Drug Study

Ampicillin Brand Name: Ampicillin Classification: Antibiotic Dosage: 500 mg Route: TIV Frequency: q 6 Action Bactericidal action againts sensitive organisms; inhibits synthesis of bacteria cell wall, causing cell death Indication
Treatment of soft tissue, respiratory tract infections, septicemia, menigitis and gonococcal infections caused by susceptible microorganisms.

Prophylaxis in caesarean section in certain high risk patients.

Contraindication Contraindicate d with allergies to penicillins, cephalosporins or other allergens. Use consciously with renal disorders.

Adverse Reaction
CNS: headache, hallucinations seizures CV: CHF GI: nausea and vomiting, abdominal pain, bloody diarrhea GU: nephritis Hematologic: anemia, leukopenia, neutropenia, prolonged bleeding time Hypersensitivity: rash, fever, wheezing Local: pain, phlebitis, thrombosis at injection site(parenteral)

Nursing Consideration Before giving, ask the patient about any allergic reaction to penicillin. Obtain specimen for culture and sensitivity test before first dose. Administer the correct dosage and stress the importance of completing the full course and duration of therapy even though the patient experiences relief earlier in the treatment Monitor renal status and function. Use initial dilution within one hour. Follow manufacturers direction for stability data when ampicillin is furthered diluted for IV infusion. Give IV intermittently to prevent vein irritation. Changes site every 48 hrs. Give ampicillin at least one hour before bacteriostatic antibiotics. Tell to the parent of the patient to call the doctor if rash, fever , or chills develop.

Ranitidine Brand Name: Zantac Classification: H2 receptor blocker Dosage: 5 mg Route: TIV Frequency: q8 Action Competitively inhibits the action of histamine (H2) at receptor sites of the parietal cells, decreasing gastric acid. Indication Short-term treatment of active duodenal ulcer Maintenance therapy for duodenal ulcer at reduced dosage. Short-term treatment of GERD Treatment of heart burn, acid indigestion and sour stomach. Contraindication Contraindicated with allergy to ranitidine, lactation. Used cautiously with impaired renal or hepatic function. Adverse Reaction CNS: Headache DERMATOLOGIC: Rash GI: constipation, diarrhea, nausea, vomiting, dyspepsia Local: pain at the IM site, local burning or itching at IV site. Nursing Consideration Administer the drug with meals at bedtime to ensure therapeutic level. One hour after Antacids Stress the importance of the continued use for the length of time prescribed. Inform patient that the medication may cause drowsiness, dizziness, or fatigue Urge patient to avoid cigarettes smoking because it may increase acid secretion and worsen disease. Arrange for follow including blood test to evaluate its effects.

Mefenamic Acid Brand Name: Dolfenal Classification: NSAIDs Dosage: 500mg 1 cap Route: PO Frequency: TID Action Antiinflammatory, analgesics, and antipyretic activities related to inhibition of prostaglandins synthesis. Indication Relief of mild to moderate pain Contraindication Contraindicated with hypersensitivity to mefenamic acid and aspirin allergy Adverse Reaction CNS: Headache; dizziness; insomnia. Dermatologic: Rash; urticaria; purpura GI: Diarrhea; vomiting; abdominal pain; GI bleeding; nausea; constipation; GU: Dysuria, renal impairment Hematologic: Decreased hematocrit; bleeding;. Respiratory: Bronchospasm; laryngeal edema; dyspnea; shortness of breath Nursing Consideration Assess patients pain before therapy Give with milk or food to decrease GI upset Monitor for possible drug induced adverse reaction Give prescribed dosage of drug to prevent overdose or under dose administering of drug may result to trauma and further injury to the patients health. Advice patient to report immediately persistence or failure to relieve pain Stay at the patient bedside during drug intake to ensure that the patient take the medicine Give exact dose of drug and administer drug in the appropriate route.

Cephalexin Brand Name: Apo-Cephalex Classification: Antibiotic Dosage: 500mg Route: TIV Frequency: TID Action Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death. Indication Skin and skin structure infections caused by staphylococcus, streptococcus. Contraindication Contraindicated with allergy to cephalosporins or penicillins. Use cautiously with renal failure, lactation, pregnancy. Adverse Reaction CNS: headache, dizziness GI: nausea, vomiting, diarrhea, anorexia, abdominal pain GU: nephrotoxicity Hypersensitivity: ranging from rash to fever to anaphylaxis Nursing Consideration Arrange for culture and sensitivity tests of infection before and during therapy if infection does not resolve. Administer with food to lessen GI discomfort Monitor patients serum creatinine levels to detect early signs of nephrotoxicity. Also monitor fluid intake and output; decreasing urine output may indicate nephrotoxicity. Monitor for allergic reactions a few days after therapy starts. Advise patient to complete prescribed course of therapy. Tell patient that yogurt and buttermilk can help maintain intestinal flora and decrease diarrhea during therapy.

Paracetamol
Brand Name: Biogesic Classification: Antipyretic Dosage: 120 mg/mL Route: PO Frequency: 1 tsp. q 6

Action Appears to inhibit prostaglandin synthesis in the CNS and, to a lesser extent, block pain impulses through peripheral action. Acts centrally on the hypothalamic heat regulating center, producing peripheral vasodition (heat loss, skin erythema, diaphoresis). Therapuetic effect: results in antipyresis; produces analgesic effect.

Indication Relief of mild to moderate pain, fever.

Contraindication Active alcoholism, liver disease, or viral hepatitis, all of which increase risk of hepatoxicity

Adverse Reaction Hema: hemolytic anemia, neutropenia, leucopenia, pancytopenia Hepa: jaundice Metabolic: hypoG GI: hepatic failure, hepatoxicity,(overdo se) GU: renal, failure (high dose/chronic use) Derm: rash, uticaria

Nursing Consideration Assess fever, note presence of associated signs (diaphoresis, tachycardia, and malaise) Assess for clinical improvement and relief of pain, fever. Assess onset, type, location, duration of pain. Effect of medication is reduced if full pain response recurs prior to next dose. Avoid using multiple preparations containing acetaminophen. Carefully check all OTC products. Give drug with food if GI upset occur. Teach patient to recognize signs of chronic overdose: bleeding, bruising, malaise, fever, sore throat. Discontinue drug if hypersensitivity reaction occur. Treatment of overdose: Monitor serum level regularly, N-acetlycysteine should be available as specific antidote; basic life support may be necessary.

FERROUS SULFATE
Brand Name: Feosol Classification: Iron preparation Dosage: 1cap Route: PO Frequency: BID

Action Elevates the serum iron concentration, and is then converted to Hgb or trapped in the reticuloendothelial cells for storage and eventual conversion to a usable form of iron.

Indication Prevent and treatment of iron deficiency anemias. Dietary supplement for iron. Unlabaled use: Supplemental use during epoetin therapy to ensure proper hematologic response to epoetin

Contraindication Contraindicated with allergy to any ingredient; hemochromatosis, hemosidorosis, hemolytic anemias. Use caustiously with normal iron balance; peptic ulcer, regional enteritis, ulcerative colitis.

Adverse Reaction CNS: CNS toxicity, acidosis, coma and death with overdose. GI: GI upset, anorexia, nausea, vomiting, constipation, diarrhea, dark stool, temporary staining of the teeth(liquid preparation)

Nursing Consideration Confirm that the patient does have iron deficiency anemia before treatment. Take drug on an empty stomach with water. Take after meals if GI upset is severe. Monitor bowel movements as constipation is a common adverse effect. Have periodic blood test during therapy to determine the appropriate dosage. Do not take this preparation with antacids or tetracycline. If these drugs are needed, they will be prescribed. Warn patient that stool may be dark or green.

TRAMADOL
Brand Name: Ultram Classification: Analgesic Dosage: 50 mg Route: TIV Frequency: q6

Action Binds to muopoid receptor, inhibits reuptake of neropinephrine and serotonin. Reduces intensity of pain stimuli incoming from sensory nerve endings.

Indication Relief of moderately to moderately severe pain. Relief of moderate to severe chronic pain in adults who needs around-theclock treatment for extended periods. Unlabeled uses: premature ejaculation; rstless leg syndrome.

Contraindication Contraindicated with allergy to tramadol or opioid or acute intoxication with alcohol. Opioids or psychoactive drugs. Use cautiously with pregnancy, lactation; seizure; concomitan of CNS depressant, renal impairment; hepatic impairment.

Adverse Reaction CNS: sedation, dizziness or vertigo, headache, confusion, dreaming, sweating, anxiety, seizures. CV: hypotension, tachycardia, bradycardia. Dermatologic: Sweating, pruritus, rash, pallor, urticaria. GI: Nausea, vomiting, dry mouth, constipation, flatulence. Other: Potential for abuse, anaphylactoid reaction.

Nursing Consideration Assess for level of pain relief and administer prn dose as needed but not to exceed the recommended total daily dose. Monitor vital signs and assess for orthostatic hypotension or signs of CNS depression. Discontinue drug and notify physician if signs and symptoms of hypersensitivity occur. Assess bowel and bladder function; report urinary frequency or retention. Use seizure precautions for patients who have a history of seizures or who are concurrently using drugs that lower the seizure threshold. Monitor ambulation and take appropriate safety precautions.

CARBOPROST
Brand Name: Hemabate Classification: prostaglandin Dosage: 1amp Route: IM Frequency: q8

Action Stimulates the myometrium of the gravid uterus to contract in a manner that is similar to the contraction of the uterus during labor, thus evacuating of the gravid uterus.

Indication Termination of pregnancy 13 20 wk of from the first day of the last menstrual period. Evacuation of the uterus in instance of missed abortion or intrauterine fetal death in the second trimester. Postpartum hemorrhage due to uterine atony unresponsive to conventional method.

Contraindication Contraindicated with allergy to prostaglandin preparations; acute PID; active cardiac, hepatic, pulmonary, renal disease. Use cautiously with history of asthma; hypotension; hypertension; CV; adrenal; renal or hepatic disease; anemia; jaundice; diabetes; epilepsy, scarred uterus; cervicitis, infected endocervical lesions; acute vaginatis.

Adverse Reaction

CNS: Headache, paresthesias, flushing, anxiety, weakness, syncope, dizziness. CV: Hypotension, arrhythmias, chest pain. GI: Endometritis, perforated uterus, uterine rupture, uterine or vaginal pain, incomplete abortion. Other: Chills, diaphoresis, backache, breast tenderness, eye pain, skin rash, pyrexia.

Nursing Consideration Monitor uterine contractions and observe and report excessive vaginal bleeding and cramping pain. Save all clots and tissue for physician inspection and laboratory analysis. Check vital signs at regular intervals. Report promptly onset of bleeding, foul-smelling discharge, abdominal pain, or fever. Administer by deep IM injection. Arrange for pretreatment of concurrent treatment with antiemetic and antidiarrheals to decrease the incidence of GI side effects.