3.5.
Drug, Diet, Special procedures
S/no. Drug Action
1 Tab.  Ciprofloxacin promotes
Ciprofloxacin breakage of double-stranded
500mg b.d 1/52 DNA in susceptible organisms
and inhibits DNA gyrase,
which is essential in
reproduction of bacterial DNA.
 Kills bacteria that causes
unfection
2 Tab.  Metronidazole is converted to
Metronidazole reduction products that interact
400mg tds 1/52 with DNA to cause destruction
of helical DNA structure and
strand leading to a protein
synthesis inhibition and cell
death in susceptible organisms.
3 Tab. Vitamin C Water-soluble vitamin essential for
200mg synthesis and maintenance of
collagen and intercellular ground
substance of body tissue cells,
blood vessels, cartilage, bones,
teeth, skin, and tendons.  particular time and excretes the rest
Nursing Implication
 Arrange for culture and sensitivity tests
before beginning therapy.
 Continue therapy for 2 days after signs and
symptoms of infection are gone.
 Ensure that the patient swallows ER
tablets whole; do not cut, crush, or chew.
 Ensure that patient is well hydrated.
 Give antacids at least 2 hr after dosing.
 Encourage patient to complete full course
of therapy.
 Avoid use unless necessary.
Metronidazole may be carcinogenic.
 Administer oral doses with food.
 Apply topically (MetroGel) after cleansing
the area. Advise patient that cosmetics
may be used over the area after
application.
 Reduce dosage in hepatic disease.
 High doses of vitamin C are not
recommended during pregnancy.
 Take large doses of vitamin C in
divided amounts because the body
uses only what is needed at a
in urine.
 Megadoses can interfere with
Adverse Effects
 GI disturbances; headache, tremor,
confusion, convulsions; rashes;
joint pain; phototoxicity. Transient
increases in serum creatinine.
Hematological, hepatic and renal
disturbances. Vasculitis,
pseudomembranous colitis and
tachycardia. Phototoxicity.
 GI disturbances e.g. nausea,
unpleasant metallic taste, vomiting,
diarrhoea or constipation.
 Numbness or tingling in the
extremities,
 Hypersensitivity reactions.
 Urethral discomfort and darkening
of urine.
 Raised liver enzyme values,
cholestatic hepatitis, jaundice.
Thrombophlebitis (IV).
GI:Nausea,vomiting,heartburn,diarrhea,
or abdominal cramps (high doses).
Hematologic:Acute hemolytic anemia
(patients with deficiency of G6PD);
sickle cell crisis.
CNS:Headache or insomnia (high
doses).
Urogenital:Urethritis, dysuria,
 3.5. Drug, Diet, Special procedures

absorption of vitamin B12. crystalluria, hyperoxaluria, or

 Note: Vitamin C increases the
absorption of iron when taken at the
same time as iron-rich foods.
 Do not breast feed while taking this
drug without consulting physician.
hyperuricemia (high doses).
other:Mild soreness at injection site;
dizziness and temporary faintness with
rapid IV administration.

4. Tab. PCM 1g  Antipyretic: Reduces fever by
tds acting directly on the
hypothalamic heat-regulating
center to cause vasodilation
and sweating, which helps
dissipate heat.
 Do not exceed the recommended dosage.
 Consult physician if needed for children <
3 yr; if needed for longer than 10 days; if
continued fever, severe or recurrent pain
occurs (possible serious illness).
 Avoid using multiple preparations
containing acetaminophen. Carefully
check all OTC products.
 Give drug with food if GI upset occurs.
 Discontinue drug if hypersensitivity
reactions occur.
 Treatment of overdose: Monitor serum
levels regularly, N-acetylcysteine should
be available as a specific antidote; basic
life support measures may be
 CNS: Headache
 CV: Chest pain, dyspnea,
myocardial damage when doses of
5–8 g/day are ingested daily for
several weeks or when doses of 4
g/day are ingested for 1 yr
 GI: Hepatic toxicity and failure,
jaundice
 GU: Acute kidney failure, renal
tubular necrosis
 Hematologic: Methemoglobinemia
—cyanosis; hemolytic anemia—
hematuria, anuria; neutropenia,
leukopenia, pancytopenia,
thrombocytopenia, hypoglycemia
 Hypersensitivity: Rash, fever

DIET:

24/2/2022 Low Residual Diet

SPECIAL PROCEDURE:
3.5. Drug, Diet, Special procedures

15/02/2022 commence Soap and water Enema today b.d

Rectal washout tomorrow morning

24/2/2022 Rectal Washout on Thursday

28/2/2022 b.d sit bath