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Name of Drug

Classification

Adverse effect

Indication

Contraindication

Nursing Considerations 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 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.

Cefuroxime IV 50mg q6 Brand Name: Zinacef

ANTIINFECTIVE; ANTIBIOTIC; SECONDGENERATION CEPHALOSPORIN

Body as a Whole: Thrombophlebi tis (IV site); pain, burning, cellulitis (IM site); superinfections , positive Coombs' test. GI: Diarrhea, nausea, antibioticassociated colitis. Skin: Rash, pruritus, urticaria. Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance.

It is effective for the treatment of penicillinaseproducing Neisseria gonorrhoea (PPNG). Effectively treats bone and joint infections, bronchitis, meningitis, gonorrhea, otitis media, pharyngitis/tons illitis, sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used for surgical prophylaxis, reducing or

Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation.

eliminating infection.

Name of Drug

Classification

Adverse effect

Indication

Contraindication

Nursing Consideration

Generic Name: Ascorbic acid 0.5 bid Brand Name: Fern-C

Vitamins

GI: Nausea, vomiting, heartburn, diarrhea. Hematologic: Acute hemolytic anemia (patients with deficiency of G6PD); sickle cell crisis. CNS: Headache (high doses). Urogenital: Urethritis, dysuria, crystalluria (high doses). Other: Mild soreness at injection site; dizziness and temporary faintness with rapid IV administration.

Pro phylaxis and treatment of scurvy and as a dietary supplement. Increases protection mechanism of the immune system, thus supporting wound healing. Necessary for wound healing and resistance to infection.

Assessment & Drug Effects Use of sodium ascorbate in patients on sodium restriction; use of calcium ascorbate in patients receiving digitalis. Safety during pregnancy (category C) or lactation is not established. Lab tests: Periodic Hct & Hgb, serum electrolytes. Monitor for S&S of acute hemolytic anemia, sickle cell crisis.

Patient & Family Education Take large doses of vitamin C in divided amounts because the body uses only what is needed at a particular time and excretes the rest in urine. Megadoses can interfere with absorption of vitamin B12.

Note: Vitamin C increases the absorption of iron when taken at the same time as iron-rich foods.

Name of Drug Generic Name : Paracetamol drops 60mg/ml 1.5ml q4 Brand Name Biogesic

Classification

Adverse effect Side effects are rare with paracetamol when it is taken at the recommended doses. Skin rashes, blood disorders and acute inflammation of the pancreas have occasionally occurred in people taking the drug on a regular basis for a long time. One advantage of paracetamol over aspirin and NSAIDs is that it doesn't irritate the stomach or causing it to bleed, potential Side effects of aspirin and NSAIDs.

Indication To relieve mild to moderate pain due to things such as headache, muscle and joint pain, backache and period pains. It is also used to bring down a high temperature. For this reason, paracetamol can be given to children after vaccinations to prevent postimmunisation pyrexia (high temperature). Paracetamol is often included in cough, cold and flu remedies.

Contraindication Hypersensitivity to acetaminophen or phenacetin; use with alcohol.

Nursing Consideration Monitor for S&S of: hepatotoxicity, even with moderate acetaminophen doses, especially in individuals with poor nutrition. Do not take other medications (e.g., cold preparations) containing acetaminophen without medical advice; overdosing and chronic use can cause liver damage and other toxic effects. Do not self-medicate children for pain more than 5 d without consulting a physician. Do not use 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.

Non-opioid analgesic

Name of Drug

Classification

Adverse effect

Indication

Contraindication

Nursing Consideration

Ambroxol

Mucolytic

Occasional gastrointestinal side effects may occur but these are almost invariably mild.

Adjuvant therapy in patients with abnormal, viscid, or inspissated mucous secretions in acute and chronic bronchopulmon ary diseases, and in pulmonary complications of cystic fibrosis and surgery, tracheostomy, and atelectasis. Also used in diagnostic bronchial studies and as an antidote for acute acetaminophen poisoning.

There are no absolute contraindication but in patients with gastric ulceration relative caution should be observed.

Monitor for S&S of aspiration of excess secretions, and for bronchospasm (unpredictable); withhold drug and notify physician immediately if either occur. Lab tests: Monitor ABGs, pulmonary functions and pulse oximetry as indicated. Have suction apparatus immediately available. Increased volume of respiratory tract fluid may be liberated; suction or endotracheal aspiration may be necessary to establish and maintain an open airway. Report difficulty with clearing the airway or any other respiratory distress.

GENERIC NAME/BRAND NAME LACTULOSE Duphalac, Cephulac, Cholac, Chronulac, Constulose, Enulose, Generlac, Kristalose

CLASSIFICATION

INDICATION

ACTION

CONTRAINDICATI ON -low-galactose diet (patients) -children with chronic constipation

SIDE EFFECTS/ADV ERSE REACTION Side effects: Abdominal cramps, belching, diarrhea, distention, flatulence Adverse Reaction: Nausea, vomiting

NSG. RESPONSIBILITIE S -Assess patients condition before starting therapy, & regularly thereafter to monitor the drugs effectiveness. -Be alert for adverse reactions & drug interactions. -Replace fluid loss.

Laxative

-for constipation -to prevent and treat encephalopath y, including hepatic precoma & coma in patients with severe hepatic dse. -to induce bowel evacuation after a barium meal examination -to restore bowel movements after hemorrhoidect omy

- Relieves constipatio n - Decrease blood ammonia concentrati on

GENERIC NAME/BRA ND NAME EPINEPHRI NE Adrenalin, Bronkaid Mistometer, MicroNefrin, Nephron, Primatene Mist

CLASSIFICAT ION Pharmacologic Class: Adrenergic Therapeutic Class: Bronchodilat or, vasopressor, cardiac stimulant, topical antihemmor hagic

INDICATION Brochospasms, hypersensitivit y reactions, anaphylaxis. -Hemostasis - Acute asthma attacks. - Prolonging local anesthetic effect - Restoring cardiac rhythm in cardiac arrest.

ACTION Chemical effect: Stimulates alpha and beat receptors in sympathetic nervous system. Therapeutic effect: Relaxes bronchial smooth muscles, causes cardiac stimulation, relieves allergic signs and symptoms, helps stop local bleeding, and decreases pain sensation.

CONTRAINIDCATI ON Contraindicated in patient with angle closure glaucoma, shock (other than anaphylaxis) organic brain damage, cardiac dilation. Arrhythmias. Coronary insufficiency or cerebral arteriosclerosis. Also contraindicated in patients receiving general anesthsia with halogenated hydrocarbons or cyclopropanes and in patients in labour. Some commercial products contain sulfides and are contraindicated in patents with sulfites allergies except when drug is used for serious allergic reaction and in other emergency situations. In conjunction with local anesthetics, epinephrine is contraindicated for use in fingers, toes, ears, nose or gentalia.

SIDE EFFECTS/ADVERSE REACTION CNS: nervousness, tremors, euphoria, anxiety, cold limbs, vertigo, headache drowsiness, diaphoresis, disorientation, agitation, fear, weakness, cerebra; hemmorhage, increased rigidity and tremors in patients with Parkinsons dse. stroke. CV: palpitations, widened pulse pressure, hypertension, tachycardia, ventricular fibrillation, shock, anginal pain, ECG changes. GI: nausea, vomiting Metabolic: hyperglyscemia, glycosuria Respiratory: dyspnea Skin: Urticaria, pain Other: Hemorrhage Injection site. Pallor, at

NSG. RESPONSIBILITI ES Briskly massage site o SC or IM injection to hasten drug action. -Discard solution if reddish brown and after expiration date. -Do not use topical preparation in children under 6 years of age.

GENERIC NAME/BRAND NAME ASPIRIN ZORpin, Easprin

CLASSIFICATION Nonsteroidal antiinflammatory drug, analgesic, antipyretic

INDICATION -pain from integumentary structure -myalgia -headache -dysmenorrhea acute rheumatic fever

ACTION Antipyretic is due to an action on the hypothalamus, resulting to heat loss by vasodilation of peripheral blood vessels and promoting sweating. Antiinflammatory effects are probably mediated through inhibition of cyclooxygenase, which results in a decrease in prostaglandin synthesis and other mediators of the pain response.

CONTRAINDICATION -hypersensitivity to salycylates -clients with asthma, hay fever, severe anemia -children or teenagers with chicken-pox or flu due to possibility of development of Reyes syndrome

SIDE EFFECTS/ADVER SE REACTION Side effects: Dyspepsia, nausea, epigastric discomfort Adverse Reaction: Massive GI bleeding, potentiation of peptic ulcer, bronchospasm, asthma like symptoms, anaphylaxis

NSG. RESPONSIBILITIES -Note any asthma, nasal polyps, hay fever or ulcer dse. -Note effectiveness of Aspirin if previously used for pain and dose used. -Document age: drug discouraged in those under 12. Assess for chickenpox or the flu.