evaluation, peripheral sensation; P, edema; R,

adventitious sounds; liver evaluation; CBC,

clotting times, LFTs, renal function tests; serum
electrolytes, stool guaiac

Mefenamic
Acid

Interventions
Give with milk or food to decrease GI upset.
Arrange
for
periodic
ophthalmologic
examinations during long-term therapy.
If overdose occurs, institute emergency
procedures supportive therapy and induced
emesis, activated charcoal, and/or an osmotic
cathartic.

( me fe nam ik)
Pregnancy Category C
Drug Class
NSAID

Mechanism of Action
Mefenamic Acid inhibits prostaglandin synthesis.
It possesses anti-inflammatory, antipyretic and
analgesic effects.

Teaching Points
Take drug with food; take only the prescribed
dosage; do not take the drug longer than 1
0
week.
Discontinue drug and consult your health care
provider if rash, diarrhea, or digestic problems
occur.
Dizziness or drowsiness can occur (avoid driving
and using dangerous machinery).
Report sore throat, fever, rash, itching, weight
gain, swelling in ankles or fingers; changes in
vision; black, tarry stools, severe diarrhea, right
upper adominal pain, flulike symptoms, chest
pain.

Indication
Relief of moderate pain when therapy will not
exceed
1
wk.
Treatment
of
primary
dysmenorrhea
Contraindication
Contraindicated
with
hypersensitivity
to
mefenamic acid, aspirin or NSAID allergy, and
as treatment of peri-operative pain with coronary
artery bypass grafting.
Use Catiously with asthma, renal or hepatic
impairment, peptic ulcer disease, GI bleeding,
hypertension, heart failure, pregnancy, lactation

Adverse Effects
CNS: Headache, dizziness, somnolence,
insomnia, fatigue, tiredness, tinnitus, ophthalmic
effects
CV: HF, hypertension, tachycardia
Dermatologic: Rash, pruritus, sweating, dry
mucous membranes, stomatitis
GI: Nausea, dyspepsia, GI pain, diarrhea,
vomiting, constipation, flatulence, ulcers, GI
bleed
GU: Dysuria, renal impairment
Hematologic: Bleeding, platelet inhibition with
higher
dose,
neutropenia,
eosinophilia,
leukopenia, pancytopenia, thrombocytopenia,
agrunlocytosis,
granulocytopenia,
aplastic
anemia, decreased Hgb or Hct, bone marrow
depression, menorrhagia
Respiratory: Dyspnea, hemoptysis, pharyngitis,
bronchospasm, rhinitis
Other: Peripheral edema, anaphylactoid
reactions to anaphylactic shock

Cefuroxime
Ketorolac

Bone and joint infections due to S.aureus

Perioperative prophylaxis
( se fyoor ox eem)
Treatment of acute bacterial maxillary sinusitis in
Pregnancy Category B
patients 3 mo-12 yr
Drug( Class
kee toe role ak )
Contraindication
Antiobiotic
Pregnancy Category C (1st and 2nd trimester)
Contraindicated
withCategory
allergy
to generation)
cephalosporins
Cephalosporin
(second
Pregnancy
D
(3rd trimester)or
penicillins.
ofwith
Action
UseMechanism
cautiously
renal failure, lactation,
Drug Class

Bactericidal:
Inhibits
synthesis of bacterial cell
pregnancy.
Antipyretic
wall,
causing cellanalgesic
death.
Nonopioid
Adverse Effects
NSAID
Indication
CNS: Headache, dizziness, lethargy,
Lower respiratory infections caused by
paresthesias
Mechanism of Action
S.pneumonia,
S.aureus,
E.coli,pain,Klebsiella
GI: Nausea,
diarrhea, vomiting,
adominal
Anti-inflammatory
and
analgesic
activity; inhibits
pneuemoniae, H.influenzae, S.pyogenes
flatulence, anorexia,
pseudo-membranous
prostaglandins
and leukotriene
Dermatologic
infections
caused bysynthesis
S.aureus,
colitis, hepatotoxicity
Indication
S.pyogenes,
E.coli,
K.pneumoniae,
GU: Nephrotoxicity
Short-term management of pain (up to 5 days)
Enterobacter
Hematologic:
Bone Relief
marrowof depression
Ophthalmic:
ocular itching due to
UTIs
caused by E.coli,
K.pneumoniae
(decreased seasonal
WBC,
decreased
platelets, relief
Nursing Considerations
conjunctivitis
Uncomplicated and
disseminatedand
gonorrhoea of
decreased
Hct)
Assessment
postoperative
inflammation
and
pain after
caused by N.gonorrhoeae

Hypersensitivity:
Ranging
from
rash
to
fever
to
History: Allergies; renal, hepatic, CV, GI
cataract surgery
Septicemia
cause by S. pneumonia ,
anaphylaxis;
serum sickness reaction
conditions; pregnancy; lactation
H.influenzae,
K.pneumoniae,
abcess S.aureus,
at injectionE.coli,
site, phlebitis,
Contraindication
Physical: Skin color and lesions; orientation, Local: Pain,
H.influenzae.
inflammation
at IV site
Contraindicated
with
significant
renal
reflexes, ophthalmologic and audiometric
Meningitis caused by S. pneumonia ,
Other: Superinfections,
disulfram-like
reaction
impairment, during labor and delivery, lactation;
H.influenzae, S.aureus, N.meningitidis
with alcoholpatients
wearing
soft
contact
lenses
(ophthalmic); aspirin allergy; concurrent use of
NSAIDs; active peptic ulcer disease, recent GI

Nursing Considerations
Assessment
History: Hepatic and renal impairment,
lactation, pregnancy
Physical: Skin status, LFTs, renal function tests,
culture of affected area, sensitivity tests
Interventions
Culture infection site, and arrange for sensitivity
tests before and during therapy if expected
response is not seen.
Give oral drug with food to decrease GI upset
and enhance absorption.
Give oral tablets to children who can swallow
tablets; crushing the drug results in a bitter,
unpleasant taste. Use solution for children who
cannot swallow tablets.
Have
vitamin
K
available
in
case
hypoprothrombinemia occurs
Discontinue if hypersensitivity reaction occurs.
Evaluate patient for Clostridium difficile infection
if diarrhea occurs.
Teaching Points
Avoid alcohol while taking this drug and for 3
days after because severe reactions often occur.
Report severe diarrhea, difficulty breathing,
unusual tiredness or fatigue, pain at injection
site.

history of peptic ulcer disease or GI bleeding;

hypersensitivity to ketorolac; as prophylactic
analgesic before major surgery; treatment of
perioperative pain CABG; suspected or
confirmed
cerebrovascular
bleeding;
hemostasis,
Other: hemorrhagic
Peripheral diathesis,
edema,incomplete
anaphylactoid
high
risk
of
bleeding;
use
with
probenecid,
reactions to anaphylactic shock; local burning,
stingingpentoxyphylline.
(ophthalmic)
Use cautiously with impaired hearing; allergies,
Nursing Considerations
hepatic, CV and GI conditions
Assessment
Adverse
Effects
History:
Renal
impairment; impaired hearing;
CNS:
Headache,
dizziness, lactation,
somnolence,
Mechanism
of Action
allergies;
hepatic,
CV,
GI conditions;
insomnia,
fatigue,
tinnitus,
ophthalmic
Needed for adequate metabolismeffects
pregnancy
Dermatologic:
Rash,lesions;
pruritus,
sweating, dry
Physical:
Skin color and
orientation,
Indication
mucous
membranes and
reflexes,
ophthalmologic
audiometric

GI:
Nausea,
dyspepsia,
GI
pain, BP;
diarrhea,

Prevention
and
treatment
of
vitamin
evaluation, peripheral sensation; P, edema;
vomiting,
constipation,
flatulence, CBC,
gastric or
deficiencies
R, adventitious
sounds;
liver evaluation;
duodenal
ulcers
clotting times, LFTs, renal function tests; serum
Contraindication
GU:
Dysuria,
renal impairment
electrolytes,
stool guaiac
Diverticular
disease,platelet
ulcer from
stomach
Hematologic:
Bleeding,
inhibition
withacid,
inflammation eosinophilia,
of the lining of
Interventions
higherulcerated
dose, colon,
neutropenia,
the
stomach
and
intestines,
several
blood
Be aware
that patient
may be at increased
risk
leukopenia,
pancytopenia,
thrombocytopenia,
transfusions,
metabolism
causing
for CV events,
GI bleeding,iron
renal
toxicity, disorder
agrunlocytosis,
granulocytopenia,
aplastic
increased
iron Hgb
storage,
increased
bodily iron
monitoranemia,
accordingly.
decreased
or Hct,
bone marrow
Do not depression,
use during
labor
or
delivery
or
in
breastfrom high
RBC
destruction,
haemolytic
anemia
menorrhagia
feeding
patients; serious
adverse
effects topharyngitis,
the
Respiratory:
Dyspnea,
hemoptysis,
Adverse
Effects
fetus orbronchospasm,
baby
are possible.
rhinitis
Constipation,
diarrhea,
stomach,
May increase
risk of bleeding.
Do upset
not use
with nausea,
stomachbefore
pain, black or
high risk of vomiting,
bleeding heartburn,
or prophylatically
dark-colored stools or urine, temporary staining
surgery.
of from
the teeth,
unusual
Discard bottle
nasalheadache,
spray within
24 hrorofunpleasant
taste in your mouth
opening.

Multivitamins
w/ Iron

Keep emergency equipment readily available at

time of initial dose, in case of severe
hypersensitivity reaction.
Protect drug vials from light.
Administer every 6 hr to maintain serum levels
and control pain.

Nursing Considerations
Assessment
Assess patient for vitamin deficiency; usually
more than one vitamin deficiency is present.

PO route
Liquid multivitamins can be diluted or dropped
Teaching Points
into patients mouth using dropper provided
Every effort will be made to administer drug on Use cautiously
with some
brands.
with
previous liver disease, renal
Nursing
Considerations

Chew
tabs
should
be chewed,
not swallowed
time to control pain; dizziness, drowsiness can
failure,
dialysis,
bilateral
cerebrovascular
Assessment
occur; burning and stinging on application
disease,whole
pregnancy, lactation
History: Assess pts history of hypersensitivity
(ophthalmic)
IVEffects
routeto methyldopa; hepatic disease, previous
Do not use ophthalmic drops with contact lenses. Adverse
(methy-ill-DOH-pah)
Sedation,
Give
by
cont inf therapy
only
afterassociated
diluting
5-10
(ra NI
ti deen)
methyldopa
withml liver
headache,
asthenia,
weakness,
Report sore throat, fever, rash, itching, weight CNS:
Pregnancy
Category
B
Pregnancy
Category
B
(multivitamins)/
disorders
500-1000
ml
of
D
W,
dizziness, light-headedness, symptoms 5 of D10W,
gain, swelling in ankles or fingers; changes in
Weight,
temperature,
skin color
D20W,Physical:
LR, Dinsufficiency,
NaCl,body
0.9%
NaCl, 3% NaCl
5/0.9%
cerebrovascular
paresthesias,
vision black, tarry stools; easy bruising.
Drug
Classification
Drug
Class

Do
not
use
sol
with
crystals,
precipitate
or
color
andBells
lesions;
color,
palsy, mucous
decreasedmembranes
mental
parkinsonism,
Antihypertensive,
centrally-acting

Gastrointestinal
agent
other
lesions,
than
bright
orientation
yellow.
affect,
reflexes
activity, involuntary choreoathetotic movements,
Antisecretory ( H2-receptor antagonist )
psychic disturbances
Mechanism
of Action
Teaching
Interventions
Points prolonged carotid sinus
CV:
Bradycardia,
Mechanism
of
action
not
conclusively
Mechanism
of that
Action
Advise
Administer
patient
IV slowly,
adequate
monitor
nutrition
injection
mustsite
be
hypersensitivity,
aggravation
of
angina
pectoris,
demonstrated;
probably
due
to
drugs

Inhibits
the
action
of
histamine
at
the
H2 Monitor
function,
especially
in the
maintained
tohepatic
prevent
furtherpericarditis,
deficiencies;
to first
paradoxical
response,
metabolismreceptor
topressor
- methylnorepinephrine,
which
site
located
primarily
in
gastric
parietal
6-12
weeks
of therapy
or
if unexplained fever
comply
with
treatment
regimen.
myocarditis,
orthostatic
hypotension,
edema
lowers
arterial
blood
pressure
bytreating
stimulating
cells,
resulting
in
inhibition
of flavoured
gastric acid

Advise
patient
to
avoid
appears
Dermatologic:
Rash
as in eczema
oradrenergic
lichenoid
central nervous
system

2
secretion
Monitor
blood
counts
periodically
multivitamins
as
candy,
child may
overdose.
eruption,
toxic
epidermal
necrolysis
fever,
lupus to direct
receptors,
which
in turn decreases
sympathetic

Caution
patient
to
store
vitamins
out of test
haemolytic
anemia;
a
direct
Coombs
like
syndrome
Indication
outflow
from the CNS
childrens
before
reach.
therapy
6-12
months
may be
Endocrine:
Breast
enlargement,
gynecomastia,
Duodenal
and andgastric
ulcer later
(short-term
helpful
Indication
lactation, treatment);
hyperprolactenemia,
amenorrhea, conditions
pathologic hypersecretory

Discontinue
therapy
if
involuntary
galactorrhea,
impotence
failure
to
ejaculate,
Hypertension
such as Zollinger-Ellison syndrome,
maintenance
choreoathetotic
occur
decreased
libido
Acute
hypertensive
(IVmovements
methyldopate);
therapy crisis
for duodenal
or gastric not
ulcer, gastro

Discontinue
if
edema
progresses
or signs of
GI:
vomiting,
distention,
drugNausea,
of choice
because of
slowdisease,
onsetconstipation,
of erosive
action esophagitis,
esophageal
reflux
CHFcolitis,
occur dry mouth, sore or lack
flatus, diarrhea,
Heartburn
Contraindication

Add
a thiazide
to drug
regimen
tongue, pancreatitis,
sialadenitis,
abnormal
liveror increase
Hypersensitivity
tojaundice,
methyldopa,
active
hepatic
dosage
if methyldopa
intolerance
occurs
functionContraindication
tests,
hepatitis,
hepatic
Monitor BPmethyldopa
carefully
discontinuing
disease,
previous
therapy
to
the drug,when
some
products that
necrosis Hypersensitivity
methyldopa
associated contain
with
liveralcohol
disorders
should be avoided with patients
with known intolerance

Methyldopa
Ranitidine

Tramadol

Teaching Points
Adverse Effects
Teach
patient
toFatigue,
report any
symptoms of CNS
Constipation,
CNS: Dizziness,
Diarrhea,
CNS stimulation,
somnolence,
Headache,
changes;
allergic
reactions
headache, anxiety,
Insomnia,
Muscle confusion,
Pain, Nausea,
euphoria,Vomiting,
seizures,
Teach patient that drowsiness, dizziness and
hallucinations,
Agitation,
Anemia,
flushing,
Confusion,
sedation
Depression, Easy
confusion
may
occur;
to call
for
assistance
CV:
Vasodilation,
Orthostatic
hypotension,
bruising or bleeding, Drowsiness,
Malaise,
Instuct patient to make position changes slowly;
tachycardia,
hypertension,
ECG
Blurred
Vision,
Rash, abnormal
Fever, Tachycardia,
(TRAM
ah dol)
orthostatic
hypotension
may
occur
Bradycardia
GI: Nausea, vomiting, constipation, dry
mouth,
Pregnancy
Category
Tell patient
to avoidC OTC medication and alcohol
diarrhea, abdominal pain, anorexia, flatulence, GI
unless
Nursing
Considerations
bleeding
Drug
Classapproved by prescriber
Assessment
GU: Urinary
retention or frequency, menopausal
Analgesic
Assess
patient
with ulcers
or suspected
symptoms,
dysuria,
menstrual
disorder ulcers:
epigastric
and
abdominal
pain,
Mechanism of Action hematemesis,
Nursing
occultConsiderations
blood
in stools,
gastric in the CNS causing
Binds
with blood
opiateinreceptors
Assessment
aspirate before
and throughout
treatment,
monitor altering
inhibition
of ascending
pain pathways,
gastric
AssesspH
pain:
location,
type,
character;
give
before
(5
should
be
maintained)
the perception of and response
to pain; also
pain becomes
extreme
inhibits
the reuptake of norepinephrine and
Interventions
Assess for serotonin,
increased side
effects
renal hepatic
which
mayin account
for tramadols
Monitor
I
&
O
ratio,
BUN,
Creatinine,
CBC with
disease analgesic effect
monthly.
differential
Assess need
for product
MonitorIndication
heart rate after administering the drug.
Interventions
To relieve moderate to moderately severe pain
Teaching
MonitorPoints
I & O ratio: check for decreasing output;
may indicate
urinary
retention
Instruct
patient
to avoid
alcohol and follow diet as
Contraindication
Monitor
CNS
changes
prescriber
recommends.
Alcohol intoxication; excessive use of centralDetermine
allergic
reactions:
rash,
urticaria
Advise
patient
to report
bruising,
fatigue,
malaise
acting analgesics, hypnotics, opioids or other
blood
Do notdyscrasias
break, crush,
chew ER product
mayoroccur.
psychotropic
drugs; hypersensitivity to tramadol
Give with antiemetic for nausea, vomiting
or its components; use within 14 days of MAO
Administer when pain is beginning to return
inhibitor therapy

Doxycycline
Ampicillin

Contraindication
During infusion protect solution from light
powder for suspension
Allergy to The
tetracyclines,
renal or expires
hepatic 12 months
date oflactation
issue
dysfunction, from
pregnancy,
Prophylaxis of malaria in pregnant individuals
Teaching Points
and in children less than 8 years old
May take with food; take caps with a full glass of
(dox-ih-SYE-kleen)
(am-pih-SILL-in)
Adverse Effects
water Dto
preventB esophageal ulceration and
Pregnancy Pregnancy
Category
Category
Anorexia, remain
Nausea,
upright Vomiting,
for 45 min. Diarrhea,
Dizziness,
Headache,
Rashes,
Sensitivity
to with a full
Drug ClassDrug
Take
1 hr before or 2 hr
after meals
Classification
sunlight tetracycline
Antibiotic,
glass of water.
May take 2 hr before or 2 hr after
Antibiotic,
penicillin
antacids containing aluminum, calcium, or
Nursing Considerations
Mechanism of Action
magnesium,
preparations containing iron or
Mechanism
of Action
Assessment
Bacteriostatic:
inhibits
protein
synthesis
of milk, ice
orfordairy
products
(e.g.
cheese,
zinc,
Bactericidal
action
against
sensitive
Note reasons
therapy,
onset,
and organisms;
susceptible bacteria,
causing cell death
cream)
inhibits
synthesis of bacterial cell wall, causing
characteristics
of S&S
Take
entire
prescription;
not signs,
stop if symptoms
Obtain C&S
when
indicated.
Monitordovital
cell
death
Indication
subside.
and report if skin rash, hives,
CBC, renal and
LFTsStop drug
Infections
caused
by
Ricketssiae,
Indication
itching,
SOB,
headache,
or blurred vision occur.
M.pneumoniae,
Check for any
allergic
or
hypersensitivity
agents
of
psittacosis,
ornithosis,
Avoid direct
to
sunlight
and wear
Treatment
of exposure
infections
caused
by susceptible
reactions;
note
expiration
date
as
expired
lymphogranuloma venerum, and granuloma
protective
clothing
and
sunscreens
when
strains
salmonella, E. coli,
H.
tetracycline B.recurrentis,
productsofareshigella,
nephrotoxic
inguinale;
H.duereyi, P.pestis;
exposed.
influenza,
P. mirabilis, N. gonorrhoeae,
S.aureus
Interventions
enterococci, gram-positive organisms.
T.pertenue,
L.monocytogenes,
Clostridium,
Administer
oral medicatoin
regard
to
the
Meningitis
caused bywithout
neisseria
meningitiditis
B.anthracids;
adjunct
to
amebicides
in
acute
Unlabelled
in cesarean
section
food or meals;
if GI use:
upsetprophylaxis
occurs, give
with
intestinal
amebiasis
meals, patients
I certain
being
high-risk
treated
patients.
for periodontal
Adjunct therapy for severe acne
disease should receive tablet at least least 1 hr
Reduce Contraindication
incidence of anthrax
before morning and evening meals

to penicillin
ProphylaxisHypersensitivity
of malaria
Avoid rapid administration. Duration of IV
infusion may vary with the dose; usually 1-4 hr.

 Use cautiously in elderly patients, children,

Adverse Effects
pregnant women, and during lactation
Rash, Urticaria, Anemia, Increased bleeding time,
Bone Adverse
marrow Effects
depression, Granulocytopenia,
Nausea, Vomiting,
Diarrhea, excitement,
Enterocolitis,
CNS: Hyperkinesia,
nervousness,
Glossitis, Pseudomembranous
colitis, vertigo,
Oliguria,weakness,
tension, tremor, dizziness,
Proteinuria, drowsiness,
Hematuria,
Vaginitis,
restlessness, headache, insomnia,
Glomerulonephritis,
Hallucinations,
malaise, Lethargy,
fatigue, lightheadedness,disturbed
Anxiety,
Depression,
Twitching,
sleep, aggresiveness behavior, Coma,
irritability
Convulsions,
Anaphylaxis,
Abdominal
pain
CV:
Palpitations,
tachycardia,
BP changes,
hypertension, tight chest, chest pain or
Nursing Considerations
discomfort, angina
I&O ratio;
report hematuria,
oliguria,
since
Hypersensitivity:
Urticaria,
angioedema,
rash,
penicillin inbronchospasm
high doses is nephrotoxic
Liver studies:
ALT
GI:AST,
Diarrhea,
dry mouth, appetite loss or
Blood studies:
WBC,
RBC,
Hgb &
Hct, bleeding
stimulation, epigastric
pain
time Miscellaneous: Flushing, sweating, bad or
Renal studies:
Urinalysis,
Protein,in Blood,
BUN, cramps,
unusual
taste, change
smell, muscle
Creatinine oropharyngeal edema, difficult urination
Culture & sensitivity before drug theraphy; drug
may beNursing
taken asConsiderations
soon as culture is taken
Assessment
Encourage
the patient to take full course of
therapy. Obtain history; assess EKG and CNS status.
with
tachyarrhythmias
Administer Avoid
drug use
orally
oncardiac
an empty
stomach 1

Document
PFTs,
CXR,
oxygen
sats and lung
hour before or 2 hours after meals.
sounds.
Monitor
pulmonary
statusor(i.e. breath
Check IV site
carefully
for signs
of thrombosis
sounds,
flow,intravenously
or ABGs)
drug reaction
when VS,
drugpeak
is given
Determine if able to self-administer medication.
Observe for allergic responses.

Albuterol
(al-BYOU-ter-ohl)
Albutamol ( Salbutamol )
Pregnancy Category C
Drug Class
Sympathomimetic
Mechanism of Action
Relaxes smooth muscles by stimulating beta-2
receptors
of
the
bronchi,
leading
to
bronchodilation
Indication
Prophylaxis and relief of bronchospasm in
reversible obstructive airway disease
Acute attacks of bronchospasm (inhalation
solution)
Prophylaxis of exercise-induced bronchospasm

Interventions
The aerosol and inhalation powder are indicated
for children 4 years and older; the solution for
inhalation is indicated for children 2 years and
older.
When given by nebulization, use either face
mask or mouthpiece.
If administering medication through inhalation,
allow at least 1 minute between inhalation of
aerosol medication.
Teaching Points
Take as directed; do not exceed prescribed dose
Maintain calm, reassuring approach. Do not
leave client/ child unattended if acute short of
breath; should improve 30-60 min after therapy

hyoscine-NAmikacin
butylbromide

Adverse Effects
Adverse Effects
Contraindications

Confusion,
disorientation,
depression,

CNS:
Dizziness,
anaphylactic
reactions/
shock, lethargy,
Hypersensitivity to the drug
(am-ih-KAY-sin)
Use cautiously in patients with cardiac disease,
visual disturbances,
increased nystagmus,
ICP, disorientation,
restlessness, headache,
Pregnancy Category D
fever, numbness,
tingling, confusion,
tremor, paresthesias,
irritability, drowsiness,
headache,
hypertension, diabetes mellitus, glaucoma,
Drug
Class
muscle
twitching,
convulsions,
muscular
hallucination,
delirium,
seizure disorder, hyperthyroidism, exercise- Pregnancy
Category
C impaired memory

Antibiotic,
aminoglycoside
CV: Hypotension,
weakness tachycardia, palpitations,
induced bronchospasm
Drug Class
flushing Mechanism of Action
Antispasmodics
Considerations
GI:
Dry Nursing
mouth,
constipation,
nausea,
epigastric
Bactericidal:
inhibits
protein
synthesis in
Assessment
distress
Mechanism ofsusceptible
Action
strains
of gram-negative
bacteria,
NoteFlushing,
reasons
for therapy,
onset, characteristics
Dermatologic:
dyshidrosis
Acts by interfering
the transmission
nerve
and thewithfunctional
integrityof of
bacterial cell
S&S, C&S
results.
Assess weight, hydration
GU: Urinaryof
retention,
urinary
hesistancy
impulses membrane
by
acetylcholine
appears to be disrupted,
in
thecausing cell
status
U/A, CBCbronchial
, renal andplugging,
LFTs; reduce dose
Respiratory:
Dyspnea,
parasympathetic
death.nervous system
with dysfunction
depressed respiration

Obtain dilated
audiometric
assessment
with high doses
Indication
Indication
EENT: Mydriasis,
pupils,
blurred vision,
use
or
Short-term
treatment
of pressure,
serious
photophobia,
Indicated
forprolonged
the relief
of spasm
of the infections
increased
intraocular
th

Note
vestibular
dysfunction;
monitor
caused
bygastrointestinal
susceptible strains
of Pseudomonas
genitourinary
tract or
tract and
for for 8 CN
difficulty
of swallowing
impairment
R/T elevated
peak drug
levelsspecies,
species, E.
coli,
indole
positive
proteus
the symptomatic
relief
of Irritable
Bowel
Nursing
Considerations
Syndrome providencia species, klebsiella, enterobacter, and
Interventions
Drug compatibility
be acinetobacter
monitored closely
in
serratiashould
species,
species.

Monitor
duration
of
treatment;
usually
7-10 days.
Contraindications
patientsContraindications
requiring adjunctive therapy

If
clinical
response
does
not
occur
Myasthenia
gravies,
megacolon,machinery
hypersensitivity
Avoid
driving
and operating
after within 3-5

Patients
with
allergy
to
aminoglycosides,
days, stop therapy.
to drug administration
contents,
narrow angle glaucoma,
parenteral

renal
or
hepatic
preexisting
hearing

Ensure
that
patient
is well hydrated
before
and
prostate
with disorder,
urinary
retention,
Avoid
stricthypertrophy
heat
loss,
myasthenia
gravis,
parkinsonism, infant
mechanical
stenosis
the GI tract,
tachycardia
Raise
side during
rails
asthe
aintherapy.
precaution
because
some
botulism,
lactation.
Use
cautiously
in elderly

Assess
I&O
ratio,
report
for
sudden
patients become temporarily excited or change in
patients
disoriented urine
and output
some develop amnesia or
Take vital signs during infusion; watch for
become drowsy
hypotension, change in pulse

Metronidazole
Tranexamic
Acid
(met-ro-ni-da-zole)
Pregnancy Category B

(tran-eks-am-ik)
Drug Class
Pregnancy Category B

Mechanism of Action
Mechanism of Action
Competitively inhibits activation of plasminogen.
Effective against anaerobic bacteria and
Directly inhibits plasmin activity, but higher doses
protozoa. Specifically inhibits growth of
are required than are needed to reduce plasmin
trichomonae and amoebae by binding to DNA,
formation.
resulting in loss of helical structure, strand
breaking, inhibition of nucleic acid synthesis,
Indication
and cell
Used after delivery
todeath.
reduce bleeding.

Treatment
Indication
of bleeding.
Reduce risk
secondary
hemorrhage
of
Serious
infections
due to outcomes
susceptible anaerobic
in patients with
traumatic hyphema.
bacteria.
Peritonitis. Intra-abdominal abscess and liver
Contraindication
abscess due to B. fragilis and so on.
Allergy toanySkin
ingredient
tranexamic
acid.
and in
skin
structure
infections due to
Patients with Bacteroides
disturbance species.
of color vision.
Patients with
irregular bleeding
of unknown
Endometritis,
endomyometritis,
tube-ovarian
cause.
abscess, and post surgical vaginal cuff infection
Conditions that
increase blood
clots.
duemay
to Bacteroides
Species.

Adverse Effects
Bacterial
vaginosis
and
symptomatic
Headache,
fatigue,
abdominal
pain,
trichomoniasis in males and females
hallucinations
Bacterial septicemia due to bacteroides species.

Adjunct therapy to treat bone and joint infections

Nursing Considerations
due to bacteroides species
Administer by mouth usually 2-4 times daily or as
Meningitis and brain abscess due to Bacteroides
directed by the physician.
species
Dosage must be based on clients weight.
Endocarditis due to Bacteroides species
Amebiasis
To reduce postoperative anaerobic infection
Nursing Considerations
following
colorectal
surgery,
elective
Reduce dosage to patients with hepatic disorder.
hysterectomy, and emergency appendectomy
Discontinue
infusion during infusion of
primary
Hepatic IV
encephalopathy
metronidazole.
Crohns disease
Monitor CBC,
LFTs, and
cultures.to
with difficile
Diarrhea
associated
withpatients
Clostridium
amebiasis, monitor stool number/characteristics.
To patients
with IV
therapy, assess for sodium
Adverse
Effects
retention.
Headache, dizziness, confusion, irritability,
With pregnancy use the 7-day regimen for
restlessness, ataxia, depression, fatigue,
trichomoniasis.
drowsiness,
insomnia,
paresthesia,
Administer PO
drug with food
to reduce
GI upset. peripheral
neuropathy,
convulsions,
Instruct patient
to take no alcohol
until at least incoordination,
48
depression, blurred vision, sore throat, retinal
hours after therapy is completed.
edema,todry
mouth,
metallic
taste, furry tongue,
Encourage patient
avoid
vaginal
intercourse
glossitis, stomatitis, nausea, vomiting, diarrhea,
during treatment.
epigastric distress, polyuria, abdominal cramps,
darkened urine, vaginal dryness, cystitis,
incontinence, rash, pruritis, urticaria, flushing