Name of Drug: Zithromax

Action:

Azithromycin is a semi-synthetic macrolide antibiotic chemically related

to erythromycin and clarithromycin (Biaxin). It is effective against a wide variety
of bacteria such as Hemophilus influenzae, Streptococcus pneumoniae, Mycoplasma
pneumoniae, Staphylococcus aureus, mycobacterium avium, and many others.
Azithromycin, like all macrolide antibiotics, prevents bacteria from growing by
interfering with their ability to make proteins. Due to the differences in the way
proteins are made in bacteria and humans, the macrolide antibiotics do not
interfere with production of proteins in humans. It is an unusual antibiotic in that
it stays in the body for quite a while (has a long half-life), allowing for once a day
dosing and for shorter treatment courses for most infections. 

Side effects:

Azithromycin is generally well tolerated. The most common side effects

are diarrhea or loose stools, nausea, abdominal pain, and vomiting which may occur
in fewer than one in twenty persons who receive azithromycin. Rare side effects
include abnormal liver tests, allergic reactions, and nervousness.

Nursing Management:

 Monitor I.V infusion site for thrombophlebitis

 Institute seizure precautions if the patient is receiving aztreonam or
imipenem and cilastatin
 Assess for cough or shortness of breath after pentamidine inhalation
therapy.
 Caution the patient to avoid alcohol when taking metronidazole to prevent
disulfiramlike reaction.
 Name of Drug: Ciprofloxacin

Action:

Ciprofloxacin is an antibiotic that is used to treat

bacterial infections. Ciprofloxacin belongs to the fluoroquinolone class of
antibiotics which
includes levofloxacin (Levaquin), ofloxacin (Floxin), gatifloxacin (Tequin),norfloxacin 
(Noroxin), moxifloxacin (Avelox), trovafloxacin (Trovan) and others. Ciprofloxacin
stops the multiplication of bacteria by inhibiting the reproduction and repair of
their genetic material (DNA).

Side effects:

The most frequent side effects of ciprofloxacin include nausea, vomiting,

diarrhea, abdominal pain, rash, headache, and restlessness. Rare allergic reactions
have been described, such as hives and anaphylaxis (shock). Ciprofloxacin should be
used with caution in patients with central nervous system diseases such as
seizures, because rare seizures have been reported in patients receiving
ciprofloxacin. Ciprofloxacin should be avoided in children and adolescents less than
18 years of age, as safe use in these patients has not been established.

Nursing Management:

 Instruct the patients to take drug with 8oz. of water.

 Teach the patient to use sunblock and protective clothing to prevent
photosensitivity reactions.
 Monitor renal functions
 Obtain urine for culture and sensitivity testing before starting drug
therapy.
 Name of Drug: Metronidazole

Action:

Metronidazole is an antibiotic effective against anaerobic bacteria and

certain parasites. Anaerobic bacteria are single-celled, living organisms that thrive
in environments in which there is little oxygen (anaerobic environments) and can
cause disease in the abdomen (bacterial peritonitis), liver (liver abscess), and pelvis
(abscess of the ovaries and the Fallopian tubes). Giardia lambliaand ameba are
intestinal parasites that can cause abdominal pain and diarrhea in infected
individuals. Trichomonas is a vaginal parasite that causes inflammation of the vagina
(vaginitis). Metronidazole selectively blocks some of the functions within the
bacterial cells and the parasites resulting in their death .

Side effects:

Metronidazole is a valuable antibiotic and is generally well tolerated with

appropriate use. Minor side effects include nausea, headaches, loss of appetite, a
metallic taste, and rarely a rash. Serious side effects of metronidazole are rare.
Serious side effects include seizures and damage of nerves resulting in numbness
and tingling of extremities (peripheral neuropathy). Metronidazole should be
stopped if these symptoms appear.

Nursing Management:

 Monitor I.V infusion site for thrombophlebitis

 Institute seizure precautions if the patient is receiving aztreonam or
imipenem and cilastatin
 Assess for cough or shortness of breath after pentamidine inhalation
therapy.
 Caution the patient to avoid alcohol when taking metronidazole to prevent
disulfiramlike reaction.
 Name of Drug: Atorvastatin

Action:

Atorvastatin is an oral drug that lowers the level ofcholesterol in the blood.
It belongs to a class of drugs referred to as statins, which
includes lovastatin (Mevacor), simvastatin, (Zocor), fluvastatin (Lescol),
and pravastatin(Pravachol). All statins, including atorvastatin, prevent the
production of cholesterol in the liver by blocking HMG-CoA reductase, an enzyme
that makes cholesterol. Statins reduce total cholesterol as well as LDL cholesterol
in blood. LDL cholesterol is believed to be the "bad" cholesterol that is primarily
responsible for the development of coronary artery disease. Reducing LDL
cholesterol levels retards progression and may even reverse coronary artery
disease. Atorvastatin also reduces the concentration of triglycerides in the blood
and raises the concentrations of HDL ("good") cholesterol. 

Side effects:

Atorvastatin is generally well-tolerated. Minor side effects

includeconstipation, diarrhea, fatigue, gas, heartburn, and headache. Atorvastatin
may cause liver and muscle damage. Serious liver damage caused by statins is rare.

Nursing Management:

 Know that drug therapy is initiated only after diet therapy has proven in
effective.
 Administer 1 hour before or 4 hours after bile sequestering drugs.
 Advise the patient to restrict alcohol intake.
 Monitor liver function tests frequently at the start of therapy and
periodically thereafter.
 Name of Drug: Amlodipine

Action:

Amlodipine belongs to a class of medications calledcalcium channel blockers.

These medications block the transport of calcium into the smooth muscle cells
lining the coronary arteries and other arteries of the body. Since calcium is
important in muscle contraction, blocking calcium transport relaxes artery muscles
and dilates coronary arteries and other arteries of the body. By relaxing coronary
arteries, amlodipine is useful in preventing chest pain (angina) resulting from
coronary artery spasm. Relaxing the muscles lining the arteries of the rest of the
body lowers the blood pressure, which reduces the burden on the heart as it pumps
blood to the body. Reducing heart burden lessens the heart muscle's demand for
oxygen, and further helps to prevent angina in patients with coronary artery
disease.

Side effects:

Side effects of amlodipine are generally mild and reversible. The two most
common side effects are headache and edema (swelling) of the lower extremities.
Less common side effects include dizziness, flushing, fatigue, nausea,
and palpitations.

Nursing Management:

 Withhold the dose and notify the practitioner if the patient’s systolic
pressure is less than 90mmHg or the heart rate is less than 60bpm.
 Monitor the patient for signs and symptoms of heart failure.
 Warn the patient not to stop the drug abruptly; gradually reducing the
dosage under practitioner’s supervision helps prevent rebound hypertension.
 Name of Drug: Telmisartan

Action:

Telmisartan is a member of a family of drugs

calledangiotensin receptor blockers (ARBs). ARBs block the ability of the chemical
angiotensin II to constrict or squeeze arteries and veins. As a result, the arteries
and veins enlarge and blood pressure falls. The reduced pressure in the arteries
also makes it easier for the heart to pump blood.

Side effects:

Like other angiotensin receptor blockers, telmisartan generally is well-

tolerated. The most common side effects have been headache (1 in 10
patients),dizziness (1 in 25), back pain (1 in 30), fatigue (1 in 30), and diarrhea (1 in
30).

Nursing Management:

 Alert the practitioner that patient is taking an ARB before surgery because
of potential complications from blocking the rennin-angiotensin system.
 Monitor the patient’s blood pressure carefully; additive therapy may be
required if drug doesn’t achieved desired levels.
 Instruct the patient to maintain fluid intake.
 Teach the patient ways to minimize orthostatic hypotension.
 Name of Drug:Erythromycin

Action:

Erythromycin belongs to the family of medicines

called antibiotics. Erythromycin ophthalmic preparations are used to treat
infections of the eye. They also may be used to prevent certain eye infections of
newborn babies, such as neonatal conjunctivitis and ophthalmia neonatorum. They
may be used with other medicines for some eye infections.

Side effects:

Serious side effects are not expected to occur during treatment with this
medication. Commonly, some eye burning, stinging, irritation, itching, redness,
blurred vision, or sensitivity to light may occur. This is not a complete list of side
effects and others may occur. Call your doctor for medical advice about side
effects.

Nursing Management:

 Assess the patient for signs and symptoms of eye disorders and adverse
effects.
 Wait at least 5 minutes before instilling a second medication, as prescribed,
if the patient is using more than one topical ophthalmic drug.
 Keep all eye medication sterile.
 Avoid skin or eye contact with the applicator.
 Name of Drug: Hepatitis B vaccine

Action:

This vaccine causes the body to produce

protective levels of hepatitis Bantibodies which will protect against infection from
hepatitis B virus. This vaccine is recommended for persons of all ages, especially
those at an increased risk of getting the infection. Those at an increased risk
include health care personnel; laboratory workers handling blood and patient
specimens; police, fire and emergency medical personnel who render first
aid treatment; hemophiliacs; household and intimate contacts of persons with
persistent hepatitis B infections; persons with multiple sex partners; homosexuals;
prostitutes; IV drug abusers; persons traveling to high risk areas.

Side effects:

This medication may cause irritation, redness, swelling, warmth, itching, bruising
or pain at the injection site. Other side effects include headache, weakness,
fatigue, sore throat, fever, nausea, dizziness, flu-like symptoms, general body
discomfort. If these symptoms continue or become bothersome, inform your
doctor. Notify your doctor if you experience any of the following after vaccination
with this medication: tingling of the hands or feet, trouble moving, stiffness,
skin rash, difficulty breathing, chest pain, vision problems.

Nursing Management:

 Additional doses may be required for individuals with a suppressed immune

system.
 Correct cold chain vaccine storage should be ensured.
 The injection site batch number and expiry date should be recorded in the
patient record.
 Name of Drug: Vitamin K

Action:

Phytonadione is a man-made form of vitamin K. Phytonadione is important in

the production of substances that cause the blood to clot. Phytonadione is used to
treat vitamin K deficiency and to treat certain bleeding or blood clotting problems.

Side effects:

An allergic reaction (difficulty breathing; closing of the throat; swelling of

the lips, tongue, or face; or hives); dizziness; fast or irregular heartbeats; or
increased sweating. Other less serious side effects may be more likely to occur.
Continue to use phytonadione and talk to your doctor if you experience flushing of
the face; an unusual taste in the mouth; or pain or irritation at the injection site
(injectable form).

Nursing Management:

 Monitor for frank and occult bleeding.

 Monitor cardiac rate frequently.
 Notify physician immediately if symptoms of internal bleeding or
hypovolemic shock develop.
 Inform all personnel of patient’s bleeding tendency to prevent further
trauma.