NAME OF DRUG: GENERIC: Paracetamol BRAND: Alaxan

Classification: pain reliver Dosage: The maximum amount of paracetamol for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Route: oral Frequency: Mechanism of Action: Paracetamol (acetaminophen) is a pain reliever and a fever reducer. The exact mechanism of action of is not known. Paracetamol is used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers. It relieves pain in mild arthritis but has no effect on the underlying inflammation and swelling of the joint.

INDICATION: Relief of mild to moderately severe pain of musculoskeletal origin egmuscle pain, arthritis, rheumatism, sprain, strain, bursitis, tendonitis,backache, stiff neck, tension headache, dysmenorrhea, toothache, pain after tooth extraction & minor surgical operations, reduction of fever. CONTRAINDICATION: Patients in whom bronchospasm, angioedema or nasal polyps are precipitated by ibuprofen, aspirin & other NSAIDs. Advanced kidney & liver diseases. ADVERSE EFFECTS: Do not use for >10 days for pain or for >3 days for fever. Peptic ulcer, liver & kidney impairment, heart failure & high BP. Pregnancy & lactation. Limit alcohol intake. NURSING RESPONSIBILITIES: Do not use for >10 days for pain or for >3 days for fever. Peptic ulcer, liver & kidney impairment, heart failure & high BP. Pregnancy & lactation. Limit alcohol intake.

Generic: Ranitidine Brand: Zantac, Zantac EFFERdose, Zantac GELdose, Zantac-75 Classification: GASTROINTESTINAL AGENT; ANTISECRETORY (H2-RECEPTOR ANTAGONIST) Dosage: 20 mg, IV q8h Route: oral or IV Frequency:

Mechanism of action: Ranitidine is an oral drug that blocks the production of acid by acidproducing cells in the stomach. INDICATION Treatment and prevention of heartburn, acid indigestion, and sour stomach. CONTRA INDICATIONS Contraindicated in: Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be avoided in patients with known intolerance. SIDE EFFECTS/ ADVERSE EFFECTS Confusion, dizziness, drowsiness, hallucinations, headache,Arrhythmias, Altered taste, black tongue, constipation, dark stools, diarrhea, drug-induced hepatitis, nausea,Decreased sperm count, impotence, Gynecomastia, Agranulocytosis, Aplastic Anemia, neutropenia, thrombocytopenia, Pain at IM site, Hypersensitivity reactions, vasculitis NURSING IMPLICATIONS/RESPONSIBILITIES Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate. Nurse should know that it may cause false-positive results for urine protein; test with sulfosalicylic acid. Inform patient that it may cause drowsiness or dizziness. Inform patient that increased fluid and fiber intake may minimize constipation. Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea; dizziness; rash; confusion; or hallucinations to health car professional promptly. Inform patient that medication may temporarily cause stools and tongue to appear gray black.

racecadotril
BRAND NAME: CADOTRIL
Dosage Oral Acute diarrhoea Adult: 100 mg tid, up to 7 days. Food(before/after) May be taken with or without food.

indications Dosage

Acute diarrhoea. Adult: PO 100 mg 3 times/day for 7 days. Click to view racecadotril Dosage by Indications

Administration Special Precautions Adverse Drug Reactions Mechanism of Action

May be taken with or without food. Renal insufficiency, pregnancy, lactation. Vomiting, nausea, constipation, abdominal pain, thirst, vertigo and headache. For details of the mechanism of action, pharmacology and pharmacokinetics and toxicology ... click to view racecadotril

Indication & Dosage Oral acute symptomatic diarrhoea Adult: 100 mg tid, up to 7 days. Administration May be taken with or without food. Special Precautions Renal insufficiency, pregnancy, lactation. Adverse Drug Reactions Vomiting, nausea, constipation, abdominal pain, thirst, vertigo and headache. Mechanism of Action Racecadotril increases the availability of endogenous opioids (enkephalins) by inhibiting the membrane-bound enkephalinase. These enkephalins activate -opioid receptors in the GI tract. This leads to a reduction in cAMP mucosal levels, resulting in a reducted secretion of water and electrolytes in the intestinal lumen. Onset: Within 30 min. MIMS Class Antidiarrheals ATC Classification A07XA04 - Racecadotril ; Belongs to the class of other antidiarrheals.

Cefalexin Brand name: Keflex

Indications Dosage Listed in Dosage. PO Susceptible infections 1-2 g/day in divided doses. Up to 6 g/day in more serious infections. Prophylaxis against recurrent UTI 125 mg/day at night. Click to view cefalexin Dosage by Indications Administration Contraindications Special Precautions May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.) Hypersensitivity to cephalosporins. Hypersensitivity to penicillins; pseudomembranous colitis; renal failure; pregnancy and lactation. Adverse Drug Reactions Pain at inj site; hypersensitivity; GI disturbances; eosinophilia, neutropenia, leucopenia, thrombocytopenia. Potentially Fatal: Anaphylactic reactions; nephrotoxicity. Drug Interactions Probenecid produces higher and prolonged serum levels. Potentially Fatal: Increased nephrotoxicity with aminoglycosides and furosemide. Click to view more cefalexin Drug Interactions

Mechanism of Action MIMS Class ATC Classification

For details of the mechanism of action, pharmacology and pharmacokinetics and toxicology ... click to view cefalexin Cephalosporins J01DB01 - Cefalexin ; Belongs to the class of first-generation cephalosporins. Used in the systemic treatment of infections.

Mefanamic acid Brand name: dolfenal

Indications Dosage Pain and inflammation. PO 250-500 mg 3 times/day. Click to view mefenamic acid Dosage by Indications Administration Contraindications Should be taken with food. Inflammatory bowel disease; peptic ulcer; neonates; pregnancy (3rd trimester), lactation. Coronary artery bypass graft surgery, severe renal impairment, severe heart failure. Special Precautions Renal and hepatic impairment, asthma. Monitor blood counts and liver function during longterm therapy. Drowsiness may affect ability to perform skilled tasks. Elderly.

Adverse Drug Reactions

Abdominal pain, dyspepsia, constipation, diarrhoea, nausea, GI ulcers; oedema; bronchospasm; headache, drowsiness, insomnia, visual disturbances; CHF, hypertension, tachycardia, syncope; urticaria, rash; thrombocytopenia, aplastic anaemia, agranulocytosis; tinnitus; elevated liver enzymes; abnormal renal function. Potentially Fatal: Autoimmune haemolytic anaemia; convulsions (overdosage).

Drug Interactions

Enhances activity of oral anticoagulants but rarely significant. Increases risk of GI irritation with alcohol. Increased ciclosporin, lithium toxicity and convulsions reported with ciprofloxacin. Absorption increased by magnesium hydroxide antacids. ACE inhibitor effects may be antagonised.

Mechanism of Action

For details of the mechanism of action, pharmacology and pharmacokinetics and toxicology ... click to view mefenamic acid

MIMS Class ATC Classification

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) M01AG01 - Mefenamic acid ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, fenamates.

Generic: multivitamin with iron Brand:stresstabs Classification: Mechanism of action: This medication is a multivitamin and iron product used to treat or prevent vitamin
deficiency due to poor diet, certain illnesses, or during

Route: Multivitamins (combinations of vitamins) and iron are available in tablets, capsules, liquids, and injections Indication: Contraindications: Precautions: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in
children younger than 6 years. Keep this product out of reach of children. If overdose does occur, seek immediate medical attention or call a poison control center.

Side effects: Constipation, diarrhea, or upset stomach may occur. These effects are usually temporary and may disappear as your body adjusts to this medication. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

VITAMIN C Generic: vitamin c Brand Name: cecon, sunkist Classification: ascorbic acid Dosage:

19 y of age and older Men -90 mg/day. Women -75 mg/day. Pregnant -85 mg/day. Breast-feeding -120 mg/day 14 to 18 y of age Male adolescents -75 mg/day. Female adolescents -65 mg/day. Pregnant -80 mg/day. Breast-feeding -115 mg/day. 9 to 13 y of age -45 mg/day. 4 to 8 y of age -25 mg/day. 1 to 3 y of age -15 mg/day. 30 days to 1 y of age -6 mg/kg/day.
Route: oral Frequency: once a day Mechanism of action: Essential vitamin believed to be important for synthesis of cellular components, catecholamines, steroids, and carnitine. Indications: Prevention and treatment of ascorbic acid deficiency.

Treatment of idiopathic methemoglobinemia; combination therapy with methenamine to increase acidity of urine. Although not proven scientifically, prevention of common colds and treatment of cancer, asthma, atherosclerosis, burns, and other wounds. Topical vitamin C may photoprotect against UV radiation because of its antioxidant and anti-inflammatory properties.
Contraindication: Hypersensitivity to any component of the product.

Side Effects: Faintness or dizziness may occur with rapid IV administration, Diarrhea, nausea, vomiting, Excessive doses over a long period of time may cause precipitation of cystine, oxalate, or urate crystals in kidney, Injection-site irritation may occur with IM or subcutaneous administration
Nursing responsibilities:

Traneaemic Acid Generic: Tranexamic Acid Brand: Hemostan, Fibrinon, Cyklokapron, Lysteda, Transamin Classification: Anti-fibrinolytic, antihemorrhagic Dosage: PO Short-term management of haemorrhage 1-1.5 g 2-4 times/day. Long-term management
of hereditary angioedema 1-1.5 g 2-3 times/day. IV Short-term management of haemorrhage 0.5-1 g 3 times/day.

Route: Frequency: May be taken with or without food. Mechanism of Action Tranexamic acid is a synthetic derivative of the amino acid lysine. It exerts its antifibrinolytic effect through the reversible blockade of lysine-binding sites on plasminogen molecules. Antifibrinolytic drug inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of blood clots. The plasminogen-plasmin enzyme system is known to cause coagulation defects through lytic activity on fibrinogen, fibrin and other clotting factors. By inhibiting the action of plasmin (finronolysin) the anti-fibrinolytic agents reduce excessive breakdown of fibrin and effect physiological hemostasis. Indications: Tranexamic acid is used for the prompt and effective control of hemorrhage in various surgical and clinical areas:
y y y

y y y y

Treating heavy menstrual bleeding Hemorrhage following dental and/or oral surgery in patients with hemophilia Management of hemophilic patients (those having Factor VIII or Factor IX deficiency) who have oral mucosal bleeding, or are undergoing tooth extraction or other oral surgical procedures. Surgical: General surgical cases but most especially operative procedures on the prostate, uterus, thyroid, lungs, heart, ovaries, adrenals, kidneys, brain, tonsils, lymph nodes and soft tissues. Obstetrical and gynecological: abortion, post-partum hemorrhage and menometrorrahgia Medical: epistaxis, hemoptysis, hematuria, peptic ulcer with hemorrhage and blood dyscrasias with hemorrhage Effective in promoting hemostasis in traumatic injuries. Preventing hemorrhage after orthopedic surgeries.

Contraindications 1. Allergic reaction to the drug or hypersensitivity

2. Presence of blood clots (eg, in the leg, lung, eye, brain), have a history of blood clots, or are at risk for blood clots 3. Current administration of factor IX complex concentrates or anti-inhibitor coagulant concentrates Side effects: nausea, drowsiness and clotting. Nursing Responsibilities 1. Unusual change in bleeding pattern should be immediately reported to the physician. 2. For women who are taking Tranexamic acid to control heavy bleeding, the medication should only be taken during the menstrual period. 3. Tranexamic Acid should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed. 4. The medication can be taken with or without meals. 5. Swallow Tranexamic Acid whole with plenty of liquids. Do not break, crush, or chew before swallowing. 6. If you miss a dose of Tranexamic Acid, take it when you remember, then take your next dose at least 6 hours later. Do not take 2 doses at once. 7. Inform the client that he/she should inform the physician immediately if the following severe side effects occur:

Multivitamins + Ferrous Sulfate Generic: Multivitamins + Ferrous Sulfate Brand: Feosol, Fer Iron, Fer-Gen-Sol, Fer-in-Sol, Fer-Iron, Feratab, FeroSul, Ferra-TD, Ferro-Bob, Lydia E.
Pinkham, MyKidz Iron 10, Slow Fe

Classification: Iron Preparation Dosage and Route: PO Frequency: BID Mechanism of Action: Elevates the serum iron concentration which then helps to form High or trapped in the reticuloendothelial cells for storage and eventual conversion to a usable form of iron. Indications: Prevention and treatment of iron deficiency anemias. Dietary supplement for iron.

Contraindications:

Hypersensitivity Severe hypotension.

Side effects:
Dizziness N&V Nasal Congestion Dyspnea Hypotension CHF MI Muscle cramps Flushing

Nursing Responsibilities:
Advise patient to take medicine as prescribed. Caution patient to make position changes slowly to minimize orhtostatic hypotension. Instruct patient to avoid concurrent use of alcohol or OTC medicine without consulting the physician. Advise patient to consult physician if irregular heartbeat, dyspnea, swelling of hands and feet and hypotension occurs. Inform patient that angina attacks may occur 30 min. after administration due reflex tachycardia. Encourage patient to comply with additional intervention for hypertension like proper diet, regular exercise, lifestyle changes and stress management.

Acetylcysteine Generic: Acetylcysteine Brand: Mucomyst, NAC, Acetadote, Mucomyst-10 Classification: antidotes, mucolytics Acetylcysteine systemic is used in the treatment of:
y y y

Acetaminophen Overdose Diagnostic Bronchograms Expectoration

Frequency: Dosage and Route: PO Mucolytic 200 mg 3 times/day. Paracetamol poisoning Initial: 140 mg/kg, then
70 mg/kg 4 hrly for another 17 doses. IV Paracetamol poisoning 150 mg/kg over 15 mins, then 50 mg/kg over the next 4 hr, then 100 mg/kg over the next 16 hr. Ophth Dry eye As 5% soln: Instill 1-2 drops 3-4 times/day. Inhalation Acute cough associated w/ excessive or viscous mucus As 20% soln: Nebulise 3-5 mL 3-4 times/day. Up to 1-10 mL 2-6 hrly if needed. Endotracheal Acute cough associated w/ excessive or viscous mucus As 10-20% soln: Instill 1-2 mL as often as hrly.

Mechanism of Action: Acetylcysteine splits linkage of mucoproteins. It reduces the viscosity of

pulmonary secretions, facilitates removal by coughing, postural drainage, mechanical means. Acetylcysteine protects against acetaminophen overdose-induced liver toxicity.

Indications: Acetylcysteine is used in adjunct treatment for abnormally viscid mucous secretions present in acute and chronic bronchopulmonary disease and pulmonary complication of cystic fibrosis, tracheostomy care and in treatment of acetaminophen overdose. It is also used in the prevention of renal damage from dyes given during certain diagnostic tests like CT scan. Contraindications: Asthmatic patients, history of bronchospasm, peptic ulceration. Pregnancy,
lactation.

Side effects:
y y y y y y y y y y y

Stickiness on face Transient unpleasant odor Increased bronchial secretions Irritated throat Nausea Vomiting Rhinorrhea Skin rash Facial edema Bronchospasm Wheezing

Nursing Responsibilities:
y y y y

Assess pretreatment respirations for rate, depth, and rhythm. If bronchospasm occurs, stop the treatment and notify the physician. Monitor rate, depth, rhythm, and type of respiration Check sputum for color, consistency and amount.

Co-Amoxicillin Generic: Co-Amoxicillin Brand: Amoxil, Apo-Amoxi , Larotid, Novamoxin, Polymox, Sumox, Trimox, Utimox, Wymox, DisperMox Classification: antiinfective; antibiotic; aminopenicillin

Frequency: Dosage and Route: 25 mg/3.6 mg to 45 mg/6.4 mg for each kilogram of body weight a day, given in
two divided doses.

Mechanism of Action: This drug acts by inhibiting the synthesis of bacterial cell walls. It inhibits cross-linkage between the linear peptidoglycan polymer chains that make up a major component of the cell walls of both Gram-positive and Gram-negative bacteria. It has two ionizable groups in the physiological range (the amino group in alpha-position to the amide carbonyl group and the carboxyl group). Indications:

Contraindications:
y y y

if they are allergic (hypersensitive) to amoxicillin, clavulanic acid, penicillin or any of the other ingredients of Co-amoxiclav (listed in section 6) if they have ever had a severe allergic (hypersensitive) reaction to any other antibiotic. This can include a skin rash or swelling of the face or neck if they have ever had liver problems or jaundice (yellowing of the skin) when taking an antibiotic.

Side effects:
y y y y y

skin rash inflammation of blood vessels (vasculitis) which may be visible as red or purple raised spots on the skin, but can affect other parts of the body fever, joint pain, swollen glands in the neck, armpit or groin swelling, sometimes of the face or mouth (angioedema), causing difficulty in breathing collapse.

Nursing Responsibilities:
y y

Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy. Lab tests: Baseline C&S tests prior to initiation of therapy, start drug pending results; periodic assessments of renal, hepatic, and hematologic functions should be made during prolonged therapy. Monitor for S&S of an urticarial rash (usually occurring within a few days after start of drug) suggestive of a hypersensitivity reaction. If it occurs, look for other signs of hypersensitivity (fever, wheezing, generalized itching, dyspnea), and report to physician immediately.

Report onset of generalized, erythematous, maculopapular rash (ampicillin rash) to physician. Ampicillin rash is not due to hypersensitivity; however, hypersensitivity should be ruled out. Closely monitor diarrhea to rule out pseudomembranous colitis.

Sodium Bicarbonate Generic: Sodium Bicarbonate Brand: Brioschi, Neut Classification:

Alkalizer (systemic; urinary) Sodium Bicarbonate Injection USP; Sodium Bicarbonate Oral Powder USP; Sodium Bicarbonate Tablets USP; Antacid Effervescent Sodium Bicarbonate; Sodium Bicarbonate Oral Powder USP; Sodium Bicarbonate Tablets USP; Electrolyte replenisher Sodium Bicarbonate Injection USP;

Frequency: Do not use sodium bicarbonate for longer than 2 weeks unless your doctor tells you to Dosage and Route: Dissolve sodium bicarbonate powder in at least 4 ounces (120 milliliters) of water.
Measure powdered doses carefully using a measuring spoon. Mechanism of Action: sodium bicarbonate , also known as baking soda, is used to relieve heartburn, sour stomach, or acid indigestion by neutralizing excess stomach acid. When used for this purpose, it is said to belong to the group of medicines called antacids. It may be used to treat the symptoms of stomach or duodenal ulcers. Sodium bicarbonate is also used to make the blood and urine more alkaline in certain conditions.

Indications: y Used to alkalinize urine and promote excretion of certain drugs in over dosage situations y Used as an antacid Contraindications: y Hypocalcemia y Excessive chloride loss y It is not recommended as an antidote following ingestion of strong mineral acids y Patients on sodium restricted diet y Renal failure

y Severe abdominal pain of unknown cause especially if associated with fever Side effects:
y y y y y y y y y y

nausea or vomiting; headache; sever mood changes; muscle pain; swelling of feet, ankles or legs decreased appetite; unusual tiredness; constipation; dry mouth or increased thirst; or increased urination.

Nursing Responsibilities:
1. Assess the client s fluid balance throughout the therapy. This assessment includes intake and output, daily weight, edema and lung sounds. 2. Symptoms of fluid overload should be reported such as hypertension, edema, difficulty breathing or dyspnea, rales or crackles and frothy sputum. 3. Sigs of acidosis should be assessed such as disorientation, headache, weakness, dyspnea and hyperventilation. 4. Assess for alkalosis by monitoring the client for confusion, irritability, paresthesia, tetany and altered breathing pattern. 5. Hypernatremia clinical manifestations should be assessed and monitored which includes: edema, weight gain, hypertension, tachycardia, fever, flushed skin and mental irritability. 6. Hypokalemia should also be assessed by monitoring signs and symptoms such as: weakness, fatigue, U wave on ECG, arrhythmias, polyuria and polydipsia. 7. IV sites should be observed closely. Extravasation should be avoided as tissue irritation or cellulitis may occur when taking sodium bicarbonate. 8. If infiltration occurs, the physician should be notified immediately. Confer with the doctor or other health care staff regarding warm compresses and infiltration site with lidocaine or hyaluronidase. 9. Monitor the client s serum calcium, sodium, potassium, bicarbonate concentrations, serum osmolarity, acid-base balance and renal function before and throughout the therapy. 10. Tablets must be taken with a full glass of water. 11. For clients taking the medication as a treatment for peptic ulcers it may be administered 1 and 3 hours after meals and at bedtime.

ampicillin Generic: Brand: Classification: Frequency:

Omnipen, Polycillin, Principen

Antibiotic, Penicillin

The usual oral dose range for most infections is 250 to 500 mg 4 times daily for 7-14 days. When used to treat gonorrhea, a single 3.5 gram dose (seven 500 mg capsules) is administered with probenecid (Benemid). The probenecid slows down the elimination of ampicillin so that ampicillin remains in the body longer. Food in the stomach reduces how much and how quickly ampicillin is absorbed. Therefore, ampicillin should be taken either 1 hour prior to or 2 hours following a meal for maximal absorption; however, for persons who experience nausea or stomach distress after taking ampicillin, it may be taken with meals.

Dosage and Route: Capsules: 250 and 500 mg. Powder oral suspension: 125 and 250 mg/5mL.
Powder for injection: 250 mg, 500 mg, 1g, and 2 g. Mechanism of Action: a semisynthetic, acid-resistant, penicillinase-sensitive penicillin used as an antibacterial against many gram-negative and gram-positive bacteria; also used as the sodium salt.

Indications:

It is prescribed in the treatment of infections caused by a broad spectrum of sensitive gram-negative and gram-positive organisms. Contraindications: Known hypersensitivity to any penicillin prohibits its use.

Side effects: Among the most serious adverse reactions are anaphylaxis, nausea, and diarrhea. Fever,
rashes, allergic reactions, and suprainfection also may occur.

Nursing Responsibilities: Assessment History: Allergies to penicillins, cephalosporins, or other allergens; renal disorders; lactation Physical: Culture infected area; skin color, lesion; R, adventitious sounds; bowel sounds; CBC, liver and renal function tests, serum electrolytes, hematocrit, urinalysis Interventions Culture infected area before treatment; reculture area if response is not as expected. Check IV site carefully for signs of thrombosis or drug reaction.

Do not give IM injections in the same site; atrophy can occur. Monitor injection sites.

Administer oral drug on an empty stomach, 1 hr before or 2 hr after meals with a full glass of water; do not give with fruit juice or soft drinks.

Gentamicin Generic: Brand:

Garamycin, G-myticin Aminoglycoside

Classification: Frequency:

Dosage and Route: Moderate to Severe Infection

Adult: IV/IM 1.5 2 mg/kg loading dose followed by 3 5 mg/kg/d in 2 3 divided doses Intrathecal 4 8 mg preservative free q.d. Topical 1 2 drops of solution in eye q4h up to 2 drops q1h or small amount of ointment b.i.d. or t.i.d. Child: IV/IM 6 7.5 mg/kg/d in 3 4 divided doses Intrathecal >3 mo, 1 2 mg preservative free q.d. Neonate: IV/IM 2.5 mg/kg q12 24h Acute Pelvic Inflammatory Disease Adult: IV/IM 2 mg/kg followed by 1.5 mg/kg q8h Prophylaxis of Bacterial Endocarditis Adult: IV/IM 1.5 mg/kg 30 min before procedure, may repeat in 8 h Child: IV/IM < 27 kg, 2 mg/kg 30 min before procedure, may repeat in 8 h

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

Indications: Parenteral Serious infections caused by susceptible strains of Pseudomonas aeruginosa, Proteus sp., Escherichia coli, Klebsiella-Enterobacter-Serratia species, Citrobacter, Staphylococcus sp.

 In serious infections when causative organisms are not known (often in conjunction with a penicillin or cephalosporin) Unlabeled use: with clindamycin as alternative regimen in PID Intrathecal For serious CNS infections caused by susceptible Pseudomonas species Ophthalmic preparations Treatment of superficial ocular infections due to strains of microorganisms susceptible to gentamicin Topical dermatologic preparation Infection prophylaxis in minor skin abrasions and treatment of superficial infections of the skin due to susceptible organisms amenable to local treatment Gentamicin-impregnated PMAA beads on surgical wire Orphan drug use: treatment of chronic osteomyelitis of post-traumatic, postoperative, or hematogenous origin Gentamicin liposome injection Orphan drug use: treatment of disseminated Myobacterium avium-intracellulare infection

Contraindications:

Contraindicated with allergy to any aminoglycosides; renal or hepatic disease; preexisting hearing loss; active infection with herpes, vaccinia, varicella, fungal infections, myobacterial infections (ophthalmic preparations); myasthenia gravis; parkinsonism; infant botulism; lactation.

Side effects: Ototoxicity--tinnitus, dizziness, vertigo, deafness (partially reversible to irreversible), vestibular paralysis, confusion, disorientation, depression, lethargy, nystagmus, visual disturbances, headache, numbness, tingling, tremor, paresthesias, muscle twitching, convulsions, muscular weakness, neuromuscular blockade Palpitations, hypotension, hypertension Hepatic toxicity, nausea, vomiting, anorexia, weight loss, stomatitis, increased salivation Nephrotoxicity

Leukemoid reaction, agranulocytosis, granulocytosis, leukopenia, leukocytosis, thrombocytopenia, eosinophilia, pancytopenia, anemia, hemolytic anemia, increased or decreased reticulocyte count, electrolyte disturbances Purpura, rash, urticaria, exfoliative dermatitis, itching Pain, irritation, arachnoiditis at IM injection sites Fever, apnea, splenomegaly, joint pain, superinfections

Nursing Responsibilities:

Give by IM route if at all possible; give by deep IM injection.

Culture infected area before therapy. Use 2 mg/mL intrathecal preparation without preservatives, for intrathecal use. Cleanse area before application of dermatologic preparations. Ensure adequate hydration of patient before and during therapy. Monitor renal function tests, complete blood counts, serum drug levels during long-term therapy. Consult with prescriber to adjust dosage.

diphenhydramine Generic: Brand: Benadryl

Classification:

Diphenhydramine is an antihistamine used for treating allergic reactions.

Frequency: Diphenhydramine has its maximal effect about one hour after it is taken. When used to combat insomnia, it is prescribed at bedtime. Patients over the age of 60 years are especially sensitive to the sedating and anticholinergic effects of diphenhydramine, and the dose should be reduced. Doses vary depending on formulation. A common regimen for treating adult allergic reaction is 25-50 mg every 4-6 hours not to exceed 300 mg daily.

Dosage and Route: Capsules: 25 and 50 mg. Tablets: 12.5, 25, and 50 mg. Strips: 12.5 and 25 mg. Elixir, oral solution, liquid: 12.5 mg per teaspoon (5 mL). Suspension: 25 mg per 5 ml. Injection: 50 mg per ml b Diphenhydramine should be stored at room temperature, 15 to 30C (59 to 86F), and protected injection from freezing and light.
Mechanism of Action: Diphenhydramine is used for the relief of nasal and non-nasal symptoms of various allergic conditions such as seasonal allergic rhinitis. It is also used to alleviate cold symptoms and chronic urticaria (hives). Although antihistamines are the preferred class of drugs in allergic rhinitis, they only reduce symptoms by 40%-60%. Diphenhydramine also is used for allergic reactions involving the eyes (allergic conjunctivitis), to prevent or treat active motion sickness, and for mild cases of Parkinsonism, including drug-induced Parkinsonism. The last two uses (motion sickness and Parkinsonism) are based on the anticholinergic effects of diphenhydramine, and not its antihistamine effects. Diphenhydramine is also used for treating insomnia.

Indications:

parkinsonism or drug-induced extrapyramidal effects

Contraindications: cardiac disease or hypertension glaucoma gastric or duodenal ulcers Side effects:
CNS: headache, fatigue, anxiety, tremors, vertigo, confusion, depression, seizures, hallucinations CV: tachycardia, palpitations, orthostaic hypotension, heart failure EENT: blurred vision GI: dry mouth, nausea, vomiting, constipation, flatulence GU: urinary hesitancy or frequency, urine retention Hematologic: leukopenia Skin: photosensitivity, dermatitis

Nursing Responsibilities:
Caution the client that the medication may cause drowsiness, creating difficulties or hazards or other activities that require alertness. Tell the client to take the medication with food to decrease GI upset. Explain to the client that arising quickly form a lying or sitting position may cause orthostatic hypotension. When taking these medications, the client needs to have blood cells counts, renal function, hepatic function, and blood pressure monitored. Adverse effects of these drugs occur more commonly in elderly clients.

Explain to the client that use of these drugs in warm weather may increase the likelihood of heatstroke.

Generic: Brand: Classification: Frequency: Dosage and Route:

Mechanism of Action

Indications: Contraindications: Side effects: Nursing Responsibilities:

Generic: Brand: Classification: Frequency: Dosage and Route:

Mechanism of Action

Indications:

Contraindications: Side effects: Nursing Responsibilities:

Generic: Brand: Classification: Frequency: Dosage and Route:

Mechanism of Action

Indications: Contraindications: Side effects: Nursing Responsibilities: