XI.

DRUG STUDY Drug Order (Generic Trade/ name, Brand dosage, Name route, frequency) Ceftin Cefuro 750 mg PO xime q 8hrs. Antibiotic

Pharmacologic Action of Drug

Indications and Contraindications

Adverse Effects

Desired Action to the Client

Nursing Responsibilities and Precautions Instruct client that this medication should be taken with food. Instruct the client to complete the drug therapy. Determine history hypersensitivity reactions cephalosporins, penicillins, and history allergies, particularly drugs, before therapy initiated. of to of to is

Binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death. Flagy Metron Inhibits growth of 500 mg TIV idazole trichomonae and q 8hrs. amoebae by Antibiotic binding to DNA,

Indication: Used to treat a wide variety of bacterial infections. It works by stopping the growth of bacteria. This antibiotic treats only bacterial infections. It will not work for viral infections (e.g., common cold, flu).

Large doses Kills can cause susceptible cerebral bacteria. irritation and convulsions; nausea, vomiting, diarrhea, GI disturbances; erythema multiforme, StevensJohnson Contraindication: syndrome, Hypersensitivity to epidermal cephalosporin. necrolysis.

Indication: Bacterial Infection Contraindication:

GI disturbances Kills nausea, susceptible unpleasant bacteria metallic taste,

Instruct the client to tingling sensation may be feel upon injection of the drug.
68

resulting in loss of helical structure strand breakage, inhibition of nucleic acid synthesis, and cell death. Cataflam Mefen 500 mg PO amic q 6hrs. acid Nonsteroida l antiinflammator y Drug Inhibits the enzyme, cyclooxygenase, thus resulting in reduced synthesis of prostaglandin precursors.

History of hypersensitivity to metronidazole or other nitroimidazole derivatives.

Potassium Chloride 1tab OD Electrolyte

Kalium Durule

Potassium chloride is a major caution of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of

vomiting, diarrhea or constipation. Weakness, dizziness, ataxia, headache, drowsiness, insomnia Indication: GI disturbances; Treatment of headache, perioperative pain. dizziness, rash; GI bleeding, Contraindication: peptic Active peptic ulcer; ulceration; local hypersensitivity to irritation (rectal); diclofenac or other burning and NSAIDs. stinging (ophthalmic). Indication: GI ulceration Hypokalemia hyperkalemia. Nausea, Contraindication: vomiting, Hyperchloraemia, diarrhea and severe renal or abdominal adrenal insufficiency. cramps. Pain or phloebitis; cardiac toxicity

Instruct the client not to take any alcoholic beverages.

Reduce pain

Instruct client that medication should be taken with food. Monitor client for signs and symptoms of overt and occult bleeding. Before the therapy, rehydrate patient. Discontinue treatment if severe nausea, vomiting or abdominal distress develops. Instruct the client that the drug should be taken with food. Report any signs and symptoms of hyperkalaemia.
69

Stabilized blood electrolyte.

Ferric Hydroxide Sucrose 500 mg 1tab PO OD Anti-anemic

cardiac skeletal and smooth muscles; maintenance of normal renal function, acidbase balance, carbo-hydrate metabolism and gastric secretion. Ferric hydroxide sucrose complex is a source of iron that is used in iron-deficiency anaemia whereby oral iron is ineffective or impractical. The released iron increases serum iron concentrations and is incorporated into haemoglobin.

Indication: Anemia Contraindication: Hypersensitivity. Evidence of iron overload. Anemia not caused by iron deficiency. History of asthma, eczema, anaphylaxis, or other allergic disorders

CV effects such as chest pain or tightness, shock, MI, hypertension, tachycardia, bradycardia, and arrhythmias. Rashes, urticaria, purpura, and pruritus. GI disturbances, haematuria, dyspnoea, and taste disturbance.

Maintain blood iron level

Regular monitoring of hematologic parameters is needed to prevent iron overload. Instruct the client to take the drug with citrus juices. Instruct the client not to chew the drug and he/she may have metallic taste.

70

Lasix 40 mg TIV prn Diuretic

Furose mide

Inhibits reabsorption of Na and chloride mainly in the medullary portion of the ascending Loop of Henle. Excretion of potassium and ammonia is also increased while uric acid excretion is reduced.

Indication: Fluid retention Contraindication Severe sodium and water depletion, hypersensitivity to sulphonamides and furosemide, hypokalaemia, hyponatraemia, anuria or renal failure. Addison's disease. Indication: Bacterial Infection Contraindication: Hypersensitivity to cephalosporins; hyperbilirubinaemic neonates.

Rocephin Ceftria Binds to one or 2 mg TIV OD xone more of the Antibiotic sodium penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly

Rashes, photosensitivity, nausea, diarrhea, blurred vision, dizziness, headache, hypotension. Bone marrow depression (rare), hepatic dysfunction. Hyperglycaemia , glycosuria, ototoxicity. Superinfection; anaphylaxis; diarrhea; local reactions; blood dyscrasias; rash, fever, pruritus; elevated transaminases and alkaline phosphatase; leucopenia, neutropenia.

Increase urine output and maintain fluid and electrolyte level.

Monitor fluid and electrolyte balance and renal function. Report any signs and symptoms of dehydration.

Kills Take note if patient has susceptible history of penicillin bacteria allergy; severe renal impairment; superinfection. Instruct the client not to stop the drug therapy. Instruct the client that tingling sensation may be felt during injection of the medication.

71

resulting bacterial death. Zithromax Azithro 500 mg mycin 1tab PO OD Antibiotic

in cell Indication: Bacterial infection Kills Instruct client that susceptible medication: bacteria. May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.) Instruct the client not to stop the drug therapy.

Blocks transpeptidation by binding to 50s ribosomal subunit of susceptible organisms and disrupting RNAdependent protein synthesis at the chain elongation step.

Zantac 1amp TIV BID Antihistami ne

Rantidi ne hydroc hloride

Zosyn

Pipera

Mild to moderate nausea, Contraindication: vomiting, Contraindicated in abdominal pain, patients with known dyspepsia, hypersensitivity to flatulence, azithromycin, diarrhea, erythromycin, any cramping; macrolide or ketolide jaundice; antibiotic. dizziness, headache, vertigo, Blocks histamine Indication: Headache, H2-receptors in Allergic reactions and dizziness. the stomach and prophylaxis for blood Rarely hepatitis, prevents transfusion reaction. thrombocytopae histaminenia, mediated gastric Contraindication: leucopaenia, acid secretion. Contraindicated for hypersensitivity, patients known to confusion, have hypersensitivity gynaecomastia, to the drug or any of impotence, the ingredients somnolence, vertigo, hallucinations. Inhibit septum Indication: GI disturbances;

Relieves symptoms of allergies.

Report any sign and symptoms of nausea and vomiting. Instruct the client to avoid strenuous activity.

Kills

Monitor

renal,

hepatic
72

4.5 mg TIV q 8hrs Antibiotic

cillin

and cell wall synthesis and has an antimicrobial activity against a wide range of gram stain organisms.

Bacterial infection Contraindication: Contraindicated in patients who has hypersensitivity to the drug.

Ultram 100 mg TIV prn Analgesic

Trama dol

Ambroxol 22 cc ambroxol + 1cc PNSS neb q 12hrs Mucolytic

Ambro xol

Inhibits reuptake of norepinephrine, serotonin and enhances serotonin release. It alters perception and response to pain by binding to muopiate receptors in the CNS. Modulates mucus production and viscosity and increases mucociliary transport, thereby

Indication: Pain due to surgery Contraindication: Suicidal patients, acute alcoholism; head injuries; raised intracranial pressure; severe renal impairment; lactation.

Indication: Clients pneumonia sputum in bronchial tract.

with and the

hypersensitivity reactions; eosinophilia, hyponatraemia, hypokalaemia. Injection-site related reactions such as pain and erythema Sweating, dizziness, nausea, vomiting, dry mouth, fatigue, asthenia, confusion, constipation, flushing, headache, vertigo, tachycardia, Mild GI effects and allergic reactions.

susceptible and haematological bacteria. functions during prolonged and high-dose therapy. Instruct the client not to stop the drug therapy.

Relieves pain.

Instruct the client not to over use the drug. Instruct the client to increase fluid intake.

To easy expectorati on of bronchial secretions

Instruct the client techniques expectorations bronchial secretions.

in in of

Contraindication: Hypersensitivity to the drug.

Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth.
73

Enalaprilat, Vasotec 2.5 mg 1tab OD ACE-inhibitor Antihypertensiv e

Enalap ril

improving expectoration. It also exhibits inhibitory activity against the effects of free radicals. Decreased in intracellular calcium will result to the relaxation of the smooth muscle airways. Inhibition of ACE thus leading to reduced levels of angiotensin II and aldosterone.

Assess lung sounds, PR and BP before drug administration and during peak of medication.

Indications: High blood pressure Contraindications: Hypersensitivity. History of angioedema due to previous treatment with ACE inhibitors; bilateral renal artery stenosis.

Initial hypotension may be severe and prolonged. Dizziness, headache, fatigue, persistent dry cough, abnormal taste, lassitude, rash, neutropenia, renal impairment or failure.

Lowers blood pressure

Instruct client that the medication may be taken with or without food. Instruct the client to take the drug exactly as prescribed.

74

Hydrocortisone

Hydroc Suppress ortison inflammatory e response.

Corticosteroid

Ectrin 2.5 mg 1tab OD Mucolytic

Ectrin

Modulates mucus production and viscosity and increases mucociliary transport, thereby improving expectoration. It also exhibits inhibitory activity against the effects of free Contraindication: radicals. Hypersensitivity to erdosteine.

Indication: Stinging, Asthma and acute burning, respiratory illness. irritation, dryness, or Contraindication: redness at the Hypersensitivity to application site the drug. may occur. Indication: Mild GI Treatment of disturbance acute bronchitis, nervousness, chronic bronchitis restlessness, and its tremor, exacerbations. headache, Respiratory disorders insomnia, characterized by chest pain, and abnormal bronchial palpitations. secretions and impaired mucus transport

Treat signs Instruct client that the and medication should be symptoms taken with food. of asthma

To easy expectorati on of bronchial secretions

Instruct the client techniques expectorations bronchial secretions.

in in of

Assess lung sounds, PR and BP before drug administration and during peak of medication. Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth.

75