DRUG NAME

Cefuroxime

GENERAL ACTION
Antiinfective; Antibiotic; Secondgeneration Cephalospori n

SPECIFIC ACTION
Cefuroxime binds to one or more of the penicillinbinding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

INDICATION
It is effective forthe treatment of penicillinaseproducing Neisseriagonorrhoea (PPNG).Effectively treatsbone and jointinfections,bronc hitis,meningitis,gono rrhea, otitismedia,pharyngit is/tonsillitis, sinusitis, lowerrespiratory tractinfections, skin andsoft tissueinfections, urinarytract infections, andis used for surgicalprophylaxis, reducing or eliminating infection

CONTRAINDICATION
Hypersensitivity tocephalosporins and relatedantibiotics; pregnancy(category B), lactation

ADVERSE EFFECT
Body as a Whole: Thrombophlebitis(IV site); pain,burning, cellulitis(IM site);superinfections, positive Coombs'test. GI: Diarrhea, nausea, antibioticassociated colitis. Skin: Rash,pruritus, urticaria. Urogenital: Increased serumcreatinine andBUN, decreasedcreatininec learance.

NURSING RES
-Determine history of hypersensitivityreactio ns tocephalosporins,penici llins, and historyof allergies, particularly to drugs, before therapy is initiated. -Inspect IM and IVinjection sitesfrequently for signs of phlebitis. -Report onset of loose stools or diarrhea. Although pseudomembranouscol itis. -Monitor I&O rates andpattern: Especially important in severely ill patients receiving high doses. Report any significant changes

DRUG NAME
Amlodipine

GENERAL ACTION
Calcium channelblocker Antianginal drug Antihyperten sive

SPECIFIC ACTION
Inhibits themovement of calcium ions across themembranes of cardiac and arterial muscle cells; inhibits transmembrane calcium flow, which results in the depression of impulse formation inspecialized cardiac pacemaker cells, slowing of the velocity of conduction of the cardiac impulse, depression of myocardial contractility and dilation of coronary arteries and arterioles and peripheral arterioles.

INDICATION
Angina pectoris due to coronary artery spasm(Prinzmetal'sva riantangina) Chronic stable angina, alone orincombination withotheragents Essential hypertension, alone or incombination with other antihypertensives

CONTRAINDICATION
Contraindicated with allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome, heart block(second or third degree), lactation. Use cautiously with CHF, pregnancy

ADVERSE EFFECT
CNS: Dizziness, lightheadedness, headache, asthenia, fatigue, lethargy CV: Peripheral edema, arrhythmias Dermatologic: Flushing, rash GI: Nausea, Abdominal discomfort

NURSING RES
Assessment History: Allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome ,heart block, lactation, CHF Physical: Skin lesions, color, edema; P, BP, baseline ECG, peripheral perfusion, auscultation; R, adventitious sounds; liver evaluation, G Inormal output; liver and renal function tests, urinalysis Interventions Monitor patient carefully Take with meals if upset stomach occurs.

DRUG NAME
Metoprolol

GENERAL ACTION
Beta1selective adrenergic blocker Antihyperten sive

SPECIFIC ACTION
Competitively blocks betaadrenergic receptors in the heart and juxtaglomerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues and the excitability of the heart, decreasing cardiac output and the release of renin, and lowering BP; acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone.

INDICATION
Hypertension, alone or with other drugs, especially diuretics Immediate-release tablets and injection: Prevention of reinfarction in MI patients who are hemodynamically stable or within 3\u201310 days of the acute MI Treatment of angina pectoris Toprol XL only: Treatment of stable, symptomatic CHF of ischemic, hypertensive, or cardiomyopathic origin

CONTRAINDICATION
Contraindicated with sinus bradycardia (HR < 45 beats/min), secondor thirddegree heart block (PR interval > 0.24 sec), cardiogenic shock, CHF, systolic BP < 100 mm Hg; lactation. Use cautiously with diabetes or thyrotoxicosis; asthma or COPD; pregnancy

ADVERSE EFFECT
Allergic: Pharyngitis, erythematous rash, fever, sore throat, laryngospasm CNS: Dizziness, vertigo, tinnitus, fatigue, emotional depression, paresthesias, sleep disturbances, hallucinations, disorientation, memory loss, slurred speech C V:CHF, cardiac arrhythmias, peripheral vascular insufficiency, claudication, CVA, pulmonary edema, hypotension Dermatologic: Rash, pruritus, sweating, dry skin EENT: Eye irritation, dry eyes, conjunctivitis, blurred vision GI: Gastric pain, flatulence,

NURSING RES
Do not stop taking this drug unless instructed to do so by a health care provider. Swallow the ER tablets whole; do not cut, crush, or chew them. These side effects may occur: Dizziness, drowsiness, lightheadedness, blurred vision (avoid driving or dangerous activities); nausea, loss of appetite (eat frequent small meals); nightmares, depression (discuss change of medication); sexual impotence. Report difficulty breathing, night cough, swelling of extremities, slow pulse, confusion, depression, rash, fever, sore throat

constipation, diarrhea, nausea, vomiting,anorexia, ischemic colitis, renal and mesenteric arterial thrombosis, retroperitoneal fibrosis, hepatomegaly, acute pancreatitis GU: Impotence, decreased libido, Peyronie's disease, dysuria, nocturia, frequent urination Musculoskeletal: Joint pain, arthralgia, muscle cramp Respiratory: Bronchospasm, dyspnea, cough, bronchial obstruction, nasal stuffiness, rhinitis, pharyngitis Other: Decreased exercise tolerance, development of antinuclear antibodies

DRUG NAME
Losartan

GENERAL ACTION
Cardio vascular agent; angiotensin II receptor antagonist; antihyperten sive

SPECIFIC ACTION
Angiotensin II receptor (type AT1) antagonist acts as a potent vasoconstrictor and primary vaso active hormone of the renin angiotensin aldosterone system

INDICATION
Hypertension

CONTRAINDICATION
Hypersensitivity to losartan, pregnancy [category C (first trimester), categoryD (second and third trimesters)], lactation

ADVERSE EFFECT
CNS: Dizziness, insomnia, headache. GI: Diarrhea, dyspepsia. Musculoskeletal: Muscle cramps, myalgia, back or leg pain. Respiratory: Nasal congestion, cough, upper respiratory infection, sinusitis

NURSING RES
Monitor BP at drugtrough (prior to ascheduled dose). Monitor drug effectiveness, especially in AfricanAmericans when losartan is used as monotherapy. Inadequate response may be improved by splitting the daily dose into twice-daily dose. Lab tests: Monitor CBC, electrolytes, liver & kidney function with long-term therapy

DRUG NAME
Ganaton

GENERAL ACTION
Antiflatulenc e & antiinfammation, GIT regulators

SPECIFIC ACTION
Ganaton activates gastrointestinal propulsive motility due to its dopamine D2 antagonizing activity and acetylcholinesteras e activity. Itropride activates acteylcholine release and inhibits its degradation.

INDICATION
GI symptoms of functional, non-ulcer dyspepsia(chronic gastritis)i.e. feeling of abdominal bloatedness, upper abdominal pain, heartburn, nausea and vomiting

CONTRAINDICATION
increase in Gi motility use precautiosly in pregnancy and lactation, children<16y/o, elderly

ADVERSE EFFECT
GIT:diarrhea, abdominal pain CV: headache

NURSING RES
do not administer with meals take before meals

DRUG NAME
Paracetam ol

GENERAL ACTION
Antipyretics Non opioid analgesic

SPECIFIC ACTION
Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS

INDICATION
Mild pain Fever

CONTRAINDICATION
Contraindicated with allergy to acetaminophen. Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation

ADVERSE EFFECT
CNS:Headache CV:Chest pain, dyspnea, Myocardial damage When doses of 58 g/day are ingested daily forseveral weeks or when doses of 4g/day are ingested for 1 yr GI: Hepatictoxicity andfailure, jaundice GU: Acute kidney failure, renal tubular necrosis Hematologic: Methemoglobinemia cyanosis; hemolytic anemia hematuria, anuria; neutropenia, leucopenia, pancytopenia, thrombocytopenia, hypoglycemia Hypersensitivity: Rash, fever

NURSING RES
Monitor liver function studies; may cause hepatic toxicity at doses>4g/day Monitor renal function studies; albumin indicates nephritis Monitor blood studies, especially CBCand pro-time if patient is onlong-term therapy. Check I&O ratio; decreasing output may indicate renal failure. Assess for fever and pain Assess hepatotoxicity: dark urine, clay-colored stools Assess allergic reactions: rash, urticaria

DRUG NAME
Captopril

GENERAL ACTION
Angiotensinconverting enzyme (ACE) inhibitor Antihyperten sive

SPECIFIC ACTION
Blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased blood pressure, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.

INDICATION
Treatment of hypertension alone or incombination with thiazide-type diuretics Treatment of CHF in patients unresponsive toconventional therapy;used with diuretics and digitalis Treatment of diabetic nephropathy Treatment of left ventricular dysfunction after MI Unlabeled uses: Management of hypertensive crises; treatment of rheumatoid arthritis; diagnosis of anatomic renal artery stenosis,hypertension related to scleroderma renal crisis; diagnosis of primary aldosteronism, idiopathic edema; Bartter's syndrome; Raynaud's syndrome

CONTRAINDICATION
Contraindicated with allergy to captopril, history of angiodema. Use cautiously with impaired renal function; CHF; salt or volume depletion, lactation, pregnancy

ADVERSE EFFECT
CV:Tachy cardia, angina pectoris, MI, Raynaud's syndrome, CHF, hypotension in saltor volume-depleted patients Dermatologic: Rash , pruritus,pemphigoid -like reaction, scalded mouth sensation, exfoliative dermatitis, photosensitivity, alopecia GI: Gastric irritation, aphthous ulcers, peptic ulcers, dysgeusia, cholestati c jaundice, hepatocellular injury, anorexia, constipation GU:Proteinuri a, renal insufficiency, renal

NURSING RES
Administer 1 hr before or 2 hr after meals. Alert surgeon and mark patient's chart with notice that captopril is being taken; the angiotensinII formation subsequent to compensatory renin release during surgery will be blocked; hypotension may be reversed with volume expansion. Monitor patient closely for fall in BP secondary to reduction in fluid volume (excessive perspiration and dehydration, vomiting, diarrhea); excessive hypotension may occur. Reduce dosage in patients with impaired renal function.

failure, polyuria, oliguria, urinary frequency Hematologic: Neut ropenia, agranulocytosis, thrombocytopenia, hemolytic anemia, pancytopenia Other:Cough, malai se, dry mouth, lymphadenopathy