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Drug

Indication

Action Disrupts DNA and protein synthesis in susceptible organisms Bactericidal, or amebicidal action

Contraindication Contraindicated with hypersensitivity to metronidazole; pregnancy (do not use for trichomoniasis in first trimester). Use cautiously with CNS diseases, hepatic disease, candidiasis (moniliasis), blood dyscrasias, lactation.

Generic name: metronidazole

Amebicidal in the Brand Name: Apomanagement of Metronidazole (CAN), amoebic Flagyl, Flagyl 375, Flagyl ER, dysentery Flagyl IV, Flagyl IV RTU, MetroCream (CAN), MetroGel, Metro I.V., NeoTric (CAN), NidaGel (CAN), Noritate, Novonidazol (CAN), PMS-Metronidazole (CAN), Protostat, Trikacide (CAN CLASSIFICATION: Antiinfectives, Anti-protozoals

Adverse reaction/ side effects Headache, dizziness, ataxia, vertigo, incoordination, insomnia, seizures, peripheral neuropathy, fatigue Unpleasant metallic taste, anorexia, nausea, vomiting, diarrhea, GI upset, cramps Dysuria, incontinence, darkening of the urine Thrombophlebitis (IV); redness, burning, dryness, and skin irritation (topical) Severe, disulfiram-like interaction with alcohol, candidiasis (superinfection)

Nursing responsibilities Administer with food or milk to minimize GI irritation. Tablets may be crushed for patients with difficulty swallowing. Instruct patient to take medication exactly as directed evenly spaced times between dose, even if feeling better. Do not skip doses or double up on missed doses. If a dose is missed, take as soon as remembered if not almost time for next dose. May cause dizziness or lightheadedness. Caution patient or other activities requiring alertness until response to medication is known. Inform patient that medication may cause an unpleasant metallic taste. Inform patient that medication may cause urine to turn dark. Advise patient to consult health care professional if no improvement in a few days or if signs and symptoms of superinfection (black furry overgrowth on tongue; loose or foul-smelling stools develop)

Drug GENERIC NAME: ampicillin BRAND NAME: Omnipen, Polycillin, Principen CLASSIFICATIONS Therapeutic: Anti-infectives Pharmacologic: Aminopenicillins/ beta lactamase inhibitors PREPARATIONS: Capsul es: 250 and 500 mg. Powder oral suspension: 125 and 250 mg/5mL. Powder for injection: 250 mg, 500 mg, 1g, and 2 g.

Indication Ampicillin is used for treating infections of the middle ear, sinuses, stomach and intestines, bladder, and kidney caused by susceptible bacteria. It also is used for treating uncomplicated gonorrhea, meningitis, endoc arditis and other serious infections.

Action Physiologic Mechanism Bactericidal action. Active against: Streptococci, Penumococci, Enterococci, Haemophilus influenzae, Use should be reserved for infections caused by beta-lactamaseproducing strains. Pharmacologic Mechanism Binds to bacteria cell wall, resulting in cell death, spectrum is broader than that of penicillin. Addition of sulbactam increases resistance to betalactamase, enzymes produced by bacteria that may inactivate ampicillin.

Adverse reaction/ side effects The use Common side effects of of Ampicillin ampicillin include iscontraindicated nausea, vomiting, loss of inindividuals with appetite, ahistory diarrhea, abdominal pain, of hypersensitivityr rash, itching, headache, eactionsto any of confusion and dizziness. thepenicillins. Patients with a history of allergic reactions to other penicillins should not receive ampicillin. Persons who are allergic to the cephalosporin class of antibiotics, which are related to the penicillins, for example, cefaclor (Ceclor), cephalexin (Keflex), and cefprozil (Cefzil), may or may not be allergic to penicillins. Serious but rare reactions include seizures, severe allergic reactions (anaphylaxis), and low platelet or red blood cell count

Contraindication

Nursing responsibilities Assess patient for infection (vital signs, wound appearance, sputum, urine, stool, and WBCs) at beginning and throughout therapy. Obtain a history before initiating therapy 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 therapy. First dose may be given before receiving results. Observe patients for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify the physician immediately if these occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction. Caution patient to notify physician if fever and diarrhea occur, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional. May occur up to several weeks after discontinuation of medication. Instruct patient to notify physician if symptoms do not improve

Drug Acetaminophen (Paracetamol) Classification: antipyretics, nonopioid analgesics Dosage: PO/Rectal 0.5-1 g 4-6 hrly when needed. Max: 4 g/day. IV >50 kg: 1 g 46 hrly (Max: 4 g/day); <50 kg: 15 mg/kg 4-6 hrly (Max: 60 mg/kg/day)

Indication Mild to moderate pain a nd fever.

Action Inhibits the synthesis of prostaglandins that mayserve asmediators of pain andfever, primarily in the CNS.

Contraindication Hypersensitivity; intolerance to tartrazine (yellow dye #5), alcohol, table sugar, saccharin.

Adverse reaction/ side effects Hema: hemolyticanemia, neutropenia, leukopenia, pancytopenia. Hepa: jaundice Metabolic: hypoG GI: HEPATICFAILURE,HEPATOT OXICITY(overdose) GU: renalfailure(highdoses/chr onic use). Derm: rash,urticaria

Nursing responsibilities BEFORE: ~ Advise parents or caregivers to checkconcentrations of liquidpreparations. Errorshave resulted in seriousliver damage. ~ Assess fever; notepresence of associatedsigns (diaphoresis,tachycardia, andmalaise). DURING: ~ Adults should not takeacetaminophen longer than 10 days andchildren not longer than5 days unless directedby health careprofessional. ~ Advise mother or caregiver to take medicationexactly as directed andnot to take more thanthe recommendedamount. AFTER: ~ Advise patient to consulthealth care professionalif discomfort or fever isnot relieved by routinedoses of this drug or if fever is greater than39.5C (103F) or lastslonger than 3 days.

Drug Zinc Brand Names: Eye-SedSolution 0.25%, Orazinc Verazinc, Zinc 15, Zinc220, Zinca-Pak Classification: Vitamins and Minerals Dosage: Syr Acute diarrhea with reduced osmolarity ORS Childn 6 mth 5 mL, <6 mth 2.5 mL. Nutritional supplementAdult 2.5-5 mL. Childn 9-13 yr 2.55 mL, 4-8 yr2.5 mL, 1-3 yr 1.25 mL. Drops Acute diarrhea with reduced osmolarity ORS Childn 6 mth 2 mL, <6 mth 1 mL. Nutritional supplement Childn 1-3 yr 0.5 mL, 6-11 mth 0.5 mL.

Indication Supplement to correct Zn deficiency e.g. malabsorption syndromes & in conditions w/ increased body losses.

Adverse reaction/ side effects E-Zinc contains zinc. Zinc helps Nausea, stomach upset, hypersensitive to iodine the body's natural defense Use cautiously: Lactating heartburn may occur. If against damaging free radicals any of and Pregnant Women (antioxidant effect) and helps these effects persist or boost immune function. Free worsen, notify your radicals are highly reactive and doctor or pharmacist unstable chemicals generated promptly. Tell your doctor during normal body activities that immediately if any of require oxygen (eg, respiration, these unlikely but digestion, blood circulation, serious side effects immune system response, etc) and after exposure to ultraviolet (UV) light, cigarette smoke and various pollutants. One major effect of zinc is on the ability of cells to properly replicate the deoxyribonucleic acid (DNA), which is required for cells to multiply. Hence, zinc is needed for normal growth.

Action

Contraindication

Nursing responsibilities 1. Check levels of trace elements in patients who have received TPN for 2 months or longer. Give supplement, if ordered. Report low levels of thee elements. 2. Normal level is 88 to 112 mcg/dl zinc. 3. Solutions of trace elements are compounded by pharmacist for addition to TPN solutions according to various formulas. 4. Explain need for zinc administration to patient and family. 5. Tell patient to report signs of hypersensitivity promptly. 6. Inform patient and family that trace elements are normally received from dietary intake that, when patient begins eating well, supplements wont be needed.