XIII.

Treatment/ Management Mechanism of Action Drug Name Ethambutol Classification Anti-TB Agents Ethambutol interferes with RNA synthesis, causing suppression of Mycobacteria multiplication. It also has bacteriostatic action against M tuberculosis by acting on rapidly growing pathogens in cavity walls and is also effective in slow-growing pathogens. Nursing Implication > Perform visual acuity and color discrimination test before and during the therapy. > Assess liver and renal function before and during the therapy. > Assess patient mental status often: affect mood, behavior change. watch out for confusion and hallucination > Assess patient for visual disturbance that may indicate optic neurisyis. >Instruct patient to take medication directed. Take missed doses as soon possible unless almost time for next dose; do not double up on missed doses. A full course of therapy may take months to years. Do not discontinue without consulting professional, even do symptoms may disappear. >Instruct patient to notify health care professional if no improvement is seen in two to three weeks. Health care professional should also be notify if unexpected weight gain or decreased urine output occurs >Emphasize the importance of Side Effects Disorders of the blood & lymphatic system, immune system, metabolism & nutrition, CNS, eye, GI, hepatobiliary, skin & SC tissues, musculoskeletal, connective tissue & bone, renal/urinary, reproductive system & breast. Fever, malaise, flu-like syndrome, dryness of mouth. Contraindication Alcoholism, optic neuritis, impaired hepatic function, severe renal insufficiency, hyperuricemia, gouty arthritis, jaundice, retro bulbar neuritis. Pregnancy & lactation.

Brand Name: Myrin P Forte

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routine exams to evaluate progress and ophthalmic examination if signs of optic neuritis occur.

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Drug Name

Classification

Mechanism of Action

Nursing Implication

Side Effects

Contraindication

Butamine citrate

Antitussive

Brand Name: Dobutrex solution

The active ingredient of Sinecod is butamirate citrate that belongs to a group of medications called central action antitussive drugs. Sinecod exerts antitussive(antitussic), expectorant, moderate bronchodilatory action with antiinflammatory effects. Sinecodlowers the resistance of airways and improves blood oxygenation and spirometery indexes.

Assess cough type and frequency. 1. Monitor the adverse reactions 2. Assess patients VS 3. Assess sleep Teach patient: 4. If cough persist 10 days + fever or chest pain check with Doctor. 5. Dont exceed recommended dose 6. Since the drug may cause dizziness or drowsiness, caution patient to avoid driving or other activities requiring alertness until response to medication is known. 7. Advise patient to minimize cough by avoiding irritants (cigarette smoke, fumes, dust) 8. Instruct patient to cough effectively, sit upright and take several deep breaths before attempting.

Sinecod is usually well tolerated. The most common side include: Central nervous system (CNS): dizziness (1%) Digestive system: nausea, diarrhea Allergic reactions: skin rash and itching(in rare cases) Sinecod overdose: Symptoms may include: drowsiness, nausea, vomiting, diarrhea, low blood pressure

Hypersensitivity, idiopathic hypertrophic subaortic stenosis

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Drug Name

Classification

Mechanism of Action

Nursing Implication

Side Effects

Contraindication

Paracetamol

Analgesics (Non-Opioid) & Antipyretics

Brand Name: Tempra

> Decrease fever by inhibiting the effect of pyrogens on the hypothalamic heat regulating center and by hypothalamic action leading to sweating and vasodilation. > Relieving of pain by inhibiting prostaglandin synthesis at the CNS but does not have anti-inflammatory action because of its minimal effect on the peripheral prostaglandin synthesis.

>Assess patients fever of pain, location, intensity, duration, temperature. >advise patient to take ibuprofen with a full glass of water and to remain an upright position for fifteen to thirty minutes after administration. >Instruct patient to take medication as directed. Take missed doses as soon as remembered but not if almost time for next dose. Do not double doses. May cause drowsiness or dizziness. Advice patient to avoid driving or other activities requiring alertness until response to medication is known. >Caution patient to avoid the concurrent use of alcohol, aspirin, acetaminophen or other OTC or herbal product without consulting health care professionals. >Caution patient that use of ibuprofen with three or more glasses of alcohol per day may increase the risk of GI bleeding.

Hypothermia, Dark urine or pale stools; unusual fatigue; yellowing of the skin or eyes.

Paracetamol should not be used in hypersensitivity

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Drug Name

Classification

Mechanism of Action

Nursing Implication

Side Effects

Contraindication

Levofloxacin

Quinolone Antibiotic (RESERVED ANTIMICROBIAL DRUG)

Brand Name: Levaquin

The levorotatory isomer of ofloxacin which inhibits DNA topoisomerase, more commonly referred to as the DNA gyrase. DNA gyrase is necessary for bacterial DNA replication and some aspects of transcription, repair, recombination and transposition. Inhibition of DNA gyrase in susceptible microorganisms results in the inhibition of ATP-dependent negative supercoiling of DNA, inhibition of ATP-independent relaxation of supercoiled DNA and promotion of double-stranded DNA breakage resulting in bacterial cell death.

> Store in a dry place at temperatures not more than 30C. > Should be used with caution in patients with a known or suspected CNS disorder that may predispose to seizures or lower seizure threshold > Take the oral solution 1 hr before or 2 hrs after eating. > Avoid multivitamins with zinc, iron products, sucralfate, and Mgor Al-containing antacids 4 hr before and after dose. >Tell patient to take drug as prescribed, even if signs and symptoms disappear. >Advised patient to take drug with plenty of fluids and to space antacids, sucralfate, and products containing iron or zinc. >Instruct patient to stop drug and notify prescriber if rash or other sign or symptoms of hypersensitivity develop.

Diarrhea, abdominal discomfort, nausea, anorexia, abdominal pain, vomiting, stomatitis & heartburn; insomnia, headache & dizziness; rash, pruritus & eczema; muscle & joint pain; bone marrow depression. Increased liver enzymes. Pain, reddening at the injection site, phlebitis

Hypersensitivity to quinolones. IV Epilepsy, history of tendon disorders related to fluoroquinolone therapy. Childn, pregnancy & lactation.

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B. IV Fluids Name D5LRS

Classification Hypertonic

Component/s Sodium Chloride USP Sodium lactate Potassium Chloride USP Calcium Chloride Dehydrate USP Hydrous Dextrose USP

Use and effects Use: Treatment for persons needing calorie who cannot tolerate fluid overload. Effects: Can cause fluid and/or solute overload resulting in dilution of serum electrolyte concentrations, over hydration, congestive states or pulmonary edema. The risk of delusional states is inversely proportional to the electrolyte concentration. The risk of solute overload causing congestive states with peripheral and pulmonary edema is directly proportional to the electrolyte concentration.

Significance Replacement of fluid and electrolyte fluid loss. Provide lactate which is metabolizing in liver. Helps buffer in the blood if acidosis is present.

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