DRUG STUDY

BRAND NAME Prescribed and Recommended Mechanism Of Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME dosage, frequency, route of Action
CLASSIFICATION administration
Generic name: 500mg 1 tab BID Increases protection  Dietary Contraindicated in: CNS: drowsiness,  Secure doctor’s Order.
Ascorbic Acid mechanism of the supplement.  Tartrazine fatigue, headache,  Do hand washing.
Brand name: immune system,  Frank and hypersensitivity insomnia  Assess patient’s condition.
Cecon thus supporting subclinical GI: cramps, diarrhea,  Give medication on right timing.
wound healing. scurvy. Use cautiously in: heartburn, nausea,  Inform patient about the possible
Classification:  Extensive burns,  Recurrent kidney vomiting side effects of the drugs.
Therapeutic: delayed fracture stones; avoid GU: kidney stones  Instruct patient to be cautious of the
Vitamins or wound chronic use of Derm: Flushing Contraindications of the drugs.
Pharmacologic: healing, sever large dose in Hemat: deep vein  Return the medication ticket on the
Water-soluble febrile or chronic pregnant women thrombosis, right box for the next timing.
vitamins disease states. hemolysis, sickle cell  Do the charting or the
 To prevent crisis documentation.
vitamin C in Local: pain at sub cut
patients with IM sites
poor nutritional
habits.
 To acidify urine
Macular
degeneration.
Generic name: 500mg TIV q8h X 3d Forms a reversible  Antihemorrhagic Contraindicated in: CNS: dizziness,  Monitor V/S, fluid intake and output,
Tranexamic acid complex that and  Hypersensitivity malaise, headache, and ECG.
Brand name: displaces antifibrinolytic  Upper urinary delirium,  Assess for signs and symptoms of
Hemostan plasminogen from for effective tract bleeding hallucinations, thrombophlebitis and pulmonary
fibrin resulting in hemostasis in  Disseminated weakness, seizures embolism.
Classification: inhibition of various surgical intravascular CV: hypotension,  Monitor neurologic status, especially
Antihemophilic fibrinolysis, it also and clinical coagulation ischemia, for signs of impending seizure.
agent inhibits the cases, in  Neonates thrombophlebitis,  Monitor kidney and liver function
proteolytic activity of traumatic (injectable form) cardiomyopathy, test results, serum electrolytes level,
plasmin. injuries, post- bradycardia, and CBC with white cell differential.
tooth extraction arrhythmias  Evaluate for blood dyscrasias,
and other dental EENT: conjunctival particularly bleeding tendencies.
procedures. suffusion, tinnitus,
nasal congestion
 GI: nausea, vomiting,
diarrhea, abdominal
pain, dyspepsia
GU: intrarenal
obstruction, renal
failure
Hematologic: bleeding
tendency, generalized
thrombosis,
agranulocytosis,
leucopenia,
thrombocytopenia
Musculoskeletal:
myopathy,
rhabdomyolysis
Respiratory: dyspnea,
pulmonary embolism
Skin: rash, pruritus
Generic name: cap 300mg PO BID Cholagogues  Treatment of Contraindicated in: Long-term use of large  Monitor vital signs.
Carnitine and promotes the mitochondrial  Contraindicated doses of Godex may  Should be taken with foods.
vitamin complex discharge of bile dysfunctions, for patients who lead to:  Assess for any signs and symptoms
Brand name: from the system, acute and are  Severe peripheral of complications.
Godex purging it chronic viral hypersensitive to neuropathies.  Assess if the patient is sensitive to
downward. hepatitis, fatty the drug.  Galactosemia the drug.
Classification: liver, drug-  Bowel obstruction  If administration through IV, inject
Prescription Drug induced liver slowly as possible.
(Rx) injury, cirrhosis,  First assess if the packaging was
alcoholic and stored open.
general  Store the packaging with a
intoxication. temperature of less than 30ᵒC, clean
and dry surface.
 Refer to physician if there is no
improvement after 1 month of
treatment.
Omeprazole 40 mg TIV OD Binds to an enzyme  GERD / Contraindicated in: CNS: dizziness, Assessment
(Losec, Prilosec, on gastric parietal maintenance of  Hypersensitivity; drowsiness, fatigue,  Assess patient routinely for
Zegerid)  PO (Adults): GERD / erosive cells in the presence healing in Metabolic headache, weakness. epigastric or abdominal pain and
esophagitis – 20 mg once of acidic gastric pH, erosive alkalosis and CV: chest pain. frank or occult blood in the stool,
Therapeutic: daily. Duodenal ulcers preventing the final esophagitis. hypocalcemia GI: abdominal pain, emesis, or gastric aspirate.
Antiulcer agents associated with H. pylori – transport of (Zegerid only). acid regurgitation,
Pharmacologic: 40 mg daily in the morning
Proton-pump with clarithromycin for 2
inhibitors weeks, then 20 mg once
daily for 2 weeks or 20 mg
twice daily with
clarithromycin 500 mg twice
daily and amoxicillin
1000mg twice daily for 10
days (if ulcer is present at
beginning of therapy,
continue omeprazole 20mg
daily for 18 more days); has
also been used with
clarithromycin and
metronidazole. Gastric
ulcer- 40mg once daily for
4-6 weeks. Reduction of the
risk of GI bleeding in
critically ill patients-40mg
initially, then another 40mg
6-8 hours later, followed by
40mg once daily for up to
14 days. Gastric
hypersecretory conditions-
60mg once daily initially;
may be increased up to
120mg 3 times daily
(doses>80mg / day should
be given in divided doses);
OTC – 20mg once daily for
up to 14 days.
 PO (Children >2years and
<20 kg): 10 mg once daily
 PO (Children >2 years and
>20 kg): 20 mg once daily.
 PO (Children): Alternative
dosing – 1 mg/kg/day given
once or divided twice daily
(range of doses in the
literature: 0.2-3.5
hydrogen ions into  Duodenal ulcers Use cautiously in: constipation, diarrhea,  Lab Test Considerations: Monitor
the gastric lumen. (with or without  Liver disease flatulence, nausea, CBC with differential periodically
anti-infectives (dosage vomiting. during therapy.
Therapeutic Effects: for Helicobacter reduction may Derm: itching, rash.  May cause increased AST, ALT,
Diminished pylori). be necessary); Misc: allergic alkaline phosphatase, and bilirubin.
accumulation of acid  Short-term Geri: Increased reactions.  May cause serum gastrin
in the gastric lumen treatment of risk of hip concentrations to increase during
with lessened active benign fractures in first 1-2 week of therapy. Levels
gastroesophageal gastric ulcer. patients using return to normal after
reflux. Healing of  Pathologic high-doses for >1 discontinuation of omeprazole.
duodenal ulcers. hypersecretory year; Bartter’s
conditions, syndrome, Implementation
including hypokalemia,  Do not confuse Prilosec
Zollinger-Ellison and respiratory (omeprazole) with Prinivil (lisinopril).
syndrome. alkalosis (Zegerid  PO: Administer doses before meals,
 Reduction of risk only); Pregnancy, preferably in the morning. Capsules
of GI bleeding in lactation, or should be swallowed whole; do not
critically ill children <2 years crush or chew. Capsules may be
patients. (safety not opened and sprinkled on cool apple
 OTC: Heartburn established). sauce, entire mixture should be
occurring ingested immediately and followed
>2X/week. by a drink of water. Do not store for
future use.
 Powder for oral suspension:
Administer on empty stomach, as
least 1 hour before a meal. For
patients with nasogastric or enteral
feeding, suspend feeding for 3 hours
before and 1 hour after
administration. Empty packet
contents into a small cup containing
1-2 tablespoons of water. Do not use
other liquids or foods. If
administered through a nasogastric
tube, suspend in 20 ml of water. Stir
well and drink immediately. Refill
cup with water and drink again.
 May be administered concurrently
with antacids.
 mg/kg/day); Adjunctive
therapy of duodenal ulcers
associated with H. pylori -
15-30kg: 10 mg BID; >30 kg:
20 mg BID.
Ceftriaxone 1g IVTT q12h
(Rocephin)
 IM, IV (Adults): Most
Therapeutic: infections – 1-2 g q12-24
Anti-infectives hours. Gonorrhea – 250 mg
Pharmacologic: IM (single dose). Meningitis
3rd generation – 2g q 12 hours.
cephalosporins Perioperative prophylaxis –
1 g 30-120 min before initial
incision (single dose).
 IM, IV (Children): Most
infections – 25-37.5 mg/kg
q 12 hour or 50-75 mg/kg q
24 hours; dose should not
exceed 2 g/ day. Meningitis
– 100 mg/kg q 24 hour or 50
Patient / Family Teaching
 Instruct patient to take medication
as directed for the full course of
therapy, even if feeling better. Take
missed doses as soon as
remembered but not if almost time
for next dose. Do not double doses.
 May cause occasional drowsiness or
dizziness. Caution patient to avoid
driving or other activities requiring
alertness until response to
medication is known.
 Advise patient to consult health care
professional before taking Rx, OTC,
or herbal products with omeprazole.
 Advise patient to avoid alcohol,
products containing aspirin or
NSAIDs, and foods that may cause
an increase in GI irritation.
 Advise patient to report onset of
black, tarry stools; diarrhea;
abdominal pain; or persistent
headache to health care professional
promptly.
Bind to the bacterial  Treatment of the Contraindicated in: CNS: Seizures (high Assessment
cell wall membrane, following  Hypersensitivity doses), headache.  Assess for infection (vital signs;
causing cell death. infections to GI: appearance of wound, sputum,
caused by cephalosporins; Pseudomembranous urine, and stool; WBC) at beginning
Therapeutic Effects: susceptible serious colitis, diarrhea, of and throughout therapy.
Bactericidal action organism: Otitis hypersensistivity nausea, vomiting,  Before initiating therapy, obtain a
against susceptible media, to penicillins; cholelithiasis, cramps history to determine previous of and
bacteria. Spectrum: perioperative Hyperbilirubine Derm: rashes, reactions to penicillins or
Similar to that of prophylaxis, and mic neonates urticarial. cephalosporins. Persons with a
second-generation Lyme disease Hemat: negative history of penicillin
cephalosporins, but Use cautiously in: agranulocytosis, sensitivity may still have an allergic
activity against  Renal bleeding, eosinophilia, response.
Staphylococci is less, impairment hemolytic anemia,  Obtain specimens for culture and
whereas activity (decreased lymphocytosis, sensitivity before initiating therapy.
against gram- dosing / neutropenia, First dose may be given before
negative pathogens I increased dosing receiving results.
mg/kg q 12 hours; dose greater, even for interval thrombocytopenia,  Observe patient for signs and
should not exceed 4g/day. organisms resistant recommended thrombocytosis. symptoms of anaphylaxis (rash,
Acute otitis media – 50 to first-and second- for: Combined GU: hematuria, pruritis, laryngeal edema, wheezing).
mg/kg IM single dose; dose generation agents. severe hepatic vaginal moniliasis. Discontinue drug and notify
should not exceed 1 g. Notable is increased and renal Local: pain at IM site, physician or other health care
Uncomplicated gonorrhea – action against: impairment phlebitis at IV site. professional immediately if these
125 mg IM (single dose) Enterobacter, (dosage Misc: allergic reactions symptoms occur. Keep epinephrine,
Haemophilus reduction / including anaphylaxis an antihistamine, and resuscitation
influenza, increased dosing and serum sickness, equipment close by in the event of
Escherichia coli, interval superinfection. anaphylactic reaction.
Klebsiella recommended  Pedi: Assess newborns for jaundice
pneumonia, for ceftriaxone; and hyperbilirubinemia before
Neisseria gonorrhea, History of GI making decision to use ceftriaxone
Citrobacter, disease, (should not be used in jaundiced or
Morganella, Proteus, especially colitis; hyperbilirubinemic neonates).
Providencia, Serratia, Patients with  Lab Test Considerations: May cause
Moraxella poor nutritional positive results for Coomb’s test in
catarrhalis, Borrelia status, patients receiving high doses or in
burgdorferi. Some malabsorption neonates whose mothers were given
agents have activity states, or cephalosporins before delivery.
against Neisseria alcoholism may  Monitor prothrombin time and
meningitides. Not be at high risk assess patient for bleeding (guaiac
active against for bleeding. stools; check for hematuria, bleeding
methicillin-resistance Geri: Dosage gums, ecchymosis) daily, as this
staphylococci or adjustment due agent may cause
enterococci. Some to age-related hypoprothrombinemia.
agents have activity decreases in  May cause increase in serum AST,
against anaerobes, renal function ALT, alkaline phosphatase, bilirubin,
including may be LDH, BUN, and creatinine.
Bacterioides fragilis. necessary;  May rarely cause leukopenia,
Pregnancy and neutropenia, agranulocytosis,
lactation (have thrombocytopenia, eosinophilia,
been used lymphocytosis, and thrombocytosis.
safely).
IV Administration
 Intermittent Infusion: Reconstitute
each 250-mg vial with 2.4 ml, each
500-mg vial with 4.8 ml, each 1-g vial
with 9.6 ml, and each 2-g vial with
19.2 ml of sterile water for injection,
 0.9% NaCl, or D5W for a
concentration of 100 mg/ml.
Diluent: Solution may be further
diluted in 50-100 ml of 0.9% NaCl,
D5W, D10W, D5/0.45%NaCl, or LR.
Solution may appear light yellow to
amber. Solution is stable for 3 days
at room temperature.
Concentration: 40 mg/ml. Rate:
Administer over 10-30 min.

Patient / Family Teaching

 Instruct patient to take medication
around the clock and to finish the
medication completely, even if
feeling better. Take missed doses as
soon as possible unless almost time
for next dose; do not double doses.
Advise patient that sharing of this
medication may be dangerous.
 Pedi: Instruct parents or caregivers
to use calibrated measuring device
with liquid preparations.
 Advise patient to report signs of
superinfection (furry overgrowth on
the tongue, vaginal itching or
discharge, loose or foul-smelling
stools) and allergy.
 Caution patients that concurrent use
of alcohol may cause a disulfiram-
like reaction (abdominal cramps,
nausea, vomiting, headache,
hypotension, palpitations, dyspnea,
tachycardia, sweating, flushing).
Alcohol and alcohol-containing
medications should be avoided
during and for several days after
therapy.
 Instruct patient to notify health care
professional if fever and diarrhea

Hydrocortisone 250mg IV
Therapeutic:  PO (Adults): 20-240 mg/day
Antiasthmatics, in 1-4 divided doses.
corticosteroids  PO (Children):
Adrenocortical insufficiency
Pharmacologic: – 0.56 mg/kg/day (15-20
corticosteroids mg/m/day) as a single dose
(systemic) or in divided doses. Other
uses – 2-8 mg/kg/day (60-
240 mg/m/day) as a single
dose or in divided doses.
 IM, IV (Adults): 100-500 mg
q2-6 hours (range 100-8000
mg/day).
 IM, IV (Children):
Adrenocortical insufficiency
– 0.186-0.28 mg/kg/day
(10-12 mg/m/day) in 3
divided doses. Other uses –
0.666-4 mg/kg (20-120
mg/m) q 12-24 hours.
develop, especially if stool contains
blood, pus, or mucus. Advise patient
not to treat diarrhea without
consulting health care professional.
In pharmacologic Cortisone, Contraindicated in: Adverse reactions / Assessment
doses, all agents hydrocortisone:  Active untreated side effects are much  These drugs are indicated for many
suppress Management of infections (may more common with conditions. Assess involved systems
inflammation and reduction in be used in high-dose / long-term before and periodically during
the normal immune symptoms of nasal patients being therapy. therapy.
response. All agents polyps. treated for some CNS: depression,  Assess patient for signs of adrenal
have numerous adrenocortical forms of euphoria, headache, insufficiency (hypotension, weight
intense metabolic insufficiency. meningitis); increased intracranial loss, weakness, nausea, vomiting,
effects. Betamethasone, Lactation (avoid pressure (children anorexia, lethargy, confusion,
dexamethasone, chronic use); only), personality restlessness) before and periodically
Therapeutic Effects: hydrocortisone, known alcohol, changes, psychosis, during therapy.
Suppression of prednis bisulfite, or restlessness.  Monitor intake and output ratios
inflammation and olone, tartrazine EENT: cataracts, and daily weights. Observe patient
modification of the prednisone,methylp hypersensitivity increased intraocular for peripheral edema, steady weight
normal immune rednisolone, or intolerance pressure. gain, rales / crackles, or dyspnea.
response. triamcinolone: Used (some products CV: hypertension. Notify health care professional if
Replacement systemically and contains these GI: Peptic Ulceration, these occur.
therapy in adrenal locally in a wide and should be anorexia, nausea,  Children should have periodic
insufficiency. variety of chronic avoided in vomiting. evaluations of growth.
Improvement in diseases including: susceptible Derm: acne,  Cerebral edema: Assess patient for
symptoms / Inflammatory, patients); decreased wound changes I level of consciousness and
sequelae of Crohn’s Allergic, Administration healing, ecchymosis, headache during therapy.
disease Hematologic, of live virus fragility, hirsutism,  Budesonide: Assess signs of Crohn’s
Neoplastic, vaccines. petechiae. disease (diarrhea, crampy abdominal
Autoimmune Endo: adrenal pain, fever, bleeding from rectum)
disorders. Use cautiously in: suppression, during therapy.
Methylpredniso  Chronic hyperglycemia.
lone, prednisone: treatment (will F and E: fluid retention Lab Test Considerations
With other lead to adrenal (long-term high  Monitor serum electrolytes and
immunosuppressant suppression; use doses), hypokalemia, glucose. May cause hyperglycemia,
in the prevention of lowest possible hypokalemic alkalosis. especially in persons with diabetes.
organ rejection in dose for shortest Hemat: May cause hypokalemia. Patients on
transplantation period of time); Thromboembolism, prolonged therapy should routinely
surgery. Asthma. Hypothyroidism; thrombophlebitis. have CBC, serum electrolytes, and
Dexamethasone: Cirrhosis ; Metab: weight gain. serum and urine glucose evaluated.
Management of  Pedi: Children MS: muscle wasting, May decrease WBC’s. May cause
cerebral edema: (chronic use will osteoporosis, aseptic hyperglycemia, especially in persons
Diagnostic agent in result in necrosis of joints, with diabetes. May decrease serum
adrenal disorders. decreased muscle pain. potassium and calcium and increase
Budesonide: growth; use Misc: cushingoid serum sodium concentrations.
corticosteroids lowest possible appearance (moon  Guaiac-test stools. Promptly report
Treatment of mild to dose for shortest face, buffalo hump), presence of guaiac-positive stools.
moderate Crohn’s period of time); increased  May increase serum cholesterol and
disease. Stress (surgery, susceptibility to lipid values. May lower uptake of
Unlabeled uses: infections); infection. thyroid.
Short-term supplemental  Suppress reactions to allergy skin
administration to doses may be tests.
high-risk mothers needed;  Periodic adrenal function tests may
before delivery to Potential be ordered to assess degree of
prevent respiratory infections may hypothalamic-pituitary-adrenal axis
distress syndrome in mask signs suppression in systemic and chronic
the newborn (fever, topical therapy.
(betamethasone, inflammation);
dexamethasone).  OB: pregnancy Patient / Family Teaching
Adjunctive therapy (safety not  Instruct patient on correct technique
of hypercalcemia established); of medication administration. Advise
(prednisone, Neonates (avoid patient to take medication as
prednisolone,methyl use of benzyl directed. Take missed doses as soon
prednisolone).Mana alcohol as remembered unless almost time
gement of containing for next dose. Do not double doses.
(pred-niss-oh-lone) injectable Stopping the medication suddenly
acute spinal cord preparations, may result in adrenal insufficiency
injury use preservative (anorexia, nausea, weakness,
(methylprednisolone free fatigue, dyspnea, hypotension,
). formulations). hypoglycemia). If these signs appear,
Adjunctive notify helth care professional
management of immediately. This can bel life-
nausea and vomiting threatening.
From chemotherapy  Corticosteroids cause
(dexamethasone, immunosuppression and may mask
predni- Sterapred symptoms of infection. Instruct
sone, patient to avoid people with known
prednisolone,methyl contagious illness and to report
prednisolone). possible infections immediately.
Management of
 croup  Caution patient to avoid
(dexamethasone). vaccinations without first consulting
Treatment of airway health care professional.
edema prior to  Review side effects with patient.
extubation Instruct patient to inform health
(dexamethasone). care professional promptly if severe
Facilitation of abdominal pain or tarry stools occur.
ventilator weaning in Patient should also report unusual
neonates with swelling, weight gain, tiredness,
bronchopulmonary bone pain, bruising, non-healing
dysplasia sores, visual disturbances, or
(dexamethasone). behavior changes.
 Advise patient to notify health care
professional of medication regimen
before treatment or surgery.
 Discuss possible effects on body
image. Explore coping mechanisms.
 Instruct patient to inform health
care professional if symptoms of
underlying disease return or worsen.
 Advise patient to carry identification
describing disease process and
medication regimen in the event of
emergency in which patient cannot
relate medical history.
 Explain need for continued medical
follow-up to assess effectiveness and
possible side effects of medication.
Periodic lab tests and eye exams
may be needed.
 Long-term Therapy: Encourage
patient to eat a diet high in protein,
calcium, and potassium, and low in
sodium and carbohydrates. Alcohol
should be avoided during therapy.

Dipenhydramine 50 mg TIV Competes with  Treatment of  Hypersensitivity Hypersensitivity  If patient is having acute allergic
histamine for H-1 allergic to reactions (eczema, reaction, obtain history of recently
Brand name: receptor site on reactions, diphenhydramin pruritus, rash, cardiac ingested foods, drugs,
Benadryl effector cells in GI including nasal e. Neonates or disturbances,
Classification: tract, blood vessels, allergies and pre-mature photosensitivity) may environmental exposure, emotional
Antihistamine (1st respiratory tract. allergic infants, occur. stress.
generation), Therapeutic Effect: dermatoses; breastfeeding. Overdose symptoms  Monitor depth, rhythm, type of
anticholinergic, Produces parkinsonism, may vary from CNS respiration; quality, rate of pulse.
antipruritic, anticholinergic, anti- including drug- Cautions: depression (sedation,  Assess lung sounds for rhonchi,
antitussive, pruritic, antitussive, induced  Narrow-angle apnea, hypotension, wheezing, rales.
antiemetic, and antiemetic, anti extrapyramidal glaucoma, cardiovascular  Monitor B/P, esp. in elderly
anitdyskinetic dyskinetic, sedative symptoms; stenotic peptic collapse, death) to (increased risk of hypotension).
effects. prevention/ ulcer, prostatic severe para-doxical Monitor children closely for
treatment of hypertrophy, reactions paradoxical reaction.
nausea, pyloroduodenal/ (hallucinations,  Monitor for sedation.
vomiting, or bladder neck tremors, seizures).  Tolerance to antihistaminic effect
vertigo due to obstruction, Children, infants, generally does not occur; tolerance
motion sickness; asthma, COPD, neonates: to sedative effect may occur.
antitussive; increased IOP, May experience  Avoid tasks that re-quire alertness,
short-term cardiovascular paradoxical reactions motor skills until response to drug is
management of disease, (restlessness, established.
insomnia; hyperthyroidism, insomnia, euphoria,  Dry mouth, drowsiness, dizziness
adjunct to elderly. nervousness, may be an expected response to
epinephrine in tremors). drug.
treatment of Overdosage in  Avoid alcohol.
anaphylaxis. children may result in
hallucinations,
seizures, death.
Paracetamol 150mg/ml PRN IV Appears to inhibit  PO, Rectal:  Hypersensitivity Early Signs of  If given for analgesia, assess onset,
prostaglandin Temporary relief to Acetaminophen type, location, duration of pain.
Brand name: synthesis in the CNS of mild to acetaminophen, Toxicity: Effect of medication is reduced if full
Panadol, Tylenol, and, to a lesser moderate pain, severe hepatic Anorexia, nausea, pain response recurs prior to next
Dymadon, extent, block pain headache, fever. impairment or diaphoresis, fatigue dose. Assess for fever. Assess LFT in
Lemsip, Panamax impulses through  IV: severe active within first 12–24 hrs. pts with chronic usage or history of
peripheral action. (Additional) liver disease. Later Signs of Toxicity: hepatic impairment, alcohol abuse.
Classification: Acts centrally on Management of Vomiting, right upper  Assess for clinical improvement and
Central analgesic, hypothalamic heat- moderate to Cautions: quadrant tenderness relief of pain, fever.
non-narcotic regulating center, severe pain  Sensitivity to elevated LFTs within  Therapeutic serum level:
analgesic, producing peripheral when combined acetaminophen; 48–72 hrs after  10– 30 mcg/mL
antipyretic. vasodilation (heat with opioid severe renal ingestion.  Toxic serum level:
loss, skin erythema, analgesia. impairment; Antidote:  Greater than 200 mcg/mL. Do not
diaphoresis). alcohol Acetylcysteine exceed maximum daily
Therapeutic Effect: dependency, recommended dose: 4 g/day.
hepatic
 Results in impairment, or  Consult physician for use in children
antipyresis. Produces active hepatic younger than 2 years, oral use
analgesic effect. disease; chronic longer than 5 days (children) or
malnutrition and longer than 10 days (adults), or fever
hypovolemia lasting longer than 3 days.
(Ofirmev); G6PD  Severe/recurrent pain or high/
deficiency continuous fever may indicate
(hemolysis may serious ill-ness.
occur). Limit  Do not take more than 4 g/day (3
dose to less than g/day if using OTC [over-the-
4 g/day. counter]). Actual OTC dosing
recommendations may vary by
product and/or manufacturer. Many
nonprescription combination
products contain acetaminophen.
 Avoid alcohol.
Vitamin K 1 amp q8h IV Promotes hepatic  Prevention of Biliary tract disease, Newborns: (esp.  Monitor patient routinely:
Phytonadione formation of treatment of hepatic disease, premature infants)  Assess skin for ecchymoses,
coagulation factors. hemorrhagic jaundice; may develop petechiae.
Classification: Essential for normal states in hypoprothrombinem hyperbilirubinemia.  Assess gums forgingival bleeding.
Vitamin clotting of blood. neonates. ia, thromboembolic Sever reaction (cramp-  Assessfor eryhthema
Readily absorbed  Antidote for disease; like pain, chest pain,  Assess Hct, platelet count,
from GI tract after hemorrhage Anticoagulant dyspnea, facial urine/stool culture for occult blood.
IM, subcutaneous induced by oral therapy; flushing, dizziness,  Assess for decreases in BP, increase
administration. anticoagulants, Pregnancy; breast- rapid/weak pulse, in PR, complaint of abdominal/back
Metabolized in liver. hypoprothrombi feeding; rash, diaphoresis, pain, severe headache (may be
Excreted in urine; nemic states due intramuscular hypotension evidence of hemorrhage).
eliminated by biliary to vitamin K administration, progressing to shock,  Assess for peripheral nerves.
system. Onset of deficiency. intravenous cardiac arrest) occurs
action (increased  Hypoprothrombi administration, rarely, immediately
coagulation factors). nemia caused by serious after IV
malbsorption or hypersensitivity administration.
inability to reactions or
synthesize anaphylaxis.
vitamin K.
Apo-Furosemide 20 mg PO Inhibits sodium and  To reduce  Anuria CNS: Dizziness, fever,  Obtain patient’s weight before and
(CAN), Furoside water reabsorption edema caused unresponsive to headache, periodically during furosemide
(CAN), in the loop of Henle by cirrhosis, furosemide; paresthesia, therapy to monitor fluid loss.
and increases urine heart failure, and hypersensitivity
Lasix, Lasix formation. As the renal disease, to furosemide, restlessness, vertigo,  For once-a-day dosing, give drug in
Special (CAN), body’s plasma including sulfonamides, or weakness the morning so patient’s sleep won’t
Myrosemide, volume decreases, nephrotic their CV: Orthostatic be interrupted by increased need to
Novosemide aldosterone syndrome. components. hypotension, shock, urinate.
(CAN), Uritol production thromboembolism,  Prepare drug for infusion with
(CAN) increases, which thrombophlebitis normal saline solution, lactated
promotes sodium EENT: Blurred vision, Ringer’s solution, or D5W.
reabsorption and the oral irritation,  Administer drug slowly I.V. over 1 to
loss of potassium ototoxicity, stomatitis, 2 minutes to prevent ototoxicity.
and hydrogen ions. tinnitus, transient  Expect patient to have periodic
Furosemide also hearing loss (rapid I.V. hearing tests during prolonged or
increases the injection), yellow high-dose I.V. therapy.
excretion of calcium, vision  Monitor blood pressure and hepatic
magnesium, ENDO: Hyperglycemia and renal function as well as BUN,
bicarbonate, GI: Abdominal cramps, blood glucose, and serum creatinine,
ammonium, and anorexia, constipation, electrolyte, and uric acid levels, as
phosphate. By diarrhea, gastric appropriate.
reducing intracellular irritation,  Be aware that elderly patients are
and extracellular hepatocellular more susceptible to hypotensive and
fluid volume, the insufficiency, electrolytealtering effects and thus
drug reduces blood indigestion, jaundice, are at greater risk for shock and
pressure and nausea, pancreatitis, thromboembolism.
decreases cardiac vomiting  If patient is at high risk for
output. Over time, GU: Bladder spasms, hypokalemia, give potassium
cardiac output glycosuria supplements along with furosemide,
returns to normal. HEME: as prescribed.
Agranulocytosis (rare),  Expect to discontinue furosemide at
anemia, aplastic maximum dosage if oliguria persists
anemia (rare), for more than 24 hours.
azotemia, hemolytic  Be aware that furosemide may
anemia, leukopenia, worsen left ventricular hypertrophy
thrombocytopenia and adversely affect glucose
MS: Muscle spasms tolerance and lipid metabolism.
SKIN: Bullous  Notify prescriber if patient
pemphigoid, erythema experiences hearing loss, vertigo, or
multiforme, exfoliative ringing, buzzing, or sense of fullness
dermatitis, in her ears. Drug may need to be
photosensitivity, discontinued.
pruritus, purpura,
rash, urticaria
 Other: Allergic
reaction (interstitial
nephritis, necrotizing
vasculitis, systemic
vasculitis),
dehydration,
hyperuricemia,
hypochloremia,
hypokalemia,
hyponatremia,
hypovolemia.

Suprax 200mg cap BID X 7d Interferes with  To treat  Hypersensitivity CNS: Chills, fever,  Use cefixime cautiously in patients
bacterial cell wall uncomplicated to headache, seizures with impaired renal function or a
synthesis by UTI caused by cephalosporins CV: Edema history of GI disease, especially
inhibiting the final Escherichia coli or their EENT: Hearing loss colitis. Also use cautiously in
step in the and Proteus components. GI: Abdominal cramps, patients hypersensitive to penicillin
crosslinking of mirabilis; otitis diarrhea, elevated because cross-sensitivity has
peptidoglycan media caused by liver function test occurred in about 10% of such
strands. Haemophilus results, hepatic failure, patients.
Peptidoglycan makes influenzae, hepatitis,  If possible, obtain culture and
cell membranes rigid Moraxella hepatomegaly, sensitivity test results, as ordered,
and protective. catarrhalis, or jaundice, nausea, oral before giving drug.
Without it, bacterial Streptococcus candidiasis,  Tablets shouldn’t be substituted for
cells rupture and die. pyogenes; pseudomembranous oral suspension to treat otitis media
pharyngitis and colitis, vomiting because cefixime suspension
tonsillitis caused GU: Elevated BUN produces a higher peak blood level
by S. pyogenes; level, nephrotoxicity, than do tablets when administered
acute bronchitis renal failure, vaginal at the same dose.
and acute candidiasis  Monitor BUN and serum creatinine
exacerbations of HEME: Eosinophilia, for early signs of nephrotoxicity. Also
chronic hemolytic anemia, monitor fluid intake and output;
bronchitis Hypoprothrombinema decreasing urine output may
caused by H. , neutropenia, indicate nephrotoxicity.
influenzae and thrombocytopenia,  Be aware that an allergic reaction
Streptococcus unusual bleeding may occur a few days after therapy
pneumoniae MS: Arthralgia starts.
RESP: Dyspnea  Assess bowel pattern daily; severe
SKIN: Ecchymosis, diarrhea may indicate
erythema, erythema pseudomembranous colitis.
multiform, pruritus,  Assess for signs of superinfection,
rash, Stevens-Johnson such as perineal itching, fever,
syndrome, toxic malaise, redness, pain, swelling,
epidermal necrolysis drainage, rash, diarrhea, and cough
Other: Anaphylaxis, or sputum changes.
angioedema, facial  Assess for pharyngitis, ecchymosis,
edema, superinfection bleeding, and arthralgia; they may
indicate a blood dyscrasia.