DRUG Generic Name: Cefuroxime Brand Name: Zinacef Classification Antibiotic Cephalosporin (second generation) Dosage 750 mg Frequency

q8h Route IV (-) ANST Date Started: June 28, 2011

INDICATION Helps in treating lower respiratoy infections caused by H. influenzae.

ACTION Bactericidal: Inhibits synthesis of bacterial cell wall of gramnegative bacteria H. influenzae causing weakened cell wall because of defective structure thus osmotic lysis occurs resulting to cell death.

SIDE EFFECTS AND ADVERSE REACTION Side Effects: CNS: headache, paresthesia

NURSING CONSIDERATION

PATIENT TEACHING

History: Allergic Take it on full course as dizziness, reaction, hepatic and prescribed even if you are renal impairment feeling better to avoid drug resistance. GI: stomach upset, moderate Physical: Skin status, to severe diarrhea, nausea, liver & renal function Avoid alcohol while vomiting, abdominal pain, test, CBC, sensitivity taking this drug and for flatulence test, signs of three days after because dehydration severe reactions often occur. Adverse Effects: GI: hepatotoxicity, pseudomembranous colitis Avoid activities that require alertness until GU: nephrotoxicity response to medication is known. HEMATOLOGIC: bone marrow depression (decreased Give without regards to WBC, decreased platelets, meals. If GI upset occurs decreased Hct) give with food or milk. LOCAL: Pain, abcess at injection site, phlebitis, inflammation at IV site Instruct patient to report immediately to healthcare provider if he/she experience any side or adverse effects.

DRUG Generic Name: Azithromycin Brand Name: Zithromax Classification Macrolide antibiotic Dosage 500 mg Frequency OD for 3 days Route Oral Date Started: June 28, 2011

INDICATION

ACTION

SIDE EFFECTS AND ADVERSE REACTION

NURSING CONSIDERATION

PATIENT TEACHING

Treatment of Bacteriostatic and mild to bacteriocidal moderate against gramcommunity negative bacteria acquired H. influenzae: pneumonia Inhibits protein caused by H. synthesis by influenzae. binding with the bacterial ribosome and mRNA hence stopping the cell to produce more amino acid chains. In addition to that, it has a higher concentration of phagocytes which the components of the drug are actively transported to the site of infection right away.

Take it on full course as Side Effects: History: CNS: headache, dizziness, Hypersensitivity to prescribed even if you are vertigo, fatigue azithromycin or any feeling better to avoid macrolide antibiotics, drug resistance. GI: stomach cramping, hepatic or renal diarrhea, nausea, vomiting, impairment Take oral medication with abdominal pain, flatulence, 8 oz water at least 1 hour dyspepsia, abnormal taste Physical: skin color, before or 2 hours after lesions, orientation, meals. GI output, culture and Adverse Effects: GI: pseudomembranous sensitivity tests of Do not take azithromycin colitis, hepatotoxicity infection, urinalysis, with foods or antacids. renal function test Avoid activities that require alertness until response to medication is known. Instruct patient to report immediately to healthcare provider if he/she experience any side or adverse effects.

DRUG Generic Name: Ketorolac Trometamol Brand Name: Tral Classification Nonopioid analgesic NSAID Dosage 30 mg Frequency Q8h Route IV (-) ANST Date Started: June 28, 2011

INDICATION

ACTION

SIDE EFFECTS AND ADVERSE REACTION

NURSING CONSIDERATION

PATIENT TEACHING Avoid activities that require alertness until response to medication is known. Advise patient to minimize GI upset by eating small, frequent servings of healthy foods. Instruct patient to avoid aspirin products and herbs during therapy. Instruct patient to report immediately to healthcare provider if he/she experience any side or adverse effects.

Short-term It inhibits management of prostaglandin pain up to 5 synthesis by days blocking COX-1 (Cyclooxygenase1) which results to the reduction of pain perceived by the client (analgesic) and reduction of signs of inflammation (antiinflammatory).

History: Impaired Side Effects: CNS: headache, dizziness, hearing, allergies, drowsiness, fatigue renal impairment; hepatic, CV, and GI GI: diarrhea, nausea, conditions vomiting, flatulence, dyspepsia, constipation Physical: skin color and lesions, Respiratory: dyspnea, orientation, reflexes, bronchospasm opthalmologic and audiometric evaluation, Adverse Effects: GI: gastric or duodenal adventitious sounds, ulcer, dark tarry stool, liver evaluation, hematemesis (bright CBC, renal function red/coffee ground emesis), tests, serum test hepatotoxicity GU: nephrotoxicity Hematologic: bone marrow depression (decreased WBC, decreased platelets, decreased Hct) LOCAL: Pain, abcess at injection site, phlebitis, inflammation at IV site

DRUG Generic Name: Hyoscine-N-Butyl Bromide Brand Name: Buscopan Classification Antispasmodic Anticholinergic Dosage 1 amp Frequency prn Route IV Date Started: June 29, 2011

INDICATION Control gastric secretion related to abdominal cramps

ACTION Inhibits acetylcholine receptor sites at the autonomic nervous system that controls the secretion of gastric acids.

SIDE EFFECTS AND ADVERSE REACTION Side Effects: CNS: headache, dizziness, drowsiness, blurred vision, dilated pupils

NURSING CONSIDERATION

PATIENT TEACHING

History: Glaucoma, Take 30-60 minutes bronchial asthma, before meals and exactly COPD, myocardial as prescribed. ischemia, fever, diarrhea, heart Avoid activities that failure, hypertension, require alertness until CV: hypertention, chest renal disease, hiatal response to medication is pain, tachycardia hernia known.

Patient complained of intermittent GI: nausea, vomiting, dry Physical: bowel Frequent oral care or abdominal pain. mouth, taste loss, sounds, urinary sugarless candies will constipation output, adventitious sooth dry mouth. sounds, IOP, vision, bilateral grip Instruct patient to report strength, renal immediately to healthcare function tests, skin provider if he/she color, lesions experience any side or adverse effects.

DRUG Generic Name: Diazepam Brand Name: Trankil Classification: Benzodiazepine Dosage 5 mg Frequency stat Route IV Date Started: June 28, 2011

INDICATION Muscle relaxant: Adjunct for relief of reflex muscle spasm.

ACTION Since the client is suffering from pneumonia, the bacteria H. influenzae activates the reflex of smooth muscle that is around the small airways and causes constriction hence resulting to difficulty of breathing. Through the use of Diazepam, it will act on the GABA transmitter on the nervous system. GABA is the one responsible for muscle tone of humans.

SIDE EFFECTS AND ADVERSE REACTION Side Effects: CNS: mild drowsiness, sedation, lethargy, fatigue, disorientation, restlessness, visual and auditory disturbances GI: constipation, dry mouth, salivation, nausea, vomiting, difficulty in swallowing, elevation of blood enzymes: AST, ALT, LDH, alkaline phosphate Other: phlebitis and thrombosis at IV injection site Adverse Effects: Respiratory: apnea CV: hypotension

NURSING CONSIDERATION

PATIENT TEACHING

Avoid activities that History: Hypersensitivity, require alertness until acute narrow angle response to medication is glaucoma, impaired known. liver or renal function Frequent oral care or Physical: lesions, sugarless candies will orientation, affect, sooth dry mouth. reflexes, bowel sounds, adventitious Instruct patient to report sounds, renal immediately to healthcare function tests, liver provider if he/she evaluation experience any side or adverse effects.

DRUG Generic Name: Butamirate Citrate Brand Name: Sinecod Forte Classification: Antitussive Dosage 1 tab Frequency TID Route Oral Date Started: June 30, 2011

INDICATION Relieve hard, dry nonproductive cough of lower respiratory infections caused by Haemophilus influenzae

ACTION Acts directly on the brain cough center, specifically on the vagus nerve, to suppress cough reflex. It also tends to reduce airway resistance.

SIDE EFFECTS AND ADVERSE REACTION

NURSING CONSIDERATION

PATIENT TEACHING

History: Allergic Avoid activities that Side Effects: CNS: headache, reaction, hepatic and require alertness until dizziness, drowsiness, renal impairment response to medication is vertigo known. Physical: Skin status, Other: skin rashes renal function test, Instruct to take several CBC, sensitivity test deep breaths before coughing. Adverse Effects: CV: hypotension Advise to avoid irritants GI: diarrhea, nausea, like fumes, dusk, or vomiting smoke. Instruct patient to report immediately to healthcare provider if he/she experience any side or adverse effects.