Name of Drug Mechanism of Action Indication Contraindications and Side Effects/Adverse Nursing Responsibilities

Cautions Effects
ceftriaxone Binds to bacterial cell UTI, lower respiratory Contraindications: GI: Before
membranes, inhibits tract, gynecologic, pseudomembranous  Question for history of
Dosage: History of
cell wall synthesis. bone or joint, intra- colitis, diarrhea. allergies, particularly
2g hypersensitivity/
Therapeutic Effect: abdominal, skin, or Hematologic: cephalosporins,
anaphylactic reaction to
Route: Bactericidal. skin-structure eosinophilia, penicillin’s
cephalosporins.
IV infection; septicemia. thrombocytosis,
During:
Cautions: leukopenia.
Frequency:  Monitor daily pattern of
OD Hepatic impairment, Skin: pain, induration, bowel activity, stool
history of GI disease (esp. tenderness at injection consistency. Mild GI
Therapeutic: site, rash. effects may be tolerable
ulcerative colitis,
Antibiotic (increasing severity may
antibiotic-associated
Other: hypersensitivity indicate onset of
Pharmacologic class: colitis). Severe renal
reactions, serum antibiotic-associated
Third generation impairment, history of
sickness, anaphylaxis. colitis).
cephalosporins penicillin allergy
Occasional: Nausea,  Monitor I&O, renal
serum sickness-like function tests for
reaction (fever, joint nephrotoxicity, CBC.
pain; usually occurs
after second course of  Be alert for super
therapy and resolves infection: fever, vomiting,
after drug is diarrhea, anal/ genital
discontinued). pruritus, oral mucosal
changes (ulceration, pain,
Rare: Allergic reaction erythema)
(rash, pruritus,
urticaria),
thrombophlebitis (pain,
redness, swelling at
injection site). After
 Doses should be evenly
spaced.
 Continue antibiotic
therapy for full length of
treatment
 Tell patient to report
adverse reactions
promptly.
 Instruct pt. to report
discomfort at IV insertion
site.
 Document and record.
 Name of Drug Mechanism of Action Indication Contraindications and Side Effects/Adverse Nursing
Cautions Effects Responsibilities
azithromycin Binds to the 50S subunit  Community-acquired  Contraindicated in  Nervous System: NOTE: Check 15 Rights
of bacterial ribosomes, pneumonia caused patients fatigue, headache, to Drug Administration
Dosage: by C. pneumoniae, hypersensitive to somnolence,
blocking protein
500 mg H. influenzae, M. azithromycin, dizziness. BEFORE
synthesis; bacteriostatic
or bactericidal, pneumoniae, or S. erythromycin, or  Cardiovascular: chest Baseline Assessment
Route:
pneumoniae other macrolide or pain, palpitations. • Question for
P.O depending on
 Community-acquired ketolide antibiotics  GI: abdominal pain, hypersensitivity to any
concentration.
Frequency: pneumonia caused and in those with anorexia, diarrhea, antibiotics.
OD by Chlamydophila history of cholestatic nausea, vomiting,
pneumoniae, H. jaundice or hepatic pseudomembranous DURING
Therapeutic Class: influenzae, dysfunction from colitis, dyspepsia, Intervention/Evaluation
Antibiotics Mycoplasma prior use of flatulence, melena.  Monitor patient for
pneumoniae, S. azithromycin.  GU: candidiasis, superinfection. Drug
pneumoniae, nephritis, vaginitis. may cause
Legionella  Hepatic: cholestatic overgrowth of no
pneumophila, M. jaundice. susceptible bacteria
catarrhalis, or S. or fungi.
 Skin:
aureus photosensitivity  Monitor patient for
reactions, rash, pain allergic and skin
at injection site, reactions.
pruritus. Discontinue drug if
reactions occur. Be
aware that allergic
symptoms may recur
when symptomatic
therapy is
discontinued; patient
may require
prolonged
monitoring and
treatment.
 Monitor patient for
jaundice,
hepatotoxicity, and
hepatitis.
Discontinue drug
immediately if signs
and symptoms
(yellowing of skin or
sclera, abdominal
pain, nausea,
vomiting, dark urine)
occur.

AFTER
Patient/Family Teaching
 Tell patient to take
drug as prescribed,
even after feeling
better.
 Tell patient to report
adverse reactions
promptly.
 Warn patient to seek
immediate medical
care for irregular
heartbeat, shortness
of breath, dizziness,
or fainting.
 Advise patient not to
stop taking drug
without first
contacting health
 care provider.
 Tell patient that
immediate-release
tablets and
suspension can be
taken with or without
food. Food may
reduce GI upset.
 Document data.
 Name of Drug Mechanism of Action Indication Contraindications and Side Effects/Adverse Nursing
Cautions Effects Responsibilities
Vitamin B complex A coenzyme that Vitamin B complex  Contraindicated with CNS: Headache, Before:
stimulate metabolic deficiency (prophylaxis hypersensitivity to dizziness, insomnia,
Dosage: function and is needed and treatment) Vit. B1, Vit. B2,Vit. fatigue, tiredness 1. Verify doctor’s order.
1 tab for cell replication, B3 or any component Derma: Rash, pruritus, 2. Know the reason for
hematopoiesis, and Indicated also too elderly of the formulation. sweating, dry MM, giving the drug.
Route: nucleoprotein and patients to improve their  Active peptic ulcer stomatitis 3. Check for
P.O myelin synthesis. disease; concurrent with  Severe hypotension GI: dyspepsia, GI pain, contraindications.
broad spectrum diarrhea, vomiting, 4. Verify dosage of the
Frequency: antibiotics after surgery. constipation drug.
OD GU: Dysuria, renal 5. Prepare drug on time.
impairment
Therapeutic Class: During:
Food supplements
1. Verify client’s
Pharmacological: identity.
Multivitamins 2. Inform client of the
purpose of the drug.
3. Assess route of
administration.
4. Check pt’s status.
5. Administer on time
6. Give the drug with
meals.

After:
1. Instruct client to
report adverse effects.
2. Warn the patient that
stool may be dark or
green.
3. Ensure pt safety.
4. Monitor accordingly.
5. Dispose of used
materials properly.
6. Document all relevant
data
 Name of Drug Mechanism of Action Indication Contraindications and Side Effects/Adverse Nursing
Cautions Effects Responsibilities
ferrous sulfate + folic Elevates the serum iron  For iron deficiency General: Contraindicated with Before:
acid concentration, and is  Used to treat iron > prevention and allergy to any ingredient;  Check the doctor’s
then converted to Hgb or deficiency anemia (a treatment of iron- sulphite allergy; order
Dosage: lack of red blood deficiency anemias hemochromatosis,  Assess for allergy to
trapped in the
1 tab cells caused by > dietary supplement for hemosiderosis, any ingredient,
reticuloendothelial cells
for storage and eventual having too little iron iron hemolytic anemias sulfite;
Route: > unlabeled use:
conversion to a usable in the body). hemochromatosis,
P.O supplemental use during
form of iron. hemosiderosis,
epoetin therapy to ensure hemolytic anemias
Frequency: proper hematologic Precaution:
OD  Assess for skin
response to epoetin Use cautiously with
lesions, color; gums,
normal iron balance;
Therapeutic Class: teeth (color); bowel
peptic ulcer, regional
Iron supplements sounds
enteritis, ulcerative
 Monitor blood
colitis
Pharmacological: Patient’s actual studies
Hematinics indication:  Confirm that client
Ferrous sulfate is given does have iron
to the patient for the Interactions: deficiency anemia
prevention and treatment > drug-drug: decreased
of iron-deficiency nti-infective response to During:
ciprofloxacin,  verify patient’s
anemia brought about by identity
norfloxacin, ofloxacin;
the illness  administer the right
decreased absorption
with antacids, drug in the right dose
cimetidine; decreased and route at the right
effects of levodopa if time
taken with iron;  do not crush, chew or
increased serum iron cut tablets and
levels with capsules
chloramphenicol  give drug with meals
> drug-food: decreased (avoiding milk, eggs,
absorption with antacids, coffee, and tea)
eggs or milk, coffee and  administer liquid
tea; avoid concurrent preparations in water
administration of any of or juice to mask the
these. taste and prevent
staining of teeth;
have patient drink
solution with a straw
 do not take this drug
with antacids nor
tetracyclines unless
prescribed

After:
 warn patient that
stool may be dark or
green
 arrange for periodic
monitoring of Hct
and Hgb levels
 keep this drug out of
reach of children
(may cause fetal
poisoning)
 report severe Gi
upset, lethargy, rapid
respirations and
constipation
 document and
record.
 Name of Drug Mechanism of Action Indication Contraindications and Side Effects/Adverse Nursing
Cautions Effects Responsibilities
tramadol Binds to mu-opioid General: Contraindicated with CNS: dizziness, Before:
receptors and inhibits the > relief of moderate to allergy to tramadol or weakness, headache, > check the doctor’s
Dosage: moderately severe pain opioids or acute drowsiness order.
reuptake of
60 mg > relief of moderate to intoxication with > assess for
norepinephrine and
serotonin severe chronic pain in alcohol, opioids or CV: orthostatic hypersensitivity to
Route: adults who need around- psychoactive drugs hypotension tramadol.
IVTT the-clock treatment for >assess for skin color,
extended periods (ER GI: nausea, anorexia, texture, lesions, mental
Frequency: Interactions: vomiting, diarrhea
tablets) status, take V/S
q 8 hrs. Drug-drug: decreased > check for the patency
Pharmacologic: effectiveness with GU: polyuria, nocturia of the IV line
Opioid analgesic Patient’s actual carbamazepine, > review the purpose and
indication: increased risk of Hematologic: importance of the drug
Therapeutic: > relief of moderate to hypokalemia
tramadol toxicity with
Centrally-acting moderately severe pain MAOIs or SSRIs. Local: pain, phlebitis at During:
analgesic injection site > administer with food
or milk to prevent GI
Other: muscle cramps upset
and muscle spasms, > measure and record
weakness regular weights to
monitor fluid changes
> administer drug early
in the day so increased
urination will not disturb
sleep
> control environment
(temperature, lighting) if
sweating or CNS effects
occur
After:
> document and record.
> monitor serum
electrolytes, hydration,
and liver function during
long-term therapy
> provide diet rich in
potassium or give
supplemental potassium
>report if side effects
occur.