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    104879609 drug-study-gbs 104879609 drug-study-gbs Presentation Transcript

    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: antibiotic Bacteriostatic effects against Serious infections for Irritation, burning, -Contraindicated with -If this side effects mayChloramphenicol susceptible bacteria; prevents which no other itching, headache, allergy to experience: cell replication antibiotic is effective nausea, vomiting chloramphenicolBRAND: -headache- request forChloromycetin -use cautiously with medication renal failure ,hepaticDOSAGE: failure, pregnancy, -confusion- avoid driving or500mg IV lactation operating machineriesFREQUENCY: - report sore throat, tiredness, unusual bleeding, or bruising, numbness, tingling, pain on extremities.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Aminoglycosides Bactericidal: inhibits protein Serious infections Tinnitus, dizziness, -contraindicated with -culture infected area before theGentamicin sulphate synthesis in the susceptible when causative agents vertigo, numbness, allergy to any amino therapy. strains, of gram negative are unknown (often in tingling, nausea, glycosidesBRAND: bacteria; appears to disrupt conjunction with a vomiting, anorexia, -avoid long term therapiesAlcomicin functional integrity of penicillin or a leukemoid reaction -use cautiously with because it may increase risk of bacterial cell membrane, cephalosporin) ,purpura, rash, pain, renal or hepatic disease, toxicity. Reduction in dose mayDOSAGE: causing cell death. irritation, itching sulfite sensitivity, pre be clinically indicated.1 mg IV existing hearing loss. -patients with edema or ascitesFREQUENCY: may have lower peakEvery 8 hours concentrations due to expanded Extracellular fluid volume. -ensure adequate hydration of patent before and during therapy.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Corticosteroid Enters target cells and binds -Trichinosis with Vertigo, headache, - Contraindicated with -take drugs exactly asHydrocortisone to cytoplasmic receptors, neurologic or hypotension, shock, allergy to any prescribed, do not stop taking initiates many complex myocardial thin, fragile skin, component of the drug drugs without notifying yourBRAND: reactions that are responsible involvement petechiae, irregular infection, amebiasis, health care providers; slowlySolucortef for its anti inflammatory, menses, amenorrhea, hepa B, taper dosage to avoid problems immunosuppressive -short term peptic ulcer, sodium immunosupression -dosage reduction may createDOSAGE: (glucocorticoid) inflammatory and retention, muscle adrenal insufficiency; report100mg IV allergic disorder weakness, -use cautiously with muscle joint pain, anorexia, immunosuppression, kidney dse, liver disease, nausea, vomiting, diarrhea,FREQUENCY: impaired wound healing cirrhosis, weight loss dizziness, low bloodEvery 6 hours Ulcerative colitis, recent sugar. GI surgery, inflammatory -frequent follow up visit to your bowel disease health care provider are needed to monitor drug response and adjust dosage. -you may experience side effects: Weight gain- monitor I&O Indigestion-eat frequent small feedings Increase susceptibility to infection- avoid crowds, avoid any one with known infections, Muscle weakness-frequent rest periods -report unusual weight gain , edema, black tarry stools, vomiting of blood, epigastric burning, irregular menstruation, sore throat, cold, other infections.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Proton pump Gastric Acid Pump inhibitor, Short term treatment Headache, dizziness, -Contraindicated with -Administer before meals,Omeprazole inhibitor suppresses gastric acid for duodenal ulcer diarrhea, abdominal hypersensitivity to swallow the whole capsule. secretion by specific inhibition pain, nausea, vomiting, omeparazole or itsBRAND: of the hydrogen potassium URI symptoms component. -if using the oral suspension,Prisolec ATPase enzyme system at the empty the pocket into a small secretory surface of the -use cautiously with cup containing 2 table spoons ofDOSAGE: gastric parietal cells; blocks pregnancy and lactation water, stir and drink20mg the final step of acid immediately. Taken for up to 8 production weeksFREQUENCY: -avoid driving and operating1 tab OD machineries -maintain proper nutrition, do not self medicate if URTI occurs consult health care providers -report head ache, worsening symptoms, chills and fever.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Penicillin Interferes with bacterial cell Severe infections CNS: Contraindicated with Before Penicillin G sodium Antibiotic wall synthesis during active caused by sensitive Lethargy, hallucinations, allergy to penicillins, - Observe 15 rights of drug multiplication, causing cell organisms seizures cephalosporins, administration. wall death and resultant (streptococci)- URTI GI: imipenem , beta - Reduce dosage with hepatic bactericidal activity against caused by sensitive Glossitis, stomatitis, lactamase inhibitors, or or renal failure.BRAND: susceptible bacteria streptococci- gastritis,sore mouth, other allergens. - Assess for hypersensitivity toBicillin L-A Treatment of syphilis, furry tongue, , nausea, drug congenital syphilis, vomiting, diarrhea, - Assess for any yaws- Prophylaxis abdominal pain, contraindications to the drug. of rheumatic fever and enterocolitis, - Educate about side effects chorea pseudomembranous, of drug. colitis, DuringDOSAGE: nonspecific hepatitis - Drug is not for IV use. Do not1 MILLION GU: inject or mix with other Nephritis IV solutions. Hematologic: - Avoid contact with the needle.FREQUENCY: Anemia - Withdraw needle as quickly asIV q 16 Hrs. ,thrombocytopenia, possible to avoid discomfort. (-) ANST leukopenia, - Stay with patient throughout neutropenia, whole duration of prolonged bleeding administration. time After Hypersensitivity: -Monitor client for at least Rash, fever, wheezing, 30minutes anaphylaxis .- Arrange for regular follow-up, Local: including blood tests, to Pain, phlebitis, evaluate effects. thrombosis at injection - Instruct to report difficulty site, when used to treat breathing, rashes, and severe syphilis pain at injection site, mouth Other: sores, unusual bleeding or Super infections, sodium bruising. overload leading to - Instruct to take medication as heart failure directed for the full course of therapy, even if feeling better. - Do proper documentation
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Anti-arrythmiic Competitively blocks beta Cardiac arrhythmias, Fatigue, bradycardia, Contraindicated with -do not discontinue drugPropanolol adrenergic receptors in the especially HF, Cardiac Arrythmias, allergy to beta blocking abruptly after long termHydrochloride heart and juxtoglumerular supraventricular sino atrial or AV nodal agent, sinus therapy. Taper drug gradually apparatus, decreasing the tachycardia, and Block, gastric pain, bradycardia, second- over two weeks with influence of the sympathetic ventricular flatulence, constipation, third degree heart block, monitoring.BRAND: nervous system on these tachycardias, induced diarrhea, nausea, cardiogenic shock, HF, -provide continuous cardiac andInderal tissues, the excitability of the by cardiac glycosides or vomiting, impotence, bronchial asthma, regular BP monitoring with IV heart, cardiac workload and cathecolamines. decrease libido, bronchospasm, COPD, form. oxygen consumption, and the pregnancy, lactation. -take this drug with meals.DOSAGE: release of renin and lower BP; -use cautiously with -if you have diabetes, the20mg has membrane stabilizing hypoglycaemia, normal sign of hypoglycaemia (local anesthesia) effects that diabetes, thyrotoxicosis, may be block by this drug,FREQUENCY: contribute to its anti hepatic impairment. monitor your blood, urine,½ tab BID arrhythmic action; acts in the glucose carefully. CNS to reduce sympathetic -avoid driving or performing outflow and vasoconstrictor hazardous task) tone. The mechanism by -eat small frequent small meals which it prevents migraine for loss of appetite. headache is unknown. -report difficulty of breathing, night cough, swelling of extremities, slow pulse, confusion, depression, rash, fever, sore throat.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Histamine 2 Competitively inhibits the Short term treatment Headache, rash, .Contraindicated with -Take drugs with meals, and atRanitidine blocker action of histamine at the H2 for active duodenal constipation, diarrhea, allergy to ranitidine bed time, therapy may continuehydrochloride receptors of the parietal cells ulcer nausea, vomiting, for 4-6 weeks or longer. of the stomach, inhibiting abdominal pain -lactationBRAND: basal gastric acid secretion -if you also are using an antacid,Zantac and gastric secretion that is take it exactly as prescribed, stimulated by food, insulin, being careful of the times of histamine, cholinergic administrationDOSAGE: agonists, gastrin, pentagastrin.1 amp. IV -have regularly medical follow- up care to evaluate yourFREQUENCY: responseEvery 8 hours -adjust light and temperature and avoid noise -report sore throat, fever, unusual bleeding, tarry stool, confusion, hallucinations, dizziness, severe headache, muscle or joint pain.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: immunoglobulin .contains human globulin, -treatment of chronic Tenderness, urticaria, Contraindicated with -do not administer to patientImmune globulin which provides passive inflammatory angioedema, nausea, patient with history of with history of allergy to gammaintravenous immunity through the demyelinating vomiting, chills, fever, allergy to gamma globulin or anti immunoglobulin presence of injected polyneuropathy chest tightness, globulin or anti A antibodiesBRAND: antibodies. IV gamma globulin anaphylactic reactions, immunoglobulin AGammunex provides immediate antibody -maintenance of precipicious fall in BP, antibodies -refrigerate drug; do not freeze, levels. Mechanism of action in patient with primary Risk for acute renal discard partially used vialsDOSAGE: idiopathic thrombocytopenic immunodeficiencies failure -check manufacturer guidelines2.5g/vial purpura not determined. before using any immunoglobulin -administer iv preparation withFREQUENCY: extreme caution -do not mix immunoglobulin with other medication -monitor pt’s vital signs continuously and observe for any symptoms during IV administration. -adverse effect appear to be related to the rate infusion
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Antibiotic Interferes with cell wall Treatment of infections EENT: History of -Perform skin testing beforeCloxacillin replication of susceptible caused by Occasionally, laryngeal hypersensitivity to giving the medication to prevent organisms, the cell wall, pneumococcal, Group edema, penicillin and anaphylactic shock whenBRAND: rendered osmotically A beta-hemolytic Skin: cephalosporin. Sever administeredCloxpen unstable, swell, bursts from streptococci, and urticaria, skin rashes, ex pneumonia, - Administer drug slowly to the osmotic pressure; resists the penicillin G sensitive foliative dermatitis, rash emphysema, IV line the drug is very irritatingDOSAGE: penicillinase action that staphylococci. GI: bacteremia, pericarditis, to the tissue and blood vessels.50mg/cap inactivates penicillins Prophylaxis: GI disturbances, nausea, meningitis and purulent Injecting slowly the drug Staphylococcal vomiting, epigastric and septic arthritis prevents phlebitisFREQUENCY: infection during major distress, diarrhea and during the acute the -Explain to the patient that1 cap/ every 6 hours cardiovascular and flatulence, antibiotic- stage. Sub-conjunctival antibiotic therapy lasts for 7 orthopedic surgery associated pseudo infections. days will take the drug without membranous colitis any miss GU: -Taking the drug for 7 days helps Interstitial nephritis and to kill the bacteria and growth vasculitis Make sure that the patient takes Hematologic: the drug at the same time of the eosinophilia, day. And also to prevent the agranulocytosis, being drug resistant to prevent anemia, growth of bacteria and to thrombocytopenia, continue the efficacy of the transient rise drug. intransminases and -Provide rest and comfort alkaline phophatase the drug may cause dizziness Other: which is a normal side effect of Hypersensitivity the drug.6.)Assess for any signs reactions, serum of hypersensitivity reaction such sickness-like reactions, as purpura, rash, urticaria, ex fever foliative dermatitis, itching to discontinue the therapy andimmediately call the physician for an antidote
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Sulfonamide It inhibits the synthesis of Drug of choice next agranulocytosis, Hypersensitivity to -Should be administered with aCotrimoxazole antibiotic nucleic acids and proteins in to pentamidine for cholestatic jaundice, sulphonamides, glass of water on empty susceptible bacteria; the the prevention and pancreatitis, colitis, pregnancy, advanced stomachBRAND: bacterial enzyme involved in therapy of nephritis, vasculitis, liver and renalBactrim this reaction is more readily pneumonias caused aseptic meningitis, insufficiencies -Finish all medication; do not inhibited than the mammalian by Pneumocystis fever, indisposition, skip dosesDOSAGE: enzyme. carinii. headaches, exanthemas160mg -You may experience increasedTab sensitivity to sunlight; use sunblock, wear protectiveFREQUENCY: clothing and dark glasses, or1 tab TID avoid direct exposure to sunlight. Small frequent meals, frequent mouth care, sucking lozenges, or chewing gum may reduce nausea or vomiting -Report skin rash, sore throat, blackened stool, or unusual bruising or bleeding immediately -Maintain adequate fluid intake to prevent crystalluria -Monitor CBC, renal function test, liver function test, urinalysis
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC: Bronchodilator It relieves nasal congestion Long-term control Nervousness, -Hypersensitivity to 1. Assess lung sounds, PR andAlbuterol and reversible bronchospasm agent for patients with Restlessness adrenergic amines BP before drug chronic or persistent by relaxing the smooth Tremor, Headache, -Hypersensitivity to administration and duringBRAND: bronchospasmSalbutamol neb muscles of the bronchioles.. it Insomnia, Chest pain, fluorocarbons peak of medication. binds to the beta2-adrenergic Palpitations, Angina, 2. Observe for paradoxicalDOSAGE: receptors in the airway of the Arrhythmias, spasm and withholdI neb smooth muscle which then Hypertension medication and notify leads to the activation of the Nausea and vomiting, physician if condition occurs.FREQUENCY: adenyl cyclase and increased Hyperglycemia, 3. Extended-release tabletEvery 4 hours levels of cyclic- 3’5’-adenosine Hypokalemia should be swallowed-whole. monophosphate (cAMP). It should not be crushed or When cAMP increases, kinases chewed. are activated. Kinases inhibit 4. . If administering medication the phosphorylation of myosin through inhalation, allow at and decrease intracellular least 1 minute between calcium. inhalation of aerosol Decreased in intracellular medication. calcium will result to the 5. Advise the patient to rinse relaxation of the smooth mouth with water after each muscle airways inhalation to minimize dry mouth. 6. . Inform the patient that Albuterol may cause an unusual or bad taste.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC NAME:Paracetamol Anti pyretic Reduces fever by acting For fever, temporarily Hematological skin and Contraindicated with -Do not exceed to directly on the hypothalamic relieves minor aches other infections allergy to recommended dosage heat regulating center to acetaminophen, use cause vasodilation and cautiously with allergy, -Reduce dose for hepaticBRAND NAME: sweating which help to impaired hepatic impairmentAeknil dissipate heat function, chronic -Avoid using multiple alcoholism preparations containingDOSAGE:1 Amp acetaminophen. carefully check all OTC productsFREQUENCY:Every 4 hours -Give drugs with food if GI upset occurs -Discontinue dug if hypersensitivity occurs -Take drugs only for complaints indicated, not an anti inflammatory agent
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONS -Should not be mixed with otherGENERIC: Penicillin Piperacillin, extended- Treatment of infections Hypertension, chest Hypersensitivity drugs in a syringe or infusionpiptaz spectrum penicillin, exerts its in the lower respiratory pain, edema, dyspnea, topenicillins, bottle due to possible problems tract Ex: severe antimicrobial action in hypotension, cephalosporins & β- with compatibility.BRAND: community-acquiredPiperacillin Sodium growing and dividing bacteria pneumonia &health Tachycardia, lactaminhibitors -Piptaz is not chemically stable& Tazobactam by interfering with septum care pneumonia; bradycardia, heart in solutions that contain onlySodium formation and cell wall uncomplicated& failure. sodium bicarbonate and synthesis of susceptible complicated skin & skin solutions that significantly alterDOSAGE: bacteria. It binds to penicillin- structure infections; pH. Lactated Ringers Solutions2.2 gram IV binding proteins on the intra-abdominal not compatible with Piptaz. infections w/FREQUENCY: bacterial cell wall and blocks -Piptaz is stable in glass and peritonitisEvery 6 hours (-) peptidoglycan synthesis. plastic containers (plasticANST Peptidoglycan is a syringes, IV bags and tubing) heteropolymeric structure once used with compatible that gives the cell wall its diluents. mechanical stability. The final -use Piptaz immediately after stage of the peptidoglycan constitution. synthesis involves the -Discard properly any unused completion of the cross- portion after 24 hrs if stored at linking with the terminal room temperature (20-25°C) or glycine residue of the after 48 hrs if stored at pentaglycine bridge linking to refrigerated temperature (2- the fourth residue of the 8°C). pentapeptide. The -Vials should not be frozen after transpeptidase that performs constitution this step is inhibited by -Stability in the IV bags has been piperacillin. The bacterial cell demonstrated for up to 24 hrs wall weakens leading to while stability in an ambulatory swelling and rupture of the IV infusion pump has been microorganism. demonstrated for a period of 12 hrs at room temperature.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC NAME:Ciprofloxacin Anti bacterial; Bactericidal; interfere with -For the treatment of -headache, nausea, Contraindicated with -if an antacid is needed, take at fluroquinolone DNA replication susceptible infections, caused by allergy to ciprofloxacin, least 2 hours before or after diarrhea, abdominalBRAND NAME: susceptible gram bacteria preventing cell pain, arrhythmias, dry norfloxacin, or other dose.Ciloxan negative bacteria ;E- reproduction coli, klebsiella mouth, vomiting, eye flu0roquinolones, -taken with meals pneumonae pain, blurred vision, pregnancy, lactation.DOSAGE: -drink plenty of water while500mg 1 cap -lower respiratory tract taking this drug infection caused by E-FREQUENCY: coli, klebbsiellaEvery 6 hours -for abdominal pain, eat frequent small meals, for blurring of vision, drowsiness, dizziness avoid driving or using dangerous equipments -report rash, visual changes, severe G.I problems, weakness, tremors.
    • NAME CLASSIFICATION ACTION INDICATION ADVERSE EFFECT CONTRAINDICATION NURSING CONSIDERATIONSGENERIC:Amikacin sulfate Aminoglycoside Inhibits protein synthesis by Serious infection cause Hypotension, -Contraindicated in -Obtain specimen for culture Headache,Drug fever, binding directly to the 30S by sensitive restrains of Rash, Nausea, Vomiting, patients hypersensitive and sensitivity test before givingBRAND: ribosomal sub unit; Pseudomonas Eosinophilia, Paresthesia, to drug or other first dose. Therapy may beginamikin bactericidal aeruginusa, E.coli, Tremor, Arthralgia, aminogycosides. while awaiting the results. Proteus, Klebsiella, Weakness, Allergic -Use cautiously in -Evaluate patient’s hearing reactionDOSAGE: staphylococcus patients with impaired before and during therapy if he250mg IV renal function or will be receiving drug for longer neuromuscular than 2weeks. Notify prescriber ifFREQUENCY: disorders, in neonates patient has tinnitus, vertigo, orEvery 12 hours and infants and in hearing loss. elderly patients -Weigh patient and review renal function studies before therapy begins. -Correct dehydration before therapy because of increase risk of toxicity. -Obtain blood for peak level 1 hour I.M injection and 30 mins. to 1 hour after IV infusion ends; for trough levels draw blood just before the next dose. Don’t collect blood in a heparinized tube; heparin is incompatible with aminoglycosides. -Peak drug levels more than 35mcg/ml and trough levels more than10 mcg/ml may linked to a higher risk of toxicity -Watch for signs and symptoms of super infection (especially URT),such as continued fever, chills, and increased pulse rate