DARUNDAY, EZRA M.

BSN III B
ROTATION 3

GENERIC NAME: MECHANISM OF ACTION: SIDE NURSING RESPONSIBILITY

Cefuroxime EFFECTS/ADVERSE
Binds to bacterial cell membranes, REACTION BASELINE ASSESSMENT
inhibits cell wall synthesis.
 Obtain CBC, renal function
Therapeutic Effect: Bactericidal. Side Effects: tests.
 Discomfort in IM  Question for history of
BRAND NAME: INDICATION:
administration allergies, particularly
Ceftin
 Oral Candidiasis cephalosporins, penicillins.
 Susceptible infection due to
group B streptococci,  Mild diarrhea
 Mild abdominal INTERVENTION/EVALUATION
pneumococci, staphylococci,
H. Influenza, E. coli, cramping  Assess oral cavity for white
Enterobacter, Klebsiella,  Vaginal patches on mucous
candidiasis membranes, tongue
 acute/chronic bronchitis,
 Nausea (thrush).
 gonorrhea
 Serum sickness-  Monitor daily pattern of
 impetigo
like reaction bowel activity, stool
 early Lyme disease consistency. Mild GI effects
 otitis media  Allergic reactions
such as pruritus, may be tolerable
 pharyngitis/tonsilitis (increasing severity may
urticaria.
 sinusitis indicate onset of antibiotic-
 Thrombophlebitis
 skin/skin structure associated colitis).
 UTI Adverse Reaction:  Monitor I&O, renal
 Perioperative prophylaxis  Antibiotic function tests for
associated colitis nephrotoxicity.
 Superinfections  Be alert for superinfection:
DRUG ILLUSTRATION: CONTRAINDICATION: fever, vomiting, diarrhea,
such as abdominal
 Hypersensitivity to cramps, severe anal/genital pruritus, oral
cefuroxime watery diarrhea, mucosal changes
 Cephalosporins infections (ulceration, pain,
 Severe renal impairments  Altered bacterial erythema).
 Penicillin allergy balance in GI
 Patient with colitis tract PATIENT/FAMILY TEACHING
 GI malabsorption  Nephrotoxicity  Discomfort may occur with
 seizures IM injection.
 Doses should be evenly
spaced.
CLASSIFICATION:
Pharmacotherapeutic; Second generation of
cephalosporin

Clinical: Antibiotic

DOSAGE/FREQUENCY/ROUTE:

Usual Dosage

IV, IM: ADULTS, ELDERLY, CHILDREN

12 YRS AND OLDER: 750 mg–1.5 g q8h up
to 1.5 g q6h for severe infections.
CHILDREN: 3 MOS TO YOUNGER THAN
12 YRS: (Mild to Moderate Infection): 75–
100 mg/kg/day divided q8h. Maximum: 1,500
mg/dose. (Severe Infection): 100–200  Continue antibiotic therapy
mg/kg/day divided into 3–4 doses. for full length of treatment.
Maximum: 1,500 mg/ dose. NEONATES: 50  May cause GI upset (may
mg/kg/dose q8–12h. PO: ADULTS, take with food, milk).
ELDERLY, CHILDREN 12 YRS AND
OLDER: 250–500 mg twice a day.
CHILDREN 3 MOS TO YOUNGER THAN
12 YRS: 20–30 mg/kg/day in 2 divided doses.
Maximum: 1 g/day (500 mg/dose).

Dosage in Renal Impairment

Adult dosage frequency is modified based

on creatinine clearance and severity of
infection

Dosage in Hepatic Impairment

No dose adjustment.
GENERIC NAME: MECHANISM OF ACTION: SIDE NURSING RESPONSIBILITY
Tramadol EFFECTS/ADVERSE
Binds to mu-opioid receptors in REACTION BASELINE ASSESSMENT
CNS, inhibiting ascending pain
pathway. Inhibits reuptake of  Obtain CBC, renal function
norepinephrine, serotonin, Side Effects: tests.
inhibiting descending pain  Discomfort in IM  Question for history of
pathways. administration allergies, particularly
 Oral Candidiasis cephalosporins, penicillins.
Therapeutic Effect: Reduces pain.  Mild diarrhea
BRAND NAME: INDICATION:  Mild abdominal INTERVENTION/EVALUATION
Ultram cramping  Assess oral cavity for white
 Immediate-Release:  Vaginal patches on mucous
Management of moderate to candidiasis membranes, tongue
moderately severe pain  Nausea (thrush).
 Extend-Release: around-  Serum sickness-  Monitor daily pattern of
the-clock like reaction bowel activity, stool
 Allergic reactions consistency. Mild GI effects
such as pruritus, may be tolerable
DRUG ILLUSTRATION: CONTRAINDICATION: urticaria. (increasing severity may
 Hypersensitivity to  Thrombophlebitis indicate onset of antibiotic-
tramadol, opiods. associated colitis).
 Pedia under 12 Adverse Reaction:  Monitor I&O, renal
 Post opt management in  Antibiotic function tests for
patients under 18 following associated colitis nephrotoxicity.
tonsillectomy and  Superinfections  Be alert for superinfection:
adenoidectomy. such as abdominal fever, vomiting, diarrhea,
 Severe respiratory cramps, severe anal/genital pruritus, oral
depression watery diarrhea, mucosal changes
 Acute bronchial asthma infections (ulceration, pain,
 GI obstruction  Altered bacterial erythema).
 balance in GI
tract PATIENT/FAMILY TEACHING
 Nephrotoxicity  Discomfort may occur with
IM injection.
 Doses should be evenly
CLASSIFICATION: spaced.
PHARMACOTHERAPEUTIC:  Continue antibiotic therapy
Centrally acting synthetic opioid.

CLINICAL: Analgesic.

DOSAGE/FREQUENCY/ROUTE:

Usual Dosage

IV, IM: ADULTS, ELDERLY, CHILDREN

12 YRS AND OLDER: 750 mg–1.5 g q8h up
to 1.5 g q6h for severe infections.
CHILDREN: 3 MOS TO YOUNGER THAN
12 YRS: (Mild to Moderate Infection): 75–
100 mg/kg/day divided q8h. Maximum: 1,500
mg/dose. (Severe Infection): 100–200
mg/kg/day divided into 3–4 doses.
Maximum: 1,500 mg/ dose. NEONATES: 50
for full length of treatment.
mg/kg/dose q8–12h. PO: ADULTS,
 May cause GI upset (may
ELDERLY, CHILDREN 12 YRS AND
take with food, milk).
OLDER: 250–500 mg twice a day.
CHILDREN 3 MOS TO YOUNGER THAN
12 YRS: 20–30 mg/kg/day in 2 divided doses.
Maximum: 1 g/day (500 mg/dose).

Dosage in Renal Impairment

Adult dosage frequency is modified based

on creatinine clearance and severity of
infection

Dosage in Hepatic Impairment

No dose adjustment.