DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES

CONTRAINDICATION

GENERIC: INDICATIONs: CNS: BEFORE:

Penicillin G Sodium Inhibits final stage of bacterial To treat systemic infections Neuroleptic malignant Dx:
BRAND: cell wall synthesis by caused by gram-positive syndrome, suicidal thoughts, a. Monitor older adults for
(benzylpenicillin sodium) competitively binding to organisms (including dizziness, drowsiness, insomnia, fluid and sodium
CLASS: penicillin-binding proteins Bacillus anthracis, anxiety imbalances.
inside the cell wall. Corynebacterium EENT: b. Assess for history of
THERAPEUTIC Penicillin-binding proteins are diphtheriae, enterococci, Pharyngitis, rhinitis, tinnitus, seizure disorders.
Antibiotic responsible for various steps in Listeria monocytogenes, visual abnormalities c. Check for allergies.
bacterial cell wall synthesis. By Staphylococcus aureus, and CV: d. Assess baseline mental
PHARMACOLOGIC: binding to these proteins, S. epidermidis), gram-negative Chest pain, palpitations status
Natural penicillins penicillin leads to cell wall lysis. organ- GI: Tx:
DOSAGE: isms (including Neisseria Diarrhea, dry mouth, a. Supervise patients at
5 Million-unit gonorrhoeae, nausea risk for suicide closely
SOURCE: Nx drug handbook N. meningitidis, Pasteurella GU: during initial therapy.
ROUTE: 10e multocida, Sexual dysfunction,
b. Perform a thorough
IV and Streptobacillus menstrual disorder.
physical assessment to
moniliformis [rat- DERM:
bite fever]), and gram-positive Sweating, hot flushes, rash establish baseline data
anaer- ENDO: before drug therapy
obes (including Actinomyces Diabetes begins, to determine
israelii [actinomycosis], MS: the effectiveness of
Clostridium perfrin- Back pain, myalgia therapy, and to
gens, C. tetani, Peptococcus NEURO:
evaluate for the
species, Tremor, hypertonia
Peptostreptococcus species,
and spiro-
chetes, especially Treponema
carateum
[pinta], T. pallidum, and
T.pertenue[yaws]
CONTRAINDICATION:
Hypersensitivity; concurrent
use of MAO-like drugs
(linezolid or methylene blue);
concurrent use of pimozide;
oral concentrate contains
alcohol; avoid patients with
known intolerance.
DRUG TO DRUG INTERACTION:
__________________
DRUG TO FOOD INTERACTION:
_________________
MISC: occurrence of any
Serotonin syndrome, fever adverse effects
and thirst. associated with drug
therapy.
c. Restrict amount of
drug available to
patient.
d. Periodically assess
dose.
EDx:
a. Instruct pt. to take
sertraline as directed
b. Caution pt. that
drowsiness or dizziness
may occur.
c. Educate client on drug
therapy to promote
compliance.
d. Insure the patient takes
the medication as
prescribed.
DURING:
Dx:
 a. Asses mental status for
worsening of
depression, suicidal
ideation, anxiety, social
functioning, and/or
panic
attack(especially
during initiation of
therapy and when
dosage is changed
b. Monitor mood
changes.
c. Monitor for adverse
effects (e.g. sedation,
dizziness, respiratory
dysfunctions, GU
problems, etc).
d. Check for drug or
herbal interactions

Tx:
a. Limit drug access if
patient is suicidal to
decrease the risk of
 overdose to cause
harm.
b. Administer a major
portion of dose at
bedtime as ordered if
drowsiness and
anticholinergic effect
are severe to decrease
the risk of patient injury.
c. Establish suicide
precautions for
severely depressed
patients to decrease
the risk of overdose to
cause harm.
d. Assist pt. in taking the
medication.

EDx:
a. Instruct pt. SO to report
diarrhea, nausea,
dyspepsia, insomnia,
drowsiness, dizziness, or
persistent headache to
physician.
 b. Report diarrhea,
nausea, dyspepsia,
insomnia, drowsiness,
dizziness, or persistent
headache to
physician.
c. Inform of drugs and
herbs that can interact
d. Instruct patient to
verbalize feelings and
concerns.

AFTER:
Dx:
a. Assess
knowledge/teach
patient appropriate
use ,interventions to
reduce side effects,
and adverse symptoms
to report
b. Monitor for
effectiveness as
exhibited by a
decrease in symptoms
 c. Monitor for side effects.
d. Assess for serotonin
syndrome

Tx:
a. Remember that a lot of
these drugs can cause
dizziness in the first few
weeks of taking so take
safety precautions.
b. Provide safety
measures (e.g.
adequate lighting,
raised side rails, etc.) to
prevent injuries.
c. Provide comfort
measures (e.g. voiding
before dosing, taking
food with drug, etc.) to
help patient tolerate
drug effects.
d. Administer drug once a
day in the evening to
 achieve optimal
therapeutic effects.

EDx:
a. Monitor patient
compliance to drug
therapy.
b. Monitor patient for 2-4
weeks to ascertain
onset of full
therapeutic effect.
c. Advise pt. to avoid
alcohol intake.
d. Instruct patient to
verbalize feelings and
concerns.

categorize your NURSING RESPONSIBILITIES as to Before, During and After giving the medication and each has Dx, Tx and EDx.