DRUG TABULATION

Name of Drug and Classification Mechanism Indication Adverse Reaction Contraindication Nursing Responsibilities
Dosage of Action
Generic: Antihypertensive Unclear. - Acute pulmonary Adverse reactions  Hypersensitivit 1. Observe 12 Rights of
FUROSEMIDE , Thought to edema CNS: dizziness, y to drug or drug administration.
40mg/tab Diuretics inhibit sodium - Edema caused by headache, vertigo, other 2. Watch for signs and
1/2 tab BID and chloride heart failure. weakness, lethargy, sulfonamides symptoms of ototoxicity.
reabsorption - Hypertension paresthesia,  Anuria 3. Assess for other
from drowsiness, evidence of drug toxicity
ascending loop restlessness, light- (arrhythmias, renal
of Henle and headedness dysfunction, abdominal
distal CV: hypotension, pain, sore throat, fever).
renal tubules. orthostatic 4. Monitor CBC, BUN, and
Increases hypotension, electrolyte, uric acid, and
potassium tachycardia, volume CO2 levels.
excretion and depletion, 5. Monitor blood pressure,
plasma necrotizing angiitis, pulse, fluid intake and
volume, thrombophlebitis, output, and weight.
promoting arrhythmias 6. Assess blood glucose
renal excretion EENT: blurred vision, levels in patients with
of water, xanthopsia, diabetes mellitus.
sodium, hearing loss, tinnitus 7. Monitor dietary
chloride, GI: nausea, vomiting, potassium intake.
magnesium, diarrhea, 8. Watch for signs and
hydrogen, and constipation, symptoms of
calcium dyspepsia, oral and hypokalemia.
gastric Patient teaching
irritation, cramping, 9. Instruct patient to take
anorexia, dry in morning with food
mouth, acute (and second dose, if
pancreatitis prescribed, in
GU: excessive and afternoon), to prevent
frequent urination, nocturia.
nocturia, glycosuria, 10. Tell patient that drug
bladder spasm, may cause serious
oliguria, interstitial interactions with many
nephritis common drugs.
Hematologic: anemia, 11. Instruct him to tell all
purpura, leukopenia, prescribers he’s taking it.
thrombocytopenia, 12. Instruct patient to report
hemolytic signs and symptoms of
anemia ototoxicity (hearing loss,
Hepatic: jaundice ringing in ears, vertigo)
Metabolic: and other drug toxicities.
hyperglycemia, 13. Caution patient to avoid
hyperuricemia, driving and other
dehydration, hazardous activities until
hypokalemia, he knows how drug
hypomagnesemia, affects concentration
hypocalcemia, and alertness.
hypochloremic 14. Instruct patient to move
alkalosis slowly when rising, to
Musculoskeletal: avoid dizziness from
muscle pain,muscle sudden blood pressure
cramps decrease.
Skin: photosensitivity, 15. Encourage patient to
rash, diaphoresis, discuss need for
urticaria, pruritus, potassium and
exfoliative dermatitis, magnesium supplements
erythema multiforme with prescriber.
Other: fever, transient 16. Caution patient to avoid
pain at I.M. alcohol and herbs while
injection site taking this drug.
17. Inform patient that he’ll
undergo regular blood
testing during therapy.
18. As appropriate, review
 all other significant and
life-threatening adverse
reactions and
interactions, especially
those related to the
drugs, tests, herbs, and
behaviors mentioned
above.
Generic: Digoxin Inotropic, Increases Heart failure; CNS: fatigue, ● Hypersensitivity to 1. Observe 12 Rights of
antiarrhythmic force and tachyarrhythmias; headache, asthenia drug Drug Administration
Brand name: velocity of atrial fibrillation and CV: bradycardia, ECG ● Uncontrolled 2. Assess apical pulse
LANOXIN myocardial flutter; paroxysmal changes, ventricular regularly for 1 full
contraction atrial tachycardia arrhythmias arrhythmias minute. If rate is less
0.25mg/tab 1/2 tab and prolongs EENT: blurred or ● AV block than 60 beats/minute,
BID refractory yellow vision ● Idiopathic withhold dose and notify
period of GI: nausea, vomiting, hypertrophic subaortic prescriber
atrioventricula diarrhea stenosis 3. Monitor for signs and
r (AV) GU: gynecomastia ● Constrictive symptoms of drug
node by Hematologic: pericarditis toxicity (such as nausea,
increasing thrombocytopenia vomiting, visual
calcium entry Other: decreased disturbances,
into appetite arrhythmias, and altered
myocardial mental status).
cells. Slows 4. Be aware that
conduction therapeutic digoxin
through levels range from 0.5 to
sinoatrial and 2 ng/ml.
AV nodes and 5. Monitor ECG and blood
produces levels of digoxin,
antiarrhythmic potassium, magnesium,
effect. calcium, and creatinine.
6. Stay alert for
hypocalcemia. Know that
this condition may
 predispose patient to
digoxin toxicity and may
decrease digoxin
efficacy.
7. Watch closely for
hypokalemia and
hypomagnesemia. Know
that digoxin toxicity may
occur with these
conditions despite
digoxin blood levels
below 2 ng/ml.

Patient teaching
8. Tell patient to take drug
at same time every day.
9. Instruct patient not to
stop drug abruptly.
10. Instruct patient not to
take over-the counter
drugs without
prescriber’s approval.
11. Teach patient how to
recognize and report
signs and symptoms of
digoxin toxicity.
12. Stress importance of
follow-up testing as
directed by prescriber.
13. As appropriate, review
all other significant and
life-threatening adverse
reactions and
interactions, especially
 those related to the
drugs, tests, foods, and
herbs mentioned above.
Spinorolactone Potassium- Inhibits - Edema caused by CNS: headache,  Anuria, acute 1. Observe 12 Rights of
25mg/tab 1/2 tab sparing aldosterone heart failure, drowsiness, lethargy, renal Drug Administration.
BID diuretic effects in distal hepatic cirrhosis, ataxia, confusion insufficiency, 2. Monitor electrolyte
renal tubule, or nephrotic GI: vomiting, diarrhea, significant levels (especially
promoting syndrome. cramping, gastritis, impairment of potassium),
sodium and - Essential GI ulcers, GI bleeding renal excretory particularly in
water hypertension GU: gynecomastia, function patients with severe
excretion and - Hypokalemia irregular menses or  Hyperkalemia heart failure.
potassium - Diagnosis and amenorrhea, 3. Watch for signs and
retention treatment of postmenopausal symptoms of
primary bleeding, imbalances and
hyperaldosteronis erectile dysfunction, metabolic acidosis.
m breast cancer 4. Interrupt or
Hematologic: discontinue
agranulocytosis treatment for serum
Metabolic: potassium level
hyponatremia, greater than 5 mEq/L
hyperchloremic or serum creatinine
metabolic acidosis, greater than 4
hyperkalemia mg/dl.
Skin: rash, pruritus, 5. Monitor weight and
hirsutism, drug fluid intake and
rash with eosinophilia output.
and systemic 6. Stay alert for
symptoms (DRESS), indications of fluid
Stevens-Johnson imbalance.
Syndrome, toxic 7. Monitor CBC with
epidermal necrolysis white cell
Other: deepening of differential.
voice, drug fever, Patient teaching
hypersensitivity 8. Tell patient to take
(including vasculitis, daily dose with
anaphylactic breakfast. If two
reactions) daily doses are
prescribed, advise
him to take second
dose with food in
mid-afternoon.
9. Advise patient to
restrict intake of
high-potassium
foods and to avoid
licorice and salt
substitutes
containing
potassium.
10. Tell male patient
drug may cause
breast enlargement.
11. Caution patient to
avoid driving and
other hazardous
activities until he
knows how drug
affect concentration
and alertness.
12. As appropriate,
review all other
significant and life-
threatening adverse
reactions and
interactions,
especially those
related to the drugs,
tests, foods, and
 herbs mentioned
above.
Cefepime 2gms IV Antibiotic, Anti- Interferes with - Urinary tract CNS: Chills, coma, Hypersensitivity to 1. Observe 12 Rights of
Q8H ANST infective bacterial cell infection caused by confusion, fever, cephalosporins or Drug administration.
wall synthesis Escherichia coli, hallucinations, penicillin 2. Assess baseline CBC and
by inhibiting Klebsiella headache, myoclonus, kidney and liver function
the final step pneumoniae, and seizures, stupor test results.
in the Proteus mirabilis. CV: Edema 3. Monitor for signs and
crosslinking - Moderate to EENT: Hearing loss symptoms of
of severe skin GI: Abdominal superinfection and other
peptidoglycan infection caused by cramps, diarrhea, serious adverse
strands. Staphylococcus elevated reactions.
Peptidoglycan aureus or liver function test 4. Monitor for
makes cell Streptococcus results, hepatic inflammation at infusion
membranes pyogenes. failure, site.
rigid and - Febrile hepatomegaly, 5. Be aware that cross-
protective. neutropenia nausea, oral sensitivity to penicillins
Without it, - Complicated intra- candidiasis, may occur.
bacterial cells abdominal pseudomembranous Patient teaching
rupture infection caused by colitis, vomiting 6. Instruct patient to report
and die. E.col, K. GU: Elevated BUN reduced urinary output,
Pneumoniae, level, nephrotoxicity, persistent diarrhea,
Pseudomonas renal failure, vaginal bruising, petechiae, or
aeruginosa, candidiasis bleeding.
Enterobacter HEME: Eosinophilia, 7. Caution patient not to
species, or hemolytic anemia, take herbs without
Bacteroids fragilis. hypoprothrombinemi consulting prescriber.
- Moderate to a, neutropenia,
severe pneumonia thrombocytopenia,
caused by unusual bleeding
K.pneumoniae, P. MS: Arthralgia
aeruginosa, RESP: Dyspnea
Enterobacter SKIN: Ecchymosis,
species, or erythema, erythema
 Streptococcus multiforme, pruritus,
pneumoniae. rash, Stevens-Johnson
syndrome
Other: Anaphylaxis;
injection site pain,
redness,
and swelling;
superinfection
FLUCONAZOLE Systemic Alters cellular - To treat oral and CNS: Chills, dizziness, ● Hypersensitivity 1. Observe 12
150mg/cap 1 cap OD Antifungal membrane, esophageal drowsiness, fever, to drug or its Rights of drug
increasing candidiasis. headache, seizures components administration.
permeability - To treat systemic CV: Prolonged QT ● Concurrent use 2. Stay alert for
and leakage of candidiasis interval, torsades de of terfenadine (not signs and
essential - To treat pointes available in U.S.) in symptoms of
elements cryptococcal GI: Abdominal pain, patients receiving anaphylaxis.
needed for meningitis anorexia, fluconazole at Stop drug
fungal growth. - To prevent constipation, multiple doses of immediately if
At candidiasis after diarrhea, hepatic 400 these occur.
higher bone marrow failure, nausea, mg or higher and 3. Monitor liver
concentrations transplantation. vomiting other drugs known function test
, may be - To treat vaginal HEME: to prolong QT results and
fungicidal. candidiasis. Agranulocytosis, interval and that hematologic
leukopenia, are studies;
thrombocytopenia metabolized via discontinue drug
SKIN: Exfoliative CYP3A4, such as if clinical signs
dermatitis, cisapride, and symptoms
photosensitivity, astemizole (not consistent with
pruritus, rash available in liver disease
Other: Anaphylaxis, U.S.), pimozide, develop that
angioedema and quinidine may be
attributable to
fluconazole.
4. Assess for rash;
if lesions
 develop, monitor
patient. Stop
drug and notify
prescriber if
lesions progress
(may signal
Stevens-Johnson
syndrome).
5. Be aware that
patients with
human
immunodeficien
cy virus have
greater risk of
adverse
reactions.
Patient teaching
6. Teach patient
how to recognize
and immediately
report signs and
symptoms of
allergic
response.
7. Urge patient to
contact
prescriber if rash
occurs, to
determine
whether
Stevens-Johnson
syndrome is
developing.
8. Caution patient
 to avoid driving
and other
hazardous
activities until he
knows how drug
affects
concentration
and alertness.
9. Advise patient to
minimize GI
upset by eating
frequent, small
servings of food
and drinking
adequate fluids.
10. Tell female
patient to inform
prescriber if she
is pregnant or
breastfeeding.
NGSTATIN Antifungal Probably binds - Intestinal GI: transient nausea, • Contraindicated 1. Observe 12 Rights of
SUSPENSION 5mL to sterols in candidiasis vomiting, diarrhea, GI in patients Drug administration.
QID fungal cell - Mycotic infections upset. GU: irritation, hypersensitive to 2. Monitor patient for
membrane, - Oral candidiasis sensitization, drug. rash.
altering cell vulvovaginal • Rarely, SJS has 3. Avoid skin contact
permeability burning (vaginal been reported. when applying.
and allowing form). Skin: rash. • Don't use topical PATIENT TEACHING
leakage of powder for the 4. Advise patient to
intracellular treatment of continue taking drug
components. systemic, oral, for at least 2 days
intravaginal, or after signs and
ophthalmic symptoms resolve.
infections. 5. Advise patient to
report redness,
 swelling, or irritation
in the mouth
6. Tell patient that
overusing
mouthwash or
wearing poorly
fitting dentures may
promote infection.
DILOXANIDE Amebicides, Unknown. Diloxanide is used alone as Flatulence, anorexia, Known 1. Observe 12 Rights of
FUROATE Anti-infective May inhibit a primary agent in the nausea, vomiting, hypersensitivity to Drug administration.
125mg/5ml. 15mL agents, protein treatment of asymptomatic pruritus, urticaria. diloxanide furoate 2. Instruct the patient
TID Antiparasitic synthesis. (cyst passers) intestinal is a to finish the entire
amebiasis caused by contraindication course of
Entamoeba histolytica. for use. medication.
Diloxanide may also be Pregnant women, 3. Instruct patient to
used concurrently, or breasfeeding. report undesirable
sequentially, with other side effects.
agents such as the 4. Instruct patient to
nitroimidazoles (eg. drink adequate
metronidazole) in the amount of fluids to
treatment of invasive or reduce kidney
extraintestinal forms of injuries.
amebiasis.
PARACETAMOL Nonopiod May block Mild to moderate pain or GI: Nausea, vomiting, Hypersensitivity to 1. Observe 12 Rights of
500mg/tab Q4H PRN analgesics pain impulses fever; arthralgia, dental abdominal pain; acetaminophen, drug administration.
for fever peripherally pain, dysmenorrhea, hepatotoxicity, severe hepatic 2. If given for analgesia,
that occur in headache, myalgia, hepatic seizure impairment assess onset, type,
response to osteoarthritis. (overdose), GI or severe active location, duration of
inhibition of bleeding. liver disease. pain. Effect of
prostaglandin GU: Renal failure medication is
synthesis; (high, prolonged reduced if full pain
does not doses) response recurs prior
possess anti- Hema: to next dose.
inflammatory 3. Assess for clinical
 properties; improvement and
antipyretic relief of pain, fever.
action results PATIENT/FAMILY TEACHING
from inhibition 4. Consult physician for
of use in children
prostaglandins younger than 2 yrs,
in the CNS oral use longer than
(hypothalamic 5 days (children) or
heat- longer than 10 days
regulating (adults), or fever
center) lasting longer than 3
Days.
Severe/recurrent
pain or high/
continuous fever
may indicate serious
illness.
5. Do not take more
than 4 g/day (3
g/day if using OTC
[over-the counter]).
6. Avoid alcohol.
METRONIDAZOLE Antibacterial, Diffuses into - To treat systemic Frequent: Systemic: Breast-feeding, 1. Observe 12 Rights of
(Rodazid) 500mg IV antiprotozoal, organism, anaerobic Anorexia, nausea, dry hypersensitivity to drug administration.
ANST amebicide. interacting infections caused mouth, metallic taste. metronidazole 2. Obtain baseline CBC,
with by Bacteroides Vaginal: Symptomatic or its components, LFT. Question for
DNA causing a fragilis, Clostridium cervicitis/vaginitis, trichomoniasis history of
loss of helical difficile, abdominal during first hypersensitivity to
DNA structure Clostridium cramps, uterine pain. trimester of metronidazole, other
and strand perfringens, Occasional: Systemic: pregnancy nitroimidazole
breakage, Eubacterium, Diarrhea, derivatives (and
inhibiting Fusobacterium, constipation, parabens with
protein Peptococcus, vomiting, topical).
synthesis. Peptostreptococcu dizziness, 3. Obtain specimens for
 s, and Veillonella erythematous rash, diagnostic tests,
species. urticaria, cultures before
- To treat amebiasis, reddish-brown urine. giving first dose
trichomoniasis. Topical: Transient (therapy may begin
- Prevent erythema, mild before results are
perioperative dryness, burning, known).
bowel infection. irritation, stinging, 4. Monitor daily
- Treat acne in tearing when applied pattern of bowel
patient with too close to eyes. activity, stool
rosacea. Vaginal: Vaginal consistency.
- To treat bacterial perineal, vulvar 5. Monitor I&O, assess
vaginosis. itching; vulvar for urinary problems.
swelling. 6. Be alert to
Rare: Mild, transient neurologic
leukopenia; symptoms (dizziness,
thrombophlebitis paresthesia of
with IV therapy. extremities).
7. Assess for rash,
Oral therapy may urticaria.
result in furry tongue, 8. Monitor for onset of
glossitis, cystitis, superinfection
dysuria, pancreatitis. (ulceration/ change
Peripheral neuropathy of oral mucosa, furry
(manifested as tongue, vaginal
numbness, tingling of discharge,
hands/feet) usually genital/anal
is reversible if pruritus).
treatment is stopped PATIENT/FAMILY TEACHING
immediately 9. Urine may be red-
upon appearance of brown or dark.
neurologic 10. Avoid alcohol,
symptoms. Seizures alcohol-containing
occur occasionally. preparations (cough
syrups, elixirs) for at
 least 48 hrs after last
dose.
11. Avoid tasks that
require alertness,
motor skills until
response to drug is
established.
12. If taking
13. metroNIDAZOLE for
trichomoniasis,
refrain from sexual
intercourse until full
treatment is
completed.
14. For amebiasis,
frequent stool
specimen checks will
be necessary.
15. Topical: Avoid
contact with eyes.
16. May apply cosmetics
after application.
17. for rosacea include
avoidance of
hot/spicy foods,
alcohol, extremes of
hot/cold
temperatures,
excessive sunlight.
GENTAMICIN 75mg Antibiotic Interferes with - To treat serious CNS: Acute organic Hypersensitivity or 1. Observe 12 rights of
IV Q8h bacterial bacterial infections mental syndrome, serious toxic drug administration.
protein caused by aerobic confusion, reaction to 2. Dehydration must be
synthesis. gram-negative depression, fever, other treated before
Binds to 30S organisms headache, aminoglycosides, beginning
ribosomal and some gram- increased protein in hypersensitivity to parenteral therapy.
subunit, positive organisms, cerebrospinal fluid, gentamicin or its 3. Establish baseline
causing a including lethargy, myasthenia components hearing acuity.
defective cell Citrobacter gravis–like syndrome, Question for history
membrane. species, neurotoxicity of allergies,
Enterobacter (dizziness, hearing esp.
species, loss, tinnitus, aminoglycosides,
Escherichia coli, vertigo), peripheral sulfites (parabens
Klebsiella species, neuropathy or for
Proteus species, encephalopathy topical/ophthalmic
Pseudomonas (muscle twitching, routes).
aeruginosa, numbness, 4. Screen for risk of
Serratia seizures, skin tingling), acute kidney injury,
species, pseudotumor esp. pts at risk for
Staphylococcus cerebri renal failure
aureus, and CV: Hypertension, (baseline renal
many strains of hypotension, insufficiency, elderly,
Streptococcus palpitations HF, hypertension,
species EENT: Blurred vision, septic shock).
- To treat increased salivation, 5. Monitor I&O
uncomplicated UTI. laryngeal edema, (maintain hydration),
ototoxicity, stomatitis, urinalysis, BUN,
vision changes creatinine.
GI: Anorexia, nausea, 6. Be alert to ototoxic,
splenomegaly, neurotoxic
transient symptoms (see
hepatomegaly, Adverse
vomiting Effects/Toxic
GU: Nephrotoxicity Reactions).
HEME: Anemia, 7. Check IM injection
eosinophilia, site for induration.
granulocytopenia, 8. Evaluate IV site
increased or for phlebitis (heat,
decreased pain, red streaking
 reticulocyte over vein).
count, leukopenia, 9. Assess for rash
thrombocytopenia (Ophthalmic:
MS: Arthralgia, leg redness, burning,
cramps itching, tearing).
RESP: Pulmonary 10. Be alert for
fibrosis, respiratory superinfection
depression (genital/anal
SKIN: Alopecia, pruritus, changes in
generalized burning oral mucosa,
sensation, diarrhea).
pruritus, purpura, PATIENT/FAMILY TEACHING
rash, urticaria 11. Discomfort may
Other: Anaphylaxis, occur with IM
injection site pain, injection.
superinfection, weight 12. Blurred vision,
loss tearing may occur
13. briefly after each
ophthalmic
dose.
14. Report any hearing,
visual, balance,
urinary problems,
even after therapy
is completed.
Ophthalmic: Report
if tearing, redness,
irritation
continues.
Amoxicillin/ Antibiotic Amoxicillin - Treatment of Occasional (9%–4%): Hypersensitivity to 1. Observe 12 Rights of
Clavonate inhibits susceptible Diarrhea, loose amoxicillin or its Drug administration.
CO-AMOXICLAV bacterial cell infections due stools, nausea, skin components 2. Question for history
625mg/tab wall to streptococci, E. rashes, urticaria. Rare of allergies, esp.
1tab BID synthesis by coli, E. faecalis, (less than 3%): penicillins,
binding to P. mirabilis, beta- Vomiting, vaginitis, cephalosporins,
PCN-binding lactamase abdominal renal impairment.
proteins. producing discomfort, flatulence, 3. Promptly report
Clavulanate H. influenzae, headache. rash, diarrhea (fever,
inhibits Klebsiella spp., M. abdominal
bacterial catarrhalis, and S. Antibiotic-associated pain, mucus and
beta- aureus (not colitis, other blood in stool
lactamase methicillin- superinfections may indicate
protecting resistant (abdominal cramps, antibiotic-associated
amoxicillin Staphylococcus severe watery colitis).
from aureus diarrhea, fever) may 4. Be alert for signs of
degradation. [MRSA]), including result from altered superinfection,
lower respiratory, bacterial balance in GI including
skin and skin tract. Severe fever, vomiting,
structure, UTIs, hypersensitivity diarrhea, black
otitis media, reactions, including “hairy”
sinusitis. anaphylaxis, tongue, ulceration or
acute interstitial changes of oral
nephritis, occur rarely. mucosa,
anal/genital pruritus
5. Monitor renal/
hepatic tests with
prolonged therapy.
PATIENT/FAMILY TEACHING
6. Continue antibiotic
for full length of
treatment.
7. Space doses evenly.
8. Take with meals if GI
upset occurs
9. Thoroughly
crush or chew the
chewable tablets
before swallowing.
 10. Notify physician if
rash, diarrhea, other
new symptoms
occurs.
CIPROFLOXACIN Antibiotic Inhibits - Treatment of Frequent (5%–2%): Hypersensitivity to 1. Observe 12 rights of
500mg/tab enzyme, DNA susceptible Nausea, dyspepsia, ciprofloxacin, drug administration.
1/2 tab BID gyrase, in infections due to E. vomiting, other quinolones. 2. Question for history
susceptible coli, K. constipation, Concurrent of hypersensitivity
bacteria, pneumoniae, E. flatulence, use of tiZANidine to ciprofloxacin,
interfering cloacae, confusion, crystalluria. quinolones;
with bacterial P. mirabilis, P. Ophthalmic: myasthenia
cell vulgaris, P. Burning, crusting in gravis, renal/hepatic
replication. aeruginosa, corner of eye. impairment.
H. influenzae, M. Occasional (less than 3. Obtain urinalysis for
catarrhalis, S. 2%): Abdominal microscopic analysis
pneumoniae, pain/discomfort, for crystalluria prior
S. aureus headache, rash. to and during
(methicillin Ophthalmic: treatment.
susceptible), Altered taste, 4. Encourage hydration
S. epidermidis, S. sensation of foreign (reduces risk of
pyogenes, C. body in eye, eyelid crystalluria).
jejuni, Shigella redness, itching. 5. Monitor for
spp., S. typhi Rare (less than 1%): dizziness, headache,
including Dizziness, confusion, visual changes,
intra-abdominal, tremors, tremors.
bone, joint, lower hallucinations, 6. Assess for chest,
respiratory hypersensitivity joint pain.
tract, skin/skin reaction, 7. Ophthalmic: Observe
structure insomnia, dry mouth, therapeutic
infections; paresthesia. response.
UTIs, infectious PATIENT/FAMILY TEACHING
diarrhea, Superinfection (esp. 8. Do not skip doses;
prostatitis, enterococcal, fungal), take full course of
sinusitis, nephropathy, therapy.
 typhoid fever, cardiopulmonary 9. Do not take antacids
febrile arrest, cerebral within 2 hrs of
neutropenia. thrombosis may ciprofloxac
- Ophthalmic: occur. (reduces/destroys
Treatment of Hypersensitivity effectiveness). •
superficial reaction (rash, 10. Shake suspension
ocular infections. pruritus, well before using; do
- Otic: Treatment of blisters, edema, not chew
acute otitis externa burning skin), microcapsules in
due to susceptible photosensitivity suspension.
strains of have occurred. 11. Sugarless gum, hard
P. aeruginosa or S. Sensitization candy may relieve
aureus to ophthalmic form bad taste.
may contraindicate 12. Avoid caffeine. 13.
later systemic use of Report tendon pain
ciprofloxacin. May or swelling.
exacerbate muscle 13. Avoid exposure to
weakness in pts with sunlight/artificial
myasthenia gravis. light (may cause
Dermatologic photosensitivity
conditions reaction).
such as toxic 14. Report persistent
epidermal necrolysis, diarrhea.
Stevens-Johnson
syndrome have been
reported. Cases of
severe hepatotoxicity
have occurred. May
increase risk of
tendonitis,
tendon rupture.
MERCAPTOPURINE Antineoplastic Inhibits RNA - Acute CNS: malaise. GI: Contraindicated in 1. Observe 12 Rights of
50mg/tab and DNA lymphoblastic nausea, vomiting, patients resistant drug administration.
1/2 tab daily synthesis. leukemia as part of anorexia, painful oral or hypersensitive 2. Monitor CBC and
 a combination ulcers, diarrhea, to drug. transaminase,
regimen. pancreatitis, GI alkaline
- Acute ulceration. phosphatase, and
promyelocytic Hematologic: bilirubin levels
leukemia, leukopenia, weekly during
maitenance. thrombocytopenia, induction and
anemia, monthly during
myelosuppression. maintenance to
Hepatic: jaundice, monitor ANC,
hepatotoxicity, platelet count, and
hepatic necrosis. hepatic function
Metabolic: to ensure sufficient
hyperuricemia. Skin: drug exposure and
rash, to adjust for
hyperpigmentation, excessive toxicity.
alopecia, urticaria. 3. Leukopenia,
thrombocytopenia,
or anemia may
persist for several
days after drug is
stopped.
4. Watch for signs of
bleeding and
infection.
5. Alert: Watch for
jaundice, clay-
colored stools, and
frothy, dark urine.
Hepatic dysfunction
is reversible when
drug is stopped. If
right-sided
abdominal
tenderness occurs,
 stop drug and notify
prescriber.
6. Anticipate need for
blood transfusions
because of
cumulative anemia.
PATIENT TEACHING
7. Educate patient or
caregivers on proper
handling, storage,
administration, and
disposal of drug
and how to clean up
accidental spillage of
the solution.
8. Instruct patient to
watch for signs and
symptoms of
infection (fever, sore
throat, fatigue) and
bleeding (easy
bruising, nosebleeds,
bleeding gums, tarry
stools). Tell patient
to take temperature
daily.
9. Advise patient to
avoid dental work
until blood counts
have returned to
normal.
10. Caution female
patient of
childbearing
 potential to consult
prescriber before
becoming
pregnant.
11. Advise female
patient to stop
breastfeeding during
therapy because of
risk of toxicity to
infant.