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Jorelle Nickolai T. Rodriguez Grp.

4; 2-A Patient: Helen Octaviano Area: 3B

Medication / Classification 1. Diclofenac (Dicloval) @ 1 amp. IM Q12 Drug Classification: Analgesic Anti-inflammatory Anti-pyretic Non-steroidal Antiinflammatory Drug (NSAID) Pregnancy Category B: Animal studies indicate no fetal risk, but no human studies; or adverse effects in animals, but not in wellcontrolled human studies. Mechanism of Indication Action Inhibits Patient was prostaglandin given synthetase to cause medication due anti-pyretic and antito pain at the inflammatory effects. incision site. (Post-operative Caesarian Section). Contraindication Hypersensitivity to Diclofenac or other NSAIDs. Side Effects/Adverse Effects SE: Constipation diarrhea dizziness drowsiness headache mild stomach pain or heartburn nausea vomiting AE: Drug-Drug Interaction/Reason Not to be taken with alcohol. ( toxicity) Risk of bleeding with anticoagulants. Nursing Considerations Administer drug with food or after meals.

3rd trimester of
pregnancy. Before or after CABG surgery. Use cautiously with impaired hearing, hepatic, CV, GI conditions, and in elderly patients.

Check patients history before Serum levels and risk administering the drug. of Lithium toxicity.

Medication was
prescribed to the patient for severe pain.

Effects of diuretics, furosemide, betablockers.


Check clients condition before administering the drug. Institute emergency procedures if overdose occurs.

Acute or long-

term treatment of mild to moderate pain.

reactions (rash, itching, swelling of the mouth, face, lips or tongue, difficulty of breathing) Chest pains Edema of the hands, legs, or feet GI Bleeding Anaphylactoid reactions to fatal anaphylactic shock

Check for clients

response to the medication.

Medication / Classification 2. Ampicillin + Sulbactam @ 750mg/tab BID Drug Classification: Anti-infectives Antibiotics Aminopenicillin/betalactamase inhibitor Pregnancy Category B: Animal studies indicate no fetal risk, but no human studies; or adverse effects in animals, but not in wellcontrolled human studies.

Mechanism of Action Destroys bacteria by inhibiting bacterial cell-wall synthesis during microbial multiplication. Addition of sulbactam enhances drugs resistance to betalactamase, an enzyme that can inactivate ampicillin.



Mild to moderate Hypersensitivity to infections (i.e.; skin, penicillins, intra-abdominal and cephalosporins, gynecological imipenem, or other infections) beta-lactamase inhibitors. Susceptible strains of S. aureus, Use cautiously in Klebsiella species, severe renal E. coli, H. insufficiency, influenzae, P. infectious mirabilis, mononucleosis, and Bacteroides fragilis, pregnant or Enterobacter specie breastfeeding s, Acinetobacter patients. calcoaceticus Patient was given medication to reduce the risk of infection.

Side Effects/Adverse Effects SE: Mild diarrhea pain swelling redness at injection site (parenteral route)

Drug-Drug Interaction/Reason Allopurinol: increased risk of rashes

AE: CNS: lethargy, hallucinations, anxiety, confusion, agitation, depression, fatigue, dizziness, seizures CV: vein irritation, thrombophlebitis, heart failure EENT: blurred vision, itchy eyes GI: nausea, vomiting, diarrhea, abdominal pain, enterocolitis, gastritis, stomatitis, glossitis, black hairy tongue, furry tongue, oral and rectal candidiasis, pseudomembranous colitis GU: hematuria, hyaline casts in urine, vaginitis, nephropathy, interstitial nephritis Hematologic: anemia, eosinophilia, agranulocytosis, hemolytic anemia, leukopenia, thrombocytopenic purpura, thrombocytopenia, neutropenia Hepatic: nonspecific hepatitis Musculoskeletal:

Nursing Considerations Instruct patient to immediately report signs and symptoms of hypersensitivity Chloramphenicol: reaction, such as synergistic or rash, fever, or antagonistic effects chills. Hormonal Check patients contraceptives: history before decreased administering the contraceptive medication. efficacy, increased risk of breakthrough bleeding Tell patient to report unusual bleeding or Probenecid: bruising. decreased renal excretion and increased blood Inform patient that level of ampicillin drug lowers resistance to certain infections. Tetracyclines: Instruct patient to reduced report new signs or bactericidal effects symptoms of infection, especially in mouth or rectum. Advice patient to minimize GI upset by increasing fluid intake and eating small, frequent servings of food.

Medication / Classification 3. Mefenamic Acid (Istan) @ 500mg/tab Q4 Drug Classification: Non-steroidal Antiinflammatory Drug (NSAID) Pregnancy Category C: Either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus.

Mechanism of Action Mefenamic acid works by reducing hormones that cause inflammation and pain in the body. Antiinflammatory, analgesic, and antipyretic activities related to inhibition of prostaglandin synthesis; exact mechanisms of action are not known.




muscular, dental, rheumatic, & traumatic pain; post-op & postpartum pain; relief of primary dysmenorrhea.

Peptic or intestinal
ulceration or inflammation

Inflammatory bowel

disease, renal or hepatic impairment.

Patient was given

medication to relieve pain (postpartum).

Hypersensitivity to aspirin AE: (acetylsalicylic acid) CNS: Headache, or other nondizziness, somnolence, steroidal antiinsomnia, fatigue, inflammatory agents. tinnitus, ophthalmic effects. Blood disorders, Dermatologic: Rash, poor platelet function pruritus, sweating, dry mucous membranes, Children below 14 stomatitis years old. GI: Nausea, dyspepsia, GI pain, diarrhea, Before or after vomiting, constipation, CABG surgery. flatulence, ulcers, GI bleeding Use with caution for GU: Dysuria, renal lactation, impairment hypertension, heart Hematologic: failure, asthma & Bleeding, platelet pregnancy. inhibition with higher doses, neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia, aplastic anemia, decreased hemoglobin/hematocrit, bone marrow depression, menorrhagia Respiratory: Dyspnea, hemoptysis,

Side Effects/Adverse Effects SE: Diarrhea Constipation Gas or bloating Headache Dizziness Nervousness Ringing in the ears

Drug-Drug Interaction/Reason ASA, anticoagulants, other NSAIDs: Increased risk of bleeding

Nursing Considerations Assess clients pain before administering medication. Monitor patients reaction with the drug.

Not to be taken

with alcohol. ( risk of bleeding.)

Not to be taken in combination with antihypertensive drugs: Inhibits effect of antihypertensive drugs Lithium & methotrexate: Increased toxicity

Advice paient to

report immediately persistence or failure to relieve pain.

Administer medication immediately after meals.

Check patients

history for allergies before administering medication.

Use caution if the patient has a weakened heart. It may cause increased shortness of breath or weight gain.