VII.

Drug Name
Dexamethason
e

Phenytoin

DRUG STUDY
Generic or
Brand Name
Cortastat,
Dalalone,
Decadron
Phosphate,
Decaject,
Dexasone,
Hexadrol
Phosphate,
PMSDexamethaso
ne (CAN)

Dilantin-125,
Dilantin

Classification

Dosage

Corticosteroid
Glucocortocoid
Hormone

4mg IV q6

Antiarrhythmic
, group 1b

33 mg IV
q12

Mechanism of
Action
Enters target
cells and binds
to specific
receptors,
initiating many
complex
reactions that
are responsible
for its antiinflammatory
and
immunosuppres
sive effects

Has antiepileptic
activity without

Indications

Contraindications

Hypercalcemia
associated with
cancer

Infections,
especially
tuberculosis, fungal
infections,
amebiasis, vaccinia
and varicella, and
antibiotic-resistant
infections, allergy
to any component
of the preparation
used
Use cautiously with
renal or hepatic
disease;
hypothyroidism,
ulcerative colitis
with impending
perforation;
diverticulitis; active
or latent peptic
ulcer; inflammatory
bowel disease;
heart failure,
hypertension,
thromboembolic
disorders, DM

Control of grand
mal (tonic-

Hypersensitivity to
hydantoins, sinus

Adverse
Reactions
CNS: Seizures,
vertigo,
headaches,
insomnia, mood
swings,
depression,
psychosis,
intrcerebral
hemorrhage
CV:
Hypertension,
heart failure
Endocrine:
Growth
retardation,
decreased
carbohydrate
tolerance, DM
GI: Peptic or
esophageal
ulcer, abdominal
distention
Hematologic:
Fluid and
electrolyte
disturbances
Musculoskeleta
l: muscle
weakness, loss
of muscle mass
CNS:

Nursing
Considerations
-Monitor blood
glucose levels
-Avoid exposure
to infection
-Report any
unusual weight
gain, swelling of
extremities,
muscle
weakness, fever,
black or tarry
stools, prolonger
sore throat,
colds or other
infections,
worsening of
this disorder
-Do not overuse
joint after
therapy, even if
pain is gone

-Take this drug

exactly as

Infatab,
Dilantin
Injection,
Dilantin
Kapseals,
Phenytek

Ceftriaxone

Rocephin

Antiepileptic
Hydantoin

Antibiotic
Cephalosporin
(3rd generation)

causing general
CNS depression;
stabilizes
neuronal
membranes and
prevents
hyeprexcitabilit
y caused by
excessive
stimulation;
limits the spread
of seizure
activity from an
active focus;
also effective in
treating cardiac
arrhythmias,
especially those
induced by
cardiac
glycosides;
antiarrhythmic
properties are
very similar to
those of
lidocaine; bothe
are class IB
antiarrhythmics

650 mg IV
q12 ANST
(-)

Bactericidal:
Inhibits
synthesis of

clonic) and
psychomotor
seizures
Parenteral
administration:
Control of status
epilepticus of
the grand mal
type

bradycardia,
sinoatrial block,
Stokes-Adams
syndrome
Use cautiously with
acute intermittent
porphyria,
hypotension, severe
myocardial
insufficiency, DM,
hyperglycemias

Nystagmus,
ataxia, slurred
speech, mental
confusion,
dizziness,
drowsiness,
insomnia,
fatigue,
irritability,
depression,
numbness,
headache,
photophobia,
conjunctivitis
IV use
complication:
Hypotension,
transient
hyperkinesias,
drowainess,
nystagmus,
circumoral
tingling, vertigo,
nausea, CV,
collapse, CNS
depression

Lower
respiratory
infections

Allergy to
cephalosporins or
penicillins

CNS: headache,
dizziness,

prescribed, with
food to reduce
GI upset, or
without food-but
maintain
consistency in
the manner in
which you take
it. Be especially
careful not to
miss a dose if
you are once-aday therapy
-Do not
discontinue this
drug abruptly or
change dosage,
except on the
advice of your
health care
provider
-Monitor your
blood or urine
sugar

-Avoid alcohol
while taking this
drug and for 3

bacterial cell
wall, causing
cell death

caused by
Streptococcus
pneumonia,
Staphylococcus
aureus,
Klebsiella

Use cautiously with

renal failure

lethargy
GI: nausea,
vomiting,
diarrhea,
anorexia,
abdominal pain,
flatulence

days after
because severe
reactions often
occur
-Report severe
diarrhea,
difficulty
breathing,
unusual
tiredness or
fatigue

GU:Nephrotoxi
city
Hematologic:
bone marrow
depressiondecreased WBC
count,platelet,
Hct
Erythromycin
ointment

Akne-mycin,
A/T/S, ApoErythro
(CAN), ApoErythro E-C
(CAN),
Erybid
(CAN), Eryc,
EryDerm

Macrolide
antibiotic

TID to OU

Bacteriostatic
orbactericidal in
susceptible
bacteria; binds
to cell
membrane,
causing change
in protein
function,
leading to cell
death

Treatment of
superficial
ocular infections
caused by
susceptible
strains of
microorganisms;
prophylaxis of
ophthalmia
neonatorum

Allergy with
erythromycin;
viral, fungal,
myobacterial
infections of the
eye

Dermatologic:
Edema,
urticaria,
dermatitis,
angioneurotic
edema
Local: irritation,
burnibg, itching
at site of
application,

-Pull the lower

eyelid down
gently and
squeeze a onehalf-inch ribbon
of the ointment
into the sac,
avoid touching
the eye or lid.
Gently close the
eye, and roll the
eyeball in all
directions
-May cause

superinfections,
particularly with
long term use

Oxacillin

Bactocill,
Oxacillin
Sodium
ADDVantage

Antibiotic
Penicillinaseresistant
penicillin

325 mg TIV
q6 ANST (-)

Bactericidal:
Inhibits
synthesis of
bacterial cell
wall, causing
cell death

Infections due to
penicillinaseproducing
staphylococci
infection is
suspected

Allergies to
penicillins,
caphalosporins, or
other allergens
Use cautiously with
renal disorders

CNS: Lethargy,
seizures
GI: glossitis,
gastritis, sore
mouth, nausea,
vomiting,
diarrhea,
abdominal pain
GU: Nephritis,
hematuria,
oliguria
Hematologic:
anemia,
thrombocytopen
ia, leucopenia,
prolonged
bleeding time
Hypersensitivit
y: rash, fever,
wheezing,

temporary
blurring of
vision, stinging
or itching
-report stinging
or itching that
becomes
pronounced
-Report
difficulty
breathing,
mouth sores
-Finish entire
course of
therapy as
prescribed

anaphylaxis
Mannitol

Osmitrol

Diagnostic
Agent
Osmotic
diuretic
Urinary irrigant

33cc ic q8

Elevates the
osmolarity of
the glomerular
filtrate, therapy
hindering the
reabsorption of
water and
leading to a loss
of water,
sodium,
chloride; creates
an osmotic
gradient in the
eye between
plasma and
ocular fluids,
thereby reducing
IOP; creates an
osmotic effect,
leading to
decreased
swelling in posttransurethral
prostatic
resection

Reduction of
intracranial
pressure and
treatment of
cerebral edema;
of elevated IOP
when the
pressure cannot
be lowered by
other means

Anuria due to
severe renal disease
Use cautiously with
pulmonary
congestion, active
intracranial
bleeding,
dehydration, renal
disease, heart
failure

CNS: Dizziness,
headache,
blurred vision,
seizures
CV:
hypotension,
hypertension,
edema, HF,
thrombophlebiti
s, tachycardia,
chest pain
Dermatologic:
urticaria, skin
necrosis with
infiltration
GI: nausea,
anorexia, dry
mouth
GU: dieresis,
urine retention
Hematologic:
fluid and
electrolyte

-Report
difficulty
breathing, pain
at IV site, chest
pain

imbalances,
hyponatremia
Respiratory:
pulmonary
congestion,
rhinitis
Ranitidine

ApoRanitidine
(CAN), CO
Ranitidine
(CAN), GenRanitidine
(CAN),
NovoRanitidine

Histamine-2
(H2) antagonist

13 mg IV
q12 PRN

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

Short term
treatment of
active duodenal
ulcer
Short term
treatment of
GERD

Allergy to
ranitidine
Use cautiously with
impaired renal or
hepatic function

CNS: headache,
malaise,
dizziness,
somnolence,
insomnia,
vertigo
CV:
tachycardia,
bradycardia,
PVCs
Dermatologic:
rash, alopecia
GI:
constipation,
diarrhea, nausea,
vomiting,
abdominal pain,
increased ALT

-Decrease doses
in renal and
liver failure
-Arrange for
regular followup, including
blood tests, to
evaluate effects
-Report sore
throat, fever,
unusual brusing
or bleeding,
tarry stools,
confusion,
hallucinations,
dizziness, severe
headache,
muscle or joint
pain

levels
Hematologic:
leucopenia,
granulocytopeni
a,
thrombocytopen
ia, pancytopenia
Local: local
burning or
itching at IV site
Diazepam

ApoDiazepam
(CAN),
Diastat
AcuDial,
Diazemuls
(CAN)

Antiepileptic
Anxiolytic
Benzodiazepin
e
Skeletal muscle
relaxant
(centrally
acting)

3.9 mg for
frank
seizure

Exact
mechanisms of
actions not
understood; acts
mainly at the
limbic system
and reticular
formation; may
act in spinal
cord and at
supraspinal sites
to produce
skeletal muscle
relaxation;
potentiates the
effects of
GABA, an
inhibitory
neurotransmitter
; anxiolytic
effects occur at

Antiepileptic:
Adjunct in
status
epilepticus and
severe recurrent
convulsive
seizures; adjunct
in seizure
disorders

Hypersensitivity to
benzodiazepines;
psychoses,acute
alcoholic
intoxication
Use cautiously with
impaired liver or
renal function

CNS:
depression,
lethargy, apathy,
fatigue,
disorientation,
restlessness,
confusion,
delirium,
headache,
euphoria
CV:
bradycardia,
tachycardia, CV
collapse,
hypertension
and

-Take this drug

exactly as
prescribed
-Report severe
dizziness, rash
or skin lesions,
palpitations,
swelling of
ankles, visual or
hearing
disturbances,
difficulty
voiding

doses well
below those
necessary to
cause sedation,
ataxia; has little
effect on cortical
function

hypotension,
palpitations
GI:
constipation,
diarrhea, dry
mouth
GU:
incontinence,
urinary retention
Hematologic:
decreased Hct