MACATANGAY, Gaea Angela F.

05/18/2020
G2B2 NCM_1O9 RLE
ACTIVITY 6: DRUG STUDY

DRUG NAME MECHANISM INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS NURSING

OF ACTION RESPONSIBILITIES

GENERIC NAME Ceftriaxone Susceptible bacterial Hypersensitivity to CNS: ♥​ ​Assess for infection
Ceftriaxone selectively and infections of the lower cephalosporins; Serious SEIZURES (HIGH (vital signs; appearance
irreversibly inhibits respiratory tract, skin hypersensitivity to DOSES). of wound, sputum, urine,
BRAND NAME bacterial cell wall and skin structure, penicillins; ​Pedi: and stool; WBC) at
Rocephin synthesis by binding bone and joint, acute Neonates ≤ 28 days (use GI: beginning of and
PSEUDOMEMBRANOUS throughout therapy.
to transpeptidases, otitis media, UTIs, in hyperbilirubinemic
COLITIS​, diarrhea,
DOSE & also called septicemia, pelvic neonates may lead to
cholelithiasis, sludging ♥ ​Watch for seizures;
FREQUENCY transaminases, which inflammatory disease kernicterus); ​Pedi:
in the gallbladder. notify the physician
IM, IV are penicillin-binding (PID), intra abdominal Neonates ≤ 28 days
immediately if the patient
(Children):​ ​Most proteins (PBPs) that infections, meningitis, requiring
Derm: develops or increases
infections​—50– catalyze the uncomplicated calcium-containingIV seizure activity.
Rashes, urticaria.
75 mg/kg/day cross-linking of the gonorrhea. Surgical solutions ( ↑ risk of
(not to exceed 2 peptidoglycan prophylaxis. precipitation formation). ♥ ​Monitor signs of
Hemat:
g/day) polymers forming the allergic reactions and
Bleeding, eosinophilia,
divided every 12– bacterial cell wall. other adverse effects.
hemolytic anemia,
24 hr. Notify physician or
leukopenia,
Meningitis​—100 nursing staff immediately
thrombocytosis.
mg/kg/day (not to if these reactions occur.
exceed 4 g/day)
Local: ♥ ​Always wash hands
divided every 12–
Pain at IM site​, thoroughly and disinfect
24 hr
phlebitis at IV site​. equipment (whirlpools,
ROUTE electrotherapeutic
Misc: devices, treatment
IV ALLERGIC REACTIONS,
IM tables, and so forth) to
INCLUDING help prevent the spread
ANAPHYLAXIS, of infection.
superinfection.
♥ ​Use universal
precautions or isolation
procedures as indicated
for specific patients.
 DRUG NAME MECHANISM INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS NURSING
OF ACTION RESPONSIBILITIES

GENERIC NAME Blocks stimulation of Management of Uncompensated HF; CNS:​ ​fatigue​, ♥ ​Monitor BP and pulse
Propranolol beta1(myocardial) hypertension, angina, Pulmonary edema; weakness​, anxiety, frequently during dose
and beta2 arrhythmias, Cardiogenic shock; dizziness, drowsiness, adjustment period and
BRAND NAME (pulmonary, vascular, hypertrophic Bradycardia, sick sinus insomnia, memory periodically during
Inderal and cardiomyopathy, syndrome, or heart block loss, mental therapy.
uterine)–adrenergic thyrotoxicosis, (unless pacemaker depression, mental
♥ ​Abrupt withdrawal of
DOSE receptor sites. essential tremors, present). status changes,
propranolol may
PO (Children): Therapeutic Effects: pheochromocytoma. nervousness,
precipitate
Antihypertensive/ Decreased heart rate Also used in the nightmares.
life-threatening
antiarrhythmic​—0 and blood pressure. prevention and EENT:​ blurred vision, arrhythmias,
.5– 1 mg/kg/day Suppression of management of MI dry eyes, nasal hypertension, or
in 2– 4 divided arrhythmias. and the prevention of stuffiness. myocardial ischemia.
doses; may be ↑ Prevention of MI. vascular headaches. Resp:​ bronchospasm,
as needed wheezing. ♥ ​Monitor intake and
IV (Children): CV:​ ​ARRHYTHMIAS, output ratios and daily
Antiarrhythmi​c— BRADYCARDIA, CHF, weight. Assess patient
10– 100 mcg; PULMONARY EDEMA​, routinely for evidence of
may be repeated orthostatic fluid overload (peripheral
q 6– 8 hr if hypotension, edema, dyspnea, rales/
needed. peripheral crackles, fatigue, weight
vasoconstriction. gain, jugular venous
FREQUENCY GI:​ constipation, distention).
OD; as needed diarrhea, nausea.
GU:​ ​erectile ♥ ​Assess for rash
dysfunction​, decreased periodically during
ROUTE
libido. ​Derm:​ itching, therapy. May cause
PO
rashes. ​Endo: Stevens-Johnson
IV syndrome. Discontinue
hyperglycemia,
therapy if severe or if
hypoglycemia
accompanied with fever,
(increased in children). general malaise, fatigue,
MS:​ arthralgia, back muscle or joint aches,
pain, muscle cramps. blisters, oral lesions,
Neuro:​ paresthesia. conjunctivitis, hepatitis
Misc:​ drug-induced and/or eosinophilia.
lupus syndrome.
 DRUG NAME MECHANISM INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS NURSING
OF ACTION RESPONSIBILITIES

GENERIC NAME Decreases hepatic Management of type Hypersensitivity; GI: ♥ ​When combined with
Metformin glucose production. 2 diabetes mellitus; Metabolic acidosis; abdominal bloating​, oral sulfonylureas,
Decreases intestinal may be used with Dehydration, sepsis, diarrhea​, ​nausea​, observe for signs and
BRAND NAME glucose absorption. diet, insulin, or hypoxemia, hepatic symptoms of
vomiting​, unpleasant
Fortamet Increases sensitivity sulfonylurea oral impairment, excessive hypoglycemic reactions
metallic taste. (abdominal pain,
Glumetza to insulin. Therapeutic hypoglycemics. alcohol use (acute or
Glucophage Effects: Maintenance chronic); Renal sweating, hunger,
Endo: weakness, dizziness,
of blood glucose. dysfunction (SCr > 1.5
hypoglycemia. headache, tremor,
DOSE mg/dL in men or > 1.4
tachycardia, anxiety).
(Adults and mg/dL in women);
children > 17 Radiographic studies
F and E:
LACTIC ACIDOSIS​. ♥ ​Patients who have
yr): ​500 mg; may requiring IV iodinated been well controlled on
↑ by 500 mg at contrast media (withhold metformin who develop
weekly metformin); HF. Misc: illness or laboratory
intervals up to ↓ vitamins B​1​ and B​2 abnormalities should be
2000 mg/day. levels. assessed for
ketoacidosis or lactic
FREQUENCY acidosis. Assess serum
BID electrolytes, ketones,
glucose, and, if
ROUTE indicated, blood pH,
PO lactate, pyruvate, and
metformin levels. If
either form of acidosis is
present, discontinue
metformin immediately
and treat acidosis.

♥ ​Assess renal function

before initiating and at
least annually during
therapy. Discontinue
metformin if renal
impairment occurs.
 DRUG NAME MECHANISM INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS NURSING
OF ACTION RESPONSIBILITIES

GENERIC NAME Binds to the bacterial Treatment of: Urinary Hypersensitivity to CNS: ♥ ​Assess for infection
Cefixime cell wall membrane, and gynecologic cephalosporins; Serious SEIZURES (VERY HIGH (vital signs; appearance
causing cell death. infections including hypersensitivity DOSES). of wound, sputum, urine,
BRAND NAME Therapeutic Effects: gonorrhea, to penicillins. and stool;
Suprax Bactericidal action Respiratory GI: WBC) at the beginning
against susceptible tract infections, Otitis PSEUDOMEMBRANOUS of and throughout
DOSE & bacteria. ​Spectrum: media. COLITIS​, ​diarrhea​, therapy.
(Adults and Similar to that of nausea​, v​ omiting​,
cramps. ♥ ​Obtain specimens for
Children > 12 yr second-generation
culture and sensitivity
or > 50 kg):​ Most cephalosporins, but before initiating therapy.
infections—400 activity against Derm:
mg. staphylococci is less, Rashes​, urticaria.
♥ ​Observe patient for
Gonorrhea—400 while activity against signs and symptoms of
mg single dose. gram-negative Hemat:
anaphylaxis (rash,
(Children):​ 8 pathogens is greater, Bleeding, blood
pruritus,
mg/kg once daily even for organisms dyscrasias, hemolytic laryngeal edema,
or 4 mg/kg every resistant to first- and anemia. wheezing). Discontinue
12 hr. second-generation the drug and notify the
agents. Notable is Misc: physician or other health
ALLERGIC REACTIONS, care professional
FREQUENCY increased action INCLUDING
OD against ​Enterobacter, immediately if these
ANAPHYLAXIS AND
Haemophilus symptoms occur.
SERUM SICKNESS​,
ROUTE influenzae, superinfection.
♥ ​Monitor bowel
PO Escherichia coli,
function. Diarrhea,
Klebsiella
abdominal cramping,
pneumoniae,
fever, and
Neisseria, Proteus, bloody stools should be
Providencia, Serratia, reported to health care
Moraxella catarrhalis, professional promptly
Borrelia burgdorferi​. as a sign of
pseudomembranous
colitis. May begin up to
several weeks
following cessation of
therapy.