Generic & Brand Name Generic: Cefuroxime

Dose, strength & formulation Ordered: CEFUROXIME 250mg IVTT q8hrs Timing: q8 hrs. Duration: immediate. Other Form:

Brand: Ceftin

Classification: Second generation cephalosporin, antibiotic

Suspension: 125mg/5ml, 250 mg/5 ml Infusion ; 750 mg, 1.5 premixed, frozen solution Injection: 750 mg, 1.5. mg Capsules; 50 mg, 100 mg, 200 mg, 400 mg:

Indication/Mechanism of Action Indication: -Serious lower respiratory tract infection, UTI, skin or skin structure infections, bone/ joint infection, septicemia meningitis and gonorrhea. -Perioperative prevention - Bacterial exacerbations of chronic bronchitis/ secondary bacterial infection of acute bronchitis -Acute bacterial maxillary sinusitis -Pharyngitis & tonsilities -Otits media -Uncomplicated skin & skin-structure infection -Uncomplicated UTI -Uncomplicated gonorrhea -Early lyme disease -Impetigo

Adverse/side effects drug Interaction Side Effects: CNS: dizziness, headache, insomnia, stroke CV: hypertension, MI, peripheral edema EENT: Pharyngitis, rhinitis, sinusitis GI: Abdominal pain, diarrhea, dyspepsia, flatulence, nausea, GI bleeding METABOLIC: Hyperchloremia, hypophosphatemia MUSCULOSKETETA L: Back pain RESPIRATORY: Upper respiratory tract infection SKIN: Erythema, multiforme, exfoliative dermatitis, rash, Stevens- Johnson syndrome, toxic epidermal necrolysis OTHER: Accidental injury INTERACTIONS Drug-drug Diuretics ; may increase risk of adverse renal reactions . Monitor

Nursing Responsibility

Rationale

Client Teaching

-Assess patients infection before therapy and regularly thereafter. -Before giving the first dose, obtain specimen for culture and sensitivity test. -Before giving first dose, ask patient about previous reactions to cephalosporin and penicillin. -Be alert for adverse reaction and drug interaction.

-To monitor drugs effectiveness.

Advise patient to take oral suspension with food to enhance absorption. Tell patient to report adverse reactions. Instruct patient to take drug exactly as prescribed, even he feels better after Stress the importance of taking the drug.

-To ensure right drug.

-to avoid cross sensitivity with other betalactamantibiotics

Maintain all of the usual activities and restrictions that apply to your condition

MECHANISM OF ACTION; Chemical effect: May selectively inhibit COX 2 decreasing prostaglandin synthesis Therapeutic effect; Relieves pain &

-To establish proper precautionary measures and management for possible adverse effects of the drug. -To prevent dehydration .

-If GI reactions occur,monitor patients hydration.

inflammation in joints and smooth muscle tissue.

renal function closely. Probenecid: may inhibit excretion & increase level of cefuroxime. Sometimes used for this effect. Drug-food: Any food: May increase drug adsorption & bioavailability of suspension. Give suspension with food. Tablets may begin without regard to food. -Before giving dose, obtain specimen for culture & sensitivity tests. Begin therapy pending test results. -Before giving the first dose, ask the pt. about previous reactions to.

DRUG STUDY Generic & Brand Name Generic: Ranitidine Brand: Zantac Classification: Pharmacologic class: H2 receptor antagonist Therapeutic class: Antiulcerative Timing: q8 Duration: 50 mg slow IVTT -Intractable duodenal ulcer; pathologic hypersecretory conditions, -Duodenal and gastric ulcer -Maintenance therapy for duodenal ulcer -Gastroesophageal -Reflux disease -Erosive esophagitis -Self-medication for occasional heartburn, -acid indigestion and sour stomach Mechanism of action: Inhibits the action of the histamine at H2 receptor site located primarily in gastric parietal cells, in resulting in inhibition of gastric acid secretion. CNS: Light headedness, dizziness, insomnia, confusion, irritability,psychosis, ataxia, depression, hallucination. -CV: CHF, orthostatic hypotension, dyspnea. -GI: Nausea,anorexia, constipation, dry mouth. -GU: Urinary retention -assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis or gastric aspirate. -Assess pt.s. GI condition before starting therapy and Regularly thereafter to monitor drugs effectiveness . *Be alert for adverse reactions and drug inter action. *asses patients and familys knowledge of drug therapy. -Do not discontinue abruptly when treating parkinsonism syndrome, parkinsonian crisis may occur. -to take an early actions of signs of internalbleeding. -inform patient that drug can cause drowsiness and dizziness. Dose, strength & formulation Ordered: Indication/Mechanism of Action Indications: Adverse/side effects drug Interaction Adverse reaction: Nursing Responsibility Assessment: Rationale Client Teaching

-instruct to report any adverse reaction occurs. -to monitor the drug effectiveness. -encourage patient to increase oral fluid intake and fibers to prevent or minimize constipation. -to establish proper precautionary measures and management for possible adverse effects of the drug. - To check the patient and the Familys level of understanding about the drug. -inform patient that this medication can cause temporary grey black color of tongue and stool. -encourage patient to have a regular check up.

ther forms: O 12.5 mg TIV q 12 hrs

-it might cause other complications.

DRUG STUDY Generic & Brand Name Generic: Bisacodyl Dulcolax rectal suppository 10 mg adult, 2 suppositories per rectum Timing: HS(8pm) Duration: Other forms: Enema: 10mg/30 ml Tablet(delayedrelease): 10 mg Tablets(entericcoated Chronic constipation, preparation for surgery/rectal/bowel examination Mechanism of action: . Bisacodyl works by stimulating enteric nerves to cause colonic mass movements. It is also a contact laxative; it increases fluid and NaCl secretion (lippicott & wilkins 2009 Ed. ;213) Bloating; faintness; nausea; rectal irritation; stomach fullness, cramps, or discomfort; vomiting. -Auscultate bowel sounds at least once per shift. -.Obtain history of bowel disorder, GI status, fluid intake, nutritional status, exercise habits & normal patterns of eliminations. -Be alert for adverse reactions and drug inter action -.By checking frequency & characteristic of stools. -Check for pain and cramping and to know the condition of the patient >.Advise patient to swallow enteric-coated tablet whole to avoid GI irritation. >Advise patient to report adverse effects to prescriber. >Warn patient against excessive use of drugs. >Teach patient about dietary sources of fiber, including bran and other cereals use of drugs.. >teach patient the proper storage of the medication. Dose, strength & formulation Ordered:] Indication/Mechanis m of Action Indications: Adverse/side effects drug Interaction Adverse reaction: Nursing Responsibility Assessment: Rationale Client Teaching

Brand: dulcolax Classification: Stimulant laxative

Drug interactions: . May cause gastric irritation or dyspnea from premature dissolution of enteric coating. avoid use together

-Assess for baseline data

-to establish proper precautionary measures and management for possible adverse effects of the drug. --to indicate baseline data and monitor drugs effectiveness. -To prepare the patient for any side effect.

DRUG STUDY

GENERIC/BRA ND NAME & CLASSIFICATI ON

DOSE, STRENGTH & FORMULATIO N

INDICATION/ MECHANISM OF DRUG ACTION

ADVERSE/SIDE EFFECTS DRUG INTERACTION

NURSING RESPONSIBILITIES

RATIONALE

CLIENT TEACHING

Generic: Ketorolac Tromethamine

Ordered:

Indications: >Short-term management of pain

Adverse/Side Effects: CNS:dizziness, drowsiness, headache,

Assessment: 1. Assess patients pain before and after drug therapy. -To monitor drugs effectiveness.

*Teach patient to recognize and immediately report signs and symptoms of GI bleeding. *Advise patient to report persistent or worsening pain.

Timing: Brand: Duration: 6-8 hours Available Forms: Classification:

insomnia, Mechanism of Action: *May inhibit prostaglandin synthesis *Relieves pain and inflammation CV:edema, hypertension, palpitations EENT:transient stinging and burning GI:diarrhea, dyspepsia, GI pain, nausea GU:hematuria, polyuria, renal failure Hematologic: anemia, eosinophilia, purpura

2. Be alert for adverse reactions and drug interactions. Planning & Implementation: 3. Drug may cause peptic ulcers, GI bleeding, or perforation of the stomach and intestine. 4. List all the medication the patient is taking. 5. Apply pressure to injection site for 15-30 seconds after injection.

-To avoid severe adverse effects.

*Explain that drug is intended only for short term use. *Take drug as prescribed by the physician. *Tell patient not to exceed to the prescribed amount.

-Monitor patient closely.

Injection:15 mg/ml,30 mg/ml Opthalmic Solution:0.4% , 0.5% Tablets:10 mg

-To prevent drug interaction. -To minimize local effects.

NSAID Analgesi cs, antiinflamm atory

Skin:sweating Other:pain at injection site.

Drug Interaction: Drug-Drug. Antihypertensive, diuretics:May decrease effectiveness of these drugs. Monitor reactions closely. Lithium:May increase lithium level. Warfarin:May increase levels of free salicylates or warfarin in blood. Methotrexate: May decrease methotrexate clearance and increase toxicity.