Name

Action

Indication - The spectrum of action includes many grampositive and gramnegative bacteria (including Pseudomonas) and even some anaerobicbacter ia. The overall spectrum is similar toimipenem although meropenem is more active against Enterobacteri aceae and less active against gram-positive bacteria. It is also very resistant to extendedspectrum beta lactamases but may be more susceptible to metallo-betalactamases.

Generic name: - is bactericidal except Meropenem againstListeria monocytogenes where it Brand name: isbacteriostatic. It inhibits meronem bacterial wall synthesis like other betaClassification: lactam antibiotics. In Anthelmintics/ contrast to other betaanti-infectives lactams, it is highly resistant to degradation Dosage: by beta310mg+30cc lactamases orcephalospo D5W to run for rinases. Resistance 50 min. q8 generally arises due to ANST(-) mutations in penicillin binding proteins, production of metallobeta-lactamases, or resistance to diffusion across the bacterial outer membrane.

Contraindicatio n hypersensitivity to carbapenems, penicillins and other betalactam antibiotics.

Adverse reaction diarrhea nausea vomiting headache rash thrombophle bitis Oral and vaginal candidiasis

Nursing management -complete C&S test before beginning drug therapy to identify if correct treatment has been initiated. -assess patient for previous reaction to carbapenem antibiotics, penicillins, cephalosphorins and other beta-lactams. -assess patient to baseline information of infection before treatment and reassess during therapy: fever, wound characteristics, sputum, urine, stool, and WBC count. -assess for allergic reaction/anaphylaxis: rash, urticaria, chills, fever, and joint pain. -assess for anemia, (fatigue, headache, irritability, faintness and shortness of breath) and bleeding. -assess patients and familys knowledge on drug therapy.

Name Generic name: Ranitidine Brand name: entac Classification: Gastric antisecretory drugs/ h2receptor antagonists Dosage:15mg IVq8

Action Inhibits histamine at H2 receptor site in the gastric parietal cells, which inhibits gastric acid secretion.

Indication Used in the manageme nt of various gastrointest inal (GI) disorder such as dyspepsia, gastroesophageal reflux disease (GERD), peptic ulcer and zollingerelison syndrome. Prophylaxis of GI hemorraha ge from stress ulceration and in patient at risk of developing acid aspiration during general anesthesia.

Contraindication Hypersensivity. History of acute prophyria. Longterm therapy

Adverse reaction Cardiac arrhythmias Bradycardia Headache Somnolence Fatigue dizziness hallucination depression insomnia rash N&V Constipation Abdominal discomfort Diarrhea Constipation Pancreatitis Hypersensitivity reaction

Nursing management Use caution in presence of renal or hepatic impairment. Monitor potential for interaction with other pharmacologic al agent patient may be taking Monitor AST,ALT, serum creatinine; when used to prevent stressrelated GI bleeding, measure the symptoms of peptic ulcer disease, accult blood with GI bleeding, monitor renal function to correct dose; monitor for side effect. Evaluate result of laboratory tests, therapeutic effectiveness, and adverse

reaction Assess knowledge/tea ch patient appropriate use, possible side effect/appropri ate interventions, and adverse symptom to report.

Name Generic name: Ethambutol Brand name: Pharex ethambutol Classification: Antituberculosis/ antileprosy Dosage: 310mg/ tab, 1ptat OD after breakfast

Action Tuberculostatic, it suppresses the growth of tubercle bacilii however the specific mechanism of action is unknown.

Indication Ethambutol is used with other antituberculou s drugs in the primary treatment of pulmonary and extrapulmonar y tuberculosis to suppress emergence of resistance to the other drugs used in the regimens. It has also been used as a component of regimens for the treatment of opportunistic mycobacterial infection.

Contraindication

Adverse reaction

Patients Reduction of with optic visual acuity neuritis. Constriction of Should visual field generally Central or not be peripheral used in scotoma children Green-red under 6 yrs color blindness of age and Hypersensitivity some reaction including: consider Skin rashes that it Pruritus should not Leucopenia be used in Fever children Joint pains under 13 years of age nor in patient with visual difect.

Nursing management Obtain history of patients infection and perform C&S test(includin g sputum test) before starting therapy to detect drug resistance. Perform visual acuity and color discriminati on tests before and during therapy. Assess liver and renal status and function before and during therapy: hepatic: appetite, jaundice; dark urine, fatigue, AST, ALT and billirubin renal:

 Monitor to adverse reactions Assess patients mental status often: affect mood, behavioral changes. Watch out for confusion and hallucinatio n. Assess patients and familys knowledge of drug therapy.

Name Generic name: pyrazinamide Brand name: PZA-ciba Classification: Antituberculosis/ antileprosy

Action Mechanism unknown, highly specific and bactericidal for mycobacteriu m tuberculosis hominis.

Indication Treatment of active tuberculosis in adults and selected children.

Contraindication Acute liver disease Porphyria Peripheral neuritis Acute gout Hypersensitivity and pregnancy

Adverse reaction Dose-related hepatotoxicity, nausea vomiting, anorexia, thrombocytope nia, vacuolation of erythrocytes, increased serum iron concentration & adverse effects on blood clotting mechanism, mild arthralgia & myalgia and hypersensitivit y reaction, gout.

Dosage:

Nursing management Assess patients condition before therapy and regularly thereafter to monitor drug effectivenes s. Obtain chest X-ray and C&S test before treatment and periodically during treatment. Obtain baseline hematologic, renal and liver status and monitor regularly during therapy: CBC, diffential and platelet count, BUN, creatinine, ALT. Monitor serum uric acid which

may be elevated and cause gout symptom Monitor for drug induced adverse reaction: CNS:malais e, fever GI: anorexia, nausea, vomiting, diarrhea GU: dysuria hematologic: Regularly assess for hepatotoxicit y: decreased appetite, jaundice, dark urine and fatigue. Regularly assess renal status: urine output, input-output ratio, urinalysis and urine specific gravity. Assess patients &

familys knowledge of drug therapy.