GENERIC NAME ACTION (BRAND NAME) Pantoprazole Inhibits both (Pantloc IV) basal and stimulated Drug gastric

acid Classification secretion by suppressing the A02BC02 final step in acids Pantoprazole ; production, Belongs to the through the class of proton inhabitation of pump inhibitors. the proton pump Used in the by binding to and treatment of inhibiting peptic ulcer and hydrogengastropotassium oesophageal adenosine reflux disease triphosphatase, (GERD). the enzyme system located Dosage & at the secretory Frequency surface of the gastric parietal 40mg, once a cell. day

INDICATION Duodenal and gastric ulcer, moderate and severe reflux esophagitis. Eradication of H. pylori in opatient with peptic ulces, zollinger-ellison syndrome and other pathological hypersecretory conditions. Symptomatic improvement and healing of mild reflux esophagitis. Prevention of gastro-duodenal ulcers induced by NSAID in patients at risk with a need for continuous NSAID treatment.

ADVERSE EFFECT Occasionally headache or diarrhea. Isolated cases of edema, blurred vision, fever, dizziness, thrombophlebitis, depression or myalgia subsiding after termination of therapy.

SIDE EFFECT Diarrhea; headache; nausea; stomach pain; vomiting. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bone pain; chest pain; dark urine; fast or irregular heartbeat; fever, chills, or sore throat; red, swollen, blistered, or peeling skin; unusual bruising or bleeding; unusual tiredness; vision changes; yellowing of the skin or eyes.

NURSING CONSIDERATION AND RESPONSIBILITY Assess underlying condition before therapy and thereafter to monitor drug effectiveness. Assess GI symptoms: epigastric/abdominal pain, bleeding and anorexia. Monitor for possible drug induced adverse reaction CNS: headache, insomnia, migraine, anxiety, dizziness, pain; CV: chest pain; EENT: pharyngitis, rhinitis, sinusitis; GI: diarrhea, flatulence, abdominal pain, constipation, dyspepsia, gastroenteritis, nausea, vomiting; GU: urinaty frequency, UTI; Metabolic: hyperglycemia, hyperlipedemia; Musculoskeletal: back pain, neck pain, arthralgia, hypertonia; Respiratory: bronchitis, increased cough, dyspnea, URTI; Skin: rash; Other: flu-like syndrome, infection. Monitor hepatic enzymes: AST, ALT, alkaline, phosphatase during treatment.

GENERIC NAME (BRAND NAME) Metronidazole (METRINOX IV) Drug Classification A01AB17 Metronidazole ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth. Dosage & Frequency 500mg, Q8

ACTION Direct-acting amebicide/trichomonacide . It binds to bacterial and protozoal DNA to cause loss of helical structure, strand breakage, inhibition of nucleic acid synthesis and cell death

INDICATION Infections in the intra-abdominal, bacterial septicemia, CNS, lower respiratory system, and endocarditis. Treatment of susceptible protozoal infectios and treatment and prophylaxis of anaerobic bacterial infections. Anaerobic infections, trichomoniasis, amoebiasis, giardiasis.

ADVERSE EFFECT Headache, nausea, dry mouth, metallic taste, hypersensitivity reactions, convulsions, peripheral neuropathy.

SIDE EFFECT Appetite loss; constipation; diarrhea; dizziness; headache; metallic taste; nausea; pain, swelling, or redness at the injection site; stomach upset; vomiting. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; fever; flushing; stuffy nose; very dry mouth or vagina); bloody stools; decreased coordination; increased or decreased urination; numbness, tingling, or burning of the arms, hands, legs, or feet; red, swollen, blistered, or peeling skin; seizures; severe diarrhea; severe or persistent dizziness or headache; sore throat, chills, or fever; speech problems; stiff neck; stomach pain or cramps; vaginal itching, odor, or discharge; vision loss or other vision changes; white patches in the mouth.

NURSING CONSIDERATION AND RESPONSIBILITY Obtain baseline information on patients : fever, wound characteristics, vaginal secretions, WBC count >100,000/mm3 and regularly assess during treatment. Obtain C&S before beginning drug therapy to identify if correct treatment has been initiated. Assess for allergic reaction; rash urticaria, pruritus. Monitor for possible drug induced adverse reactions: CNS: vertigo, headache, ataxia, fever, incoordination, confusion, irrability, depression, restlessness, weakness, fatigue, drowsiness, insomnia, sensory neuropathy, paresthesia; CV: flat T wave, edema, flushing, thrombophlebitis, (IV infusion); EENT: eye tearing; GI: abdominal cramps, stomatitis, nausea, vomiting, anorexia, diarrhea, constipation, proctitis, dry mouth, metallic taste; GU: dark urine, polyuria, dysuria, pyuria, incontinence, cystitis, dyspareunia, , dry vagina and vulva, sense of pelvic pressure;

GENERIC NAME (BRAND NAME) Telmisartan (Pritor) Drug Classification C09CA07 Telmisartan ; Belongs to the class of angiotensin II antagonists. Used in the treatment of cardiovascular disease. Dosage & Frequency 80mg, once a day

ACTION Blocks the vasoconstrictive and adosteronesecreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues (vascular smooth muscles and adrenal gland)

INDICATION Treatment of hypertension

ADVERSE EFFECT UTI, upper resp tract infections, anxiety, insomnia, depression, visual disturbance, vertigo, GI disorders, eczema, athralgia, back pain, leg cramps/pain, myalgia, tendinitis like symptoms, chest pain, influenza-like symptoms. Dyspnea, anemia, thrombocytopenia, eosinophilia. Bradycardia, tachycardia, hypotension, orthostatic hypotension.

SIDE EFFECT Back pain; diarrhea; dizziness; sinus pain or congestion; sore throat; upper respiratory tract infection. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); change in the amount of urine produced or painful urination; chest pain; difficulty swallowing; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; increased or excessive sweating; muscle pain or cramps; severe or persistent vomiting or diarrhea; severe or persistent weakness; shortness of breath; swelling of the arms or legs; symptoms of low blood pressure (eg, fainting, lightheadedness, severe dizziness); tendon or joint pain.

NURSING CONSIDERATION AND RESPONSIBILITY Assess patients condition before therapy and regularly thereafter to monitor drug effectiveness. Assess for heart failure because in patients whose renal function depend on rennin-angiotensinaldosterone system, use of ACE inhibitors and angiotensin-receptor antagonist maybe related to oliguria or progressive azothemia. Obtain baseline renal and liver status before therapy: BUN, creatinine, AST, ALT and biliribin. Assess for obstructive jaundice because drug level may elevate due to inability to excrete drug. Drug is not removed by hemodialysis, closely monitor blood pressure and pulse (rate, rhythm and quality). Monitor for possible drug induced adverse reactions: CNS: dizziness, pain,

fatigue, headache; CV: chest pain, hypertension, peripheral edema; EENT: pharyngitis, sinusitis; GI: abdominal pain, diarrhea, dyspepsia , nausea; GU: UTI; Musculoskeletal: back pain, myalgia,; Respiratory: cough, URTI; Other: flu-like symptoms. Monitor serum electrolyte levels: potassium, sodium, chloride. Assess hydration status: skin turgor and mucus membrane (moist or dry). GENERIC NAME (BRAND NAME) Cefuroxime (zinacef) Drug Classification Anti-infective; antibiotic; secondgeneration cephalosporin Dosage & Frequency 750mg, Q8 ACTION Inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death by binding to cell membrane. INDICATION Treatment for infections caused by e.coli, proteus mirabilis, klebsiella sp., lower respiratory tract infections. ADVERSE EFFECT Thrombophlebiti s, gastrointestinal tract irritation, hypersensitivity reactions, decreased hemoglobin count, decreased hematocrit, Transient rise in SGOT and SGPT, alkaline phosphatase, SIDE EFFECT Pain, swelling, or redness at the injection site. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or bloody stools; decreased urination; fever, chills, or sore throat; hearing loss; seizures; severe diarrhea, nausea, or vomiting; stomach pain or cramps; unusual bruising or bleeding; vaginal irritation or discharge; vein swelling at the injection site; yellowing of the skin or eyes. NURSING CONSIDERATION AND RESPONSIBILITY Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Inspect IM and IV injection sites frequently for signs of phlebitis. Report onset of loose

LDH, and bilirubin levels, Elevations in serum creatinine and/or blood urea nitrogen and a decreased creatinine clearance

stools or diarrhea. Although pseudomembranous colitis. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.