Drug Name

Generic
Name:
Ceftriaxone

Brand Name:
Forgram

Dosage:
450mg
TIV q12

Classification

3rd generation
cephalosporin

Mechanism of
Action

Indication

Works by inhibiting the

mucopeptide synthesis
in the bacterial cell
wall. The beta-lactam
moiety of Ceftriaxone
binds to
carboxypeptidases,
and transpeptidases in
the bacterial
cytoplasmic
membrane. These
enzymes are involved
in cell - wall synthesis
and cell division by
binding to these
enzymes, Ceftriaxone
results in the formation
of defective cell walls
and cell death.

Indicated in
patients with
neurologic
complications,
carditis and athritis.
It is also effective in
Gram negative
infections;
Meningitis,
Gonorrhea. It is
also for bone and
joint infections,
lower respiratory
tract infections,
middle ear
infection, PID,
Septicema and
Urinary Tract
infections

Contraindication

Hypersensitive to
cephalosporins,
penicillins and
related antibiotics

Adverse
Effect

Pain
Induration
Phlebitis
Rash
Diarrhea
Thrombocytosis
Leucopenia
Glossitis
Respiratory
superinfections

Nursing Consideration

Assess patient's previous

sensitivity reaction to penicillin
or other cephalosporins.
Assess patient for signs and
symptoms of infection before
and during the treatment
Obtain C&S before beggining
drug therapy to identify if
correct treatment has benn
initiated.
Report signs such as
petechiae, ecchymotic areas,
epistaxis or other forms of
unexplained bleeding
Monitor hematologic,
elctrolytes, renal and hepatic
function.sf
Assess for possible
supperinfection: itching fever

Drug Name

Mechanism of

Indication

Contraindication

Adverse Effect

Action

Generic name:
Ciprofloxacin
Brand name:
Quinosyn
Classification:
Antibacterial
Dosage:

Inhibition of
topoisomerase
(DNA gyrase)
enzymes, which
inhibits relaxation
of supercoiled
DNA and
promotes
breakage of
double stranded
DNA

500mg
Frequency:
BID
Route:
Per Orem

Ciprofloxacin is
used to treat
infections of the
skin, lungs,
airways, bones, and
joints caused by
suspectible
bacteria.
Ciprofloxacin is also
frequntly used to
treat urinary
infections caused
by bacteria such as
E. coli
Ciprofloxacin is
effective in treating
infectious diarrheas
caused by E.coli,
Campylobacter and
jejuni

Ciprofloxacin is
contraindicated
in persons with
a history of
hypersensitivity
tociproflaxin,
any member of
the quinolone
class of
antimicrobial
agents, or any
of the product
components.
Coadministratio
n of
ciprofloxacin
with other drugs
primarily
metabolized by
CYP1A2 results
in increased
plasma
concentrations
of these drugs
and could lead

Nausea
Vomiting
Stomach pain
Heartbur
Diarrhea
Feeling
anurgent need
to urinate
Headache
Hives
Difficulty
breathing or
swallowing
Hoarseness or
throating
tightness
Rapid, irregular
or pounding
heartbeat
Fainting
Fever
Joint or musle pain
Unusual
bruising or
bleeding
Extreme
tiredness

Nursing
Responsibilities

C- Antibacterial

Instuct patient not to

take ciprofloxacin with
dairy products such
as milk or yogurt, or
with calcium- fortified
juice. He may eat or
drink dairy products
or calcium- fortified
juice with a regular
meal, but do not use
them alone when
taking ciprofloxacin.
They could make the
medication less
effective.

Tell patient that

ciprofloxacin can
cause side effects
that may impairs his
thinking or reactions.

Tell patient that

ciprofoxacin can
cause side effects

H- Prevention or
treatment of
onfection; signs
and symptoms of
infection like fever
an pain are
reduced
E- twice a day
exactly at 6am and
12 noon; Make
sure to drink plenty
of water or other
fluids everyday
whike taking
Xiprofloxacine; Do
not take or eat a
lot of caffeine
produts such as
coffee, tea, energy
drinks, cola or
chocolate within 6
hourd before or 2
hours after you

Nursing
Implication

to clinically
significant
adverse events
of the
coadministered
drug
Contraindicated
for the
treatment of
certain sexuall
transmitted
diseases by
some experts
due to bacterial
resistance

Lack of energy
of appetite
Seizures
Dizziness
Confusion
Nervousness
Restlessness
Anxiety
Difficulty falling
asleeo or
staying asleep
Pain in the
upper right part
of the stomach
Yellowing of the
skin or eyes
Dark urine

take ciprofloxacin
C- Instruct client to
report any adverse
reaction to the
physician or nurse.
Tell patient that
antacids and
mineral
supplements may
decrease the
absorption of
ciprofloxaxin which
makes it less
effective when
taken at the same
time
K- Do not take the
medication in
larger amounts, or
take it for longer
than
recommended by
your doctor.

that may impair his

thinking or reactions.
Tell patient to be
careful if he plans to
be careful if he plans
to drive or do
anything that requires
him to be awake and
alert.

Instruct the patient to

take ciprofloxacin with
a full glass of water (8
ounces).

Drug Name

Generic name:
Omeprazole
Brand name:
Prilosec
Drug classification:
Proton pump inhibitor
(PPI)

Indication

Mechanism of
Action

Contraindication

Adverse Effect

Short-term treatment of
active duodenal ulcer;
First- line therapy in
treatment of heartburn or
symptoms of gastro
esophageal reflux disease
( GERD ); Short term
treatment of benign
gastric ulber; GERD,
severe esophagitis, poorly
responsove symptomatic
GERD;

Gastric acid-pump
inhibitor: Suppresses
gastric acid secretion
by specific inhibition
of the hydrogenpotassium ATPase
enzyme system at tje
secretory surface of
the gastric parietal
cells; blocks the final
step of acid
production

Contraindicated with
hypersensitivity to
omeprazole or its
components; Use
cautiously with
pregnancy lactation

CNS:Headache, dizziness,
asthenia, vertigo, insomnia,
apathy, anxiety, paresthesias,
dream abnormalities

C: Antisecretory drug; Proton

pump inhibitor

Dermatologic:Rash,
inflammation, urticaria,
pruritus, alopecia, dry skin

E:decrease gastric acid

secretion

Long term therapy:

Treatment of pathologix
hypersecretory conditions
(Zollinger - Ellisons
symdrome, multiple
adenomas, systemic
mastocytosis);

GI: Diearrhea, abdominal

pain, nausea, vomiting,
constipation, dry mouth,
tongue atrophy
Respiratory:
URI symptoms, cough,
epistxis

Nursing Consideration

H: IVTT

C: take the drug before meals.

Report severe headache,
worsening of symptoms, fever,
chills
K: Swallow the capsules whole;
do not hew, open, or crush them

Drug Name

Generic name:
Paracetamol,
Acetaminophen
Brand name:
Biogesic, Panadol,
Tylenol
Classification:
Non-narcotic
analgesic, Antipyretic
Dosage:
Per Orem: 325650mg q4h up to a
maximum of 1 gram
q6h. Suppositories:
650mg q4h not
exceed 4grams a day
for up to 10days

Mechanism of Action

Decreases fever by a
hypothalamic effect
leading to sweating and
vasodilation
Inhibits pyrogen effect on
the hypothalamic-heatregulating centers
Inhibits CNS
prostaglandin synthesis
with minimal effects on
peripjeral prostaglandin
synthesis
Does not cause ulceration
of the GI tract and causes
no anticoagulant action.

Indication

Control of pain due

to headache,
earache,
dysmenorrhea,
arthralgia, myalgia,
musculoskeletal
pain, athritis,
imuunizations,
teething,
tonsillectomy
Reduce fever in viral
and bacterial
infections

As a substitute for
aspirin in upper GI
disease, bleeding
disorders clients in
anticoagulant
therapy and gouty
athrotis

Contraindication

Adverse Effect

Renal Insufficiency

Minimal GI upset

Anemia

Methemoglobinemia

Hemolytic Anemia

Neutropenia

Thrombocytopenia

Pancytopenia

Leukopenia

Urticaria

CNS stimulation

Hypoglycemic

Coma

Jaundice

Glissitis

Drowsiness

Nursing Consideration

Do not exceed 4gm/24hr. in

adults and 75mg/kg/day in
children
Do not take for >5 days for
pain in children, 10 days for
pain in adults, or more than
3days for fever in adults
Extended- release tablets are
not to be chewed
Monitor CBC, liver and renal
functions
Assess for fecal occult blood
and nephritis
Avoid using OTC drugs with
Acetaminophen
Take with food or milk to
minimize GI upset
Report N&V cyanosis,
shortness of breath and
abdominal pain

Drug Name

Generic name:
Tramadol

Brand name:
Ultram,
Ultram ER

Mechanism of Action

Tramadol is used in the

management of
moderately severe
pain.Extended release
tablets arw used for
moderately severe
chronic pain in adults who
require continuous
treatment for an extended
period

Indication

Relief of moderate to
moderately Severe
pain

Contraindication

Contraindicated with
allergy to tramadol
or opioids or acute
in toxication with
alcohol, opioids, or
psychotropic drugs.

Use cautiously with

pregnancy, lactation,
seizures,
concomitant use of
CNS depressants or
MAOIs, renal or
hepatic impairment

Adverse Effect

Nursing
Consideration

CNS:

Assessment:

Sedation, dizziness or vertigo,

headache, confusion,
dreaming, sweating, anxiety,
seizures

History:

GI:

Physcal:

Nausea, vomiting, dry mouth,

constipation, flatulence

Skin color, texture, lesions;

orientation, reflexes, bilateral
grip strength, affect; P,
auscultation, BP; bowel
sounds, normal output; liver
and kidney function tests

Hypersensitivity to tramadol;
pregnancy; acute in toxication
with alcohol, opioids,
CV:
psychotropic drugs or other
centrally acting analgesics;
Hypotension, tachycardia,
lactation; seizures;
bradycardia
concomitant use of CNS
depressants or MOIs renal or
DERMATOLOGIC:
hepatic imapirment; past or
Sweating, pruritus, rash, pallor, present history of opioid
addiction
urticaria

OTHER:
Potential for abuse