Drug Study No.1 Brand Name: Paracetamol Generic Name: Tempra Classification: Anti-Infectives Dosage: 100mg, 1ml Drops q4hr
Drug Study No.1 Brand Name: Paracetamol Generic Name: Tempra Classification: Anti-Infectives Dosage: 100mg, 1ml Drops q4hr
Drug Study No.1 Brand Name: Paracetamol Generic Name: Tempra Classification: Anti-Infectives Dosage: 100mg, 1ml Drops q4hr
Indication:
Mild pain. Fever.
Action:
Inhibits the synthesis of prostaglandins that may serve as mediator of pain and fever primarily in
the CNS. Has no significant anti-inflammatory properties of GI toxicity. Analgesics, antipyretics.
Contraindications/ Precaution:
Contraindicated in: previous hypersensitivity; products containing alcohol, aspartame, sugar,
tartrazine, should be avoided in patients who have hypersensitivity or intolerance to these
compounds.
Adverse Reaction:
GI: hepatic failure; hepatotoxicity. GU: renal failure. HEMAT: neutropenia; pancytopenia,
leukopenia. DERM: rash, urticaria
Nursing Implication:
• Assess fever; note presence of associated signs.
• Administer with full glass of water.
• May be taken with food or on an empty stomach.
• Advise patient to take medication as directed.
• Inform patient with diabetes that acetaminophen may alter results of blood glucose
monitoring. Advise patient to notify health care professional if changes are noted.
DRUG STUDY NO.2
Indication:
Adjunct in the management of: Anxiety Disorder, Athetosis, Anxiety relief prior to
cardioversion (injection), Stiffman Syndrome, Preoperative sedation, Conscious sedation
(provides light anesthesia and anterograde amnesia). Treatment of status epilepticus/uncontrolled
seizures (injection). Skeletal muscle relaxant. Management of the symptoms of alcohol
withdrawal. Unlabeled Use :Anxiety associated with acute myocardial infarction, insomnia.
Action:
Depresses the CNS, probably by potentiating GABA, an inhibitory neurotransmitter.
Produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferent path-
ways. Has anticonvulsant properties due to enhanced presynaptic inhibition.
Thera-peutic Effects :Relief of anxiety. Sedation. Amnesia. Skeletal muscle relaxation.
Decreased seizure activity.
Contraindications/ Precaution:
Contraindicated in:Hypersensitivity; Cross-sensitivity with other benzodiazepines may occur;
Comatose patients; Myasthenia gravis; Severe pulmonary impairment; Sleep apnea; Severe
hepatic dysfunction; Pre-existing CNS depression; Un con-trolled severe pain; Angle-closure
glaucoma; Some products contain alcohol,propylene glycol, or tartrazine and should be avoided
in patients with known hypersensitivity or intolerance risk of congenital malformations; Pedi:
Children 6mo (for oral; safety not established);Lactation: Recommend to discontinue drug or
bottle-feed.
Adverse Reaction:
CNS: dizziness, drowsiness, lethargy ,depression, hangover, ataxia, slurred speech,headache,
paradoxical excitation. EENT: blurred vision. Resp: RESPIRATORY DEPRESSION CV:
hypotension (IV only). GI: constipation, diarrhea (may be caused by propylene glycol content in
oral solution), nausea, vomiting, weight gain. Derm: rashes. Local: pain (IM), phlebitis (IV),
venous thrombosis. Misc: physical dependence, psychological dependence, tolerance
Nursing Implication:
Monitor temperature, pulse, and respiratory rate prior to and periodically throughout
therapy and frequently during IV therapy.
Assess IV site frequently during administration; diazepam may cause phlebitis and
venous thrombosis.
Geri: Assess risk of falls and institute fall prevention strategies.
Seizures: Observe and record intensity, duration, and location of seizure activity. The
initial dose of diazepam offers seizure control for 15 – 20 min after administration.
Institute seizure precautions
Muscle Spasms: Assess muscle spasm, associated pain, and limitation of movement
prior to and during therapy.
DRUG STUDY NO.3
Action:
Limits seizure propagation by altering ion transport. May also decrease synaptic transmission.
Antiarrhythmic properties as a result of shortening the action potential and decreasing
automaticity. Therapeutic Effects: Diminished seizure activity. Termination of ventricular
arrhythmias.
Contraindications/ Precaution:
Contraindicated in: Hypersensitivity; Hypersensitivity to propylene glycol (phenytoin injection
only); Alcohol intolerance (phenytoin injection and liquid only); Sinus bradycardia, sinoatrial
block, 2nd- or 3rd-degree heart block, or Stokes-Adams syndrome (phenytoin injection only);
Concurrent use of delavirdine. Use Cautiously in:All patients risk of suicidal
thoughts/behaviors); Hepatic or renal disease risk of adverse reactions; dose reduction
recommended for hepatic impairment); Patients with severe cardiac or respiratory disease (use of
IV phenytoin may result in an risk of serious adverse reactions); OB: Safety not established; may
result in fetal hydantoin syndrome if used chronically or hemorrhage in the newborn if used at
term; use with extreme caution; Lactation: Safety not established; Pedi: Suspension contains
sodium benzoate, a metabolite of benzyl alcohol that can cause potentially fatal gasping
syndrome in neonates; Geri: Use of IV phenytoin may result in an risk of serious adverse
reactions. Exercise Extreme Caution in: Patients positive for HLA-B*1502 allele (unless
exceptional circumstances exist where benefits clearly outweigh the risks).
Adverse Reaction:
Most listed are for chronic use of phenytoin CNS: SUICIDAL THOUGHTS, ataxia, agitation,
confusion, dizziness, drowsiness, dysarthria, dyskinesia, extrapyramidal syndrome, headache,
insomnia, weakness. EENT: diplopia , nystagmus CV: hypotension with IV phenytoin),
tachycardia. GI: gingival hyperplasia, nausea, constipation, drug-induced hepatitis, vomiting.
Derm: STEVENS JOHNSON SYNDROME ,TOXIC EPIDERMAL NECROLYSIS,
hypertrichosis, rash, exfoliative dermatitis, pruritus, purple glove syndrome. Hemat:
AGRANULOCYTOSIS, APLASTIC ANEMIA , leukopenia, megaloblastic anemia,
thrombocytopenia. MS: osteomalacia, osteoporosis. Misc: fever, lymphadenopathy.
Nursing Implication:
Instruct the S.O to assess oral hygiene. Vigorous cleaning beginning within 10
days of initiation of phenytoin therapy may help control gingival hyperplasia.
Assess patient for phenytoin hypersensitivity syndrome (fever, skin rash
lymphadenopathy). Rash usually occurs within the first 2 wk of therapy.
Hypersensitivity syndrome usually occurs at 3–8 wk but may occur up to 12 wk
after initiation of therapy. May lead to renal failure, rhabdomyolysis, or
hepaticnecrosis; may be fatal.
Seizures: Assess location, duration, frequency, and characteristics of seizure
activity. EEG may be monitored periodically throughout therapy.
Monitor Vital signs , ECG, and respiratory function continuously during
administration of IV phenytoin and throughout period when peak serum
phenytoin levels occur (15 – 30 min after administration).
DRUG STUDY NO.4
Indication:
Treatment of: Skin and skin structure infections, Bone and joint infections, Complicated and
uncomplicated urinary tract infections, Uncomplicated gynecological infections including
gonorrhea, Lower respiratory tract infections, Intra-abdominal infections, Septicemia,
Meningitis, Otitis media. Perioperative prophylaxis.
Action:
Binds to the bacterial cell wall membrane, causing cell death. Therapeutic Effects: Bactericidal
action against susceptible bacteria. Spectrum: Similar to that of second generation
cephalosporins, but activity against staphylococci is less, while activity against gram-negative
pathogens is greater, even for organisms resistant to first- and second-generation agents. Notable
is increased action against: Acinetobacter, Enterobacter, Haemophilus influenza (including
lactamase-producing strains), Haemophilus parainfluenzae, Escherichia coli, Klebsiella
pneumoniae, Morganella morganii , Neisseria, Proteus, Providencia, Serratia, Moraxella
catarrhalis. Has some activity against anaerobes, including Bacteroides fragilis .Notactive against
methicillin-resistant staphylococci or enterococci.
Contraindications/ Precaution:
Contraindicated in: Hypersensitivity to cephalosporins; Serious hypersensitivity to penicillins;
Pedi: Neonates 28 days (use in hyperbilirubinemic neonates may lead to kernicterus); Pedi:
Neonates 28 days requiring calcium-containingIVsolutions (risk of precipitation formation).
Use Cautiously in: Combined severe hepatic and renal impairment (dose reduction dosing
interval recommended); History of GI disease, especially colitis; OB, Lactation: Pregnancy and
lactation
Adverse Reaction:
CNS: SEIZURES (high doses). GI: PSEUDOMEMBRANOUS COLITIS, diarrhea,
cholelithiasis, gallbladder sludging. Derm: rashes, urticaria.Hemat: bleeding, eosinophilia,
hemolytic anemia, leukopenia, thrombocytosis.Local: pain at IM site, phlebitis at IV site. Misc:
allergic reactions including ANAPHYLAXIS ,superinfection.
Nursing Implication:
Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC)
at beginning of and throughout therapy.
Before initiating therapy, obtain a history to determine previous use of and reactions to
penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity
may still have an allergic response.
Obtain specimens for culture and sensitivity before initiating therapy. First dose
may be given before receiving results.
Pedi: Assess newborns for jaundice and hyperbilirubinemia; can increase bilirubinemia
and should not be administered to jaundiced neonates, especially premature neonates.
Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema,
wheezing). Discontinue the drug and notify health care professional immediately if these
symptoms occur. Keep epinephrine, an antihistamine, and resuscitation equipment close
by in the event of an anaphylactic reaction.
Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should
be reported to health care professional promptly as a sign of pseudomembranous colitis.
May begin up to several weeks following cessation of therapy