C.

Drug Study

Generic Name: betamethasone dipropionate AF Route of Administration: topical Dug Name Generic Name: betamethasone dipropionate Drug Classification: >Corticosteroid (long acting) >Glucocorticoid >Hormone Mechanism of Action Betamethasone is a synthetic (man-made) corticosteroid that is used topically (on the skin). Betamethasone mimics the action of cortisol (hydrocortisone) , the naturallyoccurring steroid produced in the body by the adrenal glands. Corticosteroids have potent antiinflammatory actions and also suppress the immune response. Indication Hypercalcem ia associated with cancer Short-term management of inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders Hematologic

Brand Name: Diprolene; Diprolene Dosage/Available Stock:

Contraindicatio n Hypersensitivi ty; systemic fungal or acute infections.

Adverse Effects >Acne >cracking and stinging of the skin; >dryness; >excessive hair growth; >inflamed hair follicles; >itching; skin irritation.

Nursing Interventions Give daily dose before 9 AM to mimic normal peak corticosteroi d blood levels. Increase dosage when patient is subject to stress. Taper doses when discontinuing high-dose or longterm therapy. Do not give live virus vaccines with immunosuppressiv e doses of corticosteroids Do not stop taking the oral drug without consulting your health care provider. Avoid exposure to

Dosage:

disorders: Thrombocyto penia purpura, erythroblasto penia Ulcerative colitis, acute exacerbation s of MS, and palliation in some leukemias and lymphomas Trichinosis with neurologic or myocardial involvement

infections; ability to fight infections is reduced. Wear a medical alert tag so emergency care providers will know that you are on this medication. You may experience these side effects: Increase in appetite, weight gain (counting cal ories may help);heartburn, indigestion (eat frequent small meals; take antacids); poor wound healing (consult with your care provider); muscle weakness, fatigue (frequent rest periods will help). Report unusual weight gain, swelling of the extremities, muscle weakness, black or tarry stools, fever,

prolonged sore throat, colds or other infections, worsening of original disorder.

Generic Name:

Cefixime

Brand Name: Suprax Dosage/Available Stock: Oral suspension 100 mg per 5 mL 200 mg per 5 mL

Route of Administration: PO Oral suspension

Dug Name Generic Name: Cefixime > Suprax Drug Classificati on: Antibiotic, Cephalosp

Mechanism of Action Cefixime is a semi-synthetic (partially manmade), oral antibiotic in the cephalosporin family of antibiotics. The cephalosporin family includes cephal exin (Keflex), ce faclor (Ceclor),c efuroxime (Zina

Indication Bronchitis, Cardiopulmonar y resuscitation, Gonorrhoea, Otitis media, Pharyngitis, Pneumonia, Respiratory

Contraindicati on contraindic ated in patients with known allergies to the cephalospo rin or penicillin antibiotics

Adverse Effects CNS: Dizziness, headache, seizure (less than 2%). Dermatologic: Erythema multiforme, facial edema, pruritus, skin rash, StevensJohnson syndrome,

Nursing Interventions Caution should be exercised in patients with history of diarrhea, stomach or bowel problems (eg, inflammation), bleeding or blood clotting problems, kidney or liver problems, poor nutrition, any allergy, who are taking other medications, children, during

orin Dosage:

cef), cefpodoxime (Vantin), cefpro zil (Cefzil), and many injectable forms. Like other cephalosporins, cefixime stops bacteria fr om multiplying by preventing bacteria from forming the walls that surround them. The walls are necessary to protect bacteria from their environment and to keep the contents of the bacterial cell together; bacteria cannot survive without a cell wall. Cefixime is active against a very wide spectrum of bacteria such as Staphylococc us aureus, Strepto

tract infections, Uncomplicated UTIs,

toxic epidermal necrolysis, urticaria (less than 2%). GI: Diarrhea (16%); nausea (7%); loose or frequent stools (6%); flatulence (4%); abdominal pain, dyspepsia (3%); vomiting (less than 2%); pseudomembra nous colitis. Genitourinary : Acute renal failure, candidiasis, genital pruritus, transient elevations in BUN or creatinine, vaginitis (less than 2%).

pregnancy and breast feeding. It may cause dizziness, do not drive a car or operate machinery while taking this medication. Avoid alcohol consumption Avoid changing dose forms (eg, tablets, suspension) without your doctors advice. Take full course of treatment Review dosing schedule and prescribed length of therapy with patient. Instruct patient or caregiver to shake well before measuring dose, and to measure and administer prescribed dose using dosing spoon, dosing syringe, or medicine cup. Advise patient to take without regard to meals but to take with food if GI upset occurs.

coccus pneumoniae, St reptococcus pyogenes (the cause of strep throat), Hemop hilus influenzae, Moraxella catarrhalis, E. coli, Klebsiella, Proteus mirabilis, Salmo nella, Shigella, andNeisseria gonorrhoeae.

Advise patient to discontinue therapy and contact health care provider immediately if skin rash, hives, itching, or shortness of breath occur. Advise patient to report the following signs of superinfection to health care provider: black furry tongue, foul-smelling stools, vaginal itching or discharge, white patches in mouth

Generic Name: Ferrous Sulfate Sol, Fer-Iron Dosage:400-600 mg/day in divided doses

Brand Name: Feosol, Fer Iron, Fer-Gen-Sol, Fer-in-

Route of Administration: PO

Dug Name Generic Name:

Mechanism of Action Elevates the serum iron concentration

Indication Preventio n and

Contraindic ation Hypersens

Adverse Effects >Dizziness >N & V

Nursing Interventions Expect stools to darken in color.

Ferrous Sulfate >Feosol, Fer Iron, Fer-GenSol, Fer-inSol, Fer-Iron Drug Classificatio n: Iron Preparation Dosage:

which then helps to form High or trapped in the reticuloendotheli al cells for storage and eventual conversion to a usable form of iron.

treatment of iron deficiency anemias Dietary suppleme nt for iron.

itivity Severe hypotensi on. > Nasal Congestion > Dyspnea > Hypotension > CHF > MI > Muscle cramps > Flushing If gastrointestinal discomfort occurs, take after meals or with food Do not take within 2 hours of antacids because it rpevents absorption Decreased iron absorption with antacids, colestyra mine, trientine, proton pump inhibitors.

Decreased absorption of both iron and tetracycline wh en admin together. Delayed response to iron in patients on systemicchloramphe nicol Reduced efficacy of levothyroxine with iron. Decreased absorption of cefdinir,

bisphosphonates, entacapone, flouroquinolones, levodopa, methyldo pa and penicillamine

Generic Name: Lactulose Route of Administration: PO

Brand Name: Enulose, Generlac, Kristalose Dosage/Available Stock: PO 15 to 30 mL (10 to 20 g lactulose) daily may increase to 60mL/day.

Dug Name Generic Name: Lactulose

Mechanism of Action Lactulose is a type of sugar. It is broken down in the large intestine into mild acids that draw water into the colon, which helps soften the stools.

Indication Treatment of constipation; prevention and treatment of portalsystemic encephalopat hy, including stages of hepatic precoma and coma.

Contraindicatio n Use in patients who require lowgalactose diet.

Adverse Effects >Gaseous distention with flatulence or belching, >abdominal discomfort >cramping; >diarrhea; >nausea; >vomiting

Nursing Interventions Evaluate therapeutic response: decreased constipation or blood ammonia level. Assess amount, colour and consistency of stool Take as directed, alone, or diluted with water, juice or milk, or take with food. Laxative results may not occur for 24-48 hours; do not take more often than recommended or for a longer time than recommended

Drug Classification: Hyperosmotic agent Dosage:

. Do not use any other laxatives while taking lactulose. Increased fiber, fluids, and exercise may help reduce constipation. Do not use if experiencing abdominal pain, nausea, or vomiting. Diarrhea may indicate overdose. May cause flatulence, belching, or abdominal cramping Report persistent or severe diarrhea or abdominal cramping

Generic Name:

Mupirocin

Brand Name: Bactroban Dosage/Available Stock: three times daily.

Route of Administration: topical

Dug Name Generic Name: Mupirocin >Bactroban Drug Classification: Antibacterial Dosage:

Mechanism of Action It kills sensitive bacteria by stopping the production of essential proteins needed by the bacteria to survive.

Indication Treating impetigo, a type of skin infection. It may also be used for other conditions as determined by your doctor.

Contraindicatio n allergic to any ingredient in Mupirocin Ointment

Adverse Effects >Burning >pain >stinging >Severe allergic reactions (rash; hives; itching; >difficulty breathing; >ightness in the chest; >swelling of the mouth, face, lips, or tongue); severe irritation; >severe itching

Nursing Interventions Mupirocin Ointment is for external use only. Do not get it in your eyes or mouth. Use Mupirocin Ointment with caution on skin with open wounds. Be sure to use Mupirocin Ointment for the full course of treatment. Long-term or repeated use of Mupirocin Ointment may cause a second infection. Apply a small

amount of Mupirocin Ointment 3 times a day. Wash and completely dry the affected area. Gently rub the medicine in until it is evenly distributed. The affected area may be covered with gauze or a bandage. To clear up your infection completely, use Mupirocin Ointment for the full course of treatment. Keep using it even if you feel better in a few days. Wash your hands immediately after using Mupirocin Ointment.

Generic Name:

Nystatin

Brand Name: Mycostatin, Nilstat

Route of Administration: Oral, oral suspensions,vaginal,topical Dosage/Available Stock: Tablets500,000 units; oral suspension100,000 units/mL; troche200,000 units; vaginal tablets100,000 units; topical cream, ointment, powder100,000 units/g Dug Name Generic Name: Nystatin >Mycostati n, >Nilstat Drug Classifica tion: Antifungal Dosage: Mechanism of Action Fungicidal and fungistati c: Binds to sterols in the cell membrane of the fungus with a resultant change in membrane permeability, allowing leakage of intracellular components and causing cell death. Indication Oral: Treatment of oropharynge al candidiasis Oral suspension, troche: Treatment of oral candidiasis Vaginal: Local treatment of vaginal candidiasis (moniliasis) Topical applications: Treatment of cutaneous or mucocutane ous mycotic infections caused Contraindica tion Adverse Effects Nursing Interventions Culture fungus before therapy. Have patient retain oral suspension in mouth as long as possible before swallowing. Paint suspension on each side of the mouth. Continue local treatment for at least 48 hr after clinical improvement is noted. Prepare nystatin in the form of frozen flavored popsicles to improve oral retention of the drug for local application. Administer nystatin troche orally for the treatment of oral candidiasis; have patient dissolve 12 tablets in mouth.

Contraindic

ated with allergy to nystatin or component s used in preparation . Use cautiously with pregnancy, lactation.

>GI: Diarrhea, nausea, vomiting, GI distress Vaginal >Local: Irritation, v ulvovaginal burning >Local: Local irritation (topical)

by Candida albicans and other Candid a species

Insert vaginal suppositories high into the vagina. Have patient remain recumbent for 1015 min after insertion. Provide sanitary napkin to protect clothing from stains. Cleanse affected area before topical application unless otherwise indicated. Monitor response to drug therapy. If no response is noted, arrange for further cultures to determine causative organism. Ensure that patient receives the full course of therapy to eradicate the fungus and to prevent recurrence. Discontinue topical or vaginal administration if rash or sensitivity occurs. Take the full course of drug therapy even if symptoms improve. Continue during menstrual period if vaginal route is being

used. Long-term use of the drug may be needed; beneficial effects may not be seen for several weeks. Use appropriate hygiene measures to prevent reinfection or spread of infection. This drug is for the fungus being treated; do not self-medicate other problems. Refrain from sexual intercourse or advise partner to use a condom to avoid reinfection; use a sanitary napkin to prevent staining of clothing with vaginal use. You may experience these side effects: Nausea, vomiting, diarrhea (oral use); irritation, burning, stinging (local use). Report worsening of condition; local irritation, burning (topical application); rash, irritation, pelvic pain (vaginal use);

nausea, GI distress (oral administration

Generic Name: Omeprazole Route of Administration: Oral

Brand Name: Prilosec, Zegerid Dosage/Available Stock: Capsules: 10, 20 and 40 mg. Tablets: 20 mg (Prilosec OTC). Powder for oral suspension: 20 and 40 mg Indication Contraindicatio n Known hypersensitiv ity to omeprazole Adverse Effects >headache >abdominal pain >nausea >diarrhea >rash >dizziness >severe skin Nursing Interventions Give omeprazole before meals, preferably in the morning for once-daily dosing. If needed, also give an antacid, as prescribed. If needed,

Dug Name Generic Name: Omeprazole >Prilosec >Zegerid

Mechanism of Action Blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid is decreased, and this allows the stomach and esophagus to

Drug Classification: Proton Pump

Treatment of duodenal ulcers Prevention of relapse of duodenal ulcers Treatment of gastric ulcers Prevention of relapse of gastric ulcers

inhibitors Gastric acid pump inhibitor antiulcer agen Dosage:

heal.

rash

open capsule and sprinkle enteric-coated granules on applesauce or yogurt or mix with water or acidic fruit juice, such as apple or cranberry juice. Give immediately. To give drug via NG tube, mix granules in acidic juice because enteric coating dissolves in alkaline pH. Because drug can interfere with absorption of vitamin B12, monitor patient for macrocytic anemia. Be aware that long-term use of omeprazole

may increase the risk of gastric carcinoma Encourage patient to avoid alcohol, aspirin products, ibuprofen, and foods that may increase gastric secretions during therapy Advise patient to notify prescriber immediately about abdominal pain or diarrhea

Generic Name:

Petrolatum topical

Brand Name: Petroleum Jelly Dosage/Available Stock:

Route of Administration: topical

Dug Name

Mechanism of Action

Indication

Contraindicatio n

Adverse Effects

Nursing Interventions

Generic Name: Petrolatum topical >petroleum jelly Drug Classification: Topical emollients

For temporary relief from dry itching skin and pain due to minor burns, abrasions and other irritated skin conditions

Softening and moisturizing dry, cracked, or irritated skin. Mineral Oil/Hydrophili c Petrolatum Ointment is an emollient. It works by softening and moisturizing the skin.

Allergy to any ingredient in Mineral Oil/Hydrophili c Petrolatum Ointment

>Mild itching, >burning >drying, >or stinging.

Dosage:

Mineral Oil/Hydrophilic Petrolatum Ointment is for external use only. PREGNANCY and BREASTFEEDING: If you become pregnant while taking Mineral Oil/Hydrophilic Petrolatum Ointment, discuss with your doctor the benefits and risks of using Mineral Oil/Hydrophilic Petrolatum Ointment during pregnancy. It is unknown if Mineral Oil/Hydrophilic Petrolatum Ointment is excreted in breast milk. If you are or will be breastfeeding while

you are using Mineral Oil/Hydrophilic Petrolatum Ointment, check with your doctor or pharmacist to discuss the risks to your baby Wash your hands before using Mineral Oil/Hydrophilic Petrolatum Ointment. Wash and dry the affected area, unless otherwise directed by your doctor. Apply a thin layer of medicine to the affected area, then gently spread the medicine until it is evenly distributed. Wash your hands immediately

after using Mineral Oil/Hydrophilic Petrolatum Ointment, unless your hands are part of the treated area. Check with your doctor or pharmacist before applying a bandage to the affected area. If you miss a dose of Mineral Oil/Hydrophilic Petrolatum Ointment and are using it regularly, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Dug Name Generic Name:

Mechanism of Action

Indication

Contraindicatio n

Adverse Effects

Nursing Interventions

Drug Classification:

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