GENERIC NAME: RANITIDINE

BRAND NAME: Raxide

CLASSIFICATION: Therapeutic: Anti-ulcer agents; Pharmacologic: Histamine H2-receptor antagonists
DOSAGE:
MECHANISM OF ACTION
Chemical effect: competitively inhibits action of H2 at receptor sites of parietal cells, decreasing gastric acid secretion.
Therapeutic effect: Relieves GI discomfort.
INDICATION: Treatment and prevention of heartburn, acid indigestion, and sour stomach.
CONTRAINDICATIONS
• Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be avoided in patients with known intolerance.
• Use Cautiously in: Renal impairment
• Geriatric patients (more susceptible to adverse CNS reactions)

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SIDE EFFECTS/ ADVERSE EFFECTS
• CNS: Confusion, dizziness, drowsiness, hallucinations, headache
• CV: Arrhythmias
• GI: Altered taste, black tongue, constipation, dark stools, diarrhea, drug-induced hepatitis, nausea
• GU: Decreased sperm count, impotence
• ENDO: Gynecomastia
• HEMAT: Agranulocytosis, Aplastic Anemia, neutropenia, thrombocytopenia
• LOCAL: Pain at IM site
• MISC: Hypersensitivity reactions, vasculitis
NURSING RESPONSIBILITIES
 Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate.
 Nurse should know that it may cause false-positive results for urine protein; test with sulfosalicylic acid.
 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 gray black.
 Urge patient not to smoke cigarettes; smoking may increase gastric acid secretion and worsen disease.
 GENERIC NAME: METRONIDAZOLE
BRAND NAME: Flagyl
CLASSIFICATION: Anti-infectives, Anti-protozoals
DOSAGE:
ACTION:
• Disrupts DNA and protein synthesis in susceptible organisms
• Bactericidal, or amebicidal action
INDICATION / USES:
•Amebicide in the management of amebic dysentery
COMMON ADVERSE EFFECTS:

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•CNS: seizures, dizziness, headache
• GI: abdominal pain, anorexia, nausea, diarrhea, dry mouth, furry tongue, glossitis, unpleasant taste, vomiting
• Hematologic: leukopenia
• Skin: rashes, urticaria
CONTRA-INDICATIONS:
• hypersensitivity
NURSING CONSIDERATIONS:
• Administer with food or milk to minimize GI irritation. Tablets may be crushed for patients with difficulty swallowing.
• Instruct patient to take medication exactly as directed evenly spaced times between dose, even if feeling better. Do not skip doses or double up on missed doses.
If a dose is missed, take as soon as remembered if not almost time for next dose.
•May cause dizziness or light-headedness. Caution patient or other activities requiring alertness until response to medication is known.
• Inform patient that medication may cause an unpleasant metallic taste.
• Inform patient that medication may cause urine to turn dark.
• Advise patient to consult health care professional if no improvement in a few days or if signs and symptoms of superinfection (black furry overgrowth on tongue;
loose or foul-smelling stools develop).
 GENERIC NAME: KETOROLAC
BRAND NAME: Toradol
CLASSIFICATION: Nonsteroidal anti-inflammatory agents, nonopioid analagesics
ACTIONS: It inhibits synthesis of prostaglandins and is a peripherally acting analgesic. Ketorolac does not have any known effects on opiate receptors.
THERAPEUTIC EFFECTS: Ketorolac exhibits analgesic, antiinflammatory, and antipyretic activity.
DOSAGE:
MECHANISM OF ACTION:
- Inhibits prostaglandin synthesis, producing peripherally mediated analgesia
- Also has antipyretic and anti-inflammatory properties.

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- Therapeutic effect: Decreased pain
INDICATION: Short term management of pain (not to exceed 5 days total for all routes combined)
CONTRAINDICATIONS:
- Hypersensitivity
- Cross-sensitivity with other NSAIDs may exist Pre- or perioperative use
- Known alcohol intolerance Use cautiously in: History of GI bleeding; Renal impair-ment (dosage reduction may be required); Cardiovascular disease
SIDE EFFECTS/ ADVERSE EFFECTS:
- CNS: drowsiness, abnormal thinking, dizziness, euphoria, headache
- RESP: asthma, dyspnea
- CV: edema, pallor, vasodilation
- GI: GI Bleeding, abnormal taste, diarrhea, dry mouth, dyspepsia, GI pain, nausea
- GU: oliguria, renal toxicity, urinary frequency
- DERM: pruritis, purpura, sweating, urticaria
- HEMAT: prolonged bleeding time
- LOCAL: injection site pain
- NEURO: paresthesia
- MISC: allergic reaction, anaphylaxis
NURSING IMPLICATIONS/RESPONSIBILITIES:
- Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and
urticaria.
- Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration.
- Ketorolac therapy should always be given initially by the IM or IV route. Oral therapy should be used only as a continuation of parenteral therapy.
- Caution patient to avoid concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional.
- Advise patient to consult if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndromes (chills,
fever, muscles aches, pain) occur.
- Effectiveness of therapy can be demonstrated by decrease in severity of pain. Patients who do not respond to one NSAIDs may respond to another.

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 CELECOXIB
BRAND NAME: Celebrex
CLASSIFICATIONS: Therapeutic: anti-inflammatory; Pharmacologic: Cyclooxygenase-2 inhibitor
INDICATIONS:
•Acute pain and primary dysmenorrheal.
•Relief of signs and symptoms of osteoarthritis.
•Relief of signs and symptoms of rheumatoid arthritis in adults.
ACTIONS:
Chemical effect: May selectively inhibit COX-2, decreasing prostaglandin synthesis.
Therapeutic effect: Relieves pain and inflammation in joints and smooth muscle tissue.
SIDE EFFECTS/ADVERSE REACTION:

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CNS: dizziness, headache, insomnia.
CV: MI, CVA, peripheral edema, hypertension.
EENT: pharyngitis, rhinitis, sinusitis.
GI: abdominal pain, diarrhea, dyspepsia, flatulence, nausea.
Metabolic: hyperchloremia, hypophosphatemia.
Musculoskeletal: back pain.
Respiratory: upper respiratory tract infection.
Skin: rash
Other: accidental injury.
DOSAGE:
CONTRAINDICATIONS: Severe hepatic impairment; hypersensitivity to celecoxib; asthmatic patients with aspirin triad; advanced renal disease;
concurrent use of diuretics and ACE inhibitors; anemia; pregnancy in third trimester; lactation.
NURSING RESPONSIBILITIES:
 Drug must be used cautiously in patients with history of ulcers or GI bleeding, advanced renal disease, dehydration, anemia, symptomatic
liver disease, hypertension, edema, heart failure, or asthma.
 Assess patients for risk factors for GI bleeding, including corticosteroid or anticoagulant therapy, long-term NSAID therapy, smoking,
alcoholism, older age, and poor health. Patient with a history of ulcers or GI bleeding are at higher risk for GI bleeding while taking NSAIDs
such as celecoxib.
 Monitor patient for signs and symptoms of overt and occult bleeding.
 Assess patient’s CV status and history, particularly for recent surgery, MI, or CVA.
 Monitor patient for signs and symptoms of liver toxicity. Celecoxib may be hepatotoxic.
 Although drug may be given with or without food, food may decrease GI upset.
 Before therapy, rehydrate patient.

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 NSAIDs such as celecoxib can cause fluid retention. Closely monitor patient who has hypertension, edema, or heart failure while taking this
drug.
 Instruct patient to immediately report to attending physician signs of GI bleeding (such as blood vomitus, blood in urine or stool, and black,
tarry stools.
 Advise patient to immediately report presence of rash, unexplained weight gain, or edema.
 Instruct patient to take drug with food if stomach upset occurs.
 Advise patient that all NSAIDs, including celecoxib, may adversely affect the liver. Signs and symptoms of liver toxicity include nausea,
fatigue, lethargy, itching, jaundice, right upper quadrant tenderness, and flulike syndrome.
 GENERIC NAME: ESOMEPRAZOLE

BRAND NAME: Nexium

ACTION: Esomeprazole is in a class of drugs called proton pump inhibitors (PPIs) which block the production of acid by the stomach. Proton pump inhibitors are
used for the treatment of conditions such as stomach and duodenal ulcers, GERD and the Zollinger-Ellison syndrome which all are caused by stomach acid.
Esomeprazole, like other proton-pump inhibitors, blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid
is decreased, and this allows the stomach and esophagus to heal.
INDICATIONS: Esomeprazole is approved for the treatment of gastroesophageal reflux disease (GERD) and in combination with amoxicillin and clarithromycin
(Biaxin) for the treatment of patients with ulcers and H. pylori infection. Since it is very similar to omeprazole, it also is likely that it will be used for the treatment of

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Zollinger-Ellison syndrome. Esomeprazole also is approved for short term use in children ages 1-11 for GERD.
DOSAGE:
DRUG INTERACTIONS: Esomeprazole potentially can increase the concentration in blood of diazepam (Valium) by decreasing the elimination of diazepam in the
liver. Esomeprazole may have fewer drug interactions than omeprazole.
The absorption of certain drugs may be affected by stomach acidity. Therefore, esomeprazole and other PPIs that reduce stomach acid also reduce the absorption
and concentration in blood of ketoconazole (Nizoral) and increase the absorption and concentration in blood of digoxin (Lanoxin). This may lead to reduced
effectiveness of ketoconazole or increased digoxin toxicity, respectively.
Through unknown mechanisms, esomeprazole may increase blood levels of saquinavir and reduce blood levels of nelfinavir and atazanavir, Therefore, nelfinavir or
atazanavir should not be administered with esomeprazole, and physicians should consider reducing the dose of saquinavir in order to avoid side effects from
saquinavir.
SIDE EFFECTS: Esomeprazole, like other PPIs, is well-tolerated. The most common side effects are diarrhea, nausea, vomiting, headaches, rash and dizziness.
Nervousness, abnormal heartbeat, muscle pain, weakness, leg cramps and water retention occur infrequently.
 CEFUROXIME SODIUM
BRAND NAME: Ecocef
CLASSIFICATIONS: anti-infective; antibiotic; second-generation cephalosporin
INDICATIONS: Infections caused by susceptible organisms in the lower respiratory tract, urinary tract, skin, and skin structures; also used for treatment of
meningitis, gonorrhea, and otitis media and for perioperative prophylaxis (e.g., open-heart surgery), early Lyme disease.
ACTIONS: Semi synthetic second-generation cephalosporin antibiotic with structure similar to that of the penicillin. Resistance against beta-lactamase-producing
strains exceeds that of first generation cephalosporin. Antimicrobial spectrum of activity resembles that of cefonicid. Preferentially binds to one or more
of the penicillin-binding proteins (PBP) located on cell walls of susceptible organisms. This inhibits third and final stage of bacterial cell wall synthesis, thus
killing the bacterium. Partial cross-allergenicity between other beta-lactam antibiotics and cephalosporins has been reported.
Therapeutic Effects: hinders or kills susceptible bacteria, including many gram-positive organisms and enteric gram-negative bacilli.
ADVERSE EFFECTS
• CNS: headache, malaise, paresthesia, dizziness.

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• GI: pseudomembranous colitis, nausea, anorexia, vomiting, diarrhea, glossitis, dyspepsia, abdominal cramps, tenesmus, anal pruritus.
• GU: genital pruritus and candidiasis.
• Hematologic: transient neutropenia, eosinophilia, hemolytic anemia, thrombocytopenia.
• Respiratory: dyspnea.
• Skin: maculopapular and erythematous rashes, urticaria.
• Other: hypersensitivity reactions (serum sickness, anaphylaxis); pain, induration, sterile abcesses, warmth, tissue sloughing at injection site; phlebitis,
thrombophlebitis with IV injection.
DOSAGE:
CONTRAINDICATIONS
• Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation.
• History of allergy, particularly to drugs; penicillin sensitivity; renal insufficiency; history of colitis or other GI disease; potent diuretics.
NURSING RESPONSIBILITIES
 Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated.
 Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test
results. Monitor periodically BUN and creatinine clearance.
 Inspect IM and IV injection sites frequently for signs of phlebitis.
 Report onset of loose stools or diarrhea. Although pseudomembranous colitis rarely occurs, this potentially life-threatening complication should be ruled out
as the cause of diarrhea during and after antibiotic therapy.
 Monitor for manifestations of hypersensitivity. Discontinue drug and report their appearance promptly.
 Monitor I & O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.
 METOCLOPRAMIDE
BRAND NAME: Vomaine
CLASSIFICATION: Anti-emetic
INDICATIONS: It is used short-term to treat heartburn caused by gastroesophageal reflux in people who have used other medications without relief of symptoms. It
is also used to treat slow gastric emptying in people with diabetes (also called diabetic gastroparesis), which can cause nausea, vomiting, heartburn, loss of
appetite, and a feeling of fullness after meals.
ACTION:
Chemical effect: Stimulates motility of upper GI tract by increasing lower esophageal sphincter tone. Blocks dopamine receptors at chemoreceptor trigger zone.
Therapeutic effect: Prevents or minimizes nausea and vomiting from chemotherapy or surgery. Also reduces gag reflex in small-bowel intubation and radiologic
examinations, improves gastric emptying when diabetic gastroparesis is present, and reduces gastric reflux.
ADVERSE REACTIONS:
• CNS: restlessness, anxiety, drowsiness, fatigue, fever, lassitude, insomnia, suicide ideation, seizures, headache, dizziness, extrapyramidal symptoms, tardive

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dyskinesia, dystonic reactions, sedation.
• CV: transient hypertension.
• GI: nausea, bowel disturbances.
• Hematologic: agranulocytosis, neutropenia.
• Skin: rash.
• Other: prolactin secretion, loss of libido.
DOSAGE:
CONTRAINDICATIONS: In patients with a history of hypersensitivity to metoclopramide or any of the components. In the presence of GI hemorrhage, mechanical
obstruction, or perforation. In those with pheochromocytoma and epilepsy.
NURSING RESPONSIBILITIES
 Extract from history if the patient has epilepsy, GI perforation, pheochromocytoma, or bleeding in the intestines.
 Metoclopramide is usually taken before meals and at bedtime.
 Store metoclopramide at room temperature away from moisture and heat
 Instruct to take with a full glass of water.
 Narcotic pain medicine, sleeping pills, and medicine for anxiety can add to sleepiness caused by metoclopramide.
 Metoclopramide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and
alert.
 Avoid drinking alcohol. It can increase some of the side effects of metoclopramide.
 VITAMIN K
BRAND NAMES: AquaMEPHYTON, Mephyton
DRUG CLASSIFICATION: Clotting vitamin/agent
INDICATIONS: For those with vitamin K deficiency, thus usually more likely to have bruising and bleeding.
Vitamin K is routinely given to newborn infants to prevent bleeding problems.
ACTION: Vitamin K is a fat-soluble vitamin that plays an important role in blood clotting.
CONTRAINDICATIONS: In patients receiving anticoagulants (blood thinners) as vitamin K decreases the effects of these drugs.
Caution:
Pregnancy—Vitamin K has not been reported to cause birth defects or other problems in humans. However, the use of vitamin K supplements during pregnancy is
not recommended because it has been reported to cause jaundice and other problems in the baby. Breast-feeding—Vitamin K taken by the mother has not been
reported to cause problems in nursing babies. You should check with your doctor if you are giving your baby an unfortified formula. In that case, the baby must get
the vitamins needed some other way. Children—Children may be especially sensitive to the effects of vitamin K, especially menadiol or high doses of phytonadione.

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This may increase the chance of side effects during treatment. Newborns, especially premature babies, may be more sensitive to these effects than older children.
Older adults—Many medicines have not been tested in older people. Therefore, it may not be known whether they work exactly the same way they do in younger
adults or if they cause different side effects or problems in older people. There is no specific information about the use of vitamin K in the elderly.
ADVERSE REACTIONS:
• Decreased appetite; decreased movement or activity; difficulty in breathing; enlarged liver; general body swelling; irritability; muscle stiffness; paleness; yellow
eyes or skin.
• Less common: Difficulty in swallowing; fast or irregular breathing; lightheadedness or fainting; shortness of breath; skin rash, hives and/or itching; swelling of
eyelids, face, or lips; tightness in chest; troubled breathing and/or wheezing. Blue color or flushing or redness of skin; dizziness; fast and/or weak heartbeat;
increased sweating; low blood pressure (temporary).
• Rare: Flushing of face; redness, pain, or swelling at place of injection; skin lesions at place of injection (rare); unusual taste.
NURSING CONSIDERATIONS/PATIENT TEACHING:
 If you take warfarin (a blood thinner), you should know that vitamin K or foods containing vitamin K can affect how the drug works.
 Vitamin K deficiency is very rare. It occurs when the body can't properly absorb the vitamin from the intestinal tract.
 Vitamin K deficiency can also occur after long-term treatment with antibiotics.
 If you are taking anticoagulant medicine (blood thinners), the amount of vitamin K in your diet may affect how well these medicines work. Your doctor or
health care professional may recommend changes in your diet to help these medicines work better.
 DURAGESIC
(fentanyl transdermal system)

INDICATIONS: for management of persistent moderate to severe chronic pain that:

requires continuous, around-the-clock opioid administration for an extended period of time, and
cannot be managed by other means such as non-steroidal analgesics, opioid combination products, or immediate-release opioids
CONTRAINDICATIONS:
• in patients who are not opioid-tolerant
• in the management of acute pain or in patients who require opioid analgesia for a short period of time
• in the management of post-operative pain, including use after out-patient or day surgeries (e.g., tonsillectomies)
• in the management of mild pain
• in the management of intermittent pain [e.g., use on an as needed basis (prn)]

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 PARACETAMOL
BRAND NAME:
CLASSIFICATION: Pharmacologic class: para-aminophenol derivative; Therapeutic class: nonopioid analgesic, antipyretic
INDICATIONS: Mild pain or fever
ACTION:
Chemical effect: Produce analgesia by blocking pain impulses by inhibiting prostaglandin synthesis in the CNS or of other substances that sensitize pain receptors
to stimulation. The drug may relief fever through central action in the hypothalamic heat regulating center.
Therapeutic effect: Relieves pain and reduces fever.
SIDE EFFECTS/ ADVERSE REACTION:
• Hematologic: hemolytic anemia, neutropenia, leucopenia, pancytopenia, thrombocytopenia.
• Hepatic: liver damage (with toxic doses), jaundice.
• Metabolic: hypoglycemia

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• Skin: rash, urticaria.
DOSAGE:
CONTRAINDICATIONS:
• Contraindicated to patients hypersensitive to drug.
• Hepatic disease.
NURSING RESPONSIBILITIES:
 Assess patient’s pain or temperature before and during therapy.
 Be alert for adverse reactions and drug interactions.
 Advise patient that drug is only for short term use.
 Tell patient to increase food rich in carbohydrates to prevent hypoglycemia.
 CEFTRIAXONE SODIUM
BRAND NAME: Rocephin
CLASSIFICATION: Pharmacologic class: third-generation cephalosporin; Therapeutic class: antibiotic
INDICATIONS:
• Serious infections of lower respiratory and urinary tracts
• Preoperative prophylaxis
ACTIONS:
Chemical effect: inhibits cell-wall synthesis, promoting osmotic instability; usually bactericidal.
Therapeutic effect: hinders or kills susceptible bacteria.
SIDE EFFECTS/ADVERSE REACTIONS:
CNS: headache, dizziness, fever.

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GI: pseudomembranous colitis, nausea, vomiting, diarrhea, gysgeusia.
GU: genital pruritus and candidiasis.
Hematologic: eosinophilia, thrombocytosis, leukopenia.
Skin: rash, phlebitis.
Other: pain, induration, and tenderness at injection site; hypersensitivity reactions (serum sickness, anaphylaxis)
DOSAGE:
CONTRAINDICATIONS:
• Contraindicated in patients hypersensitive to drug or other cephalosporins.
• Use cautiously in patients with history of sensitivity to penicillin.
NURSING RESPONSIBILITIES:
 Assess patient’s infection before therapy and regularly thereafter.
 Obtain specimen for culture and sensitivity tests before giving the first dose.
 Ask patient about previous reaction to cephalosporins or penicillin before giving first dose.
 Be alert for adverse reaction and drug interaction.
 Tell patient to promptly report adverse reactions and signs and symptoms of superinfection.
 Instruct patient to report pain at the IV site.
 Tell patient to notify prescriber if loose stools or diarrhea occur.
 NALBUPHINE HYDROCHLORIDE
BRAND NAME: Nubain
CLASSIFICATION: Pharmacologic class: synthetic opioid partial agonist; Therapeutic class: analgesic, adjunct to anesthesia
INDICATIONS: Moderate to severe pain; adjunct to anesthesia
ACTIONS:
Chemical effect: Binds with opioid receptors in CNS, altering pain perception and response to pain by unknown mechanism.
Therapeutic effect: Relieves pain and enhances anesthesia.
SIDE EFFECTS/ADVERSE REACTIONS:
CNS: headache, sedation, dizziness, vertigo, nervousness, depression, restlessness, crying, euphoria, hostility, unusual dreams, confusion,
hallucinations, speech difficulty, delusions.
CV: hypertension, hypotension, tachycardia, bradycardia.

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EENT: blurred vision.
GI: cramps, dyspepsia, bitter taste, dry mouth, nausea, vomiting, constipation.
GU: urinary urgency.
Respiratory: respiratory depression, pulmonary edema.
Skin: itching; burning; urticaria; sweaty, clammy feeling
DOSAGE:
CONTRAINDICATIONS:
• Contraindicated in patients hypersensitive to the drug or sulfites present in some preparations of drug.
• Use cautiously in substance abusers, and in those with emotional instability, head injury, increased ICP, impaired ventilation, MI
accompanied by nausea and vomiting, upcoming biliary surgery, and hepatic or renal disease.
NURSING RESPONSIBILITES:
 Assess patient’s pain.
 Monitor patient closely for respiratory depression.
 Monitor patient for signs and symptoms of constipation. Advise client to increase fluid intake and food high in fiber.
 Be alert for adverse reactions and drug interactions.
 Warn ambulatory patient about getting out of bed or walking.
 Instruct patient to avoid hazardous activities until the drug’s CNS effects are known.
 CIPROFLOXACIN
BRAND NAME: Sutid
CLASSIFICATION: Pharmacologic class: Fluoroquinolone; Therapeutic class: antibiotic
INDICATIONS: Ciprofloxacin is used to treat infections of the skin, lungs, airways, bones, and joints caused by susceptible bacteria. Ciprofloxacin is also frequently
used to treat urinary infections caused by bacteria such as E. coli. Ciprofloxacin is effective in treating infectious diarrheas caused by E. coli, Campylobacter
jejuni, and Shigella bacteria.
ACTIONS:
Chemical effect: Unknown. Bactericidal effects may result from inhibition of bacterial DNA gyrase and prevention of replication in susceptible bacteria.
Therapeutic effect: Kills susceptible bacteria.
SIDE EFFECTS/ADVERSE REACTIONS:
CNS: headache, restlessness, tremor, lightheadedness, confusion, hallucinations, seizures, paresthesia.
CV: thrombophlebitis.

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GI: nausea, diarrhea, vomiting, abdominal pain or discomfort, oral candidiasis.
GU: crystalluria, interstitial nephritis.
Hematologic: eosinophilia, leucopenia, neutropenia, thrombocytopenia.
Musculoskeletal: arthralgia, joint stiffness, achiness, neck or chest pain.
Skin: rash, photosensitivity, Steven-Johnson syndrome.
Other: burning, pruritus, erythema, swelling with IV administration.
DOSAGE:
CONTRAINDICATIONS:
• Contraindicated in patients hypersensitive to fluoroquinolones.
• Use cautiously in patients with CNS disorders, such as severe cerebral arteriosclerosis or seizure disorders, and in those at increased risk for seizures. May
cause CNS stimulation.
• Immunocompormised patients may receive the usual dose and regimen for anthrax.
NURSING RESPONSIBILITIES:
 Assess patient’s infection before therapy and regularly throughout therapy.
 Obtain specimen for culture and sensitivity tests before giving the first dose. Begin therapy pending results.
 Be alert for adverse reactions and drug interactions.
 If adverse GI reactions occur, monitor patient’s hydration.
 Give oral forms 2 hours after meal or 2 hours before or 6 hours after taking antacids, sucralfate, or products that contain iron. Food doesn’t affect
absorption but may delay peak levels.
 Reduce dose in patients with renal impairment.
 Have patient drink plenty of fluids to reduce risk of crystalluria.
 Warn patient to avoid hazardous tasks that require alertness.
 Advise patient to avoid caffeine while taking drug because of potential for cumulative caffeine effects.
 Advise patient that hypersensitivity reactions may occur even after first dose.

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