DRUG STUDY DRUG NAME DOSAGE, ROUTE, FREQUENCY Dosage: 1 tablet Route: PO Frequency: T.I.D.

(8am, 2pm,8pm) INDICATION MECHANISM OF ACTION Mecobalamin is the neurologically active form of vitamin B12 and occurs as a watersoluble vitamin in the body. It is a cofactor in the enzyme methionine synthase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine. In anaemia, it increases erythrocyte production by promoting nucleic acid synthesis in the bone marrow and by promoting maturation and division of erythrocytes. Absorption: Peak plasma concentrations after 3 hr (oral); 0.9 hr ADVERSE EFFECTS NURSING RESPONSIBILITIES

Mecobalamin (methycobal)

Peripheral neuropathies; megaloblastic anemia due to vitamin B12 deficiency.

Infrequently: anorexia, -Check doctors order nausea, vomiting, diarrhea, pain and -Verify patients induration. identity RARELY: -Give with food if GI Skin rash, headache, upset occurs. sweating or hot sensation. -Encourage patient to comply with the diet recommendation. -Ask the patient to notify any of the healthcare team if the he feels nausea, vomiting, abdominal pain or tarry stools occur -Emphasize the importance follow up exams

(IM); 3 min (IV). Excretion: Via urine.

-Observe 10 Rs in drug administration

DRUG NAME

DOSAGE, ROUTE, FREQUENCY Dosage: 1 tablet Route: PO Frequency: O.D

INDICATION

MECHANISM OF ACTION is unknown, benzodiazepines appear to suppress seizures through enhancement of the actions of gammaaminobutyric acid, the major inhibitory neurotransmitter in the central nervous system.

ADVERSE EFFECTS Fatigue, somnolence, coordination disturbances, salivary hypersecretion, irritability, muscle weakness, restlessness, disorientation.

NURSING RESPONSIBILITIES -Check doctors order -Verify patients identity -Give with food if GI upset occurs. -use clonazepam cautiously in patients with renal failure because drug can increase risk of generalized tonicclonic seizures_ and troublesome secretions -monitor blood drug level, CBC and liver function test results durig long term or high dose therapy, as

rivotril (clonazepam)

Generalized tonicclonic seizures. Status epilepticus. Epilepsy of adult in focal seizures.

ordered. -Encourage patient to comply with the diet recommendation. -Ask the patient to notify any of the healthcare team if the he feels nausea, vomiting, abdominal pain or tarry stools occur -Emphasize the importance follow up exams -Observe 10 Rs in drug administration

DRUG NAME

DOSAGE, ROUTE,

INDICATION

MECHANISM OF

ADVERSE

NURSING

FREQUENCY Mannitol Dosage: 150cc Route: IV Frequency: q4 Increase urine flow in patients with acute renal failure, reduced raised intracranial pressure and treat cerebral edema. Short term management of glaucoma especially to reduce IOP prior to opth surgery to exrete toxic substances by forced diuresis.

ACTION

EFFECTS

RESPONSIBILITIES

Mannitol is an osmotic Fluid and electrolyte -Check doctors order diuretic that is imbalance metabolically inert in -Verify patients humans and occurs identity naturally, as a sugar, in fruits and -assess patient for vegetables. Mannitol signs of fluid retention. elevates blood plasma osmolality, resulting in -do not administer the enhanced flow of medication if crystals water from tissues, are noticed in the including the brain and solution. cerebrospinal fluid, into interstitial fluid -Encourage patient to and plasma. As a comply with the diet result, cerebral edema, recommendation. elevated intracranial pressure, and -Ask the patient to cerebrospinal fluid notify any of the volume and pressure healthcare team if the may be reduced. he a headache, stop the infusion immediately. -Emphasize the importance follow up exams

-Observe 10 Rs in drug administration

DRUG NAME

DOSAGE, ROUTE, FREQUENCY Dosage: 75mg Route: PO Frequency: O.D. at 12nn

INDICATION

MECHANISM OF ACTION is a prodrug that undergoes metabolism by cytochrome P450 enzymes to form an active thiol metabolite. This metabolite acts as a selective irreversible inhibitor of P2Y12 adenosine diphosphate (ADP) receptors on platelets, blocking ADPmediated activation of the glycoprotein GPIIb/IIIa complex and as a result, inhibiting platelet aggregation. Clopidogrel inhibits aggregation for the life of the platelet, typically 7 to 10 days.

ADVERSE EFFECTS Abdominal pain, dyspepsia, gastritis, diarrhea, constiptation,, GI hemorrhage, asthenia, vertigo.

NURSING RESPONSIBILITIES -Check doctors order -Verify patients identity Discontinue medication seven days before elective surgery if antiplatelet effect is not desirable.

Clopidogrel (clopidrol)

Prophylaxis of thromboembolic events and management of acute ST-elevation, unstable angina, non G wave MI.

- The combination of low-dose aspirin and clopidogrel in acute coronary syndrome without ST elevation is given for at least one month but no longer than 9-12 months. The routine long-term use of this combination

It produces a dosedependent effect, beginning 2 hours after a single dose and reaching steady-state after 3 to 7 days of treatment. After standard dosing in adults, the degree of platelet inhibition is approximately 40 to 60%. Platelet function and bleeding time typically return to baseline values within 5 days after discontinuation.

increases the risk of bleeding without clear evidence of benefits. -Ask the patient to notify any of the healthcare team if the he a headache, stop the infusion immediately. -Emphasize the importance follow up exams -Observe 10 Rs in drug administration

DRUG NAME

DOSAGE, ROUTE, FREQUENCY Dosage: 500mg Route: IV Frequency: O.D. at 12nn

INDICATION

MECHANISM OF ACTION Levofloxacin is a broad-spectrum antibiotic that is active against both Grampositive and Gramnegative bacteria. It functions by inhibiting DNA gyrase, a type II topoisomerase, and topoisomerase iv, which is an enzyme necessary to separate replicated DNA, thereby inhibiting cell division. This can also affect mammalian cell replication. In particular, some congeners of this drug family display activity not only against bacterial topoisomerases but also against eukaryotic topoisomerases, and

ADVERSE EFFECTS

NURSING RESPONSIBILITIES

Levofloxacin (Levox)

Treatment of community-acquired pneumonia, complicated UTI and skin, soft tissue infections.

Nausea, vomiting, -Check doctors order diarrhea, abdominal pain, dyspepsia, -Verify patients headache, dizziness identity and restlessness. -Ask the patient to notify any of the healthcare team if the he a headache, stop the infusion immediately. -Emphasize the importance follow up exams -Observe 10 Rs in drug administration

are toxic to cultured mammalian cells and in vivo tumor models.