DRUG STUDY

CLASSIFICATION GENERIC NAME: PIPERACILLIN SODIUM BRAND NAME: ZOSYN DOSAGE ACTION The betalactamase inhibitors are recognized as substrates for the betalactamases produced by bacteria. This allows the actual beta-lactams to attack the bacterial cell wall by binding to penicillin binding proteins INDICATION Zosyn (piperacillin and tazobactam for injection) is indicated for the treatment of patients with moderate to severe infections caused by piperacillin-resistant, piperacillin/tazobactamsusceptible, lactamase producing strains of the designated microorganisms in the specified conditions such as appendicitis . postpartum endometritis and CAD. CONTRAINDICATION Zosyn is contraindicated in patients with a history of allergic reactions to any of the penicillins, cephalosporins, or lactamase inhibitors. ADVERSE EFFECTS Agitation; constipation; diarrhea; dizziness; headache; indigestion; nausea; pain, swelling, or redness at the injection site; sleeplessness; vomiting. NURSING RESPONSIBILITIES Patients should be counseled that antibacterial drugs including Zosyn should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When Zosyn is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may (1) decrease the effectiveness of the immediate treatment and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by Zosyn or other antibacterial drugs in the future.

4.5 gram q 6 hrs

GENERIC NAME: digoxin BRAND NAME: Lanoxin 0.25 mg/dL

Digoxin works by blocking sodiumpotassium ATPase, an enzyme in the body that controls the amount of sodium and potassium that enters the cells. By blocking this enzyme, digoxin increases the amount of calciumand potassium inside heart cells. With this action, digoxin helps the heart contract more forcefully with each heartbeat, making it more efficient at pumping blood throughout the body. It also slows down the rate at which the heart beats.

Lanoxin is indicated for the treatment of mild to moderate heart failure. LANOXIN increases left ventricular ejection fraction and improves heart failure symptoms as evidenced by exercise capacity and heart failure-related hospitalizations and emergency care, while having no effect on mortality. Where possible, LANOXIN should be used with a diuretic and an angiotensinconverting enzyme inhib itor, but an optimal order for starting these three drugs cannot be specified.

Digitalis glycosides are contraindicated in patients withventricular fibrillation or in patients with a known hypersensitivity to digoxin. A hypersensitivity reaction to other digitalis preparations usually constitutes a contraindication to digoxin.

most COMMON side effects persist or become bothersome when using Lanoxin: Diarrhea; nausea. SEVERE side effects occur when using Lanoxin: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision, yellow vision, or other vision changes; confusion; fast, slow, or irregular heartbeat; hallucinations; mood or mental changes (eg, depression); severe or persistent nausea, vomiting, or stomach pain; unusual bruising or bleeding; unusual tiredness or weakness.

-Be familiar with pts baseline data as a foundation for making assessments -Baseline lab tests, draw blood samples for determining plasma digoxin levels at least 6h after daily dose preferably just before next scheduled daily dose.Therapeutic range of serum digoxin is 0.8 2 ng/ml, toxic levels are > 2ng/ml -Take apical pulse for 1 full min noting rate, rhythm, and quality before administering.If changes are noted, withhold digoxin. -Withhold med if pulse falls below ordered parameters -Monitor for S&S of drug toxicity -Monitor I&O ratio during digitalization, particularly in pts with impaired renal function.Monitor for edema daily and auscultate chest for rales -Monitor serum digoxin levels closely during concurrent antibioticdigoxin therapy, which can precipitate toxicity because of altered intestinal flora -Observe pts closely when being transferred from one prep to another; when table is replaced by elixir,

potential for toxicity increases since >=30% of drug is absorbed GENERIC NAME: Acetylcysteine Brand Name: Parvolex Acetylcysteine medication belong to Respiratory inhalant/Mucolyt ic class. Acetylcysteine decreases thickness of mucous secretions in lung. Acetylcysteine is often used to dissolve mucus and to facilitate expectoration during respiratory diseases. While there are a number of open and controlled studies that suggest a considerable benefit, there are other controlled studies that do not demonstrate a significant effect. A formal meta-analysis does not exist; however, many specialists consider the beneficial effect of acetylcysteine marginal. MAO inhibitor therapy within 14 days initiating therapy; severe hypertension; severe. Coronary artery disease, hypersensitivity to pseudoedephrine, acrivastine or any component; renal impairment. . Like other medicines, Acetylcysteine can cause side effects. Some of the more common side effect s of Acetylcysteine include Tachycardia, hypotension, hypertension, chest tightness (oral); tachycardia, chest tightness Drowsiness Rash, pruritus, angioedema (oral); pruritus, rash, flushing Rhinorrhea (oral); ear pain, pharyngitis, throat tightness Nausea, vomiting, stomatitis (oral); nausea, vomiting Bronchospasm, bronchial irritation (oral); rhinorrhea, rhonchi Fever, clamminess -Monitor effectiveness of therapy and advent of adverse/allergic effects. Instruct patient in appropriate use and adverse effects to report.

600 gram

GENERIC NAME: ASPIRIN BRAND NAME: Apo-ASA (CAN), Aspergum, Bayer, Easprin, Ecotrin, Empirin, Entrophen (CAN), Genprin, Halfprin 81, 1/2 Halfprin, Heartline, Norwich, Novasen (CAN), PMS-ASA (CAN), ZORprin

80 gram 1TAB

Analgesic and antirheumatic effects are attributable to aspirins ability to inhibit the synthesis of prostaglandins, important mediators of inflammation. Antipyretic effects are not fully understood, but aspirin probably acts in the thermoregulator y center of the hypothalamus to block effects of endogenous pyrogen by inhibiting synthesis of the prostaglandin intermediary. Inhibition of platelet aggregation is attributable to the inhibition of platelet synthesis of thromboxane A2, a potent vasoconstrictor and inducer of platelet aggregation.

-Mild to moderate pain -Fever -Inflammatory conditions rheumatic fever, rheumatoid arthritis, osteoarthritis -Reduction of risk of recurrent TIAs or stroke in males with history of TIA due to fibrin platelet emboli -Reduction of risk of death or nonfatal MI in patients with history of infarction or unstable angina pectoris -MI prophylaxis -Unlabeled use: Prophylaxis against cataract formation with long-term use

Contraindicated with allergy to salicylates or NSAIDs (more common with nasal polyps, asthma, chronic urticaria); allergy to tartrazine (crosssensitivity to aspirin is common); hemophilia, bleeding ulcers, hemorrhagic states, blood coagulation defects, hypoprothrombinemia, vitamin K deficiency (increased risk of bleeding)

Acute aspirin toxicity: Respiratory a lkalosis, hyperpnea, tachypnea, hemorrhage, excitement, confusion, asterixis, pulmonary edema, seizures, tetany, metabolic acidosis, fever, coma, CV collapse, renal and respiratory failure (dose related, 2025 g in adults, 4 g in children) Aspirin intolerance: Exacerba tion of bronchospasm, rhinitis (with nasal polyps, asthma, rhinitis) GI: Nausea, dyspepsia, heartburn, epigastric discomfort, anorexia, hepatotoxicity Hematologic: Occult blood loss, hemostatic defects Hypersensitivity: Ana phylactoid reactions to anaphylactic shock Salicylism: Dizziness, tinnitus, difficulty hearing, nausea, vomiting, diarr hea, mental confusion, lassitude (dose related)

BLACK BOX WARNING: - Do not use in children and teenagers to treat chickenpox or flu symptoms without review for Reyes syndrome, a rare but fatal disorder. -Give drug with food or after meals if GI upset occurs. -Give drug with full glass of water to reduce risk of tablet or capsule lodging in the esophagus. -Do not crush, and ensure that patient does not chew SR preparations. -Do not use aspirin that has a strong vinegar-like odor. WARNING: - Institute emergency procedures if overdose occurs: Gastric lavage, induction of emesis, activated charcoal, supportive therapy.

GENERIC NAME: ALBUTEROL BRAND NAME: Salbutamol, Proventil, Ventolin, Accuneb, airet, Novo-Salbutamol, Proventil HFA, Gen-salbutamol, Ventodisk, Ventolin HFA, Volmax, VoSpira ER Inhalation (Adults and children more than 4 years of age): 2 inhalation s every 46 hours

It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following mechanism that takes place when Salbutamol is administered.

-To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD) -Quick relief for bronchospasm -For the prevention of exercise-induced bronchospasm -Long-term control agent for patients with chronic or persistent bronchospasm

-Hypersensitivity to adrenergic amines -Hypersensitivity to fluorocarbons

-Nervousness -Restlessness -Tremor -Headache -Insomnia -Chest pain -Palpitations -Angina -Arrhythmias -Hypertension -Nausea and vomiting -Hyperglycemia -Hypokalemia

-Assess lung sounds, PR and BP before drug administration and during peak of medication. -Observe fore paradoxical spasm and withhold medication and notify physician if condition occurs. -Administer PO medications with meals to minimize gastric irritation. -Extended-release tablet should be swallowedwhole. It should not be crushed or chewed. -If administering medication through inhalation, allow at least 1 minute between inhalation of aerosol medication. -Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth. -Inform the patient that Albuterol may cause an unusual or bad taste.