Drugs acting on the gastrointestinal system

Antiemetics
Metoclopramide and domperidone

Antimicrobial drugs
Antibiotics:
Co-trimoxazole:
Nursing implications:
1 - Administer: With food or following meals.
2- Clean open wounds prior to topical applications.
3- Maintain sufficient fluid intake
4- Observation of manifestation of "blood dyscrasias (sore throat, fever,
"prostration, ulceration of mouth, of rectum, of vagina, bleeding gums,
unexplained bruising petechia).
Penicillins
Adverse effects:
1 - Hypersensitivity reactions (rash, urticaria, erythema, anaphylaxis,
laryngeal oedema, fever, malaise, arthralgia, angioedema, Stevens-
Johnson syndrome).
2- Pain at the site of injection.
3- Neurotoxicity: high dose intrathecal injection.
4- Heaemolytic anaemia in high dose.
5-Nausea, vomiting and diarrhea especially with ampicillin and
amoxacillin.
6- Interstitial nephritis e.g. methicillin.
7- Hyperkalaemia e.g. carbenicillin, ticarcillin.
Nursing implications:
1- Assess: For previous penicillin hypersensitivity.
2- Give oral penicillins on an empty stomach.
3- Store oral suspension in refrigerator.
4- Do not massage injection site of long acting penicillins.
5-Teach: To complete the entire duration of the course of therapy even
though asymptomatic.
6- Do not mix methicillin with dextrose or other drugs in syringe or IV
solution.
Cephalosporins
Nursing implications:
1-Assess: For previous penicillin or cephalosporin allergy, renal
dysfunction.
2- Discard unrefrigerated solutions after 12 hours and refrigerated
solutions after 4 days (if given for .EM or IV injections).
1 - Refrigerate oral suspensions.
Aminoglycosides
Nursing implications:
1- Assess: For myasthenia gravis, hearing deficiency, renal impairment,
concurrent use of other ototoxic and nephrotoxic drugs.
2- Reduce the dosage in patients with renal impairement, premature
infants.
3-Evaluate: For early indication of ototoxicity (dizziness, vertigo,
and hearing loss) nephrotoxicity (oliguria, proteinuria and elevated serum
creatinine).
4- All members are given by IM except neomycin given orally.
Enumerate:
Side effects of Penicillin therapy.
Describe nursing implications of:
Penicillin therapy
Aminoglycosides therapy