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BULACAN STATE UNIVERSITY

Mojon, City of Malolos, Bulacan

COLLEGE OF NURSING

DRUG STUDY
An output requirement for JBL duty; (July 16-26) Submitted By: Eries L. Lumba BSN 4-C; Group 3-A Batch 2014 Submitted to : Daisy Reyes, RN, MAN

DRUG NAME
Ceftriaxone Sodium

CLASSIFICATION
Anti-biotic; Third Generation Cephalosporin

ACTION
Binds to one or more of the Penicillin-binding proteins (PBP) located on cell walls of susceptible organisms. This inhibits third and final stage of bacterial cell wall synthesis, thus killing the bacterium. It is effective against serious gram-negative organisms and also penetrates the CSF in concentrations useful in treatment of Meningitis.

SIDE EFFECTS
Lump on the Injection Site Nausea Vomiting G.I. upset Headache Pain or swelling on Tongue Sweating Vaginal itching/ discharge

ADVERSE EFFECTS
Pruritus Fever Chills Pain Phlebitis Diarrhea Abdominal Cramps Pseudomemb ranous Colitis Biliary Sludge Genital Pruritus Moniliasis

NURSING RESPONSIBILITIES
Determine history of hypersensitivity reactions to cephalosphorins and penicillins and history of other allergies. Inspect injection site for induration and inflammation. Note IV injection sites for phlebitis. Monitor for manifestations of hypersensitivity Watch and report for: Petechiae, ecchymotic areas, epistaxis, or any unexplained bleeding. Report promptly development

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Ampicillin Sodium

Anti-biotic; Aminopenicillin Inhibits the final stage of bacterial cell wall synthesis by binding to (PBPs) located inside the bacterial cell wall resulting in Lysis and death of bacteria. Effective against grampositive bacteria as well as some gramnegative bacteria.

Nausea Vomiting Stomach Pain Vaginal Itching/ discharge Headache Swollen, black or hairy tongue Oral Thrush

Phenobarbital Sodium

Anti-convulsant; SedativeHypnotic; Barbiturate

Effective as a sedative hypnotic, and an anticonvulsant with no analgesic effect.

Somnolence Nightmares Insomnia Hangover Excitement Irritability Aggression and Confusion Loss of Balance and Coordination Constipation Nausea

Hypersensiti vity Reactions like: Pruritus Urticaria Eosinophilia Hemolytic Anemia Intestinal Nephritis Anaphylactoi d reaction Superinfectio ns Myalgia Neuralgia CNS depression COMA Death Anxiety Thinking abnormalities Ataxia Bradycardia Syncope Hypotension Liver Damage Megaloblasto c Anemia

of diarrhea. Determine history of hypersensitivity reactions to cephalosphorins and penicillins and history of other allergies. Inspect skin daily and instruct patient to do the same for allergic rashes. Report promptly development of diarrhea.

Observe patients receiving large doses for at least 30 mins to ensure that sedation is not excessive. Chronic use in children and infants requires continuous assessment related to normal cognitive and behavioural functioning. Keep patient under constant observation when drug is administered IV and record VS at least every hour or more if indicated. Check IV insertion site very frequently to prevent extravasation of

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Agranulocyto sis Thrombocyto penia Hypocalcemi a Osteomalacia Rickets Folic Acid and Vit. D Deficiency

Midazolam HCl

Anesthetic; Benzodiazepine; Calms the patient, Anxiolytic; Sedativerelaxes skeletal Hypnotic muscles, and in high doses produces Sleep. Is a CNS depressant with muscle relaxant, sedative-hypnotic, anticonvulsant and amnestic properties.

Headache Euphoria Drowsiness Confusion Blurred Vision Diplopia Nausea Vomiting Coughing Swelling Induration at the Injection site

Retrograde Amnesia Excessive Sedation Hypotension Nystagmus Laryngospas m Respiratort Failure Hives

Paracetamol

Analgesic; Antipyretics

Decreases fever by inhibiting the effects of

Diaphoresis

Stimulation] Drowsiness

phenobarbital. Expect Barbiturates to produce restlessness when given to patients in pain because it has no analgesic action. Monitor for and report chronic toxicity problems (e.g. ataxia. Slurred speech, irritability, poor judgment, slight dysarthria, nystagmus on vertical gaze, confusion, insomnia and somatic complaints) Inspect insertion site for signs of inflammation and extravasations during IV infusion. Monitor closely for indications of impending Respiratory Arrest. Resuscitative drugs and equipment should be immediately available. Monitor VS for entire recovery period. Be aware that overdose symptoms include somnolence, confusion, sedation, diminished reflexes and COMA. Assess patients fever or pain: typeof pain, location,

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pyrogens on the hypothalamus heat regulating centers & by a hypothalamic action leading to sweating & vasodilatation. Relieves pain by inhibiting prostaglandin synthesis at the CNS but does not have anti-inflammatory action because of its minimal effect on peripheral prostaglandin synthesis.

Nausea Vomiting Abdominal pain Hepatotoxicit y Hepatic seizure(overd ose, Renal failure(high, prolonged doses) Leucopenia Neutropenia Hemolytic anemia (long term use) Thrombocyto penia Pancytopeni Rash Urticaria, hypersensitiv ity Cyanosis Anemia Jaundice CNS stimulation, delirium followed by vascular collapse

intensity, duration, temperature, and diaphoresis. Assess allergic reactions: rash, urticaria; if these occur, drug may have to be discontinued. Teach patient to recognize signs of chronic overdose: bleeding, bruising, malaise, fever, sore throat. Tell patient to notify prescriber for pain/ fever lasting for more than 3 days.

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Amikacin Sulfate

Aminoglycoside; Antibiotic

Inhibits protein synthesis in bacterial cell and usually bactericidal. Effective against wide-range of gram-negative bacteria, including many strains resistant to other aminoglycosides. Also effective against penicillinase and nonpenicillinase producing Staphylococcus.

Nausea Vomiting Anorexia Rashes

Salbutamol/ Albuterol

Bronchodilator; BetaAdrenergic Agonist

Moderately selective beta adrenergic agonist that acts prominently on smooth muscles of trachea, bronchi, uterus, and vascular supply to skeletal muscles. Inhibits histamine

Fast, irregular, pounding, or racing heartbeat or pulse shakiness in the legs,

Convulsions Coma Death Drowsiness Unsteady Gait Paresthesias Tremors Convulsions Peripheral Neuritis High Frequency hearing loss Tinnitus Hepatotoxicit y Hypokalemia Hypomangan esemia Urticaria Pruritus Azotemia Super Infections Hives or welts large, hivelike swelling on the face, eyelids, lips, tongue, throat, hands,

Baseline test: Before initial dose, C&S; renal function and vestibulocochlear nerve function, ear problems, renal impairment. Monitor for and promptly report S&S of: Ototoxicity, high-frequency deafness, indicators of declining renal function, respiratory tract infections and other super infections.

Discontinue drug immediately and institute supportive measures if a serious hypersensitivity reactions occurs. Note: drug should be discontinued if CD4+T Lymphocytes counts remain

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release by Mast cells. Produces bronchodilation by relaxing smooth muscles of bronchial tree. Bronchodilation decreases airway resistance, facilitates mucus drainage, and increases vital capacity.

arms, hands, or feet trembling or shaking of the hands or feet

legs, feet, or sex organs noisy breathing redness of the skin swelling of the mouth or throat trouble breathing

below 250 cells/mcL for 1 month. Monitor for and promptly report S&S of infection.

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