NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC:Chloramphenicol

BRAND:Chloromycetin

DOSAGE:500mg IV

FREQUENCY:

antibiotic Bacteriostatic effects against susceptible bacteria; prevents cell replication

Serious infections for which no other antibiotic is effective

Irritation, burning, itching, headache, nausea, vomiting

-Contraindicated with allergy to chloramphenicol

-use cautiously with renal failure ,hepatic failure, pregnancy, lactation

-If this side effects may experience:

-headache- request for medication

-confusion- avoid driving or operating machineries

- report sore throat, tiredness, unusual bleeding, or bruising, numbness, tingling, pain on extremities.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Gentamicin sulphate

BRAND:Alcomicin

DOSAGE:1 mg IV

FREQUENCY:Every 8 hours

Aminoglycosides Bactericidal: inhibits protein synthesis in the susceptible strains, of gram negative bacteria; appears to disrupt functional integrity of bacterial cell membrane, causing cell death.

Serious infections when causative agents are unknown (often in conjunction with a penicillin or a cephalosporin)

Tinnitus, dizziness, vertigo, numbness, tingling, nausea, vomiting, anorexia, leukemoid reaction ,purpura, rash, pain, irritation, itching

-contraindicated with allergy to any amino glycosides

-use cautiously with renal or hepatic disease, sulfite sensitivity, pre existing hearing loss.

-culture infected area before the therapy.

-avoid long term therapies because it may increase risk of toxicity. Reduction in dose may be clinically indicated.

-patients with edema or ascites may have lower peak concentrations due to expandedExtracellular fluid volume.

-ensure adequate hydration of patent before and during therapy.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Hydrocortisone

BRAND:Solucortef

DOSAGE:100mg IV

FREQUENCY:Every 6 hours

Corticosteroid Enters target cells and binds to cytoplasmic receptors, initiates many complex reactions that are responsible for its anti inflammatory, immunosuppressive (glucocorticoid)

-Trichinosis with neurologic or myocardial involvement

-short term inflammatory and allergic disorder

Vertigo, headache, hypotension, shock, thin, fragile skin, petechiae, irregular menses, amenorrhea, peptic ulcer, sodium retention, muscle weakness, immunosuppression, impaired wound healing

- Contraindicated with allergy to any component of the drug infection, amebiasis, hepa B, immunosupression

-use cautiously with kidney dse, liver disease, cirrhosis,Ulcerative colitis, recent GI surgery, inflammatory bowel disease

-take drugs exactly as prescribed, do not stop taking drugs without notifying your health care providers; slowly taper dosage to avoid problems-dosage reduction may create adrenal insufficiency; report muscle joint pain, anorexia, nausea, vomiting, diarrhea, weight loss dizziness, low blood sugar.-frequent follow up visit to your health care provider are needed to monitor drug response and adjust dosage.-you may experience side effects:Weight gain- monitor I&OIndigestion-eat frequent small feedingsIncrease susceptibility to infection- avoid crowds, avoid any one with known infections,Muscle weakness-frequent rest periods-report unusual weight gain , edema, black tarry stools, vomiting of blood, epigastric burning, irregular menstruation, sore throat, cold, other infections.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Omeprazole

BRAND:Prisolec

DOSAGE:20mg

FREQUENCY:1 tab OD

Proton pump inhibitor

Gastric Acid Pump inhibitor, suppresses gastric acid secretion by specific inhibition of the hydrogen potassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production

Short term treatment for duodenal ulcer

Headache, dizziness, diarrhea, abdominal pain, nausea, vomiting, URI symptoms

-Contraindicated with hypersensitivity to omeparazole or its component.

-use cautiously with pregnancy and lactation

-Administer before meals, swallow the whole capsule.

-if using the oral suspension, empty the pocket into a small cup containing 2 table spoons of water, stir and drink immediately. Taken for up to 8 weeks

-avoid driving and operating machineries

-maintain proper nutrition, do not self medicate if URTI occurs consult health care providers

-report head ache, worsening symptoms, chills and fever.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Penicillin G sodium

BRAND:Bicillin L-A

DOSAGE:1 MILLION

FREQUENCY:IV q 16 Hrs. (-) ANST

Penicillin Antibiotic

Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria

Severe infections caused by sensitive organisms (streptococci)- URTI caused by sensitive streptococci- Treatment of syphilis, congenital syphilis, yaws- Prophylaxis of rheumatic fever and chorea

CNS:Lethargy, hallucinations,seizuresGI:Glossitis, stomatitis, gastritis,sore mouth, furry tongue, , nausea, vomiting, diarrhea, abdominal pain, enterocolitis, pseudomembranous, colitis,nonspecific hepatitisGU:NephritisHematologic:Anemia,thrombocytopenia, leukopenia,neutropenia, prolonged bleeding timeHypersensitivity:Rash, fever, wheezing, anaphylaxisLocal:Pain, phlebitis, thrombosis at injection site, when used to treat syphilisOther:Super infections, sodium overload leading to heart failure

Contraindicated with allergy to penicillins, cephalosporins, imipenem , beta lactamase inhibitors, or other allergens.

Before- Observe 15 rights of drug administration.- Reduce dosage with hepatic or renal failure.- Assess for hypersensitivity to drug- Assess for any contraindications to the drug.- Educate about side effects of drug.During- Drug is not for IV use. Do not inject or mix with other IV solutions.- Avoid contact with the needle.- Withdraw needle as quickly as possible to avoid discomfort.- Stay with patient throughout whole duration of administration.After-Monitor client for at least 30minutes.- Arrange for regular follow-up, including blood tests, to evaluate effects.- Instruct to report difficulty breathing, rashes, and severe pain at injection site, mouth sores, unusual bleeding or bruising.- Instruct to take medication as directed for the full course of therapy, even if feeling better.- Do proper documentation

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Propanolol Hydrochloride

BRAND:Inderal

DOSAGE:20mg

FREQUENCY:½ tab BID

Anti-arrythmiic Competitively blocks beta adrenergic receptors in the heart and juxtoglumerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues, the excitability of the heart, cardiac workload and oxygen consumption, and the release of renin and lower BP; has membrane stabilizing (local anesthesia) effects that contribute to its anti arrhythmic action; acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone. The mechanism by which it prevents migraine headache is unknown.

Cardiac arrhythmias, especially supraventricular tachycardia, and ventricular tachycardias, induced by cardiac glycosides or cathecolamines.

Fatigue, bradycardia, HF, Cardiac Arrythmias, sino atrial or AV nodal Block, gastric pain, flatulence, constipation, diarrhea, nausea, vomiting, impotence, decrease libido,

Contraindicated with allergy to beta blocking agent, sinus bradycardia, second-third degree heart block, cardiogenic shock, HF, bronchial asthma, bronchospasm, COPD, pregnancy, lactation.-use cautiously with hypoglycaemia, diabetes, thyrotoxicosis, hepatic impairment.

-do not discontinue drug abruptly after long term therapy. Taper drug gradually over two weeks with monitoring.-provide continuous cardiac and regular BP monitoring with IV form.-take this drug with meals.-if you have diabetes, the normal sign of hypoglycaemia may be block by this drug, monitor your blood, urine, glucose carefully.-avoid driving or performing hazardous task)-eat small frequent small meals for loss of appetite.-report difficulty of breathing, night cough, swelling of extremities, slow pulse, confusion, depression, rash, fever, sore throat.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Ranitidinehydrochloride

BRAND:Zantac

DOSAGE:1 amp. IV

FREQUENCY:Every 8 hours

Histamine 2 blocker

Competitively inhibits the action of histamine at the H2 receptors of the parietal cells of the stomach, inhibiting basal gastric acid secretion and gastric secretion that is stimulated by food, insulin, histamine, cholinergic agonists, gastrin, pentagastrin.

Short term treatment for active duodenal ulcer

Headache, rash, constipation, diarrhea, nausea, vomiting, abdominal pain

.Contraindicated with allergy to ranitidine

-lactation

-Take drugs with meals, and at bed time, therapy may continue for 4-6 weeks or longer.

-if you also are using an antacid, take it exactly as prescribed, being careful of the times of administration

-have regularly medical follow-up care to evaluate your response

-adjust light and temperature and avoid noise

-report sore throat, fever, unusual bleeding, tarry stool, confusion, hallucinations, dizziness, severe headache, muscle or joint pain.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Immune globulin intravenous

BRAND:Gammunex

DOSAGE:2.5g/vial

FREQUENCY:

immunoglobulin .contains human globulin, which provides passive immunity through the presence of injected antibodies. IV gamma globulin provides immediate antibody levels. Mechanism of action in idiopathic thrombocytopenic purpura not determined.

-treatment of chronic inflammatory demyelinating polyneuropathy

-maintenance of patient with primary immunodeficiencies

Tenderness, urticaria, angioedema, nausea, vomiting, chills, fever, chest tightness, anaphylactic reactions, precipicious fall in BP, Risk for acute renal failure

Contraindicated with patient with history of allergy to gamma globulin or anti immunoglobulin A antibodies

-do not administer to patient with history of allergy to gamma globulin or anti immunoglobulin A antibodies

-refrigerate drug; do not freeze, discard partially used vials-check manufacturer guidelines before using any immunoglobulin-administer iv preparation with extreme caution

-do not mix immunoglobulin with other medication

-monitor pt’s vital signs continuously and observe for any symptoms during IV administration.

-adverse effect appear to be related to the rate infusion

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Cloxacillin

BRAND:Cloxpen

DOSAGE:50mg/cap

FREQUENCY:1 cap/ every 6 hours

Antibiotic Interferes with cell wall replication of susceptible organisms, the cell wall, rendered osmotically unstable, swell, bursts from osmotic pressure; resists the penicillinase action that inactivates penicillins

Treatment of infections caused by pneumococcal, Group A beta-hemolytic streptococci, and penicillin G sensitive staphylococci. Prophylaxis: Staphylococcal infection during major cardiovascular and orthopedic surgery

EENT:Occasionally, laryngeal edema,Skin:urticaria, skin rashes, ex foliative dermatitis, rashGI:GI disturbances, nausea, vomiting, epigastric distress, diarrhea and flatulence, antibiotic-associated pseudo membranous colitisGU:Interstitial nephritis and vasculitisHematologic:eosinophilia, agranulocytosis, anemia, thrombocytopenia, transient rise intransminases and alkaline phophataseOther:Hypersensitivity reactions, serum sickness-like reactions, fever

History of hypersensitivity to penicillin and cephalosporin. Sever pneumonia, emphysema, bacteremia, pericarditis, meningitis and purulent and septic arthritis during the acute the stage. Sub-conjunctival infections.

-Perform skin testing before giving the medication to prevent anaphylactic shock when administered- Administer drug slowly to the IV line the drug is very irritating to the tissue and blood vessels. Injecting slowly the drug prevents phlebitis-Explain to the patient that antibiotic therapy lasts for 7 days will take the drug without any miss-Taking the drug for 7 days helps to kill the bacteria and growthMake sure that the patient takes the drug at the same time of the day. And also to prevent the being drug resistant to prevent growth of bacteria and to continue the efficacy of the drug.-Provide rest and comfortthe drug may cause dizziness which is a normal side effect of the drug.6.)Assess for any signs of hypersensitivity reaction such as purpura, rash, urticaria, ex foliative dermatitis, itching to discontinue the therapy andimmediately call the physician for an antidote

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Cotrimoxazole

BRAND:Bactrim

DOSAGE:160mgTab

FREQUENCY:1 tab TID

Sulfonamide antibiotic

It inhibits the synthesis of nucleic acids and proteins in susceptible bacteria; the bacterial enzyme involved in this reaction is more readily inhibited than the mammalian enzyme.

Drug of choice next to pentamidine for the prevention and therapy of pneumonias caused by Pneumocystis carinii.

agranulocytosis, cholestatic jaundice, pancreatitis, colitis, nephritis, vasculitis, aseptic meningitis, fever, indisposition, headaches, exanthemas

Hypersensitivity to sulphonamides, pregnancy, advanced liver and renal insufficiencies

-Should be administered with a glass of water on empty stomach

-Finish all medication; do not skip doses

-You may experience increased sensitivity to sunlight; use sunblock, wear protective clothing and dark glasses, or avoid direct exposure to sunlight. Small frequent meals, frequent mouth care, sucking lozenges, or chewing gum may reduce nausea or vomiting

-Report skin rash, sore throat, blackened stool, or unusual bruising or bleeding immediately

-Maintain adequate fluid intake to prevent crystalluria

-Monitor CBC, renal function test, liver function test, urinalysis

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Albuterol

BRAND:Salbutamol neb

DOSAGE:I neb

FREQUENCY:Every 4 hours

Bronchodilator It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles.. it binds to the beta2-adrenergic receptors in the airway of the smooth muscle which then leads to the activation of the adenyl cyclase and increased levels of cyclic- 3’5’-adenosine monophosphate (cAMP). When cAMP increases, kinases are activated. Kinases inhibit the phosphorylation of myosin and decrease intracellular calcium.Decreased in intracellular calcium will result to the relaxation of the smooth muscle airways

Long-term control agent for patients with chronic or persistent bronchospasm

Nervousness, RestlessnessTremor, Headache, Insomnia, Chest pain, Palpitations, Angina, Arrhythmias, HypertensionNausea and vomiting, Hyperglycemia, Hypokalemia

-Hypersensitivity to adrenergic amines-Hypersensitivity to fluorocarbons

1. Assess lung sounds, PR and BP before drug administration and during peak of medication.

2. Observe for paradoxical spasm and withhold medication and notify physician if condition occurs.

3. Extended-release tablet should be swallowed-whole. It should not be crushed or chewed.

4. . If administering medication through inhalation, allow at least 1 minute between inhalation of aerosol medication.

5. Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth.

6. . Inform the patient that Albuterol may cause an unusual or bad taste.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC NAME:Paracetamol

BRAND NAME:Aeknil

DOSAGE:1 Amp

FREQUENCY:Every 4 hours

Anti pyretic Reduces fever by acting directly on the hypothalamic heat regulating center to cause vasodilation and sweating which help to dissipate heat

For fever, temporarily relieves minor aches

Hematological skin and other infections

Contraindicated with allergy to acetaminophen, use cautiously with allergy, impaired hepatic function, chronic alcoholism

-Do not exceed torecommended dosage

-Reduce dose for hepatic impairment

-Avoid using multiple preparations containing acetaminophen. carefully check all OTC products

-Give drugs with food if GI upset occurs

-Discontinue dug if hypersensitivity occurs-Take drugs only for complaints indicated, not an anti inflammatory agent

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:piptaz

BRAND:Piperacillin Sodium & Tazobactam Sodium

DOSAGE:2.2 gram IV

FREQUENCY:Every 6 hours (-) ANST

Penicillin Piperacillin, extended-

spectrum penicillin, exerts its

antimicrobial action in

growing and dividing bacteria

by interfering with septum

formation and cell wall

synthesis of susceptible

bacteria. It binds to penicillin-

binding proteins on the

bacterial cell wall and blocks

peptidoglycan synthesis.

Peptidoglycan is a

heteropolymeric structure

that gives the cell wall its

mechanical stability. The final

stage of the peptidoglycan

synthesis involves the

completion of the cross-

linking with the terminal

glycine residue of the

pentaglycine bridge linking to

the fourth residue of the

pentapeptide. The

transpeptidase that performs

this step is inhibited by

piperacillin. The bacterial cell

wall weakens leading to

swelling and rupture of the

microorganism.

Treatment of infections in the lower respiratory tract Ex: severe community-acquired pneumonia &health care pneumonia; uncomplicated& complicated skin & skin structure infections; intra-abdominal infections w/ peritonitis

Hypertension, chest pain, edema, dyspnea, hypotension, Tachycardia, bradycardia, heart failure.

Hypersensitivity topenicillins, cephalosporins & β-lactaminhibitors

-Should not be mixed with other drugs in a syringe or infusion bottle due to possible problems with compatibility.-Piptaz is not chemically stable in solutions that contain only sodium bicarbonate and solutions that significantly alter pH. Lactated Ringer's Solutions not compatible with Piptaz.-Piptaz is stable in glass and plastic containers (plastic syringes, IV bags and tubing) once used with compatible diluents.-use Piptaz immediately after constitution.-Discard properly any unused portion after 24 hrs if stored at room temperature (20-25°C) or after 48 hrs if stored at refrigerated temperature (2-8°C).-Vials should not be frozen after constitution-Stability in the IV bags has been demonstrated for up to 24 hrs while stability in an ambulatory IV infusion pump has been demonstrated for a period of 12 hrs at room temperature.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC NAME:Ciprofloxacin

BRAND NAME:Ciloxan

DOSAGE:500mg 1 cap

FREQUENCY:Every 6 hours

Anti bacterial; fluroquinolone

Bactericidal; interfere with DNA replication susceptible bacteria preventing cell reproduction

-For the treatment of infections, caused by susceptible gram negative bacteria ;E-coli, klebsiella pneumonae

-lower respiratory tract infection caused by E-coli, klebbsiella

-headache, nausea, diarrhea, abdominal pain, arrhythmias, dry mouth, vomiting, eye pain, blurred vision,

Contraindicated with allergy to ciprofloxacin, norfloxacin, or other flu0roquinolones, pregnancy, lactation.

-if an antacid is needed, take at least 2 hours before or after dose.-taken with meals

-drink plenty of water while taking this drug

-for abdominal pain, eat frequent small meals, for blurring of vision, drowsiness, dizziness avoid driving or using dangerous equipments

-report rash, visual changes, severe G.I problems, weakness, tremors.

NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS

GENERIC:Amikacin sulfate

BRAND:amikin

DOSAGE:250mg IV

FREQUENCY:Every 12 hours

Aminoglycoside Inhibits protein synthesis by binding directly to the 30S ribosomal sub unit; bactericidal

Serious infection cause by sensitive restrains of Pseudomonas aeruginusa, E.coli, Proteus, Klebsiella, staphylococcus

Hypotension, Headache,Drug fever, Rash, Nausea, Vomiting, Eosinophilia, Paresthesia, Tremor, Arthralgia, Weakness, Allergic reaction

-Contraindicated in patients hypersensitive to drug or other aminogycosides.-Use cautiously in patients with impaired renal function or neuromuscular disorders, in neonates and infants and in elderly patients

-Obtain specimen for culture and sensitivity test before giving first dose. Therapy may begin while awaiting the results.-Evaluate patient’s hearing before and during therapy if he will be receiving drug for longer than 2weeks. Notify prescriber if patient has tinnitus, vertigo, or hearing loss.-Weigh patient and review renal function studies before therapy begins.-Correct dehydration before therapy because of increase risk of toxicity.-Obtain blood for peak level 1 hour I.M injection and 30 mins. to 1 hour after IV infusion ends; for trough levels draw blood just before the next dose. Don’t collect blood in a heparinized tube; heparin is incompatible with aminoglycosides.-Peak drug levels more than 35mcg/ml and trough levels more than10 mcg/ml may linked to a higher risk of toxicity-Watch for signs and symptoms of super infection (especially URT),such as continued fever, chills, and increased pulse rate