Prednisone

Brand Name: Apo-Prednisone (CAN), Deltasone, Liquid Pred, Meticorten, Novo-Prednisone (CAN), Orasone, Panasol-S, Prednicen-M, Prednisone-Intensol, Sterapred DS, Winpred (CAN) Pregnancy Category C

Drug classes: Corticosteroid (intermediate acting), Glucocorticoid, Hormone Therapeutic actions Enters target cells and binds to intracellular corticosteroid receptors, thereby initiating many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects. Indications Replacement therapy in adrenal cortical insufficiency Hypercalcemia associated with cancer Short-term management of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders Hematologic disorders: thrombocytopenia purpura, erythroblastopenia Ulcerative colitis, acute exacerbations of multiple sclerosis and palliation in some leukemias and lymphomas Trichinosis with neurologic or myocardial involvement Contraindications Contraindicated with infections, especially tuberculosis, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections; lactation. Adverse effects Vertigo, headache, paresthesias, insomnia, convulsions, psychosis, cataracts, increased intraocular pressure, glaucoma (long-term therapy) Hypotension, shock, hypertension and CHF secondary to fluid retention, thromboembolism, thrombophlebitis, fat embolism, cardiac arrhythmias Na+ and fluid retention, hypokalemia, hypocalcemia Amenorrhea, irregular menses, growth retardation, decreased carbohydrate tolerance, diabetes mellitus, cushingoid state (long-term effect), increased blood sugar, increased serum cholesterol, decreased T3 and T4 levels, HPA suppression with systemic therapy longer than 5 days Peptic or esophageal ulcer, pancreatitis, abdominal distention, nausea, vomiting, increased appetite, weight gain (long-term therapy) Hypersensitivity or anaphylactoid reactions

Drug Interactions: Increased therapeutic and toxic effects with troleandomycin, ketoconazole Increased therapeutic and toxic effects of estrogens, including hormonal contraceptives Risk of severe deterioration of muscle strength in myasthenia gravis patients who also are receiving ambenonium, edrophonium, neostigmine, pyridostigmine Decreased steroid blood levels with barbiturates, phenytoin, rifampin Decreased effectiveness of salicylates Nursing considerations Administer once-a-day doses before 9 AM to mimic normal peak corticosteroid blood levels. Increase dosage when patient is subject to stress. Taper doses when discontinuing high-dose or long-term therapy. Do not give live virus vaccines with immunosuppressive doses of corticosteroids.

ceftazidime
Generic name: ceftazidime Brand name: Tazidime Classification: Antibiotic Cephalosporin (third generation) Dosage: 300 mg Route: IVTT Frequency: connivance q 8 hr ANST(-) MECHANISM OF ACTION: Inhibits synthesis of bacterial cell wall, causing cell death. INDICATION:

CNS infections

CONTRAINDICATIONS Contraindicated to patients with allergies to penicillins, cepahlosporins.

ADVERSE EFFECTS OF THE DRUG CNS: Headache, dizziness, thethargies, paresthesias GI: nausea, vomiting, anorexia, abdominal pain, flatulence, psuedomembranous colitis, liver toxicity GU: Nephrotoxicity Hematologic: bone marrow depression- decreased WBC, decreased platelets, decrease Hct Hypersensitivity: ranging from rash to fever to anaphylaxis, serum sickness reaction Local: Pain, abscess at injection site, phlebitis, inflammation at IV site Other: Superinfections, disulfiram-like reactions with alcohol NURSING INTERVENTION and PRECAUTIONS Assess for liver and renal dysfunction Culture infection, and arrange sensitivity tests before and during therapy if expected response is not seen. Warning: Do not mix with aminoglycoside solutions, administer these drugs separately. Powder and reconstituted solution darken with storage. Have Vit. K available in case hypoprothrombinemia occurs Discontinue if hypersensitivity occurs Teach SO that patients may experience upset stomach or diarrhea but must report severe diarrhea, difficulty breathing, fatigue, pain at injection site.