DRUGS Date Ordered: 12/08/10 Generic Name: cefuroxime BRAND NAME: Zoltax CLASSIFIC ATION: ANTIINFEC TIVE; ANTIBIOTIC

; SECONDGENERATIO N CEPHALOSP ORIN DOSAGE: 750mg q 8 IV Discontinued : 12/13/10

INDICATION
Treatment of

ACTION For pharmacodyna mics and pharmacokineti cs details.

ADVERSE EFFECTS/ SIDE EFFECTS Side Effect: Diarrhea, nausea, vomiting, GI:Diarrhea, nausea, antibioticassociated colitis. Skin:Ra sh , pruritus, urticaria. Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance.

NURSING CONSIDERATION Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Inspect IM and IV injection sites frequently for signs of phlebitis. Report onset of loose stools or diarrhea. Although pseudomembranous colitis. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

PATIENT TEACHINGS Advise patient to immediately report rash or bleeding tendency. Advise patient to report CNS changes.

infections caused by susceptible organisms eg bone & joint infections, bronchitis, gonorrhea, meningitis, otitis media, peritonitis, pharyngitis, sinusitis, skin & soft tissue infections, UTI & for surgical infection prophylaxis.

Adverse:

DRUGS Date Ordered: 12/13/10 Generic Name: Co-amoxiclav BRAND NAME: Augmentin

INDICATION - Known or suspected amoxicillinresistant infections including respiratory tract, skin and soft tissue, genitourinary, and ear, nose and throat infections.

ACTION An antibiotic that combines amoxicillin and clavulanic acid. It destroys bacteria by disrupting their ability to form cell walls.

ADVERSE EFFECTS/ SIDE EFFECTS Diarrhoea, vomiting Rashes Anaemia, itching, rashes, fever - Hepatitis. - Cholestatic jaundice. - Erythema multiforme (including StevensJohnson syndrome). - Toxic epidermal necrolysis. - Exfoliative dermatitis. - Vasculitis. - Dizziness. - Headache. - Convulsions (especially in high doses or in renal

NURSING CONSIDERATION Assess bowel pattern before and during treatment as pseudomembranous colitis may occur. - Report haematuria or oliguria as high doses can be nephrotoxic. - Assess respiratory status. - Observe for anaphylaxis. - Ensure that the patient has adequate fluid intake during any diarrhoea attack.

PATIENT TEACHINGS If the patient develops a rash, wheezing, itching, fever or swelling in the joints, this could indicate an allergy and should be reported. - Patients must ensure they take the full course of the medicine. - The medicine must be taken in equal doses around the clock to maintain level in the blood. - If oral contraceptives are used, use alternative contraception. - Report diarrhoea, cramping and blood in stools as pseudomembranous colitis may occur.

- Clavulanic acid blocks the chemical defence, known as betaCLASSIFIC - Effective against lactamase, that ATION: strains of some bacteria have BroadEscherichia coli, against penicillins. spectrum Proteus mirabilis, l Co-amoxiclav is penicillins / Haemophilus active against beta-lactamase influenzae, bacterial infections inhibitors. Streptococcus that have become faecalis, resistant to DOSAGE: Streptococcus amoxicillin. 625 mg tab pneumoniae and TID some betalactamaseproducing organisms.

impairment). - Superficial teeth staining when using the suspension.

DRUGS Date Ordered: 12/08/10 Generic Name: Tranexamic Acid BRAND NAME: CLASSIFIC ATION: Fibrinolytic Inhibitor DOSAGE: IV 500 mg q6 Discontinued : 12/13/10

INDICATION treatment of excessive bleeding resulting from systemic or local hyperfibrinolysis prophylaxis in patients with coagulopathy undergoing surgical procedures

ACTION
Forms a

reversible complex that displaces plasminogen from fibrin resulting in inhibition of fibrinolysis; it also inhibits the proteolytic activity of plasmin.

ADVERSE EFFECTS/ SIDE EFFECTS Back pain; headache; joint pain; muscle pain or cramps; nasal or sinus congestion; stomach pain; tiredness. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); calf pain, swelling, or tenderness; chest pain; confusion; coughing up blood; decreased urination; one-sided weakness; severe or persistent headache; severe or persistent tiredness or weakness; shortness of breath; slurred speech; vision changes (disturbance of color, sharpness,

NURSING CONSIDERATION >Assess patients history, if with active intravascular clotting, predisposed to to thrombosis; hemorrhage due to disseminated intravascular coagulation. >Monitor anticoagulant cover. >perform eye examination >Obtain PT time of patient before administration.

PATIENT TEACHINGS Advise patient to inform health care professional of any changes in vision. Caution patient to avoid products containing aspirin or NSAIDs without consulting health care professional

or field of vision).

DRUGS Date Ordered: 12/08/10 Generic Name: Clarithromyci n BRAND NAME: Clariget CLASSIFIC ATION: Macrolide Antibiotics DOSAGE:
500g 1tab once a day for 10days

INDICATION Indicated for the treatment of mild to moderate infections such as Pharyngitis/Tonsi llitis, Acute maxillary sinusitis, Acute bacterial exacerbation of chronic bronchitis, CommunityAcquired Pneumonia, Uncomplicated skin and skin structure infections and along with omeprazole also indicated for the treatment of patients with an active duodenal ulcer associated with H.pylori infection.

ACTION
prevents

bacteria from growing by interfering with their protein synthesis.

ADVERSE EFFECTS/ SIDE EFFECTS - abnormal taste; - diarrhea; - difficulty breathing or swallowing; - fast, pounding, or irregular heartbeat; - fever; - flu-like symptoms; - headache; - heartburn; - hives; - hoarseness; - itching; - lack of energy; - nausea; - pain in the upper right part of the stomach; - rash; - stomach pain; - swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs;

NURSING CONSIDERATION Culture infection before therapy. Monitor patient for anticipated response. Administer without regard to meals; administer with food if GI effects occur.

PATIENT TEACHINGS Take drug with food if GI effects occur. Take the full course of therapy. Do not drink grapefruit juice while taking this drug. Shake suspension before use; do not refrigerate; do not cut, crush, or chew ER tablets; swallow them whole. You may experience these side effects: Stomach cramping, discomfort, diarrhea; fatigue, headache (medication may be ordered); additional infections in the mouth or vagina (consult with care provider for treatment). Report severe or watery diarrhea, severe nausea or vomiting, rash or itching, mouth sores, vaginal sores.

- unusual bruising or bleeding;

DRUGS Date Ordered: 12/08/10 Generic Name: Butamirate Citrate BRAND NAME: Sinecod CLASSIFIC ATION: Antitussive DOSAGE: 1 tab TID OD for 5 days

INDICATION

ACTION

Acute cough of any etiology. Pre and Post op cough sodation for surgical procedures and bronchoscopy.

Act centrally (on brain, and specifically the GI: Nausea and vagus nerve) or vomiting, diarrhea. locally (on the respiratory tract) to Skin: rash suppress the cough reflex.

ADVERSE EFFECTS/ SIDE EFFECTS CNS: dizziness.

NURSING CONSIDERATION Assess cough type and frequency. Monitor the adverse reactions. Assess patients VS. Assess sleep pattern.

PATIENT TEACHINGS

-If cough persist 10 days + fever or chest pain check with Doctor. -Dont exceed recommended dose. Drink fluids but not immediately after dose Since the drug may cause dizziness or drowsiness, caution patient to avoid driving or other activities requiring alertness until response to medication is known. Advise patient to minimize cough by avoiding irritants (cigarette smoke, fumes, dust) Instruct patient to cough effectively, sit upright and take several deep breaths before attemting.

DRUGS Date Ordered: 12/13/10 Generic Name: Multivit. + ascorbic acid BRAND NAME: Moriamin Forte CLASSIFIC ATION: multivitamins and minerals DOSAGE: 1 cap OD for 30 days

INDICATION

ACTION
Combination of

ADVERSE EFFECTS/ SIDE EFFECTS

hypervitaminosis (large doses)

NURSING CONSIDERATION Assess patient for signs of vitamin deficiency before and periodically throughout therapy. Assess nutritional status through 24 h diet recall. Determine frequency of consumption of vit rich foods

PATIENT TEACHINGS Can be taken with or without meals. Should not be taken more than what is prescribed. Teach patient the side and toxic effects of the drug. Report appearance of sude effects to physician.

malnutrition, protein and vitamin deficiencies, anemia, convalescence, restoration and maintenance of body resistance, pregnancy and lactation, adjuvant in the therapy of peptic ulcer and TB.

8 essential amino acids and 11 vitamins in wellproportioned contents for daily requirement. In addition, 5hydroxyanthran ilic acid HCl helps the essential amino acids combine with the vitamins so that they become a highly effective nutriment.

DRUGS Date Ordered: 12/13/10

INDICATION Actively

ACTION Unknown. Appears to inhibit cellwall biosynthesis by interfering with lipid and DNA synthesis

growing tubercle bacilli >prevention of Generic tubercle bacilli Name: in those HRZE exposed to (isoniazid+rifa tuberculosis mpicin+pyrazi namide+etham or those with positive skin butol) test results BRAND whose chest NAME: x-rays and Myrin bacteriologic CLASSIFIC studies are ATION: consistent Anti-infective with nonprogressive DOSAGE: tuberculosis 3 tab 30 min before breakfast

ADVERSE EFFECTS/ SIDE EFFECTS peripheral neuropathy, fluid discoloration, optic neuritis, hepatitis

NURSING CONSIDERATION Use cautiously in elderly patients. Peripheral neuropathy is more common in patients who are slow acetylators or who are malnourished, alcoholic or diabetic. Monitor hepatic function closely for changes

PATIENT TEACHINGS Do not take any new medication without prescription Maintain dosing scheduled as directed Take medication on an empty stomach, at least 1 hour before meals or 2 hours after a meal. Patient must complete full course of therapy. Keep appointments scheduled for lab tests and chest x-rays Medication may cause discoloration of bodily fluids. Stains are permanent. Report persistent vomittin or diarrhea; rashes; fever, chills or flu-like symptoms.

DRUGS Date Ordered: 12/13/10 Generic Name: Streptomycin BRAND NAME: CLASSIFIC ATION: Antibiotics DOSAGE: 750 mg OD

INDICATION

ACTION

treatment of It inhibits individuals with protein moderate to synthesis severe infections caused by susceptible strains of microorganisms

ADVERSE EFFECTS/ SIDE EFFECTS headache nausea difficulty in hearing, ringing sensation in the ears loss of balance fatigue difficulty in passing urine itchy rashes on the skin

NURSING CONSIDERATION >Obtain patients history and drug history >Assess for previous sensitivity reaction >Report decreasing urinary output to physician >monitor for deafness >monitor for dehydration >obtain serum peak 60 min after IM inj. Blood level should be 2-4x bacteriostatic level

PATIENT TEACHINGS Instruct the patient to report to physician if with sore throat, bruising, bleeding, joint pain, weakness and tremor. Not to take OC drugs during therapy without consultation Caution patient against activities requiring high levels of alertness (i.e driving) To take small frequent meals, perform regular mouth care. Sucking on lozenges or chewing gum may help decrease nausea, vomiting and loss of appetite.

DRUGS Date Ordered: Generic Name: BRAND NAME: CLASSIFIC ATION: DOSAGE:

INDICATION

ACTION

ADVERSE EFFECTS/ SIDE EFFECTS

NURSING CONSIDERATION

PATIENT TEACHINGS