Drugs utilized by the Patient

Anti-microbials

GENERIC NAME BRAND NAME DRUG CLASS ACTION INDICATION

Meropenem Meronem Carbapenem -inhibits cell wall >pneumonia
synthesis
Ciprofloxacin Ciprobay Flouroquiñolone -interferes with >pneumonia
DNA, thus
inhibiting
replication of
bacteria
Clindamycin Dalacin C Tetracyclines -inhibits CHON >pneumonia
synthesis of
bacterial cell
Cefixime Tergecef 3rd generatio - inhibits bacterial >pneumonia
Cephalosporin cell wall synthesis
Piperacillin Na + Pintaz Penicillin-beta - inhibits bacterial >pneumonia
Tazobactam lactamase inhibitor cell wall synthesis,
tazobactam
potentiates the
effect of
piperacillin and
inhibits the action
of beta lactamase
Clarithromycin Klaz Macrolides -blocks CHON
synthesis

Nursing Responsibilities

Before Administration of Drugs:

- Check doctors order and double check label (expiry date) and content (must be intact)
- Maintain asepsis in preparation of medications
- On preparation of the drugs, don’t use the same syringe for aminoglycosides and piperacillin
- Assess client’s history of allergy to the drugs stated above.
- Assess the result of skin test.
- Assess baseline CBC (may cause leukopenia, thrombocytopenia), BUN, Creatinine, LFT, C&S and Electrolytes
(K, Na and Ca) results
- Get baseline VS and I&O
- Piperacillin Na + Tazobactam must not be administered simultaneously with Tetracyclines, because
Tetracyclines decrease the efficacy of Piperacillin Na + Tazobactam
- Assess Neurologic functioning
- If taken PO, must be administered 1 hour prior or 2 hours after meals for maximum absorption
- Ask patient to state full name and birth date or check medical bracelet.
- Observe the five rights of drug administration (right drug, dose, patient, route and time PDQ for RN, 2007:
58).

During Administration of Drugs:

-Maintain asepsis during administration, disinfect y-port prior to administration

-Assess for allergic reactions to the drugs
-Ask SOs or client to report immediately rash, hives, severe diarrhea, black tongue, sore throat, fever, or
unusual bleeding or bruising. Hold drug, Reassess patient and notify physician
-Monitor VS and I&O
-Assess neurologic status of client
After Administration of Drugs:

- Review to client or SOs, possible adverse effects of the drugs (rash, hives, severe diarrhea, black tongue, sore
throat, fever, or unusual bleeding or bruising.)
-Documentation
- Advise SOs or client to report immediately any adverse effects
- Encourage SOs or client to administer drug on the time
- Encourage SOs or client, not to stop medication even if they are feeling well
- Tell SOs or client if taken PO, must be administered 1 hour prior or 2 hours after meals for maximum
absorption
-Assess for ototoxicity, nephrotoxicity, hepatoxicity and photosensitivity.
- As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially
those related to the drugs, tests, foods, and herbs mentioned above.
-Observe for the desired therapeutic as evidence by Normal WBC, ABG, X-ray, normalization of breathing and
absence of sputum.

Bronchodilators and Mucolytic

GENERIC NAME BRAND NAME DRUG CLASS ACTION INDICATION

Salbutamol Ventolin B2 Agonist -Relaxation of >bronchospasm and
smooth muscles promotes passage of
via stimulation of secretions due to
B2 receptor sites pneumonia
in bronchi to
promote
vasodilation and
brochodilation
Salbutamol + Duavent B2 Agonist and -Relaxation of >bronchospasm and
Ipratropium Cholinergic Blocking smooth muscles promotes passage of
Agents via stimulation of secretions ( due to
B2 receptor sites pneumonia)
in bronchi to
promote
vasodilation and
brochodilation
and inhibits the
effect of
cholinergic
receptors thus
promoting
bronchodilators
N-acetylcysteine Flumucil Mucolytic -Decreases > Mucolytic agent in
viscosity of adjunctive
secretions, treatment of acute
promoting and chronic
secretion removal bronchopulmonary
through coughing, disease
postural drainage,
and mechanical
means.

Before Administration of Drug

 Get baseline V/S of the patient and I&O.

 Assess if the patient is allergic to the drugs stated above
 Check doctors order and double check label (expiry date) and content (must be intact)
 Maintain asepsis in preparation of medications
  Consult physician about giving last albuterol dose several hours before bedtime, if drug-induced
insomnia is a problem.
 Assess symptom characteristics, onset, frequency, and any precipitating factors.
 Ask patient or mother (if child)to state full name and birth date or check medical bracelet.
 Observe the five rights of drug administration (right drug, dose, patient, route and time PDQ for RN,
2007: 58).

During Administration of Drug

 Use either a face mask or mouthpiece.

 Use this medication exactly as prescribed.
 Instruct SOs that the polyampule must be fully consumed, before stopping the nebulizer
 On administration of N-acetylcysteine, utilized straw and allow patient to sip the medication
 Ensure that all of the medication vaporize is administered without waste to ensure proper dosage.

After Administration of Drug

 Provide oral care after administration

 Provide Chest physiotherapy after nebulization
 Turn patient to sides for postural drainage and promote passage of secretions
 Monitor for evidence of allergic reaction.
 Monitor therapeutic effectiveness which is indicated by significant subjective improvement in
pulmonary function within 60–90 min after drug administration.

Diuretics

GENERIC NAME BRAND NAME DRUG CLASS ACTION INDICATION

Hydrochlorothiazide Diuzid Thiazide Diuretics Promote the >Pulmonary
excretion of congestion,
sodium and secondary to left
chloride, and thus ventricular
water, by the hypertrophy
distal renal tubule.
Also may produce
arteriolar dilation,
reducing blood
pressure.
Furosemide Lasix Loop Diuretics Inhibits the >Pulmonary
reabsorption of congestion,
sodium and secondary to left
chloride in the ventricular
proximal and hypertrophy
distal tubules as
well as the
ascending loop of
Henle
Spironolactone Aldactone Potassium – Sparing Mild diuretic that >Pulmonary
Diuretics acts on the distal congestion,
tubule to inhibit secondary to left
sodium exchange ventricular
for potassium, hypertrophy
resulting in >In aid of treatment
increased for Potassium
secretion of deficiency
sodium and water
and conservation
of potassium. An
 aldosterone
antagonist.

Before Administration of Drug

 Get baseline V/S( especially BP) of the patient and I&O(Don’t not give if patient is having anuria UO of
50cc/day).
 Assess if the patient is allergic to the drugs stated above
 Check doctors order and double check label (expiry date) and content (must be intact)
 Maintain asepsis in preparation of medications
 Administer in the morning, to prevent disturbances in sleep
 Assess baseline CBC, BUN, Creatinine, LFT and Electrolytes (K, Na and Ca) Ask patient to state full name
and birth date or check medical bracelet.
 To be given with food, to prevent GI upset especially when administered per orem
 Observe the five rights of drug administration (right drug, dose, patient, route and time PDQ for RN,
2007: 58).

During Administration of Drug

 If administered, via IVTT disinfect y-port prior to administration to maintain asepsis

 If to mix with liquids, mix thoroughly to ensure the right dose of the drug is given to the patient

After Administration of Drug

 Explain to SO, that patient will be frequently urinating as the desired effect of the drug
 Documentation
 If taking potassium – wasting diuretics, Encourage SO to allow patient eat potassium rich foods (citrus
fruits, banana, coconut juice)
 If taking potassium – sparing diuretics, Encourage SO to decrease potassium rich foods in the patients
diet
 Teach SOs about the signs and symptoms of possible F&E imbalance Hyperkalemia (PSD), Hypokalemia
(PWD), Hyponatremia(Both), Hypocalcemia.
 Assess for possible hyperglycemia and dehydration.
 Review to SO, adverse effects of the drugs and advise SOs to report immediately if adverse effects
occurs
 Assess for ototoxicity, nephrotoxicity, hepatoxicity.

Anti-pyretics, Analgesic and Anti-inflammatory

GENERIC NAME BRAND NAME DRUG CLASS ACTION INDICATION

Paracetamol Opigesic Analgesic, Pain relief may >Fever and Pain
Antipyretic result from
Non-opioid inhibition of
derivative prostaglandin
synthesis in CNS,
with subsequent
blockage of pain
impulses. Fever
reduction may
result from
vasodilation and
increased
peripheral blood
flow in
hypothalamus,
which dissipates
heat and lowers
 body
temperature.
Ibuprofen Dolan NSAIDs Inhibits >Pharmacologic
cyclooxygenase, approach to closure
thus inhibiting of PDA
prostaglandin >Fever and pain
synthesis in the
body, in which is
responsible for
the patency of the
DA
Before Administration of the Drug

 Get baseline V/S of the patient and I&O.

 Assess if the patient is allergic to the drugs stated above
 Check doctors order and double check label (expiry date) and content (must be intact)
 Maintain asepsis in preparation of medications
 Assess baseline CBC, BUN, Creatinine, LFT and PT
 Ask patient to state full name or mother(if a child) and birth date or check medical bracelet.
 To be given with food, to prevent GI upset especially when administered per orem
 Observe the five rights of drug administration (right drug, dose, patient, route and time PDQ for RN,
2007: 58).

During Administration of the Drug

 Use droppers in the administering the drug

 Administer only the prescribed amount to prevent toxicity

After Administration of Drug

 Explain to SOs, the desired effect of the drugs (pain relief, normothermia and possible closure of PDA)
 Documentation
 Teach SOs possible adverse effects of the drugs and advise them to report immediately when
presented by the patient
 To help prevent esophageal irritation, instruct SO that patient should avoid lying down for 30 to 60
minutes after taking dose.
 Watch for possible signs of bleeding( prolong PT time, black tarry stools, petechaie, bleeding in the
gums)

Vitamins and Minerals

GENERIC NAME BRAND NAME DRUG CLASS ACTION INDICATION

Zinc SO4 Prozinc Vitamins and Serves as cofactor Dietary supplement
Monohydrate Minerals for more than 70
enzymes;
promotes wound
healing and helps
maintain normal
growth rate,
normal skin
hydration, and
taste and smell
sensations

Before Administration of Drugs

 Assess if the patient is allergic to the drugs stated above

  Check doctors order and double check label (expiry date) and content (must be intact)
 Maintain asepsis in preparation of medications
 Ask patient to state full name or mother(if a child) and birth date or check medical bracelet.
 To be taken 1 hour before or 2 hours after meals
 Observe the five rights of drug administration (right drug, dose, patient, route and time PDQ for RN,
2007: 58).

During Administration of Drugs

 Administer using droppers to ensure proper dose is given to patient

After Administration of Drugs

 Documentation
 Store at room temperature away from moisture and heat.
 Report for any adverse effects of the drugs.

Topical Corticosteroid and Anti-biotic

GENERIC NAME BRAND NAME DRUG CLASS ACTION INDICATION

Betamethasone, Triderm Topical Is diffused across >Diaper rashes
dipropionate, Corticosteroid and cell membranes to
gentamycin sulfate Anti-biotic form complexes
with cytoplasmic
receptors. Shows
anti-inflammatory,
anti-pruritic,
vasoconstrive, and
antiproliferation
activity.
Considered a
medium- potency
drug, according to
vasoconstrictive
properties.
(Williams and
Wilkins, 2006:
1193).
Calamine+Zinc Calmoseptine Combination of Promotes wound > Preventing and
Oxide+Sodium ointment analgesic, antiseptic, granulation and treating minor skin
Bicarbonate antipruritic, and skin reepithelialisation irritations secondary
protectant (PPDr, Medicomm to diaper rashes
Phillipines,
2009/2010)

Before Administration of the Drug

 Assess if the patient is allergic to the drugs stated above

 Check doctors order and double check label (expiry date) and content (must be intact)
 Maintain asepsis in preparation of medications
 Ask patient to state full name or mother(if a child) and birth date or check medical bracelet.
 Assess baseline CBC, BUN, Crea and LFT.
 Wash the area to be applied with the ointment
 Observe the five rights of drug administration (right drug, dose, patient, route and time PDQ for RN,
2007: 58).
During Administration of the Drug

 Use clean gloves or clean cotton pledget to administer the drug

 Do not touch the opening of the ointment tube to prevent contamination of contents
 Apply on affected areas only


After Administration of Drug

 Avoid using plastic pants or tight-fitting diapers on treated areas on young children
 Documentation
 Advise SOs to report adverse effects of the drug
 Advise SOs to wash hands after application.
 Discuss personal hygiene measures to reduce chances of infection.

Opioid Analgesic

GENERIC NAME BRAND NAME DRUG CLASS ACTION INDICATION

Nalbuphine Nubain Opioid Analgesic Binds with opiate >Moderate to
receptors in the Severe Pain
central nervous
system,altering
perception and
emotional response
to pain( Lippincott
Williams and
Wilkins, 2008: 410)

Before Administration of the Drug

 Get baseline V/S(especially RR) of the patient and I&O.

 Assess if the patient is allergic to the drugs stated above
 Check doctors order and double check label (expiry date) and content (must be intact)
 Maintain asepsis in preparation of medications
 Assess baseline CBC, BUN, Creatinine, LFT
 Ask patient to state full name or mother(if a child) and birth date or check medical bracelet.
 To be infused in IV, mix well
 Prepare on station/bedside Naloxone(Narcan) antidote for toxicity
 Observe the five rights of drug administration (right drug, dose, patient, route and time PDQ for RN,
2007: 58).

During Administration of the Drug

 Regulate IV rate as prescribed

 Administer only the prescribed amount to prevent toxicity

After Administration of Drug

 Explain to SOs, the desired effect of the drugs (pain relief)

 Documentation
 Teach SOs possible adverse effects of the drugs and advise them to report immediately when
presented by the patient
 Keep patient on bedrest while on medication.