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E. Jacinto Street, Davao City

Name: Civil Status: Date Admitted:
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______ Religion: Diagnosis:_________________________________
Age: _____________________________________________ ______________
______________________________________________ Occupation: Attending Physician:
_______ __________________________________________ __________________________________
Sex: Date/Time of Evaluation:
______________________________________________ ___________________________
Date/Time of Assessment:

Date Drug Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsibility

A broad-spectrum Treatment of Hypersensitivity to CNS: Headache, • Lab tests: Do C&S test prior
to beginning therapy and
fluoroquinolone maxillary sinusitis, levofloxacin and insomnia, dizziness. periodically.
antibiotic that inhibits acute exacerbations quinolone antibiotics; GI: Nausea, diarrhea, • Withhold therapy and report
DNA bacterial of bacterial bronchitis, hypokalemia, tendon constipation, vomiting, to physician immediately any
Levaquin, Iquix, of the following: Skin rash or
Quixin topoisomerase II, an community-acquired pain, pregnancy abdominal pain, other signs of a
hypersensitivity reaction (see
Classifications: enzyme required for pneumonia, (category C); syphilis; dyspepsia. Skin: Rash, Appendix F); CNS symptoms
antiinfective; DNA replication, uncomplicated viral infections; pruritus. Special such as seizures,
antibiotic; quinolone transcription, repair, skin/skin structure phototoxicity; Senses: Decreased
restlessness, confusion,
hallucinations, depression;
Prototype: skin eruption following sun
and recombination. infections, UTI, acute lactation. vision, foreign body
Ciprofloxacin exposure; symptoms of colitis
Pregnancy pyelonephritis caused sensation, transient such as persistent diarrhea;
joint pain, inflammation, or
Category: C by susceptible ocular burning, ocular rupture of a tendon;
bacteria; chronic pain, photophobia. hypoglycemic reaction in
diabetic on an oral
Availability bacterial prostatitis; Urogenital: Vaginitis. hypoglycemic agent.
250 mg, 500 mg bacterial Body as a Whole:
tablets; 250 mg, 500 conjunctivitis. Injection site pain or Patient & Family Education

mg injection; 0.5% inflammation, chest or

back pain, fever, • Learn important indications
ophthalmic solution for discontinuing drug and
pharyngitis. immediately notifying
• Consume fluids liberally while
taking levofloxacin.
• Allow a minimum of 2 h
between drug dosage and
taking any of the following:
Aluminum or magnesium
antacids, iron supplements,
multivitamins with zinc, or
• Avoid exposure to excess
sunlight or artificial UV light.
• Avoid NSAIDs while taking
levofloxacin, if possible.
• Do not breast feed while
taking this drug.

Year and Section:
Clinical Instructor: