NAME OF DRUG Generic: Metronidazole

MECHANISM OF ACTION Metronidazole selectively blocks some of the functions within the bacterial cells and the parasites resulting in their death.

INDICATIONS Metronidazole is used to treat parasitic infections including Giardia infections of the small intestine, amebic liver abscess, and amebic dysentery (infection of the colon causing bloody diarrhea),

CONTRAINDICATIONS *Contraindicated in patients hypersensitive to drug and those with with acute porphyria *Use cautiously in patients with hepatic dysfunction. Adjust dosage in patients with impaired renal f

SIDE EFFECTS include nausea, headaches, loss of appetite, a metallic taste, and rarely a rash. Serious side effects of metronidazole are rare. Include seizures a nd damage of nerves resulting in numbness and tingling of extremities (peripheral neuropathy), ence phalopathy, and aseptic meningitis. Metronidazole should be stopped

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 lightheadedness. Caution patient or other activities requiring alertness until response to medication is known.

Brand: Flagyl

Dosage: 500 mg one tab B.I.D.; p.o. Classification: antiprotozoal/ amoebicide

if these symptoms appear. *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). *Instruct patient to take without regard to meals because absorption isnt affected by food.

NAME OF DRUG Generic: Sodium Bicarbonate Brand: Bakin Soda, BellAns, Citrocarbonate, Neut, Soda Mint Dosage: 325 mg p.o; two tabs t.i.d Classification: antiulcer agents, alkalinizing agent

MECHANISM OF ACTION Sodium Bicarbonate acts as an alkalinizing agent by releasing bicarbonate ions. Following oral administration of this medication, it releases bicarbonate which is capable of neutralizing gastric acid.

INDICATIONS Management of metabolic acidosis. Used to alkalinize urine and promote excretion of certain drugs in over dosage situations Used as an antacid.

CONTRAINDICATIONS Metabolic or respiratory alkalosis Hypocalcemia Excessive chloride loss It is not recommended as an antidote following ingestion of strong mineral acids Patients on sodium restricted diet Renal failure Severe abdominal pain of unknown cause especially if associated with fever

SIDE EFFECTS Edema Flatulence Gastric distention Metabolic alkalosis Hypernatremia Hypocalcemia Hypokalemia Sodium and water retention Irritation at IV site Tetany

NURSING CONSIDERATIONS * Assess the clients fluid balance throughout the therapy. This assessment includes intake and output, daily weight, edema and lung sounds. *Symptoms of fluid overload should be reported such as hypertension, edema, difficulty breathing or dyspnea, rales or crackles and frothy sputum. *Signs of acidosis should be assessed such as disorientation, headache, weakness, dyspnea and hyperventilation. *Assess for alkalosis by monitoring the client for confusion, irritability, paresthesia, tetany and altered breathing

pattern. *Hypernatremia clinical manifestations should be assessed and monitored which includes: edema, weight gain, hypertension, tachycardia, fever, flushed skin and mental irritability. *Hypokalemia should also be assessed by monitoring signs and symptoms such as: weakness, fatigue, U wave on ECG, arrhythmias, polyuria and polydipsia. *IV sites should be observed closely. Extravasation should be avoided as tissue irritation orcellulitis may occur when taking sodium bicarbonate. *Monitor the clients serum calcium, sodium, potassium, bicarbonate

concentrations, serum osmolarity, acid-base balance and renal function before and throughout the therapy. *Tablets must be taken with a full glass of water. *For clients taking the medication as a treatment for peptic ulcers it may be administered 1 and 3 hours after meals and at bedtime.

NAME OF DRUG Generic: Ciprofloxacin Brand: Ciprobay; Cipromax Dosage: 500 mg opne tab b.i.d.; p.o. Classification: Fluoroquinolone and an Antiinfective

MECHANISM OF ACTION Ciprofloxacin is a broad-spectrum antibiotic active against both Grampositive and Gram -negative bacteria . It functions by inhibiting DNA gyrase, a type II topoisomerase, and topoisomerase IV, enzymes necessary to separate bacterial DNA, thereby inhibiting cell division.

INDICATIONS Ciprofloxacin is used to treat a number of infections including: infections of bones and joints, endocarditis, gastroenteritis , malignant otitis externa, respiratory tract infections,cellulitis, urinary tract infections, prostatitis, anthrax, chancroid, among others.

CONTRAINDICATIONS During Pregnancy fluoroquinolones rapidly cross the blood-placenta and blood-milk barriers, and are extensively distributed into the fetal tissues.

SIDE EFFECTS CNS: Headache, dizziness, lethargy, paresthesias GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomembranous colitis, liver toxicity oHematologic: Bone marrow depression: decreased WBC, decreased platelets, decreased Hct GU: Nephrotoxicity oHypersensitivity: Ranging from rash to fever to anaphylaxis, serum sickness reaction

NURSING CONSIDERATIONS *Question for history of hypersensitivity to Ciprofloxacin or Quinolones.

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*May be given without regards to meals. Preferred dosing time 2 hours after meals.

*Do not administer antacids within 2 hours of Ciprofloxacin.

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*Encourage cranberry juice or citrus fruits.

*Determine pattern of bowel activity.

*Check for dizziness, headache, visual diffi-

culties, and tremors.

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*Observe therapeutic response.