 Report any suspected side-effects to the health care professional who prescribed

the medication

 During breastfeeding traces of trimethoprim may be found in milk, but in short-

term use this is not thought to be harmful.

 Women of childbearing age must be cautioned against becoming pregnant while

taking trimethoprim, as there are teratogenic risks due to the folate-antagonist
effects.

 Nurses should refer to manufacturer’s summary of product characteristics and to

appropriate local guidelines.

1.1 Tetracyclines

General action- tetracyclines inhibit protein synthesis by bacterial cells and are effective
against both gram-positive and gram-negative bacteria.

Uses- used in patients allergic to penicillin for the treatment of some venereal diseases,
UTIs, upper respiratory tract infections, pneumonia. Effective against skin (acne),
rickettsial and mycoplasmic infections.

Side effects:
Nausea and vomiting
Anorexia
Abdominal cramps
Photosensitivity (exaggerated sunburn
after short exposure)
Nursing Responsibilities-
- check patient's tongue for Monilia infection
-monitor I and O
-maintain fluid intake

1.2 Antimycobacterial Antibiotics

a.) Antituberculosis drugs
Action:
It diffuses into mycobacteria and appears to suppress multiplication by interfering with
RNA synthesis. It is effective only against mycobacteria that are actively dividing.

Uses:
Myrin P Forte Tablet is used for Tuberculosis, Bacterial infection of membranes
covering the spinal cord, Bacterial infection of membranes covering the brain,
Contagious disease of mucous membrane, Contagious disease of skin, Contagious
disease of nerves and other conditions. Myrin P Forte Tablet may also be used for
purposes not listed in this medication guide.
Side effects:
Leukopenia, thrombocytopenia, hypersensitivity syndrome, eosinophilia, fever,
lymphadenopathy; anorexia, elevations of serum uric acid conc; dizziness, paresthesia;
epigastric distress, constipation, nausea, vomiting, anorexia; hepatic impairment,
jaundice; pruritus, rash, acute gout; malaise; headache; mental confusion; hepatitis or
hepatitis prodromal syndrome.

Nursing responsibility:
 Patients at risk for peripheral neuropathy as a result of malnutrition, chronic
alcohol dependence, or diabetes should additionally receive pyridoxine, 10 mg
daily. Where the standard of health in the community is low, this should be
offered routinely.
 Myrin should be administered with care to epileptic patients, since it may induce
convulsions, or to patients in psychotic states characterized by mania or
hypomania.
 Myrin should be used with caution in patients with diabetes mellitus, as
management may be more difficult. Patients with decreased renal function need
the dosage reduced as determined by serum levels of ethambutol hydrochloride,
 since the main path of excretion of this drug is by the kidneys.

b.) Leprostatic drugs

ACTIONS:
The overall process of DNA biosynthesis can be divided into two major steps, one
consisting essentially of nucleotide synthesis from low-molecular-weight metabolites
and the other of polymerization of the nucleotides to form the duplicated DNA. Some
antineoplastic agents are structural analogues of bases or nucleosides of intermediate
metabolites, and are converted to their ribotides by enzymes catalyzing nucleotide
metabolism
USE:
use to treat infection caused by leptospirosis.

SIDE EFFECTS:
ever, easy bruising or bleeding;red spots on the skin (not related to herpes or
chickenpox),bloody diarrhea, vomiting;,pale or yellowed skin,weakness

NURSING RESPONSE:
> Maintain hydration level of the patient and assess for the integumentary
abnormalities and if there is bleeding episodes notify the physician immediately

2. Antiviral agents
  For clients taking the medication as a treatment for peptic ulcers it may be
administered 1 and 3 hours after meals and at bedtime.

1.1 Abortifacients

Action: increase saliva and blood flow to the tissues in the mouth, stomach, intestines,
and pelvic area

Uses: start menstruation or cause an abortion.

Side Effects:

Restlessness
Vomiting
Stomach pain
Dizziness
Tremors
Bleeding
Abortions in pregnant women,

Nursing Responsibilities
•Continue taking your temperature (late afternoon) for a few days after discharge.
Contact physician with onset of fever, bleeding, abdominal cramps, abnormal or foul-
smelling vaginal discharge.
•Avoid douches, tampons, intercourse, and tub baths for at least 2 wk. Clarify with
physician.
•Note: Dinoprostone may exacerbate joint pain and limitation due to its effect on the
inflammatory process.

2. Drugs affecting the male Reproductive System

2.1 Androgens

Action: Androgens stimulate the development of male sexual characteristics (such as

deepening of the voice and beard growth) and development of male sex organs

Uses: used to treat delayed puberty in adolescent boys, hypogonadism and impotence in
men, anemia, osteoporosis, weight loss disease in HIV, and other conditions with
hormonal imbalance.
Side Effects:
Severe acne, oily skin and hair
Hair loss
Liver disease, such as liver tumors and cysts
Kidney disease
Heart disease, such as heart attack and stroke
Altered mood, irritability, increased aggression, depression or suicidal tendencies
Alterations in cholesterol and other blood lipids
High blood pressure
Shrinking of testicals
Stunted growth and height in teens
Risk of viral or bacterial infections due to unsterile injections

Nursing Responsibilities
•Review directions for application of transdermal patches.
•Report soreness at injection site, because postinjection furunculosis may be an
associated adverse reaction.
•Report priapism (sustained and often painful erections occurring especially in early
replacement therapy), reduced ejaculatory volume, and gynecomastia to physician.
Symptoms indicate necessity for temporary withdrawal or discontinuation of
testosterone therapy.
•Notify physician promptly if pregnancy is suspected or planned. Masculinization of the
fetus is most likely to occur if testosterone (androgen) therapy is provided during first
trimester of pregnancy.
•Androgens may cause virilism in women at dosage required to treat carcinoma. Report
increase in libido (early sign of toxicity), growth of facial hair, deepening of voice, male-
pattern baldness. The onset of hoarseness can easily be overlooked unless its
significance as an early and possibly irreversible sign of virilism is appreciated.
Reevaluation of treatment plan is indicated.

2.2 Anabolic Steroids

Action: Stimulate growth in many other types of tissues, especially bone and muscle.
Anabolic effects also include increased production of red blood cells.

Uses: Used to treat delayed puberty in adolescent boys, hypogonadism and impotence in
men, anemia, osteoporosis, weight loss disease in HIV, and other conditions with
hormonal imbalance.

Side Effects:
Severe acne, oily skin and hair
Hair loss
Liver disease, such as liver tumors and cysts
Kidney disease
Heart disease, such as heart attack and stroke
Altered mood, irritability, increased aggression, depression or suicidal tendencies
Alterations in cholesterol and other blood lipids
High blood pressure
Shrinking of testicals
Azoospermia (absence of sperm in semen)
Infertility
Excess facial or body hair

Nursing Responsibilities
•Note: Pain and discomfort are usually relieved in 2 or 3 mo; the nodularity in 4–6 mo.
Menses may be regular or irregular in pattern during therapy.
•Note: Drug-induced amenorrhea is reversible. Ovulation and cyclic bleeding usually
return within 60–90 d after therapeutic regimen is discontinued as well as the potential
for conception.
•Use a nonhormonal contraceptive during treatment because ovulation may not be
suppressed until 6–8 wk after therapy is begun. If pregnancy occurs while taking this
drug, discontinue danzol. Continue discussing the question of continuing the pregnancy
considered.
•Report voice changes promptly. Stop drug to avoid permanent damage to voice.
Virilizing adverse effects may persist even after drug therapy is terminated.

2.3 Drugs for treating penile erectile dysfunction

Action:
Sildenafil is an oral therapy for erectile dysfunction. In the natural setting, i.e. with
sexual stimulation, it restores impaired erectile function by increasing blood flow to the
penis.

The physiological mechanism responsible for the erection of the penis involves the
release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation

Uses:
Sildenafil is used to treat male sexual function problems (impotence or erectile
dysfunction-ED). In combination with sexual stimulation, sildenafil works by
increasing blood flow to the penis to help a man get and keep an erection.
Side effects:
Dizziness, headache, flushing, or stomach upset may occur. Vision changes such as
increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart
may also occur. If any of these effects persist or worsen, tell your doctor
or pharmacist promptly.
Nursing responsibility:
 History: Allergy to any component of the tablet; hepatic or renal impairment;
with anatomical deformation of the penis, known cardiac disease;
concomitant use of nitrates
 Physical: Orientation, affect; skin color, lesions; P, BP, ECG, LFTs, renal
function tests
 Take this drug 30 minutes to 4 hours before anticipated sexual activity. The
usual timing is 1 hour. The drug will have no effect in the absence of sexual
stimulation.
 If taking this drug for pulmonary arterial hypertension, take three times a
day; make sure the doses are 4-6 hours apart.
 Onset of drug effects will be slowed if taken with a high-fat meal; plan
accordingly. Avoid drinking grapefruit juice if using this drug.
 This drug will not protect you from sexually transmitted diseases; use
appropriate precautions.
 Stop the drug and call your health care provider immediately if you
experience sudden loss of vision.
 Do not take this drug if you are taking any nitrates; serious side effects and
even death can occur.
 You may experience these side effects: Headache, dizziness, rash, flushing.
 Report difficult or painful urination, rash, dizziness, palpitations, loss of
vision.

3. Drugs for STD

Action: Stops the multiplication of bacteria by inhibiting the reproduction and repair of
their genetic material (DNA)

Uses: used to treat bacterial infections

Side Effects:

Nausea Vaginitis in women

Vomiting Anxiety,
Diarrhea Euphoria
Insomnia Hallucinations
Headache
Dizziness
Itching
Nursing Responsibilities
• Adhere closely to the established regimen without schedule interruption or
changing the dose.
• Refrain from intercourse during therapy for trichomoniasis unless male
partner wears a condom to prevent reinfection.
• Have sexual partners receive concurrent treatment. Asymptomatic
trichomoniasis in the male is a frequent source of reinfection of the female.
• Do not drink alcohol during therapy; may induce a disulfiram-type reaction (see
Appendix F). Avoid alcohol or alcohol-containing medications for at least 48 h after
treatment is completed.
• Urine may appear dark or reddish brown (especially with higher than
recommended doses). This appears to have no clinical significance.
• Report symptoms of candidal overgrowth: Furry tongue, color changes of
tongue, glossitis, stomatitis; vaginitis, curd-like, milky vaginal discharge;
proctitis. Treatment with a candidacidal agent may be indicated.
• Do not breast feed while taking this drug.

A. Drugs affecting fluid and electrolyte balance

Action:
Drenex, a potent corticosteroid, has been shown to suppress inflammation by inhibiting
multiple inflammatory cytokines resulting in decreased edema, fibrin deposition,
capillary leakage and migration of inflammatory cells.

Uses:
Dexamethasone is used to treat conditions such as arthritis, blood/hormone/immune
system disorders, allergic reactions, certain skin and eye conditions, breathing problems,
certain bowel disorders, and certain cancers. It is also used as a test for an adrenal gland
disorder (Cushing's syndrome).
Side effects:
Stomach upset, headache, dizziness, menstrual changes, trouble sleeping, increased
appetite, or weight gain may occur. If any of these effects persist or worsen, notify your
doctor or pharmacist promptly.
Nursing responsibility:
 Do not stop taking the oral drug without consulting your health care
provider.
 Avoid exposure to infection.
 Report unusual weight gain, swelling of the extremities, muscle weakness,
black or tarry stools, fever, prolonged sore throat, colds or other infections,
worsening of this disorder.
 History for systemic administration: Active infections; renal or hepatic
disease; hypothyroidism, ulcerative colitis; diverticulitis; active or latent
peptic ulcer; inflammatory bowel disease; CHF, hypertension,
thromboembolic disorders; osteoporosis; seizure disorders; diabetes
mellitus; lactation
 History for ophthalmic preparations: Acute superficial herpes simplex
keratitis, fungal infections of ocular structures; vaccinia, varicella, and other
viral diseases of the cornea and conjunctiva; ocular TB
 Physical for systemic administration: Baseline body weight, T; reflexes, and
grip strength, affect, and orientation; P, BP, peripheral perfusion,
prominence of superficial veins; R and adventitious sounds; serum
electrolytes, blood glucose
 Physical for topical dermatologic preparations: Affected area for infections,
skin injury

K. Nutritional Supplements

Action:
Combination of many different vitamins that are normally found in foods and other
natural sources to nourish the body.

Uses:
Used to provide vitamins that are not taken in through the diet. It is also used to treat
vitamin deficiencies (lack of vitamins) caused by illness, pregnancy, poor nutrition,
digestive disorders, and many other conditions.

Side Effects:

• Hives
• Difficulty in Breathing
• Swelling of your face, lips, tongue, or throat.
• Headache
• Upset Stomach
• Unusual or unpleasant taste in your mouth.
Nursing Responsibilities:
• Seek emergency medical attention if you think you have used too much of this
medicine. An overdose of vitamins A, D, E, or K can cause serious or life-
threatening side effects. Certain minerals contained in a multivitamin may also
cause serious overdose symptoms if you take too much.
• Do not take this medicine with milk, other dairy products, calcium supplements,
or antacids that contain calcium. Calcium may make it harder for your
body to absorb certain ingredients of the multivitamin.
• Many vitamins can cause serious or life-threatening side effects if taken in large
doses. Do not take more of this medicine than directed on the label or prescribed by
your doctor.
• Before you use multivitamins, tell your doctor about all your medical
conditions and allergies. In some cases, you may not be able to use
multivitamins, or you may need a dose adjustment or special precautions

L. Immunizing Agents

General Action:
They stimulate the part of the immune system, known as the humoral immune system,
which synthesizes immunoglobulins.

Uses:
Toxoids and vaccines are the active immunizing drugs for the prevention of illnesses.
They are administered orally or intramuscularly.

Side Effects:
Fever, Minor Rash, Edema (face, tongue and throat), Urticaria, Arthritis, Cough,
Dyspnea, Cyanosis, Vomiting, Cardiovascular Collapse

Nursing Responsibilities
•Check vial at least three times making sure that it is the correct vaccine and is not
expired.
• Shake well the vial before withdrawing each dose.
• Special care should be taken to ensure that the injection does not enter the
blood vessel

For Nursing Mothers:

• Tetanus Toxoid does not affect the safety of mothers who are breastfeeding or
their infants.
• Breastfeeding does not adversely affect immune response and is not a
contraindication for vaccination.