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8/3/2019 8. Drug Study 68-75
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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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