Drug Name Mechanism of action Indication/Contraindication Adverse Effects Nursing Consideration

Generic Name: Hydrochloric acid (HCl) secretion Indication: CNS: BEFORE:

Omeprazole into the gastric lumen is a process -Treatment of doudenal ulcers, pathologic Dizziness Assess for vital signs
regulated mainly by the H(+)/K(+)- hypersecretory conditions, Drowsiness Assess and teach significant
Brand Name: ATPase of the proton pump , gastroesophageal reflux disease. Fatigue others of the patient the
hyperzole expressed in high quantities by the Headache Weakness common side effects of the
parietal cells of the stomach. Contraindications: drug and to report any severe
Pharmacologic Source Contraindicated to hypersensitivity CV: adverse effects stat.
effect: Shirasaka Y, Sager JE, Lutz JD, Chest pain
a specific inhibitor Davis C, Isoherranen N: Inhibition Drug to drug interaction: DURING:
of H+,K(+)-ATPase of CYP2C19 and CYP3A4 by can interact with clopidogrel, warfarin, and GI: Perform 15 rights of
or 'proton pump' in omeprazole metabolites and their certain HIV medications. Other interacting Abdominal Pain Acid medication
parietal cells. contribution to drug-drug medications, like citalopram and St. John's regurgitation Constipation Assess patient routinely for
interactions. Drug Metab Dispos. wort, also exist. In some cases, your Diarrhea epigastric or abdominal pain,
Therapeutic effect: 2013 Jul;41(7):1414-24. doi: healthcare provider may need to adjust the Flatulence Nausea and frank or occult blood for
used to treat certain 10.1124/dmd.113.051722. Epub dosage of one or more of your Vomiting the
conditions where 2013 Apr 25. [ medications. Monitor CBC with
there is too much Drug to food interaction: DERM: differentid periodically
acid in the stomach. There are no specific foods that interact Itching Rash during therapy Take tablet or
with omeprazole, therefore there are no capsule with a full glass of
Route: foods that you need to avoid. MISC: water.
IV Allergic reaction
AFTER:
Dose: May cause serum gastrin
40mg/ml concentrations to increase
during first 1-2 weeks of
therapy. Levels return to
normal after discontinuation
of
Report to physician if any
allergic reaction occurs
Document findings.
Generic Name: Ceftriaxone works by inhibiting the Indication: CNS: headache, dizziness, BEFORE:
Cetriaxone mucopeptide synthesis in the Postoperative prophylaxis for potentially lethargy check doctor's order
bacterial cell wall.The beta-lac tam contaminated surgical procedure. perform handwashing
Brand Name: moiety of ceftriaxone binds to - Treatment for lower respiratory Gl: nausea, vomiting, - introduce drug to the patient
rocepin carboxypeptidases, endopeptidases, infections caused by streptococcus diarrhea, anorexia, and educate her about its
and transpeptidases in the bacterial pneumoniae. pseudomembranou s colitis purpose and importance
Pharmacologic cytoplasmic membrane. These
effect: enzymes are involved in cell-wall
Cephalosporin synthesis and cell division. Binding
antibiotic of ceftriaxone to these enzymes
causes the enzyme to lose activity;
Therapeutic effect: therefore, the bacteria produce
Cephalosporin defective cell walls, causing cell
Antibiotic death.
Route: Source:
IV Sivapalasingam S., Steigbigel N.
(2015). Mandell, Douglas and
Dose: Bennett's Principles and practice of
500mg/ml infectious diseases (8th ed.).
Elsevier.DailyMed Label:
ceftriaxone sodium injection,
powder for solution [Link]
Generic Name: Metronidazole is a nitroimidazole
Metronidazole anti-infective drug used mainly in
the treatment of infections caused
Contraindications:
Contraindicated with allergy to
cephalosporin or penicillin
Drug to drug interaction:
Antibiotic medicines can cause diarrhea,
which may be a sign of a new infection. If
you have diarrhea that is watery or bloody,
call your doctor. Do not use anti-diarrhea
medicine unless your doctor tells you to
Drug to food interaction:
No food found
Indication
>amebic hepatic abscess
>intestinal amebiasis
GU: nephrotoxicity
Hematologic: bone marrow
depression - decrased WBC
count,decreased platelets,
decreased Hct
Hypersensitivity: ranging
from rash to fever to
anaphylaxis
Local: pain, abscess
Others:
superinfections,disulfram-like
reaction with alcohol
CNS: seizures, dizziness,
headache
- assess for hepatic and renal
impairment, lactation,
pregnancy
-assess skin status, LFTs,
renal function tests, culture
of affected area, sensitivity
tests
DURING:
administer the right drug at
the right dose check the
patency of the IV site and IV
line have vitamin K ready in
case hypoprothrombinemia
occurs do not mix ceftriaxone
with any other antimicrobial
drug
-discontinue if
hypersensitivity reaction
occurs
AFTER:
-educate patient to avoid
alcohol while taking this drug
and for 3 days after because
severe reactions often occur
- monitor ceftriaxone blood
levels in patients with severe
renal impairment and in
patients with renal and
hepatic impairment
--report severe diarrhea,
difficulty breathing, unusual
tiredness or fatigue, pain at
injection site
-document and record.
BEFORE
>assess pts. Infection
>watch carefully for edema
Brand Name: by susceptible organisms, >trichomoniasis EENT: Tearing(topical only) because it may cause sodium
erzol particularly anaerobic bacteria and >retractory trichomoniasis retention
protozoa. The nitro group of >bacterial infection caused by anaerobic GI: abdominal pain, anorexia, >assess skin for severity
Pharmacologic metronidazole is chemically reduced microorganisms nausea and vomiting, areas of local adverse
class: by ferredoxin and the products are >to prevent postoperative infection in diarrhea, dry mouth, glossitis reactions
Nitroimedazole responsible for disrupting the DNA contaminated colorectal surgery >record number and
helical structure, thus inhibiting >pelvic inflammatory disease Derm: rashes, urticarial, mild character of stools
Therapeutic class: nucleic acid synthesis dryness, skin irritation >assess pt’s and family’s
Antibacterial Contraindication knowledge of drug therapy
Antiptotozoal >hypersensitivity Hemat: leukopenia
>hypersensitivity to parabens DURING
Route: >first trimester of pregnancy Local: Phlebitis at Iv site >give drug with meals to
IV minimize GI distress
Neuro: peripheral neuropathy >to treat trichomoniasis, give
Dose: drug for 7days instead of 2-g
5mg/ml Misc: superinfection single dose
>use only after T.vaginalis
has been confirmed by wet
smear
>tablets may be crushed for
pt’s. with difficult
swallowing
>do not use aluminium
needles or hubs, color will
turn orange/rust

AFTER
>tell pt. that metallic taste
and dark or red brown urine
may occur
>instruct pt. to take oral form
with meals to minimize
reactions
>instruct to complete full
course of therapy
>tell pt. not to use alcohol or
drugs that contain alcohol.
>may cause dizziness/ light

Generic Name: Clindamycin works primarily by
Clindamycin binding to the 50s ribosomal subunit
of bacteria. This agent disrupts
Brand Name: protein synthesis by interfering with
klinbac the transpeptidation reaction, which
thereby inhibits early chain
Pharmacologic elongation. Chloramphenicol and
class: macrolides such as erythromycin,
Nitroimedazole clarithromycin, and azithromycin
also act at the 50s ribosomal subunit
Therapeutic class: and may compete for binding at this
Antibacterial site. Clindamycin and the related
Antiptotozoal drug lincomycin are often discussed
along with the macrolides but are
Route: not chemically related
IV
Dose:
160mg/ml
Indication Systemic
> systemic administration: serious CNS: cardiac arrest (with
infections caused by susceptible strains of rapid IV transfusion)
anaerobes, streptococci, staphylococci,
penumococci GI: pseudomembranous
> parenteral: treatment of septicemia colitis
> topical dermatologic solution: treatment
of acne vulgaris Hematologic: neutropenia,
> vaginal preparation: treatment of leukopenia
bacterial vaginosis
Hyppersensitivity: rashes
Contraindication
Contraindicated with allergy to Local: pain following
clindamycin, lactation injection, thrombophlebitis
after IV use
Interactions:
> drug-drug:increased neuromuscular Topical dermatologic sol’n
blockade with neuromuscular blocking CNS: fatigue, headache
agents; decreased GI absorption with
kaolin, aluminium salts Dermatologic: contact
dermatitis, dryness
GI: pseudomembranous
colitis, bloody diarrhea
GU: urinary frequency
Vaginal preparation
GU: cervicitis, vulvar
irritation
headedness
Before:
> check doctor’s order
> assess for allergy to
clindamycin, history of
asthma or other allergies,
allergy to tartrazine
> assess history of renal
impairment, lactation,
regional enteritis or
ulcerative colitis
> assess site of infection or
acne, skin color, lesions,
> take client’s BP
During:
> verify patient’s identity
> administer the right drug
with the right dose at the
right time
> state the importance and
purpose of the drug to the
patient
> check the patency of the IV
site and IV line
> if hypersensitivity reaction
occurs, stop the
administration immediately
After:
> regulate the IVF with the
prescribed flow rate
> monitor LFT’s and renal
function tests, and blood
counts
 > report severe or watery
diarrhea, abdominal pain,
inflamed mouth or vagina,
skin rash or lesions
> take full prescribed course
of oral drug. Do not stop
taking without notifying your
health care provider
> document and record.
Generic Name: Indication
Piperacillin Tazobactam inhibits beta-lactamase Moderate to severe pneumonia caused by CNS: fever, headache,  Observe the 14 rights in
Tazobactam piperacillin-resistant, beta-lactmase- insomnia, seizures, agitation, medication
and prevents the destruction of producing strains of S. aureus,or by anxiety, dizziness, pain administration.
Brand Name: piperacillin tazobactam susceptible
zosyn piperacillin. Therefore, tazobactam Acinetobacter baumannii,H. influenza, K. CV: arrhythmia, chest pain,  Monitor patient for
is given with piperacillin to enhance pneumoniae, and Pseudomonas edema, hypertension, diarrhea and initiate
Pharmacologic aeruginosa, tachycardia therapeutic measures as
class: the activity of piperacillin in needed.
penicillins and Contraindication EENT: rhinitis
beta-lactamase eradicating bacterial infections.  Contraindicated in patients  Monitor patient for
inhibitors hypersensitive to drug other GI: diarrhea, constipation, superinfection.
Piperacillin kills bacteria by penicillins. nausea, pseudomembranous
Therapeutic class:  Use cautiously in patients with colitis, abdominal pain,  Serious skin reactions
inhibiting the synthesis of bacterial bleeding tendencies, uremia, dyspepsia, stool changes,
penicillins and can occur. If rash
hypokalemia, and allergies to other vomiting develops, monitor
beta-lactamase cell walls.
drugs, especially cephalosporins, patient closely and
inhibitors because of possible cros-sensitivity. GU: candidiasis, interstitial discontinue if lesion
nephritis progresses.
Route:
IV Hematologic: leukopenia, Patient teaching
neutropenia,  Tell patient to report
Dose: thrombocytopenia, anemia,
1.4g IVTT adverse reactions or
eosinophilia signs of superinfections
promptly.
Respiratory: dyspnea
 Instruct patient to report
Skin: rash, pruritus discomfort at IV
insertion site.
 Other: anaphylaxis, pain,
inflammation,
hypersensitivity reactions
Generic Name: Gentamicin is an aminoglycoside Indication Dizziness or vertigo; acute · Avoid long-term therapies
Gentamycine that binds to 30s and 50s ribosomal Susceptible infections renal failure, interstitial because of increased risk of
subunits of susceptible bacteria Biliary tract infections nephritis, acute tubular toxicities. Reduction in
Brand Name: disrupting protein synthesis, thus Brucellosis necrosis; electrolyte dose may be clinically
erzol rendering the bacterial cell Cat scratch disease imbalances; transient indicated.
membrane defective. Cystic fibrosis elevation of serum bilirubin · Patients with edema or
Pharmacologic Endocarditis and aminotransferases; ascites may have lower peak
class: Endometritis purpura; nausea, vomiting; concentrations due to
Aminoglycoside Gastroenteritis convulsions, mental expanded extracellular fluid
antibiorics Granuloma inguinale depression, hallucinations. volume.
Listeriosis Atrophy or rat necrosis at inj · Cleanse area before
Therapeutic class: Meningitis sites. application of dermatologic
Aminoglycoside Otitis externa Potentially Fatal: preparations.
antibioticl Pelvic inflammatory disease Nephrotoxicity, ototoxicity · Ensure adequate hydration
Peritonitis and neuromuscular blockade of patient before and during
Route: Plague (may unmask or aggravate therapy.
IV Pneumonia myasthaenia gravis). · Monitor renal function
Septicaemia tests, CBCs, serum drug
Dose: Skin infections levels during long-term
10mg/ml Urinary tract infections therapy.
Prophylaxis of surgical infections Consult with prescriber to
adjust dosage.

Generic Name: The short term effects of
Dexamethasone corticosteroids are decreased
vasodilation and permeability of
Brand Name: capillaries, as well as decreased
dextar leukocyte migration to sites of
inflammation.3 Corticosteroids
Pharmacologic binding to the glucocorticoid
class: receptor mediates changes in gene
Contraindication
History of hypersensitivity to
aminoglycoside; pregnancy; hepatic
impairment, perforated ear drum.
Indication • vision changes, Assessment
• As an anti-inflammatory • swelling, ▪ History for systemic
medication. Dexamethasone • rapid weight gain, administration: Active
relieves inflammation in various • sleep problems (insomnia), infections; renal or
parts of the body. It is used • mood changes, hepatic disease;
specifically to decrease swelling • acne, hypothyroidism,
(edema), associated with tumors of • dry skin, ulcerative colitis;
the spine and brain, and to treat eye • thinning skin, diverticulitis; active or
Synthetic expression that lead to multiple
adrenocortical downstream effects over hours to
steroid days.3
Glucocorticoids inhibit neutrophil
Therapeutic class: apoptosis and demargination; they
Anti-inflamatory inhibit phospholipase A2, which
decreases the formation of
Route: arachidonic acid derivatives; they
IV inhibit NF-Kappa B and other
inflammatory transcription factors;
Dose: they promote anti-inflammatory
4mg/ml genes like interleukin-10.3
Lower doses of corticosteroids
provide an anti-inflammatory effect,
while higher doses are
immunosuppressive.3 High doses of
glucocorticoids for an extended
period bind to the mineralocorticoid
receptor, raising sodium levels and
decreasing potassium levels
inflammation. •bruising or discoloration, latent peptic ulcer;
• To treat or prevent allergic •slow wound healing, inflammatory bowel
reactions. •increased sweating, disease; CHF,
• As treatment of certain kinds of •headache, hypertension,
autoimmune diseases, skin •dizziness, thromboembolic
conditions, asthma and other lung •spinning sensation, disorders;
conditions. •nausea, osteoporosis; seizure
• As treatment for a variety of •stomach pain, disorders; diabetes
cancers, such as leukemia, •bloating, mellitus; lactation
lymphoma, and multiple myeloma. •muscle weakness, or ▪ Physical for systemic
• To treat nausea and vomiting •changes in the shape or administration:
associated with some chemotherapy location of body fat Baseline body weight,
drugs. (especially in your arms, T; reflexes, and grip
• Used to stimulate appetite in legs, face, neck, breasts, strength, affect, and
cancer patients with severe appetite and waist). orientation; P, BP,
problems. Rare instances peripheral perfusion,
Also used to replace steroids in prominence of
conditions of adrenal insufficiency (low superficial veins; R
production of needed steroids produced by and adventitious
the adrenal glands). sounds; serum
electrolytes, blood
Contraindication glucose
• visible water retention Interventions
• inherited deficiency of ▪ For systemic
argininosuccinate lyase administration, do not
• inherited carbamoyl phosphate give drug to nursing
synthetase deficiency mothers; drug is
• citrullinemia secreted in breast milk.
• infection caused by the varicella ▪ WARNING: Give
zoster virus daily doses before 9
• measles AM to mimic normal
• ornithine carbamoyltransferase peak corticosteroid
deficiency blood levels.
▪ Increase dosage when
• arginase deficiency
patient is subject to
• exposure to the measles
stress.
• exposure to the chickenpox ▪ Taper doses when
• muscle pain or tenderness with discontinuing high-
increase creatine kinase
• broken bone due to disease or dose or long-term
illness therapy.
• osteonecrosis ▪ Do not give live virus
vaccines with
immunosuppressive
doses of
corticosteroids.
▪ For respiratory
inhalant, intranasal
preparation, do not use
respiratory inhalant
during an acute
asthmatic attack or to
manage status
asthmaticus.
▪ Do not use intranasal
product with untreated
local nasal infections,
epistaxis, nasal trauma,
septal ulcers, or recent
nasal surgery.
▪ WARNING: Taper
systemic steroids
carefully during
transfer to inhalational
steroids; adrenal
insufficiency deaths
have occurred.
▪ For topical
dermatologic
preparations, use
caution when occlusive
dressings, tight diapers
cover affected area;
these can increase
systemic absorption.
▪ Avoid prolonged use
near the eyes, in
genital and rectal areas,
and in skin creases.