DE LA SALLE LIPA

COLLEGE OF NURSING
1962 J.P. Laurel National Highway, Lipa City Tel. (043)756-5555, 756-2491, 756-2391 loc 270

Drug Study

Generic Name: Ceftriaxone sodium

Brand Name: Ceftriaxone sodium

Major Drug Category Anti-infective

Drug Action Interferes with bacterial cell-wall synthesis and division binding to cell wall, causing cell to die Significant Drug Interaction Aminoglycosides, loop diuretics, probenecid, decreased excretion and increased blood level of cefoxitin

Uses Respiratory tract infections, skin infections, joint and bone infections, UTI, septicaemia Usual Drug Dose 1 g IV q12 ANST (-)

Side Effects/Adverse Reactions Headache, lethargy, seizures, thrombophlebitis, nephrotoxicity, hepatomegaly, thrombocytopenia Contraindications Hypersensitivity to cephalosporins or penicillin

Nursing Medication Management 1) Assessment Assess CBC and kidney and liver function test results. Be aware that cross sensitivity to penicillin may occur. Assess for irritation and phlebitis daily. 3) Education Instruct to report reduced urinary output, persistent diarrhea and bruising. Instruct to take medication as prescribed. 2) Intervention Monitor fluid intake and output. Report significant decrease in output. Monitor for signs and symptoms of superinfection and other serious adverse reactions. Advise to report bloody diarrhea.

4) Evaluation Absence of signs and symptoms of infection. Observed and experienced improvement in symptoms of infection. Absence of drug induced adverse reaction.

DE LA SALLE LIPA

COLLEGE OF NURSING
1962 J.P. Laurel National Highway, Lipa City Tel. (043)756-5555, 756-2491, 756-2391 loc 270

Drug Study

Generic Name: Ranitidine

Brand Name: Zantac

Major Drug Category Gastrointestinal Drugs (H2 Receptor antagonist) Side Effects/Adverse Reactions Cardiac arrhythmias Headache, Fatigue, Dizziness, Depression, Insomia, Alopecia, Rash, Nausea, Vomiting, Abdominal discomfort, Diarrhea

Drug Action Inhibits Histamine at H2 receptor site in the gastric parietal cell, which inhibits gastric acid secretion. Significant Drug Interaction Antacids, propantheline

Uses Hyperacidity.Prophylaxis of GI hemorrhage. Active duodenal ulcer

Usual Drug Dose 50 mg IV q8 ANST (-)

Contraindications Hypersensitivity to drug.

Nursing Medication Management 1) Assessment Use caution in presence of renal or hepatic impairment. Assess patient for abdominal pain. Note presence of blood in emesis, stool, or gastric aspirate. 3) Education 2) Intervention Monitor serum creatinine, AST, ALT alkaline phosphatase and total bilirubin. Monitor for bleeding, bruising, including complete blood count. 4) Evaluation Remain free of side effects including abdominal pain, heartburn, jaundice, hematemesis, and respiratory difficulty. Demonstrate understanding of risks and benefits of drug therapy. Maintain balanced nutrition, and weight within expected levels

Teach patient appropriate use, possible effects/ appropriate interventions, and adverse symptoms to report.

Caution patient to avoid hazardous activities.

DE LA SALLE LIPA

COLLEGE OF NURSING
1962 J.P. Laurel National Highway, Lipa City Tel. (043)756-5555, 756-2491, 756-2391 loc 270

Drug Study

Generic Name: Clarithromycin Drug Action Reversibly binds to 50s ribosomal sub-unit of susceptible bacterial organisms, blocking protein synthesis Significant Drug Interaction Carbamazepine, digoxin, theophylline.

Brand Name: Claryl Uses Pharyngitis or tonsillitis, acute maxillary sinusitis, chronic bronchitis, community acquired pneumonia Usual Drug Dose 500 mg 1 tab BID Nursing Medication Management

Major Drug Category Anti-infective Side Effects/Adverse Reactions Headache, diarrhea, nausea, vomiting, stomach upset, changes in taste, and headache Contraindications Hypersensitivity to drug

1) Assessment Assess the cardiovascular status. Monitor hepatic enzyme and creatinine levels during long term therapy. Monitor for signs and symptoms of superinfection and other serious adverse reactions. 3) Education

2) Intervention Assist patient in taking medication by mouth with

or without food.

Advise patient to take drug with full glass of water.

Tell patient not to stop taking the medication without the doctor's approval. Tell patient not to double the dose to catch up.

4) Evaluation Absence of signs and symptoms of infection. Observed and experienced improvement in symptoms of infection.

Absence of drug induced adverse reaction.

DE LA SALLE LIPA

COLLEGE OF NURSING
1962 J.P. Laurel National Highway, Lipa City Tel. (043)756-5555, 756-2491, 756-2391 loc 270

Drug Study

Generic Name: Aspirin

Brand Name: Scheeprin

Major Drug Category Anti-platelet drug, anti-pyretic

Drug Action Reduces pain and inflammation by inhibiting prostaglandin production. Significant Drug Interaction Ammonium chloride, ACE inhibitors, anticoagulants

Uses Reduce risk of myocardial infarction, mild to moderate pain caused by inflammation, fever, acute rheumatic fever Usual Drug Dose 80 mg 1 tab OD after lunch Nursing Medication Management

Side Effects/Adverse Reactions Hearing loss, tinnitus, ototoxicity, nausea, vomiting, hepatotoxicity, dyspepsia Contraindications Hypersensitivity to drug and other NSAIDs

1) Assessment Frequently assess, hematocrit, hemoglobin and kidney function. Check salicylate blood levels frequently.

2) Intervention Give with food or large amounts of water or milk to minimize GI irritation. Watch for signs and symptoms of hypersensitivity and other adverse reactions.

3) Education Caution patient to avoid activities that may cause injury. Advise to use soft toothbrush to avoid gum injury.

4) Evaluation Absence of drug induced adverse reaction. Patient is free from any injury.

DE LA SALLE LIPA

COLLEGE OF NURSING
1962 J.P. Laurel National Highway, Lipa City Tel. (043)756-5555, 756-2491, 756-2391 loc 270

Drug Study

Generic Name: Dopamine hydrochloride

Brand Name: Dopamine hydrochloride

Major Drug Category Inotropic, vasopressor

Drug Action Causes norepinephrine release, leading to vasodilation of renal and mesenteric ateries. Exerts inotropic effects on heart that increases heart rate and blood flow. Significant Drug Interaction MAO inhibitors, alpha or beta adrenergic inhibitors

Uses Shock, hemodynamic imbalance

Side Effects/Adverse Reactions Headache, palpitations, hypotension, tachycardia, nausea, vomiting, dyspnea

Usual Drug Dose Premix @ 18 ugtts/min Nursing Medication Management

Contraindications Hypersensitivity to drug, tacchyarrythmias

1) Assessment Monitor BP, pulse and urinary output. Assess the cardiovascular status.

2) Intervention Inspect IV site regularly for irritation. Never stop the infusion abruptly, this may cause severe hypotension. Taper gradually.

3) Education Explain the need for close observation during infusion. Instruct patient to report adverse reactions and IV site discomfort.

4) Evaluation Patient does not develop hypotension. Absence of drug induced adverse reaction. Desired BP and heart rate is maintained.

DE LA SALLE LIPA

COLLEGE OF NURSING
1962 J.P. Laurel National Highway, Lipa City Tel. (043)756-5555, 756-2491, 756-2391 loc 270

Drug Study

Generic Name: Dobutamine hydrochloride

Brand Name: Dobutamine hydrochloride

Major Drug Category Inotropic Side Effects/Adverse Reactions Increased heart rate and BP, palpitation, nausea, headache, chest pain, palpitation, dyspnea, leg cramps, tissue necrosis

Drug Action Stimulates beta adrenergic receptors of heart, causing a positive inotropic effect that increases myocardial contractility

Uses Short term treatment of cardiac compensation

and stroke volume. Significant Drug Interaction Nitroprusside, Bretylium, guanethidine 1) Assessment Assess electrolyte levels. Stay especially alert for hypokalemia. Assess cardiovascular function. Usual Drug Dose 1 amp + D5W 250 cc @ 15 ugtts/min Nursing Medication Management 2) Intervention Patient must be on cardiac monitor. Contraindications Hypersensitivity to drug

ECG, BP, and hourly urine measures must be continuously monitored. Monitor BP continuously. Use infusion pump or micro drip set.

3) Education

4) Evaluation Absence of drug induced adverse reaction. Desired BP and heart rate is maintained.

Instruct patient to report angina pain, headache, leg cramps and shortness of breath.