DRUG STUDY Name of Drug Action Bactocil Bactericidal: (Oxacillin) inhibits cell wall synthesis of sensitive organisms causing

cell death Indication Infections due to penicillinaseproducing staphylococci; may be used to initiate treatment when a staphylococci infection is suspected Contraindication Contraindicated with allergies to penicillins, cephalosporins, or other allergens. Use cautiously with renal disorders, pregnancy, lactation Adverse Reaction NSG Consideration CNS: Lethargy, Side effects may be experienced, such hallucinations, seizures as: upset stomach, GI: Glossitis, stomatitis, nausea, diarrhea black hairy tongue, (small frequent nausea, vomiting, meals), mouth diarrhea, abdominal sores (perform pain, frequent mouth care) and pain at GU: nephritis-oliguria, injection site. proteinuria, hematuria, Report difficulty of casts, azotemia, pyuria breathing, rashes, Hematologic: anemia, severe diarrhea, thrombocytopenia, severe pain at leukopenia, neutropenia, injection site, prolonged bleeding time mouth sores. Hypersensitivity: rash, Finish entire course of therapy as fever, wheezing, prescribed. anaphylaxis Local: pain, phlebitis, thrombosis at injection site Other: superinfections, sodium overload leading to heart failure

Students Signature Clinical Instructor and Signature

DRUG STUDY Name of Drug Action Gentamycin Bactericidal: (Garamycin) inhibits protein synthesis in susceptible strains of gramnegative bacteria; appears to disrupt functional integrity of bacterial cell membrane, causing cell death Indication Contraindication Serious Contraindicated infections with allergy to any caused by aminoglycosides susceptible Use cautiously with strains of renal or hepatic Pseudomonas disease; sulfite aeruginosa, sensitivity; preProteus species, E. coli, existing hearing Klebsiellaloss; active Enterobacterinfection with Serratia species, herpes, vaccinia, Citrobacter, varicella, fungal Staphylococcus infections, species Unlabeled used: with clindamycin as alternative regimen in PID. Adverse Reaction NSG Consideration CNS: Ototoxicity-tinnitus, Client may experience side dizziness, vertigo, effects, such as: depression, lethargy, ringing in the ears, nystagmus, visual headache, dizziness disturbances, headache, (reversible; use CV: Palpitations, safety measures if hypertension, severe), nausea, vomiting, loss of hypotension appetite (eat GI: hepatic toxicity, frequent small nausea, vomiting, meals, perform anorexia, frequent mouth GU: nephrotoxicity care) Hematologic: Leukemoid Report pain at reaction, injection site, severe headache, Hypersensitivity: dizziness, loss of Purpura, rash, urticaria, hearing, changes in Local: pain, irritation, urine pattern, arachnoiditis at IM difficulty breathing, injection sites rash or skin lesions Other: fever, apnea, splenomegaly, joint pain, superinfections Students Signature Clinical Instructor and Signature

DRUG STUDY Name of Drug Action Hydrocortisone Enters target cells and binds to cytoplasmic receptors; initiates many complex reactions that are responsible for its anti-inflammatory, immunosuppressive (glucocorticoid), and salt retaining (mineralocorticoid) actions. Indication Contraindication Replacement Allergy to any therapy in component of the adrenal cortical drug, fungal insufficiency infections, Allergic statesamebiasis, severe or hepatitis B, incapacitating vaccinia, or allergic conditions varicella and Hypercalcemia antibiotic-resistant associated with infections, cancer immunosuppressio Short term ns. inflammatory Use cautiously and allergic with kidney disorders, such as rheumatoid disease (risk for arthritis, edema); liver collagen disease, cirrhosis, diseases (SLE), hypothyroidism, dermatologic ulcerative colitis diseases with impending (pemphigus), status perforation; asthmaticus, diverticulitis; and recent GI surgery; autoimmine active or latent disorders peptic ulcer; Hematologic Adverse Reaction SYSTEMIC CNS: vertigo, headache, paresthesia, insomnia, seizures, psychosis CV: hypotension, shock, HPN and heart failure secondary to fluid retention, thromboembolism, thromphlebitis, fat embolism, cardiac arrhythmias 2 to electrolyte disturbances Dermatologic: thin, fragile skin; petechiae; ecchymoses; purpura; striae; subcutaneous fat atrophy EENT: cataracts, glaucoma, increased IOP Endocrine: amenorrhea, irregular NSG Consideration Take drugs exactly as prescribed. Do not stop intake without notifying healthcare provider; slowly taper dosage to avoid problems. Dosage reductions may create adrenal insufficiency. Report any fatigue, muscle and joint pains, anorexia, nausea, vomiting, diarrhea, weight loss, weakness, dizziness, or low blood sugar. Take with meals or snacks if GI upset occurs. Take single daily or alternative-

disordes thrombocytope nic purpura, erythroblastop enia Trichinosis with neurologic or myocardial involvement Ulcerative colitis, acute exacerbations of MS, and palliation in some leukemias and lymphomas

inflammatory bowel disease (risks exacerbations or bowel perforation); HPN, heart failure; thromboembolic tendencies, thrombophlebitis, osteoporosis, convulsive disorders, metastatic carcinoma, DM; TB; lactation

menses, growth day doses before 9AM; mark retardation, decreased calendar or use carbohydrate other measures tolerance and DM, as reminder of cushingoid state, HPA treatment days. suppression systemic Frequent followwith therapy longer up visits to your healthcare than 5 days, Cushings provider are syndrome, needed to hyperglycemia monitor drug GI: peptic or response and esophageal ulcer, adverse pancreatitis, reactions. abdominal distenstion, Side effects may be experienced: nausea, vomiting, increase in increased appetite and appetite, weight weight gain gain, heartburn, Hematologic: Na+ and indigestion (eat fluid retention, frequent small hypokalemia, meals, use of hypocalcemia, antacids may help); increased increased blood sugar, susceptibility to increased serum infection (avoid cholesterol, decreased crowds during serum T3 and T4 levels peak cold or flu Hypersensitivity: seasons and Anaphylactoid or avoid anyone hypersensitivity with a known infection); poor reactions wound healing Musculoskeletal:

muscle weakness, steroid myopathy and loss of muscle mass, osteoporosis, spontaneous fractures Other: immunosuppression, aggravation or masking of infections, impaired wound healing

(if injured/wounde d, consult healthcare provider); muscle weakness, fatigue (frequent rest periods may help). Report unusual weight gain, swelling of lower extremities, muscle weakness, black or tarry stools, vomiting of blood, epigastric burning, menstrual irregularities, fever, prolonged sore throat, cold or other infection, worsening of symptoms.

Students Signature Clinical Instructor and Signature

DRUG STUDY Name of Drug Action Indication Contraindication Albuterol In low doses, acts Relief and Contraindicated prevention of with (Salbutamol) relatively bronchospasm hypersensitivity to selectively at in patients with albuterol; beta2-adrenergic reversible tachyarrhythmias, receptors to obstructive tachycardia caused cause airway disease by digitalis bronchodilation or COPD intoxication; general anesthesia and vasodilation; Inhalation: Treatment of with halogenated at higher doses, acute attacks hydrocarbons or beta2 receptors of cyclopropane (this to cause typical bronchospasm sensitize the sympathomimetic Prevention of myocardium to cardiac effects exercisecatecholamines); induced unstable bronchospasm vasomotor system Unlabeled use: disorders; HPN; Adjunct in coronary treating insufficiency, CAD; moderate to Hx of CVA; COPD severe patients with hyperkalemia degenerative heart in dialysis disease patients; seems Use cautiously with to lower DM (large IV doses potassium can aggravate concentrations diabetes and when inhaled ketoacidosis); by patients on hyperthyroidism; hemodialysis Hx of seizure Adverse Reaction NSG Consideration CNS: restlessness, Do not exceed apprehension, anxiety, recommended fear, CNS stimulation, dosage; adverse hyperkinesia, insomnia, effects or loss of tremor, drowsiness, effectiveness may irritability, weakness, result. Read the vertigo, headache instructions that CV: cardiac come with arrhythmias, respiratory tachycardia, inhalants. palpitations, PVCs Do not cut, crush, (rare), angina pain or chew ER Dermatologic: tablets; swallow sweating, palor, them whole. flushing Possible GI: nausea, vomiting, experienced side heartburn, unusual or effects: Dizziness, bad taste in mouth drowsiness, GU: increased incidence fatigue, headache of leiomyomas of (use caution if uterus when given in driving or higher than human performing tasks doses in preclinical that require studies alertness); nausea, Respiratory: respiratory vomiting, change difficulties, pulmonary in taste (eat edema, coughing, frequent small bronchospasm; meals); rapid heart paradoxical airway rate, anxiety, resistance with sweating, flushing, repeated, excessive use insomnia.

disorders; of inhalation psychoneurotic preparations. individuals; labor and delivery (oral use has delayed second stage of labor; parenteral use of beta2adrenergic agonists can accelerate fetal heartbeat and cause hypoglycemia, hypokalemia, pulmonary edema in mother and hypoglycemia in neonate); lactation; the elderly (more sensitice to CNS effects).

Report chest pain, dizziness, insomnia, weakness, tremors or irregular heartbeat, difficulty breathing, productive cough, failure to respond to usual dosage.

Students Signature Clinical Instructor and Signature

DRUG STUDY Name of Drug Action Indication Contraindication Acetaminophen Antipyretic: Temporary Allergy to reduction of acetaminophen (Paracetamol) reduces fever fever; Use cautiously with by acting temporary impaired hepatic directly on relief of minor function, chronic the aches and pains alcoholism, hypothalamic caused by pregnancy, heatcommon cold lactation. and influenza, regulating headache, sore center to throat, cause toothache vasodilation (patient ages 2 and sweating, years and older which helps Unlabeled use: dissipate prophylaxis in children and heat. patients at risk Analgesic: site for seizures and who are mechanism of receiving DTP action unclear vaccination to reduce incidence of fever and pain Adverse Reaction CNS: headache CV: chest pain, dyspnea, myocardial damage when doses of 5-8 g/day are ingested daily for several weeks or when doses of 4 g/day are ingested for one year GI: hepatic toxicity and failure, jaundice GU: acute renal failure, renal tubular necrosis Hematologic: methemoglobinemiacyanosis; hemolytic anemia-hematuria, anuria; neutropenia, leukopenia, pancytopenia, thrombocytopenia, hypoglycemia Hypersensitivity: rash, fever Health Teaching Do not exceed recommended dose; do not take for longer than ten days unless directed by prescriber. Take the drug only for complaints indicated; its not an anti-flammatory agent. Avoid the use of other over-thecounter or prescription preparation, consult healthcare provider. Report rash, unusual bleeding or bruising, yellowing of skin or eyes, changes in voiding patterns.

Students Signature Clinical Instructor and Signature