VI.

DRUG STUDY
Name: Mrs. LM Unit: Pavilion 2; room 226 Date: March 1, 2011

Generic Dose/ Classificatio Mechanism Of Side effects/ Nursing Management

Name/ Dosage/ n/ Action/
Adverse
Route
Brand Indication Contraindicati Reaction
Name on

Salbutamol 2 doses Classificatio Action: Body as a  Monitor therapeutic

Nebule ns: Synthetic Whole: effectiveness which is
q6˚
indicated by significant
bronchodilato Sympathomime Hypersensitivity
(12-6-12- subjective improvement
r tic amine and reaction.
6) in pulmonary function
mod. selective
(respiratory CNS: Tremor, within 60–90 min after
beta2-
smooth anxiety, drug administration.
adrenergic
muscle agonist nervousness,
relaxant) restlessness,
with  Monitor for: S&S of
comparatively convulsions, finetremor in fingers,
long action. weakness, which may interfere
Indication: Acts more with precision
prominently on headache, handwork; CNS
To relieve
beta2 receptors hallucinations. stimulation, particularly
bronchospas
(particularly in children 2–6 y,
m CV: Palpitation,
smooth (hyperactivity,
associated muscles of hypertension, excitement,
with acute or nervousness, insomnia),
bronchi, uterus, hypotension,
 VI. DRUG STUDY
chronic and vascular bradycardia, tachycardia, GI
asthma, supply to symptoms. Report
reflex
bronchitis, or skeletal promptly to physician.
tachycardia.
other muscles) than
Special
reversible on beta1
obstructive (heart) Senses: Blurred  Lab tests: Periodic
airway receptors. vision, ABGs, pulmonary
diseases. Also Minimal or no functions, and pulse
used to effect on dilated pupils.
oximetry.
prevent alphaadrenergi GI:
exercise c
Nausea,
induced
receptors. vomiting. Other:  Consult physician about
bronchospas
Inhibits giving last albuterol
m. Muscle cramps,
histamine dose several hours
release hoarseness. before bedtime, if drug-
induced insomnia is a
by mast cells. problem.

Contraindicati
on:

Pregnancy
(category C),

lactation. Use
of oral syrup in
children <2 y.
 VI. DRUG STUDY

Cefuroxime 75 mg IV Classificatio Action: Blocks Thrombophlebitis  Determine history of

q8˚ n: beta-adrenergic , hypersensitivity
receptors of the gastrointestinal reactions to
(ANST) Antibiotic cephalosporins,
sympathetic tract
nervous system irritation, penicillins, and history
(Cephalospori
in the heart and hypersensitivity of allergies,
n)
juxtaglomerular reactions, particularly to drugs,
before therapy is
apparatus decreased
initiated.
(kidney), thus hemoglobin
Indication:  Inspect IM and IV
decreasing the count,
injection sites
Treatment of excitability of decreased
frequently for signs of
lower the hematocrit,
phlebitis.
respiratory heart, Transient rise in
 Report onset of loose
tract infection decreasing SGOT and SGPT,
stools or diarrhea.
cardiac output alkaline
Although
and phosphatase,
pseudomembranous
oxygen LDH, and
colitis.
consumption, bilirubin
 Monitor I & O rates and
decreasing the levels, Elevations
pattern: Especially
release of renin in
important in severely ill
from the serum creatinine
patients receiving high
kidney, and/or blood
doses. Report any
and lowering urea
significant
BP. nitrogen and a
changes.
decreased
creatinine
 VI. DRUG STUDY
clearance

Contraindicati
on:

Hypersensitivity
to the
cephalosporin
group of
antibiotics

 Use cautiously in
patients with long term
Paracetamo Prn for Classificatio Action: Hematologic:
alcohol use because
l temperatu n: Thought to hemolytic
therapeutic doses cause
re ≥ 38˚C produce anemia,
Antipyretic hepatotoxicity in these
analgesia by
patients.
Analgesic blocking
 Advise patient that drug is
500mg/ta generation of Hepatic: Jaundice only for short-term use
b pain impulses, and to consult prescriber
probably by if giving to adults
Indication:
1 tab q4˚ inhibiting for longer than 10 days.
Metabolic:
Mild pain prostaglandin  Warn patient that high
Hypoglycemia
synthesis in the doses or unsupervised long-
fever CNS or the term use can cause hepatic
synthesis or damage.
action of other Skin: rash,  Tell patient not to use f
 VI. DRUG STUDY
substances that urticaria. or marked fever (higher
sensitize pain than 39.5 C), fever
receptors to persisting longer than 3
mechanical or days, or recurrent fever
chemical unless directed by
stimulation. prescriber.
 Advise patient that
excessive ingestion
of alcohol may increase the
Contraindicati risk of hepatotoxicity
on:

Contraindicated
inpatients
withhypersensit
ive to drug.

Azithromyci 500mg 1 Classificatio Action: Inhibits CNS: dizziness, Use cautiously with
n cap OD x n: protein seizures, gonorrhea or syphilis,
5 days synthesis at the drowsiness, pseudomembranous
(Zithromax) Anti-
level of the 50S fatigue, colitis, hepatic or renal
infectives
bacterial headache. impairment, lactation
ribosome.
CV: chest pain,
Therapeutic
Indication: hypotension,
Effects: Interventions:
Treatment of palpitations, QT
Bacteriostatic
lower RT prolongation
action against
infections: S.
GI: PSEUDO-  Culture site of infection
Susceptible
 VI. DRUG STUDY
pneumoniae; bacteria. MEMBRANOUS before therapy.
community- COLITIS,
acquired abdominal pain,
pneumonia Contraindicati diarrhea, nausea,  Administer on an empty
due to S. on: cholestatic stomach 1 hr before or
pneumoniae, jaundice, 2–3 hr after meals. Food
Hypersensitivity elevated liver
affects the absorption of
to enzymes, this drug.
azithromycin, dyspepsia,
erythromycin, flatulence,
or other melena, oral
 Counsel patients being
macrolide anti- candidiasis. GU:
treated for STDs about
infectives. nephritis,
appropriate precautions
vaginitis. Hemat:
and
anemia,,
 additional therapy.
leukopenia,,

thrombocytopeni
a. Teaching points:

Derm: STEVENS-  Take this drug on an

JOHNSON empty stomach 1 hr
SYNDROME, before or 2–3 hr after
TOXIC meals; it should never
EPIDERMAL be taken with food.
NECROLYSIS, Take the full course
prescribed. Do not take
VI. DRUG STUDY
photosensitivity, with
rashes. EENT: antacids.
ototoxicity. F and
E hyperkalemia.
Misc:  These side effects may
ANGIOEDEMA. occur: Stomach
cramping, discomfort,
diarrhea; fatigue,
headache (medication
may help); additional
infections in the mouth
(consult with health
care provider for
treatment).

 Report severe or watery

diarrhea, severe nausea
or vomiting, rash or
itching,
 mouth sores
 VI. DRUG STUDY

Acetylcystei 600 Classificatio Action: CNS: fever,  Drug smells strongly

n mg/tab n: drowsiness, of sulfur. Mixing oral
Mucolytic that
Miscellaneous abnormal form with juice or cola
1 tab OD reduces the
respiratory thinking, gait improves its taste.
dissolved viscosity of
Drugs disturbances
in ½ glass pulmonary
of water (mucolytic secretions by CV: tachycardia,
 Drug delivered
cough) splitting hypotension,
through nasogastric
disulfide hypertension,
tube may be diluted
linkages flushing, chest
with water.
Indication: between tightness
mucoprotein
Adjunct EENT:
molecular
therapy for rhinorrhea, ear  Monitors cough type
complexes.
abnormal pain, eye pain, and frequency.
Also, restores
viscid or pharyngitis,
liver stores of
thickened throat tightness
glutathione to
mucous treat  Be aware that facial
GI: stomatitis,
secretions in acetaminophe erythema may occur
nausea,
patients with n toxicity. within 30 to 60
vomiting
minutes after the
pneumonia,
Respiratory: start of an I.V.
rhonchi, infusion and usually
Contraindicati
bronchospasm, resolves without
on:
cough, dyspnea infusion interruption.
Skin: rash,
VI. DRUG STUDY
Contraindicate clamminess,
d in patients diaphoresis,
hypersensitive pruritus,
to drug. urticaria

Other:
angioedema,
Use cautiously
chills,
in elderly or
anaphylactoid
debilitated
reaction
patients with
severe
respiratory
insufficiency.
Use I.V.
formulation
cautiously in
patients with
asthma or a
history of
bronchospasm.
 VI. DRUG STUDY

Furosemide 20 mg IV Classificatio Action: CNS: Dizziness,  Assessment

q8˚ n: vertigo,
Inhibits the
paresthesias,
Diuretics reabsorption of
xanthopsia,  Administer with food or
sodium and
weakness,head milk to prevent GI
chloride from
ache, upset.
Indication: the ascending
drowsiness,
limb of the loop
fatigue, blurred
Oral, IV: of Henle,
vision, tinnitus,
Edema leading to a  Reduce dosage if given
irreversible
associated sodium-rich with other
hearing loss
with CHF, diuresis antihypertensives;
cirrhosis, readjust dosage
renal disease gradually as
C V:Orthostatic  BP responds.
hypotension,
Contraindicati volume
IV: Acute
on: depletion,
pulmonary  Give early in the day so
cardiac
edema that increased urination
Contraindicated arrhythmias,
will not disturb sleep.
with allergy to
furosemide, thrombophlebitis
Oral: HPN sulfonamides;
allergy to  Avoid IV use if oral use
tartrazine (in Dermatologic: is at all possible.
oral solution); Photosensitivity,
anuria, severe rash, pruritus,
VI. DRUG STUDY
renal failure; urticaria,  Do not mix parenteral
hepatic coma; purpura, solution with highly
pregnancy; exfoliative acidic solutions with pH
lactation. below 3.5.
dermatitis,
erythema
multiforme
Use cautiously  Do not expose to light,
with SLE, gout, may discolor tablets or
diabetes solution; do not use
GI: Nausea,
mellitus discolored
anorexia,
 drug or solutions.
vomiting, oral
and gastric
irritation,
 Measure and record
constipation,
weight to monitor fluid
diarrhea, acute changes.
pancreatitis,
jaundice
 Arrange to monitor
serum electrolytes,
GU: Polyuria, hydration, liver
nocturia, function.
glycosuria,
urinary bladder
spasm  Arrange for potassium-
rich diet or
supplemental
VI. DRUG STUDY
Hematologic: potassium as needed.
Leukopenia,
anemia,
thrombocytopeni
a, fluid and
electrolyte

imbalances

Other: Muscle
cramps and
muscle spasms