Drug CEFUROXIME

Classification Antiinfective. Second generation cephalosporin

Mode of Action Inhibition of cell wall synthesis, causing cell death; bactericidal effect.

Indication Lower Respiratory Tract Infection, UTI, Tonsillitis, Bacterial Meningitis, Preop prophylaxis

Side Effects / Adverse Reaction Nausea Anorexia Fever Headaches Pruritus Adverse Reaction: Super infection Seizures (high doses) Renal Failure

Nursing Responsibilities Assess allergy to drug. If allergic, client should not take the drug. Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results. Monitor periodically BUN and creatinine clearance. Inspect IM and IV injection sites frequently for signs of phlebitis. Report onset of loose stools or diarrhea. Although pseudomembranous colitis rarely occurs, this potentially lifethreatening complication should be ruled out as the cause of diarrhea during and after antibiotic therapy. Monitor for manifestations of hypersensitivity. Discontinue drug and report their appearance promptly. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

Dosage: 500 mg q8 Contraindication: Hypersensitivity. GI absorption difficulties. Children <5yr.

Drug NIFEDIPINE

Classification Antihypertensive: Calcium Channel Blockers

Mode of Action Decreases peripheral vascular resistance (vasodilation), promoting a decrease in blood pressure.

Indication For mild and moderate hypertension

Side Effects / Adverse Reaction Peripheral Edema Headache Flushing Dizziness Nausea Adverse Reaction: Reflex tachycardia Marked hypotension Gingival hyperplasia

Nursing Responsibilities Monitor BP carefully during titration period. Patient may become severely hypotensive, especially if also taking other drugs known to lower BP. Withhold drug and notify physician if systolic BP <90. Monitor blood sugar in diabetic patients. Nifedipine has diabetogenic properties. Monitor for gingival hyperplasia and report promptly. This is a rare but serious adverse effect (similar to phenytoininduced hyperplasia).

Dosage: 5 mg BID Prn BP> 120/60

Drug FUROSEMIDE

Classification Loop high ceiling diuretic

Mode of Action Inhibition of sodium and water reabsorption from the loop of Henle and distal renal tubules Potassium, magnesium and calcium may also be excreted

Indication To treat fluid retention/ fluid overload, edema, hypertension

Side Effects / Adverse Reaction Nausea, diarrhea, electrolyte imbalance, vertigo, cramping, rash, headache, weakness, ECG changes, blurred vision, photosensitivity Adverse Reaction: Severe dehydration Marked hypotension Renal Failure Thrombocytopenia Agranulocytosis

Nursing Responsibilities
Closely monitor BP and vital signs. Monitor BP during periods of diuresis and through period of dosage adjustment. Sudden alteration in fluid and electrolyte balance may precipitate significant adverse reactions. Report symptoms to physician. Lab tests: Obtain frequent blood count, serum and urine electrolytes, CO2, BUN, blood sugar, and uric acid values during first few months of therapy and periodically thereafter. Monitor for S&S of hypokalemia Monitor I&O ratio and pattern. Report decrease or unusual increase in output. Excessive diuresis can result in dehydration and hypovolemia, circulatory collapse, and hypotension. Weigh patient daily under standard conditions. .

Dosage: BID Do not give if BP is < 90/60

Drug PARACETAMOL Dosage: 120 mg/5ml 4ml q4 T> 37.8

Classification Non opioid analgesic

Mode of Action Inhibition or weaken prostaglandin synthesis, inhibition of hypothalamic heat regulator center

Indication To decrease pain and fever

Side Effects / Adverse Reaction Anorexia, nausea, vomiting, rash. Side effects are rare.

Nursing Responsibilities
Monitor for S&S of: hepatotoxicity, even with moderate acetaminophen doses, especially in individuals with poor nutrition or who have ingested alcohol over prolonged periods; poisoning, usually from accidental ingestion or suicide attempts; potential abuse from psychological dependence (withdrawal has been associated with restless and excited responses). Patient Teaching:
Do not take other medications (e.g., cold preparations) containing acetaminophen withoutmedical advice; overdosing and chronic use can cause liver damage and other toxic effects.

Adverse Reaction Severe hypoglycemia Oliguria Hemolytic anemia

Do not self-medicate adults for pain more than 10 d (5 d in children) without consulting a physician. Do not use this medication without medical direction for: fever persisting longer than 3 d, fever over 39.5 C (103 F), or recurrent fever. Do not give children more than 5 doses in 24 h unless prescribed by physician.

Drug DIAZEPAM Dosage: 10 mg IM

Classification Antianxiety agents, anticonvulsants, sedative/hyptonics, skeletal muscle relaxants (centrally acting)

Mode of Action

Indication

Side Effects / Adverse Reaction dizziness drowsiness lethargy hangover headache depression respiratory depression hypotension Adverse Reaction 1) physical & psychological depen-dence 2)tolerance

Nursing Responsibilities
Monitor BP, PR,RR prior to periodically throughout therapy and frequently during IV therapy. Assess IV site frequently during administration, diazepam may cause phlebitis and venous thrombosis. Prolonged high-dose therapy may lead to psychological or physical dependence. Restrict amount of drug available to patient. Observe depressed patients closely for suicidal tendencies. Observe and record intensity, duration and location of seizure activity. The initial dose of diazepam offers seizure control for 15-20 min after administration. IM injections are painful and erratically absorbed. If IM route is used, inject deeply into deltoid muscle for maximum absorption. Effectiveness of therapy can be demonstrated by decrease anxiety level; control of seizures; decreased tremulousness.

Depress the CNS, probably Anxiety by potentiating GABA, an inhibitory neurotransmitter. Preoperative sedation Produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferent pathways. Has anticonvul-sant properties due to enhanced presynaptic inhibi-tion. Conscious sedation Provides light anesthesia and anterograde amnesia Treatment of status epilepticus/ uncontrolled seizures Skeletal muscle relaxant Management of the symptoms of alcohol withdrawal

Drug PENICILLIN-G Dosage: 435,000 ANST (-)

Classification Antiinfectives

Mode of Action Bactericidal action. Active against: Streptococci, Penumococci, Enterococci, Haemophilus influenzae,

Indication Treatment for respiratory infection

Side Effects / Adverse Reaction Hypersensitivity.

Nursing Responsibilities
Assess patient for infection (vital signs, wound appearance, sputum, urine, stool, and WBCs) at beginning and throughout therapy. Obtain a history before initiating therapy to determine previous use of and reactions to penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still have an allergic response. Obtain specimens for culture and sensitivity before therapy. First dose may be given before receiving results. Observe patients for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify the physician immediately if these occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction. Caution patient to notify physician if fever and diarrhea occur, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional. May occur up to several weeks after discontinuation of medication. Instruct patient to notify physician if symptoms do not improve.

Drug CEFOTAXIME Dosage: IM/IV 1-2 g q8

Classification Antiinfective. Second generation cephalosporin

Mode of Action Inhibition of cell wall synthesis, causing cell death; bactericidal effect.

Indication Lower Respiratory Tract Infection, UTI, Tonsillitis, Bacterial Meningitis, Preop prophylaxis

Side Effects / Adverse Reaction Nausea Anorexia Fever Headaches Pruritus Adverse Reaction: Super infection Seizures (high doses) Renal Failure

Nursing Responsibilities Assess allergy to drug. If allergic, client should not take the drug. Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results. Monitor periodically BUN and creatinine clearance. Inspect IM and IV injection sites frequently for signs of phlebitis. Report onset of loose stools or diarrhea. Although pseudomembranous colitis rarely occurs, this potentially lifethreatening complication should be ruled out as the cause of diarrhea during and after antibiotic therapy. Monitor for manifestations of hypersensitivity. Discontinue drug and report their appearance promptly. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

Contraindication: Hypersensitivity. GI absorption difficulties. Children <5yr.

TRINITY UNIVERSITY OF ASIA ST. LUKE S COLLEGE OF NURSING

DRUG STUDY

Apryll Kristin P. Villaluna 3nu10 Group 5