DRUG STUDY

Drug Name
Generic name:
Co-Amoxiclav
Brand name:
Natravox
Addex
Amoclav
Amoclav Forte
Demoxil Forte
Fimoxy Clav

Classification
Antibacterial

Mechanism of
Action
Co-amoxiclav is
an antibacterial
combination
consisting of
amoxicillin (as
sodium) and the
beta-lactamase
inhibitor,
clavulanic acid
(as potassium
clavulanate).
Amoxicillin is the
4-hydroxy
analogue of
ampicillin. Amox
icillin hinders the
cell wall
synthesis of
sensitive
bacteria and is
bactericidal
against many
Gram-positive
and Gramnegative
bacteria.

Dosage, Route
Preparation
Adults and children
40 kg: Oral 500
mg/125 mg dose
taken three times a
day.

Children < 40 kg:

20 mg/5 mg/kg/day to
60 mg/15 mg/kg/day
given in three divided
doses.

Availability:
Co-amoxiclav tablets
Suspensions
Pediatric sachets

Indications

Contraindications

Lower respiratory
tract infections,
otitis media,
sinusitis, skin &
soft tissue
infections, UTI,
pre& postsurgical procedur
es, bone & joint,
infections, dental
infections

History of penicillin
hypersensitivity.
Superinfections
involving
Pseudomonas
or candida.
Pregnancy &
lactation

Adverse
Reactions
GI:
Diarrhea,

Nursing
Responsibilities
Ensure that the
patient has
adequate fluid
intake during any
diarrhea attack.

Nausea and
vomiting

Ice chips and

crackers to prevent
nausea and
vomiting

Hematology:
Anemia,
Neutropenia

The drug must be

taken in equal
doses around the
clock to maintain
level in the blood.

Allergic
reactions
- itching,
rashes,
wheezing

This could indicate

allergy to drug and
it should be
reported.

Hepatitis,
cholestatic
jaundice

Dose with caution

and monitor hepatic
function at regular
intervals

DRUG
NAME
Generic
Name:
Celecoxib
Brand
Name:
Celebrex

DRUG CLASS
Pharmacologi
c class:
Nonsteroidal
cyclooxygenas
e-2 (COX-2 )
inhibitor,
antiinflammatory
drug (NSAID)
Therapeutic
class:
Antirheumatic
Pregnancy
risk category
C

DOSAGE AND
MECHANISM
FREQUENCY
OF ACTION
400 mg OD p.r.n Exhibits antiinflammatory,
analgesic,
and antipyretic
action due to
inhibition
of the enzyme
COX-2

INDICATION

CONTRAINDICATION

SIDE - EFFECTS

Adjunctive
treatment to
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: menorrhagia
Hematologic:
decreased
hemoglobin
or hematocrit,
eosinophilia,
epistaxis,
bruising,

NURSING
RESPONSIBILITIES
Before:
- Assess pts history of
allergic reaction to the
drug
- Monitor complete blood
count, electrolyte
levels, creatinine clearance,
and
occult fecal blood test and
liver function
test results every 6 to 12
months
During:
- Instruct patient to take drug
with
food or milk.
- Teach patient to avoid
aspirin and
other NSAIDs (such as
ibuprofen and
naproxen) during therapy.
After:
- Advise patient to
immediately report
bloody stools, blood in vomit,
or
signs or symptoms of liver
damage
(nausea, fatigue, lethargy,
pruritus, yellowing
of eyes or skin, tenderness on
upper right side of abdomen,
or flulike
symptoms).

DRUG
NAME
Generic
Name:
Metoprolol
Brand
Name:
Lopressor

DRUG CLASS
Betaadrenergic
blocking
agents

DOSAGE AND
FREQUENCY
100mg

MECHANISM
OF ACTION
Unknown. A
selective beta
blocker that
selectively
blocks beta1
receptors;
decreases
cardiac
output,
peripheral
resistance,
and cardiac
oxygen
consumption;
and
depresses
rennin
secretion.

INDICATION
Hypertension
Acute MI
Angina
Pectoris

CONTRAINDICATION

Hypersensitive to
drug.
Pt. with sinus
bradycardia,
cardiogenic shock
and heart failure

SIDE EFFECTS
CV: hypotension
GI: nausea and
vomiting
Respi:
dyspnea
Skin: rash

NURSING
RESPONSIBILITIES
1. Always check patients
apical pulse
2. Monitor BP
3. Store drug at room
temperature.
4. Inform patient about the
side effects and adverse
effects of the medication.
5. Advise patient to take it
with meals.
6. Tell patient to report if
he/she feels shortness of
breath.
7. Tell patient that
metoprolol is not advisable
to breastfeeding mothers.
8. Advise not to withdrawn
drug abruptly.

DRUG
NAME
Generic
Name:
Cetirizine
Brand
Name:
Zyrtec,
Zyrtec
Allergy,
Zyrtec
Hives

DRUG CLASS
Non-sedating
antihistamine

DOSAGE AND
FREQUENCY
ADULTS

MECHANISM
OF ACTION
Potent
histamine (H1)
510 mg daily
receptor
PO; maximum
antagonist;
dose 20 mg/day. inhibits
histamine
release and
eosinophil
chemotaxis
during
inflammation,
leading to
reduced
swelling and
decreased
inflammatory
response

INDICATION
Management of
seasonal and
perennial
allergic rhinitis
Treatment of
chronic,
idiopathic
urticarial
Treatment of
year-round
allergic rhinitis
and chronic
idiopathic
urticaria in
infants > 6 mo

CONTRAINDICATION

Contraindicated
with allergy to any
antihistamines,
hydroxyzine.
Use cautiously
with narrow-angle
glaucoma,
stenosing peptic
ulcer, symptomatic
prostatic
hypertrophy,
asthmatic attack,
bladder neck
obstruction,
pyloroduodenal
obstruction (avoid
use or use with
caution as
condition may be
exacerbated by
drug effects);
lactation

SIDE EFFECTS
CNS:
Somnolence,
sedation
CV: Palpitation,
edema
GI: Nausea,
diarrhea,
abdominal pain,
constipation
Respiratory:
Bronchospasm,
pharyngitis
Other: Fever,
photosensitivity,
rash, myalgia,
arthralgia,
angioedema

NURSING
RESPONSIBILITIES
Assessment
History: Allergy to any
antihistamines,
hydroxyzine; narrow-angle
glaucoma, stenosing
peptic ulcer, symptomatic
prostatic hypertrophy,
asthmatic attack, bladder
neck obstruction,
pyloroduodenal
obstruction; lactation
Physical: Skin color,
lesions, texture;
orientation, reflexes, affect;
vision examination; R,
adventitious sounds;
prostate palpation; renal
function tests
Interventions
Give without regard to
meals.
Provide syrup form or
chewable tablets for
pediatric use if
needed.
Arrange for use of
humidifier if thickening
of secretions, nasal
dryness become
bothersome;
encourage adequate
intake of fluids.
Provide skin care for
urticaria.

Teaching points
Take this drug without
regard to meals.
You may experience
these side effects:
Dizziness, sedation,
drowsiness (use
caution if driving or
performing tasks that
require alertness);
thickening of bronchial
secretions, dryness of
nasal mucosa
(humidifier may help).
Report difficulty
breathing,
hallucinations,
tremors, loss of
coordination, irregular
heartbeat.

DRUG
NAME
Generic
Name:
Losartan
Potassium
Brand
Name:
Cozaar

DRUG CLASS
Antihypertensive

DOSAGE AND
FREQUENCY
For
Hypertension:
Adults- Initially
25-50mg PO
daily, For
Nephropahty:
Adults-50mg PO
OD.

MECHANISM
OF ACTION
Inhibits vasoconstrictive and
aldosteronesecreting action
of angiotensin II
by blocking
angiotensin II
receptor on the
surface of
vascular
smooth muscle
and other tissue
cells.

INDICATION
Hypetension,
Nephepatically
in type 2
daibetic
patients, to
reduce risk of
CVA in patients
with
hypertension
and left
ventricular
hypertrophy

CONTRAINDICATION

SIDE EFFECTS
Patients hypersensitive CNS-dizziness,
to drug, breast-feeding asthenia, fatigue,
is not recommended,
headache,
causes fetal and
insomia.
neonatal morbidity and CV-edema, chest
death when
pain.
administered in the
EENT-nasal
2nd and 3rd trimester
congestion,
of pregnancy.
sinusitis,
pharyngitis, sinus
disorder.
GI-Abdominal
pain, nausea,
diarrhea,
dyspepsia.
Musculoskeletal
-muscle cramps,
myalgia, back or
leg pain.
Respiratorycough, upper
respiratory
infection.

NURSING
RESPONSIBILITIES
Monitor patients
BP.
Monitor patients
who are also
taking diuretics for
symptomatic
hypotension.
Assess patients
renal function
Tell patient to
avoid salt
substitutes