DARUNDAY, EZRA M.
BSN II B
ROTATION 4
GENERIC NAME: MECHANISM OF ACTION:
Cefuroxime
Binds to bacterial cell membranes,
inhibits cell wall synthesis.
Therapeutic Effect: Bactericidal.
BRAND NAME: INDICATION:
Ceftin
● Susceptible infection due to
group B streptococci,
pneumococci, staphylococci,
H. Influenza, E. coli,
Enterobacter, Klebsiella,
● acute/chronic bronchitis,
● gonorrhea
● impetigo
● early Lyme disease
● otitis media
● pharyngitis/tonsilitis
● sinusitis
● skin/skin structure
● UTI
SIDE NURSING RESPONSIBILITY
EFFECTS/ADVERSE
REACTION
BASELINE ASSESSMENT
Side Effects: ● Obtain CBC, renal function
tests.
● Discomfort in IM
● Question for history of
administration
allergies, particularly
● Oral Candidiasis cephalosporins, penicillins.
● Mild diarrhea
● Mild abdominal INTERVENTION/EVALUATION
cramping
● Assess oral cavity for white
● Vaginal
patches on mucous
candidiasis membranes, tongue
(thrush).
● Nausea
● Monitor daily pattern of
● Serum sickness-
bowel activity, stool
like reaction consistency. Mild GI effects
● Allergic reactions may be tolerable
such as pruritus, (increasing severity may
urticaria. indicate onset of antibiotic-
associated colitis).
● Thrombophlebitis
● Monitor I&O, renal
function tests for
nephrotoxicity.
Adverse Reaction:
 ● Perioperative prophylaxis
DRUG ILLUSTRATION: CONTRAINDICATION:
● Hypersensitivity to
cefuroxime
● Cephalosporins
● Severe renal impairments
● Penicillin allergy
● Patient with colitis
● GI malabsorption
● seizures
CLASSIFICATION:
Pharmacotherapeutic; Second generation of
cephalosporin
Clinical: Antibiotic
DOSAGE/FREQUENCY/ROUTE:
● Antibiotic ● Be alert for superinfection:
associated colitis fever, vomiting, diarrhea,
anal/genital pruritus, oral
● Superinfections
mucosal changes
such as abdominal (ulceration, pain,
cramps, severe erythema).
watery diarrhea,
infections
● Altered bacterial PATIENT/FAMILY TEACHING
balance in GI
tract ● Discomfort may occur with
IM injection.
● Nephrotoxicity
● Doses should be evenly
spaced.
● Continue antibiotic therapy
for full length of treatment.
● May cause GI upset (may
take with food, milk).
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
mg/kg/dose q8–12h. PO: ADULTS,
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
EFFECTS/ADVERSE
Acetaminophen
REACTION
Appears to inhibit prostaglandin BASELINE ASSESSMENT
synthesis in the CNS and, to a lesser
extent, block pain impulses through
peripheral action. Acts centrally on
Side Effects: ● If given for analgesia, assess
hypothalamic heat-regulating
center, producing peripheral onset, type, location,
vasodilation (heat loss, skin ● Hypersensitivity duration of pain. Effect of
erythema, diaphoresis). reaction medication is reduced if full
pain response recurs prior
to next dose.
Therapeutic Effect: Results in Adverse Reaction: ● Assess for fever.
antipyresis. Produces analgesic
effect ● Anorexia ● Assess LFT in pts with

BRAND NAME: INDICATION: chronic usage or history of

● Nausea
hepatic impairment, alcohol
Tylenol ● Diaphoresis abuse.
● Temporary relief to
moderate pain ● Fatigue within 12-
INTERVENTION/EVALUATION
● Headache 24 hours
● Fever ● Vomiting ● Assess for clinical
improvement and relief of
● Elevated LFTs pain, fever. Therapeutic
within 48-72 serum level: 10–30
hours after mcg/mL; toxic serum level:
DRUG ILLUSTRATION: CONTRAINDICATION: ingestion greater than 200 mcg/mL.
Do not exceed maximum
● Hypersensitivity to daily recommended dose: 4
acetaminophen g/day.
● Severe hepatic impairment
PATIENT/FAMILY TEACHING
● Active liver disease

● Alcohol dependency ● Consult physician for use in

 children younger than 2
● Active hepatic disease
yrs, oral use longer than 5
● Chronic malnutrition days (children) or longer
than 10 days (adults), or
● Hypovolemia fever lasting longer than 3
days.
● G6PD deficiency
● Severe/recurrent pain or
CLASSIFICATION: high/ continuous fever may
indicate serious illness.
Pharmacotherapeutic: Central Analgesic Continue antibiotic therapy
for full length of treatment.
Clinical: Non-narcotic Analgesic, Antipyretic
● Do not take more than 4
g/day (3 g/day if using OTC
[over-the-counter]). Actual
OTC dosing
recommendations may vary
by product and/or
manufacturer. Many
DOSAGE/FREQUENCY/ROUTE: nonprescription
combination products
contain acetaminophen.
Note: Over-the-counter (OTC) use of Avoid alcohol.
acetaminophen should be limited to
3,000 mg/day.

Analgesia and Antipyresis

IV: ADULTS, ELDERLY, ADOLESCENTS

WEIGHING 50 KG OR MORE: 1,000 mg
q6h or 650 mg q4h. Maximum single dose:
1,000 mg; maximum total daily dose: 4,000
mg. ADULTS, ADOLESCENTS
WEIGHING LESS THAN 50 KG: 15 mg/kg
q6h or 12.5 mg/kg q4h. Maximum single
dose: 750 mg; maximum total daily dose: 75
mg/kg/day (3,750 mg). CHILDREN 2–12
YRS: 15 mg/ kg q6h or 12.5 mg/kg q4h.
Maximum single dose: 750 mg. Maximum:
75 mg/kg/day, not to exceed 3,750 mg/ day.
INFANTS AND CHILDREN LESS THAN 2
YRS (Fever only): 7.5–15 mg/kg q6h.
Maximum: 60 mg/kg/day. NEONATES
(Fever only): (Limited data available)
Loading dose: 20 mg/kg. PMA 37 or greater
than 37 wks: 10 mg/kg/ dose q6h. Maximum:
40 mg/kg/day. PMA 33–36 wks: 10
mg/kg/dose q8h. Maximum: 40 mg/kg/day.
PMA 28–32 wks: 10 mg/kg/dose q12h.
Maximum: 22.5 mg/kg/day. PO: ADULTS,
ELDERLY, CHILDREN 13 YRS AND
OLDER: (Regular Strength) 325–650 mg q4–
6h. Maximum: 3,250 mg/day unless directed
by health care provider. (Extra Strength)
1000 mg q6h. Maximum: 3,000 mg/day
unless directed by health care provider.
(Extended Release) 1300 mg q8h. Maximum:
3,900 mg/day. CHILDREN 12 YRS AND
YOUNGER: (Weight dosing preferred; if
not available, use age. Doses may be repeated
q4h. Maximum: 5 doses/day.) NEONATES:
Term: 10–15 mg/kg/dose q4–6h. Maximum:
75 mg/kg/day. GA 33–37 wks or term less
than 10 days: 10–15 mg/kg/dose q6h.
Maximum: 60 mg/kg/day. GA 28–32 wks:
10–12 mg/kg/dose q6–8h. Maximum: 40
mg/kg/day. Rectal: ADULTS, ELDERLY,
CHILDREN 12 YRS AND OLDER: 325–650
mg q4–6h. Maximum: 4 g/24 hrs.
CHILDREN: (7-11 YRS): 325 mg q4–6h.
Maximum: 1,625 mg/day. (4-6 YRS): 120 mg
q4–6h. Maximum: 600 mg/day. (1-3 YRS):
80 mg q4–6h. Maximum: 400 mg/day. (6-11
mos): 80 mg q6h. Maximum: 320 mg/ day.
NEONATES: Term: Initially, 30 mg/
kg/once, then 20 mg/kg/dose q6–8h.
Maximum: 75 mg/kg/day. GA 33–37 wks or
term less than 10 days: Initially, 30 mg/kg
once, then 15 mg/kg/ dose q8h. Maximum: 60
mg/kg/day. GA 28–32 wks: 20 mg/kg/dose
q12h. Maximum: 40 mg/kg/day.

Dosage in Hepatic Impairment

Use with caution. IV contraindicated with

severe impairmen