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V.

DRUG STUDY HEPATITIS B VACCINE Name of Drug Generic (Brand) Hepatitis B (Hepavax) vaccine Classification Dose/ Frequency/ Route 0.5 mL/ one dose/ IM @ vastus lateralis Mechanism of Action Hepatitis B immunoglobulins contain specific neutralising antibodies (mainly IgG) that provide passive immunisation for individuals exposed to the hepatitis B virus. It is used for postexposure prophylaxis in persons who are not vaccinated, or whose prior vaccination regimen is incomplete or when the antibody level is <10 IU/ml. It may also be used in haemodialysis patients and receptors of certain blood products who are unable to develop adequate immune protection. Indication Contraindication Side Effects Nursing Precaution As with all biologicals, epinephrine should always be readily available for immediate use in case of a rare anaphylactic reaction.

Vaccines, antisera & Immunologicals

Prevention of hepatitis B.

Hypersensitivity; severe allergy to gamma globulin or antiimmunoglobulin therapies. IM inj in patients with thrombocytopenia or coagulation disorders.

Soreness, erythema, swelling at the inj site, fever, headache, nausea, dizziness, fatigue.

V. DRUG STUDY PHYTO MENADIONE Name of Drug Generic (Brand) Phytomenadione (Hema-K) Classification Dose/ Frequency/ Route 1 mg/one dose/ IM @ L vastus lateralis Mechanism of Action Phytomenadione promotes hepatic synthesis of clotting factors. It is a naturally occurring compound that is used to prevent and treat haemorrhages related to vitamin K deficiency. Indication Contraindication Side Effects Nursing Precaution May be taken with or without food. Temporary resistance to prothrombindepressing anticoagulants may result especially when larger doses are used.

Haemostatics

Anticoagulant-induced prothrombin deficiency; prophylaxis & therapy of hemorrhagic disease of the newborn & it may also be given to the mother before delivery; hypoprothrombinemia due to oral antibacterial therapy; hypoprothrombinemia.

Hypersensitivity.

Anaphylaxis, dyspnea, cyanosis, pain, swelling, phlebitis at the Inj site, diaphoresis, dizziness, hypotension (rare), allergic reactions after SC and IM inj.

V. DRUG STUDY OXYTETRACYCLINE Name of Drug Generic (Brand) Oxytetracycline (Terramycin) Classification Dose/ Frequency/ Route Ophthalmic ointment O. U. Mechanism of Action Oxytetracycline binds reversibly to the 30S and possibly 50S ribosomal subunits, thus inhibiting bacterial protein synthesis and arresting cell growth. It is active against a wide range of gram-positive and gram-negative organisms.. Indication Contraindication Side Effects Nursing Precaution Elderly, renal or hepatic impairment; myasthenia gravis; lupus erythematosus, children <12 yr.

Tetracyclines / Topical Antibiotics / Eye AntiInfectives & Antiseptics

Credes Prophylaxis for Superficial ophthalmic infections

Hypersensitivity to tetracyclines, children <8 yr, renal damage. Pregnancy, lactation.

Anorexia, nausea, vomiting,diarrhea, glossitis, dysphagia, photosensitivity, esphageal irritation and ulceration, nephrotoxicity, enterocolitis, rash (rare), blood dyscrasias. Headache, visual disturbances; intracranial hypertension; bulging fontanelles (infants).

V. DRUG STUDY FUROSEMIDE Name of Drug Generic (Brand) Furosemide (Lasix) Classification Dose/ Frequency/ Route 2 mg IVT now Mechanism of Action Furosemide inhibits reabsorption of Na and chloride mainly in the medullary portion of the ascending Loop of Henle. Excretion of potassium and ammonia is also increased while uric acid excretion is reduced. It increases plasmarenin levels and secondary hyperaldosteronism may result. Furosemide reduces BP in hypertensives as well as in normotensives. It also reduces pulmonary oedema before diuresis has set in. Indication Contraindication Side Effects Nursing Precaution May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.) Prostatic hyperplasia. Hepatic or renal impairment, gout, DM, impaired micturition. Infusion rate should not exceed 4 mg/min to reduce the risk of ototoxicity. Monitor fluid and electrolyte balance and renal function. May lower serum levels of calcium and magnesium, thus serum levels should be monitored. Pregnancy and lactation.

Diuretics

Edema; Pulmonary edema

Severe sodium and water depletion, hypersensitivity to sulphonamides and furosemide, hypokalaemia, hyponatraemia, precomatose states associated with liver cirrhosis, anuria or renal failure. Addison's disease.

Fluid and electrolyte imbalance. Rashes, photosensitivity, nausea, diarrhoea, blurred vision, dizziness, headache, hypotension. Bone marrow depression (rare), hepatic dysfunction. Hyperglycaemia, glycosuria, ototoxicity. Potentially Fatal: Rarely, sudden death and cardiac arrest. Hypokalaemia and magnesium depletion can cause cardiac arrhythmias.

V. DRUG STUDY GENTAMYCIN Name of Drug Generic (Brand) Gentamycin Classification Dose/ Frequency/ Route 10 mg IVTT OD N.T. Mechanism of Action Gentamicin is an aminoglycoside that binds to 30s and 50s ribosomal subunits of susceptible bacteria disrupting protein synthesis, thus rendering the bacterial cell membrane defective. Indication Contraindication Side Effects Nursing Precaution Concurrent use of neuromuscular blocking agents; myasthenia gravis, parkinsonism; conditions predisposing to ototoxicity and nephrotoxicity; lactation. Monitor plasma concentrations of gentamicin in patients receiving high doses or prolonged courses, in infants, elderly, patients with renal impairment, cystic fibrosis or significant obesity. Monitor auditory and renal functions.

Aminoglycosides / Topical Antibiotics / Eye AntiInfectives & Antiseptics / Ear AntiInfectives & Antiseptics

Susceptible infections; Superficial ophthalmic infections

History of hypersensitivity to aminoglycoside; pregnancy; hepatic impairment, perforated ear drum.

Dizziness or vertigo; acute renal failure, interstitial nephritis, acute tubular necrosis; electrolyte imbalances; transient elevation of serum bilirubin and aminotransferases; purpura; nausea, vomiting; convulsions, mental depression, hallucinations. Atrophy or rat necrosis at inj sites. Potentially Fatal: Nephrotoxicity, ototoxicity and neuromuscular blockade (may unmask or aggravate myasthaenia gravis).

V. DRUG STUDY AMPICILLIN Name of Drug Generic (Brand) Ampicillin Classification Dose/ Frequency/ Route 100 mg IVT q 12oN.T. Mechanism of Action Ampicillin exerts bactericidal action on both gm+ve and gm-ve organisms. Its spectrum includes gm+ve organisms eg, S pneumoniae and other Streptococci, L monocytogenes and gm-ve bacteria eg, M catarrhalis, N gonorrhoea, N meningitidis, E coli, P mirabilis, Salmonella, Shigella, and H influenzae. Ampicillin exerts its action by inhibiting the synthesis of bacterial cell wall. Indication Contraindication Side Effects Nursing Precaution Should be taken on an empty stomach. (Take on an empty stomach 1 hr before or 2 hr after meals.) Renal failure; patients with lymphatic leukaemia or HIV infections; pregnancy and lactation.

Anti-infectives (Penicillins )

Susceptible infections

Hypersensitivity; infectious mononucleosis.

GI upset, nausea, vomiting, diarrhoea; blood dyscrasias; urticaria, exfoliative dermatitis, rash; fever, seizures; interstitial nephritis. Potentially Fatal: Anaphylactic shock; pseudomembranous colitis; neuromuscular hypersensitivity; electrolyte imbalance.

V. DRUG STUDY CEFTAZIDIME Name of Drug Generic (Brand) Ceftazidime Classification Dose/ Frequency/ Route 100 mg slow IVT q 12o N.T. Mechanism of Action Ceftazidime binds to one or more of the penicillinbinding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death. Indication Contraindication Side Effects Nursing Precaution History of penicillin allergy; severe renal impairment; pregnancy, lactation.

Anti-infectives (Cephalosporins)

Susceptible infections

Hypersensitivity to cephalosporins.

Hypersensitivity, dizziness, diarrhoea, nausea, vomiting, renal impairment, rash, erythema multiforme, thrombocytopaenia, superinfection, phloebitis and thrombophloebitis at the site of injection. Potentially Fatal: Anaphylactic reactions, nephrotoxicity, pseudomembranous colitis.

V. DRUG STUDY AMIKACIN Name of Drug Generic (Brand) Amikacin Classification Dose/ Frequency/ Route 15 mg slow IVT OD N.T. Mechanism of Action Amikacin binds to 30S ribosomal subunits of susceptible bacteria, thus inhibiting its protein synthesis. Indication Contraindication Side Effects Nursing Precaution Renal impairment; vertigo, tinnitus. Discontinue if signs of ototoxicity, neurotoxicity or hypersensitivity occurs; lactation. Safety has not been established for treatment period >14 days. Monitor renal function before and during treatment.

Anti-infective) Aminoglycosides

Susceptible Gm-ve infections

Pregnancy, perforated ear drum, myasthenia gravis, hypersensitivity.

Tinnitus, vertigo; ataxia and overt deafness. Potentially Fatal: Ototoxicity, nephrotoxicity, neuromuscular blockade.

V. DRUG STUDY DIBENCOZIDE Name of Drug Generic (Brand) Dibencozide (Hernaclene) Classification Dose/ Frequency/ Route 1 mg (HErnaclene) mix with milk OD Mechanism of Action Indication Contraindication Side Effects Nursing Precaution None

Appetite Enhancers

Dibencozide increases the protein "efficiency coefficient" ie, the percentage of "bound nitrogen" for protein build-up in the body compared to "ingested nitrogen" with food intake. The initial sign of effectiveness is manifested by a marked increase in appetite. Thus, dibencozide facilitates optimum utilization of dietary protein intake, contributes to the formation and repair of body tissues and stimulates appetite.

Premature babies, low birth wt, retarded growth, poor appetite in infant, childn & adult, adjuvant to treatment of TB & other chronic ailments, convalescence from acute infection or surgery, faulty nutrition in older people.

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