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7/27/2019 Case Pres Drug Analysis
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DRUG ANALYSIS
NAME OF THE DRUG MODE OF ACTION INDICATIONS/CONTRAINDICATIONS
SIDE/ADVERSEEFFECTS
NURSINGRESPONSIBILITIES
Generic Name:Vancocin
Brand Name:Vancomycin
Classification:
Therapeutic: Anti-infectives
Route and Dosage:IV (Adults): 1 cpm q12
Binds to bacterial cell wall,resulting in cell death
Indication: (IV)-Staphylococcal infections-Soft-tissue infections in
patients who have allergiesto penicillin or itsderivatives or when
sensitivity testingdemonstrates resistance tomethicillin
Contraindication:-Hypersensitivity
EENT: ototoxicity
CV: hypotension
GI: nausea andvomiting
GU: nephrotoxicity
Derm: rashes
Hemat: eosinophilia,leucopenia
Local: Phlebitis
MS: back and neck
pain
Misc:hypersensitivityreactions includinganaphylaxis, chills,fever, superinfection
-Assess patient for infection (v/s, appearanceof wound, sputum, urine,and stool; WBC) at
beginning of andthroughout therapy-Obtain specimens for
culture and sensitivity prior to initiating therapy-Monitor IV site closely.Vancomycin is irritatingto tissues and causesnecrosis and severe painwith extravasation.Rotate infusion site-Monitor blood pressurethroughout IV infusion
-Monitor intake andoutput ratios and dailyweight. Cloudy or pink urine may be a sign of nephrotoxicity-Assess patient for signsof superinfection (black,furry overgrowth ontongue; loose or foul-smelling stools)
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-Observe patient for anysigns of anaphylaxis(rash, pruritus, laryngealedema)
Lab Test Considerations:-Monitor for casts,albumin, or cells in theurine or decreasedspecific gravity, CBC,and renal function
periodically duringtherapy-May cause increasedBUN levels
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NAME OF THE DRUG MODE OF ACTION INDICATIONS/
CONTRAINDICATIONSSIDE/ADVERSE
EFFECTS NURSING
RESPONSIBILITIES
Generic Name:Primaxin
Brand Name:Imipenem/Cilastatin
Classification:Therapeutic: Anti-infectives
Pharmacologic:carbapenems
Route and Dosage:IV (Adults): 500 mg q6
Binds to the bacterial cellwall, resulting in cell death.Combination with cilastatin
prevents renal inactivation of imipenem, resulting in highurinary concentrations.Imipenem resists the actionsof many enzymes thatdegrade most other
penicillins and penicillin-likeanti-infectives
Indication:-Treatment of skin and skin structureinfections
Contraindication:-Hypersensitivity-Cross-sensitivity mayoccur with pencillins and
cephalosporins
CNS: seizures,dizziness,
CV: hypotension
GI: pseudomembranousdiarrhea, nausea,vomiting
Derm: rash, pruritus,sweating, uticaria
Hemat: eosinophilia
Local: Phlebitis atIV site
Misc: allergicreaction includinganaphylaxis, fever,
superinfection
-Assess patient for infection (v/s, appearanceof wound, sputum, urine,and stool; WBC) at
beginning of andthroughout therapy-Obtain history beforeinitiating therapy todetermine previous useof and reactions to
penicillin-Obtain specimens for culture and sensitivity
prior to initiating therapy-Assess patient for signsof superinfection (black,furry overgrowth ontongue; loose or foul-smelling stools)-Observe patient for anysigns of anaphylaxis
(rash, pruritus, laryngealedema)
Lab Test Considerations:-Monitor for BUN, AST,ALT, LDH, serumalkaline phosphatise,
bilirubin, and creatininemay be transientlyincrease
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-hemoglobin andhematocritconcentrations may bedecreased-May cause positivedirect Coombs test
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muscle cramps,hyperhidrosis
effect may not be seenfor 4 hr. Do notadminister second doseuntil BP has beenchecked.
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