DRUG STUDY

Name of Classification Dose Mechanism Indication Contraindication Adverse Effects Nursing Responsibility
Drug
Cefuroxime Antibiotics 500mg Inhibits cell-wall ➤ To provide Hypersensitivity to CNS: Chills, fever, headache, •Use cefuroxime cautiously in
IV every synthesis, perioperative cephalosporins or seizures patients hypersensitive to penicillin
8 hours promoting prophylaxis their CV: Edema because crosssensitivity has occurred
ANST osmotic ➤ To treat components EENT: Hearing loss, oral in about 10% of such patients.
instability; moderate candidiasis
usually infections GI: Abdominal cramps, diarrhea, •If possible, obtain culture and
bactericidal. elevated liver function test sensitivity results, as ordered, before
results, hepatic failure, giving drug.
hepatomegaly, nausea,

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pseudomembranous colitis, •Give oral form with food to decrease

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vomiting GI distress, as needed.
GU: Elevated BUN level,

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nephrotoxicity, renal failure, •Remember that oral forms—tablets
vaginal candidiasis and suspension—aren’t

e
HEME: Eosinophilia, hemolytic bioequivalent.

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anemia, hypoprothrombinemia,
neutropenia, thrombocytopenia, •For I.V. use, reconstitute using

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unusual bleeding MS: Arthralgia manufacturer’s instructions according
RESP: Dyspnea to type of preparation available.

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SKIN: Ecchymosis, erythema, Solution ranges in color from light
erythema multiforme, pruritus, yellow to amber.

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rash, Stevens-Johnson syndrome
Other: Anaphylaxis; injection- •For I.M. use, add 3 or 3.6 ml sterile
site edema, pain, and redness; water for injection to each 750-mg
m e superinfection vial to yield 220 mg/ml.
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•If using a container of frozen
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parenteral solution, thaw at room
temperature or under refrigeration
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before administration; make sure all

ice crystals have melted. Don’t force
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 thawing by microwaving.

•Store reconstituted parenteral drug

for up to 24 hours at room
temperature or 96 hours in
refrigerator. (Thawed solutions may
be stable 24 hours at room
temperature or 28 days if
refrigerated.) Store reconstituted oral
suspension in refrigerator or at room
temperature up to 10 days.

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•Give I.V. injection over 3 to 5
minutes through tubing of a flowing

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compatible I.V. fluid.

e
•Monitor I.V. site for extravasation

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and phlebitis.

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•Monitor BUN and serum creatinine
levels and fluid intake and output to

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detect signs of nephrotoxicity.
Monitor patients with renal

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impairment closely because they may
have greater toxic reactions to
cefuroxime.
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•Monitor patient for allergic reactions
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continuing up to a few days after
therapy starts. Patients with a history
of some form of allergy, especially to
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drugs, are at increased risk for an

allergic reaction.
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DRUG STUDY

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Name of Classification Dose Mechanism Indication Contraindication Adverse Effects Nursing Responsibility
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Drug
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 Diclofenac Analgesic, 500mg Blocks the activity of To relieve Active GI bleeding or CNS: Aseptic meningitis, •Use diclofenac with extreme
anti- IM cyclooxygenase, the pain and ulcers; asthma attacks, cerebral hemorrhage, CVA, caution and for shortest
inflammatory every 6 enzyme needed to inflammation rhinitis, or urticaria from dizziness, drowsiness, possible time in patients with a
hours synthesize aspirin or other NSAIDs; headache history of GI bleeding or ulcer
for pain prostaglandins, which hypersensitivity to CV: Bradycardia and other disease because NSAIDs
mediate inflammatory diclofenac or NSAIDs; arrhythmias, hypotension, increase risk of GI bleeding
response and cause treatment of perioperative MI, thrombotic events, and ulceration.
local pain, swelling, and pain after coronary artery vasculitis
vasodilation bypass grafting EENT: Glaucoma, hearing •Don’t substitute one form of
loss, tinnitus ENDO: oral diclofenac for another.
Hypoglycemia Different formulations aren’t

a
GI: Abdominal pain, bioequivalent.

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constipation, diarrhea,
dysphagia, elevated liver •Be aware that serious GI tract

d
function test results, ulceration and bleeding, as

e
esophageal ulceration, well as perforation of stomach
flatulence, GI bleeding or or intestine, can occur without

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ulceration, hepatic failure, warning or symptoms. Elderly

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hepatitis, indigestion, patients are at greater risk.
jaundice, nausea, perforation Monitor patient for signs of GI
of stomach or intestine irritation and ulceration,

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GU: Acute renal failure, especially if patient has a
interstitial nephritis predisposing condition (such

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HEME: Agranulocytosis, as a history of GI bleeding);
aplastic anemia, takes an oral corticosteroid,
eosinophilia, leukocytosis, anticoagulant, or NSAID
m e leukopenia, pancytopenia, (long-term); smokes; is an
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porphyria, thrombocytopenia alcoholic; is over age 60; has
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SKIN: Erythema poor general health; or tests
multiforme, exfoliative positive for Helicobacter
dermatitis, pruritus, rash, pylori. To minimize risk, give
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Stevens-Johnson syndrome, diclofenac with food. If patient

toxic epidermal necrolysis develops GI distress, withhold
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 Other: Anaphylaxis, drug and notify prescriber
angioedema, fluid retention, immediately.
hyperkalemia,
hyperuricemia, •Use diclofenac cautiously in
hyponatremia, patients with hypertension,
lymphadenopathy and monitor blood pressure
closely; drug can cause or
worsen hypertension.

•Assess patient for

hypotension. If patient takes a

a
potassium-sparing diuretic,

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check for elevated serum
potassium level.

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