DRUG STUDY

VITAMIN K
ERYTHROMYCIN
BCG
HEPATITIS B
Generic Name Phytonadione
Brand Name
Therapeutic
Mephyton V
I
Vitamins
Classification
Dosage, Route and 0.5 - 1 mg IM one time only after 1 hour of birth ; 2 mcg/day after birth PO
Frequency

Indication
Prevention, treatment of hemorrhagic states in neonates. Antidote for
hemorrhage induced by oral anticoagulants, hypoprothrombinemic states
T
A
due to vitamin K deficiency. Hypoprothrombinemia caused by
malabsorption or inability to synthesize vitamin K.
Contraindication Lack of parental consent ; Biliary disease, hepatic disease and jaundice ;

M
Hypersensitivity to Vitamin K.
Promotes hepatic formulation of coagulation factors II, VII, IX, X. Essential
Mechanism of for normal clotting of blood. Readily absorbed from GI tract (duodenum)
Action after IM, subcutaneous administration. Metabolized in liver. Excreted in
urine; eliminated by biliary system. Onset of action (increased coagulation
factor)
I
Drug to Drug
Interaction
Warfarin, Oral anti-coagulant, Mineral oil and cholestyramine N
Adverse Effects Hyperbilirubinemia, Severe reaction

K
 NURSING RESPONSIBILITY
• Document the giving of the medication to newborn to prevent
an accidental doubling of the dose.
• Observe for bleeding (usually occurs on second or third day).
Bleeding may be seen as generalized ecchymosis or bleeding
from umbilical cord, circumcision site, nose or gastrointestinal
tract.
• Observe for jaundice and kernicterus, especially in preterm
infants.
• Observe for signs of local inflammation.
• Apply pressure to the injection site to prevent further bleeding
• Protect drug from light.
• Give vitamin K before circumcision procedure.
Generic Name
Brand Name
Erythromycin Opthalmic
Ilotycin Ophthalmic E
Therapeutic
Classification
Anti-infectives for Treatment of Acne, Macrolide Antibiotics, Ophthalmological
Anti-infectives R
Dosage, Route and
Frequency
0.5 – 1 cm in conjunctival sac once after birth, topical Y
Indication
Treatment of superficial ocular infections caused by susceptible strains of
microorganisms; prophylaxis of ophthalmia neonatorum caused by N. T
Contraindication
gonorrhoeae or C. trachomatis.
Minor ocular irritation, Hypersensitivity H
Inhibits protein synthesis in susceptible organisms by binding to 50S
ribosomal subunits, thereby inhibiting translocation of aminoacyl transfer-RNA R
Mechanism of Action
and inhibiting polypeptide synthesis.
Exerts effect only against multiplying organisms; penetrates cell wall of gram- O
positive bacteria more readily than that of gram-negative bacteria, and thus,
gram-positive organisms may accumulate 100 times more erythromycin than
gram-negative organisms do
M
Drug to Drug
Interaction Do not use other eye medications unless the doctor tells to. Y
Adverse Effects Hypersensitivity reaction, Minor ocular reaction, Redness C
I
N
 NURSING RESPONSIBILITY
• History: Allergy to erythromycin, hepatic impairment, lactation;

viral, fungal, mycobacterial infections of the eye

(ophthalmologic), pregnancy

• Use topical products only when needed. Sensitization produced

by the topical use of an antibiotic may preclude its later

systemic use in serious infections. Topical antibiotic

preparations not normally used systemically are best.

• Cover the affected area with a sterile bandage if needed

(topical)
Generic Name BCG (Bacillus Calmette-Guerin)
Brand Name TICE BCG
Therapeutic Anti-tuberculosis live, attenuated vaccine, immunotherapy

B
Classification
Dosage, Route and 0.05 ml after birth one dose, ID
Frequency
Indication Protect tuberculin skin test-negative infants and children, and groups with an
excessive rate of new TB infections ; Carcinoma in situ of the bladder.

C
Contraindication Impaired immune responses; Immuno-suppressive corticosteroid therapy;
asymptomatic carriers with positive HIV serology; fever; UTI; lactation
Mechanism of BCG vaccine is an attenuated strain of bacillus Calmette-Guerin Mycobacterium
Action bovis used as biologic response modifier. It is also used as an active
immunotherapy for the treatment of bladder carcinoma in situ by causing
local, chronic inflammatory response involving macrophage and leukocyte

G
infiltration of the bladder, resulting in the destruction of superficial tumor
cells of the urothelium.
Drug to Drug Concurrent antimycobacterial therapy , Cyclosporine, Cytomegalovirus
Interaction immune globulin and other live vaccines, Previous vaccination with or other
exposure to BCG
Adverse Effects Abdominal pain, bladder spasm, cough, systemic BCG infection, allergic
reactions
 NURSING RESPONSIBILITY
• Monitor for signs and symptoms of systemic BCG infection:

Fever, chills, severe malaise, or cough.

• Culture blood and urine, if systemic infection is suspected.

• Assess for regional lymph node enlargement and report fistula

formation.

• A small ulcer will occur and leave the ulcer uncovered.

• If necessary, cover it with a dry dressing only

Generic Name
Brand Name
Hepatitis B Vaccine
Engerix-B, Hepaccine, HBV, Recombivax
H
Therapeutic
Classification Anti-hepatitis B vaccine, Antisera E
Dosage, Route and
Frequency
1st dose: 0.5 ml, 24 hours after birth, IM ; 2nd dose: 0.5 ml 1-2 months, IM
3rd dose: 0.5 ml 6-15 months, IM
P
Indication To promote active immunity in individuals at high risk if potential exposure to A
hepatitis B virus or HBsAg positive materials. Has been used simultaneously
(into different sites) with hepatitis B immune globulin (H-BIG) for post-exposure
prophylaxis inselected patients and infants born to HBsAG positive mothers.
T
Contraindication Severe allergic reaction (e.g., anaphylaxis) after a previous dose of any hepatitis
B-containing vaccine, or to any component of ENGERIX-B, including yeast
I
Mechanism of Action Suspension of inactivated and purified hepatitis B surface antigen (HBsAg) T
derived from human plasma of screened asymptomatic HBsAg positive carriers
of hepatitis B virus. Hepatitis B vaccine recombinant is the first vaccine
produced by gene splicing. No human plasma is used in its production.
I
Drug to Drug
Interaction Protein-based therapies S
Adverse Effects Mild local tenderness at injection site, local inflammatory reaction, fever,
malaise, fatigue, headache, dizziness, faintness, leg cramps, myalgia, arthralgia,
nausea, vomiting, diarrhea, rash, urticarial, pruritus
B
 NURSING RESPONSIBILITY
• Note: the ACIP recommends serologic confirmation of post

vaccination immunity in patients undergoing dialysis and

immune-deficient patients

• Monitor temperature. Some patients develop a temperature

elevation of 38.3 ̊C following vaccination that may last 1 or 2

days.

• Keep track of any and all side effects the child has after

receiving this vaccine