SCHOOL OF NURSING
General Luna Road, Baguio City Philippines 2600
Telefax No.: (074) 442-3071
DRUG NAME
Generic Name: Gentamicin
Brand Name: Gentamicin,
Alcomicin, Gentacidin
Dose:
Adults: 3–7.5 or 4–7 mg/kg
Children 5-12 years old: 2–2.5
mg/kg
Children younger than 5: 2.5 mg/kg
Neonate: 2.5 mg/kg
Frequency: IV and IM
Adults: q8h or qd
Children 5-12 years old: q8h
Children younger than 5: q8h
Neonate: q8h-24h
Frequency: Ophthalmic
Adults, Elderly: 2–4 times/day.
Adults, Elderly, Children: 1–2 drops
q2–4h up to 2 drops/hr.
Route: IV, IM and Ophthalmic
Website: www.ubaguio.edu
DRUG STUDY
MODE OF ACTION
Drug Classification: Antibiotic
Therapeutic Action: Irreversibly
binds to protein of bacterial
ribosomes. Therapeutic Effect:
Interferes with protein synthesis of
susceptible microorganisms.
Bactericidal.
E-mail Address: ub@ubaguio.edu
DRUG EFFECTS
Side Effects:
IM: Pain, induration at injection site.
IV: Phlebitis, thrombophlebitis,
hypersensitivity reactions (fever, pruritus,
rash, urticaria).
Ophthalmic: Burning, tearing, itching,
blurred vision. Rare:
Alopecia, hypertension, fatigue.
Adverse Effect:
Nephrotoxicity (increased BUN, serum
creatinine; decreased creatinine clearance)
may be reversible if drug is stopped at first
sign of symptoms. Irreversible ototoxicity
(tinnitus, dizziness, diminished hearing),
neurotoxicity (headache, dizziness,
lethargy, tremor, visual disturbances) occur
occasionally. Risk increases with higher
dosages, prolonged therapy, or if solution is
applied directly to mucosa. Super
infections, particularly with fungi, may
result from bacterial imbalance via any
route of administration. Ophthalmic
application may cause paresthesia of
conjunctiva, mydriasis.
RESPONSIBILITIES
Dehydration must be treated before
beginning parenteral therapy. Monitor
I&O (maintain hydration), urinalysis
(casts, RBCs, WBCs, decrease in
specific gravity). Be alert to ototoxic,
neurotoxic symptoms (see Adverse
Effects/ Toxic Reactions). Check IM
injection site for induration. Evaluate
IV site for phlebitis (heat, pain, red
streaking over vein). Assess for rash
(Ophthalmic: redness, burning,
itching and tearing). Be alert for
super infection (genital/anal pruritus,
changes in oral mucosa, diarrhea).
When treating pts with neuromuscular
disorders, assess respiratory
response carefully. Therapeutic
serum level: peak: 4–10 mcg/ml;
peak levels are 2–3 times greater with
once-daily dosing trough: 0.5–2
mcg/ml. Toxic serum level: peak:
greater than 10 mcg/ ml; trough:
greater than 2 mcg/ml.
Generic Name: Ertapenem
Brand Name: Ivanz
Dose: IM, IV:
Adults, elderly, children 13 yrs and
Older: 1 g
Children 3 mos–12 yrs: 15 mg/kg
Maximum: 1 g/day
Frequency:
Adults, elderly, children 13 yrs and
older: QD
Children 3 mos–12 yrs: BID
Route: IV and IM
Generic Name: Ciprofloxacin
Brand Name: Apo-Ciproflox ,
Cetraxal, Ciloxan, Cipro, Cipro IV,
Cipro XR, NovoCiprofloxacin
Dose: PO
Adults, elderly: 250–750 mg q12h.
Children: 20–30 mg/kg/day
Drug Classification: Antibiotic
Therapeutic Action: Penetrates
bacterial cell wall of
microorganisms, binds to
penicillin-binding proteins,
inhibiting cell wall synthesis.
Therapeutic Effect: Produces
bacterial cell death
Drug Classification: Antibiotic
Therapeutic Action: Inhibits
enzyme, DNA gyrase, in
susceptible bacteria, interfering
with bacterial cell replication.
Therapeutic Effect: Bactericidal.
Side Effects:
Diarrhea, nausea, headache. Altered
mental status, insomnia, rash, abdominal
pain, constipation, chest pain, vomiting,
edema, fever. Dizziness, cough, oral
candidiasis, anxiety, tachycardia, phlebitis
at IV site.
Adverse Effect:
Antibiotic-associated colitis, other super
infections (abdominal cramps, severe
watery diarrhea, and fever) may result from
altered bacterial balance. Anaphylactic
reactions have been reported. Seizures
may occur in those with CNS disorders
(brain lesions, history of seizures),
bacterial meningitis, severe renal
impairment
Side Effects:
Nausea, diarrhea, dyspepsia, vomiting,
constipation, flatulence, confusion,
crystalluria. Ophthalmic: Burning, crusting
in corner of eye. Abdominal
pain/discomfort, headache, rash.
Ophthalmic: Bad taste, sensation of foreign
Dehydration must be treated before
beginning parenteral therapy.
Establish baseline hearing acuity.
Question for history of allergies,
Esp. aminoglycosides, sulfites
(parabens for topical/ophthalmic
routes). Monitor I&O (maintain
hydration), urinalysis (casts, RBCs,
WBCs, decrease in specific gravity).
Be alert to ototoxic, neurotoxic
symptoms (see Adverse Effects/ Toxic
Reactions). Check IM injection site for
induration. Evaluate IV site for
phlebitis (heat, pain, red streaking
over vein). Assess for rash
(Ophthalmic: redness, burning,
itching, tearing). Be alert for super
infection (genital/anal pruritus,
changes in oral mucosa, diarrhea).
When treating pts with neuromuscular
disorders, assess respiratory
response carefully. Therapeutic
serum level: peak: 4–10 mcg/ml;
peak levels are 2–3 times greater with
once-daily dosing trough: 0.5–2
mcg/ml. Toxic serum level: peak:
greater than 10 mcg/ ml; trough:
greater than 2 mcg/ml.
Question for history of allergies,
particularly cephalosporins, penicillins.
Assess oral cavity for white patches
on mucous membranes, tongue
(thrush).
Monitor daily pattern of bowel activity,
stool consistency. Mild GI effects may
Maximum: 1.5 g/day.
Dose: IV
Adults, elderly: 200–400 mg
Children: 20–30 mg/kg/day in
divided doses
Maximum: 800 mg/day.
Frequency: IV
Adults, elderly: q12h.
Children: divided doses q12h.
Frequency: PO
Adults, elderly: q12h.
Children: 2 divided doses.
Dose & Frequency: Ophthalmic
Route: IV, PO and Ophthalmic
Generic Name: Amoxicillin
Brand Name: Apo-
Amoxi ,Moxatag , Novamoxin
Dose: PO
Adults, elderly, children 12 yrs and
older: 250–500 mg or 500– 875 mg
or 775 mg (Moxatag) once daily.
Children older than 3 mos: 20–50
mg/kg/day
Children 3 mos and younger: 20– 30
mg/kg/day
Frequency: PO
Adults, elderly, children 12 yrs and
older: As follows ^ q8h or q12h or
(Moxatag) once daily.
Children older than 3 mos: 2 divided
doses q8– 12h.
Children 3 mos and younger:
divided doses q12h.
Route: PO
Drug Classification: Antibiotic
Therapeutic Action: Inhibits
bacterial cell wall synthesis.
Therapeutic Effect: Bactericidal in
susceptible microorganisms.
body in eye, eyelid redness, itching.
Dizziness, confusion, tremors,
hallucinations, hypersensitivity reaction,
insomnia, dry mouth, paresthesia.
Adverse Effect:
Super infection (esp. enterococcal,
fungal), nephropathy and
cardiopulmonary arrest, cerebral
thrombosis may occur. Hypersensitivity
reaction (rash, pruritus, blisters, edema,
burning skin), photosensitivity have
occurred. Sensitization to ophthalmic form
may contraindicate later systemic use of
ciprofloxacin.
Side Effects:
GI disturbances (mild diarrhea, nausea,
vomiting), headache, oral/ vaginal
candidiasis. Occasional: Generalized rash,
urticaria
Adverse Effect:
Antibiotic-associated colitis, other
superinfections (abdominal cramps,
severe watery diarrhea, fever) may result
from altered bacterial balance. Severe
hypersensitivity reactions, including
anaphylaxis, acute interstitial nephritis,
occur rarely.
be tolerable (increasing severity may
indicate onset of antibiotic-associated
colitis). Monitor I&O, renal function
tests for nephrotoxicity. Be alert for
super infection: fever, vomiting,
diarrhea, anal/genital pruritus, oral
mucosal changes (ulceration, pain,
erythema).
Question for history of allergies, esp.
penicillins, cephalosporins. Hold
medication and promptly report
rash, diarrhea (fever, abdominal pain,
mucus and blood in stool may indicate
Antibiotic-associated colitis). Be alert
for super infection: fever, vomiting,
diarrhea, anal/genital pruritus, oral
mucosal changes (ulceration, pain,
erythema).Monitor renal/hepatic
function tests.
Generic Name: Cotrimoxazole
Brand Name: Bactrim
Dose:
PO: One double-strength tablet.
IV: 8–20 mg/kg/day as trimethoprim
in
Frequency:
PO: q12–24h.
IV: divided doses q6–12h.
Route: IV, IM and PO
Drug Classification:
Sulfonamides antibiotic
Therapeutic Action: Block para-
aminobenzioc acid necessary in
folic acid for the production of
RNA and DNA.
Side Effects:
Passing of gas, photosensitivity, nausea,
vomiting,
Adverse Effect:
GI upsets, glossitis, Stomatitis. Anorexia.
Skin rashes, Arthralgia, myalgia.
Hematological changes, reversible
neutropenia and thrombocytopenia, Steven-
john-syndrome, lrell’s syndrome. Skin
andsystemic reactions. Tinnitus, erythema
multiforme, blood dyscrasias, headache,
emesis, recurrent fever, and raised liver
enzyme values. Rarely, jaundice, aplastic
and hemolytic anemia, headache,
depression, dizziness, hallucination.
Assess patient’s infection before
therapy and regularly thereafter-teach
patient to complete course of full
treatment even if he feel better to
prevent superinfection. teach patient
to avoid exposure to direct sunlight or
use of sunscreen to prevent burns-
teach patient to notify physician if skin
rash, sore throat, fever, mouth sore,
unusual bruising, bleeding occur.
Generic Name: Tetracycline
Brand Name: Apo-Tetra , Nu-Tetra
Dose: PO
Adults, elderly: 250–500 mg q6–
12h. Children 8 yrs and older: 25–50
mg/kg/day in 4 divided doses.
Maximum: 3 g/day
Frequency: PO
Adults, elderly: q6– 12h.
Children 8 yrs and older: 4 divided
doses.
Route: PO
Generic Name: Isoniazid
Brand Name: Isotamine , PMS
Isoniazid
Dose: Active Tuberculosis
IM/PO
Adults, elderly: 5 mg/kg/day
Usual dose: 300 mg/ day.
Children: 10–15 mg/kg/day
Maximum: 300 mg/day.
Tuberculosis Prophylaxis
IM/PO
Adults, elderly: 5 mg/kg/day
(maximum: 300 mg) or 15 mg/kg
(maximum: 900 mg).
Drug Classification: Antibiotic
Therapeutic Action: Inhibits
bacterial protein synthesis by
binding to ribosomes. Therapeutic
Effect: Bacteriostatic.
Drug Classification: Anti-
tubercular
Therapeutic Action: Inhibits
mycolic acid synthesis. Causes
disruption of bacterial cell wall,
loss of acid-fast properties in
susceptible mycobacteria. Active
only during bacterial cell division.
Therapeutic Effect: Bactericidal
against actively growing
intracellular, extracellular
susceptible mycobacteria.
Side Effects:
Dizziness, light-headedness, diarrhea,
nausea, vomiting, abdominal cramps,
photosensitivity (may be severe).
Pigmentation of skin, mucous membranes;
anal/genital pruritus; stomatitis;
discoloration of teeth.
Adverse Effect:
Super infection (esp. fungal),
anaphylaxis, increased ICP may occur.
Bulging fontanelles occur rarely in infants.
Side Effects:
Nausea, vomiting, diarrhea, abdominal
pain. Rare: Pain at injection site,
hypersensitivity reaction.
Adverse Effect:
Neurotoxicity (ataxia, paresthesia), optic
neuritis, hepatotoxicity occur rarely.
Establish baseline weight, B/P, Hgb,
Hct. Check serum hepatic function,
electrolytes, cholesterol. Wrist X-rays
may be ordered to determine bone
maturation in children. Weigh daily,
report weekly gain of more than 5 lb;
evaluate for edema. Monitor I&O.
Check B/P at least twice daily. Assess
serum electrolytes, cholesterol, Hgb,
Hct (periodically for high dosage),
hepatic function test results, radiologic
exam of wrist, hand (when using in
prepubertal children). With breast
cancer or immobility, check for
hypercalcemia (lethargy, muscle
weakness, confusion, irritability).
Ensure adequate intake of protein,
calories. Assess for virilization.
Monitor sleep patterns. Check
injection site for redness, swelling,
pain.
Question for history of hypersensitivity
reactions, hepatic injury or disease,
sensitivity to nicotinic acid or
chemically related medications.
Ensure collection of specimens for
culture, sensitivity. Evaluate initial
hepatic function results. Monitor
hepatic function test results, assess
for hepatitis: anorexia, nausea,
vomiting, weakness, fatigue, dark
urine, jaundice (hold concurrent INH
therapy and inform physician
promptly). Assess for paresthesia of
extremities (those esp. at risk for
Children: 10–20 mg/kg/day
Maximum: 300 mg/day or 20–40
mg/kg
Maximum: 900 mg/dose.
Frequency:
Dose: Active Tuberculosis
IM/PO
Adults, elderly: single daily dose.
Children: single daily dose.
Tuberculosis Prophylaxis
IM/PO
Adults, elderly: twice weekly
Children: single daily dose.
Maximum: 2 times/wk.
Route: IM and PO
Generic Name: Dapsone
Brand Name: Avlosulfon
Tuberculoid and Indeterminate-
type Leprosy
Adult: PO 100 mg/d (with 6 mo of
rifampin 600 mg/d) for a minimum of
3y
Lepromatous and Borderline
Lepromatous Leprosy
Adult: PO 100 mg/d for  10 y
Child: PO 1–2 mg/kg/d once daily in
combination therapy (max: 100
mg/d)
Dermatitis Herpetiformis
Adult: PO 50 mg/d, may be
increased to 300 mg/d if necessary
(max: 500 mg/d)
Prophylaxis for Close Contacts of
Drug Classification: Anti-
infective; antileprosy (sulfone)
agent
Therapeutic Action: Sulfone
derivative chemically related to
sulfonamides, with bacteriostatic
and bactericidal activity similar to
that group. Interferes with
bacterial cell growth by
competitive inhibition of folic acid
synthesis by susceptible
organisms.
Side Effects:
Nausea, vomiting, loss of appetite,
dizziness, or blurred vision.
Adverse Effect:
ast heartbeat, unusually fast breathing,
bluish lips/skin, chest pain, mental/mood
changes, muscle weakness, difficulty
urinating. May cause very serious low blood
counts (bone marrow suppression) or liver
disease. easy bruising/bleeding, unusual
tiredness, pale skin, yellowing eyes/skin,
dark urine, stomach/abdominal pain.
neuropathy may be given pyridoxine
prophylactically: malnourished,
elderly, diabetics, pts with chronic
hepatic disease [including alcoholics]).
Be alert for fever, skin eruptions
(hypersensitivity reaction).
Monitor for therapeutic effectiveness
that may not appear for leprosy until
after 3–6 mos of therapy. Skin lesions
respond well; recovery from nerve
involvement is usually limited. Lab
tests: Perform baseline then weekly
CBC during the first month of therapy,
at monthly intervals for at least 6 mos,
and semiannually thereafter.
Determine periodic dapsone blood
levels. Perform liver function tests in
patients who complain of malaise,
fever, chills, anorexia, nausea,
vomiting, and have jaundice. Dapsone
therapy is usually suspended until
etiology is identified. Monitor severity
of anemia. Nearly all patients
demonstrate hemolysis. Manufacturer
states that Hgb level is generally
Patient with Multibacillary
Leprosy
Adult: PO 50 mg/d
Child: PO <6 mo, 6 mg 3
times/wk; 6–23 mo, 12 mg 3
times/wk; 2–5 y, 25 mg 3
times/wk; 6–12 y, 25 mg/d
P. carinii Pneumonia Prophylaxis
Adult: PO 50 mg b.i.d. or 100 mg
q.d.
Child: PO 2 mg/kg once daily (max:
100 mg/d)
Route: PO and Topical
Generic Name: Telithromycin
Brand Name: Ketek
Dose: Adults age 18 and older: 800
mg daily
Frequency: OD
Route: PO
Generic Name: Clindamycin
Brand Name: Apo-Clindamycin ,
Cleocin, Cleocin Pediatric, Cleocin
Drug Classification: Anti-
infective
Therapeutic Action: Blocks
protein synthesis by binding to
domains II and V of 23S rRNA of
50S ribosomal subunit. Binding at
domain II enables drug to retain
activity against gram-positive
cocci in resistance mediated by
methylases that alter domain-V
binding site.
Drug Classification: Antibiotic,
anti-acne
Therapeutic Action: Penetrates
Side Effects:
Nausea, vomiting, mild diarrhea, headache,
anxiety, or a strange taste in the mouth may
occur.
Adverse Effect:
Headache, dizziness, fatigue, loss of
consciousness, prolonged QT interval with
increased risk of ventricular arrhythmias
and torsades de pointes, visual
disturbances, poor visual accommodation,
nausea, vomiting, diarrhea, loose stools,
light-colored stools, dysgeusia, anorexia,
pseudomembranous colitis (possibly
caused by Clostridium difficile). Dark urine,
abnormal hepatic function, fulminant
hepatitis, hepatic necrosis, hepatic failure
and pruritus.
Side Effects:
IV: Abdominal cramping/ discomfort,
phlebitis/thrombophlebitis. Topical: Dry
decreased by 1–2 g/dL; reticulocytes
increase by 2–12%; RBC life span is
shortened; and methemoglobinemia
occurs in most patients receiving
dapsone. Monitor temperature during
first few weeks of therapy. If fever is
frequent or severe, leprosy reactional
state should be ruled out. Reduction
of or interruption of therapy may be
sufficient for improvement. Report
cyanotic appearance or mucous
membranes with brownish hue to
physician as possible
methemoglobinemia.
Monitor liver function tests frequently.
Discontinue drug permanently if
patient develops clinical hepatitis or
transaminase elevations and other
systemic symptoms. Monitor patient
closely for adverse GI reactions,
especially diarrhea. In patients
receiving drug concurrently with
anticoagulants, stay alert for
potentiation of anticoagulant effects.
In patients receiving drug concurrently
with midazolam, stay alert for need to
adjust midazolam dosage. In patients
receiving drug concurrently with
digoxin, monitor peak and trough
digoxin levels periodically, and stay
alert for adverse reactions to digoxin.
Question pt for history of allergies.
Avoid, if possible, concurrent use of
neuromuscular blocking agents.
T, Cleocin Vaginal, Clindagel, bacterial cell membranes, skin Nausea, vomiting, diarrhea, rash, Monitor daily pattern of bowel activity,
Clindamax, Clindesse, Novo- reversibly binds to bacterial urticaria. Ophthalmic: Sensitivity reaction stool consistency. Report diarrhea
Clindamycin ribosomes, inhibiting protein with increased irritation, burning, itching, promptly due to potential for serious
Dose: IV, IM synthesis. Therapeutic Effect: inflammation. Urticaria. colitis (even with topical or vaginal
Adults, elderly: 1.2–2.7 g/day Bacteriostatic Adverse Effect: administration). Assess skin for rash
Maximum: 4.8 g/ day. Antibiotic-associated colitis, other super (dryness, irritation) with topical
Children 1 mo–16 yrs: 20–40 mg/ infections (abdominal cramps, severe application. With all routes of
kg/day Maximum: 4.8 g/day. watery diarrhea, fever), reversible administration, be alert for super
Children younger than 1 mo: 15–20 cholestatic hepatitis may occur. High infection: fever, vomiting, diarrhea,
mg/kg/day. dosage in pts with renal impairment may anal/genital pruritus, oral mucosal
Neonates: 10–30 mg/kg/day lead to reversible hearing loss. changes (ulceration, pain, erythema).
PO: Anaphylaxis occurs rarely. Ventricular
Adults, elderly: 150–450 mg arrhythmias, prolonged QT interval occur
Maximum: 1.8 g/day. rarely with IV form
Children: 8–25 mg/kg/day
Neonates: 10–30 mg/kg/day
Frequency: IV, IM
Adults, elderly: 2–4 divided doses.
Children 1 mo–16 yrs: 3–4 divided
doses.
Children younger than 1 mo 3–4
divided doses.
Neonates: q6–12h.
PO: Adults, elderly: 150–450 mg
q6h.
Maximum: 1.8 g/day.
Children: 3–4 divided doses.
Neonates: q6–12h.
Route: IV, IM and PO

Generic Name: Erythromycin
Brand Name: Akne-Mycin, Apo-
Erythro Base , EES, Erybid , Eryc,
EryDerm, EryPed,
Dose: PO:
Drug Classification: Antibiotic,
anti-acne
Therapeutic Action: Penetrates
bacterial cell membranes,
reversibly binds to bacterial
Side Effects:
IV: Abdominal cramping/ discomfort,
phlebitis/thrombophlebitis. Topical: Dry
skin Nausea, vomiting, diarrhea, rash,
urticaria. Ophthalmic: Sensitivity reaction
Question for history of allergies
(particularly erythromycins), hepatitis.
Monitor daily pattern of bowel activity,
stool consistency. Assess skin for
rash. Assess for hepatotoxicity
Adults, elderly: base: 250–500 mg
Children: 30–50 mg/kg/day
Maximum: 2 g/day.
Ethylsuccinate: 400–800 mg
Maximum: 4 g/day.
Children: 30–50 mg/kg/day
Maximum: 3.2 g/day.
Neonates: 20–40 mg/kg/
IV: Adults, elderly: 15–20 mg/kg/day
Maximum: 4 g/day.
Children, infants: 15–50 mg/kg/day
Maximum: 4 g /day
Frequency: PO:
Adults, elderly: base: q6–12h.
Children: 2–4 divided doses.
Ethylsuccinate: q6–12h.
Children: divided doses.
Neonates: divided doses q6–12h.
IV: Adults, elderly: divided q6h.
Children, infants: divided q6h.
Route: IV,PO and Ophthalmic
Generic Name: Rimantadine
Brand Name: Zantac, Zantac-75,
Zantac-150, Zantac
Dose: PO
Adults: 100 mg.
Elderly, debilitated pts, pts with
severe hepatic/renal impairment:
100 mg
Frequency: PO
Adults: twice a day for 7 days.
Elderly, debilitated pts, pts with
severe hepatic/renal impairment:
once a day for 7 days.
ribosomes, inhibiting protein
synthesis. Therapeutic Effect:
Bacteriostatic
Drug Classification: Antiviral
agent.
Therapeutic Action: Exerts
inhibitory effect early in viral
replication cycle. May inhibit
uncoating of virus. Therapeutic
Effect: Prevents replication of
influenza A virus.
with increased irritation, burning, itching,
inflammation. Urticaria.
Adverse Effect:
Antibiotic-associated colitis, other super
infections (abdominal cramps, severe
watery diarrhea, fever), reversible
cholestatic hepatitis may occur. High
dosage in pts with renal impairment may
lead to reversible hearing loss.
Anaphylaxis occurs rarely. Ventricular
arrhythmias, prolonged QT interval occur
rarely with IV form
Side Effects:
Insomnia, nausea, nervousness, impaired
concentration, dizziness. Vomiting,
anorexia, dry mouth, abdominal pain,
asthenia (loss of strength, energy), fatigue.
Adverse Effect:
None
(malaise, fever, abdominal pain, GI
disturbances). Be alert for super
infection: fever, vomiting, diarrhea,
anal/genital pruritus, oral mucosal
changes (ulceration, pain, erythema).
Check for phlebitis (heat, pain, red
streaking over vein). Monitor for high-
dose hearing loss.
Assess for anxiety, nervousness;
evaluate sleep pattern for insomnia.
Provide assistance if dizziness
occurs. Avoid contact with those who
are at high risk for influenza
(rimantadineresistant virus may be
shed during therapy). Avoid tasks that
require alertness, motor skills until
response to drug is established. Do
not take aspirin, acetaminophen,
compounds containing these drugs.
May cause dry mouth.
Route: PO

Generic Name: Zidovudine Drug Classification: Antiviral Side Effects: Pts requiring an inhaled
Brand Name: Apo-Zidovudine , Therapeutic Action: Interferes Nausea, headache. Abdominal pain, bronchodilator at same time as
Novo-AZT , Retrovir with viral RNA-dependent DNA asthenia (loss of strength, energy), rash, zanamivir should use the
Dose: PO polymerase, an enzyme fever, acne. Diarrhea, anorexia, malaise, bronchodilator before zanamivir
Adults, elderly, children older than necessary for viral HIV replication. myalgia, drowsiness. Dizziness, administration. Provide assistance if
12 yrs: 200 mg or 300 mg. Therapeutic Effect: Slows HIV paresthesia, vomiting, insomnia, dyspnea, dizziness occurs. Monitor daily pattern
Children 12 yrs and younger: 160 replication, reducing progression altered taste. of bowel activity, stool consistency.
mg/m2 /dose (maximum: 200 mg) or of HIV infection Adverse Effect:
240 mg/m2 (maximum: 300 mg). Anemia (occurring most commonly after 4–
Full-term neonates: 2 mg/kg/ dose. 6 wks of therapy), granulocytopenia are
Premature neonates: 2 mg/ kg/dose, particularly significant in pts with pre-
IV therapy low baselines. Neurotoxicity
Adults, elderly, children older than (ataxia, fatigue, lethargy, nystagmus,
12 yrs: 1 mg/kg/dose seizures) may occur
Children 12 yrs and younger: 120
mg/m2 /dose
Full-term neonates: 1.5 mg/kg/dose.
Premature neonates: 1.5
mg/kg/dose
Frequency: PO
Adults, elderly, children older than
12 yrs: as follow ^ q8h or q12h.
Children 12 yrs and younger: q8h or
240
Full-term neonates: q6h.
Premature neonates: q12h,
increased to q8h at 2 or 4 wks
based on gestation at birth.
IV
Adults, elderly, children older than
12 yrs: q4h around the clock.
Children 12 yrs and younger: q6h.
Full-term neonates: q6h.
Premature neonates: increased to
q8h at 2 or 4 wks based on
gestation at birth.
Route: IV and PO

Generic Name: Acyclovir Drug Classification: Antiviral Side Effects: Question for history of allergies, esp.
Brand Name: Apo-Acyclovir , Novo- Therapeutic Action: Converts to Phlebitis or inflammation at IV site, nausea, to acyclovir. Assess herpes simplex
Acyclovir , Zovirax acyclovir triphosphate, becoming vomiting. Burning, stinging. Occasional: lesions before treatment to compare
Dose: IV part of DNA chain. Therapeutic Pruritus, rash, urticaria. PO Malaise, baseline with treatment effect. Assess
Adults, elderly, children 12 yrs and Effect: Interferes with DNA nausea. Pruritus. Vomiting, rash, diarrhea, IV site for phlebitis (heat, pain, red
older: 5 mg/kg synthesis and viral replication. headache. Confusion, hallucinations, streaking over vein). Evaluate
Adults, elderly, children 12 yrs and Virustatic. seizures, tremors. Topical Rash. cutaneous lesions. Ensure adequate
older: 200 mg or 400 mg Adverse Effect: ventilation. Manage chickenpox and
Children younger than 12 yrs: 40–80 Rapid parenteral administration, disseminated herpes zoster with strict
mg/kg/day in Maximum: 1 g/day. excessively high doses, or fluid and isolation. Provide analgesics and
Topical: electrolyte imbalance may produce renal comfort measures; esp. exhausting to
Adults: (Ointment) ½ inch for 4-inch failure (abdominal pain, decreased elderly. Encourage fluids.
square surface urination, decreased appetite, increased
Frequency: IV thirst, nausea, vomiting). Toxicity not
Adults, elderly, children 12 yrs and reported with oral or topical use.
older: q8h for 5–7 days.
PO
Adults, elderly, children 12 yrs and
older: q4h 5 times a day for 10 days
or 3 times a day for 5–10 days.
Children younger than 12 yrs: 3–4
divided doses for 5–10 days
Topical:
Adults: (Ointment) q3h (6 times a
day) for 7 days.
Route: PO, IV and Topical

Generic Name: Enfuvirtide Drug Classification: Antiretroviral Side Effects: Obtain baseline laboratory tests, esp.
Brand Name: Fuzeon agent Local injection site reactions (pain, serum hepatic function, triglycerides
Dose: Subcutaneous:
Adults, elderly: 90 mg (1 ml)
Children 6–16 yrs: 2 mg/kg.
Maximum: 90 mg twice a day
Frequency: Subcutaneous:
Adults, elderlytwice a day.
Children 6–16 yrs: twice a day.
Route: IM
Generic Name: Maraviroc
Brand Name: Selzentry
Dose:
Adults, elderly, children over 16 yrs
with concurrent antiretroviral agents:
300 mg twice a day. (with CYP3A4
inhibitors): Clarithromycin,
delavirdine, itraconazole,
ketoconazole, nefazodone,
telethromycin: 150 mg twice a day.
(with CYP3A4
inducers):Carbamazepine,
efavirenz, phenobarbital, phenytoin,
rifampin: 600 mg twice a day.
Frequency:
Adults, elderly, children over 16 yrs
with concurrent antiretroviral agents:
twice a day. (with CYP3A4
inhibitors): Clarithromycin,
Therapeutic Action: Interferes
with entry of HIV-1 into CD41 cells
by inhibiting fusion of viral, cellular
membranes. Therapeutic Effect:
Impairs HIV replication, slowing
progression of HIV infection.
Drug Classification: Antiretroviral
Therapeutic Action: Binds to
human chemokine receptor
(CCR5), present on CD-4 and T-
cell membranes, preventing
interaction of HIV-1 and CCR5,
necessary for HIV-1 to enter cells.
Therapeutic Effect: Decreased
invasion of HIV-1 virus into cells.
discomfort, induration, erythema, nodules,
cysts, pruritus, ecchymosis). Frequent
(26%–16%): Diarrhea, nausea, fatigue.
Occasional (11%–4%): Insomnia,
peripheral neuropathy, depression, cough,
decreased appetite or weight loss, sinusitis,
anxiety, asthenia (loss of strength, energy),
myalgia, cold sores. Rare (3%–2%):
Constipation, influenza, upper abdominal
pain, anorexia, conjunctivitis.
Adverse Effect:
May potentiate bacterial pneumonia.
Hypersensitivity (rash, fever, chills, rigors,
hypotension), thrombocytopenia,
neutropenia, renal insufficiency/failure
occur rarely
Side Effects:
Upper respiratory tract infection. Cough,
fever, rash, musculoskeletal pain,
abdominal pain, dizziness, appetite change,
herpes simplex infection, sleep
disturbances. Sinusitis, joint pain,
bronchitis, constipation, bladder infection,
paresthesia, sensory abnormalities. Sleep
disturbances, pruritus, peripheral
neuropathy, dermatitis, dyspepsia.
Adverse Effect:
Cardiovascular events (MI, ischemia,
unstable angina, coronary artery occlusion/
disease), CVA, hepatic failure/cirrhosis,
neoplasms occur in less than 2% of pts.
before beginning enfuvirtide therapy
and at periodic intervals during
therapy. Offer emotional support.
Assess skin for local injection site
hypersensitivity reaction. Question for
evidence of nausea, fatigue. Assess
sleep pattern. Monitor for insomnia,
signs/symptoms of depression,
pneumonia. Monitor serum chemistry
tests for marked abnormalities.
Obtain baseline laboratory testing,
esp. hepatic function tests, before
beginning therapy and at periodic
intervals during therapy. Offer
emotional support. Obtain medication
history. Closely monitor for evidence
of GI discomfort. Monitor daily pattern
of bowel activity, stool consistency.
Assess skin or evidence of rash.
Monitor serum chemistry tests for
marked laboratory abnormalities,
particularly hepatic profile. Assess for
opportunistic infections: onset of
fever, cough, or other respiratory
symptoms.
delavirdine, itraconazole,
ketoconazole, nefazodone,
telethromycin: twice a day. (with
CYP3A4 inducers):Carbamazepine,
efavirenz, phenobarbital, phenytoin,
rifampin: twice a day.
Route: PO

Generic Name: Raltegravir Drug Classification: Antiviral Side Effects: Obtain baseline laboratory testing
Brand Name: Isentress Therapeutic Action: Inhibits Diarrhea, nausea, headache. Fever. before beginning therapy and at
Dose: activity of HIV-1 integrase, an Vomiting, abdominal pain, fatigue, periodic intervals during therapy. Offer
Adults, elderly, children 12 yrs and enzyme required for viral dizziness. emotional support. Obtain medication
older: 400 mg Dosage increased to replication. Therapeutic Effect: Adverse Effect: history. Closely monitor for evidence
800 mg Prevents integration and Hypersensitivity, anemia, neutropenia, MI, of GI discomfort. Monitor daily pattern
Children 6–11 yrs, weighing 25 kg replication of viral HIV-1. gastritis, hepatitis, herpes simplex, toxic of bowel activity, stool consistency.
or greater: 400-mg tablet or nephropathy, renal failure, chronic renal Monitor serum chemistry tests for
chewable tablet based on weight. failure, renal tubular necrosis occur rarely marked laboratory abnormalities.
Maximum chewable dose: 300 mg Assess for opportunistic infections:
Weighing less than 25 KG: onset of fever, cough, other
Chewable tablets based on weight. respiratory symptoms.
Maximum chewable dose: 300 mg
Children 2–5 yrs and at least 10 kg:
Chewable tablet based on weight to
maximum of 300 mg
Frequency:
Adults, elderly, children 12 yrs and
older: as follows ^twice a day or
twice a day when given with
rifampin.
Children 6–11 yrrs: twice daily
Maximum chewable dose: twice
daily.
Weighing less than 25 KG: -
Maximum chewable dose: twice
daily.
Children 2–5 yrs and at least 10 kg:
twice daily
Route: PO
Generic Name: Adefovir
Brand Name: Hepsera
Dose:
Adults, elderly with creatinine
clearance 30–49 ML/MIN: 10 mg.
Adults, elderly with creatinine
clearance 10–29 ml/min: 10 mg.
Adults, elderly on hemodialysis: 10
mg.
Frequency:
Adults, elderly with creatinine
clearance 30–49 ML/MIN: q48h.
Adults, elderly with creatinine
clearance 10–29 ml/min: q72h.
Adults, elderly on hemodialysis:
every 7 days following dialysis.
Route: PO
Generic Name: Nevirapine
Brand Name: Nevirapine
Dose:
Adults: 200 mg
Maintenance: 200 mg.
Children 8 yrs and older: Initially,
120–150 mg/m2 /dose (maximum:
200 mg) Increase to 120–150
mg/m2 /dose
Children 8 yrs of age or younger:
200 mg/m2 /dose Increase to 200
Drug Classification: Antiviral
Therapeutic Action: Inhibits DNA
polymerase, an enzyme, causing
DNA chain termination after its
incorporation into viral DNA.
Therapeutic Effect: Prevents cell
replication.
Drug Classification: Antiviral
Therapeutic Action: Binds
directly to HIV-1 reverse
transcriptase, changing shape of
enzyme, blocking RNA-, DNA-
dependent polymerase activity.
Therapeutic Effect: Interferes with
HIV replication, slowing
progression of HIV infection
Side Effects:
Asthenia (loss of strength, energy).
Headache, abdominal pain, nausea,
flatulence. Diarrhea, dyspepsia.
Adverse Effect:
Nephrotoxicity, characterized by increased
serum creatinine and decreased serum
phosphorus levels, is treatmentlimiting
toxicity of adefovir therapy. Lactic acidosis,
severe hepatomegaly occur rarely,
particularly in female pts.
Side Effects:
Rash, fever, headache, nausea,
granulocytopenia (more common in
children). Stomatitis (burning, erythema,
ulceration of oral mucosa; dysphagia).
Paresthesia, myalgia, abdominal pain.
Adverse Effect:
Skin reactions, hepatitis may become
severe, life-threatening.
Obtain baseline renal function lab
values before therapy begins and
routinely there after. Those with renal
insufficiency, preexisting or during
treatment, may require dose
adjustment. HIV antibody testing
should be performed before therapy
begins (unrecognized or untreated
HIV infection may result in emergence
of HIV resistance). Monitor I&O,
serum creatinine; AST, ALT, alkaline
phosphatase levels. Closely monitor
for adverse reactions in those taking
other medications that are excreted
renally or with other drugs known to
affect renal function. For patient and
family teaching, Report nausea,
vomiting, abdominal pain. Avoid
alcohol.
Establish baseline lab values, esp.
hepatic function tests, before initiating
therapy and at intervals during
therapy. Obtain medication history
(esp. use of oral contraceptives).
Closely monitor for evidence of rash
(usually appears on trunk, face,
extremi ties; occurs within first 6 wks
of drug initiation). Observe for rash
accompanied by fever, blistering, oral
lesions, conjunctivitis, swelling,
mg/m2 muscle/joint aches, general malaise.
Frequency:

Adults: once daily for 14 days (to

reduce risk of rash).
Maintenance: twice daily in
combination with nucleoside
analogues.
Children 8 yrs and older: once daily
for 14 days. Increase to twice daily
(if no rash).
Children 8 yrs of age or younger:
once daily for 14 days Increase to
twice daily (if no rash)
Route: PO

Generic Name: Chloroquine
Brand Name: Aralen
Dose: Initially, 1 g (600-mg base)
P.O., then an additional 500 mg
(300- mg base)
Frequency: Single dose
Route: PO
Drug Classification:
Antiprotozoal
Therapeutic Action: Unknown.
Antimalarial action may occur
through inhibition of protein
synthesis and alteration of DNA in
susceptible parasites.
Side Effects:
Special Senses: ocular reactions:
Irreversible retinal damage in patients
receiving long-term or high-dosage 4-
aminoquinoline therapy; visual disturbances
(blurring of vision and difficulty of focusing
or accommodation); nyctalopia;
scotomatous vision with field defects of
paracentral, pericentral ring types, and
typically temporal scotomas.
Adverse Effect:
allergic reaction, like rash; hives; itching;
red, swollen, blistered, or peeling skin with
or without fever; wheezing; tightness in the
chest or throat; trouble breathing,
swallowing, or talking; unusual hoarseness;
or swelling of the mouth, face, lips, tongue,
or throat.
Monitor CBC and hepatic enzyme
levels in prolonged therapy. Monitor
renal and hepatic studies. Assess
patient for apnea, bradycardia, and
hypotension. For patient and family
teaching, Caution patient to avoid
driving and other hazardous activities
until he knows how drug affects
concentration and alertness. Advise
patient to avoid alcohol during
therapy. Tell patient not to stop taking
drug abruptly. Instruct him to discuss
dosagetapering schedule with
prescriber. Caution female patient not
to take drug if she’s pregnant or might
become pregnant during therapy.
Advise her to use reliable
contraception
Generic Name: Metronidazole
Brand Name: MetroGel
Dose:
PO, IV: Adults, elderly: 500 mg.
Maximum: 4 g/day.
PO: Children, infants: 15–35 mg/kg
IV: Children, infants: 30 mg/kg/day
Frequency:
PO, IV: Adults, elderly: q6–8h.
PO: Children, infants: divided doses
q8h.
IV: Children, infants: divided doses
q6h
Route: PO and IV
Generic Name: Fluconazole
Brand Name: Diflucan
Dose:
PO, IV: Adults, Elderly: 200 mg
once, then 100 mg/day atleast 14
days
Children: 6 mg/kg/day once, then 3
mg/kg/day for at least 14 days.
Frequency:
PO: Adults, Elderly: q72h
PO: Children: q72h
Route: PO and IV
Generic Name: Clotrimazole
Drug Classification:
Antiprotozoal
Therapeutic Action:
Disrupts DNA, inhibiting nucleic
acid synthesis. Therapeutic Effect:
Produces bactericidal,
antiprotozoal, amebicidal,
trichomonacidal effects. Produces
anti-inflammatory,
immunosuppressive effects when
applied topically
Drug Classification: Antifungal
Therapeutic Action: Interferes
with cytochrome P-450, an
enzyme necessary for ergosterol
formation. Directly damages
fungal membrane, altering its
function Fungistatic.
Drug Classification: Antifungal
Side Effects:
Anorexia, nausea, dry mouth, metallic taste.
Vaginal: Symptomatic cervicitis/vaginitis,
abdominal cramps, uterine pain. Systemic:
Diarrhea, constipation, vomiting, dizziness,
erythematous rash, urticaria, reddish-brown
urine. Topical Transient erythema, mild
dryness, burning, irritation, stinging, tearing
when applied too close to eyes. Vaginal:
Vaginal, perineal, vulvar itching; vulvar
swelling. Mild, transient leukopenia;
thrombophlebitis with IV therapy
Adverse Effect:
Oral therapy may result in furry tongue,
glossitis, cystitis, dysuria, and pancreatitis.
Peripheral neuropathy (manifested as
numbness, tingling of hands/feet) usually is
reversible if treatment is stopped
immediately upon appearance of neurologic
symptoms. Seizures occur occasionally
Side Effects:
Hypersensitivity reaction (chills, fever,
pruritus, rash), dizziness, drowsiness,
headache, constipation, diarrhea, nausea,
vomiting, abdominal pain.
Adverse Effect:
Exfoliative skin disorders, serious hepatic
effects, blood dyscrasias (eosinophilia,
thrombocytopenia, anemia, leukopenia)
have been reported rarely.
Side Effects:
Question for history of hypersensitivity
to metronidazole, other nitroimidazole
derivatives (and parabens with
topical). Obtain specimens for
diagnostic tests, cultures before giving
first dose (therapy may begin before
results are known). Monitor daily
pattern of bowel activity, stool
consistency. Monitor I&O, assess for
urinary problems. Be alert to
neurologic symptoms (dizziness;
paresthesia of extremities). Assess for
rash, urticaria. Watch for onset of
superinfection (ulceration/change of
oral mucosa, furry tongue, vaginal
discharge, genital/anal pruritus).
Assess infected area. Establish
baselines for CBC, serum potassium,
hepatic function studies. Assess for
hypersensitivity reaction (chills, fever).
Monitor serum hepatic/ renal function
tests, potassium, CBC, platelet count.
Report rash, itching promptly. Monitor
temperature at least daily. Monitor
daily pattern of bowel activity, stool
consistency. Assess for dizziness;
provide assistance as needed.
Advise patient to report increased skin
Brand Name: Canesten
Dose:
Cream, topical: 15g, 30g, 45g, 90g
Cream, vaginal: 25g ,45g, 90g
Lotion: 30 mL
Solution, topical: 10 mL, 30 mL
Tablet, vaginal:  100mg, 200mg,
500mg
Troche: 10mg
Frequency:
Adults and children: 10 mg troche
dissolved 5 times/day for 14 days.
Adults and children:  applicatorful
daily (preferably at bedtime) for 7 –
14 days.
Adults and children: Insert 100
mg/day for 7 days or 500 mg single
dose.
Adults and children: Apply to
affected area twice daily (morning
and evening)
Route: oral/transmucosal lozenges
(troches), topically, or intravaginally
Generic Name: Mebendazole
Brand Name: Vermox
Dose:
Adult and child : 100 mg
Frequency:
single dose
Route: PO
Therapeutic Action: Alters cell
membrane permeability by binding
with phospholipids in the fungal
cell membrane. Inhibits or kills
many fungi, including yeast and
dermatophytes, and also is active
against various species of gram-
positive bacteria.
Drug Classification: Anthelmintic
Therapeutic Action:
Rash, hives, stomach pain, fever, chills,
nausea, vomiting, foul-smelling vaginal
discharge.
Adverse Effect:
Light burning has been observed
after vaginal application. Itching, skin
rashes, lower abdominal pain, flatulence or
cramps, dyspareunia and bladder irritation
are rare. When it is applied on the skin,
blisters, reddening, local edemas, itching,
burning, stinging, urticaria, skin fissures,
and exceptionally extensive skin irritation
can sometimes develop. Severe problems
(vomiting, diarrhea, neuropsychiatric
disturbances, allergic exanthema), such as
have occured in certain studies on oral
administration, do not occur after topical
application.
Side Effects:
Causes degenerative alterations in the
tegument and intestinal cells of the worm by
binding to the colchicine-sensitive site of
tubulin, thus inhibiting its polymerization or
assembly into microtubules.
Adverse Effect:
Transient abdominal pain and diarrhea
irritation or lack of response to
therapy to health care professional.
Inform patient that early relief of
symptoms may be seen in 2–3 days.
For Candida, tinea cruris, and tinea
corporis, 2 wk are needed, and for
tinea pedis, therapeutic response may
take 3–4 wk.
Initiate second course of treatment if
cure does not occur within 3 wk.
Examine and treat all family members
simultaneously because pinworms are
readily transmitted from person to
person. For patient and family
teaching, Practice thorough hand
washing after touching any potentially
contaminated item.
Change underclothing, bedclothes,
towels, and facecloths daily; bathe

Generic Name: Chlorambucil Drug Classification: Side Effects:
Brand Name: Leukeran Antineoplastic GI effects (nausea, vomiting, anorexia,
Dose: Therapeutic Action: Inhibits diarrhea, abdominal distress) generally
Adults, elderly: 0.1 mg/kg/day or 0.4 DNA, RNA synthesis by cross- mild, last less than 24 hrs, occur only if
mg/kg linking with DNA, RNA strands. single dose exceeds 20 mg. Rash,
Frequency: Cell cycle– phase nonspecific. dermatitis, pruritus, cold sores. Alopecia,
Adults, elderly: 3–6 wks or pulsed Therapeutic Effect: Interferes with urticaria, erythema, hyperuricemia.
doses administered intermittently, nucleic acid function. Adverse Effect:
biweekly or monthly Hematologic toxicity due to severe
Route: PO myelosuppression occurs frequently,
manifested as neutropenia, anemia, and
thrombocytopenia. After discontinuation of
therapy, thrombocytopenia, neutropenia
usually last for 1–2 wks but may persist for
3–4 wks. Neutrophil count may continue to
decrease for up to 10 days after last dose.
Toxicity appears to be less severe with
intermittent drug administration.
Overdosage may produce seizures in
children. Excessive serum uric acid level,
hepatotoxicity occur rarely.
frequently, preferably by showering.
Infected person should sleep
alone.Do not breast feed while taking
this drug without consulting physician.
CBC should be performed before
therapy and each wk during therapy,
WBC count performed 3–4 days
following each weekly CBC during first
3–6 wks of therapy (4–6 wks if pt on
intermittent dosing schedule). Monitor
CBC, platelet count, serum uric acid,
hepatic function tests. Monitor for
hematologic toxicity (fever, sore
throat, signs of local infection, unusual
bruising/ bleeding from any site),
symptoms of anemia (excessive
fatigue, weakness). Assess skin for
rash, pruritus, urticaria.
Generic Name: Methotrexate
Brand Name: Rheumatrex
Dose:
Adults, elderly: 30–40 mg/m2 /wk up
to 100–12,000 mg/m2 with
leucovorin rescue
PO, IM: Adults, elderly: 15–30
mg/day
Frequency:
NOT INDICATED FOR IV
PO, IM: Adults, elderly: for 5 days;
repeat in 7 days for 3–5 courses
Route: IV, IM and PO
Generic Name: DOXOrubicin
Brand Name: Adriamycin
Dose:
IV (Adriamycin): Adults: 60–75
mg/m2 as a single dose every 21
days, 20 mg/m2 once weekly, or
20–30 mg/m2 /day on 2–3
successive days q4wks. Because of
risk of cardiotoxicity, do not exceed
cumulative dose of 550 mg/m2
(400–450 mg/m2 for those
Drug Classification: :
Antineoplastic
Therapeutic Action:
Competes with enzymes
necessary to reduce folic acid to
tetrahydrofolic acid, a component
essential to DNA, RNA, protein
synthesis. Therapeutic Effect:
Inhibits DNA, RNA, protein
synthesis.
Drug Classification:
Antineoplastic
Therapeutic Action:
Inhibits DNA, DNA-dependent
RNA synthesis by binding with
DNA strands. Liposomal
encapsulation increases uptake by
tumors, prolongs drug action, may
decrease toxicity. Therapeutic
Effect: Prevents cell division.
Side Effects:
Nausea, vomiting, stomatitis;
burning/erythema at psoriatic site (in pts
with psoriasis). Occasional (3%–1%):
Diarrhea, rash, dermatitis, pruritus,
alopecia, dizziness, anorexia, malaise,
headache, drowsiness, blurred vision
Adverse Effect:
High potential for various, severe toxicities.
GI toxicity may produce gingivitis, glossitis,
pharyngitis, stomatitis, enteritis,
hematemesis. Hepatotoxicity more likely to
occur with frequent small doses than with
large intermittent doses. Pulmonary toxicity
characterized by interstitial pneumonitis.
Hematologic toxicity, resulting from marked
myelosuppression, may manifest as
leukopenia, thrombocytopenia, anemia,
hemorrhage. Dermatologic toxicity may
produce rash, pruritus, urticaria,
pigmentation, photosensitivity, petechiae,
ecchymosis, pustules. Severe
nephrotoxicity produces azotemia,
hematuria, renal failure.
Side Effects:
Complete alopecia (scalp, axillary, pubic
hair), nausea, vomiting, stomatitis,
esophagitis (esp. if drug is given on several
successive days), reddish urine. Doxil:
Nausea. Anorexia, diarrhea;
hyperpigmentation of nailbeds, phalangeal,
dermal creases. Fever, chills, conjunctivitis,
lacrimation.
Adverse Effect:
Myelosuppression manifested as
Rheumatoid arthritis: Assess pain,
range of motion. Psoriasis: Assess
skin lesions. Question for possibility of
pregnancy before initiating therapy
(Pregnancy Category X) in pts with
psoriasis, rheumatoid arthritis (RA).
Obtain all functional tests before
therapy, repeat throughout therapy.
Antiemetics may prevent nausea,
vomiting. Monitor hepatic/renal
function tests, Hgb, Hct, WBC,
differential, platelet count, urinalysis,
chest X-rays, serum uric acid.
Monitor for hematologic toxicity (fever,
sore throat, signs of local infection,
unusual bruising/bleeding from any
site), symptoms of anemia (excessive
fatigue, weakness). Assess skin for
evidence of dermatologic toxicity.
Keep pt well hydrated, urine alkaline.
Avoid rectal temperatures, traumas
that induce bleeding. Apply 5 full min
of pressure to IV sites.
Obtain WBC, platelet, erythrocyte
counts before and at frequent
intervals during therapy. Obtain EKG
before therapy, hepatic function
studies before each dose. Antiemetics
may be effective in preventing,
treating nausea. Monitor for stomatitis
(burning or erythema of oral mucosa
at inner margin of lips, difficulty
swallowing). Observe IV injection site
for infiltration, vein irritation.
previously treated with related
compounds or irradiation of cardiac
region).
Children: 35–75 mg/m2 as a single
dose q3wks or 20–30 mg/m2
weekly, or 60–90 mg/m2 as
continuous infusion over 96 hrs q3–
4wks.
Frequency:
Adult: Single dose every 21 days/
once weekly/
Child: single dose every 3 weeks/
continuous infusion over 96 hrs q3–
4wks.
Route: IV
hematologic toxicity (principally leukopenia
and, to lesser extent, anemia,
thrombocytopenia) generally occurs within
10– 15 days, returns to normal levels by
third wk. Cardiotoxicity (either acute,
manifested as transient EKG abnormalities,
or chronic, manifested as CHF) may occur.
May lead to ulceration of mucous
membranes within 2–3 days. Assess
dermal creases, nailbeds for
hyperpigmentation. Monitor
hematologic status, renal/ hepatic
function studies, serum uric acid
levels. Monitor daily pattern of bowel
activity, stool consistency. Monitor for
hematologic toxicity (fever, sore
throat, signs of local infection, unusual
bruising/ bleeding from any site),
symptoms of anemia (excessive
fatigue, weakness).