Digoxin(Lanoxin) papertab (0.

07 mg/papertab) one papertab q12H PO

C: cardiac Glycoside

A: Digoxin increases the strength and vigor of heart contractions by inhibiting the
activity of an enzyme (ATPase) that controls movement
of calcium,sodium and potassium into heart muscle. It is also used to slow the heart
rate in patients with chronic atrial fibrillation, a heart rhythm disorder of the atria by
slowing the rate of depolarization.

I: congestive heart failure and for treating an abnormal heart rhythm called atrial
fibrillation.

Preparation: Tablets: 0.125, and 0.25 mg; Elixir: 0.05, 0.25, and 0.1 mg/ml.

Adverse effects: headache, weakness, drowsiness and vision changes, bradycardia,

anorexia. GI upset.

Contraindications and caution:

• Allergy, ventricular tachycardia, fibrillation, idiopathic hypertrophic subaortic

stenosis, electrolyte abnormalities

• Caution in pregnancy and lactation

NC:

 Consult with the prescriber about the need for a loading dose when beginning
therapy.

 Check the dosage and preparation carefully because it has a small margin of
safety

 Check pediatric dose with extreme care

 Follow dilution instructions carefully for intravenous route

 Monitor apical pulse for 1 full minute before administering the drug. Hold if
pulse is less than 60 in adults or less than 90 in infants; retake the pulse in
one hour.

 Administer IV doses very slowly over at least 5 minutes. Avoid IM because it

could be quite painful.

 Avoid administering the oral drug with food or antacids to avoid delay in
absorption.

 Monitor the patient for therapeutic digoxin level 0.5-2 ng/ml

  Severe toxicity with digoxin is treated with digoxin immune fab(Digibind)

 Avoid hypokalemia. Hypokalemia makes the heart muscle more sensitive to

digitalis.

COTRIMOXAZOLE (TMP-SMZ) 1 tbsp TID

C: SULFONAMIDE ANTIBIOTIC

A:bacteriostatic; antagonizes para amino bezoic acid(PABA) to prevent the

synthesis of folic acid in susceptible bacteria that synthesize their own folates for
the production of RNA and DNA. Once the rate of bacterial multiplication is slowed,
the body’s own defense mechanism can be able to get rid of the invading
microorganism.

I: urinary tract infections, respiratory tract infections, middle ear infections, for
prevention of infections due to pneumococcus in transplant recipients, for the
treatment or prevention of Pneumocystis carinii pneumonia, chancroid, and
prevention of toxoplasma encephalitis in patients with AIDS.

SE: upset stomach, vomiting, loss of appetite

AR: Skin: hypersensitivity, stevens-johnson syndrome, urticarial, photosensitivity

GI: anorexia, vomiting, abdominal pain, nausea, diarrhea, stomatitis

Hema: Agranulocytosis, thrombocytopenia, aplastic anemia, leukopenia(related

to bone marrow

Suppression)
 Renal: crystalluria, hematuria, proteinuria(related to filtration of the drug in the
glomerulus)

CNS: headache, dizziness, vertigo, ataxia, convulsion, seizures and

depression(possibly related to the drug’s effects on the nerves)

SUMAPEN(Ampicillin) capsule 500 mg/cap, PO BID

C: Beta-Lactam Antibiotic Drug (Aminopenicillins)

A:bactericidal; acts as a competitive inhibitor of the enzyme transpeptidase, which is needed by

bacteria to make their cell walls. It inhibits bacterial cell wall synthesis, thus exposing the
osmotically less stable membrane. This cause lysis of the bacterial cell wall.

I: treatment of infections caused by supsceptible strains of Shigella, Salmonella, S.

typhosa, Escherichia coli, Haemophilus influenzae, preoteus mirabalis, Neisseria
Gonorrhoeae, enterococci, gram-positive organisms (penicilin G-sensitive
staphylococci, pneumococci)

Meningitis caused by Neisseria meningitides

CI: Allergy to penicillins, cephalosporins, or other allergens.

Use cautiously with renal disorders.

SE: Inflammation and redness of the tongue; irritation of mouth or throat; mild diarrhea; nausea;
second infection; vomiting.
AR: ash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or
tongue, bloody stools; severe diarrhea; stomach pain/cramps; vaginal irritation or discharge.

NC:

• Assess history for allergies to penicillins, or other allergens; renal disorders;

lactation

• Physical: culture infected area;skin color or lesion; R, adventitious

sounds;bowel sounds, CBC, LFTs, renal function tests, serum electrolytes,
Hct, urinalysis

• Check IV site carefully for signs of thrombosis or drug reaction.

• Do not give IM injections in the same site, atrophy can occur. Monitor
injection sites.

• Administer oral drug on an empty stomach 1 hr or 2hr after meals with a full
glass of water; do not give fruit juice or drinks.