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XI.DRUG STUDY
DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
CONSIDERATION
Generic Name:
RANITIDINE
Brand Name:
Ranitac
Classification:
Gastro intestinal
agent; H-2 receptor
antagonist.
Dosage:
50 g IV q 8
 Potent
Anti-ulcer that
competitively and
reversibly inhibits
histamine actions
on parietal cells,
thus blocking
gastric acid
secretion.
 Short term (4-8
weeks)
Treatment of
active duodenal
ulcer.
 Short term
treatment of
active, benign
gastric ulcers.
 Gastro
esophageal
disease
 Maintenance of
healing of
gastric ulcers
 Maintenance
therapy for
duodenal ulcer
at reduce dosage
 Contra indicated
with allergy to
ranitidine, lactation
 Cirrhosis of the
liver
 Impaired renal or
hepatic function
 GI :
Constipation,
N&V,Diarrhea,
Abdominal pain
 CNS:
Head ache,dizziness,
insomnia, vertigo
 CV
Bradycardia or
tachycardia, cardiac
arrest
 Hepatic
Hepatotoxicity,
Jaundice
 Dermatologic
Rash, Alopecia
 Document
indications for
therapy, onset,
characteristics of
symptoms, other
agents used and
anticipated
treatment.
 Assess stomach
 Pain, noting
Characteristics,
frequency of
occurrence and
things that alter it
 Obtain CBC.
DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE
EFFECT
NURSING
CONSIDERATIONS
Generic Name:
KETOROLAC
Thrometamine
Brand Name:
Toradol
CLASSIFICATION:
Non-Steroidal Anti-
Inflammatory Drug
(NSAID)
DOSAGE:
1 amp IV q 6
 Inhibit
prostaglandin
synthesis to
produce anti-
inflammatory,
analgesic and
anti-pyretic
effect.
 Short- term
management of
moderately
severe,acute
pain for single
dose treatment
 Short term
management of
moderately
severe,acute
pain for
multiple dose
treatment.
 Contraindicated in
patients hypersensitive
to drug and those with
active peptic ulcer
disease, recent GI
bleeding or perforation,
advance renal
impairment, cerebro
vascular bleeding,
hemorrhagic diathesis, or
incomplete hemostasis,
and those at risk for
renal impairement from
volume depletion or at
risk of bleeding.
 CNS:
Headache,
Dizziness,
Drowsiness,
Sedation
 CV:
Arrhythmias,
Edema,
Hypertension,
 Hematologic:
Decreased
platelet,
Adhesion,
Prolonged
bleeding time,
 Skin:
Diaphoresis,
Pruritus, Rash
 Correct
hypovolemia before
giving.
 Put pressure on site
for 15-30 seconds.
 Don’t give drug
epiduraly because of
alcohol content.
 Tell patient not to
take drugs for more
than 5 days in a
row.
DRUGS ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECT NURSING
CONSIDERATION
Generic Name:
METRONIDAZOLE
Brand Name:
Cetaz
Classification:
Anti-infectives
Anti-protozoal
Dosage:
500mg IV q 8
 Disrupts DNA
and protein
synthesis in
susceptible
organism
 Bactericidal, or
amebicidal action
 Asymptomatic
and symptomatic
tricomoniasis in
females and
males; acute
intestinal
amebiasis and
amebic liver
abscess;
IV metronidazole
is used for the
treatment of
serious infection
caused by
susceptible
anaerobic bacteria
in intra abdominal
infections, skin
i9nfections,
gynecologic
infections,
septicemia, and
for both pre- and
postoperative
prophylaxis
 Blood dyscariasis;
active CNS disease;
first trimester of
pregnancy (catergory
B), lactation.

 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,
drowsiness,
insomnia
 GI: Nausea,
vomiting,
anorexia,
epigastric
distress,
abdominal
cramps, diarrhea,
constipation, dry,
maouth, metallic
or bitter taste,
proctitis.
 Urogenital:
Polyuria, dysuria,
pyuria,
incontinence
 CV:ECG changes
(flattening of T
wave)
 Administer with
food or milk to
minimize GI
irritation. Tablets
may be crushed
for patients with
difficulty in
swallowing
 Discontinue
therapy
immediate if
symptoms of
CNS toxicity
develop. Monitor
especially for
seizures and
peripheral
neuropathy (e.g.
numbness, and
parasthesia of
extremities)
 Lb test: Obtain
total and
differential WBC
counts before,
during, after
therapy,
especially if a
second course is
necessary
 Monitor for S&S
of sodium
retention,
especially in
patients on
corticosteroids
therapy or with a
history of CHF
 Monitor patients
on lithium for
elevated lithium
levels.
 Report
appearance of
candidiasis (milk-
vaginal discharge,
stomatitis, fury
tongue) or its
becoming more
prominent with
therapy to
physician
promptly.
 Repeat feces
examinations,
usually up to 3
months to ensure
that amebae have
been eliminated.
 Urine may appear
dark or reddish
brown (especially
with higher than
recommended
doses ). This
appears to have
no clinical
significance.
DRUGS ACTION INDICATION CONTRAINDICATION SIDE EFFECTS
NURSING
CONSIDERATION
Generic Name:
PARACETAMOL/
ACETAMINOPHEN
Brand Name:
Sinomol
Classification:
Non-narcotic analgesic;
Antipyretic
Dosage/Route:
300mg IV prn
 Decrease fever by
a hypothalamic
effect leading to
sweating and
vasodilatation.
Also inhibits the
effect of
pyrogenes on the
hypothalamic heat
regulating centers.
May cause
analgesia by
inhibiting CNS
prostaglandin
synthesis.
 Control of pain
due to headache,
dysmenorrhea,
 To reduce fever in
the bacterial or
viral infections
 Generally as
substitute when
latter is not
tolerated or is
contraindicated.
 Renal
insufficiency,
anemia.
 Clients with
cardiac or
pulmonary disease
are more
susceptible to
acetaminophen.
 Hematologic:
Hemolytic
Anemia
 Allergic:
Erythematous skin
reaction, fever
 Miscellaneous:
jaundice,
drowsiness,
glossitis
 Monitor for S/Sx
of:
hepatotoxicity,
even with
moderate
acetaminophen
doses, especially
in individuals
with poor
nutrition or who
have ingested
alcohol over
prolonged
periods; potential
abuse from
psychological
dependence.
 Give drugs with
food if GI upset
occurs.
 Avoid using
multiple
preparations
containing
acetaminophen.
DRUG ACTION INDICATION CONTRAINDICATION SIDE EFFECT NURSING
RESPONSIBILITY
GENERIC:
Celecoxib
BRAND:
Celeberex
Classification:
Non steroidal
cyclooxegenase-2 (COX-
2) inhibitor, anti
inflammatory drug
(NSAID)
DOSAGE :
250 mg IV
p.r.n
 Exhibits anti-
inflammatory,
analgesic, and
antipyretic action
due to inhibition
of the enzyme
COX-2
 Adjunctive
treatment of
decrease the
number of
adenomatous
colorectal polyps
in familial
adenomatous
polyposis
 Hypersensitivity to
drug, sulfonamides,
or other NSAIDs
 Severe hepatic
impairment
 History of asthma or
urticaria
 Advanced renal
disease
 Late pregnancy
 Breastfeeding
 CNS : dizziness,
drowsiness,
headache,
insomnia, fatigue
 CV: peripheral
edema
 EENT:
ophthalmic
effects,tinnitus,
pharyngitis,
rhinitis, sinusitis
 GI: nausea,
diarrhea,,
constipation,
abdominal pain,
dyspepsia,
flatulence, dry
mouth, GI
bleeding
 GU: constipation,
dry mouth, tongue
atrophy
 Respiratory:
URI symptoms, cough,
epistaxis
 OTHER: Cancer
in preclinical
studies, back pain,
fever
Before:
 Asses pt. history
of allergic
reaction to the
drug
 Monitor CBC,
electrolyte
levels, creatinine
clearance,and
occult fecal
blood test and
liver function
test results every
6-12 months
During :
 Instruct pt. to
take drug with
food or milk
 Teach pt. to
avoid aspirin and
other NSAIDs
(such as
Ibuprofen and
Naproxen)
during therapy
Drug Name Action Indication Contraindication Adverse effect Nursing Responsibility
GENERIC:
Cefixime
BRAND:
Suprax
Classification:
Antibiotic
cephalosporin
DOSAGE :
250 mg IV
p.r.n
Cefixime binds to one or
more of the penicillin-
binding proteins (PBPs)
which inhibits the final
transpeptidation step of
peptidoglycan synthesis
in bacteria cell wall, thus
inhibiting biosynthesis
and arresting cell wall
assembly resulting in
bacterial cell death.
 Uncomplicated
urinary tract
infections caused
by Escherichia coli
and Proteus
mirabilis,
 Otitis media
caused by
Haemophilus
influenzae (Beta-
lactamase positive
and negative
strains), Moraxella
catarrhalis (most
of which are beta-
lactamse positive),
and S.pyrogenes
 Acute bronchitis
and acute
exacerbations of
chronic bronchitis
caused by
streptococcus
pneumonia and
Haemophilus
infuenzae( beta-
lactamase positive
and negative
strains), and
 Uncomplicated
gonorrhea
 Hypersensitivity to
cephalosporin.
 History of allergy to
penicillins;
pregnancy,
lactation; renal
failure; GI disease.
DIARRHEA:
 Difficulty
breathing or
swallowing
 Headache
 Hives
 Itching
 Mild skin rash
 Severe skin rash
 Upset stomach
 Vaginal infection
 Vomiting
 Wheezing
 Assess patient’s
previous reaction
to penicillin or
other
cephalosporins.
Cross sensitivity
between penicillin
is common.
 Assess patient for
signs and
symptomsof
infection before
and during
treatment; fever,
earache,
characteristics of
wounds, sputum,
urine, stool, and
WBC>10,000/mm
 Obtain C&N
before beginning
drug therapy to
identify if correct
treatment has
been initiated
 Assess for allergic
reactions
 Assess renal
function before
and during
therapy; urine
(cervical/urethral)
caused by
Neisseria
gonorrheae
(penicillinase- and
non-penicillinase-
producing strains)
output.BUN and
creatinine.
DRUG ACTION INDICATION CONTRAINDICATIO
N
ADVERSE EFFECT NURSING
MANAGEMENT
Generic Name:
Omeprazole
Brand Name:
Prilosec
Classification:
Proton pump inhibitor
Dosage:
40mg IV OD
 Inhibits activity of
acid(proton)pump and
binds to hydrogen
potassium adenosine
triphosphatase at
secretory surface of the
gastric parietal cells to
block formation of
gastric acid.
 Symptomatic
gastroesophagea
l reflux disease.
 Duedunal
ulcer(short term
treatment)
 Short term
treatment of
active benign
gastric ulcer.
 Frequent heart
burn (2 or more
days a week).
 Contraindicated
in patient
hypersensitive
to drug or its
components.
 Use cautiously
in patients with
Barther
syndrome,
hypocalemia,
and respiratory
alcalosis.
 Long term
administration
of bicarbonate
with calcium or
milk can cause
milk alkaline
syndrome.
 CNS: Dizziness,
headache.
 GI: abdominal
pain,
constipation,
diarrhea,
flatulence,
nausea and
vomiting,
 Musculoskeletal
: back pain.
 Respiratory:
cough, upper
respiratory tract
infection.
 Skin: rash
 Other: cancer in
preclinical
studies, back
pain, fever.
 Assessment
History:
 Hypersensitivit
y to omeprazole
or any of its
components
;pregnancy
Physical:
 Skin lesion:
reflexes, affect,
urinary output,
abdominal
exam,
respiratory
auscultation
intervention.
2. Administer before
meals. Caution patient to
swallow capsules whole,
not to open chew,or
crush them
DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
MANAGEMENT
GENERIC NAME:
Amino acid sorbitol
BRAND NAME:
Celemin
CLASSIFICATION:
Parenteral
Nutritional
Products
Dosage:
Incorporate to IVF(250cc
q8x2doses)
 Amino acids
promote the
production of
proteins
(anabolism)
needed for
synthesis of
structural
components,
reduce the rate of
the protein
breakdown
(anabolism),
promote wound
healing and act as
a buffers in the
extracellular and
intracellular
fluids.
 Sorbitol is a
source of calories.
Non protein
calories are
required for
efficient
utilization of
amino acid. It
decreases protein
and nitrogen
losses, promotes
glycogen
deposition and
prevents ketosis.
 Electrolytes are
provided to
compensate for
normal sensible
 Celemin 10-plus is
highly used as a
parenteral
nutrition
supplement in the
following
condition:
prophylaxis and
therapy for protein
deficiency; pre-
and post-operative
conditions; in
adequate or
impossible oral
feeding, eg.
Following
operative
procedure on GIT,
GI
bleeding,corrosive
injury to
esophagus or
stomach; stenosis
in the GIT;
inflammatory
bowel disease and
short-gut
syndrome; chronic
diarrhea and
vomiting;
malabsorption
syndrome; sepsis;
diffuse peritonitis;
fistulas; chylous
ascites;
malnutrition and
clinical outcomes;
 Disturbances of
the amino acid
metabolism;
hepatic coma;
serious renal
disturbances;
hypernatremia and
hyperkalemia;
congestive cardiac
failure;
hyperhydration;
metabolic
acidosis; sorbitol
intolerance
 Occasional chest
discomfort and
palpitations.
Nausea,vomiting,
chill, fever and
vasalgia may
occur if the
recommended rate
of infusion is
exceeded.
 Monitor for S/Sx
of hepatotoxicity.
 Do not administer
simultaneously
with blood
through the same
infusion site
because of
possible
pseudoagglutinati
on. Antibiotics,
steroids and
pressor agents
should not be
added to these
solutions.
and insensible
losses as well as
the additional
losses often
present in patient
requiring
parenteralnutrion.
persistent pyrexial
state; nephrosis;
amyloidosis;
immunocompromi
sed patients; HIV
infection;
transplantations;
cancer and related
cachexia ; burns;
pregnancy; head
injuries;prolonged
,
DRUGS ACTION INDICATIONS CONTRAINDICATIONS ADVERSE EFFECT NURSING
MANAGEMENT
GENERIC:
Cefuroxime
CLASSIFICATION:
Antibiotic cephalosporins
Dosage and Route:
750 mg IV q8
 Inhibits cell wall
synthesis,
promoting
osmotic
instability;
usually
bactericidal.
 Serious lower
respiratory
infection, UTI,
skin or skin-
structure
infections, bone
or joint infections,
septicemia,
meningitis and
gonorrhea
 Hypersensitivity to
drug or other
cephalosporins.
 Use cautiously in
patients
hypersensitivity to
penicillin because
of possibility of
cross-sensitivity
with other beta-
lactam antibiotics
 CV: phlebitis,
thrombophlrbitis
 GI: diarrhea,
nausea,vomiting
 Hematologic:
hemolytic anemia,
thrombocytopenia,
transient
neutropenia,
eosinophilia
 Skin:
maculopapular
and erythematous
rashes,urticaria,
pain, induration,
sterile abscess,
+temperature
elevation,
 Other:
anaphylaxis,
serum suckness
 Obtain specimen
for culture and
sensitivity test
before giving first
dose.Therapy may
begin while
awaiting results.
 Monitor patient
for signs and
symptoms of
superinfection
 Advise patient
receiving drug IV
to report
discomfort at IV
insertion site
 Instruct patient to
notify prescriber
about rash, loose
stools, diarrhea,
or evidence of
superinfection
60180538 case-study

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60180538 case-study

  • 1. XI.DRUG STUDY DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING CONSIDERATION Generic Name: RANITIDINE Brand Name: Ranitac Classification: Gastro intestinal agent; H-2 receptor antagonist. Dosage: 50 g IV q 8  Potent Anti-ulcer that competitively and reversibly inhibits histamine actions on parietal cells, thus blocking gastric acid secretion.  Short term (4-8 weeks) Treatment of active duodenal ulcer.  Short term treatment of active, benign gastric ulcers.  Gastro esophageal disease  Maintenance of healing of gastric ulcers  Maintenance therapy for duodenal ulcer at reduce dosage  Contra indicated with allergy to ranitidine, lactation  Cirrhosis of the liver  Impaired renal or hepatic function  GI : Constipation, N&V,Diarrhea, Abdominal pain  CNS: Head ache,dizziness, insomnia, vertigo  CV Bradycardia or tachycardia, cardiac arrest  Hepatic Hepatotoxicity, Jaundice  Dermatologic Rash, Alopecia  Document indications for therapy, onset, characteristics of symptoms, other agents used and anticipated treatment.  Assess stomach  Pain, noting Characteristics, frequency of occurrence and things that alter it  Obtain CBC.
  • 2. DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING CONSIDERATIONS Generic Name: KETOROLAC Thrometamine Brand Name: Toradol CLASSIFICATION: Non-Steroidal Anti- Inflammatory Drug (NSAID) DOSAGE: 1 amp IV q 6  Inhibit prostaglandin synthesis to produce anti- inflammatory, analgesic and anti-pyretic effect.  Short- term management of moderately severe,acute pain for single dose treatment  Short term management of moderately severe,acute pain for multiple dose treatment.  Contraindicated in patients hypersensitive to drug and those with active peptic ulcer disease, recent GI bleeding or perforation, advance renal impairment, cerebro vascular bleeding, hemorrhagic diathesis, or incomplete hemostasis, and those at risk for renal impairement from volume depletion or at risk of bleeding.  CNS: Headache, Dizziness, Drowsiness, Sedation  CV: Arrhythmias, Edema, Hypertension,  Hematologic: Decreased platelet, Adhesion, Prolonged bleeding time,  Skin: Diaphoresis, Pruritus, Rash  Correct hypovolemia before giving.  Put pressure on site for 15-30 seconds.  Don’t give drug epiduraly because of alcohol content.  Tell patient not to take drugs for more than 5 days in a row.
  • 3. DRUGS ACTION INDICATION CONTRAINDICATIONS ADVERSE EFFECT NURSING CONSIDERATION Generic Name: METRONIDAZOLE Brand Name: Cetaz Classification: Anti-infectives Anti-protozoal Dosage: 500mg IV q 8  Disrupts DNA and protein synthesis in susceptible organism  Bactericidal, or amebicidal action  Asymptomatic and symptomatic tricomoniasis in females and males; acute intestinal amebiasis and amebic liver abscess; IV metronidazole is used for the treatment of serious infection caused by susceptible anaerobic bacteria in intra abdominal infections, skin i9nfections, gynecologic infections, septicemia, and for both pre- and postoperative prophylaxis  Blood dyscariasis; active CNS disease; first trimester of pregnancy (catergory B), lactation.   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, drowsiness, insomnia  GI: Nausea, vomiting, anorexia, epigastric distress, abdominal cramps, diarrhea, constipation, dry, maouth, metallic or bitter taste, proctitis.  Urogenital: Polyuria, dysuria, pyuria, incontinence  CV:ECG changes (flattening of T wave)  Administer with food or milk to minimize GI irritation. Tablets may be crushed for patients with difficulty in swallowing  Discontinue therapy immediate if symptoms of CNS toxicity develop. Monitor especially for seizures and peripheral neuropathy (e.g. numbness, and parasthesia of extremities)  Lb test: Obtain total and differential WBC counts before, during, after therapy, especially if a second course is necessary  Monitor for S&S of sodium retention, especially in patients on corticosteroids therapy or with a
  • 4. history of CHF  Monitor patients on lithium for elevated lithium levels.  Report appearance of candidiasis (milk- vaginal discharge, stomatitis, fury tongue) or its becoming more prominent with therapy to physician promptly.  Repeat feces examinations, usually up to 3 months to ensure that amebae have been eliminated.  Urine may appear dark or reddish brown (especially with higher than recommended doses ). This appears to have no clinical significance.
  • 5. DRUGS ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION Generic Name: PARACETAMOL/ ACETAMINOPHEN Brand Name: Sinomol Classification: Non-narcotic analgesic; Antipyretic Dosage/Route: 300mg IV prn  Decrease fever by a hypothalamic effect leading to sweating and vasodilatation. Also inhibits the effect of pyrogenes on the hypothalamic heat regulating centers. May cause analgesia by inhibiting CNS prostaglandin synthesis.  Control of pain due to headache, dysmenorrhea,  To reduce fever in the bacterial or viral infections  Generally as substitute when latter is not tolerated or is contraindicated.  Renal insufficiency, anemia.  Clients with cardiac or pulmonary disease are more susceptible to acetaminophen.  Hematologic: Hemolytic Anemia  Allergic: Erythematous skin reaction, fever  Miscellaneous: jaundice, drowsiness, glossitis  Monitor for S/Sx of: hepatotoxicity, even with moderate acetaminophen doses, especially in individuals with poor nutrition or who have ingested alcohol over prolonged periods; potential abuse from psychological dependence.  Give drugs with food if GI upset occurs.  Avoid using multiple preparations containing acetaminophen.
  • 6. DRUG ACTION INDICATION CONTRAINDICATION SIDE EFFECT NURSING RESPONSIBILITY
  • 7. GENERIC: Celecoxib BRAND: Celeberex Classification: Non steroidal cyclooxegenase-2 (COX- 2) inhibitor, anti inflammatory drug (NSAID) DOSAGE : 250 mg IV p.r.n  Exhibits anti- inflammatory, analgesic, and antipyretic action due to inhibition of the enzyme COX-2  Adjunctive treatment of decrease the number of adenomatous colorectal polyps in familial adenomatous polyposis  Hypersensitivity to drug, sulfonamides, or other NSAIDs  Severe hepatic impairment  History of asthma or urticaria  Advanced renal disease  Late pregnancy  Breastfeeding  CNS : dizziness, drowsiness, headache, insomnia, fatigue  CV: peripheral edema  EENT: ophthalmic effects,tinnitus, pharyngitis, rhinitis, sinusitis  GI: nausea, diarrhea,, constipation, abdominal pain, dyspepsia, flatulence, dry mouth, GI bleeding  GU: constipation, dry mouth, tongue atrophy  Respiratory: URI symptoms, cough, epistaxis  OTHER: Cancer in preclinical studies, back pain, fever Before:  Asses pt. history of allergic reaction to the drug  Monitor CBC, electrolyte levels, creatinine clearance,and occult fecal blood test and liver function test results every 6-12 months During :  Instruct pt. to take drug with food or milk  Teach pt. to avoid aspirin and other NSAIDs (such as Ibuprofen and Naproxen) during therapy
  • 8. Drug Name Action Indication Contraindication Adverse effect Nursing Responsibility GENERIC: Cefixime BRAND: Suprax Classification: Antibiotic cephalosporin DOSAGE : 250 mg IV p.r.n Cefixime binds to one or more of the penicillin- binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacteria cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.  Uncomplicated urinary tract infections caused by Escherichia coli and Proteus mirabilis,  Otitis media caused by Haemophilus influenzae (Beta- lactamase positive and negative strains), Moraxella catarrhalis (most of which are beta- lactamse positive), and S.pyrogenes  Acute bronchitis and acute exacerbations of chronic bronchitis caused by streptococcus pneumonia and Haemophilus infuenzae( beta- lactamase positive and negative strains), and  Uncomplicated gonorrhea  Hypersensitivity to cephalosporin.  History of allergy to penicillins; pregnancy, lactation; renal failure; GI disease. DIARRHEA:  Difficulty breathing or swallowing  Headache  Hives  Itching  Mild skin rash  Severe skin rash  Upset stomach  Vaginal infection  Vomiting  Wheezing  Assess patient’s previous reaction to penicillin or other cephalosporins. Cross sensitivity between penicillin is common.  Assess patient for signs and symptomsof infection before and during treatment; fever, earache, characteristics of wounds, sputum, urine, stool, and WBC>10,000/mm  Obtain C&N before beginning drug therapy to identify if correct treatment has been initiated  Assess for allergic reactions  Assess renal function before and during therapy; urine
  • 10. DRUG ACTION INDICATION CONTRAINDICATIO N ADVERSE EFFECT NURSING MANAGEMENT
  • 11. Generic Name: Omeprazole Brand Name: Prilosec Classification: Proton pump inhibitor Dosage: 40mg IV OD  Inhibits activity of acid(proton)pump and binds to hydrogen potassium adenosine triphosphatase at secretory surface of the gastric parietal cells to block formation of gastric acid.  Symptomatic gastroesophagea l reflux disease.  Duedunal ulcer(short term treatment)  Short term treatment of active benign gastric ulcer.  Frequent heart burn (2 or more days a week).  Contraindicated in patient hypersensitive to drug or its components.  Use cautiously in patients with Barther syndrome, hypocalemia, and respiratory alcalosis.  Long term administration of bicarbonate with calcium or milk can cause milk alkaline syndrome.  CNS: Dizziness, headache.  GI: abdominal pain, constipation, diarrhea, flatulence, nausea and vomiting,  Musculoskeletal : back pain.  Respiratory: cough, upper respiratory tract infection.  Skin: rash  Other: cancer in preclinical studies, back pain, fever.  Assessment History:  Hypersensitivit y to omeprazole or any of its components ;pregnancy Physical:  Skin lesion: reflexes, affect, urinary output, abdominal exam, respiratory auscultation intervention. 2. Administer before meals. Caution patient to swallow capsules whole, not to open chew,or crush them
  • 12. DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING MANAGEMENT GENERIC NAME: Amino acid sorbitol BRAND NAME: Celemin CLASSIFICATION: Parenteral Nutritional Products Dosage: Incorporate to IVF(250cc q8x2doses)  Amino acids promote the production of proteins (anabolism) needed for synthesis of structural components, reduce the rate of the protein breakdown (anabolism), promote wound healing and act as a buffers in the extracellular and intracellular fluids.  Sorbitol is a source of calories. Non protein calories are required for efficient utilization of amino acid. It decreases protein and nitrogen losses, promotes glycogen deposition and prevents ketosis.  Electrolytes are provided to compensate for normal sensible  Celemin 10-plus is highly used as a parenteral nutrition supplement in the following condition: prophylaxis and therapy for protein deficiency; pre- and post-operative conditions; in adequate or impossible oral feeding, eg. Following operative procedure on GIT, GI bleeding,corrosive injury to esophagus or stomach; stenosis in the GIT; inflammatory bowel disease and short-gut syndrome; chronic diarrhea and vomiting; malabsorption syndrome; sepsis; diffuse peritonitis; fistulas; chylous ascites; malnutrition and clinical outcomes;  Disturbances of the amino acid metabolism; hepatic coma; serious renal disturbances; hypernatremia and hyperkalemia; congestive cardiac failure; hyperhydration; metabolic acidosis; sorbitol intolerance  Occasional chest discomfort and palpitations. Nausea,vomiting, chill, fever and vasalgia may occur if the recommended rate of infusion is exceeded.  Monitor for S/Sx of hepatotoxicity.  Do not administer simultaneously with blood through the same infusion site because of possible pseudoagglutinati on. Antibiotics, steroids and pressor agents should not be added to these solutions.
  • 13. and insensible losses as well as the additional losses often present in patient requiring parenteralnutrion. persistent pyrexial state; nephrosis; amyloidosis; immunocompromi sed patients; HIV infection; transplantations; cancer and related cachexia ; burns; pregnancy; head injuries;prolonged ,
  • 14. DRUGS ACTION INDICATIONS CONTRAINDICATIONS ADVERSE EFFECT NURSING MANAGEMENT GENERIC: Cefuroxime CLASSIFICATION: Antibiotic cephalosporins Dosage and Route: 750 mg IV q8  Inhibits cell wall synthesis, promoting osmotic instability; usually bactericidal.  Serious lower respiratory infection, UTI, skin or skin- structure infections, bone or joint infections, septicemia, meningitis and gonorrhea  Hypersensitivity to drug or other cephalosporins.  Use cautiously in patients hypersensitivity to penicillin because of possibility of cross-sensitivity with other beta- lactam antibiotics  CV: phlebitis, thrombophlrbitis  GI: diarrhea, nausea,vomiting  Hematologic: hemolytic anemia, thrombocytopenia, transient neutropenia, eosinophilia  Skin: maculopapular and erythematous rashes,urticaria, pain, induration, sterile abscess, +temperature elevation,  Other: anaphylaxis, serum suckness  Obtain specimen for culture and sensitivity test before giving first dose.Therapy may begin while awaiting results.  Monitor patient for signs and symptoms of superinfection  Advise patient receiving drug IV to report discomfort at IV insertion site  Instruct patient to notify prescriber about rash, loose stools, diarrhea, or evidence of superinfection