: contraindicated in patients receiving monoamine oxidase
inhibitors (MAOIs).
Side Effects: Mild nausea and vomiting may occur. These effects can be decreased by
taking this product slowly in small amounts with a spoon. If any of these effects persist or
worsen, contact your doctor or pharmacist promptly.
Nursing Considerations: Take with a full glass of water. Take without regard to meals.
Replace solution upon 24 hrs.

9. Mefenamic acid
Generic name: Mefenamic acid
Brand name: Ponstan
Indication: Anthranilic acid derivative. Like ibuprofen inhibits prostaglandin synthesis
and affects platelet function. No evidence that it is superior to aspirin. Short-term relief of
mild to moderate pain.
Special Precautions: History of kidney or liver disease; blood dyscrasias; asthma;
diabetes mellitus; hypersensitivity to aspirin. Long term use increases risk of serious
adverse events.
Drug to Drug Interactions: Serious Interactions
These medications may interact and cause very harmful effects.
Nephrotoxic agents
NSAIDS
Nursing Considerations:
Assess patients who develop severe diarrhea and vomiting for dehydration and
electrolyte imbalance.
Lab tests: With long-term therapy (not recommended) obtain periodic complete blood
counts, Hct and Hgb, and kidney function tests.

10. Doxycycline
Generic name: Doxycycline Hyclate
Brand name: Doxycin
Indication: Primarily bacteriostatic in effect. Similar in use to tetracycline (e.g., effective
against Chlamydial and Mycoplasmal infections; gonorrhea, syphilis, rickettsia).
Similar to those of tetracycline, e.g., Chlamydial and mycoplasmal infections; gonorrhea,
syphilis in penicillin-allergic patients; rickettsial diseases; acute exacerbations of chronic
bronchitis.
Special Considerations:
Known allergies to tetracyclines or to tartrazine
Pregnancy and lactation. Effect on developing bones and teeth
Fungal, mycobacterial, or viral ocular infections. Ophthalmic preparations can kill both
undesired bacteria and normal flora
Use in caution in children below age of 8. Can potentially damage developing bones and
teeth.
Hepatic or renal dysfunction. Drugs are concentrated in the bile and are excreted in
urine.
Drug to Drug Interactions:
Penicillin G: decreased effectiveness of penicillin G
Oral contraceptives: decreased effectiveness of oral contraceptives and additional form
of birth control is needed
Digoxin: increased digoxin toxicity
Calcium salts, magnesium slats, zinc salts, aluminum salts, bismuth salts, iron, urinary
alkalinizers, and charcoal: decreased absorption of tetracyclines
Nursing Considerations:
Report sudden onset of painful or difficult swallowing promptly to physician. Doxycycline
(capsule and tablet forms) is associated with a comparatively high incidence of
esophagitis,especially in patients >40 y.
Report evidence of super infections.