DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION SIDE EFFECTS/ NURSING CONSIDERATIONS

ACTION ADVERSE EFFECTS

GENERIC NAME ACTION Induction or Stimulation
oxytocin Affects uterine myofibril of Labor
activity, stimulates IV: ADULTS: 0.5–1
mammary smooth muscle. milliunit/min. May
BRAND NAME gradually increase in
Pitocin, Syntocinon Therapeutic Effect: increments of 1–2
Contracts uterine smooth milliunits/min. Rates of
AVAILABLE FORM muscle. Enhances lactation. 9–10 milliunits/ min are
Injection (Pitocin): 10 rarely required.
units/ml.
Abortion
IV: ADULTS: 10–20
milliunits/min.
Maximum: 30 units/12-hr
dose.
Control of Postpartum
Bleeding
IV Infusion: ADULTS:
10–40 units in 1,000 ml
IV fluid at rate sufficient
to control uterine atony.
IM: ADULTS: 10 units
(total dose) after delivery.
Contraindications:
Adequate uterine activity
that fails to progress,
cephalopelvic
disproportion, fetal distress
without imminent delivery,
grand multiparity,
hyperactive or hypertonic
uterus, obstetric
emergencies that favor
surgical intervention,
prematurity, unengaged
fetal head, unfavorable
fetal position/presentation,
when vaginal delivery is
contraindicated, (e.g.,
active genital herpes
infection, invasive cervical
cancer, placenta previa,
cord presentation).
Cautions: Induction of
labor should be for
medical, not elective,
reasons.
SIDE EFFECTS BASELINE ASSESSMENT
Occasional: Tachycardia,
premature ventricular
contractions,
hypotension, nausea,
vomiting.
Rare: Nasal: Lacrimation/
tearing, nasal irritation,
rhinorrhea, unexpected INTERVENTION/EVALUATION
uterine
bleeding/contractions.
ADVERSE EFFECTS/
TOXIC REACTIONS
Hypertonicity may occur
with tearing of uterus,
increased bleeding,
abruptio placentae (i.e.,
placental abruption),
cervical/ vaginal
lacerations. Fetal:
Bradycardia, CNS/brain
damage, trauma due to
rapid propulsion, low
Apgar score at 5 min,
retinal hemorrhage occur
rarely. Prolonged IV
infusion of oxytocin with PATIENT/FAMILY TEACHING
excessive fluid volume
has caused severe water
intoxication with
seizures, coma, death.
 Assess baselines for vital
signs, B/P, fetal heart rate.
 Determine frequency,
duration, strength of
contractions.
 Monitor B/P, pulse,
respirations, fetal heart
rate, intrauterine pressure,
contractions (duration,
strength, frequency)
q15min.
 Notify physician of
contractions that last longer
than 1 min, occur more
frequently than every 2
min, or stop.
 Maintain careful I&O; be
alert to potential water
intoxication. Check for
blood loss.
 Keep pt, family informed
of labor progress.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
2st Semester, S.Y. 2018-2019

DRUG STUDY
SUBMITTED BY:
ALGO, ROMWELLA MAY A.
BSN-2A
SUBMITTED TO:
MRS. REBECCA DE ASIS
 DRUG SIDE/ADVERSE NURSING
ACTION INDICATION CONTRAINDICATION PHARMACOKINETICS
CLASSIFICATION EFFECTS RESPONSIBILITIES
Extended Spectrum Inhibits cell wall Treatment of Hypersensitivity to  Moderately Side effects: Baseline assessment
Penicillin synthesis in susceptible susceptible ampicillin or any absorbed from GI Pain at IM Question for history of
Generic Name: microorganisms. infections due to penicillin. Infections tract. Protein injection site, GI allergies, esp.
Ampicillin Therapeutic Effect: streptococci, S. caused by penicillinase- binding: 15%– disturbances (mild penicillins,
 Bactericidal in pneumoniae, producing organisms. 25%. Widely diarrhea, cephalosporins; renal
Brand Name: susceptible staphylococci Cautions: History of  distributed. nausea,vomiting), impairment.
Principen microorganism (non– allergies, esp. oral or vaginal Intervention/evaluation
Partially
Available form: s penicillinase- cephalosporins, renal candidiasis. Promptly report rash
metabolized in
 Capsules: 250 producing), impairment, asthmatic Occasional: (although common with
meningococci, pts, infectious liver. Primarily Generalized rash, ampicillin, may indicate
mg, 500 mg.
Injection, Listeria, some mononucleosis. excreted in urine. urticaria, phlebitis, hypersensitivity) or
 Powder for Klebsiella, E. Removed thrombophlebitis diarrhea (fever,
Reconstitution: coli, H.  by hemodialysis. (with IV abdominal pain, mucus
125 mg,250 influenzae, Half-life: 1–1.5 administration), and blood in stool
mg, 500 mg, 1 Salmonella, hrs (increased in headache. Rare: may indicate antibiotic-
g, 2 g. Shigella, renal Dizziness, seizures associated colitis).
 Powder for including GI, impairment). (esp. with IV Evaluate IV site for
Oral GU, respiratory therapy). phlebitis. Check
Suspension: infections, IM injection site for
125 mg/5 mL, meningitis, Adverse effects: pain, induration.
250 mg/5 mL. endocarditis Antibiotic- Monitor I&O, urinalysis,
Dosage/Route prophylaxis.. associated colitis, renal function
Adult: 250–500 mg other tests. Be alert for
PO q8h superinfections superinfection: fever,
Pediatric: 20 mg/kg/d (abdominal vomiting, diarrhea,
PO in divided doses cramps, severe anal/genital pruritus,
q8h watery diarrhea, oral mucosal changes
Adult: 250–500 mg fever) may result (ulceration, pain,
IM or IV q6h, then from altered erythema).
500 mg bacterial balance Patient/family teaching
PO q6h when oral use in GI tract. • Continue antibiotic for
is feasible Severe full length of treatment.
Pediatric: 60 mg/kg/d hypersensitivity • Space doses evenly.
IM or IV in four to six reactions, • More effective if taken
divided doses, then including 1 hr before or 2 hrs after
250 mg PO q6h anaphylaxis, acute food/beverages.
 interstitial • Discomfort may occur
nephritis, occur with IM injection.
rarel • Report rash, diarrhea,
or other new symptoms..

DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION SIDE/ADVERSE NURSING

ACTION EFFECT CONSIDERATION
Generic Name: Inhibits cell-wall used to treat a wide • Contraindicated in SIDE EFFECTS BEFORE:
CEFUROXIME synthesis, promoting variety of bacterial patients hypersensitive  diarrhea.
 Determine history
AXETIL osmotic instability; infections to drug or other  dizziness.
usually bactericidal cephalosporins.  headache. of hypersensitivity reactions
Brand Name: • Use cautiously in  drowsiness. to cephalosporins,
CEFTIN patients hypersensitive  itching/swelling.
to penicillin because of  rash. penicillins, and history of
Available Form: possibility of
Suspension: 125 mg/5 cross-sensitivity with allergies, particularly to
ml, 250 mg/5 ml other beta-lactam ADVERSE EFFECTS
drugs, before therapy is
Tablets: 125 mg, 250 antibiotics. CV: phlebitis,
mg, 500 mg • Use cautiously in breast- thrombophlebitis. initiated.
feeding women GI: diarrhea,
DURING:
Dosages: and in patients with pseudomembranous
1 tab 500 mg history of colitis or colitis,  Inspect IM and IV
renal insufficiency. nausea, anorexia,
injection sites frequently for
vomiting.
Hematologic: hemolytic signs of phlebitis.
anemia,
 Monitor for
thrombocytopenia,
transient neutropenia, manifestations
eosinophilia.
Skin: maculopapular of hypersensitivity (see
and erythematous Appendix F). Discontinue
rashes, urticaria, pain,
induration, sterile drug and report their
abscesses, temperature appearance promptly.
elevation, tissue
sloughing at I.M.  Monitor I&O rates and
injection site. pattern: Especially
important in severely ill
patients receiving high
doses. Report any
significant changes.
 Report onset of loose
stools or diarrhea. Although
 pseudomembranous colitis
(see Signs & Symptoms,
Appendix F) rarely occurs,
this potentially life-
threatening complication
should be ruled out as the
cause of diarrhea during
and after antibiotic therapy.
AFTER:
 Instruct patient to take
medication around the clock
at evenly spaced times and
to finish the medication
completely, even if feeling
better
 Advise patient to report
signs of superinfection and
allergy
 Instruct patient to notify
health professional if fever
and diarrhea develop

MECHANISM OF CONTRAINDICATIO SIDE EFFECT/

DRUG NAME INDICATION NURSING CONSIDERATION
ACTION N ADVERSE EFFECT
GENERIC NAME
Cefepime
BRAND NAME
Maxipime
AVAILABLE FORM
Injection, Powder for
Reconstitution: 500 mg, 1 g, 2 g.
Injection, Premix: 1 g (50 ml), 2
g (100 ml).
DOSAGES
Pneumonia
IV: ADULTS, ELDERLY: 1–2
g q12h for 7–10 days.
CHILDREN 2 MOS AND
OLDER: 50 mg/kg q12h.
Maximum: 2 g/dose.
Intra-Abdominal Infections
IV: ADULTS, ELDERLY: 2 g
q12h for 7–10 days.
Skin/Skin Structure Infections
IV: ADULTS, ELDERLY: 2 g
q12h for 10 days. CHILDREN 2
MOS AND OLDER: 50 mg/ kg
q12h. Maximum: 2 g/dose.
UTI
IV: ADULTS, ELDERLY: 0.5–
2 g q12h for 7–10 days.
CHILDREN 2 MOS AND
OLDER: 50 mg/kg q12h.
Maximum: 2 g/ dose.
Febrile Neutropenia
Binds to bacterial Treatment of empiric History of anaphylactic ADVERSE EFFECT BEFORE
cell wall febrile neutropenia, reaction to penicillins,  mild diarrhea 1. Question for history of allergies,
membranes, inhibits intra-abdominal hypersensitivity to  mild abdominal particularly cephalosporins,
cell wall synthesis. infections, skin/skin cephalosporins. cramping penicillins.
structure infections,  Nausea
Therapeutic Effect: UTIs, pneumonia. Cautions: Renal  fever
Bactericidal. impairment, history of DURING
 joint pain 1. Evaluate IM site for induration and
OFF-LABEL: Brain seizure disorder.  severe watery
abscess, malignant tenderness.
diarrhea 2. Assess oral cavity for white patches
otitis externa, septic
 severe pruritus on mucous membranes, tongue
lateral/cavernous sinus
 angioedema (thrush).
thrombus.
 bronchospasm 3. Monitor daily pattern of bowel
 anaphylaxis activity, stool consistency. Mild GI
effects may be tolerable (increasing
severity may indicate onset of
antibiotic- associated colitis).
4. Monitor I&O, CBC, renal function
tests for nephrotoxicity. Be alert for
superinfection: fever, vomiting,
diarrhea, anal/genital pruritus, oral
mucosal changes (ulceration, pain,
erythema).
AFTER
1. Provide thorough patient teaching,
including measures to avoid adverse
effects and warning signs of
problem, to improve patient
compliance.
2. Monitor the patient’s vital signs and
report any side effects observed.
IV: ADULTS, ELDERLY: 2 g
q8h.
CHILDREN 2 MOS AND
OLDER: 50 mg/kg q8h.
Maximum: 2 g/dose.

MECHANISM OF CONTRAINDICATIO SIDE EFFECT/

DRUG NAME INDICATION NURSING CONSIDERATION
ACTION N ADVERSE EFFECT
GENERIC NAME 1. Inhibits bacterial 1. Treatment of severe 1. Contraindicated in ADVERSE EFFECT BEFORE
Clindamycin protein synthesis by infections when patients with  Headache 1. Assess if the patient has a disease that
binding to 50S penicillin or other, less hypersensitivity to the  Thrombophlebitis is contraindicated with the drug.
BRAND NAME subunit of ribosome. toxic antibiotics cannot drug and lincomycin  Pharyngitis 2. Before giving first dose, obtain
Cleocin be used.  Abdominal pain specimen for culture and sensitivity test.

DOSAGES
Adult: 150-300mg PO q6h or
600-2,700 mg/d in two to four
equal doses; reduce dose with
renal impairment.
2. Hinders or kills 2. Use cautiously in  Anorexia 3. If the drug is given through IM
susceptible bacteria. 2. Used to treat patients with renal or  Bloody stools injection, instruct the client that it may
infections caused by hepatic disease, asthma,  Constipation or sting a little.
sensitive history of Diarrhea
staphylococci, Gastrointestinal disease,  Dysphagia DURING
streptococci, or significant allergies.  Esophagitis 1. Monitor renal, hepatic, and
pneumococci,  Flatulence hematopoietic functions during
bacteroids, prolonged therapy of the drug.
 Nausea and
clostridium, and other 2. Be alert for adverse reactions and
Vomiting
sensitive aerobic and drug interactions.
 Urticaria
anaerobic organisms. 3. If adverse Gastrointestinal reactions
 Anaphylaxis occur, monitor the client’s hydration.
 Erythema AFTER
1. Instruct client to report diarrhea
and avoid self-threatening
pseudo membranous colitis.
2. Teach client how to store oral
solution.
3. Tell client to take entire amount
prescribed even after she feels
better.

DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION SIDE EFFECTS/ NURSING

ACTION ADVERSE EFFECTS CONSIDERATION

Generic name: Enter the target cells and bind Replacement Presence of any known Vertigo, headache, Baseline assessment
hydrocortisone to cytoplasmic receptors, therapy, treatment allergy to any steroid paresthesias, insomnia, Assess history of allergy to any
initiating many complex of allergic and preparation to avoid convulsions, psychosis, steroid preparations, acute
Brand name: reactions that are responsible inflammatory hypersensitivity reactions; pancreatitis, nausea, infections, peptic ulcer disease,
Cortef for anti-inflammatory and disorders in the presence of an acute vomiting, weight gain, pregnancy, lactation, endocrine
immunosuppressive effects infection; and with hypotension, shock, heart disturbances and renal
lactation failure secondary to fluid dysfunction
retention, thrombophlebitis,
Caution should be used in hypokalemia, Assess weight, temperature,
patients with diabetes; hypocalcemia, increased orientation and affect; grip
acute peptic ulcers; and blood sugar, muscle strength, eye examination;
with other endocrine weakness, steroid blood pressure, pulse,
disorders myopathy, loss of muscle peripheral perfusion and vessel
mass, osteoporosis, evaluation; respiration and
cataracts, glaucoma, adventitious breath sounds;
petechiae, ecchymoses, glucose tolerance, renal
purpura, amenorrhea, function, serum electrolyte and
immunosuppression, endocrine function tests
aggravation or masking of
infections, impaired wound Intervention/evaluation
healing Monitor patient response to the
drug

Monitor for adverse effects

Evaluate effectiveness of the

teaching plan

MECHANISM OF
DRUG NAME INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION

LIDOCAINE Similar to those of  For the treatment History of hypersensitivity to CNS: Headache, Assessment & Drug Effects
Brand Name: procainamide and of perfusing amide-type local anesthetics; dizziness, fatigue.  Lab tests: Monitor urinalysis for
quinidine, but has ventricular application or injection of hematuria and proteinuria.
Anestacon, Dilocaine, little effect on arrhythmias lidocaine anesthetic in presence  GI: Diarrhea, Periodic liver function tests with
L-Caine, Lidoderm, myocardial including of severe trauma or sepsis, blood abdominal pain, nausea, prolonged use.
Lida-Mantle, Lidoject- contractility, AV and ventricular dyscrasias, supraventricular mild transient increases
1, LidoPen,Auto intraventricular fibrillation (VF) arrhythmias, Stokes-Adams in liver function tests.  Patient & Family Education
Injector, Nervocaine, conduction, cardiac and ventricular syndrome, untreated sinus
Octocaine, Xylocaine, output, and systolic tachycardia (VT) bradycardia, severe degrees of Urogenital: Hematuria,  Report any changes in urinary
Xylocard arterial pressure in that may result sinoatrial, atrioventricular, and proteinuria.  elimination such as pain or
equivalent doses. during acute intraventricular heart block. Safe discomfort associated with
Available Form: Exerts antiarrhythmic myocardial use during pregnancy (category Skin: Rash. urination, or blood in urine.
Antidysrhythmic action (Class IB) by infarction or B), lactation, or in children is not
300 mg/3 mL auto- suppressing cardiac established.  Report severe diarrhea; drug
injector; 0.2%, 0.4%, automaticity in His- manipulation (e.g., may need to be discontinued.
0.8%, 1%, 2%, 4%, Purkinje system and cardiac surgery).
10%, 20% injections  Do not breast feed while taking
by elevating electrical  For topical
stimulation threshold anesthesia of skin this drug.
Local Anesthetic of ventricle during and mucous
0.5%, 1%, 1.5%, 2%, diastole. Action as membranes or
4% local anesthetic is stomatitis.
more prompt, more  For prevention of
Topical intense, and longer dental pain† and
2%, 2.5%, 4%, 5% lasting than that of for topical
solution; 2.5%, 5% procaine. anesthesia of
ointment; 0.5%, 4%
mucous
cream; 0.5%, 2.5% gel;
membranes.
0.5%, 10% spray; 2%
jelly; 0.5% patch  For nonurgent
painful procedures
Dosages: including IV
cannulation,
Anesthetic Uses venipuncture,
Adult: Infiltration 0.5 lumbar puncture,
–1% solution or arterial
 Nerve Block 1–2% puncture.
solution   For the treatment
Epidural 1–2% of stage 1 thru 4
solution  pressure ulcers,
Caudal 1–1.5%
solution  venous stasis
Spinal 5% with ulcers, ulcerations
glucose of mixed vascular
Saddle Block 1.5% etiologies, diabetic
with dextrose skin ulcers, first
Topical 2.5–5% jelly, and second degree
ointment, cream, or burns, and post
solution surgical incisions,
cuts, and
abrasions.
 For the treatment
of pain associated
with postherpetic
neuralgia.
 For local
anesthesia
including
peripheral nerve
block anesthesia.
 For epidural
anesthesia.
 For caudal
anesthesia.
 For obstetric
anesthesia.
 For caudal
anesthesia.
 For obstetric
anesthesia.

MECHANISM OF SIDE EFFECT/ NURSING

DRUG NAME INDICATION CONTRAINDICATION
ACTION ADVERSE EFFECT RESPONSIBILITIES
DRUG CLASS: Orally: Acts as a laxative Orally to relieve acute  Myocardial damage Body as a Whole: Flushing, BEFORE:
Anticonvulsant by osmotic retention of constipation and to  heart block sweating, extreme thirst, 1. Observe constantly
Gastrointestinal Agent fluid, which distends colon,
evacuate bowel in  cardiac arrest except sedation, confusion, when given IV. Check
Saline Cathartic increases water content of preparation for x-ray of for certain arrhythmias depressed reflexes or no BP and pulse q10–15
Replacement Agent feces, and causes intestines. Parenterally to  IV administration reflexes, muscle weakness, min or more often if
mechanical stimulation of control seizures in toxemia during the 2 h flaccid paralysis, indicated.
GENERIC NAME: bowel activity. of pregnancy, epilepsy, and preceding delivery hypothermia.
magnesium sulfate acute nephritis and for  PO use in patients
Parenterally: Acts as a prophylaxis and treatment CV: Hypotension, DURING:
with abdominal pain, 2. Monitor respiratory
BRAND NAME: CNS depressant and also as of hypomagnesemia. nausea, vomiting, depressed cardiac function,
Epsom salt a depressant of smooth, Topically to reduce edema, complete heart block, rate closely. Report
fecal impaction, or immediately if rate
skeletal, and cardiac inflammation, and itching. intestinal irritation, circulatory collapse.
AVAILABLE FORM: muscle function. falls below 12.
obstruction, or 3. Test patellar reflex
0.8 mEq/mL, 1 mEq/mL, 4 Anticonvulsant properties perforation. Respiratory: Respiratory
mEq/mL injection thought to be produced by paralysis. before each repeated
CNS depression, parenteral dose.
DOSAGES: principally by decreasing Metabolic: Depression or absence
Laxative the amount of Hypermagnesemia, of reflexes is a useful
Adult: PO 10–15 g once/d acetylcholine liberated hypocalcemia, dehydration, index of early
from motor nerve electrolyte imbalance magnesium
Preeclampsia, Eclampsia terminals, thus producing including hypocalcemia intoxication.
Adult: IM/IV 4 g in 250 peripheral neuromuscular with repeated laxative use.
mL D5W infused slowly, blockade. AFTER:
followed by 4–5 g IM in 4. Observe newborns of
alternate buttocks q4h mothers who received
Effective parenterally as a parenteral magnesium
Hypomagnesemia Seizures CNS depressant, smooth sulfate within a few
Adult: IM/IV Mild, 1 g q6h muscle relaxant and hours of delivery for
for 4 doses; Severe, 250 anticonvulsant in labor and signs of toxicity,
mg/kg infused over 4 h delivery, and cardiac including respiratory
Child: IV 20–100 mg/kg disorders. It is a laxative and neuromuscular
q4–6h prn when taken orally. depression.
5. Observe patients
Total Parenteral Nutrition receiving drug for
Adult: IV 0.5–3 g/d hypomagnesemia for
improvement.

DRUG SIDE/ADVERSE NURSING

ACTION INDICATION CONTRAINDICATION PHARMACOKINETICS
CLASSIFICATION EFFECTS RESPONSIBILITIES
 Calcium Channel It works by Nifedipine is used to Allergies to the drug,  Nifedipine is Side effects: Baseline assessment
Blockers relaxing the treat hypertension Porphyria, almost completely dizziness, peripheral Question for the
Generic Name: muscles of your (high blood myasthenia gravis, absorbed from the edema, lower presence of allergies to
Nefedipine heart and blood pressure) and angina a skeletal muscle gastrointestinal extremity edema, the drug and other
vessels. (chest pain). disorder, tract as shown by flushing, and contraindications
Brand Name: It works by a sudden worsening of plasma levels after flushing sensation. 
Procardia relaxing the angina called acute sublingual, oral, Adverse effects: Intervention/evaluation
Available form: muscles of your coronary syndrome, and rectal acute myocardial Assess for anginal pain,
capsule heart and blood severe narrowing of the administration. infarction, muscle including location,
 10mg vessels. aortic heart valve, Because of cramps, tremor, intensity, duration, and
 20mg severe heart failure presystemic cough, dyspnea, alleviating and
tablet, extended low blood pressure, metabolism, the hypotension, and aggravating factors.
release significantly low blood bioavailability is wheezing. See - Assess cardiac status
 30mg pressure, about 56% to below for a with BP, pulse,
 60mg hardening of the liver 77%. comprehensive list respiration and ECG.
 90mg liver problems, of adverse effects. - Monitor potassium and
kidney disease with liver function tests
reduction in kidney throughout treatment
Dosage/Route function, with nifedipine.
30-60 mg (extended fluid retention in the legs
release) PO once Patient/family teaching
daily; may be Avoid dangerous
increased every 7-14 activities until stabilised
days PRN; not to on the medicine or
exceed 90 mg/day dizziness is not present.
(Adalat CC) or 120 - Limit caffeine.
mg/day (Procardia - Avoid alcohol.
XL) - Patients should change
position carefully as
orthostatic hypotension
can occur.

DRUG NAME MECHANISM INDICATION CONTRAINDICATION SIDE NURSING CONSIDERATION

 OF ACTION EFFECTS/ADVERSE
EFFECTS
GENERIC NAME Binds to bacterial Systemic: Hypersensitivity to Nephrotoxicity (acute BASELINE ASSESSMENT
vancomycin cell walls, altering Treatment of vancomycin kidney injury, acute Avoid other ototoxic, nephrotoxic
cell membrane infections caused tubular necrosis, renal medications if possible. Obtain culture,
Drug class permeability, by Cautions: Renal failure), ototoxicity sensitivity test before giving first dose
Antibiotic inhibiting RNA staphylococcal, impairment; concurrent (temporary or (therapy may begin before results are
synthesis. streptococcal spp. therapy with other permanent hearing loss) known). Consider placement of central
Availability (Rx) Therapeutic bacteria. PO: ototoxic, nephrotoxic may occur. Too-rapid venous line/PICC line.
Capsules (Vancocin): 125 mg, 250 Effect: Treatment of C. medications, infusion may cause "red
mg. Infusion (Premix [Vancocin Bactericidal. difficile– elderly pts, dehydration. man syndrome," a INTERVENTION/EVALUATION
HCl]): associated common adverse Monitor serum renal function tests, I&O.
500 mg/100 mL, 750 mg/150 mL, 1 diarrhea and reaction characterized Assess skin for rash. Check hearing
g/200 mL. Injection, Powder for treatment of by pruritus, urticaria, acuity, balance. Monitor B/P carefully
Reconstitution (Vancocin HCl): 500 enterocolitis erythema, angioedema, during infusion. Monitor for "red man"
mg, 750 mg, 1 g. Solution, Oral: 25 caused by S. tachycardia, syndrome. Evaluate IV site for phlebitis
mg/mL, 50 mg/mL. Suspension, aureus (including hypotension, myalgia, (heat, pain, red streaking over vein).
Oral: 50 mg/mL MRSA). maculopapular rash Obtain vancomycin peak/trough level as
OFF-LABEL: (usually appears on face, ordered by physician or pharmacist.
Indications/routes/dosage Treatment of neck, upper torso). Therapeutic serum level: peak: 20–40
Note: A loading dose of 25–30 infections caused Cardiovascular toxicity mcg/mL; trough: 10–20 mcg/mL.
mg/kg may be used to rapidly by gram-positive (cardiac depression, Toxic serum level: peak: greater than 40
achieve target organisms in pts arrest) occurs rarely. mcg/mL; trough: greater than 20
concentration for complicated with serious Onset usually occurs mcg/mL.
infections in seriously ill allergies to beta- within 30 min of start of
lactam infusion, resolves within Patient/ family teaching
antibiotics; hrs following infusion. • Continue therapy for full length of
treatment of beta- May result from too- treatment.
lactam–resistant rapid rate of infusion • Doses should be evenly spaced.
gram-positive • Report ringing in ears, hearing loss,
infections. changes in urinary frequency or
Surgical consistency.
prophylaxis, • Lab tests are important part of total
treatment of therapy.
prosthetic joint
infection.