Gracie Allaine Sugatan-Placino, MSN, RN

Faculty
Learning Outcomes
At the end of the discussion, the student will be able to:
▪ Explain various antimicrobial drugs and antiseptic
medicine use relevant to the present health condition
of the patient.
▪ Analyze the importance of appropriate antimicrobial
drugs and antiseptic herbal medicine administration
▪ Integrate knowledge of nursing process and
pharmacology in administering antimicrobial drugs and
antiseptic herbal medicine
FINDING THE
MISSING YOU…

• Puzzle pieces will be put under the chair

(selected chairs only)
• Student who has a puzzle piece under
his/her chair will be participating the
game
• They’ll need to look for the missing
pieces;
• Once completed, they need to assemble it
all together;
• Paste it on the white board and identify
the image posted.
 Disease-producing Organisms
Gram-positive and gram-negative
➢ Bacteria
➢ Viruses
➢ Protozoans
➢ Fungi
➢ Helminths
The degree to which they are pathogenic depends on the microorganism
and its virulence
Antimicrobial / Anti-infective Agents
➢ Antibacterial / Antibiotics
➢ Antiviral agents
➢ Antifungal agents
➢ Antiprotozoal agents
➢ Anthelmintics
Disease-producing Organisms and its Characteristics:

Bacteria - reproduce by cell division ranging from 12 minutes

to 24 hours.
1. Gram-positive (e.g., Staphylococcus aureus, Streptococcus
pneumoniae, group B Streptococcus, and etc.)
2.Gram-negative (e.g., Neisseria meningitides, Escherichia coli,
and Haemophilus influenzae).
Disease-producing Organisms and its Characteristics:

Viruses - reproduces within living cells and uses their DNA and
RNA to generate more viruses.
- some viral hepatitis, viruses are self-limiting that do
not require antiviral (e.g.,influenza A, B, & C, herpes viruses,
hepatitis virus, and HIV)
Disease-producing Organisms and its Characteristics:

Fungi –reproduce by both sexually and asexually & disperses by

spores (e.g., Aspergillosis, moniliasis, histoplasmosis, and
mucormycosis)

Protozoan –reproduce by both sexually and asexually. It could

be aerobic or anaerobic species that lives mostly in moist areas
(e.g., Plasmodium falciparum, Plasmodium vivax, Plasmodium
malariae and Plasmodium ovale)

Helminths- are large parasitic worms that live and lay eggs in
warm, moist soil where sanitation and hygiene are poor (e.g.,
Cestodes (tapeworms), Intestinal nematodes (roundworms),
Trematodes (flukes), and Tissue-invading nematodes (tissue
roundworms and filarae)
ANTIBACTERIAL
1. Antibacterial / Antimicrobial/Antibiotic
Antibacterials and antimicrobials
• substances that inhibit bacterial growth or kill
bacteria and other microorganisms

Antibiotic
• Chemicals produced by one kind of
microorganism that inhibit the growth of or
kill another.
Antibacterial Drugs
. Antibacterial drugs

1. Natural sources. The use of moldy bread on wounds to

fight infection dates back 3500 years

2. Synthetically manufactured
• 1928, British bacteriologist Alexander Fleming
noted that a mold that had contaminated his
bacterial cultures was inhibiting bacterial growth
Antiseptic Herbal medicine (DOH - Approved)

Guava (Psidium guajava L.)

• Common names: Guava, bayabas (Tagalog); Guava (English).
• Indications: antiseptic (disinfect wounds and mouth wash to treat
tooth decay and gum infection
• Found in: Common in the Philippines
• Parts used: Leaves
Special precautions:
• Do not cover the pot boiling leaves and other plant parts and boil in low
flame.
• Do not use stainless steel utensils when boiling decoctions. Earthen,
enameled or glass are allowed
Preparation: For washing wounds
• Wash the leaves with running water before boiling it for
10 minutes. Wait until the decoction cools down into
lukewarm temperature before rinsing the wound with
it. Be careful not to use it while it is still hot as it may
cause burn.
• Decoctions loose potency after some time. Dispose
of decoctions after one day. To keep fresh during the
day, keep lukewarm in a flask or thermos
• Wash affected areas with the decoction of leaves 2 to 3
times a day.
Mechanism of Antibacterial Action
Pharmacokinetics of Antibacterial Drugs
Pharmacokinetics
Antibacterial drugs not only penetrate the bacterial cell wall but also
have an affinity for the binding sites on the bacterial cell.

Considerations:
• Length of time the drug remains at the binding sites increases the
effect of the antibacterial action (distribution, half-life and
elimination)
Pharmacokinetics of Antibacterial Drugs
Pharmacodynamics
• Antibacterial drugs are used to achieve the minimum MEC
necessary to halt the growth of a microorganism
• Duration of use varies according to the type of pathogen, site of
infection, and immunocompetence of the host
Pharmacokinetics of Antibacterial Drugs
Pharmacodynamics
Type of action:
1. Bacteriostatic – stop
from reproducing
2. Bactericidal – Kills
microorganisms
Check your Knowledge!
A patient is receiving amoxicillin (Amoxil). The nurse
understands that the action of this drug is by which
process?

a. Inhibition of protein synthesis

b. Alteration of membrane permeability
c. Inhibition of bacterial cell-wall synthesis
d. Alteration of bacterial ribonucleic acid synthesis
Check your Knowledge!
The following are Gram-positive bacteria disease
producing organisms. Which among the following is
not included?

a. Staphylococcus aureus
b. Streptococcus pneumoniae
c. Grp B Streptococcus
d. Neisseria meningitides
Check your Knowledge!
The action of this type of antibacterial drug is to stop
the microorganism from reproducing

a. Bacteriostatic
b. Bactericidal
Resistance to Antimicrobial
Drugs
Bacteria can be either sensitive or resistant to certain
antibacterial drugs.
• Sensitive -inhibited or destroyed the pathogen
• Resistant – pathogen continues to grow despite
administration of antibacterial drug
Antibiotic / Antimicrobial
Resistance
Antibiotic misuse occur
When antibiotics are taken:
• Unnecessarily
• Incorrectly

resistance to antibacterial may develop due to misuse

General Adverse Reactions of Antibacterial Drugs
1. Allergy or hypersensitivity – could be mild (rash, pruritus, and hives),
treated with antihistamine or severe (anaphylactic shock, which results in
vascular collapse, laryngeal edema, bronchospasm, and cardiac arrest).
Shortness of breath is the first symptom of anaphylactic shock which
usually occurs within 20 minutes.

1. Superinfection - is a secondary infection that occurs when the normal

microbial flora of the body are disturbed during antibiotic therapy.
• Superinfections can occur in the mouth, respiratory tract, intestine,
genitourinary tract, and skin

3. Organ toxicity - the liver and kidneys are involved in drug metabolism and
excretion, and antibacterials may result in damage to these organs.
Example:
Aminoglycosides can be nephrotoxic and ototoxic
Penicillins and Cephalosporins
Penicillin’s beta-lactam ring structure interferes with bacterial cell-wall
synthesis by inhibiting the bacterial enzyme.
• The bacteria die of cell lysis (cell breakdown) and is primarily
bactericidal
• The penicillins can be both bacteriostatic and bactericidal, depending
on the drug and dosage.
• Penicillins are mainly referred to as beta-lactam antibiotics
Check your Knowledge!

A patient has been prescribed amoxicillin (Amoxil). What does the

nurse know is true about this medication?

a. It has a normal adult dose of 2 grams q6h.

b. It has a common side effect of hypotension.
c. It has an intramuscular administration route.
d. It is used to treat respiratory infections.
Cephalosporins
• Cephalosporins are a major antibiotic group used in hospitals and in
health care offices. These drugs are bactericidal with actions similar
to penicillin.
• Like penicillin, cephalosporins have a beta-lactam structure and act by
inhibiting the bacterial enzyme necessary for cell-wall synthesis.
• For antibacterial activity, the beta-lactam ring of cephalosporins is
necessary
• Five groups of cephalosporins have been developed, identified as
generations. Each generation is effective against a broader spectrum
of bacteria
 Generations of Cephalosporins
Generation Example of drug Target pathogens Indication
1st Generation Cephalexin Effective mostly against gram (+) bacteria Treating otitis media, skin, bone, joint,
Cefazolin sodium (streptococci and most staphylococci) and some gram respiratory and urinary tract infections
(-) bacteria (E. coli and species of Klebsiella, Proteus,
Salmonella, and Shigella)
2rd Generation Cefaclor Same effectiveness as 1st generation but it broader For pharyngitis, tonsillitis, otitis media, skin
Cefoxitin sodium spectrum against other gram-(-) bacteria such as structure, respiratory and urinary tract
Cefuroxime Haemophilus influenzae, Neisseria gonorrhoeae and infections
N. meningitidis, Enterobacter species
3th Generation Cefixime Same effectiveness as 1st & 2nd generations and also For otitis media, acute sinusitis, tonsillitis,
Cefotaxime effective against gram (-) bacteria (Pseudomonas and respiratory and skin infections
Ceftazidime aeruginosa and Serratia and Acinetobacter species)
Ceftriaxone
4th Generation Cefepime Similar to 3rd -generation drugs with broad-spectrum For bacteraemia, skin, intraabdominal, and
antibacterial activity and good penetration to urinary tract infections
cerebrospinal fluid; effective against E. coli, P.
aeruginosa, and Klebsiella, Proteus, and
Streptococcus species and certain staphylococci
5th Generation Ceftaroline Similar characteristics of third and fourth generations, For skin & respiratory infections,
fosamil also broad spectrum, and the only cephalosporins intraabdominal and urinary infections
Ceftolozone effective against methicillin-resistant Staphylococcus
& tazobactam aureus (MRSA)
 Other Classifications of Antibiotic and its Indication
Classification Example
Aminoglycosides Amikacin sulfate, Gentamicin sulfate,
Neomycin sulfate, Streptomycin sulfate, aeruginosa; e.coli, Proteus species, Klebsiella-Enterobacter-Serratia
Tobramycin sulfate
Cephalosphorins Cefazolin, Cephalexin, Cefaclor,
Cefoxitin, Cefuroxime, Cefotaxime,
Ceftriaxone, Ceftazidine
Fluoroquinoles Ciprofloxacin, Levofloxacin, Norfloxacin, Wide spectrum of gram (-) bacteria
Ofloxacin
Macrolides azithromycin, clarithromycin,
erythromycin, dirithromycin
Lincosamides Clindamycin, Lincomycin
Monobactam Aztreonam, Tigemonam, Carumonam,
Nocardicn A
Penicillins -Penicillin G benzathine, potassium,
procaine, and Penicillin V,
- Amoxcillin, Ampicillin, Carbenicillin
Penicillinase-resistant -Dicloxacillin, nafcillin and
Extended spectrum Oxacillin
penicillins - Piperacillin-tazobactam (Zosyn)
Sulfonamides Sulfadiazine, sulfsalazine, cotrimoxazole,
sulfizoxazole
Antimicobac ethambutol, pyrazinamide, rifampin,
terial /Antitubercular pyrazinamide, dapsone
Tetracyclines Doxycycline, tetracycline,
demeclocycline, minocycline,
oxytetracycline
Indication
Broad spectrum antibiotic. For gram (-) bacteria it is indicated for aerobic bacilli such as P.
both gram (+) & (-) depending on the generation of cephalosphorin. Treat respiratory,
urinary, skin, bone, joint, and genital infections
S. pneumoniae, M. pneumoniae, Listeria Monocytogenes, Legionella pneumophilia, grp A
beta hemolytic streptococci, N. gonorrhea, H. influenzae,
Severe infections when penicillin cannot be used
UTI, Skin, intra-abdominal and gyne infections; E.coli, Enterobacter, Serratia, Proteus,
Salmonella, Providencia, Pseudomonas, Citrobacter, Haemophilus, Neisseria, Klebsiella
-Narrow spectrum Introduced to kill Staphylococcus
-Broad spectrum both gram (-) and gram (-) organisms such as E. coli, H. influenzae,
Shigella dysenteriae, Proteus mirabilis, and Salmonella species.
-Used to treat penicillinase-producing S. aureus
- Against gran (-) Pseudomonas aeruginosa, Proteus spp., Serratia spp., Klebsiella
pneumoniae, Enterobacter spp., and Acinetobacter spp
C. trachomatis, Nocardia, H influenzae, E coli, P.mirabilis
gram (+) & (-) bacteria
Mycobacterium tuberculosis, Mycobacterium leprae
Ricketssiae, M.pneumoniae, Borrelia recurrentis, H. influenzae, haemophilus ducreyi,
pasteurella tularensis, Bartonella bacilliformis, bacteroides species, vibrio comma, vibrio
fetus, Brucella species, E.coli, E. aurogenes, Shigella, Klebsiella, Diplococcus, S. aureus,
ADVERSEREACTIONS Aminoglycosides

• Superinfection Life threatening:

• Peripheral neuropathy • Anaphylaxis
• Thrombocytopenia
• Laryngeal edema
• Anemia
• Hypokalemia • Agranulocytosis
• Hypomagnesemia • Leukopenia
• Hyponatremia • Hepatic dysfunction
• Neurotoxicity • Increased intracranial
pressure
• Hyperbilirubinemia • Steven’s Johnson syndrome

Serious adverse reactions

• Hearing loss (ototoxicity)
• Nephrotoxicity
Check your Knowledge!
A 28-year-old female patient presents to the clinic with
complaints of severe vaginal itching and discharge. She tells the
nurse that she is usually very healthy but has been taking
antibiotics for an ear infection. What does the nurse recognize as
a possible cause of her vaginal itching and discharge?

a. Anaphylaxis
b. Hypersensitivity
c. Nephrotoxicity
d. Superinfection
Nursing Process: Patient-Centered Collaborative Care
Assessment

Patient Problems
• Tissue injury
• Nausea
• Vomiting

Planning
• The patient’s white blood cell will be within normal limits
Nursing Process: Patient-Centered Collaborative Care

Patient Teaching
General
Encourage to increase fluid intake unless contraindicated
Side Effects
• Advise the patient to report side effects of the drug
• Advise to use sunblock and protective clothing because aminoglycosides can
cause photosensitivity
Evaluation
• Evaluate whether the infection has ceased and whether any side effects occurred
ANTIVIRAL
2. ANTIVIRAL
Virus is an obligate intracellular organism that must reside
within a living host cell to survive and reproduce
• Use their DNA and RNA to generate more viruses.
• With the exception of HIV and certain kinds of viral
hepatitis, viruses are self-limiting illnesses that usually do
not require treatment with a specific antiviral
Antiviral
Antiviral Drugs - are used to prevent or delay the spread of
viral infections. They inhibit viral replication by interfering
with viral nucleic acid synthesis in the cell.
• Some groups of antiviral drugs are effective against
various viruses, such as influenzas A and B, herpesviruses,
HBV and HCV, and HIV.
• With the exception of HIV and some viral hepatitis,
viruses are self-limiting that do not require antiviral
 INFLUENZA
Highly contagious viral infections.
Mostly seasonal and more prevalent
from fall to spring.
• MOT - Droplets begin to enter to the
respiratory tract and begin replication
in 24 hours before the appearance of
symptoms.
• Symptoms include high fever,
headache, fatigue, and myalgia
(muscle ache). Chills, sore throat, non
productive cough, watery nasal
discharge, weakness, red watery eyes,
and photophobia
COVID 19
Emerging infectious disease and
considered one of the respiratory
diseases that is highly virulent
• MOT – Contact, droplet, and
airborne
• Symptoms include fever or chills,
cough, shortness of breath,
fatigue, muscle or body aches,
headache, loss of taste or smell,
sore throat, congestion or runny
nose, nausea or vomiting, and
diarrhea
Types of Viruses
VIRUSES Types
Influenza (FLU) A – moderate to severe infection,
Subtypes B – usually causes mild illness in children,
• H1N1, H3N2 C – infection is a mild respiratory illness not thought to cause epidemics
COVID 19 Virus that cause Covid 19 (2019); first case in the Philippines in 2020. Considered one of the
(SARS-CoV-2) respiratory diseases that is highly virulent.
Herpesviruses Herpes simplex virus (HSV1&2) - HSV 1 (cold sores; lession) HSV2 (genetal herpes-lesions and
ulceration in genetalia),
Varicella Zoster Virus (VZV) - chicken pox/shingles
Epstein-Barr Virus (EBV) or human herpesvirus (HHV-4) - infectious mononucleosis-fever,
tonsillitis, enlarged lymphnodes
Cytomegalovirus (CMV) – mostly asymptomatic. Common in patient with weakened immune
system (HIV, transplant, immunosuppressant drugs, pregnant, neonates
HAV, HBV, HCV, HDV, HEV
Hepatitis HAV&HEV – self limiting (A-vaccine)
HBV&HCV – chronic, co-infected with HDV (B-vaccine, C – no vaccine, common those who inject
drugs )
HIV Virus that attacks the immune system. If not treated appropriately, may lead to AIDS (CD4 cell
count drops below 200 cells/mm)
Nursing Process: Patient-Centered Collaborative Care
Nursing Process: Patient-Centered Collaborative Care
ANTIFUNGAL
Fungal Infection

An infection caused by a fungus may also be called mycosis, tinea, or

candidiasis
Types of fungal infection
• local or systemic
Local fungal infections - can be acquired by contact with an infected
person
Systemic fungal infections - usually transmitted to an individual
through inhalation into the lungs.
Types of Fungal Infection
1. Local infection
• dermatophytes can cause local fungal infections
involving the integumentary system including mucous
membranes, hair, nails, and moist skin areas.
2. Systemic infection
• may involve the lungs, CNS, or abdomen and are
usually transmitted to an individual through inhalation
into the lungs.
Category of fungal infection
• Mild fungal infection (e.g., tinea pedis (athlete’s
foot)
• Severe fungal infection- (e.g.,disease of the lungs or
fungal meningitis).
3. Antifungal / Antimycotic Drugs
Antifungal / Antimycotic drugs - are used to treat fungal infections such as
the superficial infections (mucous membranes, hair, nails, and moist skin
areas, oral candidiasis or thrush, and vaginal candidiasis); and systemic
infections (lungs, CNS, abdomen)

Types of Antifungal / Antimycotic

1. Fungistatic
2. Fungicidal depending upon the susceptibility of the fungus and the
dosage.).
Classification of Antifungal
Classification Example
Polyenes Amphotericin B, Nystatin
Amphotericin – drug of choice for severe infection
Nystatin – Treat Candida infection
Azoles Fluconazole - effective in candidiasis,
coccidioidomycosis, histoplasmosis,
Ketoconazole – variety of fungal infections
Antimetabolites Flucytosine - used in combination with other
antifungal drugs (DNA/RNA
Echinocandins Caspofungin – newest class of antifungal; treat
Aspergillus Candida infections
Miscellaneous Griseolfulvin – for tinea infection
Check your Knowledge!

Metronidazole is primarily used for treatment of disorders caused

by organisms in which area of the body?

a. Gastrointestinal tract
b. Peripheral nervous system
c. Respiratory tract
d. Urinary tract
Antifungal Herbal Medicine (DOH - Approved)
Akapulko (Cassia alata)
• Common names - also known as "bayabas-bayabasan" and "ringworm bush" or Acapulko
in English
• Indications: used to treat ringworms and skin infections. It contains chrysophanic acid, a
fungicide used to treat fungal infections, like tinea pedis, scabies, and eczema.
• Found in: Common in the Philippines
• Parts used: Leaves
Special precautions if given orally for other diseases:
• A strong decoction of Akapulko leaves is an abortifacient. Pregnant women should not
take decoction of the leaves or any part of this plant orally
Preparation: For external use
• Pound the leaves of the Akapulko plant, squeeze the juice and apply on affected areas.
• Pounded leaves may be applied thinly on the affected part twice a day. Marked
improvement may be expected after two to three weeks of continuous application
❖ Other herbal medicine with fungicidal effect: Bayabas
ANTIPROTOZOAL
4. Antiprotozoan Drugs

Protozoa
• Are able to multiply in humans, which contributes to their
survival and also permits serious infections
• Transmission of protozoa that live in a human’s intestine to
another human typically occurs through a fecal-oral route
• Protozoa that live in the blood or tissue of humans are
transmitted to other humans by an arthropod vector (e.g.,
through the bite of a mosquito such as the anopheles
mosquitoes in malaria).
Protozoa

Protozoa - one-celled organisms that can be free-living or

parasitic in nature.
Classifications of protozoa
• Mastigophora – the flagellates (e.g., Gardia, Leishmania)
• Ciliophora – the ciliates (e.g., Balantidium)
• Sarcodina – the ameba(e.g., Entamoeba)
• Sporozoa – organisms whose adult stage is not motile
(e.g., Cryptosporidium, Plasmodium)
Antiprotozoa

Antimalarial - Used to treat Malaria. A life threatening disease

caused by multiple species of protozoan parasites of Genus
Plasmodium.
❖ Malaria is caused by multiple species of protozoan parasites of
the genus Plasmodium that are carried by infected Anopheles
mosquitoes, and it remains one of the most prevalent
protozoan diseases
Plasmodium specie-causing Malaria:

• Plasmodium falciparum - is the most severe

• Plasmodium vivax – most prevalent
• Plasmodium malariae
• Plasmodium ovale
Antimalarial Drugs

• Antimalarial drugs provide treatment and prophylaxis

• Chloroquine is a commonly prescribed drug for malaria.
• When drug-resistant malaria occurs, combinations of antimalarials
are used to facilitate effective treatment.
• If drug resistance to chloroquine occurs, another antimalarial such as
mefloquine hydrochloride (HCl) or combinations of antimalarials with or
without antibiotics (e.g., tetracycline, doxycycline, clindamycin) may be
prescribed
Antimalarial Drugs
General Side Effects and Adverse
Reactions to Antimalarial drugs

• GI upset
• Cranial nerve VIII involvement (quinine and
chloroquine)
• Renal impairment (quinine),
• Cardiovascular effects (quinine).
Check your Knowledge!

What is the causative agent for malaria?

a. Bacterium
b. Fungus
c. Protozoan
d. Virus
Check your Knowledge!

Which among the following Plasmodium specie is not

known to cause Malaria?

a. Plasmodium Ovale
b. Plasmodium Falciparum
c. Plasmodium Malariasis
d. Plasmodium Vivax
Check your Knowledge!

What is not considered general side effects and adverse

reactions to Antimalarial drugs?

a. Respiratory distress
b. GI upset
c. Cranial nerve VIII involvement
d. Renal impairment
ANTHELMINTIC
5. Anthelmintic Drugs
Helminths are large parasitic worms that live and lay eggs in warm,
moist soil where sanitation and hygiene are poor
Transmission occurs from infected soil to the person, whereupon the
helminth then feeds on host tissue. It enter to the human hosts via
contaminated food, bites of carrier insects, or direct penetration to skin.
Most common site for helminthiasis (worm infection) is the intestine.
Other sites for parasitic infection
• lymphatic system blood vessels, and liver.
• These parasites cause disability and developmental delays in
children and adolescents
Mode of Transmission
 4 Major Groups of Parasitic Worms
1. Cestodes (tapeworms) – enter to the intestine via contaminated food (pork, beef,
fish, and dwarf) Taenia solium (pork tapeworm), T. saginata (beef tapeworm),
Diphyllobothrium latum (fish tapeworm), and Hymenolepis nana (dwarf
tapeworm)..
2. Trematodes (flukes) - feed on the host. Fasciola hepatica (liver fluke),
Fasciolopsis buski (intestinal fluke), Paragonimus westermani (lung fluke), and
Schistosoma species (blood flukes)
3. Intestinal nematodes (roundworms) - may feed on intestinal tissue (Ascaris
lumbricoides (giant roundworm), Necator americanus (hookworm), Enterobius
vermicularis (pinworm), Strongyloides stercoralis (threadworm), and Trichuris
trichiura (whipworm).
4. Tissue-invading nematodes (tissue roundworms and filarae) - Trichinella
spiralis (pork roundworm) and Wuchereria bancrofti (filariae)
Anthelmintic Drugs
Side Effects and Adverse Reactions
of Anthelmintics
• Side effects
• GI distress (e.g., anorexia, nausea, vomiting, and occasionally diarrhea and
stomach cramps).
• Neurologic problems (e.g., dizziness, weakness, headache, and drowsiness.
• Adverse reactions do not occur frequently because the drugs usually
are given for a short period (1 to 3 days).
Antimicrobial
Herbal Medicine
among Filipinos
AKAPULKO
Scientific Name: Cassia, Alata L.

Description: contain chrysophanic acid, a fungicide that is used

to treat fungal infections, like ringworms, scabies and eczema

- common ingredient in soaps, shampoos, and lotions in the

Philippines.

Uses: Anti-fungal, Tinea Flava, ringworm, athletes foot, and scabies

also known to be sudorific, diuretic and purgative, used to treat

intestinal problems including intestinal parasite

Preparation: Fresh, matured leaves are pounded.

Dosage: Apply as soap to the affected part 1-2 times a day.

TSAANG GUBAT
Scientific Name: Carmona Retusa

Description: A shrub with small, shiny nice-looking leaves that

grows wild uncultivated areas and forests. Mature stems are used
for planting.

Uses: Diarrhea, Stomachache

Preparation: Boil the leaves in 2 glasses of water for 15 minutes or

until amount of water goes down to 1 glass. Cool and strain

Wash leaves and chop. Boil chopped leaves in 1 glass of water for
15 minutes. Cool and filter/strain and drink.
Dosage: Dried Fresh
Leaves Leaves
Adult 10 tbsp 12 tbsp
7-12 yrs 5 tbsp 6 tbsp
2- 6 yrs 2 ½ tbsp 3 tbsp
NIYOG-NIYOGAN
Scientific Name: Quisqualis Indica L

Description: A vine which bears tiny fruits and grows wild in

backyards. The seeds must come from mature, dried, but newly
opened fruits. Propagated through stem cuttings about 20 cm in
height.

Uses: Antihelmintic

Preparation: Used to expel round worms (ascariasis). The seeds are

taken 2 hours after supper. If no worms are expelled, the dose may
be separated after one week.

Dosage: Adult 8-10 seeds

7-12 yrs 6-7 seeds
6- 8 yrs 5-6 seeds
4- 5 yrs 4-5 seeds

Caution: Not to be given to children below four years old.

BAYABAS
Scientific Name: Psidium guajava L.

Description: A tree about 4-5 meters high with tiny white flowers
with round or oval fruits that are eaten raw. Propagated through
seeds.

Uses: washing wounds, diarrhea

Preparation: As gargle and to relieve toothache. Warm decoction is

used for gargle. Freshly pounded leaves are used for toothache.
Guava leaves are to be washed well and chopped. Boil for 15
minutes at low fire. Do not cover pot. Coll and strain before use.

Dosage: May be used twice a day

May be taken 3-4 twice a day
References
Cantley, A. (2016). Antibiotic resistance: Old genes, new problems
https://sitn.hms.harvard.edu/flash/2016/antibiotic-resistance
Center for Disease Control and Prevention (2021). About HIV.
https://www.cdc.gov/hiv/basics/whatishiv.html
Center for Disease Control and Prevention (2021). Covid 19
https://www.cdc.gov/coronavirus/2019-ncov/symptoms
testing/symptoms.html
Department of Health (2020). Philippine herbal medicine.
http://www.philippineherbalmedicine.org/doh_herbs.htm
McCuistion, L., DiMaggio, K., Winton, M., and Yeager, J. (2021). Pharmacology:
A Patient-Centered Nursing Approach. (10th edition). Elsevier, USA