(Tañeza BSN2C)

Drug Study: COTRIMOXAZOLE

Complete the drug study of the ordered drug below. You may use a drug handbook such as Lippincott’s Nursing Drug Guide as your reference.
Dr. Postrano ordered the drug: Cotrimoxazole 500mg tab PO TID x 7 days

Patient HRN: 1234567 Age/Gender: 30/F Rm: 102

Admitting Diagnosis: Urinary Tract Infection Birthday: 10/24/1990
 Drug Mechanism of Action Indications or Contraindications Side Effects  Adverse Reactions Nursing Responsibilities 
Purpose

To the patients who Nausea, CNS:headache,depressi

Generic Name: Inhibits para-aminobenzoic To treat chlamydial had a Vomiting and on,hallucina- • Use sulfamethoxazole carefully in
acid, a bacterial enzyme conjunctivitis; malaria hypersensitivity to loss of appetite. patients with blood dyscrasia or folate-
(as an adjunct to sulfonamides, tions,insomnia,drowsines deficient megaloblastic anemia because
responsible for the synthesis s,fatigue,
of folic acid, which is quinine sulfate and trimethoprim, the drug can cause dyscrasia in the
pyrimethamine); sulfonylureas, blood; in patients with G6PD deficiency
Sulfamethoxazole- necessary for growth by apathy,anxiety,ataxia,vert
toxoplasmosis (as an thiazides, or loop due to hemolysis; in patients with
trimethoprim susceptible bacteria. Sulfa- igo,poly-
adjunct to diuretics, those with hepatic or renal impairment due to
methoxazole avoids or pyrimethamine); and increased risk of toxicity; and in patients
severe renal neuritis,peripheral
alleviates infection by UTI caused by with porphyria because the drug can
impairment neuropathy,seizures
inactivating the bacteria. susceptible species, precipitate acute attack.
Brand Name: (creatinine clearance
including CV:allergic myocarditis or
pyelonephritis and of less than
pericarditis
cystitis. 15ml/minute) or
porphyria those with EENT:periorbital
Co-trimoxazole is effective megaloblastic
•Provide blood samples for CBC and
Bactrim, Septra, against Escherichia coli, edema,optic neuri- body tissue or fluid specimens for
Cotrim, anemia caused by
Klebsiella, Enterobacter, culture and sensitivity tests, as
folate deficiency, tis,transient
Proteus instructed, prior to drug administration.
pregnant women at myopia,tinnitus
Expect to be given first dose before
mirabilis,Haemophilus term, breast-feeding
influenzae, Streptococcus GI:nausea,vomiting,abdo results are available.
women, and children
Classification: pneumoniae, Staphylococcus minal pain,
younger than age 2
aureus, Acinetobacter, months. stomatitis,glossitis,dry
Salmonella, Shigella, and P. mouth,pan- Monitor patient for drug-induced fever,
carinii.
Pharmacologic   Use cautiously in which may develop 7 to 10 days after
creatitis,anorexia,pseudo
Classification- patients with sulfamethoxazole starts. Signs and
membra-
Sulfonamide and impaired renal or symptoms include abdominal pain,
Folate antagonist hepatic function, nous colitis anorexia, ataxia, depression, diarrhea,
severe allergies, headache, insomnia, nausea, peripheral
GU:hematuria,proteinuria neuropathy, tinnitus, and vomiting.
severe bronchial
,crystal-
asthma, chronic •Monitor the intake and output of fluids
Therapeutic alcoholics, G6PD luria,toxic nephrosis with during treatment. Altered fluid balance
Classification- deficiency, or blood oliguria
Antibiotic, may increase crystalluria risk.
dyscrasia.
Antiprotozoal and and anuria,renal failure •Monitor blood glucose levels regularly,
Anti-infective
Hematologic:megalobla and assess signs and symptoms of
stic anemia, hypoglycemia in patients taking an oral
antidiabetic medicine. If hypoglycemia
agranulocytosis,aplastic occurs, be prepared to respond.
Dose, Route &
anemia,
Timing: •Instruct patients to take
thrombocytopenia,leukop sulfamethoxazole precisely as
enia, prescribed, and complete the full course
even though they feel better.
hemolytic anemia
Dose: 500 mg
•Advise patient to take drug with a full
Reference/s:
McGraw-Hill Nurse's Drug Handbook 7th Edition (pp 1175- pp 1177)
Jones and Bartlett Learning 2015 Nurse's Drug Handbook 4th Edition (pp 1108 - pp 1109)
Drug Study: RIMANTIDINE
Complete the drug study of the ordered drug below. You may use a drug handbook such as Lippincott’s Nursing Drug Guide as your reference.
Dr. Postrano ordered the drug: Rimantidine 100mg PO BID x 5 days

Patient HRN: 1234567 Age/Gender: 30/F Rm: 102

Admitting Diagnosis: Influenza A Birthday: 10/24/1990
 Drug Mechanism of Action Indications or Contraindication Side Effects  Adverse Reactions Nursing Responsibilities 
Purpose s

Prevents nucleic acid ●Prophylaxis and ●Contraindicated CNS: headache, ● Monitor vital signs; watch for
Generic Name: uncoating during viral cell treatment of with allergy to Trouble dizziness, fatigue, hypotension.
replication, preventing illness caused by amantadine, sleeping, naus depression,
penetration in host. Also inflfluenza A virus rimantadine;lacta ea, vomiting, l insomnia, poor ●Closely monitor nutritional
causes dopamine release in adults tion. oss of concentration, status and hydration.
Rimantadine
hydrochloride from neurons. appetite, dry asthenia,
●Prophylaxis ●Use cautiously mouth, weakn
nervousness
against with seizures, ess, dizziness,
inflfluenza A virus liver or renal drowsiness, or CV: hypotension ● Advise patient to take several
Brand Name: in children disease, nervousness hours before bedtime.
may occur. EENT: tinnitus
pregnancy.
●Unlabeled uses: ● If patient’s taking syrup, tell
GI: nausea,
Treatment and him to use specially marked oral
Flumadine vomiting, diarrhea,
prophylaxis of syringe or measuring device to
abdominal pain,
H1N1 (swine flflu) ensure accurate dose.
dyspepsia, dry
infection,
mouth, anorexia ● Instruct patient to contact
Classification: treatment of
prescriber if symptoms don’t
inflfluenza A in Respiratory:
improve within 2 to 3 days.
children dyspnea
● Caution patient to avoid
Pharmacologic- Skin: rash
classification: driving and other hazardous
activities until he knows how
Miscellaneous drug affects concentration,
and
motor function, and alertness.
anticholinergic-like
agent

Therapeutic
Classification:

Antiviral

Dose, Route &

Timing:
Reference/s:
McGraw-Hill Nurse's Drug Handbook 7th Edition (pp 1103 - pp 1104)
Lippincott's Nursing Drug Guide 2015 (pp 1020 - pp 1021)
Drug Study: DOXORUBICIN
Complete the drug study of the ordered drug below. You may use a drug handbook such as Lippincott’s Nursing Drug Guide as your reference.
Dr. Postrano ordered the drug: Doxorubicin 60–75 mg/m2 as a single IV dose; repeat every 21 d

Patient HRN: 1234567 Age/Gender: 30/F Rm: 102

Admitting Diagnosis: Leukemia Birthday: 10/24/1990
 Drug Mechanism of Action Indications or Contraindications Side Effects  Adverse Reactions Nursing Responsibilities 
Purpose

inhibit DNA and RNA -To treat acute -Contraindicated Common CNS: drowsiness, -Watch for acute life-threatening
Generic Name: synthesis by forming lymphocytic with allergy to dizziness, asthenia, arrhythmias, which may occur
complex with DNA. Also leukemia, acute doxorubicin -Pain along the during or within a few hours after
fatigue, malaise,
exerts immuno-suppressive nonlymphocytic hydrochloride, site where the administration.
paresthesia,
Doxorubicin activity. Cell-cycle–S-phase leukemia; bladder,malignant medication was
headache,
breast, gastric, melanoma, kidney given.
specific. depression,
Hydrochloride epithelial ovarian,
carcinoma, large -Monitor for cardiomyopathy and
insomnia, anxiety,
or thyroid cancer;bowel carcinoma, -Nausea or subsequent heart failure with
emotional lability
brain tumors, CNS vomiting (You chronic overdose (more common
Hodgkin’s will be
Brand Name:
metastases, in children).
disease;
myelosuppression, pretreated for
neuroblastoma this side CV: chest pain,
cardiac disease
hypotension,
or Wilms’ tumor; (may predispose to effect)Later ● Stay alert for erythematous
Adriamycin PFS, Side Effects: tachycardia,
non-Hodgkin’s cardiac toxicity), streaking along vein next to
Adriamycin RDF, (within two peripheral edema,
Rubex
lymphoma; small- pregnancy, injection site, which may indicate
weeks after cardiomyopathy,
cell lung lactation. too-rapid infusion.
treatment heart failure,
carcinoma; and
begins) arrhythmias,
soft-tissue
pericardial
sarcoma or ●Use cautiously ● Watch for nausea and
-Low blood effusion
osteosarcoma. with impaired vomiting. Administer antiemetics
Classification: counts . Your
hepatic function, as needed.
previous courses of white and red
doxorubicin or blood cells and GI: nausea,
daunorubicin platelets may vomiting, diarrhea,
Pharmacologic -Check for superinfection or
classification: ●To produce therapy (may temporarily constipation,
regression in the predispose to enlarged abdomen, hemorrhage caused by persistent
decrease. This
Anthracycline following abdominal pain, bone marrow depression (but
cardiac toxicity), can put you at
neoplasms: ALL, prior mediastinal increased risk dyspepsia, oral expect WBC counts as low as
AML, Wilms candidiasis, 1,000/mm3 during therapy).
irradiation, for infection,
Therapeutic
tumor, concurrent anemia and/or moniliasis,
Classification:
neuroblastoma, cyclophosphamide bleeding. stomatitis, glossitis,
Antibiotic and soft tissue and esophagitis, -Watch closely for infusion-
Antineoplastic therapy related reactions and
bone sarcoma, (predispose to Uncommon dysphagia.
breast carcinoma, cardiac toxicity). anaphylaxis.
ovarian -Eyes watering
carcinoma, GU: albuminuria,
transitional cell -Mouth sores hyperuricosuria, red ● Monitor CBC, hepatic profile,
coagulation tests, ejection
Reference/s:
http://chemocare.com/chemotherapy/drug-info/doxorubicin.aspx#:~:text=Doxorubicin%20is%20the%20generic%20name,the%20generic%20drug%20name%20Doxorubicin.
McGraw-Hill Nurse's Drug Handbook 7th Edition (pp 398 - pp 401)
Jones and Bartlett Learning 2015 Nurse's Drug Hanbook 4th Edition (pp 1321)
Lippincott's Nursing Drug Guide 2015 (pp 411 - pp 412)