DRUG STUDY

BRAND NAME GENERIC NAME INDICATION CONTRAINDICATION DOSAGE CLASSIFICATION NURSING

INTERVENTION/RESPONSIBILITIES
Augmentin Amoxicillin/ Treatment of a Contraindicated in: Adult usual Aminopenicillins/beta  Look alike–sound alike:
clavulanate variety Hypersensitivity to dosage: lactamase inhibitors Don't confuse amoxicillin
of infections penicillins or 250 mg/125 mg- with amoxapine or
including: Skin and clavulanate; 500 mg/125 mg q Azulfidine
skin structure Suspension and 8 hours.  Assess for infection (vital
infections, Otitis chewable tablets Pedia dosage: signs; appearance of wound,
media, Sinusitis, contain aspartame Depends on sputum, urine, and stool;
Respiratory tract and should be Pediatrician WBC) at beginning of and
infections, avoided in throughout therapy.
Genitourinary tract phenylketonurics;  Observe for signs and
infections. History of symptoms of anaphylaxis
amoxicillin/clavulana (rash, pruritus, laryngeal
te-associated edema, wheezing). Notify
cholestatic jaundice. health care
professional immediately if
these occur.
 Monitor bowel function.
Diarrhea, abdominal
cramping, fever, and bloody
stools should be reported to
health care professional
promptly as a sign of
Clostridium difficile-
associated diarrhea (CDAD).
May begin up to several
week following cessation of
therapy.
 PO: Administer around the
clock. Administer at the start
 of a meal to enhance
absorption and to decrease
GI side effects. Do not
administer with high fat
meals; clavulanate
absorption is decreased. XR
tablet is scored and can be
broken for ease of
administration. Capsule
contents may be emptied
and swallowed with liquids.
Chewable tablets should be
crushed or chewed before
swallowing with liquids.
Shake oral suspension
before administering.
Refrigerated reconstituted
suspension should be
discarded after 10 days.
 Alert: Ratios of amoxicillin
and clavulanic acid aren't
consistent from product to
product. Therefore,
formulations aren't
equivalent. For example,
don't substitute two 250-mg
tablets for one 500-mg
tablet or substitute one 250-
mg film-coated tablet for
one 250-mgchewable tablet.
Each Augmentin XR tablet
contains 29.3 mg (1.27 mEq)
of sodium and 13 mg of
potassium (0.33 mEq).
  Advise patient to report the
signs of superinfection (furry
overgrowth on the tongue,
vaginal itching or discharge,
loose or foul-smelling stools)
and allergy.
 Instruct patient to notify
health care professional
immediately if diarrhea,
abdominal cramping, fever,
or bloody stools occur and
not to treat with
antidiarrheals without
consulting health care
professionals
 Instruct the patient to notify
health care professional if
symptoms do not improve or
if nausea or diarrhea persists
when drug is administered
with food.
 Continue antibiotic for full
length of treatment

Norvasc Amlodipine -Angina pectoris due -Contraindicated Tablet – 2.5, 5, Antianginal  Monitor patient carefully
to coronary artery with allergy to 10mg Antihypertensive (BP, cardiac rhythm, and
spasm (Prinzmetal’s amlodipine, impaired Calcium channel output) while adjusting drug
variant angina) hepatic function, sick blocker to therapeutic dose; use
sinus syndrome, special caution if patient has
-Chronic stable heart block (second heart failure.
angina, alone or in or third degree),  Monitor BP very carefully if
combination with lactation. patient is also on nitrates.
other drugs  Monitor cardiac rhythm
-Use cautiously with regularly during stabilization
 -To reduce the risk of heart failure, of dosage and periodically
hospitalization due pregnancy. during long-term therapy.
to angina and to  Administer drug without
reduce the need for regard to meals.
coronary
revascularization
procedures in
patients with
angiographically
documented CAD
without heart failure
or ejection fraction
less than 40%

-Essential
hypertension, alone
or in combination
with other
antihypertensives

Ponstel Mefenamic Acid -Relief of moderate -Contraindicated Capsule – 250mg NSAID  Be aware that patient may
pain when therapy with hypersensitivity be at increased risk for CV
will not exceed 1 to mefenamic acid, events, GI bleeding; monitor
week aspirin or NSAID accordingly.
allergy, and as
-Treatment of treatment of  Give with milk or food to
primary perioperative pain decrease GI upset.
dysmenorrhea with coronary artery  Arrange for periodic
bypass grafting ophthalmologic
examinations during long-
-Use cautiously with term therapy.
asthma, renal or  Warning If overdose occurs,
hepatic impairment, institute emergency
peptic ulcer disease, procedures—supportive
 GI bleeding therapy and induced emesis,
hypertension, heart activated charcoal, and/or
failure, pregnancy, an osmotic cathartic.
lactation.

Losartan Potassium Cozaar -Treatment of -Contraindicated Film-Coated Cardiovascular  Administer without regard
hypertension, alone with hypersensitivity Tablet – 25, 50, agent Angiotensin II to meals. Ensure that patient
or in combination to losartan, 100mg receptor antagonist is not pregnant before
with other pregnancy (use Antihypertensive beginning therapy, suggest
antihypertensives during the second or the use of barrier birth
third trimester can
control while using losartan;
-Treatment of cause injury or even
fetal injury and deaths have
diabetic death to the fetus),
been reported.
nephropathy with an lactation.
elevated serum
creatinine and -Use cautiously with
proteinuria in hepatic or renal  Find an alternative method
patients with type 2 impairment, of feeding the baby if given
(non–insulin- hypovolemia, history to a nursing mother.
dependent) diabetes of angioedema. Depression of the renin-
and a history of angiotensin system in infants
hypertension is potentially very
dangerous. Alert surgeon
-Reduction of the
and mark the patient’s chart
risk of CVA in
with notice that losartan is
patients with
hypertension and being taken. The blockage of
left ventricular the renin-angiotensin system
hypertrophy following surgery can
produce problems.
Hypotension may be
reversed with volume
expansion.
  Monitor patient closely in
any situation that may lead
to a decrease in BP
secondary to reduction in
fluid volume—excessive
perspiration, dehydration,
vomiting, diarrhea excessive
hypotension can occur.

Lopressor Metoprolol -Hypertension, alone -Sinus bradycardia Film-Coated Antihypertensive  Do not discontinue drug
tartrate or with other drugs, (HR <45 beats/min), tablet – 50mg abruptly after long-term
especially diuretics second or third therapy (hypersensitivity to
degree heart block catecholamines may have
-Prevention of (PR interval >0.24 developed, causing
reinfarction in MI sec), canliogenic exacerbation of angina, MI,
patient who are shock, CHF, systolic and ventricular arrhythmias).
hemodynamically BP <100mm Hg; Taper drug gradually over 2
stable or within 3- lactation week with monitoring.
10d of the acute MI
-Use cautiously with  Ensure that patient swallows
-Treatment of angina diabetes or the ER tablets whole; do not
pectoris thyrotoxicosis, cut, crush, or chew. Toprol
asthma or COPD, XL tablets may be divided at
pregnancy the score; divided tablets
should be swallowed whole,
not crushed or chewed.

 Consult physician about

withdrawing drug if patient
is to undergo surgery
(controversial).
  Give oral drug with food to
facilitate absorption.

 Provide continual cardiac

monitoring for patients
receiving IV metoprolol.

Aciphex Rabeprazole Gastroesophageal -Hypersensitivity to  Tablet, Proton-pump  Assess routinely for

reflux disease rabeprazole or delayed- inhibitors epigastric or abdominal pain
(GERD). Duodenal related drugs release- and frank
ulcers (including (benzimidazoles) 20 mg or occult blood in the stool,
combination therapy  Capsule, emesis, or gastric aspirate.
with clarithromycin Concurrent use of sprinkle-5  Monitor bowel function.
and amoxicillin to rilpivirine mg, 10 Diarrhea, abdominal
eradicate mg cramping, fever, and bloody
Helicobacter pylori stools should be reported to
and prevent health care professional
recurrence). promptly as a sign of
Pathological Clostridium
hypersecretory difficileassociated diarrhea
conditions, including (CDAD). May begin up to
Zollinger-Ellison several week following
syndrome. cessation of therapy
 Lab Test Considerations:
Monitor CBC with
differential periodically
during therapy.
 May cause
hypomagnesemia. Monitor
serum magnesium
prior to and periodically
during therapy
 PO: Administer doses before
 meals, preferably in the
morning. Tablets should be
swallowed whole; do not
break, crush, or chew.
 Instruct patient to take
medication as directed for
the full course of therapy,
even if feeling better. Take
missed doses
as soon as remembered but
not if almost time for next
dose. Do not double doses.
 Advise patient to avoid
alcohol, products containing
aspirin or NSAIDs, and foods
that may cause an increase
in GI irritation.
 May cause occasional
drowsiness or dizziness.
Caution patient to avoid
driving or other activities
requiring alertness until
response to medication is
known.
 Advise patient to report
onset of black, tarry stools;
diarrhea; abdominal pain; or
persistent headache to
health care professional
promptly.
 Instruct patient to notify
health care professional of
onset of black, tarry stools;
diarrhea; abdominal pain; or
 persistent headache or if
fever and diarrhea develop,
especially if stool contains
blood, pus, or mucus. Advise
patient not to treat diarrhea
without consulting health
care professional.
Tylenol Paracetamol, -Mild to moderate -Contraindicated in 600mg IVTT q 6 Non-narcotic  Assess overall health status
Acetaminophen pain and fever. patients hrs analgesic, antipyretic and alcohol usage before
hypersensitive to administering
-Reduce fever in viral drug. acetaminophen. Patients
and bacterial who are malnourished or
infections. -Use cautiously in chronically abuse
patients with long- alcohol are at higher risk of
term alcohol use developing hepatotoxicity
because therapeutic with chronic
doses cause use of usual doses of this
hepatotoxicity in drug.
these patients.  Pain: Assess type, location,
and intensity prior to and
30– 60 min
following administration.
 Fever: Assess fever; note
presence of associated signs
(diaphoresis,
tachycardia, and malaise).
 Increased serum bilirubin,
LDH, AST, ALT, and
prothrombin time
may indicate hepatotoxicity.
 Toxicity and Overdose: If
overdose occurs,
acetylcysteine (Acetadote) is
the antidote.
 To prevent fatal medication
errors ensure dose in
milligrams (mg) and
milliliters (mL) is not
confused; dosing is based on
weight for patients under 50
kg; programming of infusion
pump is accurate; and
total daily dose of
acetaminophen from all
sources does not exceed
maximum daily limits.
 When combined with
opioids do not exceed the
maximum
recommended daily dose of
acetaminophen.
 PO: Administer with a full
glass of water. May be taken
with food or on an empty
stomach
 Advise patient to take
medication exactly as
directed and not to take
more than the
recommended amount.
Chronic excessive use of >4
g/day (2 g in chronic
alcoholics) may lead to
hepatotoxicity, renal, or
cardiac damage
 Advise patient to avoid
alcohol (3 or more glasses
per day increase the risk of
 liver damage) if taking more
than an occasional 1– 2
doses and to avoid taking
concurrently with salicylates
or NSAIDs for more than a
few days, unless directed by
health care professional.
Zithromax Azithromycin Treatment of the Contraindicated in: 500 mg/vial Macrolides  Assess patient for infection
following infections Hypersensitivity to Tablet (vital signs; appearance of
due to susceptible azithromycin, 250 mg wound, sputum, urine, and
organisms: Upper erythromycin, or 500 mg stool; WBC) at beginning of
respiratory tract other macrolide anti- Oral suspension and throughout
infections, including infectives; History of 100 mg/5 ml therapy
streptococcal cholestatic jaundice 200 mg/ml  Observe for signs and
pharyngitis, acute or hepatic symptoms of anaphylaxis
bacterial dysfunction with (rash, pruritus,
exacerbations of prior use of laryngeal edema, wheezing).
chronic bronchitis azithromycin; QT Notify health care
and tonsillitis, Lower interval professional
respiratory tract prolongation, immediately if these occur.
infections, including hypokalemia,  Assess patient for skin rash
bronchitis and hypomagnesemia, or frequently during therapy.
pneumonia, Acute bradycardia; Discontinue azithromycin at
otitis media, Skin Concurrent use of first sign of rash; may be
and skin structure quinidine, lifethreatening. Stevens-
infections, procainamide, Johnson syndrome or toxic
Nongonococcal dofetilide, epidermal
urethritis,cervicitis, amiodarone, or necrolysis may develop.
gonorrhea, and sotalol. Treat symptomatically; may
chancroid. recur once treatment is
Prevention stopped.
of disseminated  Lab Test Considerations:
Mycobacterium May cause increase serum
avium complex bilirubin,
(MAC) infection in AST, ALT, LDH, and alkaline
patients with phosphatase concentrations.
advanced HIV  PO: Administer 1 hr before
infection. Extended or 2 hr after meals.
release suspension  For administration of single
(ZMax) Acute 1-g packet, thoroughly mix
bacterial sinusitis entire contents of packet
and community- with 2 oz (60 mL) of water.
acquired pneumonia Drink entire contents
in adults. immediately; add an
additional 2 oz of water, mix
and drink to assure complete
consumption of dose. Do not
use the
single packet to administer
doses other than 1000 mg of
azithromycin. Pedi: 1-g
packet is not for pediatric
use.
 Advise patient to take
suspension 1 hour before or
2 hours after
meals.
 Remind patient to complete
entire course of therapy as
ordered, even after
symptoms improve.
 Advise patient not to wear
contact lenses if signs or
symptoms
of bacterial conjunctivitis
exist.
 Advise patient to report
symptoms of chest pain,
 palpitations,
yellowing of skin or eyes, or
signs of superinfection
(black, furry overgrowth on
the tongue; vaginal itching
or discharge; loose or foul-
smelling stools) or rash.
Acticlate Doxycycline Treatment of Contraindicated in: 1 cap (100 mg) Anti-infective,  If patient receives large
susceptible Hypersensitivity to Tetracycline doses or prolonged therapy
infections doxycycline, or if patient is at high risk,
due to H. ducreyi, other tetracyclines. watch for signs and
Pasteurella pestis, P. symptoms of superinfection.
tularensis, If superinfection occurs,
Bacteroides drug should be discontinued
spp., V. cholerae, and appropriate therapy
Brucella spp., instituted.
Rickettsiae, Y. pestis,  Cutaneous anthrax with
Francisella signs of systemic
tularensis, involvement, extensive
M. pneumoniae, edema, or lesions on the
includingbrucellosi, head or neck requires
chlamydia, cholera, IV therapy and a multidrug
granuloma inguinale, approach.
lymphogranuloma  Ciprofloxacin and
venereum, malaria doxycycline are first-line
prophylaxis, therapies
nongonococcal for anthrax. If anthrax
urethritis, pelvic patient also has meningitis,
inflammatory ciprofloxacin is preferred
disease (PID), because of better
plague, psittacosis, distribution to the CNS.
relapsing fever,  Drug may increase risk of
rickettsia infections, intracranial HTN (IH) and
primary pseudotumor cerebri,
and secondary especially in women who are
syphilis, tularemia. overweight or have a history
(Oracea): of IH. Monitor patient for
Treatment headache, blurred vision,
of inflammatory diplopia, and vision loss. If
lesions in adults with visual changes occur, prompt
rosacea. OFFLABEL: ophthalmic evaluation is
Sclerosing agent for needed.
pleural effusion;  Check patient's tongue for
vancomycin-resistant signs of fungal infection.
enterococci (VRE); Emphasize good oral
alternative for hygiene.
MRSA, treatment of  Photosensitivity reactions
refractory may occur within a few
periodontitis, minutes to several hours
juvenile after exposure and may last
periodontitis. after therapy ends.
Discontinue drug at first
evidence of
skin erythema.
 Look alike–sound alike:
Don't confuse doxycycline
with doxylamine or
dicyclomine. Don't confuse
Oracea with
Orencia.
 Instruct patient to report
adverse reactions promptly,
especially signs or symptoms
of hypersensitivity or IH. If
drug is being given IV, tell
patient to report discomfort
at IV site.
 Warn patient to avoid direct
 sunlight and ultraviolet
light, wear protective
clothing, and use sunscreen.
 Tell patient to report signs
and symptoms of
superinfection to prescriber.
Grilinctus Dextromethorpha Grilinctus Syrup -If you are allergic to Common Adult Levorphanol derivative  Grilinctus Syrup can be taken
n + Guaiphenesin serves a Ammonium Chloride, dose 5-10ml of + Propanediol with or without water as
+ Ammonium great purpose in the Chlorpheniramin, Syrup daily in 2-3 derivative + advised by the physician at a
chloride + prevention or Dextromethorph, divided doses, Electrolyte fixed time.
Chlorpheniramine treatment Guaifenesin, or any unless stated Supplements +  Shake the bottle well before
Maleate of the following other ingredient of otherwise by the Propylamine consuming the drug and
conditions: this syrup. doctor. (nonselective) always use a measuring cup
Allergy: Used for to consume advised dose.
symptomatic -If you are currently  Grilinctus Syrup should be
relief of allergy taking psychiatric accompanied by plenty of
Rhinitis: Used in treatment, have a fluids to aid mucus removal.
cases of allergic respiratory disorder,  Complete dose/therapy as
Rhinitis (Hay or prone to get such prescribed by the doctor
fever) disorders. should be taken.
Emergency: Used as  Overdose of Grilinctus syrup
an adjunct in -Grilinctus syrup can result in symptoms like
the emergency should not be used vomiting, increased thirst,
treatment of for children under 12 headache, extreme
Anaphylactic years of age. drowsiness, fits, irregular
Shock and severe heartbeats, reduced
Angioedema Insect potassium levels, confusion,
Sting: Used in irritation and coma in the
cases of Insect Stings case of severe overdose.
Pruritis: Used in Advise patient to report such
cases of Pruritis manifestations.
of allergic origin  Grilinctus Syrup should not
Others: Used to be consumed with alcohol as
treat Dry cough, it may cause excessiveness
Bronchitis, numbness or drowsiness.
Common cold,  Grilinctus Syrup should not
and Nasal be consumed in pregnancy
Congestion as it may have adverse
effects on the fetus.
 It is unsafe to use Grilinctus
Syrup by the patients
suffering from some type of
liver-related disease.
 In case the patient missed a
dose, the skipped dose
should be taken as soon as
possible. The skipped dose
and the next dose should
not coincide. Doses should
not be doubled to make up
for the next doses.
 The drug should be
administered in patients
with renal or liver disease
with caution.