Mechanism of Action

Effective against anaerobic

bacteria and protozoa. Specifically
inhibits growth of trichomonae and
amoebae by binding to DNA, resulting
in loss of helical structure, strand
breaking, inhibition of nucleic acid
synthesis, and cell death.

Indication
Serious infections due to

susceptible anaerobic bacteria.

Peritonitis. Intra-abdominal

abscess and liver abscess due to

B. fragilis and so on.
Skin and skin structure infections
due to Bacteroides species.
Endometritis, endomyometritis,
tube-ovarian abscess, and post
surgical vaginal cuff infection
due to Bacteroides Species.
Bacterial vaginosis and
symptomatic trichomoniasis in
males and females.
Bacterial septicemia due to
bacteroides species.
Adjunct therapy to treat bone and
joint infections due to
bacteroides species.
Meningitis and brain abscess due
to Bacteroides species,
Endocarditis due to Bacteroides
species.
Amebiasis
To reduce postoperative anaerobic
infection following colorectal
surgery, elective hysterectomy,
and emergency appendectomy.
Hepatic encephalopathy.
Crohns disease
Diarrhea associated with
Clostridium difficile.

Metronidazole
Contraindication
Patients with blood dyscrasias, active organic

disease of the CNS, trichomoniasis during the

first trimester of pregnancy.
Lactation
Consumtion of alcohol during use.
Hypersensitivity.
Side Effects
Headache, vaginitis, nausea, metallic taste, genital

(vaginitis) pruritis, bacterial infection, flu-like symptoms.

Nursing Interventions
Reduce dosage to patients with hepatic disorder.
Discontinue primary IV infusion during infusion of

metronidazole.
Monitor CBC, LFTs, and cultures.to patients with amebiasis,
monitor stool number/characteristics.
To patients with IV therapy, assess for sodium retention.
With pregnancy use the 7-day regimen for trichomoniasis.
Administer PO drug with food to reduce GI upset.
Instruct patient to take no alcohol until at least 48 hours after
therapy is completed.
Encourage patient o avoid vaginal intercourse during
treatment.

Mechanism of Action
Bactericidal action against
sensitive organisms; inhibits
synthesis of bacterial cell wall,
causing cell death.

Side Effects
Lethargy, hallucinations, seizures, CHF, glossitis,

stomatitis, gastritis, sore-mouth, nausea and

vomiting, diarrhea, abdominal pain.

Indication
Treatment
of
infections
caused by susceptible
strains
of
shigella,
salmonella, E. coli, H.
influenza, P. mirabilis, N.
gonorrhoeae, enterococci,
gram-positive organisms.
Meningitis
caused
by
neisseria meningitiditis
Unlabelled use: prophylaxis
in cesarean section I
certain high-risk patients.

Nursing Interventions
Take drug around the clock.
Encourage the patient to take full course of
therapy.
Administer drug orally on an empty stomach 1 hour
before or 2 hours after meals.
Check IV site carefully for signs of thrombosis or
drug reaction when drug is given intravenously.
Assessment
Contraindication
Allergies to penicillins, cephalosporins, or

other allergens.

Use cautiously to patients with renal

disorder.

Ampicillin (am-pih-SILL-in)

Amikacin

Mechanism of Action

Indication

Bactericidal:
inhibits
protein
synthesis in susceptible strains
of gram-negative bacteria, and
the
functional
integrity
of
bacterial cell membrane appears
to be disrupted, causing cell
death.

Confusion,
disorientation,
depression,
lethargy,
nystagmus, visual disturbances, headache, fever,
numbness, tingling, tremor, paresthesias, muscle
twitching, convulsions, muscular weakness.

Short-term treatment of

serious infections caused

by susceptible strains of
Pseudomonas species, E.
coli, indole positive proteus
species, providencia
species, klebsiella,
enterobacter, and serratia
species, acinetobacter
species.

Contraindication

Patients with allergy to aminoglycosides.

Patients with renal or hepatic disorder,
preexisting hearing loss, myasthenia gravis,
parkinsonism, infant botulism.
Lactation
Use cautiously to elderly patients.
Nursing Interventions

- am-ih-KAY-sin
contraindications
concurrent use of nephrotixic agents
Monitor duration of treatment; usually 7-10 days. If clinical response does not occur within 3-5 days, stop
therapy.
Ensure that patient is well hydrated before and during the therapy.
Assessment (note reasons for therapy, onset, characteristics of s&s, c&s results. Assess weight, hydration
status U/A,CBC, renal and LFTs; reduce, dose with dysfunction2) obtain audiometric assessment with
high doses or prolonged use 3) note vestibular dysfunction; monitor for 8th CN impairment R/T elevated
peak drug levels
drug is administered parenterally (IV or IM) to treat susceptible infections
-report lack of response; adverse side effects. Consume 2-3 liters/day of fluids to ensure to ensure hydration

Tranexamic Acid

Mechanism of Action
Competitively inhibits
activation of plasminogen. Directly
inhibits plasmin activity, but higher
doses are required than are needed to
reduce plasmin formation.

Indication
Used after delivery to reduce

bleeding.
Treatment of bleeding.
Reduce risk of secondary

hemorrhage outcomes in
patients with traumatic
hyphema.
Contraindication
Allergy to any ingredient in tranexamic acid.
Patients with disturbance of color vision.
Patients with irregular bleeding of unknown

Side Effects

cause.
Conditions that may increase blood clots.

Dizziness, fatigue, headache

Nursing Interventions
Administer by mouth usually 2-4 times daily or as directed

by the physician.
Dosage must be based on clients weight.

Photos of ranitidine, tramadol,& tranexamic acid