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XI. DRUG STUDY

Drug Order(Generic

name,dosage,route,

frequency)

Trade/BrandName

PharmacologicAction of Drug

Indications andContraindications

AdverseEffects

DesiredAction tothe Client

NursingResponsibilities and

Precautions

Ceftin750 mg POq 8hrs.Antibiotic

Cefuroxime

Binds to one ormore of thepenicillin-bindingproteins (PBPs)

which inhibits thefinaltranspeptidationstep ofpeptidoglycansynthesis inbacterial cellwall, thusinhibitingbiosynthesis and

arresting cell wallassemblyresulting inbacterial celldeath.

Indication:Used to treat a widevariety of bacterialinfections. It works by

stopping the growthof bacteria. Thisantibiotic treats onlybacterial infections. Itwill not work for viralinfections(e.g., commoncold, flu).

Contraindication:

Hypersensitivity tocephalosporin.

Large dosescan causecerebralirritation and

convulsions;nausea,vomiting,diarrhea, GIdisturbances;erythemamultiforme,Stevens-Johnsonsyndrome,

epidermalnecrolysis.

Killssusceptiblebacteria.

Instruct client that thismedication should betaken with food.

Instruct the client tocomplete the drugtherapy.

Determine history ofhypersensitivityreactions tocephalosporins,penicillins, and history ofallergies, particularly to

drugs, before therapy isinitiated.

Flagy500 mg TIVq 8hrs.Antibiotic

Metronidazole

Inhibits growth oftrichomonae andamoebae bybinding to DNA,

Indication:Bacterial Infection

Contraindication:

GI disturbancesnausea,unpleasantmetallic taste,

Killssusceptiblebacteria

Instruct the client totingling sensation maybe feel upon injection ofthe drug.

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resulting in lossof helical

structure strandbreakage,inhibition ofnucleic acidsynthesis, andcell death.

History ofhypersensitivity to

metronidazole orother nitroimidazolederivatives.

vomiting,diarrhea or

constipation.Weakness,dizziness,ataxia,headache,drowsiness,insomnia

Instruct the client not to

take any alcoholicbeverages.

Cataflam500 mg POq 6hrs.

Nonsteroidal anti-inflammatory Drug

Mefenamicacid

Inhibits theenzyme, cyclo-oxygenase, thus

resulting inreducedsynthesis ofprostaglandinprecursors.

Indication:Treatment ofperioperative pain.

Contraindication:Active peptic ulcer;hypersensitivity todiclofenac or otherNSAIDs.

GI disturbances;headache,dizziness, rash;

GI bleeding,pepticulceration; localirritation (rectal);burning andstinging(ophthalmic).

Reducepain

Instruct client thatmedication should betaken with food.

Monitor client for signsand symptoms of overtand occult bleeding.

Before the therapy,rehydrate patient.

PotassiumChloride1tab OD

Electrolyte

KaliumDurule

Potassiumchloride is amajor caution of

the intracellularfluid. It plays anactive role in theconduction ofnerve impulsesin the heart,brain andskeletal muscle;contraction of

Indication:Hypokalemia

Contraindication:Hyperchloraemia,severe renal oradrenal insufficiency.

GI ulcerationhyperkalemia.Nausea,

vomiting,diarrhea andabdominalcramps. Pain orphloebitis;cardiac toxicity

Stabilizedbloodelectrolyte.

Discontinue treatment ifsevere nausea, vomitingor abdominal distress

develops.

Instruct the client thatthe drug should be takenwith food.

Report any signs andsymptoms ofhyperkalaemia.

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cardiac skeletaland smooth

muscles;maintenance ofnormal renalfunction, acid-base balance,carbo-hydratemetabolism andgastric secretion.

FerricHydroxide

Sucrose500 mg 1tabPO ODAnti-anemic

Ferric hydroxidesucrose complex

is a source ofiron that is usedin iron-deficiencyanaemiawhereby oral ironis ineffective orimpractical. Thereleased ironincreases serumiron

concentrationsand isincorporated intohaemoglobin.

Indication:Anemia

Contraindication:Hypersensitivity.Evidence of ironoverload. Anemia notcaused by irondeficiency. History ofasthma, eczema,anaphylaxis, or otherallergic disorders

CV effects suchas chest pain or

tightness,shock, MI,hypertension,tachycardia,bradycardia,andarrhythmias.Rashes,urticaria,purpura, and

pruritus. GIdisturbances,haematuria,dyspnoea, andtastedisturbance.

Maintainblood iron

level

Regular monitoring ofhematologic parameters

is needed to prevent ironoverload.

Instruct the client to takethe drug with citrusjuices.

Instruct the client not tochew the drug andhe/she may have

metallic taste.

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Lasix40 mg TIV

prnDiuretic

Furosemide

Inhibitsreabsorption of

Na and chloridemainly in themedullary portionof the ascendingLoop of Henle.Excretion ofpotassium andammonia is alsoincreased whileuric acid

excretion isreduced.

Indication:Fluid retention

ContraindicationSevere sodium andwater depletion,hypersensitivity tosulphonamides andfurosemide,hypokalaemia,hyponatraemia,anuria or renal

failure. Addison'sdisease.

Rashes,photosensitivity,

nausea,diarrhea, blurredvision,dizziness,headache,hypotension.Bone marrowdepression(rare), hepaticdysfunction.

Hyperglycaemia, glycosuria,ototoxicity.

Increaseurine

output andmaintainfluid andelectrolytelevel.

Monitor fluid andelectrolyte balance and

renal function.

Report any signs andsymptoms ofdehydration.

Rocephin2 mg TIV ODAntibiotic

Ceftriaxonesodium

Binds to one ormore of thepenicillin-bindingproteins (PBPs)which inhibits thefinaltranspeptidation

step ofpeptidoglycansynthesis inbacterial cellwall, thusinhibitingbiosynthesis andarresting cell wallassembly

Indication:Bacterial Infection

Contraindication:Hypersensitivity tocephalosporins;hyperbilirubinaemic

neonates.

Superinfection;anaphylaxis;diarrhea; localreactions; blooddyscrasias;rash, fever,pruritus;

elevatedtransaminasesand alkalinephosphatase;leucopenia,neutropenia.

Killssusceptiblebacteria

Take note if patient hashistory of penicillinallergy; severe renalimpairment; super-infection.

Instruct the client not to

stop the drug therapy.

Instruct the client thattingling sensation maybe felt during injection ofthe medication.

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resulting inbacterial cell

death.

Zithromax500 mg1tab PO ODAntibiotic

Azithromycin

Blockstranspeptidationby binding to 50sribosomalsubunit ofsusceptibleorganisms anddisrupting RNA-

dependentprotein synthesisat the chainelongation step.

Indication:Bacterial infection

Contraindication:Contraindicated inpatients with knownhypersensitivity toazithromycin,

erythromycin, anymacrolide or ketolideantibiotic.

Mild tomoderatenausea,vomiting,abdominal pain,dyspepsia,flatulence,diarrhea,

cramping;jaundice;dizziness,headache,vertigo,

Killssusceptiblebacteria.

Instruct client thatmedication:

May be taken with orwithout food. (May betaken w/ meals toreduce GI discomfort.)

Instruct the client not tostop the drug therapy.

Zantac1amp TIVBIDAntihistamine

Rantidinehydrochloride

Blocks histamineH2-receptors inthe stomach andpreventshistamine-

mediated gastricacid secretion.

Indication:Allergic reactions andprophylaxis for bloodtransfusion reaction.

Contraindication:Contraindicated forpatients known tohave hypersensitivityto the drug or any ofthe ingredients

Headache,dizziness.Rarely hepatitis,thrombocytopaenia,

leucopaenia,hypersensitivity,confusion,gynaecomastia,impotence,somnolence,vertigo,hallucinations.

Relievessymptomsofallergies.

Report any sign andsymptoms of nauseaand vomiting.

Instruct the client to

avoid strenuous activity.

Zosyn Pipera Inhibit septum Indication: GI disturbances; Kills Monitor renal, hepatic

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4.5 mg TIV q 8hrsAntibiotic

cillin and cell wallsynthesis and

has anantimicrobialactivity against awide range ofgram stainorganisms.

Bacterial infection

Contraindication:Contraindicated inpatients who hashypersensitivity tothe drug.

hypersensitivityreactions;

eosinophilia,hyponatraemia,hypokalaemia.Injection-siterelatedreactions suchas pain anderythema

susceptiblebacteria.

and haematologicalfunctions during

prolonged and high-dosetherapy.

Instruct the client not tostop the drug therapy.

Ultram100 mg TIV prn

Analgesic

Tramadol

Inhibits reuptakeof

norepinephrine,serotonin andenhancesserotoninrelease. It altersperception andresponse to painby binding to mu-opiate receptorsin the CNS.

Indication:Pain due to surgery

Contraindication:Suicidal patients,acute alcoholism;head injuries; raisedintracranial pressure;severe renalimpairment; lactation.

Sweating,dizziness,

nausea,vomiting, drymouth, fatigue,asthenia,confusion,constipation,flushing,headache,vertigo,tachycardia,

Relievespain.

Instruct the client not toover use the drug.

Instruct the client toincrease fluid intake.

Ambroxol22 cc ambroxol +1cc PNSS neb q12hrsMucolytic

Ambroxol

Modulatesmucus

production and

viscosity and

increases

mucociliary

transport,

thereby

Indication:Clients withpneumonia andsputum in thebronchial tract.

Contraindication:Hypersensitivity tothe drug.

Mild GI effectsand allergicreactions.

To easyexpectoration ofbronchialsecretions

Instruct the client intechniques inexpectorations ofbronchial secretions.

Advise the patient torinse mouth with waterafter each inhalation tominimize dry mouth.

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improving

expectoration. It

also exhibits

inhibitory activity

against the

effects of free

radicals.

Decreased in

intracellular

calcium will

result to the

relaxation of thesmooth muscle

airways.

Assess lung sounds, PR

and BP before drugadministration andduring peak ofmedication.

Enalaprilat,Vasotec2.5 mg 1tab ODACE-inhibitorAntihypertensive

Enalapril

Inhibition of ACEthus leading toreduced levels ofangiotensin IIand aldosterone.

Indications:High blood pressure

Contraindications:Hypersensitivity.History ofangioedema due toprevious treatmentwith ACE inhibitors;bilateral renal arterystenosis.

Initialhypotensionmay be severeand prolonged.Dizziness,headache,fatigue,persistent drycough,abnormal taste,lassitude, rash,neutropenia,renalimpairment orfailure.

Lowersbloodpressure

Instruct client that themedication may betaken with or withoutfood.

Instruct the client to takethe drug exactly asprescribed.

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Hydrocortisone

Corticosteroid

Hydrocortisone

Suppressinflammatoryresponse.

Indication:Asthma and acuterespiratory illness.

Contraindication:Hypersensitivity tothe drug.

Stinging,burning,irritation,dryness, orredness at theapplication sitemay occur.

Treat signsandsymptomsof asthma

Instruct client that themedication should betaken with food.

Ectrin

2.5 mg 1tab ODMucolytic

Ectrin Modulates

mucusproduction andviscosity andincreasesmucociliarytransport,therebyimprovingexpectoration. Italso exhibits

inhibitory activityagainst theeffects of freeradicals.

Indication:

Treatment ofacute bronchitis,chronic bronchitisand itsexacerbations.Respiratory disorderscharacterized byabnormal bronchialsecretions andimpaired mucus

transport

Contraindication:Hypersensitivity toerdosteine.

Mild GI

disturbancenervousness,restlessness,tremor,headache,insomnia,chest pain, andpalpitations.

To easy

expectoration ofbronchialsecretions

Instruct the client in

techniques inexpectorations ofbronchial secretions.

Assess lung sounds, PRand BP before drugadministration andduring peak ofmedication.Advise the patient to

rinse mouth with waterafter each inhalation tominimize dry mouth.

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