COLLEGE OF NURSING

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

DE LA SALLE LIPA

Drug Study

Generic Name: Hyoscine

Brand Name: Buscopan

Major Drug Category Anti-spasmodic

Drug Action

Uses

Side Effects/Adverse Reactions

Acts as a competitive inhibitor of post-ganglionic muscarinic receptor sites of PNS

Acute GI; Biliary and genitourinary spasm, include biliary and renal colic, dysmenorrhea

Tachycardia, urinary retention, xerostomia, dizziness, bronchospasm

Significant Drug Interaction TCADs, antihistamines, quinidine, amantadine, disopyramide, Beta-adrenergic agents

Usual Drug Dose Adult & children > 6yrs: 10-20mg 3-5 times daily

Contraindications Myasthenia gravis, megacolon, hypersensitivity, glaucoma, tachycardia, mechanical stenosis of GIT

Nursing Medication Management 1) Assessment -Assess for eye pain -Assess for parkinsonism -Assess for urinary hesitancy, retention -Assess for constipation -Assess mental status 2) Intervention -Monitor I&O ratio (retention commonly causes decreased urine output) -Palpate bladder if bladder retention occurs

3) Education -Tell patient to avoid hazardous activities requiring alertness -Advise patient to avoid use of alcohol or other CNS depressants while taking medication

4) Evaluation -Decreased secretions -Absence of motion sickness

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

DE LA SALLE LIPA

Drug Study

Generic Name: Ceftriaxone

Brand Name: Forgram

Major Drug Category Antibiotic

Drug Action

Uses

Side Effects/Adverse Reactions

Inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death Significant Drug Interaction Aminoglycosides and diuretics, Nephrotoxic antibiotics such as furosemide

Treatment of susceptible infections including chancroid, gastroenteritis, lyme disease, meningitis, syphilis, typhoid Usual Drug Dose Adult 1g-2g/day once daily according to infection severity Pedia 50-100mg/kg/day

Pain, rash, diarrhea, eosinophilia, casts in urine, thrombocytosis, leucopenia

Contraindications Hypersensitivity to cephalosporins, penicillins, lidocaine and other local anesthetic product of amide type.

Nursing Medication Management 1) Assessment -Assess patient previous sensitivity to cephalosporins/penicillins -Assess patient for signs and symptoms of infection -Assess for allergic reaction and anaphylaxis -Assess renal function before and during therapy 2) Intervention -Obtain C&S before beginning therapy to identify if correct treatment has been initiated -Monitor hematologic, electrolyte & hepatic status on long term therapy

3) Education -Instruct patient to take medication as prescribed for the length of time ordered -Teach patient to report sore throat, bruising, bleeding and joint pain.

4) Evaluation -Absence of signs and symptoms of infection -Observed and experienced improvements in symptoms of infection -Negative C&S -Absence of drug induced adverse effects

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

DE LA SALLE LIPA

Drug Study

Generic Name: Racecadotril

Brand Name: Hidrasec

Major Drug Category Anti-diarrheals

Drug Action

Uses

Side Effects/Adverse Reactions

Inhibitor of enkephalinase this drug antagonise the effect of enkephalins which is agonist of a recaptor(opioid) & maintain the cAMP level. Significant Drug Interaction Racecadotril does not inhibit or induce cytochrome P-450 in animal models.

Treatment of acute diarrhea

Drowsiness, nausea, vomiting, constipation, dizziness, headache

Usual Drug Dose Adult 100mg Child, infant 1.5mg/kg/dose with 1 initial dose

Contraindications Renal & hepatic impairment, fructose intolerance, glucose and galactose malabsorption

Nursing Medication Management 1) Assessment -Consider severe or prolonged diarrhea -Assess patients weight to determine appropriate dosage 2) Intervention -Assess clients elimination pattern to determine effectiveness of drug -Monitor intake and output -Monitor for possible signs of drug induced adverse effects 3) Education -Can be taken with or without food -Maintain feeding during diarrhea, severe vomiting, refusal of food 4) Evaluation -Patient state understanding of drug therapy -Less occurrence of watery stools after proper length of treatment

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

DE LA SALLE LIPA

Drug Study

Generic Name: Dextromethorphan/Guaifenesin

Brand Name: Mucobron

Major Drug Category Antitussive

Drug Action

Uses

Side Effects/Adverse Reactions

Supresses cough reflex by direct action on the cough center in the medulla

Relief of cough due to minor throat & bronchial irritation as may occur with the common cold, bronchitis or inhaled irritants

Nausea, drowsiness, dizziness

Significant Drug Interaction Monoamine oxidase inhibitors (MAOIs), haloperidol, fluoxetine, quinidine, amiodarone

Usual Drug Dose Adult: 15ml Pedia: 5-10 ml

Contraindications -Should not be taken for persistent/chronic cough -When coughing accompanied by excessive secretions

Nursing Medication Management 1) Assessment -Obtain patient history of cough before therapy and reassess after giving the drug -Assess cough: type, frequency, character including sputum 3) Education -Instruct patient to follow exactly the direction on medication -Advice medical consultation for persistent cough more than 7 days -Suggest sugarless lozenges to decrease throat irritation and cough 4) Evaluation Relief of dry, irritating cough 2) Intervention -Monitor for possible adverse reactions: CNS: drowsiness, dizziness GI: Nausea, vomiting, abdominal pain

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

DE LA SALLE LIPA

Drug Study

Generic Name: Mometasone

Brand Name: Nasonex

Major Drug Category Anti-pruritic/Anti-inflammatory

Drug Action

Uses

Side Effects/Adverse Reactions

Inhibition of prostaglandin synthesis and inhibition of macrophage and leukocyte migration to site of inflammation

-Prophylaxis and treatment of symptoms of seasonal and perennial allergic rhinitis

Paresthesia, pruritus, skin atrophy, burning, tingling, folliculitis, acneiform reaction

Significant Drug Interaction -no significant drug interaction

Usual Drug Dose Adult and Pedia: -1-2 sprays each nostril per day

Contraindications -Untreated localized infection involving the nasal mucosa. -Recent nasal surgery/trauma

Nursing Medication Management 1) Assessment -Document onset, duration and character of symptoms -Attempt to identify triggers -Assess patients family knowledge on drug therapy 3) Education -Instruct patient to use regularly as directed -Instruct patient to report failure to improve condition after 3-5 days therapy -Teach patient to limit treatment to 14 days -Instruct to monitor for and report drug induced adverse reactions 2) Intervention -Monitor for systemic absorption and fever (increased temperature) -Monitor for possible drug induced adverse effects -Prime pump until fine spray appear -Store protected from sunlight 4) Evaluation -Absence of severe itching, patches on or flaking of skin -Relief of allergic rhinitis -Patient does not develop injury related to drug induced adverse reactions.

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

DE LA SALLE LIPA

Drug Study

Generic Name: Isoniazid

Brand Name: INH

Major Drug Category Anti-infectives

Drug Action

Uses

Side Effects/Adverse Reactions

Inhibits RNA synthesis, decreases tubercle bacilli

For pulmonary and extrapulmonary TB

Fever, lymphadenopathy, vasculitis, hypersensitivity, nausea, vomiting, GI disturbances

Significant Drug Interaction Phenytoin, carbamezapine, cycloserine, ethionamide, BCG vaccine Administer before taking antacids

Usual Drug Dose Adult 300mg OD Pedia 5-10ml OD

Contraindications Should not be given to patients with drug induced liver disease

Nursing Medication Management 1) Assessment -Assess lab exams & sputum, CXR before treatment -Assess CNS often: affect, mood, behavioral changes -Assess hepatic status,: decreased appetite, jaundice, dark urine, fatigue 2) Intervention -Monitor liver/renal function: ALT, AST, bilirubin, increased results may indicate hepatitis -Give with meals to decrease GI symptoms: 1 hour to 2 hours after meals

3) Education -Instruct patient that compliance with dosage schedule for duration is necessary to gain benefits -Tell patient to report peripheral neuritis: weakness, tingling/numbness of feet.

4) Evaluation -Decreased symptoms of TB -Culture negative for TB

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

DE LA SALLE LIPA

Drug Study

Generic Name: Ampicillin

Brand Name: Excillin

Major Drug Category Anti-infectives

Drug Action

Uses

Side Effects/Adverse Reactions

Interferes w/ cell wall synthesis of susceptible organisms, preventing bacterial multiplication

Treatment of respiratory tract and soft tissue infections, bacterial meningitides, septicemia and gonococcal infections

Thrombophlebitis at injection site, dizziness, fatigue, insomnia, reverse hyperactivity, neurotoxicity

Significant Drug Interaction Probenecid interferes/impairs drug excretion Allopurinol increases risk for skin rashes

Usual Drug Dose Adult 1-2g/day Pedia 50-200mg/kg/day

Contraindications Hypersensitivity to penicillins, cephalosporins or imipenen

Nursing Medication Management 1) Assessment -Obtain patient history of infection before and during therapy to assess response. -Assess patient for signs and symptoms of infection, fever, characteristics of wounds, sputum, urine, stool, earache and WBC count 2) Intervention -Monitor renal function: urine output, urinalysis, protein and blood, BUN, creatinine -Monitor blood studies: AST, ALT, CBC, Hct, bilirubin, LDH, alkaline phosphatase -Given by direct IV over 3-5mins in lower dosages

3) Education -Instruct patient to take all medications prescribed for the length of time ordered -Instruct patient to monitor adverse reaction: sore throat, bruising, bleeding, joint pain -Instruct patient if diarrhea with blood occurs

4) Evaluation -Control of infection manifested by absence of signs/symptoms of infection -Reported improvement in symptoms of infection -Patient and family state understanding of drug therapy

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

DE LA SALLE LIPA

Drug Study

Generic Name: Cefuroxime

Brand Name: Zegen

Major Drug Category Anti-infectives

Drug Action

Uses

Side Effects/Adverse Reactions

Binds to bacterial cell wall membrane which causes death

Treatment of bone and joint infections, bronchitis and other LRTIs, gonorrhea, meningitis, pharyngitis, UTI

Thrombophlebitis, pruritus, urticarial, diarrhea, nausea, pseudomembrane colitis

Significant Drug Interaction Other antibiotics, probenecid, water pills

Usual Drug Dose Adult 750mg-1.5g Pedia 500mg-750mg

Contraindications Hypersensitivity to cephalosporins and penicillins

Nursing Medication Management 1) Assessment -Assess patient history of allergies particularly cephalosporins and penicillins -Assess mouth for white patches in mucous membranes and tongue 2) Intervention -Monitor bowel activity and stool consistency carefully -Monitor I&O and renal function reports for nephrotoxicity -Monitor for drug adverse effects: pruritus, abdominal pain, mouth sores

3) Education -Instruct client that doses should be evenly spaced -Instruct client to continue medication therapy for full length of treatment -Inform patient that the drug may cause GI upset. (may take with food or milk)

4) Evaluation -Reported improvements in symptoms of infection -Control of infection manifested by absence or less occurrence of signs and symptoms of infection

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

DE LA SALLE LIPA

Drug Study

Generic Name: Budesonide & Formoterol

Brand Name: Symbicort Turbuhaler

Major Drug Category Anti-asthma

Drug Action

Uses

Side Effects/Adverse Reactions

Dose-dependent antiinflammatory action in the airways; rapid & long-lasting relaxation of bronchial smooth muscles

Treatment of asthma in combination with a corticosteroid, treatment of moderate and severe COPD

Headache, palpitations, tremor candida infections, mild throat irritation, coughing hoarseness

Significant Drug Interaction Ketoconazole, Acarbose, aceclofenac, aclofenac, BCG

Usual Drug Dose Adult and >12yrs 2 inhalations 320/9mcg Pedia: 1-2 inhalations 80/4.5mcg

Contraindications Hypersensitivity to inhaled lactose

Nursing Medication Management 1) Assessment -Assess respiratory function: breathing patterns and cough sputum -Assess ability to use the inhaler device and reassess technique at regular appointments 2) Intervention -Monitor for evidence of allergic reactionsand paradoxical bronchospasms -Monitor for adverse reactions at beginning of therapy and periodically with long term use.

3) Education -Instruct the patient to use the inhaler at regular intervals -Ensure patients know never to use the medication to treat acute attack

4) Evaluation -Relief of dyspnea and wheezing -Improved airway exchange

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

DE LA SALLE LIPA

Drug Study

Generic Name: Hydrocortisone

Brand Name: Solu-cortef

Major Drug Category Corticosteroids

Drug Action

Uses

Side Effects/Adverse Reactions

Glucocoorticoid with antiinflammatory effect because of its ability to inhibit prostaglandins synthesis

Treatment of primary and secondary adrenal cortex insufficiency, allergic states, allergic and inflammatory ophthalmic processes

Depression, flushing, sweating, headache, mood changes, hypertension, thrombophlebitis, embolism, tachycardia

Significant Drug Interaction May decrease effects of the anticholinesterase in treatment of myasthenia gravis -Alkaline antiseptics

Usual Drug Dose Adult 100-250mg Pedia 0.186-1mg/kg 2x-3x/day

Contraindications Systemic fungal infections, IM use in idiopathic thrombocytopenic purpura and administration of live vaccines in patient receiving immunosuppressive corticosteroid doses

Nursing Medication Management 1) Assessment -Assess patients condition before starting therapy and reassess regularly -Assess mental status and affect, mood, behavioral changes, aggression -Assess for signs of infection 3) Education -teach patient all aspects of drug usage, the danger of stopping abruptly after long term therapy and signs of early adrenal insufficiency -Patient does not develop serious infection -Warn patient receiving long term therapy about cushingoid symptoms (weight gain and swelling) -Patient and family state understanding of drug therapy 4) Evaluation -Patients condition improves -Serious drug induced complications does not develop 2) Intervention -Monitor patients weight, BP, glucose and electrolyte levels -Monitor for possible drug induced adverse effects -Monitor I&O ratio, urine output and increasing edema

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

DE LA SALLE LIPA

Drug Study

Generic Name: Cefixime

Brand Name: Ultraxime

Major Drug Category Anti-infectives

Drug Action

Uses

Side Effects/Adverse Reactions

Inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death

Bronchitis, secondary infections of the respiratory tract, pneumonia, otitis media, sinusitis, bronchiectasis

Shock, granulocytopenia, anaphylactoid symptoms, lyells syndrome, hematologic disorders

Significant Drug Interaction Co-administration with warfarin Probenecid, Inhibition of renal excretion of cefixime

Usual Drug Dose Adult-12yrs&up : 400mgOD Pedia: 5-10ml OD

Contraindications Hypersensitivity, history of shock due to any ingredient to this product

Nursing Medication Management 1) Assessment -Assess patients previous sensitivity reaction to penicillin or other cephalosporins -Assess patient for signs and symptoms of infection 2) Intervention -Obtain C&S before beginning therapy to identify if correct treatment has been initiated -Monitor hematologic, electrolyte and hepatic status -Assess for allergic reactions and anaphylaxis

3) Education -Instruct patient to take medication as prescribed for the length of time ordered even if he feels better -Teach patient to report sore throat bruising, bleeding and joint pain

4) Evaluation -Absence signs and symptoms of infection -Observed and experienced improvement in symptoms of infection -Negative C&S -Absence of drug induced adverse reaction

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

DE LA SALLE LIPA

Drug Study

Generic Name: Rifampicin Drug Action

Brand Name: Rifamax Uses

Major Drug Category Anti-infectives Side Effects/Adverse Reactions

Inhibits DNA-dependent polymerase, decreases replication

Maintenance phase treatment of pulmonary and extra-pulmonary TB.

GI disturbances, nausea, vomiting, diarrhea, anorexia, shortness of breath, shock, GI bleeding

Significant Drug Interaction Corticosteroids, digitoxin derivatives, methadone, oral contraceptives

Usual Drug Dose Adult: 10mg/kg 600mg max Pedia: 10/kg

Contraindications Jaundice associated with reduced bilirubin excretions. 1 trimester of pregnancy

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Nursing Medication Management 1) Assessment -Assess lung sounds and character of sputum periodically during therapy -Perform mycobacterial studies and susceptibility tests prior to and periodically during therapy to detect possible resistance. 2) Intervention -Assess periodic results of lab tests and CXR on a regular basis during theraoy -Monitor patient compliance with the treatment regimen

3) Education -Do not take any new medication during therapy without consulting a physician -Take rifampin on an empty stomach, 1 hour before or 2 hours after meals -Instruct client to complete the full course of therapy and not skip doses

4) Evaluation -Decreased symptoms of TB