DRUG STUDY Prescribed and Recommended Dosage, Frequency, and route of Administration 39 mg IV Drip q 24 hours

Generic Name Brand Name Classifications

Mechanism of Action

Indication

Contraindication

Adverse Reaction

Nursing Responsiblities

Ceftriaxone Forgram Cephalosporins- 3rd generation

Bind to the bacterial cell wall membrane, causing cell death. Therapeutic effects: bactericidal action against susceptible bacteria.

Respiratory tract infection

Contraindicated in: CNS: seizures (high > hypersensitivity to doses) cephalosporins. GI: pseudolithiasis > Carnitine deficiency or inborn DERM: rashes, errors of metabolism urticaria Use cautiously in: HEMAT: blood > Renal impairment dyscrasias , > Severe hepatic/ biliary hemolytic anemia impairment

> Assess for infection (V/S, sputum, urine, and stool; WBC) at beginning of and throughout therapy. > Observe pt for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify the physician of other health professional immediately if symptoms occur > Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.

DRUG STUDY

Generic Name Brand Name Classifications

Prescribed and Recommended Dosage, Frequency, and route of Administration

Mechanism of Action

Indication

Contraindication

Adverse Reaction

Nursing Responsiblities

Paracetamol Para-aminophenol derivative, Nonopoid Analgesics, Antipyretics

1 tab q 4 hours, PRN for fever

Thought to produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in the CNS or of other substances that sensitize pain receptors to stimulation. The drug may relieve fever through central action in the hypothalamic heat-regulating center.

>Mild pain >Fever

> Contraindicated Hema: hemolytic anemia, hypertensive to drug leukemia, neutropenia, pancytopenia >Used cautiously to in pts. With long term Hepatic: jaundice alcohol use because therapeutic doses Metab: hypoglycemia Skin: rash, uticaria

>Many OTC and prescription products contain acetaminophen, be aware of these when calculating total daily dose. >Tell pt. not to use for mark fever (temperature higher than 39 C) fever persisting longer than 3 days or recurrent fever unless directed by prescriber. >warn pt. that high dose are unsupervised long term use can cause liver damage. Excessive alcohol use may increase liver damage. Caution: Long term alchoholics to limit drug to 2 grams/day or less.

Skin: Rash.Name of Drug Classification Adverse effect Indication Contraindication Nursing Considerations Cefuroxime IV 50mg q6 ANTIINFECTIVE. penicillins. pruritus. decreased creatinine clearance. Urogenital: Increased serum creatinine and BUN. Hypersensitivity to cephalosporins and related antibiotics. sinusitis. nausea. urticaria. before therapy is initiated. burning. Report onset of loose stools or diarrhea. urinary tract infections. lower respiratory tract infections. superinfections. Effectively treats bone and joint infections. positive Coombs' test. meningitis. bronchitis. Although pseudomembranous colitis. pharyngitis/tonsillitis. and history of allergies. pregnancy (category B). Inspect IM and IV injection sites frequently for signs of phlebitis. cellulitis (IM site). SECONDGENERATION CEPHALOSPORIN Body as a Whole: Thrombophlebitis (IV site). lactation. antibioticassociated colitis. otitis media. skin and soft tissue infections. It is effective for the treatment of penicillinase-producing Neisseria gonorrhoea (PPNG). reducing or eliminating infection. Report any significant changes. . pain. GI: Diarrhea. particularly to drugs. ANTIBIOTIC. gonorrhea. y y y y Determine history of hypersensitivity reactions to cephalosporins. and is used for surgical prophylaxis. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses.

Also used in diagnostic bronchial studies and as an antidote for acute acetaminophen poisoning. y Lab tests: Monitor ABGs. Patient & Family Education y Report difficulty with clearing the airway or any other respiratory distress. y Have suction apparatus immediately available. There are no absolute contraindication but in patients with gastric ulceration relative caution should be observed. suction or endotracheal aspiration may be necessary to establish and maintain an open airway. Increased volume of respiratory tract fluid may be liberated.Classification Name of Drug Adverse effect Indication Contraindication Nursing Consideration Ambroxol 0. Adjuvant therapy in patients with abnormal. viscid. Assessment & Drug Effects y Monitor for S&S of aspiration of excess secretions. . and atelectasis. pulmonary functions and pulse oximetry as indicated. withhold drug and notify physician immediately if either occur. and in pulmonary complications of cystic fibrosis and surgery. or inspissated mucous secretions in acute and chronic bronchopulmonary diseases. and for bronchospasm (unpredictable).5m tid Mucolytic Occasional gastrointestinal side effects may occur but these are almost invariably mild. tracheostomy.

growing adolescents. Infants and children. fever.paranasal sinuses. eyes. diarrhea. urinary tract ACTION Inhibits bacterial DNA gyrase thus preventing replication in susceptible bacteria CONTRAINDICATION Drugs that inhibit peristalsis. confusion. middle ear. GI and abdominal pain. tract. flatulence. vertigo NURSING CONSIDERATION >Assess pt for previous sensitivity reaction >Assess pt for any s/s of infection before & during treatment >Assess for adverse reactions >assess pt.Classification: ANTI-INFECTIVES-Quinolones GENERIC NAME INDICATION Infections of the resp. rash Uncommon: Anorexia. vomiting. headache.dizziness. & family s knowledge of drug therapy Ciprofloxacin BRAND NAME Ciprobay DOSAGE 250-500mg BID . kidneys. Pregnancy and lactation PRECAUTION/ ADVERSE REACTION PRECAUTION Severe and persistent diarrhea during and after treatment ADVERSE RXN Common:Nausea.

migraine. hypersensitivity. active ulceration or chronic inflammation of either upper or lower GIT. administration should be stopped. drowsiness NURSING CONSIDERATION > assess pt. kidney or liver impairment. dysmenorrhea ACTION Aspirin-like drug that has analgesic. nausea. poor platelet function. rheumatic. vomiting. dental. headache. fever. s pain before therapy >monitor for possible drug induced adverse reactions >advice pt.antipyreti c. & antiinflammatory activities CONTRAINDICATION Pregnancy & lactation. not to take drug for more than 7 days >advice pt. blood disorders. postop and postpartum pain. Hx of liver and kidney disease ADVERSE RXN GI discomfort. gas pain. children < 14 yrs PRECAUTION/ ADVERSE REACTION PRECAUTION: If rash occurs. to report immediately persistence or failure to relieve pain . diarrhea or constipation.Classification: GASTROINTESTINAL DRUGS-Laxatives GENERIC NAME Mefenamic acid BRAND NAME Dolfenal DOSAGE Adult: start with 75150mcg BID Severe HPN 300mg BID INDICATION Relief of pain including muscular. traumatic. asthmatics.

vomiting of central and peripheral origin assoc. epileptics. lactation. drowsiness. To avoid driving & other hazardous activities for at least 2 hrs >advice pt. fatigue. lactation ADVERSE RXN Restlessness. headache. to avoid alcohol and other CNS depressant that enhance sedating properties of this drug . pts. dizziness. nausea NURSING CONSIDERATION >give 30 mins before meals and at bed time > assess mental status during treatment >tell pt. with surgery ACTION Dopamine antagonist that acts by increasing receptor sensitivity and response of upper GIT tissues to acetylcholine CONTRAINDICATION GI hemorrhage. elderly. insomnia. hypersensitivity.5-5mg 3x/day 3-4yrs: 3mg 2-3x/day 1-2yrs: 1mg 2-3x/day Under 1 yr: 1mg 2x/day INDICATION Gastrointestinal motility. With breast cancer PRECAUTION/ ADVERSE REACTION PRECAUTION: Activities requiring mental alertness. nausea.Classification: ANTI-INFECTIVES GENERIC NAME metoclopramide BRAND NAME Plasil DOSAGE Adult 10mg 3x/day pedia: 15-20yrs 510mg 3x/day 5-14yrs: 2.

cardiogenic shock. sinus bradycardia PRECAUTION/ ADVERSE REACTION PRECAUTION: Slowing of heart rate. not to discontinue drug abruptly can worsen angina . GI disturbance. skin rashes nausea NURSING CONSIDERATION >tablet may be crashed or swallowed whole > instruct pt to take with meals >inform the pt that drug only controls but does not cure the disorder >tell the pt. occasionally severe bradycardia may lead to vertigo ADVERSE RXN Occasionally fatigue. headache.BETA-BLOCKERS GENERIC NAME metropolol BRAND NAME Neobloc DOSAGE Adult : 50mg BID or 100 mg OD INDICATION Hypertension. dizziness.Classification: CARDIOVASCULAR DRUGS. chronic angina pectoris ACTION Exerts mainly beta1 adrenergic blocking activity but also blocks beta-2 receptors at high doses CONTRAINDICATION AV blocks.

cough. Syncope. puritus NURSING CONSIDERATION y Don t give immediate-release form within 1 week of acute MI or in acute coronary syndrome y Alert: despite the previously widespread SL use nifedipine capsule. nasal congestion. palpitations.Classification: CNS DRUGS. rash. constipation. hypotension. lightheadedness. diarrhea. dyspnea. especially in patients who take beta blockers or antihypertensive y Watch for symptoms of heart failure . and death may result y Monitor blood pressure regularly. Use extended-release tablets cautiously in patients with severe GI narrowing ADVERSE REACTION Dizziness. flushing. Excessive hypotension. classic chronic stable angina pectoris Hypertension ACTION Thought to inhibit calcium ion influx across cardiac and smooth-muscle cells. decreasing contractility and oxygen demand. pulmonary edema.HYPNOTICS/ SEDATIVES GENERIC NAME Nifedipine BRAND NAME Adalat DOSAGE Adults: Initial: 10-30mg PO TID Maximum: 120-180mg Hypertension: 30-60mg PO INDICATION Vasospastic angina. MI. Also may dilate coronary arteries and arteriole CONTRAINDICATION Contraindicated in patients hypersensitive to drug Use cautiously in patients with heart failure or hypotension and in elderly patients. headache. abdominal discomfort. avoid this route of administration. nausea. nervousness. muscle cramps. peripheral edema. weakness.

DRUG NAME GENERIC NAME: cefalexin BRAND NAME: Bioflex CLASSIFICATION: Cephalosporins (antiinfectives) PREPARATION: capsule DOSAGE: 500mg ROUTE: Oral FREQUENCY: q6 ACTION Inhibits bacterial cell wall synthesis. INDICATION Skin and skin structure infections caused by staphylococcus streptococcus. pruritus.coli klebsiella. headache NURSING CONSIDERATIONS Assess patient s previous sensitivity to penicillin or other cephalosporins. CONTRAINDICATION Contraindicated with allergy to cephalosporins of penicillins. Assess for anaphylaxis: rash. lactation. Assess renal function before and during therapy. GU infections caused by E. flushing. Assess patient for signs and symptoms of infection before and during treatment. chills. urticaria. ADVERSE REACTION Skin rashes. pregnancy. Use cautiously with renal failure. . fever. thus promoting osmotic instability which eventually leads to bacterial cell death.

Hyperthyroidism. decreases allergic response by blocking histamine. blurred vision. urticaria. food and drug allergy and insect bites. CONTRAINDICATION Lower respiratory tract symptoms. Patients receiving monoamine oxidase inhibitors (MAOI) therapy. watering eyes. insomnia. frequency. Herpes simplex of the eye. wheezing or chest tightness Monitor I & O: be alert for urinary retention. Delirium agitation. INDICATION Treatment of allergic disorders of allergic rhinitis. contact dermatoses. dysuria. constipation. difficulty with micturition. . Newborn or premature infants. bronchial asthma. before and periodically during treatment Assess respiratory status and increase in bronchial secretions. drug should be discontinued if these occur.DRUG NAME GENERIC NAME: chlorpheniramine BRAND NAME: Antamin CLASSIFICATION: Anti-histamine PREPARATION: Ampoule DOSAGE: 1 amp ROUTE: IV FREQUENCY: STAT ACTION Competes with histamine for H1-receptor site on effector cells. Jaundice. elderly. vasomotor (non allergic) rhinitis. postural hypotension. esp. ADVERSE REACTION Dry mouth. Cardiac arrhythmias including atrial arrhythmia. NURSING CONSIDERATIONS Assess for allergy symptoms: rhinitis. coronary disease. hypertension. pruritus. urticaria.

abdominal pain. and fever) that requires urgent treatment. hemolytic anemia. dyspepsia.  Alert: Drug may cause fatal thrombotic thrombocytopenic purpura (thrombocytopenia. ulcers GU: UTI Hematologic: purpura Musculoskeletal: arthralgia Respiratory: bronchitis.MEDICATION (include dosage.  Use cautiously in patients at risk for bleeding from trauma. headache. pruritus Other: flulike syndrome NURSING RESPONSIBILITIES  Platelet aggregation won t return to normal for at least 5 days after drug has been stopped. impending ADPmediated activation and subsequent platelet aggregation. CONTRAINDICATIONS AND CAUTIONS  Contraindicated in patients hypersensitive to drug or its components and in those with pathologic bleeding (such as peptic ulcer or intracranial hemorrhage). surgery. constipation. neurologic findings. pain CV: edema. SIDE EFFECTS/ ADVERSE REACTIONS CNS: depression. or other pathologic conditions and in those with renal or hepatic impairment. upper respiratory tract infection Skin: rash. including plasmapharesis. gastritis. coughing. diarrhea. hypertension EENT: epistaxis. fatigue. dizziness. MI. or peripheral arterial disease  To reduce thrombotic events in patients with acute coronary syndrome (unstable angina and non-Q-wave MI). rhinitis GI: hemorrhage. including those receiving drugs and those having percutaneous coronary intervention (with or without stent) or coronary artery bypass graft (CABG) y ST-segment elevation acute MI . and irreversibly modifies the platelet ADP receptor. dyspnea. route & frequency) CLOPIDOGREL 75 mg OD DRUG CLASSIFICATION Adenosine diphosphate (ADP)induced platelet aggregation inhibitor INDICATION MECHANISM OF ACTION Inhibits the binding of adenosine diphosphate (ADP) to its platelet receptor. renal dysfunction.  To reduce thrombotic events in patients with atherosclerosis documented by recent stroke.

diarrhea. . ask patient about allergic reactions to penicillin y In patients with impaired renal function. insertion site.V. Penbritin Penicillins 250 mg IV q 6H ANST(-) Inhibits cell wall synthesis during bacterial multiplication Respiratory tract infection y Patients hypersensitive to drugs and other penicillins y Used cautiously in patients with other drug allergies CV: thrombophlebitis. y Advise patient to report discomfort at I. black hairy tongue. leukopenia. thrombocytopenic purpura. and route of Administration Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsiblities Ampicillin sodium Ampicin. vain irritation GI: nausea. agranulocytosis Other: anaphylaxis y Before giving drug. Frequency. Ampicyn. y Monitor liver function test results before therapy y Tell patient to report rash. vomiting. fever or chills. HEMA: thrombocytopenia.Generic Name Brand Name Classifications Prescribed and Recommended Dosage. increase dosage.

diarrhea RESPIRATORY: respiratory depression CONTRAINDICATIONS AND CAUTIONS Contraindicated in patients hypersensitive to drug or other opioids. malaise CV: vasodilation GI: nausea. Thought to bind to opioid receptors and inhibit reuptake of norepinephrine and serotonin SIDE EFFECTS ADVERSE REACTIONS CNS: dizziness. and in those with acute intoxication from alcohol. dyspepsia.MEDICATION (include dosage route & Frequency) Tramadol hydrochloride 50 mg IVTT q 6 hrs RTC x 8 doses DRUG CLASSIFICATION Opioid analgesics INDICATION Moderate to moderately severe pain MECHANISM OF ACTION Unknown: a centrally acting synthetic analgesic compounds not chemically related to opioids. constipation. hypnotics. headache. vertigo. in breastfeeding women. dry mouth. y Drug can produce dependence similar to that of codeine or dextroppropoxyphene and thus has potential for abuse . vomiting. centrally acting analgesics. opioids or psychotropic drugs NURSING RESPONSIBILITIES y Reassess patient s level of pain at least 30 minutes after administration y Monitor CV and respiratory status. CNS stimulation. Withhold dose and notify prescriber if respirations decrease or rate is below 12 bpm y Monitor patients at risk for seizures y Monitor patient for drug dependence. somnolence.

severe febrile or chronic disease states To prevent vitamin C deficiency in patients with poor nutritional habits or Increased requirements.DRUG NAME CLASS INDICATIONS DOSAGE Ascorbic Acid (Vitamin C) Vitamins RDA 500mg/tab Frank and subclinical 1tab OD scurvy Extensive burns. To acidify urine Macular degeneration MECHANISM OF ACTION Stimulates collagen formation and tissue formation. . Dissolve tablet in glass of water immediately before giving. ADVERSE REACTIONS Transient mild soreness may occur at the site intramuscular or subcutaneous injection. Utilization of vitamin may be better with IM route. involved in oxidationreduction reactions throughout the body. In pregnant women. CONTRAINDICATIONS AND CAUTIONS Contraindicated in patients who are hypersensitive to the drug. Give PO solution directly into mouth or with food. Too rapid IV administration of the solution may cause temporary faintness or dizziness. postoperative wound healing. NURSING RESPONSIBILITIES Protect drug from heat and sunlight. Inform patient that there may be changes in the color of his urine. give only if clearly needed. delayed fracture or wound healing.

to produce antiinflammatory. dizziness. diarrhea. insomnia CV: peripheral edema EENT: pharyngitis. antipyretic SIDE EFFECTS ADVERSE REACTIONS CNS: headache. abdominal pain. urine or stool. watch for signs and symptoms of liver toxicity y Drug may be given without regard to meals.MEDICATION (include dosage route & Frequency) Celecoxib 200 mg 1 cap PO BID PRN for pain DRUG CLASSIFICATION Nonsteroidal antiinflammatory drugs INDICATION Acute pain MECHANISM OF ACTION Thought to inhibit prostaglandin synthesis impeding cyclooxygenase2 (COX-2). HPN In elderly or debilitated patients NURSING RESPONSIBILITIES y Watch for signs and symptoms of overt and occult bleeding y Monitor patient with HPN. flatulence METAB: hyperchloremia MUSCULO: back pain RESPI: URTI SKIN: erythema. but food may decrease GI upset y Instruct patient to promptly report sign of GI bleeding such as blood in the vomit. sulfonamides. DHN. asthma. or black tarry stools . heart failure. anemia. rhinitis. analgesic. edema or heart failure y Drug may be hepatotoxic. sinusitis GI: nausea. vomiting. rash. renal disease. or other NSAIDs With severe hepatic impairment Avoid use in the third trimester of pregnancy Use cautiously in patients with history of ulcers or GI bleeding. aspirin. dermatitis Other: accidental injury CONTRAINDICATIONS AND CAUTIONS Patients hypersensitive to drugs.

MEDICATION (include dosage route & Frequency) Metronidazole 500 mg IVTT q 6hrs ANST(-) DRUG CLASSIFICATION Amebicides and antiprotozoal INDICATION Bacterial infections caused by anaerobic microorganism To prevent postoperative infection MECHANISM OF ACTION Direct acting trichomonaside and amebecide that works inside and outside the intestines. metallic taste GU: darkened urine. confusion. flushing EENT: rhinitis. polyuria. sinusitis. constipation. diarrhea. vertigo. vomiting. forming unstable compounds that bind to DNA and inhibit synthesis causing cell death SIDE EFFECTS ADVERSE REACTIONS CNS: fever. headache. CNS disorder or retinal or visual field changes Used cautiously in patients who take hepatotoxic drugs or have hepatic disease or alcoholism NURSING RESPONSIBILITIES y Monitor liver function test results y Give oral forms with meals y Observe patient for edema especially if he is receiving corticosteroids y Record number and character of stools y Instruct patient in proper hygiene y Tell patient to avoid alcohol and alcholo containing drugs during and for atleast 3 days after treatment y Tell patient that he might experience metallic taste and have dark or red brown urine . dysuria HEMA: transient leukopenia MUSCULO: fleeting joint pains RESPI: URTI SKIN: rash OTHER: decrease libido CONTRAINDICATIONS AND CAUTIONS Patients hypersensitive to drug or other nitroimidazole derivatives Used cautiously in patients with history of blood dyscrasia. dizziness CV: flattened T wave. edema. nausea. It is thought to enter the cells of microorganisms that contain nitroreductase. dry mouth. pharyngitis GI: abdominal cramping or pain.

anaphylaxis. angioedema CONTRAINDICATIONS AND CAUTIONS patients hypersensitive to drug and those with acute porphyria use cautiously on patients with hepatic dysfunction. headache EENT: blurred vision HEPA: jaundice OTHER: burning and itching at the injection site.MEDICATION (include dosage route & Frequency) Ranitidine hydrochloride 50 mg IVTT q 8hrs DRUG CLASSIFICATION Antiulcer drugs. H2-receptor antagonist INDICATION Active duodenal and gastric ulcer MECHANISM OF ACTION Competitively inhibits action of histamine on the H2 at receptor sites at parietal cells. Tell him to notify prescriber if any of these occurs . Adjust dosage in patients with impaired renal function NURSING RESPONSIBILITIES y Assess patient for abdominal pain y Note presence of blood in emesis. decreasing gastric acid secretion SIDE EFFECTS ADVERSE REACTIONS CNS: vertigo. stool or gastric aspirate y Remind patient to take once daily prescription drug at bedtime for best results y Instruct patient to take drug without regard to meals because absorption isn t affected with food y Urge patient to avoid cigarette smoking because this may increase gastric acid secretion and worsen disease y Correct hypovolemia before giving drug y Don t give drug epidurally. malaise. coffee-ground vomit. and black tarry stools. intrathecally because of alcohol-content y Carefully observe patient with coagulopathies and those taking anticoagulants y Teach patient signs and symptoms of GI bleeding including blood in vomit. urine or stool.

seizures CV: phlebitis. soft tissue. drug fever CONTRAINDICATIONS AND CAUTIONS Patients hypersensitive to drug and other cephalosporins Used cautiously in patients hypersensitive to penicilin NURSING RESPONSIBILITIES y Before giving drug. abdominal cramps GU: genital pruritus. usually bactericidal SIDE EFFECTS ADVERSE REACTIONS CNS: headache. diarrhea. bone and joints MECHANISM OF ACTION First generation cephalosporins that inhibits cell way synthesis. ask patient if he is allergic to penicillin y Obtain specimen for culture and sensitivity test y Instruct patient to report adverse reactions promptly y Advise patient to notify prescriber if rashes develop or if signs and symptoms of super infection appear such as recurring fever. GU tract. . malaise and chills . urticaria. pruritus OTHER: anaphylaxis. candidiasis HEMA: leukopenia. promoting osmotic instability. neutropenia. thrombophlebitis GI: nausea. thrombocytopenia SKIN: maculopapular and erythematous rashes. confusion. vomiting.MEDICATION (include dosage route & Frequency) Cefazolin 1 gm IVTT q 8hrs ANST (-) DRUG CLASSIFICATION First generation cephalosporins INDICATION Perioperative prevention in contaminated surgery Infections of biliary.

Discontinue drug and notify physician. pseudomembranous colitis GU: interstitial nephritis HEMA: eosinophilia. hemolytic anemia. bactericidal action against susceptible bacteria SIDE EFFECTS ADVERSE REACTIONS CNS: seizures GI: diarrhea. epigastric distress. Keep epinephrine. an antihistamine. pneumococcal pneumonia MECHANISM OF ACTION Bind to bacterial cell wall. leukopenia SKIN: rashes. vomiting. and resuscitation equipment close by in case of an anaphylactic reaction . serum sickness and superinfection CONTRAINDICATIONS AND CAUTIONS Previous hypersensitivity to penicillins Hypersensivity to procaine or benzathine. y Obtain specimens for culture and sensitivity before initiating therapy y Observe patient for signs and symptoms of anaphylaxis. resulting in cell death.MEDICATION (include dosage route & Frequency) Penicillin G 5 ml IVTT q 6hrs ANST(-) DRUG CLASSIFICATION Penicillin INDICATION Treatment of a wide variety of infections including: treatment of enterococcal infections. nausea. severe renal insufficiency NURSING RESPONSIBILITIES y Assess for infection at beginning of and during therapy y Obtain a history to determine previous use of and reactions to penicillins or cephalosporins. tartrazine Use cautiously in geriatric patients. urticaria OTHER: anaphylaxis.

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