NAME OF DRUG AMPICILLIN SULBACTAM 1.

5 gm

CLASSIFICATION Antiinfective Antibiotic Aminopenicillin

ACTION Antibiotic agent with broad spectrum of activity resulting from beta-lactamase inhibition. Sulbactam inhibits beta-lactamases most frequently responsible for transferred drug resistance. Because of this action, a wide range of beta-lactamases found in organisms resistant to penicillins and cephalosporins are inhibited.

INDICATION Treatment of infections due to susceptible organisms in skin and skin structures For intraabdominal infections For gynecologic infections For infections cause by ampicillin susceptible organisms

CONTRAINDICATION Hypersensitivity to penicillins; mononucleosis

ADVERSE EFFECTS GI: Diarrhea, nausea, vomiting, abdominal distention, candidiasis Hematologic: neutropenia, thrombocytopenia Urogenital:dysuria CNS: seizures

NURSING RESPONSIBILITIES 1. Determine hypersensitivity to this drug. 2. Monitor I&O ratio and pattern. Report dysuria,urine retention and hematuria. 3. Report chills, wheezing, pruritus, respiratory distress or palpitations to physician immediately 4. Do not breast feed while taking this drug without consulting physician.

NAME OF DRUG CLINDAMYCIN HYDROCHLORIDE

CLASSIFICATION Anti-infective Antibiotic

ACTION

INDICATION Serious infections when less toxic alternatives are inappropriate. Treatment of acne vulgaris Treatment of bacterial vaginosis in nonpregnant women

CONTRAINDICATION Contraindicated with allergy to clindamycin, history of asthma or other allergies, tartrazine (in 75- and 150-mg capsules); hepatic or renal dysfunction; lactation.

ADVERSE EFFECTS CV: Hypotension, cardiac arrest (with rapid IV infusion) GI: Severe colitis, including pseudomembranous colitis, nausea, vomiting, diarrhea, abdominal pain, esophagitis, anorexia, jaundice, liver function changes Hematologic: Neutropenia, leukopenia, agranulocytosis, eosinophilia Hypersensitivity: Rashes, urticaria to anaphylactoid reactions Local: Pain following injection, induration and sterile abscess after IM injection, thrombophlebitis after IV use

NURSING RESPONSIBILITIES 1. Culture infection before therapy. 2. Monitor BP and pulse in patients receiving this parenterally. 3.Report severe or watery diarrhea, abdominal pain, inflamed mouth or vagina, skin rash or lesions. 4.Take full prescribed course of oral drug. Do not stop taking without notifying health care provider.

Inhibits protein synthesis in susceptible bacteria, causing cell death.

Use caution with history of regional enteritis or ulcerative colitis; history of antibiotic-associated colitis.

NAME OF DRUG CLOPIDOGREL BISULFATE 75 mg tab

CLASSIFICATION

ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECTS

NURSING RESPONSIBILITIES

Adenosine diphosphate (ADP) receptor antagonist Antiplatelet Anticoagulant

Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing clumping of platelets.

Treatment of patients at risk for ischemic eventshistory of MI, ischemic stroke, peripheral artery disease Treatment of patients with acute coronary syndrome

Contraindicated with allergy to clopidogrel, active pathological bleeding such as peptic ulcer or intracranial hemorrhage, lactation. Use cautiously with bleeding disorders, recent surgery, hepatic impairment, pregnancy.

CNS: Headache, dizziness, weakness, syncope, flushing CV: Hypertension, edema Dermatologic: Rash, pruritus GI: Nausea, GI distress, constipation, diarrhea, GI bleed Other: Increased bleeding risk

1.Report promptly any unusual bleeding. 2. Avoid chronic aspirin or NSAID use unless approved by physician 3.Take daily as prescribed. May be taken with meals.

NAME OF DRUG FUROSEMIDE 40mg IV

CLASSIFICATION Loop diuretic

ACTION Inhibits the reabsorption of sodium and chloride from the ascending limb of the loop of Henle, leading to a sodium-rich diuresis.

INDICATION

CONTRAINDICATION Contraindicated with allergy to furosemide, sulfonamides; allergy to tartrazine (in oral solution); anuria, severe renal failure; hepatic coma; pregnancy; lactation.

ADVERSE EFFECTS CNS: Dizziness, vertigo, paresthesias, xanthopsia, weakness, headache, drowsiness, fatigue, blurred vision, tinnitus, irreversible hearing loss CV: Orthostatic hypotension, volume depletion, cardiac arrhythmias, thrombophlebitis Dermatologic: Photosensitivity, rash, pruritus, urticaria, purpura, exfoliative dermatitis, erythema multiforme GI: Nausea, anorexia, vomiting, oral and gastric irritation, constipation, diarrhea, acute pancreatitis, jaundice GU: Polyuria, nocturia, glycosuria, urinary bladder spasm Hematologic: Leukopenia, anemia, thrombocytopenia, fluid and electrolyte imbalances, hyperglycemia, hyperuricemia Other: Muscle cramps and muscle spasms

NURSING RESPONSIBILITIES 1. Assess allergy to furosemide 2. Closely monitor BP during periods of diuresis and through period of dosage adjustment. 3. Monitor for s/sx of hypokalemia. 4. Monitor I&O ratio and pattern. 5.ingestion of potassiumrich foods daily to reduce or prevent potassium depletion 6. Give early in the day so that increased urination will not disturb sleep. 7.Reduce dosage if given with other antihypertensives; readjust dosage gradually as BP responds.

Oral, IV: Edema associated with CHF, cirrhosis, renal disease IV: Acute pulmonary edema Oral: Hypertension

NAME OF DRUG IPRATROPIUM BROMIDE

CLASSIFICATION

ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECTS

NURSING RESPONSIBILITIES

Anticholinergic Antimuscarinic drug Parasympatholytic

Anticholinergic, chemically related to atropine, which blocks vagally mediated reflexes by antagonizing the action of acetylcholine. Causes bronchodilation and inhibits secretion from serous and seromucous glands lining the nasal mucosa.

Bronchodilator for maintenance treatment of bronchospasm associated with COPD (solution, aerosol), chronic bronchitis, and emphysema Nasal spray: Symptomatic relief of rhinorrhea associated with perennial rhinitis, common cold

Contraindicated with hypersensitivity to atropine or its derivatives, soy bean or peanut allergies (aerosol).

CNS: Nervousness, dizziness, headache, fatigue, insomnia, blurred vision GI: Nausea, GI distress, dry mouth Respiratory: Dyspnea, bronchitis, bronchospasms, URI, cough, exacerbation of symptoms, hoarseness Other: Back pain, chest pain, allergictype reactions, palpitations, rash

1.Use nebulizer mouthpiece instead of face mask to avoid blurred vision or aggravation of narrowangle glaucoma. 2.Ensure adequate hydration, control environmental temperature to prevent hyperpyrexia. 3.Have patient void before taking medication to avoid urinary retention. 4. Report rash, eye pain, difficulty voiding, palpitations, vision changes.

NAME OF DRUG PARACETAMOL 500mg

CLASSIFICATION

ACTION

INDICATION Analgesic-antipyretic in patients with aspirin allergy, hemostatic disturbances, bleeding diatheses, upper GI disease, gouty arthritis Arthritis and rheumatic disorders involving musculoskeletal pain (but lacks clinically significant antirheumatic and anti-inflammatory effects) Common cold, flu, other viral and bacterial infections with pain and fever Unlabeled use: Prophylactic for children receiving DPT vaccination to reduce incidence of fever and pain

CONTRAINDICATION Contraindicated with allergy to acetaminophen. Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation.

ADVERSE EFFECTS CNS: Headache CV: Chest pain, dyspnea, myocardial damage when doses of 58 g/day are ingested daily for several weeks or when doses of 4 g/day are ingested for 1 yr GI: Hepatic toxicity and failure, jaundice GU: Acute kidney failure, renal tubular necrosis Hematologic: Methemoglobinemia cyanosis; hemolytic anemiahematuria, anuria; neutropenia, leukopenia, pancytopenia, thrombocytopenia, hypoglycemia Hypersensitivity: Rash, fever

NURSING RESPONSIBILITIES 1. Assess allergy to acetaminophen, impaired hepatic function, chronic alcoholism, pregnancy, lactation 2.Give drug with food if GI upset occurs. 3.Avoid the use of other over-the-counter preparations. They may contain acetaminophen, and serious overdosage can occur. If you need an over-the-counter preparation, consult your health care provider. 4.Report rash, unusual bleeding or bruising, yellowing of skin or eyes, changes in voiding patterns.

Antipyretic Analgesic (nonopioid)

Antipyretic: Reduces fever by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating, which helps dissipate heat. Analgesic: Site and mechanism of action unclear.

NAME OF DRUG TRAMADOL HYDROCHLORIDE 500mg IV

CLASSIFICATION

ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECTS

NURSING RESPONSIBILITIES

Narcotic analgesic CNS agent Opiate agonist

Binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin; causes many effects similar to the opioidsdizziness, somnolence, nausea, constipationbut does not have the respiratory depressant effects..

Relief of moderate to moderately severe pain

Contraindicated with allergy to tramadol or opioids or acute intoxication with alcohol, opioids, or psychoactive drugs. Use cautiously with pregnancy, lactation, seizures, concomitant use of CNS depressants or MAOIs, renal dysfunction, or hepatic impairment.

CNS: Sedation, dizziness or vertigo, headache, confusion, dreaming, sweating, anxiety, seizures CV: Hypotension, tachycardia, bradycardia Dermatologic: Sweating, pruritus, rash, pallor, urticarial GI: Nausea, vomiting, dry mouth, constipation, flatulence Other: Potential for abuse, anaphylactoid reactions

1. Assess for level of pain relief and administer prn as needed but not to exceed the recommended total daily dose. 2.Monitor v/s and assess for orthostatic hypotension or signs of CNS depression. 3.Assess bowel and bladder function; report urinary frequency or retention. 4.Advise patient to report severe nausea, dizziness, severe constipation.

NAME OF DRUG OMEPRAZOLE 40 mg IV

CLASSIFICATION

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

INDICATION Short-term treatment of active duodenal ulcer First-line therapy in treatment of heartburn or symptoms of GERD Short-term treatment of active benign gastric ulcer GERD, severe erosive esophagitis, poorly responsive symptomatic GERD Long-term therapy: Treatment of pathologic hypersecretory conditions (ZollingerEllison syndrome, multiple adenomas, systemic mastocytosis) Eradication of Helicobacter pylori with amoxicillin or metronidazole and clarithromycin Prilosec OTC: Treatment of frequent heartburn (2 or more days per week)Unlabeled use: Posterior laryngitis; enhance efficacy of pancreatin for the treatment of steatorrhea in cystic fibrosis

CONTRAINDICATION Contraindicated with hypersensitivity to omeprazole or its components. Use cautiously with pregnancy, lactation.

ADVERSE EFFECTS CNS: Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities Dermatologic: Rash, inflammation, urticaria, pruritus, alopecia, dry skin GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy Respiratory: URI symptoms, cough, epistaxis Other: Cancer in preclinical studies, back pain, fever

NURSING RESPONSIBILITIES 1. Monitor urinalysis for hematuria or proteinuria. 2. Report any changes in urinary elimination such as pain or discomfort associated with urination, or blood in urine. 3. Report severe diarrhea; drug may need to be discontinued. 4.Take the drug before meals.

Antisecretory agent Proton pump inhibitor

NAME OF DRUG ISOSORBIDE DINITRATE 10mg

CLASSIFICATION

ACTION Relaxes vascular smooth muscle with a resultant decrease in venous return and decrease in arterial BP, which reduces left ventricular workload and decreases myocardial oxygen consumption.

INDICATION Treatment and prevention of angina pectoris

CONTRAINDICATION Contraindicated with allergy to nitrates, severe anemia, head trauma, cerebral hemorrhage, hypertrophic cardiomyopathy, narrowangle glaucoma, postdural hypotension Use cautiously with pregnancy, lactation, acute MI, CHF.

ADVERSE EFFECTS CNS: Headache, apprehension, restlessness, weakness, vertigo, dizziness, faintness CV: Tachycardia, retrosternal discomfort, palpitations, hypotension, syncope, collapse, orthostatic hypotension, angina, rebound hypertension, atrial fibrillation, postdural hypertension Dermatologic: Rash, exfoliative dermatitis, cutaneous vasodilation with flushing GI: Nausea, vomiting, incontinence of urine and feces, abdominal pain, diarrhea GU: Dysuria, impotence, urinary frequency Other: Muscle twitching, pallor, perspiration, cold sweat, arthralgia, bronchitis

NURSING RESPONSIBILITIES 1.Give sublingual preparations under the tongue or in the buccal pouch; discourage the patient from swallowing.. 2.Give oral preparations on an empty stomach, 1 hr before or 2 hr after meals; take with meals if severe, uncontrolled headache occurs. 3.Report blurred vision, persistent or severe headache, rash, more frequent or more severe angina attacks, fainting.

Antianginal Nitrate Vasodilator

NAME OF DRUG KALIUM DURULE

CLASSIFICATION Electrolytic and Water Balance Agent Replacement Solution

ACTION Principal intracellular cation,; essential for maintenance of intracellular isotonicity, transmission of nerve impulses, contraction of cardiac, skeletal and smooth muscles, maintenance of normal liver function, and for enzyme activity.

INDICATION To prevent and treat potassium deficit secondary to diuretic or corticosteroid therapy.

CONTRAINDICATION Severe renal impairment; severe hemolytic reactions; untreated Addisons disease; crush syndrome; early postoperative oliguria; acute dehydration

ADVERSE EFFECTS GI: nausea, vomiting, diarrhea, abdominal distention UROGENITAL: oliguria, anuria HEMATOLOGIC: hyperkalemia RESPIRATORY: respiratory distress CV: cardiac depression, arrhythmias, or arrest

NURSING RESPONSIBILITIES 1.Monitor I&O ratio and pattern. If oliguria occurs, stop infusion promptly and notify physician. 2. Avoid licorice: large amounts can cause both hypokalemia and sodium retention. 3.Do not use any salt substitute unless it is specifically ordered by the physician 4.Notify physician of persistent vomiting because losses of potassium can occur 5. Report continuing signs of potassium deficit to physician: weakness, fatigue, polyuria, polydipsia