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8/13/2019 Pon Drugstudyvjhvjhvjhjv

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Drug Study

Genericname

Brandname

classification Indication Mode of action Contraindication Usualdose

Actualdose

Side effects Nsg. responsibilities

CE

FTR

IA

ZO

NE

S

O

DUI

M

RO

CEP

HI

N

CE

PHA

LO

PO

RI

NS

Third-generation

Seriouslower

respiratorytractinfections

UTIs.

Third-generationcephalosporin that

inhibits cell-wallsynthesis,

promoting osmotic

instability; usuallybactericidal.

Contraindicatedin patients

hypersensitive todrug or othercephalosporins.

Use cautiously in

patientshypersensitive to

penicillinbecause of

possibility ofcross-sensitivity

with other beta-

lactamantibiotics.

5075mg/kg/d

in 2divideddoses

(max 2g/d)

3g OD+ 50 cc

D5waterIV

infusion

persoluset

to runfor for

30 min

CNSFever

HeadacheDizziness

CVPhlebitis

GI

Diarrhea

GUGenital

pruritus

Candidiasis

OTHERS

Anaphylaxis

Observe 10R Determine history of hypersensitivity

reactions to cephalosporins andpenicillins and history of other allergieparticularly to drugs, before therapy is

initiated.

Lab tests: Perform culture and sensitivtests before initiation of therapy and

periodically during therapy. Dosage ma

be started pending test results. Periodiccoagulation studies (PT and INR) shou

be done.

Inspect injection sites for induration aninflammation. Rotate sites. Note IV

injection sites for signs of phlebitis(redness, swelling, pain).

Monitor for manifestations ofhypersensitivity . Report their appearan

promptly and discontinue drug.

Watch for and report signs: petechiae,ecchymotic areas, epistaxis, or any

unexplained bleeding. Ceftriaxoneappears to alter vitamin K-producing gu

bacteria; therefore, hypoprothrombinembleeding may occur.

Check for fever if diarrhea occurs: Repboth promptly.

Report any signs of bleeding. Report loose stools or diarrhea promptl


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Generic

name

Brand

name

classification Indication Mode of action Contraindication Usual

dose

Actual

dose


C

LA

RIT

HR

OM

YC

IN

B

IA

XI

N

Macrolide

anti-infectives

Mild-to-

moderatecommunity-

acquiredpneumonia,caused by

H.influenzae, h.parainfluenzae,

m.catarrhalis, S.pneumonia, C.

pneumonia, orM. pnuemoniae.

Inhibits protein

synthesis insusceptible

bacteria, causingcell death

Contraindicated in

patientshypersensitive to

clarithromycin,erythromycin, orother macrolides

and thosereceiving

pimozide or otherdrugs that prolong

QT interval orcause cardiac

arrhythmias.

Use cautiously in

patients withhepatic or renalimpairment.

15

mg/kg/dayPO

dividedevery 12hours for

10 days

125/5mg

10ml 2xa day for

1 week

CNS

Headache

GIDiarrheaNausea

Tasteperversion

Abdominal painor discomfort

vomiting

SKINRash

Observe 10R Tell patient to take drug as

prescribed, even she feels bett

Report rash or other signs ofhypersensitivity immediately.

Report loose stools or diarrheaeven after completion of drug

therapy

When clarithromycin is givenconcurrently with anticoagulandigoxin, or theophylline, blood

levels of these drugs may beelevated. Monitor appropriate

serum levels and assess for S&of drug toxicity.

Tell patient that they may feelthe side effects like: fever. Ras

nausea, vomiting, fatigue,, paiat injection site

Report numbness or tingling ,severe headache, nausea, rash,extreme, extreme fatigue, edem

pain or swelling at injection si


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4/8

Genericname

Brandname


Actualdose


CE

TI

RIZ

IN

E

HY

DR

O

CHL

OR

ID

E

ZY

RT

EC

AN

TI

HIS

TA

MI

NE

S

Seasonalallergic

rhinitis

A long-actingnonsedating

antihistamine thatselectively

inhibits peripheralH1 receptors.

Contraindicatedin patients

hypersensitiveto drug or

hydroxyzine andin breast-feeding women.

Use cautiously

in patients withrenal or hepatic

impairement.

5 to 10mg

1 tabOD at

HS

CNSFatigue

HeadacheDizziness

EENTPharyngitis

GI

DiarrheaDry mouth

NauseaAbdominal

distress

Observe 10RAssessment

History:Allergy to any antihistamines,hydroxyzine; narrow-angle glaucoma,

stenosing peptic ulcer, symptomatic prostatichypertrophy, asthmatic attack,

bladder neck obstruction, pyloroduodenal

obstruction; lactationPhysical:Skin color, lesions, texture; orientatio

reflexes, affect; vision exam; R,adventitious sounds; prostate palpation; renal

function testsInterventions

Give without regard to meals.Provide syrup form for pediatric useif needed.

Arrange for use of humidifier if thickening of

secretions, nasal dryness becomebothersome; encourage adequate intake of fluidProvide skin care for urticaria.

Teaching pointsTake this drug without regard to meals.

These side effects mayoccur: Dizziness, sedatidrowsiness (use caution if

driving or performing tasks that require alertnesthickening of bronchial

secretions, dryness of nasal mucosa (humidifiermay help).

Report difficulty breathing, hallucinations,

tremors, loss of coordination, irregularheartbeat


5/8

Genericname

Brandname


Actualdose


IpratropiumBr,

Salbutamol/albuterol

sulfate

Combivent Antiasthmatic& COPD

Preparations

Management ofreversible

bronchospasmassociated with

obstructiveairway diseasesin patients who

require morethan a single

bronchodilator

Beta2 adrenergicreceptor cause

bronchodilationand vasodilation

Anticholinergic,blocks reflexes by

antagonizing actionof acetylcholine

Patient with cardiactachyarrythmias,

hypertropicobstructive

cardiomyopathyand patient withhistory of

hypersensitivity

1 nebevery

6-8 hr

1 nebq 8

mildheadach

e; or

coldsymptoms suchas

stuffynose,

sneezing,

cough,or sore

throat.

1.) Use Cautiously to patientswith known sensitivity to

atropine, soybeans, soyalecithin, and peanuts.

2.) Assess Vital Signs Beforedrug administration3.) Observe for paradoxical

bronchospasm (WheezingIf Condition occurs, withh

Medication and notifyphysician or other health c

professional immediately.4.) Instruct patient to contact

health care professionalimmediately if shortness o

breath is not relieved by

medication or isaccompanied by diaphoresdizziness, palpitations, or

chest pain.Advise the patient to rinse

mouth with water after usithe nebulizer to minimize

mouth.


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Genericname

Brandname


Actualdose


Ranitidine Zantac HistamineH2

antagonists

reatment andprevention of

acid indigestion,and sour

stomach.

nhibits the actionof histamine at the

H2 receptor sitelocated primarily

in gastric parietalcells, resulting ininhibition of

gastric acidsecretion.

Hypersensitivity,Cross-sensitivity

may occur;

20 mgIV

q8h

33 mgIVTT

q 8

NS:Confusion,

dizziness,drowsiness,

hallucinations,headache CV:

Arrhythmias GI:

Altered taste,black tongue,

constipation, darkstools, diarrhea,

drug-inducedhepatitis, nausea

GU:

Decreased spermcount, impotence ENDO:

Gynecomastia HEMAT:

Agranulocytosis,Aplastic Anemia,

neutropenia,thrombocytopenia

LOCAL:Pain at IM site

MISC:

Hypersensitivityreactions,vasculitis

Assess patient for epigastric orabdominal pain and frank or occ

blood in the stool, emesis, orgastric aspirate.

Nurse should know that it maycause false-positive results forurine protein; test with

sulfosalicylic acid. Inform patient that it may caus

drowsiness or dizziness. Inform patient that increased

fluid and fiber intake mayminimize constipation.

Advise patient to report onset black, tarry stools; fever, sore

throat; diarrhea; dizziness; rash;

confusion; or hallucinations tohealth car professional promptly Inform patient that medication

may temporarily cause stools antongue to appear gray black.


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Genericname

Brandname

classification

Indication Mode ofaction

Contraindication Usualdose

Actualdose


spironolactone

Aldactone

Potassium-sparing

diuretic

Preventfluid

overload

Spironolactone acts on the

distal renaltubules as a

competitiveantagonist ofaldosterone.

It increasesthe excretion

of sodiumchloride and

water whileconserving

potassiumand hydrogen

ions.

Anuria,hyperkalemia,

acute orprogressive renal

insufficiency.Addisonsdisease.

13.3mg/kg/da

y POadjusted

topatientsresponse,

administered as

single ordivided

dose

25 mgtab BID

Fluid orelectrolyte

imbalance,gynecomastia,

GI upset,drowsiness,headache,

hyponatremia;tachycardia,

hypotension,oliguria,

hyperkalemia;confusion,

weakness,paresthesia,

Assessment

History:Allergy to spironolactone; hyperkalemrenal disease; pregnancy, lactation

Physical:Skin color, lesions, edema; orientatioreflexes, muscle strength; P, baseline ECG, BP;

pattern, adventitious sounds; liver evaluation,bowel sounds; urinary output patterns, menstru

cycle; CBC, serum electrolytes, renal functiontests, urinalysis

Interventions

Mark calendars of edema outpatients as remindof alternate day or 3- to 5-day/wk therapy.

Make suspension as follows: Tablets may bepulverized and given in cherry syrup for youngchildren. This suspension is stable for 1 mo if

refrigerated.

Measure and record regular weight to monitormobilization of edema fluid. Avoid giving food rich in potassium. Arrange for regular evaluation of serum

electrolytes and BUN.

Teaching points

Record alternate-day therapy on a calendar, orprepare dated envelopes. Take the drug earlybecause of increased urination.

Weigh yourself on a regular basis, at the sametime and in the same clothing, and record the

weight on your calendar.

Avoid foods that are rich in potassium (fruits,Sanka); avoid licorice.

You may experience these side effects: Increasevolume and frequency of urination; dizziness,confusion, feeling faint on arising, drowsiness

(avoid rapid position changes, hazardous


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activities: such as driving, using alcohol);increased thirst (suck on sugarless lozenges; use

frequent mouth care); changes in menstrual cycdeepening of the voice, impotence, enlargemen

the breasts can occur (reversible).

Report weight change of more than 3 pounds inday, swelling in your ankles or fingers, dizzinestrembling, numbness, fatigue, enlargement of

breasts, deepening of voice, impotence, muscleweakness, or cramps.

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