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Generic

Name

Classific
ation

Mechanis
m of
Action

Dose

Indicati
on

29

Contraindic
ation

Side
Effects

Nursing Responsibilities

Paraceta
mol
Brand
Name:
Biogesic

Non
Opiod
Analgesic
Antipyret
ic

Produce
analgesia
by blocking
pain
impulses
by
inhibiting
prostagland
in synthesis
in the CNS
or of other
substances
that
sensitize
pain
receptors
to
stimulation.
The
drug
may relief
fever
through
central
action
in
the
hypothala
mic
heat
regulating
center.

Ordered:
1
tablet
500mg
PO
for
temperatu
re
> 38C

Relief of Contraindicat
fever,
ed in patient
minor
hypersensitivi
aches
ty to drug
and
pains
Use
cautiously in
patients with
long
term
alcohol
use
because
therapeutic
doses
can
cause
hepatoxicity

Hematologic
:
Hemolytic
anemia,
leukopenia,
neutropenia,
Hepatic:
Jaundice
Metabolic:
Hypoglycemi
a
Skin:
rash

Observe 12 Rights in giving

medications
Assess

DRUG STUDY

30

patients
temperature
before
therapy
and
regularly
thereafter
Take with food or milk to
minimize GI upset.
Advise to increase oral
fluid intake.
Report
nausea
and
vomiting
cyanosis,
shortness of breath and
abdominal pain as these
are signs of toxicity.
Report paleness, weakness
and heart beat skip
Report pain that persists
for more than 3-5 days
Avoid alcohol
Warn patients that high
doses or unsupervised long
term use can cause liver
damage

Generic
Name

Classifica
tion

Mechanism of
Action

Dose

Indicatio
n

Contraindi
cation

Side
Effects

Tranexa
mic Acid

Antifibrinolytic

Tranexamic
acid
is
a
synthetic
derivative
of
the amino acid
lysine. It exerts
its
antifibrinolytic
effect through
the
reversible
blockade
of
lysine-binding
sites
on
plasminogen
molecules. The
plasminogenplasmin
enzyme system
is
known
to
cause
coagulation
defects through
lytic activity on
fibrinogen,
fibrin and other
clotting factors.
By
inhibiting
the action of
plasmin
(finronolysin)
the
antifibrinolytic
agents reduce
excessive
breakdown
of
fibrin and effect

Ordered:
6/24/14
11pm
Tranexami
c
acid
500mg
IVTT NOW

Tranexami
c acid is
used
for
the
prompt
and
effective
control of
hemorrhag
e like
epistaxis,
hemoptysi
s,
hematuria,
peptic
ulcer with
hemorrhag
e
and
blood
dyscrasias
with
hemorrhag
e

Contraindica
ted
in
patient
hypersensiti
vity to drug

GI
disorders:
nausea,
vomiting

Brand
Name:
Hemosta
n

Anti
hemorrhag
ic

Presence of
blood clots
(eg, in the
leg,
lung,
eye, brain),
have
a
history
of
blood clots,
or are at
risk
for
blood clots
Not
recommend
ed
for
prophylaxis
during
pregnancy
and before
delivery.
Not
recommend
ed
for
lactating
mothers

31

CNS:
anorexia,
headache
may
appear,
impaired
renal
insufficienc
y,
hypotensio
n when IV
injection is
too rapid

Nursing Responsibilities
Observe

12 Rights in
giving medications
Watch out for any signs of
bleeding
Inform the client that
he/she should inform the
physician immediately if
the following severe side
effects occur:
such as rash, hives,
itching,
dyspnea,
tightness in the chest,
swelling of the mouth,
face, lips or tongue

physiological
hemostasis.

32

Generic
Name

Classifica
tion

Mechanism of
Action

Dose

Indication

Contraindi
cation

Ceftriaxo
ne

Antiinfective
(Cephalos
porin)

Inhibits
bacterial
cell
wall synthesis,
rendering
cell
wall osmotically
unstable,
leading to cell
death.

Ordered:
Ceftriaxon
e 1 gram
ANST
every
8
hours
6/2227/14
Then
shifted

Treatment
of
susceptible
infections
including
chancroid,
gastroenter
itis,lyme
disease,
meningitis,
syphilis,
typhoid
fever,
Whipples
disease.
Treatment
of
LRTI,
skin
and
soft tissue
infections,
UTI,
uncomplica
ted
gonorrhea,
pelvic
inflammato
ry disease,
bacterial
septicemia,
intraabdominal
infections,
meningitis

Contraindica
ted
in
patient
hypersensiti
vity to drug

Brand
Name:
Keptrix

33

Side
Effects

INTEGUMEN
TARY :
exanthema,
allergic
dermatitis,
pruritus,
Hypersensiti urticaria,
ve
to edema,
cephalospor erythema
ins
and
penicillins,
HEMATOLOG
lidocaine or Y:
any
other eosinophilia,
local
leukopenia,
anesthetic
hemolytic
product
of anemia,
the
amide thrombocyt
type.
openia
Neonates
and
premature
infants with
billirubin
encephalop
athy

CNS:
headache,
dizziness
REPRODUCT
IVE
vaginitis
GI:
diarrhea,
nausea,
vomiting,
stomatitis,
glossitis

Nursing Responsibilities
Observe 12 Rights in
giving medications
Assess patient for sign
and
symptoms
of
infection
before
and
during treatment: fever,
earache, characteristics
of
wounds,
sputum,
urine, stool and WBC
>10,000/mm
Obtain
C&S
before
beginning drug therapy
to identify if correct
treatment
has
been
initiated.
Assess renal function
before
and
during
therapy: urine output,
BUN
and
creatinine.
Monitor
for
nephrotoxicity.
Assess
for
possible
superinfection: perineal
itching, fever, malaise,
redness, pain, swelling,
drainage, rash, diarrhea
and change in cough or
sputum. Severe diarrhea
may
indicate
pseudomembranous
colitis.

Generic
Name

Classifica
tion

Hexetidin Oral
e
antiseptic
Brand
Name:
Bactidol

Mechanism of
Action
Protection
against
oral
bacterial
and
fungal infection
to
give
fast
relief from sore
throat
and
mouth
ulcers.
First,
bactidol
quickly reduces
bacteria in the
affected areas
to help relieve
and
prevent
soreness, then
hexetidine
adheres
to
affected areas
for
extended
period of time,
giving
long
lasting
protection.

Dose
Ordered:
Bactidol
gargle
TID
6/23/14

Indication

Contraindi
cation

Minor sore
throat;
halitosis,
general
oral
hygiene,

Lesions and No available


ulcerations
data
of
oral/buccal
mucosa

Improves
appearance
of
mouth
tissue,
protects
tooth
surfaces
against
formation
of
decay
acids

34

Side
Effects

Nursing Responsibilities
Observe 12 Rights in
giving medications
Instruct patient to gargle
30cc or mouthful
should be held in the
mouth,
swished
and
gargled for 30sec in the
morning, afternoon and
evening.
Use
full
strength.
Instruct patient not to
swallow the medication.
Caution the patient that
the solution may be too
harsh to taste.
Assess for any lesions in
the mouth of the patient.

Generic
Name

Classifica
tion

Mechanism of
Action

Dose

Indication

Contraindic
ation

Side
Effects

Ranitidin
e
Hydrochl
oride

Anti-ulcer

Inhibits
the
action
of
histamine
at
theH2 receptor
site
located
primarily
in
gastric parietal
cells, resulting
inhibition
of
gastric
acid
secretion
and
has
some
antibacterial
action against
H. pylori

Ordered:
Ranitidine
(Ulcin)
150mg 1
tablet PO
BID

Treatment
and
prevention
of
heartburn,
acid
indigestion,
and
sour
stomach

Contraindicat
ed in patient
hypersensitiv
ity to drug

Headache,
dizziness.
Rarely
hepatitis,
thrombocyt
openia,
leukopenia,
hypersensit
ivity,
confusion,
gynecomas
tia,
impotence,
somnolenc
e, vertigo,
hallucinatio
n
Anaphylaxi
s,
hypersensit
ivity
reactions

Brand
Name:
Ulcin

Prophylaxis
of
GI
hemorrhag
e
from
stress
ulceration
Short-term
treatment
of GERD

Nursing Responsibilities
Observe

35

12 Rights in
giving medications
Instruct patient not to
take new medication
without
consulting
physician
Allow 1 hour between
any other antacid
Avoid excessive alcohol
Assess
patient
for
epigastric or abdominal
pain and frank or occult
blood in the stool and
emesis
Inform patient that it
may cause drowsiness or
dizziness
Inform
patient
that
increased fluid and fiber
intake may minimize
constipation
Advise patient to report
onset of black, tarry
stools; fever, sore throat;
diarrhea; dizziness; rash;
confusion;
or
hallucinations to health
care
professional
promptly
Inform
patient
that
medication
may
temporarily cause stools
and tongue to appear
grayish black
Instruct
patients
to

monitor for and report


occurrence
of
druginduced
adverse
reaction

Generic
Name

Classifica
tion

Mechanism of
Action

Dose

Indication

36

Contraindic
ation

Side
Effects

Nursing Responsibilities

Before:
Celecoxi
b
Brand
Name:
Celebrex

Pharmacol
ogic class:
Nonsteroid
alcyclooxy
genase2(COX-2)
inhibitor,
antiinflammat
ory
drug
(NSAID)
Therapeuti
c class:
Antirheum
atic

Exhibits
antiinflammatory,
analgesic, and
anti
pyretic
action due to
inhibition of the
enzymeCOX-2

Ordered:
Celecoxib
200mg 1
capsule
for
headache
every 12
hours
6/27/14
2:45AM

Acute and
long-term
treatment
of
signs
and
symptoms
of
rheumatoid
arthritis
and
osteoarthrit
is
Reduction
of
the
number of
colorectal
polyps
in
familial
adenomato
us
polyposis
(FAP)
Manageme
nt of acute
pain
Treatment
of primary
dysmenorr
hea

Hypersensiti
vity to drug,
sulfonamides
,
or
other
NSAIDs

CNS:
dizziness,
drowsiness,
headache,
insomnia,
fatigue

Advanced
renal disease

Pregnancy
Breastfeedin
g

GI:

nausea,
diarrhea,
constipatio
n,
abdominal
pain,

dyspepsia,
flatulence,
dry mouth,
GI bleeding
GU:
Menorrhagi
a
Hematologi
c:
Decreased
hemoglobin
or
hematocrit

37

Severe
hepatic
impairment
History
asthma
urticaria

EENT:
ophthalmic
effects,
tinnitus,
of pharyngitis,
or rhinitis,
sinusitis

Observe

12 Rights in
giving medications
Assess patients history
of allergic reaction to the
drug
Monitor complete blood
count, electrolyte levels,
creatinine
clearance,
and occult fecal blood
test and liver function
test results every 6 to
12months
During:
Instruct patient to take
drug with food or milk
Teach patient to avoid
aspirin and other NSAIDs
(such as ibuprofen and
naproxen)
during
therapy
After:
Advise
patient
to
immediately
report
bloody stools, blood in
vomit,
or
signs
or
symptoms
of
liver
damage
(nausea,
fatigue,
lethargy,
pruritus, jaundice

Generic
Name
Metoclopr
amide
Brand
Name:
Plasil

Classifica
tion
Antiemetic

Mechanis
m of
Action

Dose

Indication

Contraindica
tion

Adverse
Effects

It
blocks
dopamine
receptors
and makes
the GI cells
more
sensitive to
acetylcholi
ne, leading
to
increased
GI activity
and
rapid
movement
of
food
through the
upper
GI
tract

Ordered:
Metoclopra
mide
(Plasil)
1
ampule
now
6/26/14

Treatment of
nausea and
vomiting of
a variety of
etiologies
like
gastric
ulcer,
anorexia
nervosa,
hyperemesi
s
gravidarum

Contraindicat
ed
to
hypersensitiv
e to drug,
possible
obstruction or
hemorrhage,
history
of
seizure
disorders,
pheochromoc
ytoma,
Parkinsons
disease

CNS:
restlessness
,
drowsiness,
fatigue,
insomnia,
extrapyrami
dalreactions
,
parkinsonis
m-like
reactions,
akathisia,
dystonia,
myoclonus,
dizziness,
anxiety

Observe

CV:
Transient
hypertensio
n

Prevention
of
chemothera Precaution
py induced Previously
emesis
detected
breast cancer,
Facilitation
lactation,
of
small pregnancy,
bowel
fluid overload,
intubations
renal
in
impairment
radiographic
procedures
38

GI:
Nausea,
diarrhea

Nursing
Responsibilities

12 Rights in
giving medications
Before:
Keep diphenhydramine
injection
readily
available
in
case
extrapyramidal
reactions
Have
phentolamine
readily available in case
of hypertensive crisis.
During:
- Monitor BP carefully
during IV administration
Monitor
for
extrapyramidal
reactions, and consult
physician if they occur
Monitor
diabetic
patients
Give direct IV doses
slowly over 1-2minutes
After:
Educate patient about
side
effects
like
involuntary movement
of the face, eyes, or
limbs,
severe

depression,
severe
diarrhea
Instruct
to
avoid
alcohol and other CNS
depressants
Do
proper
documentation

Treatment
and
prevention
of
postoperativ
e
nausea
and
vomiting
when
nasogastric
suctioning is
undesirable

Generic
Name

Classifica
tion

Mechanis
m of
Action

Dose

Indication

39

Contraindica
tion

Side
Effects

Nursing
Responsibilities

Methisopr
inosine
Brand
Name:
Isoprinosi
ne

Immunom
odulator
and
Antiviral

Has a double
mode of action
that enables a
fast
and
vigorous
immune
system
response
at
the same time
that it prevents
viral
replication,
quickly
resulting in the
disappearance
of
clinical
symptoms

Ordered:
Methisoprin
osine
(Isoprinosin
e)
500mg
1
tablet TID
PO
6/23/14

Viral
Infection
like
rhinovirus,
herpes
genitalis,
measles,
encephalitis,
influenza,
herpes
zoster,
herpes
simplex,
type A & B
hepatitis,
AIDS related
complex,
neoplastic
diseases

40

Contraindicat
ed in patients
hypersensitiv
e to drug
First trimester of
pregnancy
Unused
Isoprinosine
is
converted by the
body to uric acid
which may be
hazardous
to
people at risk for
gout

Dizziness,
problems with
digestion and
itchiness

Observe

12 Rights in
giving medications
Store medicine away
from heat and direct
light

Monitor serum uric acid


levels for patients who have
gout, kidney disease, or
kidney stones
Inform patient that the drug
must be taken 1 hour apart on
an empty stomach

Generic
Name
Cefixime
Brand
Name:
Triocef

Classific
ation

Mechanis
m of
Action

Dose

Indication

Contraindica
tion

Side Effects

Nursing
Responsibilities

Antibacte
rial
(Cephalo
sporins)

The
bactericidal
action
of
cefixime
is
due to the
inhibition of
cell
wall
synthesis. It
binds to one
of
the penicillin
binding
proteins(PBP
s)
which
inhibits
the
final
transpeptidati
on step of the
peptidoglycan
synthesis in
the bacterial
cell wall, thus
inhibiting
biosynthesis
and arresting
cell
wall
assembly
resulting
in
bacterial cell
death

Ordere
d:
Cefixim
e
200mg/
capsule
TID PO
6/27/14

Uncomplicated
urinary
tract
infections
caused
by
Escherichia
coli
and
Proteus
Mirabilis

Contraindicat
ed to patients
with a history
of
hypersensitivi
ty to
penicillins or
other
cephalosporin
Otitis
media s
caused
by
Haemophilus
Anaphylactic/
influenza,
anaphylactic
reactions
Pharyngitis
(including
and tonsillitis shock
and
caused by S. fatalities)
pyogenes,
have
been
reported with
Lower
the use of
respiratory
cefixime
tract infections
caused by
haemophilus
influenzae

Hypersensiti
vity
Reactions:
skin rashes,
urticaria,
fever,
pruritus,
angioedema,
facial edema

Observe 12 Rights in giving


medications
Instruct patient that drug can
be taken by mouth with or
without food. If stomach upset
occurs, take with food to
reduce stomach irritation
To clear up your infection
completely, continue using
Cefixime for the full course of
treatment even if you feel
better in a few days
Store away from heat,

Uncomplicated
gonorrhea
Typhoid fever

41

GI: Diarrhea,
loose
or
frequent
stools,
abdominal
pain,
anorexia,
flatulence,
dry mouth,
dyspepsia,
nausea, and
vomiting

moisture, and light.