Drug name ClassificationMechanism Indication Contraindication Adverse Nursing

of Action Effect Consideration

Generic Antibacterial- Interferes -treatment of -contraindicated CNS: -allergy to
name: bactericidal with DNA UTIs caused with allergy to headache, Ciprofloxacin
Ciprofloxacin replication in by E.coli Ciprofloxacin , dizziness, -arrange for
susceptible -Otic: norfloxacin, or insomnia, culture and
Brand bacteria treatment of other fatigue, sensitivity
name: preventing acute otitis fluoroquinolones, blurred test before
Ciloxan, cell externa pregnancy, vision beginning
Cipro reproduction -oral: STDs lactation. CV: therapy.
caused by N. -use cautiously arrhythmias, -continue
gonorrhea with renal hypotension, therapy for 2
Availability: -LRTI: caused dysfunction, angina days after
-tablets by E.coli, tendinitis or GI: nausea, signs and
-injection Enterobacter tendon rupture vomiting, dry symptoms of
-oral species, associated with mouth, infection are
suspension S.pneumoniae fluoroquinolones diarrhea, gone
-opthalmic -effective in abdominal -ensure that
ointment patient with pain patient is well
- otic cystic fibrosis Hematologic hydrated
suspension who have : elevated -give antacids
pulmonary BUN, AST, at least 2 hr
exacerbations. ALT, serum after dosing
creatinine -monitor
and alkaline clinical
phosphatase, response; if
decreased no
WBC, improvement
neutrophil is seen or a
count, Hct relapse
EENT:dry occurs, repeat
 eye, eye pain culture and
Other: fever, sensitivity
rash -encourage
Patient to
complete full
course of
therapy.

Drug Classification Mechanism of action Indication Contraindication Adverse effects Nursing responsibilities
Generic Name: Oxytocic Directly stimulates Prevention and CNS: headache,
Methylergonovine vascular smooth- muscle treatment of hallucination, Inform patient and
Maleate contractions in uterus postpartum Hypersensitivity seizures, family of reason for
and cervix and decreases hemorrhage. CVA (with I.V.
Brand Name: Methergin bleeding after delivery use) using drug, and
Dosage and Route:
to drug CV: hypertension, provide reassurance.
hypotension,
For transient chest
• Hypertension pain, palpitations, • Tell patient drug
stimulation of thrombophlebitis
EENT: tinnitus, may cause nausea,
labor: • Toxemia
vomiting, dizziness,
nasal congestion increased blood
10 units(1ml) of drug • Pregnancy
GI: nausea, pressure, headache,
infused in 1L (except during
vomiting, diarrhea ringing in ears, chest
D5LRS before third stage of
GU: hematuria pain, or shortness of
deliver labor)
breath. Advise her to
Musculoskeletal
report severe or
For troublesome
: leg cramps Respiratory:
Reduction of symptoms.
dyspnea
Postpartum
bleeding: 1 amp after Skin: • As appropriate,
diaphoresis, rash, review all other
delivery of
allergic reactions
placenta Other: foul taste significant and life-
threatening adverse
 reactions and
interactions,
especially those
related to the drugs
and tests mentioned
above.

doxycycline
(dox i sye' kleen)
Adoxa, Apo-Doxy (CAN), Doryx, Doxy 100, Doxy 200, Doxycin (CAN), Doxytec (CAN), Novo-Doxylin (CAN), Nu-
Doxycycline (CAN), Periostat, Vibra-Tabs, Vibramycin

Drug classes
Antibiotic

Therapeutic actions
Bacteriostatic: Inhibits protein synthesis of susceptible bacteria, causing cell death.

Indications
 Infections caused by rickettsiae; M. pneumoniae; agents of psittacosis, ornithosis, lymphogranuloma venereum and granuloma
inguinale; B. recurrentis; H. ducreyi; P. pestis; P. tularensis; B. bacilliformis; Bacteroides; V. comma; V. fetus; Brucella; E.
coli; E. aerogenes; Shigella; A. calcoaceticus; H. influenzae; Klebsiella; D. pneumoniae; S. aureus
 When penicillin is contraindicated, infections caused by N. gonorrhoeae, T. pallidum, T. pertenue, L. monocytogenes,
Clostridium, B. anthracis, Chlamydia psittaci, C. trachomatis
 Oral tetracyclines used for acne, uncomplicated adult urethral, endocervical, or rectal infections caused by C. trachomatis
 Acute intestinal amebiasis
  Reduction of incidence and progression of disease following exposure to anthrax
 Malaria prophylaxis for malaria due to Plasmodium falciparum for short-term use in travelers
 Treatment of periodontal disease as an adjunct to scaling and root planing
 Unlabeled use: Prevention of "traveler's diarrhea" commonly caused by enterotoxigenic E. coli

Contraindications and cautions

 Contraindicated with allergy to tetracyclines
 Use cautiously with renal or hepatic dysfunction, pregnancy, lactation.

Adverse effects
 Dental: Discoloring and inadequate calcification of primary teeth of fetus if used by pregnant women, discoloring and
inadequate calcification of permanent teeth if used during period of dental development
 Dermatologic: Phototoxic reactions, rash, exfoliative dermatitis (more frequent and more severe with this tetracycline than
with any others)
 GI: Fatty liver, liver failure, anorexia, nausea, vomiting, diarrhea, glossitis, dysphagia, enterocolitis, esophageal ulcer
 Hematologic: Hemolytic anemia, thrombocytopenia, neutropenia, eosinophilia, leukocytosis, leukopenia
 Local: Local irritation at injection site
Other: Superinfections, nephrogenic diabetes insipidus syndrome

Interventions
 Administer the oral medication without regard to food or meals; if GI upset occurs, give with meals; patients being treated for
periodontal disease should receive tablet at least 1 hr before morning and evening meals.
 Protect patient from light and sun exposure.

METRONIDAZOLE
(me-troe-ni'da-zole)
Flagyl, Flagyl ER, Flagyl IV RTU, Flagyl 375, Metizol, Metric 21, Metro I.V., MetroGel, MetroGel Vaginal, MetroLotion, Noritate, Protostat
Classifications: antiinfective; antitrichomonal; amebicide; antibiotic

Actions
Synthetic compound with direct trichomonacidal and amebicidal activity as well as antibacterial activity against anaerobic bacteria and some
gram-negative bacteria.

indication
Asymptomatic and symptomatic trichomoniasis in females and males; acute intestinal amebiasis and amebic liver abscess; preoperative
prophylaxis in colorectal surgery, elective hysterectomy or vaginal repair, and emergency appendectomy. IV metronidazole is used for the
treatment of serious infections caused by susceptible anaerobic bacteria in intraabdominal infections, skin infections, gynecologic infections,
septicemia, and for both pre- and postoperative prophylaxis, bacterial vaginosis. Topical: Rosacea.

Adverse Effects ( 1%)

Body as a Whole: hypersensitivity (rash, urticaria, pruritus, flushing), fever, fleeting joint pains, overgrowth of Candida. CNS: Vertigo, headache,
ataxia, confusion, irritability, depression, restlessness, weakness, fatigue, drowsiness, insomnia, paresthesias, sensory neuropathy (rare). GI:
Nausea, vomiting, anorexia, epigastric distress, abdominal cramps, diarrhea, constipation, dry mouth, metallic or bitter taste, proctitis.
Urogenital: Polyuria, dysuria, pyuria, incontinence, cystitis, decreased libido, dyspareunia, dryness of vagina and vulva, sense of pelvic pressure.
Special Senses: Nasal congestion. CV: ECG changes (flattening of T wave).

NURSING IMPLICATIONS
Assessment & Drug Effects

 Discontinue therapy immediately if symptoms of CNS toxicity (see Appendix F) develop. Monitor especially for seizures and peripheral
neuropathy (e.g., numbness and paresthesia of extremities).
 Lab tests: Obtain total and differential WBC counts before, during, and after therapy, especially if a second course is necessary.
 Monitor for S&S of sodium retention, especially in patients on corticosteroid therapy or with a history of CHF.
 Monitor patients on lithium for elevated lithium levels.
 Report appearance of candidiasis or its becoming more prominent with therapy to physician promptly.
  Repeat feces examinations, usually up to 3 mo, to ensure that amebae have been eliminated.

Drug Dosage Classif Mecha Indicat Contra Adver Nursin

Name ication nism of ion - se g
Action indicat Effects Respo
ion nsibiliti
es

Gener 500mg Iron Elevate Preve With Acidos Confir

ic 1 cap Prepar s the ntion allergy is, m that
Name: OD ation serum and to any anorex patient
FERR per iron treatm ingredi ia does
OUS orem concent ent of ent; have
SULF ration, iron- hemol iron
ATE which deficie ytic deficie
then ncy anemi ncy
Brand helps to anemi as anemi
Name: form as a
Feozol Hgb or With before
Fer- trapped Dietar normal treatm
gen- in the y iron ent.
sol reticulo supple balanc
Fer-in- endothe ment e Advise
sol lial cells for patient
for iron to give
storage drug
and with
eventua meals
l (avoidi
convers ng
ion to a milk,
usable eggs,
form of coffee,
iron and
tea) if
GI
disco
mfort
is
severe
.

Inform
patient
that
stool
may
be
dark or
green.

Advice
patient
to
arrang
e for
periodi
c
monito
ring of
Hct
and
Hgb
levels.
Name of Drug Classification Adverse effect Indication Contraindication Nursing Considerations

It is effective for
Cefuroxime ANTIINFECTIVE; Body as a Whole: the treatment of
Hypersensitivity to  Determine history of
IV 50mg q6 ANTIBIOTIC; SECOND- Thrombophlebitis penicillinase-
cephalosporins and related hypersensitivity
GENERATION (IV site); pain, producing Neisseria
antibiotics; pregnancy reactions to
CEPHALOSPORIN burning, cellulitis gonorrhoea (PPNG).
(category B), lactation. cephalosporins,
(IM site); Effectively treats
penicillins, and history
superinfections, bone and joint
of allergies,
positive Coombs' infections,
particularly to drugs,
test. bronchitis,
before therapy is
GI: Diarrhea, meningitis,
initiated.
nausea, antibiotic- gonorrhea, otitis
 Inspect IM and IV
associated colitis. media,
injection sites
Skin: Rash, pharyngitis/tonsilliti
frequently for signs of
pruritus, urticaria. s, sinusitis, lower
phlebitis.
Urogenital: respiratory tract
 Report onset of loose
Increased serum infections, skin and
stools or diarrhea.
creatinine and soft tissue
Although
BUN, decreased infections, urinary
pseudomembranous
creatinine tract infections, and
colitis.
clearance. is used for surgical
 Monitor I&O rates and
prophylaxis,
pattern: Especially
reducing or
important in severely
eliminating
ill patients receiving
infection.
high doses. Report
any significant
changes.

Classification Adverse effect Indication Contraindication Nursing Consideration

Name of Drug

Assessment & Drug Effects

GI: Nausea,
vomiting, Prophylaxis and
treatment of scurvy Use of sodium ascorbate in  Lab tests: Periodic Hct
heartburn, & Hgb, serum
and as a dietary patients on sodium
Ascorbic acid Vitamins electrolytes.
diarrhea. supplement. restriction; use of calcium
 Monitor for S&S of
Hematologic: ascorbate in patients
0.5 bid acute hemolytic
Increases receiving digitalis. Safety
Acute hemolytic anemia, sickle cell
protection during pregnancy crisis.
anemia (patients (category C) or lactation is
mechanism of the
with deficiency of not established.
immune system, Patient & Family
G6PD); sickle cell thus supporting Education
crisis. CNS: wound healing.
Headache (high Necessary for Take large doses of
wound healing and vitamin C in divided
doses).
resistance to amounts because the body
Urogenital: infection. uses only what is needed
Urethritis, dysuria, at a particular time and
crystalluria (high excretes the rest in urine.
doses). Other:
Mild soreness at  Megadoses can
interfere with
injection site; absorption of vitamin
dizziness and B12.

temporary
Note: Vitamin C increases the
faintness with
absorption of iron when taken
rapid IV at the same time as iron-rich
administration. foods.

DRUG NURSING
NAME DOSAGE ACTION INDICATION EFFECT RESPONSIBILITY
Generic: Cefalexin 500mg Tab of Cefalexin interferes > Skin and soft tissue >Fever, headache, >Assess the patient
Cefalexin tid with bacterial cell- infections. lethargy, paresthesia, before and after giving
wall synthesis, syncope, seizures. the drug.
Brand: Cefacure, causing cell to >Edema, >Monitor patient’s
Keflex, Oracef. rupture and die. hypotension, vital signs.
Active against many vasodilation, >Watch for drug’s side
gram-positive palpitations, chest effects.
CLASSIFICATION: bacteria; shows pain.
Antibiotic. limited activity >Nausea, vomiting,
against gram- diarrhea, abdominal
negative bacteria. cramps, oral
candidiasis,
pseudomembranous
colitis

DRUG INDICATIONS CONTRAINDICATION ADVERSE EFFECTS INTERACTIONS NURSING

S & CAUTIONS CONSIDERATIONS
Ranitidine Short-term Contrainidicated with CNS: headcahe, Imncreased effects 1. Administer oral
 treatment of active allergy to ranitidine, malaise, dizziness, of warfarin; drug with meals
I. DRUG CLASS: duodenal ulcer lactation somnolence, moniotr patient and at bedtime.
Histamine2 insomia, vertigo closely and adjust
antagonist Maintenance Use cautiously with dosage as needed 2. Decrease doses
therapy for impaired renal or CV: tachycardia, in renal and liver
II. THERAPEUTIC duodenal ulcer at hepatic function, bradycardia failure.
ACTIONS: reduced dosage pregnancy
Competitively GI: constipation, 3. Provide
inhibits the action Short-term diarrhea, nausea, concurrent antacid
of histamine at the treatment of vomiting, therapy to relieve
H2 receptors of the active, benign abdominal pain pain.
parietal cells of the gastric ulcer
stomach, inhibiting LOCAL: pain at IM 4. Adminsiter IM
basal gastric acid Short-term site, local burning dose undiluted,
secretion and treatment of GERD or itching at IV site deep into large
gastric acid muscle group.
secretion that is Treatment of
stimulated by food, heartburn, acid 5. Arrange for
insulin, histamine, indigestion, sour regular follow-up,
cholinergic stomach including blood
agonists, gastrin, tests to evaluate
and pentagastrin effects.

III. DOSAGE: 6. Report sore

12.5 mg TIV q 12 throat, fever,
hrs unusual blleding or
bruising, severe
headcahe and etc.