Drug study of metronidazole, cefuroxime, ketorolac

1. Drug name Dosages Therapeutic actions Indications Adverse effects Contraindications Nursing considerations
Brand name:
Flagyl
Generic
name:
Metronidazole
Classification:
Antibiotic and
Antiprotozoal
Dosage:
Metronidazole
dosage can vary
depending on the
specific infection and
patient factors.
Common dosages
include:
- For bacterial
infections: Typically,
500 mg orally every 8
hours or 250 mg
orally every 6 hours.
- For certain
protozoal infections:
The dosage may
range from 1 to 2
grams as a single
dose or in divided
doses.
Route:
Metronidazole can be
administered orally,
intravenously (IV), or
topically (as a gel or
cream).
Frequency:
The frequency of
dosing depends on
the type and severity
of the infection. It can
range from every 6 to
8 hours for oral
• Metronidazole's
mechanism of action
involves the reduction of its
nitro group by anaerobic
microorganisms,
generating toxic
intermediates that disrupt
DNA synthesis, leading to
strand breakage and cell
death.
• This selective toxicity
targets anaerobic bacteria,
protozoa, and certain
parasites, making it
effective against infections
caused by these pathogens,
including anaerobic
bacterial infections and
protozoal diseases like
trichomoniasis and
giardiasis.
• Metronidazole is used to
treat various infections,
including bacterial
infections of the
gastrointestinal tract,
skin, and gynecological
infections. It is also
effective against certain
protozoal infections, such
as Trichomonas vaginalis
and Giardia lamblia.
• Common adverse
effects of
metronidazole may
include nausea,
metallic taste in the
mouth, and
gastrointestinal
upset.
• Less common but
more serious side
effects can include
peripheral
neuropathy,
seizures, and
allergic reactions.
• Metronidazole is
contraindicated in
patients with a
known
hypersensitivity to
the drug or other
nitroimidazole
derivatives.
• It should be used
cautiously in
patients with a
history of central
nervous system
disorders or blood
dyscrasias.
Before Administration:
1. Review the patient's medical
history, allergies, and previous use
of antibiotics.
2. Assess vital signs and gather
information about the specific
infection.
3. Confirm the prescribed dose,
route of administration, and
frequency.
4. Educate the patient about the
purpose of the medication,
potential side effects, and the
importance of completing the full
course of treatment.
During Administration:
1. Administer the medication as
ordered, ensuring proper dilution
and rate for IV administration.
2. Monitor the patient for any signs
of allergic reactions, such as rash,
itching, swelling, or difficulty
breathing.
3. Ensure that the patient takes the
medication with food or milk if
gastrointestinal upset occurs.
After Administration:
1. Continuously assess the patient's
response to the medication,
including any improvement or
worsening of symptoms.
2. Monitor for adverse effects,
especially allergic reactions, and
take appropriate action if they
occur.

2. dosing or as a single
dose for specific
infections.
3. Encourage the patient to report
any side effects or changes in their
condition.
4. Document the administration,
patient response, and any observed
adverse effects in the patient's
medical record.
Drug name Dosages Therapeutic actions Indications Adverse effects Contraindications Nursing considerations
Brand name:
Ceftin, Zinacef
Generic name:
Cefuroxime
Classification:
Second-
generation
Cephalosporin
Antibiotic
Dosage:
The dosage of
cefuroxime can vary
based on the specific
infection being
treated, patient age,
and other factors.
Common dosages
include:
- For mild to
moderate
infections: 250-500
mg orally every 12
hours.
- For more severe
infections: 750 mg to
1.5 grams
intravenously (IV)
every 8 hours.
Route:
Cefuroxime can be
administered orally
or intravenously
(IV/IM).
Frequency:
The frequency of
dosing depends on
the severity of the
• Cefuroxime is a second-
generation cephalosporin
antibiotic that exerts its
bactericidal action by
inhibiting bacterial cell wall
synthesis. It does so by
binding to and disrupting
the transpeptidation and
cross-linking of
peptidoglycan, a crucial
component of the bacterial
cell wall.
• This interference weakens
the structural integrity of
the cell wall, leading to
osmotic instability and
eventual cell lysis.
Cefuroxime is effective
against a broad spectrum of
gram-positive and gram-
negative bacteria, making it
a valuable tool in the
treatment of various
bacterial infections.
• Cefuroxime is a versatile
antibiotic used in the
management of various
bacterial infections. It is
commonly employed to
treat respiratory tract
infections like bronchitis
and pneumonia, as well
as skin and soft tissue
infections, urinary tract
infections, and specific
types of bacterial
sinusitis.
• Additionally, cefuroxime
finds utility as a
prophylactic measure
during surgical
procedures, particularly
those involving the
respiratory,
gastrointestinal, and
genitourinary systems.
The choice of cefuroxime
hinges on the
identification of the
suspected pathogens
responsible for the
infection and their
• Common adverse
effects of
cefuroxime may
include diarrhea,
nausea, vomiting,
rash, and allergic
reactions.
• More serious side
effects, although
less common, can
include severe
allergic reactions
(anaphylaxis),
kidney problems,
and blood
disorders.
• Cefuroxime is
contraindicated
in patients with a
known allergy to
cephalosporin
antibiotics or
those who have
had severe
allergic reactions
to penicillin. It
should also be
used with caution
in patients with a
history of
gastrointestinal
disease.
Before Administration:
1. Review the patient's medical
history, including allergies and
previous reactions to antibiotics.
2. Assess vital signs and perform a
thorough physical examination.
3. Confirm the prescribed dose,
route of administration, and
frequency.
4. Inform the patient about the
purpose of the medication and
potential side effects.
During Administration:
1. Administer the medication as
ordered, ensuring proper dilution
and rate for IV administration.
2. Monitor the patient for any signs
of allergic reactions, such as rash,
itching, swelling, or difficulty
breathing.
3. Maintain good hand hygiene and
use aseptic technique during IV
administration.
4. Educate the patient on the
importance of completing the full
course of antibiotics, even if
symptoms improve.

3. infection and the
route of
administration,
typically ranging
from every 8 to 12
hours.
susceptibility to the drug,
determined through
culture and sensitivity
testing.
After Administration:
1. Continuously assess the patient's
response to the medication,
including any improvement or
worsening of symptoms.
2. Monitor for adverse effects,
especially allergic reactions, and
take appropriate action if they
occur.
3. Encourage the patient to report
any side effects or changes in their
condition.
4. Document the administration,
patient response, and any observed
adverse effects in the patient's
medical record.
Drug name Dosages Therapeutic actions Indications Adverse effects Contraindications Nursing considerations
Brand name:
Toradol
Generic name:
Ketorolac
Classification:
Nonsteroidal
Anti-
Inflammatory
Drug (NSAID)
Dosage:
Typically, the
recommended oral
dose for adults is 20
mg every 6 hours as
needed for pain. For
intravenous (IV) or
intramuscular (IM)
administration, the
usual dose is 30 mg
once, followed by
15-30 mg every 6
hours, not to
exceed 120 mg per
day. Dosage may
vary depending on
the specific
condition and the
patient's age.
Route:
• Ketorolac, a nonsteroidal
anti-inflammatory drug
(NSAID), exerts its
mechanism of action by
inhibiting the activity of
cyclooxygenase (COX)
enzymes, particularly COX-
1 and COX-2. By doing so, it
hinders the conversion of
arachidonic acid into
prostaglandins, which are
key mediators of
inflammation, pain, and
fever. This suppression of
prostaglandin production
results in reduced pain,
inflammation, and fever.
Unlike some other NSAIDs,
ketorolac is available in
both oral and injectable
forms, making it useful for
• Ketorolac is typically
indicated for the short-term
management of moderate to
severe pain, such as post-
operative pain following
surgery, pain due to various
medical conditions, or pain
management in a hospital
setting when oral
administration may be
impractical.
• It is often used as a potent
analgesic option to provide
rapid relief, but its use should
be limited to short durations
(usually up to five days) due
to the potential for serious
side effects, including
gastrointestinal bleeding and
kidney impairment.
• Common adverse
effects of ketorolac
may include
nausea, vomiting,
abdominal pain,
diarrhea, and
headache. These
side effects are
often mild to
moderate in
intensity and tend
to occur more
frequently with
short-term use.
• Severe adverse
effects of ketorolac
are less common
• Ketorolac is
contraindicated
in patients with
a history of
peptic ulcers,
gastrointestinal
bleeding,
severe kidney
impairment, or
known
hypersensitivity
to NSAIDs.
• It should not be
used in the
setting of
recent or
impending
surgery where
there is a high
risk of bleeding.
Before Administration:
1. Obtain a thorough patient
history, including allergies,
previous NSAID use, and any
gastrointestinal issues.
2. Assess baseline vital signs, kidney
function, and pain level.
3. Verify the prescription, dosage,
and route of administration.
4. Ensure the patient is informed
about the medication, its purpose,
and potential side effects.
During Administration:
1. Administer the medication as
ordered by the physician, paying
attention to the correct route.
2. Monitor the patient for any signs
of adverse effects, such as
gastrointestinal distress, bleeding,
or allergic reactions.

4. Ketorolac can be
administered orally,
intravenously (IV),
or intramuscularly
(IM).
Frequency:
The frequency of
dosing depends on
the route of
administration and
the patient's needs.
It can be given every
6 hours as needed,
but the total daily
dose should not
exceed the
recommended
limit.
the short-term
management of moderate
to severe pain, such as
post-operative pain or pain
due to various medical
conditions.
• Ketorolac is generally
reserved for situations where
other less potent pain
relievers are not sufficient,
and it should be administered
under the guidance of a
healthcare professional.
but can be serious.
They include
gastrointestinal
problems such as
ulcers, bleeding,
and perforation,
which may lead to
abdominal pain,
black tarry stools,
and vomiting
blood. Ketorolac
can also have
adverse effects on
the kidneys,
potentially causing
reduced urine
output, swelling,
and signs of kidney
dysfunction.
3. Ensure proper IV or IM injection
technique if applicable.
After Administration:
1. Continuously assess the patient's
pain level and response to the
medication.
2. Monitor vital signs, particularly
blood pressure, to detect any
abnormalities.
3. Educate the patient on the
importance of taking the
medication as directed and
reporting any unusual symptoms.
4. Be vigilant for signs of adverse
effects, especially in patients with a
history of gastrointestinal
problems or bleeding disorders.
5. Document the administration,
patient response, and any observed
adverse effects in the patient's
medical record.